Anuradhapura Medical Journal最新文献

{"title":"Eosinophilic granulomatosis with polyangiitis: easy to miss at an early stage; easy to halt progression if caught early; a success story presented as a case report","authors":"D. Satharasinghe, H. Atukorale, S. Siribaddana, C. Sarathchandra, S. Pilapitiya","doi":"10.4038/amj.v14i2.7666","DOIUrl":"https://doi.org/10.4038/amj.v14i2.7666","url":null,"abstract":"Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare multisystemic small-vessel vasculitic disease. We report a case of non-severe eosinophilic granulomatosis with polyangiitis who was treated early in its course and remained in remission. A 57-year-old lady presented with new-onset episodic wheezing for six months. This was associated with rhinitis, sinusitis and chronic urticaria for the same duration. Examination revealed tender skin nodules.  Investigations revealed elevated inflammatory markers with positive Myeloperoxidase (MPO) antibodies. She was diagnosed with the early stage of eosinophilic granulomatosis with polyangiitis. She was treated with oral prednisolone and mycophenolate mofetil as induction therapy and treatment is maintained with mycophenolate mofetil. She remains in remission to date. This case highlights the importance of early detection and treatment of Antineutrophil cytoplasmic antibodies (ANCA)-associated-vasculitis and explores the potential of mycophenolate mofetil as a therapeutic agent.","PeriodicalId":30600,"journal":{"name":"Anuradhapura Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47690042","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":"Sleep quality and daytime sleepiness in medical students of a state university of Sri Lanka: a cross-sectional study","authors":"M. D. K. L. Gunathilaka, R. Rajapaksha, N. Senevirathna, B. A. Ekanayaka, M. Gunathilaka, D. Chinthani, T. D. Ekanayaka, J. Warnasekara, S. Wickramage","doi":"10.4038/amj.v14i2.7677","DOIUrl":"https://doi.org/10.4038/amj.v14i2.7677","url":null,"abstract":"An adequate amount of good quality sleep is essential for better cognitive performance and to maintain good physical and mental health. Poor sleep quality is related to poor academic achievement in medical students.The objective of this study was to describe the sleep quality of the undergraduates of the Faculty of Medicine and Allied Sciences (FMAS), Rajarata University of Sri Lanka (RUSL). All medical students of FMAS, RUSL were recruited for the study. A questionnaire comprised of the original, untranslated versions of the Epworth Daytime Sleepiness Scale (ESS) and Pittsburgh Sleep Quality Index (PSQI) were used with written permission from relevant authorities. The response rate of this study was 82.7% (662/800). After excluding participants with missing information, data of 649 were analysed. The mean age of the participants was 23 (±1.7) years and the majority were females (n=460,70.8%). The median duration of sleep per night was 6 hours (IQ range: 4 - 8 hours). According to PSQI and ESS 25.9% (n=168) of the study, participants had poor sleep quality (PSQI>5) while 35% (n=227) had abnormally high levels of daytime sleepiness (ESS ≥11). A weak positive correlation was observed between the Global PSQI score and ESS (r = 0.099, p = 0.012, Pearson correlation). The academic year showed significant differences in the sleep quality among medical students, where the percentages of students with poor sleep quality are comparatively higher in the first two academic years and the final year.  The academic year and gender of the students showed a statistically significant association with excessive daytime sleepiness","PeriodicalId":30600,"journal":{"name":"Anuradhapura Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44249036","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":"A case of the first presentation of pre-eclampsia and eclampsia as posterior reversible leukoencephalopathy syndrome: A case report","authors":"S. Rupasinghe, W. Kularatne, S. Jayasekara","doi":"10.4038/amj.v14i2.7662","DOIUrl":"https://doi.org/10.4038/amj.v14i2.7662","url":null,"abstract":"Posterior reversible leukoencephalopathy syndrome [PRES] is a rare disorder which is usually associated with a wide variety of diseases including renal diseases, autoimmune diseases, hypertension, pre-eclampsia and immunosuppressive therapy. The exact aetiology remains unknown.  