The Ceylon medical journal最新文献

{"title":"Prevalence and correlates of depression in patients with epilepsy in Sri Lanka.","authors":"S. de Silva, A. Isuru, A. Rodrigo, Lalith Kuruppuarachchi","doi":"10.4038/cmj.v66i3.9492","DOIUrl":"https://doi.org/10.4038/cmj.v66i3.9492","url":null,"abstract":"Background\u0000Depression is one of the most common psychiatric disorders in patients with epilepsy and it is often associated with poor quality of life, increased risk of suicide and poor seizure control, yet remains underdiagnosed and undertreated. The prevalence and associations for depression in patients with epilepsy vary between studies reflecting regional and cultural influences. Therefore, it is important to identify unique attributes within a community on this phenomenon This is the first study from Sri Lanka on the prevalence and correlates of depression in patients with epilepsy.\u0000\u0000\u0000Method\u0000We conducted this cross-sectional study at the Epilepsy clinic, Colombo North Teaching Hospital, Ragama. All consenting patients with a diagnosis of epilepsy followed up at the clinic, during study period, were enrolled. Symptoms of depression were screened with Beck Depression Inventory II and diagnosis was confirmed with a clinical assessment by psychiatrist.\u0000\u0000\u0000Results\u0000Of 150 participants, majority were female 63.3%. (95) and 36.7% (55) of the sample were between 26-45 years. The prevalence of depressive disorder was 22% (33). The prevalence of depression was significantly associated with the recent diagnosis of epilepsy, use of multiple antiepileptic medications and duration of seizure free period (p<0.05). There is a statistically significant association between prevalence of depression with the use of carbamazepine, topiramate, clobazam and phenobarbitone. Regression analysis revealed higher the duration individuals suffering from epilepsy were at lower odds of having depression compared with that of individuals suffering from lower duration of epilepsy. For each year in increase of duration of epilepsy, the odds of depression decreased by 2% (95% CI 0.3% to 5.1%).\u0000\u0000\u0000Conclusion\u0000The prevalence of depression is high in patients with epilepsy. Risk of having depression is higher during the early phase of the illness. Therefore, it is important to screen patients with epilepsy for depressive disorder during the early course of the illness.","PeriodicalId":122256,"journal":{"name":"The Ceylon medical journal","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131331918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What is evidence-based medicine?","authors":"K. Mendis","doi":"10.4038/cmj.v66i3.9495","DOIUrl":"https://doi.org/10.4038/cmj.v66i3.9495","url":null,"abstract":"The author’s ‘objective of this three-part article series is to have a simple philosophical discourse using the EBM paradigm’. Philosophy consists of speculations on questions to which there are no universally accepted answers such as origin of what really exists (ontology), the nature of human knowledge (epistemiology) and how we ought to conduct ourselves (ethics) [1]. It is acceptable that the author may be exploring an issue thinking EBM is not universally accepted.","PeriodicalId":122256,"journal":{"name":"The Ceylon medical journal","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127244500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-time laboratory surveillance of Dengue antigen(NS1) - Best proposed early warning and response system for Dengue in Sri Lanka? - Results from a pilot study.","authors":"Lasantha Ranwala, Yudhisteera Wedisinghe, S. Perera, D. Jayamanne","doi":"10.4038/cmj.v66i3.9490","DOIUrl":"https://doi.org/10.4038/cmj.v66i3.9490","url":null,"abstract":"Introduction\u0000During the recent past, dengue fever and associated complications have been the most important concern for health policy makers of Sri Lanka. The current notification system has considerable inevitable delays in preventive measures.\u0000\u0000\u0000Objectives\u0000Implementing a laboratory-based real-time antigen (NS1) surveillance system for notification coupled with a rapid preventive response within the Colombo district as a pilot project and compares the notifications with existing national surveillance systems.\u0000\u0000\u0000Methods\u0000An online notification platform was established with a centralized database. Seven main laboratories of the private sector linked with the notification system, where they can create new notifications at the central database, whenever the NS1 test detected as positive. Relevant Medical Officers of Health should update action implemented to complete the response process. A dashboard was designed to visualize each notification and its status with a predefined colour code.\u0000\u0000\u0000Results\u0000Patients from 14 Medical Officer of Health (MOH) areas out of 15 were captured. The immediate preventive response was recorded from the field preventive staff for 90% of the reporting. All most all attended patients have given health advice on awareness, prevention, and source reduction through premise inspection by trained field staff with 24hrs of notification.