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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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 Epidemiological patterns and trends of paediatric snakebites in Sri Lanka(Biomed Central, 2024-12) Dayasiri, K.; Caldera, D.; Suraweera, N.; Thadchanamoorthy, V.; Hettiarachchi , M.; Denipitiya, T.; Bandara, S.OBJECTIVES This study aimed to analyse the epidemiological patterns of paediatric snake bites in Sri Lanka over a 4-year period (2020-2024).METHODS A multi-centre, retrospective observational study was conducted from June 2020 to June 2024 across nine governmental hospitals in seven provinces of Sri Lanka. Data were collected based on 757 children presenting with snake bites. The snake bites were analysed based on age, gender, and seasonal variations. Data on the type of snake involved, geographic variations and the temporal trends in snake bite occurrences were also analysed.RESULTS The mean age of the 757 children recruited to the study was 10.3 years (SD-5.00, range-0.1-17 years). Males (57.7%) were significantly more affected than females (42.3%) (p < 0.05). Visual identification confirmed the snake species in 58.4% of cases. The hump-nosed viper (16.7%), Russell's viper (14.7%), and common krait (12.9%) were the most common medically important snakes identified in the study. Seasonal peaks in snake bites occurred in May-July and November-December. An increasing trend in snake bite incidence was noted over the first three years, with a slight decline in the final year.CONCLUSION Paediatric snake bites in Sri Lanka show significant age, gender, and seasonal patterns. Targeted public health interventions are needed to mitigate the impact on children.Item Comparative Analysis of Albumin Measurement by Bromocresol Green Versus Capillary Zone Electrophoresis(College of Chemical Pathologists of Sri Lanka, 2024) Harshanee, T.; Jayasekara, D.; Fernando, K.; Kulasinghe, M.; Silva, P.; Bandara, S.; Dayanath, B.K.P.T.INTRODUCTION Quantitative assessment of albumin and globulins in serum protein electrophoresis (SPE) relies on the calculation derived from total protein measurements obtained from the biuret assay. Validation of these results involves comparing sample albumin concentration assessed using the bromocresol green (BCG) method to those obtained from capillary zone electrophoresis (CZE). This study aimed to assess the relationship between albumin values derived from SPE and routine spectrophotometric analysis with BCG method, and to establish a cut-off value to identify significant differences between the two values in SPE validation process. METHODS 187 serum samples were subjected to total protein assessment by biuret method, albumin assessment by BCG method, and SPE by CZE method. SPE derived albumin level using total protein values and BCG method indicated albumin values were analyzed by correlation analysis. The standard error for the difference (SEdif) between the two albumin results were calculated, with statistical significance set at p <0.05. Internal and external quality assessments were deemed acceptable for all three analytical procedures. RESULTS Mean albumin levels obtained via BCG and CZE methods were 38.3 mg/dL and 33.2 mg/dL, respectively, indicating a negative bias for the latter method. A strong correlation (r=0.844, p<0.001) was observed between albumin levels measured by BCG and CZE methods, with Bland-Altman analysis revealing an average negative bias of 5 mg/dL. Using SEdif at 95% significance, the maximum acceptable difference between the two albumin values was determined to be -5.4 mg/dL. CONCLUSIONS BCG method yielded higher albumin results compared to CZE method. This positive bias could be attributed to potential lack of specificity of BCG assay for albumin. A maximum allowable difference of 5.5 mg/dL between the two methods is suggested. Exceeding this threshold indicates potential issues with either the BCG albumin assay, biuret total protein assay, or SPE assay, necessitating further investigation for assay reliability, particularly in reporting SPE by CZE.Item Spondylometaphyseal dysplasia in a 2-year-old Sri Lankan girl(The Sri Lanka Collage of Paediatricians, 2024) Madawala, P.; Lokuhewage, C.; Bandara, S.; Randeny, S.; Mettananda, S.No abstract availableItem Lysinuric protein intolerance presenting as pancytopenia and splenomegaly mimicking acute leukaemia: a case report(BioMed Central, 2023) Lokuhewage, C.; Pathiraja, H.; Madawala, P.; Bandara, S.; Mettananda, S.BACKGROUND: Lysinuric protein intolerance is a rare inherited metabolic disease due to autosomal recessive mutations of the SLC7A7 gene. The affected patients commonly present with protein-rich food intolerance, failure to thrive, hepatosplenomegaly, muscle hypotonia and lung involvement due to impaired intestinal absorption and excessive urinary excretion of dibasic amino acids. Presentation with splenomegaly and cytopenia without other features has not been reported. Here we report a Sri Lankan girl with lysinuric protein intolerance presenting with pancytopenia and splenomegaly mimicking acute leukaemia. CASE PRESENTATION: Two years and six months old Sri Lankan girl presented with persistent pancytopenia following a viral illness. She was asymptomatic without vomiting, diarrhoea, abdominal pain or irritability. Physical examination revealed pallor and isolated firm splenomegaly of 2 cm. Growth parameters and other system examinations were normal. Full blood count revealed anaemia, leukopenia and thrombocytopenia. The blood picture showed a mixture of hypochromic microcytic and normochromic normocytic red cells with occasional pencil cells and macrocytes. Bone marrow examination was normal except for occasional megaloblasts; however, serum vitamin B12 and red blood cell folate were normal. The metabolic screen showed a high anion gap compensated metabolic acidosis, high lactate and ketosis. Genetic mutation analysis using whole exome sequencing revealed compound heterozygous variants of the SLC7A7 gene, confirming the diagnosis of lysinuric protein intolerance. CONCLUSION: We report a child with lysinuric protein intolerance presenting with pancytopenia and splenomegaly without other disease features. This case report adds to the heterogenic presentations of lysinuric protein intolerance, which is considered a multifaceted disease.Item A comparative study of subjective experiences related to driving among outpatient psychotropic users and controls in Ragama, Sri Lanka(Sri Lanka College of Psychiatrists, 2016) Chandradasa, M.; Champika, L.; Amarasuriya, M.; Wijelakshman, P.; Bandara, S.; Ranaweera, T.; Fernando, L.Aim: To identify and explore the impact of illness and medications on the driving of patients visiting an outpatient clinic. Method: A retrospective-cohort design was used. The data was collected using a semi-structured, intervieweradministered questionnaire among consecutive patients with schizophrenia or bipolar disorder. An age, gender and vehicle matched control group was obtained. Result: A total of 2887 consecutive clinic patients were asked about driving and 57 (1.9%) who had driven a vehicle regularly during the last 12 months were included in the study group. A majority were in the 30-45 year category (47%). All were men and a majority were motor-bike riders (53%). Collision-accidents were experienced by 42% of participants during the last 12 months. Conclusion: The patient group had lower hours of driving per week, less subjectively claimed earning per day and more with at least one collision-accident during the past year compared to the control group.