Even though there are cases of PRES occurring in patients with pre-eclampsia, cases of the first presentation of pre-eclampsia and eclampsia as PRES are rare. Here we report a case of a previously healthy primigravida presenting with generalized tonic-clonic convulsions. Her blood pressure had been normal throughout pregnancy as well as on admission. Following admission there were two high blood pressure recordings. Pre-eclamptic toxaemia [PET] screening reported as positive, indicating pre-eclampsia. Magnetic resonance imaging [MRI] brain was suggestive of PRES. She was treated with magnesium sulphate, anticonvulsants and antihypertensives after which seizures were controlled and blood pressure was normalized. Emergency lower segment caesarean section was performed and the baby was delivered without any complications. Therefore, it is important to consider PRES as a differential diagnosis in a pregnant patient presenting with convulsions even in the absence of a background history of pre-eclampsia. Early recognition and treatment of PRES will enhance prognosis.","PeriodicalId":30600,"journal":{"name":"Anuradhapura Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41861168","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":"Dolichoectasia of vertebrobasilar arteries leading to vascular dementia: A case report","authors":"P. P. B. Herath, W. Kularatne","doi":"10.4038/AMJ.V14I1.7663","DOIUrl":"https://doi.org/10.4038/AMJ.V14I1.7663","url":null,"abstract":"The term dolichoectasia stands for a dilated, elongated and tortuous vessel. Dolichoectasia of the cerebral vasculature is rare but well-described and commonly involves vertebral and basilar arteries. It may be an incidental finding or the patient may present with local compression leading to hydrocephalus, cranial nerve palsies or with ischemic symptoms. We present a case of dolichoectasia of basilar artery contributing to multiple cerebral thromboembolisms where the patient presented with cerebellar symptoms and signs with vascular dementia.","PeriodicalId":30600,"journal":{"name":"Anuradhapura Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45403353","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":"A review on potential herbal treatments for ‘dandruff’ - the embarrassing scalp disorder","authors":"R. Keragala, K. Kempitiya, K. Kumara, N. Kumarapeli, T. Kasunsiri, S. Gunathilaka","doi":"10.4038/AMJ.V14I1.7653","DOIUrl":"https://doi.org/10.4038/AMJ.V14I1.7653","url":null,"abstract":"Dandruff is a scalp disorder that is characterized by itching, and abnormal and rapid turnover of the outermost layer of the skin of the scalp. The fungi of the genus Malassezia are responsible for causing dandruff.  Several herbal remedies have been in use since ancient times for curing dandruff. The effectiveness of herbal extracts and their formulations against the fungi causing dandruff has been assessed previously. This review summarizes the findings of the studies which were focused on assessing the anti-dandruff effect of medicinal plants that are commonly available in Sri Lanka. Punica granatum, Mentha piperita, Bacopa monnieri, Asparagus racemosus, Azadirachta indica, Elaeocarpus serratus, Psidium guajava, Trigonella foenum-graecum, Cuminum cyminum, and Hibiscus spp. have been shown to be having in-vitro anti-malassezial action. However, the number of clinical trials done on assessing such effects of herbal preparations are limited, and the knowledge generated through the clinical trials hitherto shows that the use of combined preparations of plant extracts are successful in treating dandruff compared to single herb preparations.","PeriodicalId":30600,"journal":{"name":"Anuradhapura Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44740870","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":"A male presenting with polyuria: a case of primary Sjögren syndrome","authors":"D. Satharasinghe, S. H. Atukorale, P. Weerawansa, H. Senanayake","doi":"10.4038/AMJ.V14I1.7659","DOIUrl":"https://doi.org/10.4038/AMJ.V14I1.7659","url":null,"abstract":"Sjogren syndrome is a chronic autoimmune disorder with lymphocytic infiltration of exocrine glands causing oral and ocular dryness and well recognized systemic manifestations. Although primary Sjogren syndrome (pSS) is common in women, it is not well recognized in men. This is the first reported case of pSS in a Sri Lankan male to the best of our knowledge. A 58-year-old man presented with polyuria. He has had sicca symptoms for six months and polyuria was secondary to the increased water intake to relieve oral dryness. Examination revealed enlarged tender bilateral salivary glands. After