\u0000\u0000\u0000Conclusions\u0000Salient features of the novel system are notification of antigen-positive patients, the rapidity of notification (real-time) and response, user-friendliness, access to multiple stakeholders simultaneously without data duplication, early involvement of the field staff, the ability to trace the cases using checklists and a color-coding system from a dashboard.","PeriodicalId":122256,"journal":{"name":"The Ceylon medical journal","volume":"322 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124559286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Constipation in children: the Sri Lankan perspective.","authors":"W. Hathagoda, S. Rajindrajith, N. Devanarayana","doi":"10.4038/cmj.v66i3.9487","DOIUrl":"https://doi.org/10.4038/cmj.v66i3.9487","url":null,"abstract":"Functional constipation (FC) is a common problem in the world. The estimated global prevalence is 9.5% [1]. The disorder leads to significant healthcare expenditure. Furthermore, FC significantly affects the health-related quality of life of children and their academic performances [2, 3]. These facts indicate that FC is a global health problem with a significant impact. Diagnosis of FC in children has been a dilemma for a long time. The first concrete scientific-based diagnostic criteria for FC was released in 1999 as Rome II criteria[4]. The definition evolved over the last two decades, and currently, Rome IV criteria are being used in both scientific research and clinical settings to identify children with FC. These criteria include two or fewer stools in the toilet per week, fecal withholding, history of painful or hard bowel movements, fecal incontinence, large diameter stools and rectal fecal mass found on physical examination. The Rome IV committee of experts recommends that at least 2 of the above criteria should be present at least one month for the diagnosis [5]. Constipation was thought to be a disease of the Western world for many decades. However, one of the first few epidemiological research in Sri Lanka noted a prevalence of 15.4%, indicating the gross underestimation of the prevalence of FC in developing countries [6]. Thereafter several research conducted in Sri Lanka had indicated high prevalence in districts such as Galle, Ampara, and Badulla [6-8]. In addition, the first epidemiological survey from Nigeria found a prevalence of 27%, confirming a high disease burden in the developing world, indicating that childhood constipation is not a disease of the western hemisphere but a global health problem across all socioeconomic strata [9]. In addition, other epidemiological studies from Asia also illustrated the higher prevalence of FC in Hong Kong, Taiwan, Indonesia, and India, possibly indicating the shifting of the global epidemiological epicenter from the West to the East [10-13]. Several risk factors are known to associate with FC in children. Poor toilet training is the commonest cause for FC in young children. A study from Sri Lanka first reported the association between psychological stress and FC. It was reported that several psychological stressors such as separation from the best friend, failing an exam, alcoholism of the father, and frequent Ceylon Medical Journal 2021; 66: 105-109 Constipation in children: the Sri Lankan perspective","PeriodicalId":122256,"journal":{"name":"The Ceylon medical journal","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124554826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genotyping Sri Lankan women with polycystic ovary syndrome (PCOS): towards a novel screening tool.","authors":"Umayal Branavan, K. Muneeswaran, Sulochana Wijesundera, N. Chandrasekharan, C. Wijeyaratne","doi":"10.4038/cmj.v66i3.9491","DOIUrl":"https://doi.org/10.4038/cmj.v66i3.9491","url":null,"abstract":"Introduction\u0000Polycystic ovary syndrome (PCOS) is the multigenic, endocrine disorder of young women. Inheritance of PCOS is likely to be oligogenic and genetic basis remains largely unknown. Screening the candidate genes of PCOS and their SNPs individually is time consuming. Hence, developing a tool that would help in screening multiple candidate genes simultaneously is essential to determine the exact genetic basis of PCOS. Objectives: This study aimed to develop a simple and cost-effective genetic screening tool to simultaneously genotype 16 single nucleotide polymorphisms (SNPs) of PCOS. Methods: The genetic screening tool was developed using allele specific real time quantitative PCR (AS-qPCR) in 96 well PCR plate. Eight SNPs identified in our previous study as well as 8 SNPs identified from other reported studies that had a strong association in the etiology of PCOS were used to develop the tool. Samples from our previous study were reanalyzed using the developed genetic screening tool. Genetic screening tool results were validated with Sanger sequencing. Results: Totally 10 AS-qPCR runs (160 reactions = 16SNPs*10runs) were performed using the developed tool and all except 3 genotype results agreed with Sanger sequencing. The tool showed 100% specificity and 96% sensitivity. Conclusion: The developed genetic screening tool has excellent potential in determining the genotype of multiple SNPs of PCOS simultaneously. This tool is highly suitable for developing countries as a cost effective and accurate early genetic screening test for PCOS. Thus, provides a reliable, fast and user-friendly genotyping method facilitating a wider implication in clinical practice.","PeriodicalId":122256,"journal":{"name":"The Ceylon medical journal","volume":"90 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124627822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Massive cerebral infarct following multiple honeybee stings.","authors":"N. Rathnayaka, Anusha Nishanthi Ranathunga, Bandusiri Rathnayaka, S. Kularatne","doi":"10.4038/cmj.v66i3.9494","DOIUrl":"https://doi.org/10.4038/cmj.v66i3.9494","url":null,"abstract":"Bees belong to the class insects, to the order Hymenoptera and to the family Apidae. The order Hymenoptera includes the bees, wasps and ants. According to the type of nest that bees build and what are stored there, they are classified in to two major