The Ceylon medical journal最新文献

{"title":"Varicella zoster virus as a cause of infectious encephalitis in a cohort of Sri Lankan patients","authors":"D. Gunathilake, R. Ramesh, N. Wickramasinghe, J. Abeynayake, G. Galagoda","doi":"10.4038/cmj.v61i4.8392","DOIUrl":"https://doi.org/10.4038/cmj.v61i4.8392","url":null,"abstract":"This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Infectious encephalitis (IE) usually presents with an abrupt history of fever, headache, progressive decline of mental status with or without development of focal neurological symptoms and focal seizures [1]. Varicella-zoster virus (VZV) is one of the major causes of IE worldwide [2]. The primary infection manifests as chickenpox. It is capable of remaining dormant in the nerves to reactivate later causing neurological disorders including encephalitis [3]. There are reports of primary infection of VZV manifesting as encephalitis in immunecompetent children [4]. This study describes the VZV infection in a group of Sri Lankan patients with IE. Approval for the study was obtained from the Ethics Review Committee of the Institute.","PeriodicalId":122256,"journal":{"name":"The Ceylon medical journal","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125773424","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":"Pattern of clinical benign euthyroid goitre in a tertiary care center in the Central Province of Sri Lanka from 1981-2011","authors":"P. Ratnatunga, R. Dassanayaka, A. Kumari, A. B. Aglawatta, K. Galketiya, N. Ratnatunga","doi":"10.4038/cmj.v61i4.8385","DOIUrl":"https://doi.org/10.4038/cmj.v61i4.8385","url":null,"abstract":"Objectives\u0000To describe the pattern of clinical euthyroidgoitre in a tertiary care unit in Sri Lanka before and after iodination of salt in Sri Lanka.\u0000\u0000\u0000Methods\u0000We reviewed our thirty-one year computerised database of patients with goitres, spanning iodination in 1995.\u0000\u0000\u0000Results\u0000Prevalence of euthyroid clinical simple diffuse goitre did not reduce during the first thirteen years (p=0.822). However, it reduced in the latter four years from 2008 to 2011. There is significant reduction of prevalence in the younger age groups (p<0.001). A significant reduction of nodular change was observed in all groups within seven years after iodination (p<0.001).\u0000\u0000\u0000Conclusions\u0000There was a significant reduction in the prevalence of clinical nodularity in the post-iodination era in all age groups. Reduction in prevalence of clinical euthyroid simple diffuse goitre was observed only during the period 2008-2011.","PeriodicalId":122256,"journal":{"name":"The Ceylon medical journal","volume":"114 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124773701","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":"Magnetic resonance imaging findings of patients with suspected tuberculosis from a tertiary care centre in Sri Lanka","authors":"A. Pallewatte, N. Wickramasinghe","doi":"10.4038/cmj.v61i4.8387","DOIUrl":"https://doi.org/10.4038/cmj.v61i4.8387","url":null,"abstract":"Introduction\u0000Spinal tuberculosis (TB) is a relatively common cause for spinal pathology in Sri Lanka and a common indication for magnetic resonance imaging (MRI).\u0000\u0000\u0000Objectives\u0000The objective of the study was to describe the MRI imaging pattern of spinal TB in a series of patients.\u0000\u0000\u0000Methods\u0000One hundred and nine patients with clinically confirmed spinal tuberculosis who had undergone MRI scans at the National Hospital of Sri Lanka from 2012-2016 were included in the study.\u0000\u0000\u0000Results\u0000The commonest vertebral level of spinal TB involvement was at L4/5 level, followed by L5/S1 level. L5 vertebral body involvement was the commonest and L4 was second commonest. Single level involvement (68.8%) was commoner than multiple (31.2%) involvement or contiguous involvement. Wedging (24.8%), erosions (89%), end plate changes (96.3%), canal stenosis (77.1%), paravertebral collection (65.1%), prevertebral collection (39.4%), psoas abscess (23.9%) and epidural collection (45.9%) were noted. No significant difference was seen between females and males.