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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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 Anti-tuberculous drug induced hepatitis in Sri Lankan patients(Sri Lanka Medical Association, 2007) Senaratne, W.V.; Pinidiyapathirage, M.J.; Perera, G.A.M.H.E.; Wickremasinghe, A.R.OBJECTIVE: To determine the incidence and risk factors of anti-TB drug induced hepatitis (AIH) in Sri Lankan patients and to address management options. DESIGN, SETTING AND METHODS: 783 patients with a confirmed diagnosis of TB who presented to a unit at Chest Hospital, Welisara from April 2001 to April 2002 were recruited for a follow up study. WHO category 1 for new and category 2 for re-treatment cases was commenced using single drug formulations. Doses were based on three weight bands. AIH was diagnosed when patients complained of decreased appetite, nausea/vomiting and elevated serum biliru&n (SB) l.lmg/dl or elevated serum alanine transferase (ALT) 3 times upper limit of normal (ULN). Results: 74 patients (9.5%) out of 783 enrolled patients developed AIH; the majority (58%) developing AIH within the first two weeks of the intensive phase of treatment. AIH was commoner among patients over 60 years (p=0.018), with pulmonary TB (p=0.028) and weighing 33-35 kg (p=0.004). Using regression analysis, age, weight and rifampicin overdosage were significant predictors of AIH. Of the 74 AIH patients, standard treatment was restarted in 60 and treatment was modified in six; two defaulted and six died. Conclusions: Incidence of AIH among Sri Lankan patients is 9.5%. They develop symptoms of hepatitis when ALT levels rise to three times the ULN lowering the threshold for diagnosis of AIH. Old age, 33-55 kg weight band and rifampicin over dosage are risk factors for AIH. Majority (81%) of AIH patients could be restarted on standard treatment.Item Anti-tuberculosis drug inducd hepatitis:a Sri Lankan experience(Sri Lanka Medical Association, 2006) Senaratne, W.V.; Pinidiyapathirage, M.J.; Perera, G.A.M.H.E.; Wickremasinghe, A.R.OBJECTIVE: To assess the incidence of anti-tuberculosis (TB) drug induced hepatitis (AIH) in Sri Lankan patients, determine risk factors of AIH, and to address management options in AIH. DESIGN: A prospective study. SETTING: Chest Hospital, Welisara, Sri Lanka, from April 2001 to April 2002. PATIENTS: Seven hundred and eighty three patients with a confirmed diagnosis of TB and resident in the Colombo and Gampaha districts who presented to Chest Hospital, Welisara, Sri Lanka. METHODS: WHO recommended treatment was commenced in all cases. AIH was diagnosed when patients complained of decreased appetite with nausea or vomiting and elevated serum bilirubin (SB; >1.1 mg/dL) or elevated serum alanine transferase (ALT; > 3 times upper limit of normal).RESULTS: Of 783 enrolled patients, 74 (9.5%) developed AIH, the majority (58%) developing AIH within the first 2 weeks of the intensive phase of treatment. AIH was more common among patients over 60 years (p = 0.018), who developed pulmonary TB (p = 0.028), and in patients weighing 33-55 kg (p = 0.004). Age, weight and rifampicin overdosage were significant predictors of AIH. Of the 74 AIH patients, standard treatment was restarted in 60, treatment modified in six, two defaulted and six died. CONCLUSIONS: The incidence of AIH in Sri Lanka is 9.5% in treated patients. AIH was associated with age, low body weight and rifampicin over dosage.