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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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 Organophosphate poisoning complicated by rhabdomyolysis-induced acute kidney injury: A Case report and review of literature(Longdom Publishing SL, 2020) Gunasena, J.B.; de Silva, S.T.BACKGROUND: Rhabdomyolysis induced acute kidney injury (AKI) following organophosphate poisoning is a rare complication. The mechanism responsible is uncertain. CASE REPORT: A 42 years old male was admitted to a tertiary care hospital in Sri Lanka after deliberate self-ingestion of Calcron® (Profenophos, an organophosphorus pesticide). He developed rhabdomyolysis induced AKI requiring regular haemodialysis. During the hospital stay he also developed bronchopneumonia with acute respiratory distress syndrome, requiring intubation and ventilation. The patient improved with intravenous antibiotics and repeated renal replacement with haemodialysis. At discharge he had made a full recovery. CONCLUSION: Organophosphate poisoning can rarely lead to rhabdomyolysis induced AKI. It is an adverse predictor of outcome. Clinicians should be vigilant about this complication since, with early diagnosis and aggressive treatment, a favourable outcome is possible.Item Emerging pesticides responsible for suicide in rural Sri Lanka following the 2008-2014 pesticide bans.(BioMed Central, 2020) Weerasinghe, M.; Pearson, M.; Konradsen, F.; Agampodi, S.; Sumith, J. A.; Jayamanne, S.; Senanayake, S. M. H. M. K.; Rajapaksha, S.; Eddleston, M.BACKGROUND: Sri Lanka has reduced its overall suicide rate by 70% over the last two decades through means restriction, through a series of government regulations and bans removing highly hazardous pesticides from agriculture. We aimed to identify the key pesticide(s) now responsible for suicides in rural Sri Lanka to provide data for further pesticide regulation. METHODS: We performed a secondary analysis of data collected prospectively during a cluster randomized controlled trial in the Anuradhapura district of Sri Lanka from 2011 to 16. The identity of pesticides responsible for suicides were sought from medical or judicial medical notes, coroners' records, and the person's family. Trend analysis was done using a regression analysis with curve estimation to identify relative importance of key pesticides. RESULTS: We identified 337 suicidal deaths. Among them, the majority 193 (57.3%) were due to ingestion of pesticides while 82 (24.3%) were due to hanging. A specific pesticide was identified in 105 (54.4%) of the pesticide suicides. Ingestion of carbosulfan or profenofos was responsible for 59 (56.2%) of the suicides with a known pesticide and 17.5% of all suicides. The increasing trend of suicides due to carbosulfan and profenofos over time was statistically significant (R square 0.846, F 16.541, p 0.027). CONCLUSIONS: Ingestion of pesticides remains the most important means of suicides in rural Sri Lanka. The pesticides that were once responsible for most pesticide suicides have now been replaced by carbosulfan and profenofos. Their regulation and replacement in agriculture with less hazardous pesticides will further reduce the incidence of both pesticide and overall suicides in rural Sri Lanka. KEYWORDS: Pesticide; Pesticide regulation; Self-poisoning; Sri Lanka; Suicide.