\u0000\u0000\u0000Conclusions\u0000Spinal tuberculosis commonly involves L4/5 level.","PeriodicalId":122256,"journal":{"name":"The Ceylon medical journal","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128714079","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":"Dengue fever associated with extreme reactive thrombocytosis","authors":"U. Egodage, N. Dissanayake, M. Dahanayake, C. Bodinayake","doi":"10.4038/cmj.v61i4.8391","DOIUrl":"https://doi.org/10.4038/cmj.v61i4.8391","url":null,"abstract":"Dengue is an important viral illness which has the potential to progress into dengue hemorrhagic fever (DHF) or dengue shock syndrome (DSS). Leucopenia and throm-bocytopenia are the hallmarks of acute dengue which normalise with recovery [1]. Progression from thrombo-cytopenia to severe thrombocytosis is uncommon. We describe a patient presenting with acute dengue, who developed extreme reactive thrombocytosis.","PeriodicalId":122256,"journal":{"name":"The Ceylon medical journal","volume":"141 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121323361","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":"Perception on the abortion laws in Sri Lanka: A community based study in the city of Colombo","authors":"M. Suranga, K T Silva, L. Senanayake","doi":"10.4038/cmj.v61i4.8384","DOIUrl":"https://doi.org/10.4038/cmj.v61i4.8384","url":null,"abstract":"Introduction\u0000Abortion is legally permitted in Sri Lanka, only if it is performed to save the mother’s life. However, it is estimated that a large number of induced abortions take place in Sri Lanka. Knowledge and attitudes towards induced abortion in the society are key issues influencing the policy response towards changes in the law. This study aimed to assess the knowledge and attitudes of adults towards induced abortion in Sri Lanka.\u0000\u0000\u0000Methods\u0000Six Grama Niladhari Divisions (GNDs) and five to eight housing clusters from each GND were selected from Thimbirigasyaya Divisional Secretariat Division using multi stage stratified random sampling. Fifty households were systematically selected from each GND. An interview was scheduled among 743 residents aged between 19 to 49 years of age after receiving written informed consent.\u0000\u0000\u0000Results\u0000Only 11% of the respondents knew the situations in which abortion was legal in Sri Lanka. Approximately one tenth of the respondents (11%) did not agree with the current law which allows an induced abortion only to save the life of the mother. However, a majority agreed to legalization of abortion for rape (65%), incest (55%) and pregnancies with lethal fetal abnormalities (53%). Less than one tenth of respondents agreed with legalisation of induced abortion for other reasons such as con-traceptive failure (6%), poor economic conditions (7%) and, on request (4%).\u0000\u0000\u0000Conclusions\u0000Although the society rejects abortion on request majority are in favour of allowing abortions for rape, incest and fetuses with lethal abnormalities.","PeriodicalId":122256,"journal":{"name":"The Ceylon medical journal","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114783245","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":"Authors reply re: HLA-B27 allele frequency in Sri Lankan patients with spondyloarthritides","authors":"S. Kidnapillai, N. Sirisena, V. Dissanayake","doi":"10.4038/cmj.v61i4.8399","DOIUrl":"https://doi.org/10.4038/cmj.v61i4.8399","url":null,"abstract":"The authors agree with the reader’s comment that if this cohort of SA patients had only a few AS patients, it would reduce the overall frequency of the HLA-B27 alleles. This point has been addressed in the published paper where we mentioned that in contrast to published literature from other populations, the relatively lower allele frequency (22.8%) obtained in this study could probably be attributed to the small sample size.","PeriodicalId":122256,"journal":{"name":"The Ceylon medical journal","volume":"56 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126870185","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":"Medicines use in hospitalised children: current status and outcome after an intervention.","authors":"S. N. Thiyahiny, M. G. Sathiadas, K. Sanchayan, C. Vamadevan, R. Balasubramaniam, S. Sri Ranganathan","doi":"10.4038/CMJ.V61I3.8348","DOIUrl":"https://doi.org/10.4038/CMJ.V61I3.8348","url":null,"abstract":"INTRODUCTION\u0000Challenges in rational use of medicines (RUM) in children are different from that of adults. In Sri Lanka, data on RUM in children are limited.\u0000\u0000\u0000OBJECTIVE\u0000To assess the current status and to investigate effectiveness of an intervention in improving RUM in children.