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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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 Postinfectious Acute Cerebellar Syndromes in children: A nationally ascertained case series from Australia 2013-2018(Littleton, 2022) Gunaratna, G.P.S.; Mohammad, S.S.; Blyth, C.C.; Clark, J.; Crawford, N.; Marshall, H.; Dale, R.C.; Jones, C.A.; Britton, P.N.; PAEDS NetworkIntroduction: Postinfectious acute cerebellar syndromes show a wide spectrum of acute severity and can occur with acute febrile illness or vaccine receipt. Varicella has historically been the most common cause, associated with up to 25% of cases in large cohorts. This study aimed to describe the spectrum of syndromes in a setting with high varicella vaccine coverage. Method: Data were collected on children initially identified as "suspected encephalitis" subsequently designated "not-encephalitis" at participating children's hospitals in the Paediatric Active Enhanced Disease Surveillance (PAEDS) network, Australia, as part of the Acute Childhood Encephalitis study. A comprehensive descriptive analysis was undertaken on prospectively identified, national series of children with postinfectious acute cerebellar syndromes from 2013 to 2018. Cases were classified using a previously validated severity score, and the outcome was assessed at 12 months using the Liverpool Outcome Scale score. Results: A total of 20 cases (65% were vaccinated for varicella) were included, of which 70% were subcategorized as acute cerebellar ataxia (ACA), 20% acute cerebellitis (AC), and 10% acute fulminant cerebellitis (AFC). An acute febrile illness was noted in 55% and none were related to varicella or were temporally related to varicella vaccination or other childhood vaccines. A subset (total of 7 children) followed up at 12 months all showed reduced Liverpool Outcome Scale scores. Discussion: The study provides an overall description of this uncommon spectrum of neurologic syndromes and shows the infrequency of varicella zoster virus as a cause in a vaccinated population.Item Paradoxical lymph node reaction during treatment of scalp tuberculosis [Case report](Blackwell Scientific Publications., 2022) Gunaratna, G.P.S.; Howard-Jones, A.R.; Marais, B.; Britton, P.N.No abstract availableItem Introduction of Recombinase Polymerase Amplification assay based mobile suitcase laboratory as a point of need tool to diagnose cutaneous leishmaniasis in Sri Lanka(Sri Lanka Medical Association, 2018) Gunaratna, G.P.S.; Ranasinghe, P. H. K. I. S.; Manamperi, A.; Pathirana, N.; Pathirana, H.; Wickremasinghe, R.; de Silva, N.R.; Sooriyarachchi, M.; Ahmed, A.E.W.INTRODUCTION AND OBJECTIVES: Cutaneous leishmaniasis (CL) caused by the vector-borne protozoan parasite is now endemic in Sri Lanka. Microscopy of Giemsa stained slit skin smears (SSS), lesion aspirates or scrapings for the presence of amastigotes, is widely used for laboratory confirmation of CL, although the reported sensitivity is low. Facilities for more sensitive culture and molecular techniques are available only in reference laboratories. A newly developed, Recombinase Polymerase Amplification (RPA) assay based Mobile Suitcase Laboratory (MSL) is a promising, molecular point of care test with high sensitivity and specificity for diagnosis of both post-kala• azar dermal leishmaniasis and visceral leishmaniasis. Objective was to assess RPA based MSL as a point of need tool to diagnose CL in Sri Lanka.METHODS: Twenty seven army personnel at Mullaitivu Army camp clinically suspected of having CL were recruited for this pilot study. Two slit skin smears and two punch biopsy specimens were obtained from each of them. Slit skin smears were stained with Giemsa in the field and examined for the presence of amastigotes and RPA was carried out at the point of collection. PCR was performed at the Parasitology Department, Sri Jayewardenepura University. RESULTS: Fifteen patients were confirmed by PCR as having CL and 14 of them were also positive by RPA based MSL conducted in the field (93.33% sensitivity). Only 3/15 were positive with microscopy of SSS (20% sensitivity). CONCLUSION: This pilot study shows RPA based MSL as a promising tool to diagnose CL at point of need.