International Postgraduate Research Conference (IPRC)
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Item Implementation of an Online Histopathology Reporting System in the Department of Pathology, Faculty of Medicine, University of Kelaniya(19th Conference on Postgraduate Research, International Postgraduate Research Conference 2018, Faculty of Graduate Studies,University of Kelaniya, Sri Lanka, 2018) Hettiarachchi, W.G.; Ediriweera, E.P.D.S.; Mahendra, B.A.G.G.; Liyanage, S.K.; Hewavinsenthi, S.J.D.S.; Ratnayake, R.M.U.S.The Department of Pathology, Faculty of Medicine, University of Kelaniya provides histopathology reporting for the Colombo North Teaching Hospital (NCTH) as an honorable service. The department currently uses a standalone Microsoft access database to generate reports and it has limited data retrieval capabilities. A newer system was required to address the issues faced, mainly a prolonged turnaround time caused by lack of clinical data, inability to track delays in sample processing, delays in data entry and report dispatch. More efficient data retrieval for research purposes and monitoring of postgraduate training were also considered important. The aim of the work was to implement anonline histopathology reporting system that has facility to track the reporting stage, postgraduate evaluation and data retrieval for researches. Every report is attached with a diagnostic code that can be used in research purposes. A web-based application was developed that has ability to capture data at each step from specimen receiving from the surgery theatre until dispatch of reports. The system has developed to easily customizable to different settings. Thus, it has facility to add new reporting templates, anatomical sites, surgical specimens or diagnostic codes to system through web forms. Data entry was facilitated by using drop down menus and prompts. Standard templates for reports with option to edit were uploaded enabling quick report generation. It facilitates postgraduate supervision by enabling the trainer to determine the time taken, quality and quantity of work done by the trainees. Mainly open source scripting languages and databases were used to developed the system: PHP, HTML 5, CSS Javascript, Ajax and MySQL. The system hosted on the faculty intranet and available 24/7 from anywhere at the faculty. The system supports both windows and androids operating systems and the system can be accessed in desktop and tablet computers using any commonly used modern web browsers.Item A Retrospective Study on Perinatal Post Mortems(Faculty of Graduate Studies, University of Kelaniya, Sri Lanka, 2016) Liyanage, S.K.; Mahendra, G.; Ratnayake, S.; Hewavisenthi, J.A detailed post mortem examination is the key to the recognition of pathologies related to perinatal deaths. Post mortem findings assist the clinical team in confirming their clinical and radiological findings and the family for future pregnancy planning. However, this facility is still underutilized in Sri Lanka. Furthermore, examination of the placentas is an important aspect in recognizing the cause of perinatal death. The department of pathology, faculty of medicine, University of Kelaniya provides the perinatal pathology service to the Obstetrics and Gynaecology unit and the neonatal unit of the Teaching Hospital Ragama. This study was carried out in view of improving and expanding the perinatal pathology service provided by the department. Objectives were (1). To identify the number of perinatal post mortems (PPMs) reported over a period of six years. (2). To identify the number of PPMs that showed multiple congenital anomalies (3). To identify the number of PPMs accompanied by a placenta and the number of placentas with identifiable pathology. This was a retrospective study on already reported PPMs in the Department of Pathology, Faculty of medicine, University of Kelaniya, From January 2011 to August 2016. The PPM databases maintained in the department were used to extract data. A total of 118 PPMs were reported (2011-17, 2012-16, 2013- 17, 2014-21, 2015-31, 2016-16). 65 % (75/118) were premature deliveries. 56% (67/118) were performed following intrauterine deaths. 14 % (16/118) of PPMs showed multiple congenital anomalies. Placentas ware submitted for examination in 31 PPMs (31/118) and clinically significant placental pathologies were noted in 7/31 placentas (23%). 76/118 (64%) showed no gross abnormality in the fetus/baby and placenta was not available for examination in 72% (55/76). Major congenital anomalies were detected in 14% of PPMs. In majority of the PPMs, the placenta was not available for examination, therefore cannot exclude the possibility of placental pathology which might have led to the death.Item Quantification of mucosal eosinophils in histologically normal ileal, colonic and rectal biopsies(Faculty of Graduate Studies, University of Kelaniya, 2015) Liyanage, S.K.Introduction: Increased gastrointestinal tissue eosinophils are noted secondary to many known disease entities and also due to primary eosinophilic gastrointestinal disorders. There is no general agreement with regard to the normal range of eosinophils in the intestinal mucosa. This study was carried out in a population of adults suspected of having irritable bowel syndrome (IBS). Objectives: To quantify the normal eosinophil counts in different segments of the lower gastrointestinal tract (LGIT). Methodology: The ileal, serial segmental colonic and rectal biopsies of 25 patients, suspected as having IBS, whose endoscopic findings and the routine histological findings were normal, were included in the study. Eosinophils were counted in up to 10 high power fields (HPFs) in each of these biopsies including ileum(174HPFs), caecum(185HPFs), ascending colon(AC- 165HPFs), transverse colon(TC-182HPFs), descending colon(DC-177HPFs), sigmoid colon(SC-192HPFs) and rectum (183HPFs). Using the data analysis software ‗Stata‘, the 95th percentile was obtained and taken as the upper normal limit /cut off level for mucosal eosinophils in each of these sites. Results: The 95th percentile values for the mucosal eosinophils were, ileum-20/HPF, caecum- 20/HPF, AC-15/HPF, TC-12/HPF, DC-12/HPF , SC-11/HPF and rectum-6/HPF. Conclusion: There is a variability in the normal eosinophil counts in different segments of the LGIT. This study showed that it is necessary to have different upper normal limits for mucosal eosinophil counts in each segment of the bowel rather than a single value for the entire LGIT. Discussion – A population suspected of having IBS were used to establish the normal eosinophil counts in different segments of the LGIT, because IBS is known to be a functional disorder and the routine histological examination reveals no mucosal abnormality. It has also been proven that this population reveals no increase in mucosal eosinophils and therefore, in the local settings, was considered as the best possible sample to represent the normal population in this study.