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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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 Epidemiological evidence of acute transmission of zika virus infection in dengue suspected patients in Sri-Lanka(Elsevier, 2023) Ngwe, T.M.M.; Raini, S.K.; Fernando, L.; Gunawardene, Y.I.N.S.; Inoue, S.; Takamatsu, Y.; Urano, T.; Muthugala, R.; Hapugoda, M.; Morita, K.Background: Zika Virus (ZIKV) is a re-emerging, arthropod-borne flavivirus transmitted by Aedes mosquitoes (Ae. aegypti and Ae. albopictus). The coexistence of dengue virus (DENV) and ZIKV concurrently has been associated with a wide array of neurological complications, which may influence the clinical outcomes of infections. Sri Lanka witnessed a severe dengue epidemic in 2017, characterized by extraordinary and severe disease manifestations with considerable morbidity. Therefore, this study assessed the potential occurrence of ZIKV infection during DENV outbreak in Sri Lanka from 2017 to 2019, which could bear substantial implications for public health. Methods: Five hundred ninety-five serum samples were procured from individuals suspected of dengue and admitted to Kandy National Hospital between 2017 and 2018 and the Negombo District General Hospital between 2018 and 2019. These samples underwent quantitative real-time RT-PCR (qRT-PCR) to identify the presence of the ZIKV gene, while enzyme-linked immunosorbent assay was employed to detect ZIKV-specific IgM and IgG antibodies. Focus reduction neutralization tests were subsequently conducted to confirm ZIKV infection. Results: Among the 595 serum samples, 6 (1.0%) tested positive for ZIKV using qRT-PCR. Anti-ZIKV IgM and IgG were identified in 18.0% and 38.6% patients. Sixty-six (11.0%) samples demonstrated the presence of anti-ZIKV IgM and IgG. Within ZIKV IgM-positive samples, 2.2% exhibited neutralizing antibodies against ZIKV. Through the implementation of qRT-PCR, ZIKV IgM detection, and neutralization testing, 2% and 3.7% cases of ZIKV infections were confirmed in the Kandy and Negombo regions, respectively. Conclusion: This study is the inaugural endeavor to substantiate the existence of ZIKV infection in Sri Lanka utilizing molecular and serological analysis. The findings of this investigation imply that ZIKV was circulating throughout the 2017-2019 DENV outbreak. These results underscore the necessity for improved preparedness for future outbreaks, fortifying governmental policies on public health, and establishing effective early warning systems regarding the emergence of these virusesItem Spontaneous intracerebral haemorrhages from a Sri Lankan tertiary care center: 5-year data(Ceylon College of Physicians, 2021) Dep, W.D.C.; Deelaka, A.G.S.; Somaratne, K.G.S.K.; Meegahapola, H.; Premadasa, H.M.S.D.; Kurukulasuriya, S.A.F.; Mettananda, K.C.D.; Ranawaka, U.K.Introduction and Objectives Epidemiological data on spontaneous intracerebral haemorrhage (sICH) is limited from South Asia. We sought to describe epidemiology of sICH in a Sri Lankan cohort. Methods We studied all patients with stroke admitted to the Stroke Unit, Colombo North Teaching Hospital over five years. Data from sICH patients regarding treatment seeking delays, clinical char-jcteristics, risk factors, stroke severity and functional outcome were compared with ischa-mic stroke (IS) patients. Resists 984 patients (mean age 58.7 years; 62.1% males) were studied: sICH 15.0% (147 patients), IS 85.0%. sICH patients: mean age 58.0 years; 67.3% males. sICH patients presented to hospital earlier (<3h sICH 70.6%, IS 37.2%, p<0.001) and had more severe strokes (NIHSS>15) (sICH 21.3%, IS 12.2%; p<0.001). Hypertension was commoner in sICH group (sICH 72.6%, IS 63.5%; p=0.034), whereas diabetes (sICH 39.0%, IS 51.6%; p=0.005) and smoking (sICH 16.6%, IS 25.5%; p=0.021) were less common. Altered consciousness (sICH 30.3%, IS 18.3%; p=0.001), dysphagia (sICH 55.9%, IS 34.4%; p<0.001), bladder involvement (sICH 56.6%, IS 28.7%; p<0.001), and seizures (sICH 4.1%, IS 1.5%; p=0.029) were commoner among sICH patients. sICH patients had more severe disability on discharge (Barthel index 0-60: sICH 71.1%, IS 45.2%; p<0.001; modified Rankin scale (mRS) 3-6: sICH 76.7%, IS 52.1%; p<0.001). sICH location (lobar vs. deep) and presence of intraventricular haemorrhage was not associated with stroke severity. Lobar ICHs had more severe disability on discharge (Barthel index <60: p=0.037; mRS>3: p=0.020). On logistic regression, sICH was independently associated with early presentation to hospital (OR 1.79; p=0.039), and severe disability on discharge (Barthel index <60: OR 2.42, p=0.028; mRS>3: OR 2.70, p=0.012). Conclusions sICH patients sought medical attention early and had different clinical profiles, more severe strokes and more severe disabilities.