groups; the honeybees and the pollen bees. There are four species of honeybees in Sri Lanka naming Asian honeybee (Apis cerana – ‘Meemessa’), Rock honeybee or feral giant honeybee (Apis dorsata –‘Bambara’), feral dwarf honeybee (Apis florae – ‘Danduwel meemessa’) and stingless bee (Trigona iridipennis – ‘Kaneyiya messa’) [1]. The bees are medically important because their stings cause multiple clinical manifestations including simple allergic reaction [2, 3, 4] and severe complications such as acute kidney injury [5], acute myocardial infarction [6], pulmonary haemorrhage [7], intracerebral haemorrhage [8] and ischemic infarcts [9]. We report a 63-year-old healthy male presenting with right side hemiplegia due to a cerebral ischemic infarct in the left side following multiple bee stings. Extensive literature search found no similar reported cases in Sri Lanka.","PeriodicalId":122256,"journal":{"name":"The Ceylon medical journal","volume":"124 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127233116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evidence based medicine : ideology, hegemony, statistical gaze and beyond part three.","authors":"H. Karunatilake","doi":"10.4038/cmj.v66i3.9488","DOIUrl":"https://doi.org/10.4038/cmj.v66i3.9488","url":null,"abstract":"Michel Foucault was a nineteenth century French philosopher who coined the term “medical gaze”. In his book “Birth of the Clinic” he described how doctors modify the patient’s story, fitting it into a biomedical paradigm, filtering out rest. Foucault says “facilitated by the medical technologies, the physician abstracts the suffering person from her sociological context and reframes her as a “case” or a “condition”[12]. Foucault referred to this ‘medical separation’ between a patient's body and his identity and detachment or dehumanization of the body into an object to be isolated, probed, analyzed, examined, and classified as “medical gaze”. Then patient becomes a faceless entity and there is minimum or no intimate and personal doctor-patient relationship. Doctors do not identify the names or faces of their patients but, rather, recognize them from their diseased organ or the test results.","PeriodicalId":122256,"journal":{"name":"The Ceylon medical journal","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134320936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spiritual health.","authors":"S. Epa","doi":"10.2307/j.ctv1fj84w3.11","DOIUrl":"https://doi.org/10.2307/j.ctv1fj84w3.11","url":null,"abstract":"","PeriodicalId":122256,"journal":{"name":"The Ceylon medical journal","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123516399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimation of prevalence of red cell alloantibodies in patients with Beta Thalassaemia Major in Sri Lanka.","authors":"S. Senavirathna, Sunethra Lakmali Ranasinghe, Yashobha Thilakarathne","doi":"10.4038/cmj.v66i2.9474","DOIUrl":"https://doi.org/10.4038/cmj.v66i2.9474","url":null,"abstract":"Background and objectives\u0000Major beta thalassaemia is an inherited haemolytic disease that needs regular blood transfusion as a standard treatment. Blood transfusion is generally safe; however, adverse effects can occur and one of which is red cell alloimmunization that can lead to acute or delayed haemolytic transfusion reactions. This study was designed to estimate the prevalence of red cell alloantibodies in patients with thalassaemia in Sri Lanka.\u0000\u0000\u0000Methods\u0000The study was carried out at three tertiary care hospitals of Sri Lanka. Every beta thalassaemia patients transfused with packed red cells were included. Data collected to a form by analysing the cross match request form sent to the blood bank prior to the transfusion.\u0000\u0000\u0000Results\u0000There were 398 patients in all hospitals. 188 (47.24%) of them were males and 210 (52.76%) were females. Mean age was 18.41 (SD=11.67) years. Out of 398 patients, unexpected red cell antibodies are present only in 6 (1.51%) patients. Identified antibodies were Anti E, Anti K, Anti D, Anti C, Anti S, Anti Jkb and autoantibodies. There was one patient who had developed multiple antibodies.\u0000\u0000\u0000Conclusion\u0000Prevalence of red cell antibodies is lower, even though the patients were been transfused without phenotypically matched red cells. Further studies are suggested to decide the practice of Rh and Kell matching for transfusion in patients with beta thalassaemia.","PeriodicalId":122256,"journal":{"name":"The Ceylon medical journal","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129215043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pyomyositis masquerading as suprapubic mass: An unusual presentation of melioidosis.","authors":"C. Chang","doi":"10.4038/cmj.v66i2.9475","DOIUrl":"https://doi.org/10.4038/cmj.v66i2.9475","url":null,"abstract":"Melioidosis, an infection caused by the Gramnegative bacterium Burkholderia pseudomallei is associated with a broad spectrum of clinical manifestations involving different organ systems [1]. Musculoskeletal melioidosis is an uncommon but well-recognized manifestation of the disease [2,3]. Here, we report a case of pyomyositis with abscesses in the obturator externus and adductor muscles. The patient underwent surgical drainage in which B. pseudomallei was cultured from the pus. He received antimicrobial therapy consisting of intravenous ceftazidime and oral trimethoprimsulfamethoxazole which eventually led to resolution of the abscesses.","PeriodicalId":122256,"journal":{"name":"The Ceylon medical journal","volume":"199 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132708366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}