Medicine
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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty
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Item Cross-fused right-to-left renal ectopia presenting as hypertension in a threeyear-old(Sri Lanka College of Paediatricians, 2023) Sandakelum, U.; Samararathna, R.; Kumarasiri, I.; Balasubramaniam, R.; Mettananda, S.No abstract availableItem Focal seizures as first presentation of Pepper syndrome in a six-week-old girl(Sri Lanka College of Paediatricians, 2022) Sandakelum, U.; Balasubramaniam, R.; Fernando, M.; Gunasekera, S.; Ganewatte, E.; Fernando, S.; Dissanayake, D.No abstract availableItem Acute disseminated encephalomyelitis presenting as bilateral ptosis in a Sri Lankan Child(Hindawi Pub. Corp., 2022) Kumarasiri, I.; Samararathna, R.; Sandakelum, U.; Muthukumarana, O.; Balasubramaniam, R.; Mettananda, S.Introduction: Acute disseminated encephalomyelitis is a rare inflammatory demyelinating disease characterized by acute onset polyfocal neurological deficits associated with encephalopathy. It commonly presents with fever, meningism, seizures, ataxia, motor deficits, and bladder dysfunction. Although cranial neuropathies, including optic neuritis and facial nerve palsies, have previously been reported, children presenting with bilateral ptosis is extremely rare. Here, we report a 3-year-old child with acute disseminated encephalomyelitis presenting with acute onset bilateral ptosis due to involvement of the single central levator subnucleus of the oculomotor nerve. Case Presentation. A 3-year-old Sri Lankan boy presented with drooping of the upper eyelids for three days and unsteady gait for two days. He did not have seizures, blurring of vision, limb weakness, swallowing or breathing difficulties, or bladder dysfunction. On examination, he had bilateral ptosis, gait ataxia, and dysmetria. His vision, eye movements, and examination of other cranial nerves were normal. MRI brain revealed high signal intensities involving the subcortical white matter of parietal and occipital lobes, midbrain in the area of single central levator subnucleus of the oculomotor nerve, cerebellar vermis, and right cerebellar hemisphere. Based on the clinical features suggesting polyfocal neurological involvement of the midbrain and cerebellum and characteristic MRI findings, the diagnosis of acute disseminated encephalomyelitis was made. He responded well and rapidly to high-dose intravenous methylprednisolone and showed a complete clinical and radiological recovery. Conclusion: This case report describes a rare presentation of acute disseminated encephalomyelitis, bilateral ptosis due to involvement of the single central levator subnucleus of the oculomotor nerve. It highlights that the presenting manifestations of acute disseminated encephalomyelitis can be subtle and vary; however, timely diagnosis and treatment result in complete recovery.Item Multisystem inflammatory syndrome in children: A Sri Lankan case series(Sri Lanka College of Paediatricians, 2021) Sandakelum, U.; Samararathna, R.; Pathiraja, H.; de Silva, L.; Balasubramaniam, R.; de Abrew, G.; Adihetty, D.; Fernando, M.; Randeny, S.; Mettananda, S.No Abstract AvailableItem Comparison of number of dog Rabies diagnosed at the Medical Research Institute before and after stray dog elimination cessation policy(College of the Community Physicians of Sri Lanka, 2013) Balasubramaniam, R.; Kasturiratne, A.; Wimalaratne, O.; Wickremasinghe, A.R.INTRODUCTION: In Sri Lanka, elimination of stray dogs was completely halted in 2007 and has been replaced by animal birth control methods. Incidence of human Rabies is steadily declining even after this transition in Rabies control activities. However, effect of it on other Rabies related statistics remains undocumented. OBJECTIVES: To compare the number of confirmed cases of dog Rabies at the Medical Research Institute (MRI) before and after implementation of stray dog elimination cessation policy. METHODS: This cross sectional descriptive study analysed the data on dog brains sent to the MRI for Rabies virus diagnosis and found positive (confirmed cases of dog Rabies (CCDR)) for a period of 10 years from 2002-2011. The required information was extracted manually from the records maintained in the MRI, computerized and subjected to further analysis. RESULTS: Annual mean of 964.2 (SD±192.7) brain specimens from suspected cases of dog Rabies (SCDR) have been received at the MRI during the study period. Although the number has increased by 80% from 541 in 2002 to 975 in 2011, it was steadily declining from 2008 onwards. Despite this drop, the annual mean of SCDR was higher after (1094±86.9) stray dog elimination has been halted than 2007 and before (877.67±199.5). Of these SCDR, approximately two-thirds were confirmed by laboratory testing. This led to an annual mean of 577.3 (SD±111.19) CCDR during the study period. Similar to the trend seen with SCDR, although the number has increased by 40.1% from 391 in 2002 to 548 in 2011, it was steadily declining from 2009 onwards. Despite this drop, the annual mean of CCDR was higher after (629.25±77.8) stray dog elimination has been halted than 2007 and before (542.67±122.6). The percentage increase in SCDR (24.6%) during the study period was slightly higher than the percentage increase in CCDR (16%). CONCLUSIONS AND RECOMMENDATIONS: Annual mean of SCDR and CCDR at the MRJ has not grossly increased