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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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 Evaluation of the ICT whole-blood antigen card test to detect infection due to Wuchereria bancrofti in Sri Lanka(Oxford University Press, 2002) Chandrasena, T.G.A.N.; Premaratna, R.; Abeyewickreme, W.; de Silva, N.R.The sensitivity, specificity and cost effectiveness of an immunochromatographic card test (ICT, AMRAD) for the diagnosis of bancroftian filariasis were estimated against 2 standard parasitological techniques: thick blood film (TBF) and Nuclepore membrane filtration (NMF). Individuals were selected from endemic localities in the Western Province (n = 213) and from the non-endemic Central Province (n = 29) of Sri Lanka. Blood was collected between 21:00 and midnight. Sixty microlitre of non-heparinized blood, and 1 mL and 100 microL of heparinized blood were used in TBF, NMF andICT, respectively. NMF was positive in 31.5% (67/213) of the endemic group, with a mean microfilaria (mf) count of 343/mL (range 8-1782, SD 422). All 67 were positive by ICT (sensitivity 100%), but only 63 by TBF (sensitivity 94%). Among the endemic population there were 12 who were mf negative but antigen positive by ICT. There were, however, no false positives among the non-endemic controls, indicating the possibility that the ICTmay in fact be more sensitive and 100% specific. Thus, ICT filariasis test appears to be more effective (both sensitive and specific) than TBF or NMF in diagnosing infection in lymphatic filariasis. The direct unit recurrent costs of the 2 survey tools, TBF and ICT, were US$ 0.30 (Rs. 27/=) and US$ 2.75 (Rs. 248/=), respectively. The high cost of the ICT may be offset by other factors that are difficult to cost.Item Sleeping sickness in Sri Lanka(Sri Lanka Medical Association, 2000) Gunatilake, S.B.This is a response to Saroj Jayasinghe's article (CMJ 99:44:174). Comments on Jayasinghe's calculations of student time, student seminars and the case of trypanosomiasis in a farmer from Kalmunai. (letter to editor)Item A Clinical and cost evaluation between outpatient endometrial biopsy and dilatation and curettage(Sri Lanka College of Obstetricians and Gynaecologists, 1997) Gunasekera, P.C.; Wijesinghe, P.S.; Saparamadu, P.A.M.Objective To evaluate the clinical and financial benefits of endometrial aspiration biopsy using a new aspiration device (Probet) over conventional dilatation and curettage. Design Comparison of histology and adequacy of samples obtained by endometrial aspiration and formal curettage. The histopathologist was blinded with regard to the biopsy method. Setting The gynaecology outpatient department of a teaching hospital. Patients 52 consecutive women requiring dilatation and curettage (D and C). Interventions Endometrial aspiration was performed in the out patient department and conventional D and C performed within 3 days. Main outcome measures Degree of discomfort to patients during endometrial aspiration was assessed by a visual analogue scale. Histological adequacy of the endometrial samples obtained was determined. The histological diagnosis of samples obtained by the two methods was passed. Cost of the two methods was determined. Results Eight patients experienced moderate to severe discomfort during endometrial aspiration. These were done for investigation of subfertility (2) and postmenopausal bleeding (6). Scanty or no endometrial aspirate was obtained in 9 women, 6 of whom had postmenopausal bleeding. No curettings were obtained in 5 of the women with postmenopausal bleeding. Active bleeding was present at the time of the procedure in 5 patients which was reported as blood clot and menstrual endometrium. In only 2 of the paired endometrial samples did the histological diagnosis differ from the specimen obtained by endometrial aspiration. Histological concordance was noted in 30 pairs. Conclusions Outpatient endometrial biopsy is acceptable to the majority of patients. Nulliparous and postmenopausal woman feel discomfort. Endometrial biopsy in the presence of active bleeding is of little value. There is good histological concordance between samples from endometrial aspiration is as ten times cheaper than conventional curettage