Symposia and Conferences
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Item Dengue Encephalitis with Concurrent Infections by Multiple Dengue Virus Serotypes(International Postgraduate Research Conference 2019, Faculty of Graduate Studies, University of Kelaniya, Sri Lanka, 2019) Jayarathne, J.A.J.C.; Wijesinghe, W.A.T.A.; Mendis, S.; Waidyasekara, J.; Gunathilaka, P.A.D.H.N.; Gunasekara, D.Dengue is a serious public health problem caused by an arbovirus. Abnormal-neurological presentations associated with dengue infection is rare. Herewith, we report a case of a patient with dengue encephalitis who was concurrently infected with multiple serotypes. A 36-year-old, male resident from Poogoda presented to North Colombo Teaching Hospital with a history of generalized tonic-clonic seizures (GTCS) and unconsciousness. On admission, he displayed only a persisting headache. He had no significant illnesses in the past. Detailed history revealed that he has had a fever and left the hospital against the medical advice on the same day. On clinical examination, he was afebrile and blood pressure was 110/80 mmHg. He was well oriented with a Glasgow Coma Scale (GCS) of 15/15 and there was no focal neurological deficit. The funduscopic examination was normal. His initial full blood count revealed a rise in white blood cells with a predominant elevation of neutrophils of 12.44 x 103/uL. His platelet count was reported to be 306 x103/uL and, he was treated for a bacterial infection. On the following day, the patient started developing a fever and GTCS. Aggressive behavior, confusion, and delirium were also demonstrated. Neck stiffness was not observed. Non-contrast computed tomography (NCCT) scan, contrast-enhanced computed tomography (CECT) scan, chest X-ray scan and magnetic resonance image (MRI) of the brain were normal. Electroencephalography (EEG) revealed encephalopathy with non-epileptic discharge. Lumbar puncture was performed on the third day of admission and analysis of cerebrospinal fluid (CSF) was unremarkable. IgM antibody for the dengue virus (DENV) was detected in CSF. All the other viral and parasitological studies were normal. The patient was treated with anti-epileptic, anti-psychotic, antibacterial and antiviral drugs. High fever spikes and seizures were continued. GCS started to deteriorate from 9/15 to 3/15. Urine out-put started to decline. Ultra-sound scanning revealed mild ascites. Blood picture analysis showed evidence of having a severe bacterial infection. On day 9, both CSF and serum specimens were referred to Molecular Diagnostic Laboratory, Faculty of Medicine, Ragama for dengue viral investigations. The presence of NS-1 antigen, IgM/IgG antibodies, and the occurrence of concurrent infections with serotype 2 and 3 in the serum sample confirmed that the patient was infected with DENV. The presence of IgM/IgG antibodies were observed in the CSF sample. On day 10, the patient was transferred to the medical intensive care unit and monitored thoroughly. As the condition was deteriorated, he was ventilated and incubated for 11 days in the intensive care unit. He started to recover gradually after the 31st day. On day 36, the patient was discharged without any residual neurological symptoms. The patient is currently being followed up at the neurological clinic. Dengue encephalitis is a rare and deleterious manifestation of dengue infection. It is believed that concurrent infections with multiple serotypes and serotype replacement may cause disease severity. Therefore, reporting uncommon cases will provide insights for the physicians in early diagnosis and effective managementItem A Biological System with Bristle Fiber of Coconut to Reduce COD Level of Synthetic Rubber Waste(University of Kelaniya, 2012) Prasanna, M.A.U.U.; Ganepola, K.; Mendis, S.It is a great problem to reduce COD (Chemical Oxygen Demand) levels of water soluble synthetic rubber waste which comes from rubber factories. Solid waste can be removed by using alum and lime. After removing solid waste subjecting to clarifier, the effluent is treated by secondary digestion using aerobic and anaerobic bacteria. Bristle fiber bacterial system is used