Medicine

Permanent URI for this communityhttp://repository.kln.ac.lk/handle/123456789/12

This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty

Browse

Author: search.filters.author.Seneviratne, S.L.Subject: search.filters.subject.Prospective Studies

Search Results

Now showing 1 - 5 of 5
  • No Thumbnail Available
    Item
    Envenoming due to snake bite during pregnancy
    (Oxford University Press, 2002) Seneviratne, S.L.; de Silva, C.E.; Fonseka, M.M.D.; Pathmeswaran, A.; Gunatilake, S.B.; de Silva, H.J.
    No Abstract Available
  • No Thumbnail Available
    Item
    Juvenile myoclonic epilepsy : a study in Sri Lanka
    (Elsevier-W.B. Saunders, 2000) Gunatilake, S.B.; Seneviratne, S.L.
    Juvenile myoclonic epilepsy (JME) has a distinct clinical profile. Often JME is not recognized, with the result that proper treatment is not instituted, leading to poor control of seizures. This study is an attempt to identify the factors that contribute to the delay in diagnosing this condition. During a period of 3 years 40 patients (21 females) with JME were identified and all were included in a prospective follow-up study. The age range was 12-58 years. Twenty-seven patients (67%) had already seen at least one specialist; however, diagnosis had not been made despite the presence of characteristic features. The duration of delay in diagnosis varied from months to years with a mean of 11 years. Myoclonic jerks were the most characteristic feature, but only six volunteered this information spontaneously. The response to treatment with sodium valproate was excellent, although only three were taking it when first seen. As a result of treatment with other drugs all patients were having recurrent seizures. The main reasons for the delay in diagnosis found in our study were that the physicians were unaware of the condition, the occurrence of myoclonic jerks were overlooked either because the patients were not directly questioned about them or because the patients did not volunteer the information.
  • No Thumbnail Available
    Item
    Use of antivenom serum in snake bite: a prospective study of hospital practice in the Gampaha district
    (Sri Lanka Medical Association, 2000) Seneviratne, S.L.; Opanayaka, C.J.; Ratnayake, N.S L.A.; Sarathkumara, K.E.; Sugathadasa, A.M.; Weerasuriya, N.; Wickrama, W.A.S.S.; Gunatilake, S.B.; de Silva, H.J.
    OBJECTIVE: To record current practices in hospital management of snake bite, especially with regard to use of antivenom serum (AVS). METHODS: Management of all snake bite victims admitted to the four main hospitals of the Gampaha district was prospectively studied during a 5-month period. A pretested data collection sheet was used. Relevant information was obtained from patients, accompanying persons, medical staff and hospital records. RESULTS: 466 patients (M:F = 7:3; 402 adults and 64 children) were admitted following snake bite during the study. The offending snake was identified in 357 (76.6 percent) cases [172 (36.9percent) by examining the dead snake, 185 by identification of the snake in a photograph]. 273 (76.5 percent) of the 357 admissions were due to hump nosed viper bite. AVS was given to 184 (39.5 percent) patients, including 99 (36.3 percent) with hump nosed viper bite. A sensitivity test of AVS was used in all 184 patients. Premedication with hydrocortisone and/or antihistamines before AVS infusion was given to 89 patients. Acute adverse reactions to AVS occurred in 102 (55.4 percent) patients given AVS. There was no significant difference in the rate of reactions whether premedication was given or not. CONCLUSION: Precise identification of the offending snake was not possible in many instances. Practices that are of no benefit in the treatment of snake bite are still widely used. Acute adverse reactions to AVS are common, and neither hydrocortisone nor antihistamines seem to be of benefit as prophylaxis. Evidence based management guidelines, especially with regard to AVS therapy, are urgently required.
  • No Thumbnail Available
    Item
    Anorectal physiology and transit in patients with disorders of thyroid metabolism
    (Blackwell Scientific Publications, 1999) Deen, K.I.; Seneviratne, S.L.; de Silva, H.J.
    BACKGROUND: Data on anorectal physiology in patients with disordered thyroid metabolism are lacking. This prospective study was performed to evaluate anorectal physiology in patients with either hyperthyroidism and diarrhoea, or hypothyroidism and constipation in order to assess slow transit in hypothyroid patients. METHODS: Thirty patients with hypothyroidism and constipation (24 females, median age 59 years, range 23-80) and 20 patients with hyperthyroidism and diarrhoea (12 females, median age 46 years, range 36-62) were evaluated by anal manometry, rectal balloon sensation and whole-gut transit markers. Data were compared with anorectal physiology and whole-gut transit in 22 healthy controls (13 females, median age 51 years, range 24-65). RESULTS: In the hypothyroid patients, maximum resting pressure (MRP) and maximum squeeze pressure (MSP) were similar to controls (patients, median MRP 55 mmHg (18-98); controls, median MRP 41 mmHg (20-105) and patients, median MSP 83 mmHg (39-400); controls, median MSP 88 mmHg (30-230); P 0.05 for both resting and squeeze pressures). In hyperthyroid patients, median MRP and MSP were significantly lower than controls (patients, MRP 33 mmHg (8-69); controls MRP 41 mmHg (20-105) P = 0.04 and patients, MSP 60 mmHg (26-104); controls, MSP 88 mmHg (30-230); P = 0.03). Threshold sensation for impending evacuation in hypothyroid patients was significantly higher than controls, while in hyperthyroid patients, threshold sensation was significantly lower compared with controls. Maximum tolerable rectal volumes in hypothyroid patients was significantly lower compared with controls, while no significant difference was found between maximum tolerable rectal volumes in hyperthyroid patients and controls. Prevalence of delayed whole-gut transit in both hypothyroid and hyperthyroid patients was similar to controls. Furthermore, 33 percent of hypothyroid patients and 40 percent of hyperthyroid patients experienced symptoms of bowel dysfunction prior to the onset of their thyroid disorder. CONCLUSIONS: Patients with altered thyroid function and bowel dysfunction demonstrated abnormalities of anal manometry and rectal sensation.
  • No Thumbnail Available
    Item
    Excessive fibrinolysis: the coagulopathy following Merrem's hump-nosed viper( Hypnale hypnale) bites
    (1998) Premawardhena, A.P.; Seneviratne, S.L.; Gunatilake, S.B.; de Silva, H.J.
    In 56 patients with proven hump-nosed viper (Hypnale hypnale) bites, 12 (21.4 percent) developed continued oozing of blood from the site of the bite and a prolonged clotting time. Further investigations showed low fibrinogen levels and increased fibrinogen degradation products in plamsa. The bleeding time, platelet count, prothrombin time, and partial thromboplastin time with kaolin were normal. The bite of this snake can be complicated with a coagulopathy in which excessive fibrinolysis seems to be the main abnormality
All items in this Institutional Repository are protected by copyright, with all rights reserved, unless otherwise indicated. No item in the repository may be reproduced for commercial or resale purposes.