\u0000\u0000\u0000METHODS\u0000Non-randomised controlled before and after study design was employed. Study settings were one paediatric unit in two Teaching Hospitals one for intervention (IU) and the other as a control (CU) unit. After assessing the current status in both units, a combined intervention (one-time training and distribution of a paediatric formulary) was offered to IU and medicine use was re-assessed in both units three months and one year after intervention. Fourteen indicators (7 WHO and 7 developed by investigators) were employed in the assessment. Any improvement was analysed using percentage changes, Chi-square or t tests as appropriate.\u0000\u0000\u0000RESULTS\u0000A total of 1134 charts, 735 (3197 medicines) in IU and 399 (1539 medicines) in CU were subjected to analysis. At base level, of the 14 indicators, 9 were assessed satisfactory in both units. Four could not be assessed without knowing the clinical setting. The remaining indicator, reason for prescribing was recorded for 48% and 76% of medicines respectively in IU and CU. After intervention, only three indicators, medicines that had the reason for prescription recorded in the patient records, children treated without regular medicines, and children received the recommended doses of paracetamol, showed favourable changes in three months and one year. Percentage of medicines written in abbreviation showed an undesirable increase in IU (6.9, 16.2, 29.6) which was higher than what was observed in CU (3.2, 13.5, 18.4).\u0000\u0000\u0000CONCLUSIONS\u0000Passive interventions appear to be ineffective in improving RUM in children. In addition, general medicine use indicators seem to be insensitive to capture the true challenges in paediatric pharmacotherapy.","PeriodicalId":122256,"journal":{"name":"The Ceylon medical journal","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125075933","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":"Online resources on writing, publishing, and presenting: some top choices for the medical community.","authors":"B. Gastel","doi":"10.4038/CMJ.V61I3.8343","DOIUrl":"https://doi.org/10.4038/CMJ.V61I3.8343","url":null,"abstract":"","PeriodicalId":122256,"journal":{"name":"The Ceylon medical journal","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129237905","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":"Depressive disorder in patients attending the outpatient department of a tertiary care hospital in Colombo.","authors":"D. Anandakumar, S. Ratnatunga, M. Dayabandara, R. Hanwella, V. D. de Silva","doi":"10.4038/CMJ.V61I3.8347","DOIUrl":"https://doi.org/10.4038/CMJ.V61I3.8347","url":null,"abstract":"INTRODUCTION\u0000Lifetime prevalence of depression varies across countries and different populations. Depression is a common comorbidity of physical illness. Patients with depression are known to present with somatic symptoms. Depression is under-diagnosed in primary care settings. Objectives To estimate the prevalence of depression in patients attending the outpatient department (OPD) of a tertiary care hospital in the Western Province of Sri Lanka.\u0000\u0000\u0000METHODS\u0000A cross-sectional descriptive study was conducted in the OPD of the National Hospital of Sri Lanka (NHSL). Sample size was 205. Every fifth patient aged between 18 and 60 years who attended the OPD was recruited until the required number was met. Centre for Epidemiologic Studies Depression Scale (CES-D) was used to identify depression.\u0000\u0000\u0000RESULTS\u0000There were 114 (55.6%) females. Mean age was 50 years (SD 13.68).Overall prevalence of depression in the sample was 22.4% (95% CI 16.68-28.20). Prevalence of depression was higher among females 25.4% (95% CI 17.32-33.56) than in males 18.7% (95% CI 10.52- 26.84). Prevalence of severe depression was 15.1% (95% CI 10.18-20.07). Adjusted odds ratios showed that pain related presenting complaints were significantly associated with depression [adjusted OR 1.99 (95% CI 1.01-3.96)].\u0000\u0000\u0000CONCLUSIONS\u0000Prevalence of depression in outpatients is similar to that reported in other parts of the world. None of the patients with depression presented seeking help for depressive symptoms.","PeriodicalId":122256,"journal":{"name":"The Ceylon medical journal","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114664607","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":"Time to change the paradigm of children's medicines from liquid formulations to flexible solid oral dosage forms.","authors":"K. Hoppu","doi":"10.4038/CMJ.V61I3.8340","DOIUrl":"https://doi.org/10.4038/CMJ.V61I3.8340","url":null,"abstract":"","PeriodicalId":122256,"journal":{"name":"The Ceylon medical journal","volume":"53 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120950665","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}