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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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
15 results
Search Results
Item Acute hemolytic crisis complicated with ischemic cardiac injury and methemoglobinaemia following ingestion of naphthalene: a case report(BioMed Central, 2024-12) Dayasiri, K.; Pathiraja, H.; Thadchanamoorthy, V.BACKGROUND Naphthalene is an aromatic hydrocarbon that potentially produces methemoglobinaemia but rarely causes hemolysis, especially in children with underlying glucose-6-phosphate dehydrogenase deficiency. Although ingestion of a single moth ball by an older child may not be life threatening, it can be fatal if ingested by a toddler. CASE PRESENTATION A 2-year-old Singhalese boy developed acute severe hemolysis and methemoglobinaemia following ingestion of a mothball. On admission, the patient was ill and pale. The child was tachycardic and tachypnoiec with oxygen saturation of 76% on air. Blood investigations showed significant anemia, elevated reticulocytes, and evidence of hemolysis in a blood picture, along with elevated lactate dehydrogenase and indirect bilirubin. Child also had ST depressions on electrocardiogram examination with negative troponin-I. He was given four packed red blood cell (PRBC) transfusions and was successfully discharged in 3 days time following optimal supportive treatment. A glucose-6-phosphate dehydrogenase assay confirmed the diagnosis of glucose-6-phosphate dehydrogenase deficiency in this child: 0.9 U/gHb (4.0-13.0 U/gHb).CONCLUSION This case report highlights a rare life-threatening presentation of naphthalene ingestion in a child with previously undiagnosed glucose-6-phosphate dehydrogenase deficiency. Ingestion of even a single moth ball can be fatal in vulnerable children given the altered toxicokinetics of naphthalene in children.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 Parental knowledge, attitudes and practices regarding safe handling and disposal of alcohol-based hand sanitizers and surface disinfectants in urban Sri Lanka(Ethiopian Pediatric Society, 2024) Dayasiri, K.; Pathiraja, H.; De Soyza, E.K.N.; Thadchanamoorthy, V.; Dassanayaka, S.J.S.INTRODUCTION Hand sanitizers were increasingly used in most households during the COVID-19 pandemic. This study aimed to assess knowledge and practices regarding the safe handling and disposal of alcohol-based hand sanitizers and surface disinfectants in urban Sri Lanka.METHODS A cross-sectional study was performed including parents of children admitted to North Colombo Teaching Hospital for a period of one year in August 2021. Data were collected regarding parental knowledge about the safe handling and disposal of hand sanitizers, and their health hazards by paediatric post-graduate trainees. All data were analyzed using SPSS 17.0. Chi-square test was used to find the association of overall knowledge and attitude scores with potential sociodemographic determining factors.RESULTS A total of 153 parents were recruited. The majority of mothers (126, 82.4%) and fathers (133, 86.9%) had attended up to secondary school. Approximately 113(73.9%) parents believed that pre-school children were the most vulnerable for accidental ingestion of sanitizers and 40 parents (26.1%) did not believe that sanitizer solutions can be accidentally inhaled by toddlers. Only 132 parents (86.2%) knew how to disinfect their home premises safely and 29 parents (18.9%) didn’t know how to store cleaning products safely. Overall, lower knowledge scores correlated with lower maternal education (p<0.05) and lower socio-economic status (p<0.05). The gender (p = 0.06) and age of the parent (>35 years versus <35 years) (p = 0.21) did not show a significant association. Attitude scores positively correlated with parental education (p<0.002) and socio-economic status (p<0.03). The gender (p = 0.12) and age of the parent (>35 years versus <35 years) (p = 0.07) did not show a significant association.CONCLUSION Overall knowledge and attitude scores in parents were associated with education level of parents and the level of socio- economic status. Gender and parental age did not show a significant association.Item A rare case of abrupt onset vascular lump in the newborn; neonatal kaposiform haemangioendothelioma(Batticaloa Medical Association, 2023) Dayasiri, K.; de Abrew, G.; Samaraweera, S.; Thadchanamoorthy, V.Item Metatropic dysplasia; A case report.(Batticaloa Medical Association, 2023) Dayasiri, K.; Thadchanamoorthy, V.Item Button battery ingestion in a child: is it always necessary to perform urgent endoscopy(Batticaloa Medical Association, 2023) Dayasiri, K.; de Abrew, G.; Thadchanamoorthy, V.Item Two cases of “Rusty pipe syndrome”; a potential barrier for establishment of breastfeeding(Batticaloa Medical Association, 2023) Vijayakumar, V.; Dayasiri, K.; Thadchanamoorthy, V.; Gunathilake, M.D.A.S.Item Epidemiology of acute poisoning among children in urban Sri Lanka: the experience of two tertiary care hospitals in Colombo district(The Jaffna Medical Association, 2023) Dayasiri, K.; Thadchanamoorthy, V.; Jansz, M.; Dassanayake, S.; Anand, G.Acute poisoning in children is an important public health problem and one of the leading causes of emergency department admissions following childhood injuries. Although most paediatric ingestions are accidental, children are at a higher risk for serious complications following ingestion of a similar toxic dose compared to adults. The current study evaluated the recent patterns and trends in acute poisoning among children in two tertiary care centers in urban Sri Lanka: Lady Ridge Hospital for Children, Colombo and North Colombo Teaching Hospital, Ragama. Out of 200 cases, the majority were between 1-5 years and male children outnumbered female children. The most common poisons included kerosene oil, paracetamol and “Good Luck” plants. Complication rate was low, and no mortalities were reported. Deliberate poisoning accounted for 1% of total poisonings. The current trends in poisoning among children living in urban Sri Lanka showed decreasing incidence of pesticide poisonings and increasing incidence of pharmaceutical poisonings and poisoning with ornamental plants.Item Impact of covid-19 on the education and health of schooling children in Sri Lanka; A multi-provincial study(Sri Lanka College of Paediatricians, 2022) Dayasiri, K.; Thadchanamoorthy, V.; kankananarachchi, I.; Umasankar, N.; Dassanayake, S.; Gunasekara, S.; Mettananda, S.Item Acute appendicitis during the recovery phase of dengue hemorrhagic fever: two case reports(BioMed Central, 2022) Thadchanamoorthy, V.; Ganeshrajah, A.; Dayasiri, K.; Jayasekara, N.P.Background: Dengue fever is one of the most common tropical diseases, with high prevalence in many tropical countries including Sri Lanka. Dengue infection can present from subclinical infection to dengue shock syndrome. Further, the disease also shows a variety of atypical presentations and has been reported to mimic a number of causes of acute abdomen. Case presentation: The authors report two children (a 6-year-old Tamil girl and an 8-year-old Muslim girl) who were diagnosed to have acute appendicitis during the early recovery phase of dengue hemorrhagic fever (DHF) and late recovery period of dengue hemorrhagic fever with platelet count of 92 × 103/cumm and 102 × 103/cumm, respectively. Both children were investigated with abdomen ultrasound as they developed severe abdominal pain and tenderness on palpation during the recovery phase, which was felt to be very unusual. Acute appendicitis was diagnosed in one child, while the other child had a ruptured appendicular abscess. Both children were treated with laparoscopic appendectomy and a 7-day course of intravenous antibiotics. Both children were reviewed in 1 month following treatment and had complete recovery. Conclusion: Although precise pathophysiology and associations of the surgical abdomen with dengue fever remain to be elucidated, there are known factors in dengue fever that can potentially lead to secondary bacterial infections and surgical abdomen. Awareness and increased suspicion by the clinician are paramount to detect such complications early, especially in children who demonstrate unusual clinical features during various stages of dengue infection.