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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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 Audit on management of past section(Sri Lanka College of Obstetricians and Gynaecologists, 2005) Padumadasa, G.S.; Ratnatilake, R.M.K.R.M.; Amarasena, J.M.T.; Wijesinghe, P.S.OBJECTIVE: To audit management of women with one past section. DESIGN AND SETTING: A retrospective audit at the University Obstetric Unit, North Colombo Teaching Hospital. Method: Twenty five records of women with one past section awaiting delivery, who presented between 01 April 2005 and 22 May 2005 were analyzed. "Whether the placental site was checked, estimated fetal weight assessed and pelvic assessment done was assessed. Ninety percent was considered the target, Results: The mean age of the women was 33.1 years (SD 2.6). The mean period of gestation was 37.6 weeks (SD 0.7) and the mean height of the women was 152.4cm (SD 2.7). In eight women a decision was taken to subj ect them to a trial of scar and in 11, it was decided to perform an elective caesarean section. Six women underwent emergency caesarean section on admission. The placental site was checked in 13 (52 %), estimated fetal weight assessed in 12 (48 %) and pelvic assessment done in four (16 %) women. Out of the eight women who were awaiting a trial of scar, seven (87 %) had the placental site checked and seven (87 %) had the estimated fetal weight assessed. However only four (50 %) had a pelvic assessment performed. CONCLUSION: The results were discussed at an audit meeting. It was concluded that assessment in women with one past section awaiting delivery was not adequate. The importance of proper assessment was stressed to the team members. A re-audit is planned in three months to assess any improvement.Item Xanthogranulomatous salpingitis and oophoritis associated with endometriosis and uterine leiomyoma presenting as intestinal obstruction(Informa Healthcare, 2012) Abeysundara, P.K.; Padumadasa, G.S.; Tissera, W.G.; Wijesinghe, P.S.Xanthogranulomatous inflammation is a rare form of chronic granulomatous inflammation. Bacterial infections, immunosuppression, chronic inflammatory conditions, luminal obstruction, endometriosis, leiomyoma, abnormal lipid metabolism, ineffective antibiotic therapy, ineffective clearance of bacteria by phagocytes and chronic irritation of the urachal remnant have been implicated in the pathogenesis. There are very few reported cases of xanthogranulomatous salpingitis and oophoritis. We present such a case in a 34-year-old female, with primary subfertility for eight years, endometriosis, uterine leiomyoma, type II diabetes mellitus and a history of surgery for endometriosis and fibroids and surgical wound infection, who presented with symptoms of intestinal obstruction. The patient underwent emergency laparotomy followed by total abdominal hysterectomy and bilateral salpingo-oophorectomy. Histology revealed xanthogranulomatous salpingitis and oophoritis. Chronic inflammation due to inadequate treatment of bacterial infection, coupled with pelvic endometriosis and uterine leiomyoma may have led to xanthogranulomatous salpingitis and oophoritis.