for secondary digestion and efficiency of this system was very high. After the chemical treating, COD level was between 2000 mg/L and 4000 mg/L. The retention time of the new system was 30 hours and it contained anaerobic system, rotating batch contactor (RBC) system, and finalizing system. Bristle fiber of coconut was used as retention medium in every step and specially developed bacterial culture was used. Under the lab scale project, the following data were reported. Average value of input COD was 2784 mg/L. System A (anaerobic tank, tank capacity-50 L, flow rate-24 L/hour, retention time - 2 hours, output COD - 2202 mg/L, COD reduction percentage - 20.89%, pH - 6.8), System B (RBC with Bristle fiber, tank capacity - 350 L, flow rate - 24 L/hour, retention time - 14 hours, output COD- 330 mg/L, COD reduction percentage - 67.26%, pH - 7 and System C (contact with bristle fiber, tank capacity - 350 L, flow rate - 24 L/hour, retention time - 14 hours, output COD- 110 mg/L, COD reduction percentage- 7.89%, pH - 7). The final COD, BOD, pH and total suspended solids (TSS) values of treated water were 110 mg/L, 23mg/L, pH 7 and 20mg/L respectively while total COD reduction percentage was 96% and total retention time was 30 hours. The treated volume of water per day was 576 L. In the large scale project, the following data were reported. Average value of input COD was 2790.8 mg/L. System X (anaerobic tank, tank capacity - 7000 L, flow rate – 625 L/hour, retention time - 11.4 hours, output COD - 1755 mg/L, COD reduction percentage - 36.16%, pH - 6.8), System Y (RBC system with Bristle fiber, tank capacity – 10000 L, flow rate - 625 L/hour, retention time - 16 hours, output COD - 84.7 mg/L, COD reduction percentage 60 %, pH - 6.8) and System Z (contact with bristle fiber, tank capacity - 1500 L, flow rate - 625 L/hour, retention time - 2.6 hours, output COD - 62.45 mg/L, COD reduction percentage - 0.82%, pH - 6.8). Final COD value of treated water was 62.45 mg/L. Total COD reduction percentage was 96.8% and total retention time was 30 hours. The treated volume of water per day was 15000 L. 96% of COD can be reduced through this system within 30 hours.Item The Role of a Cardiac Rehabilitation Programme on Risk Modification in Patients with Established Coronary Heart Disease(University of Kelaniya, 2007) Pinidiyapathirage, M.J.; Wickremasinghe, A.R.; Mendis, S.Objective: To evaluate the effectiveness of a cardiac rehabilitation programme (CRP) on risk modification behaviour of patients following a major cardiac event. Methods: A quasi-experimental pre-test post-test design was used to evaluate the CRP. The study was conducted at the National Hospital of Sri Lanka (NHSL) from July 2005 to August 2006. Patients admitted with a myocardial infraction (MI) to the Institute of Cardiology of the NHSL and all patients who underwent a coronary artery by-pass graft (CABG) surgery or a Percutaneous Transluminal Coronary Angioplasty (PTCA) during the study period were invited to participate in the CRP. Control group consisted of patients admitted with a MI to all medical wards at the. NHSL. An intervieweradministered questionnaire with a food frequency questionnaire and a physical activity questionnaire was used to collect data. Weight, height, and waist and hip circumferences were measured adhering to standard protocols and using standardized instruments. Biochemical analysis of blood at follow up was done at the laboratory of the Nawaloka Group of Hospitals and the National Diabetes Centre. Results: 91% of those who participated in the CRP (n=167) and 75% of the control group (n=168) were followed up at six months following the major cardiac event. There were significant changes in the risk profiles at six months in both groups when each group was taken separately. However, the absolute changes were seen only with regard to serum LDL cholesterol level (difference in improvement in the two groups=9.7%, p=0.015), quality of diet (difference in improvement in the two groups=19.3%, p<0.001), physical activity levels (difference in improvement in the two groups =22.2%, p<0.001) and smoking status (difference in improvement in the two'groups=16%, p