excluding secondary causes, he was diagnosed with pSS. The treatment commenced with steroids, azathioprine, and symptomatic therapy. Primary Sjogren syndrome is an overlooked diagnosis, especially in men, leading to increased morbidity given its multi-organ involvement. Recognition and supportive therapy can help to improve the quality of life of patients.","PeriodicalId":30600,"journal":{"name":"Anuradhapura Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44508940","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":"Idiopathic acquired haemophilia with inhibitors to factor VIII and IX in an elderly female: a case report","authors":"S. Rupasinghe, W. Kularatne, D. Dissanayaka","doi":"10.4038/AMJ.V14I1.7661","DOIUrl":"https://doi.org/10.4038/AMJ.V14I1.7661","url":null,"abstract":"Acquired haemophilia is a rare but life-threatening haematological disorder, commonly occurring in postpartum women and elderly age groups. Although 50% of cases are idiopathic, most cases of elderly patients are associated with malignancies and drugs such as penicillin and interferon. Early diagnosis with prompt control of bleeding and treating the underlying condition is important to reduce morbidity and mortality. Here we report a rare case of an elderly female presenting with mucocutaneous bleeding found to have inhibitors against both factors VIII and IX. She was diagnosed to have idiopathic acquired haemophilia after excluding the secondary causes. She was promptly started on immunosuppressive therapy which led to complete remission. We confirm that early diagnosis and aggressive treatment of acquired haemophilia in elderly patients presenting with bleeding disorders will enhance prognosis.","PeriodicalId":30600,"journal":{"name":"Anuradhapura Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46138524","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":"Chronic asthma in childhood and its economic impact on the family","authors":"K. H. Thalagahage, R. Ediriweera, E. Ranasinghe","doi":"10.4038/AMJ.V14I1.7673","DOIUrl":"https://doi.org/10.4038/AMJ.V14I1.7673","url":null,"abstract":"Asthma is an inflammatory condition that leads to narrowing of airways, especially in the lower respiratory tract. Chronic asthma can cause airway swelling, cough, shortness of breath (SOB), and chest tightness. In Sri Lanka, between 13% to 25% of asthmatics are children who are between 5 to 11 years of age. The current study was planned to assess and explain the economic burden to families having children with bronchial asthma. This descriptive cross-sectional study was conducted with 388 patients (age range: 5 to 15 years) attending the asthma clinic at the Lady Ridgeway Hospital, Colombo, Sri Lanka over the period of April 2020 to September 2020. A total of 388 patients were studied with the majority being female children (n=203, 52.5%). The mean income of the guardians was noted as Rs. 46992 ± 62949. The total expenses related to drug purchase was Rs.1389.18 ±1237.06. The highest expenditure out of the cost of equipment(s) was for the nebulizer machines and masks (Rs. 10259.67 ± 2381.11). Expenses for the steroid inhalers was the highest (Rs. 1215.15 ± 225.68) in the category of “drugs”. Considering other expenses related to childhood asthma, an average of Rs.1033.06 ± 1796.70 were spent monthly on travel, and 73 (18.8%) parents spent Rs. 2465.48 (±2798.36) on vitamins and related foods to relieve asthma. Further, parents lost an average of Rs.4117.00 (±7776.38) monthly allowance due to absenteeism, and 30 (7.7%) parents had obtained loans to treat the child. Gender of the child, the number of people involved for clinic visit, spending night away from home, spending money on food at the clinic, use of ayurvedic treatment, providing additional supplements, and having medical insurance exhibited significant relationships with higher expenditure. There is a significant burden endured by guardians on account of childhood asthma. In addition to the expenditure on the drugs and equipment, a significant amount of money is spent by the families of the children with asthma on traveling to Colombo and staying overnight for clinics. This may be minimized by timely referral of patients to local clinics instead of getting them down to tertiary care centres on a regular basis.","PeriodicalId":30600,"journal":{"name":"Anuradhapura Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42504547","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":"Life skills training as a promising preventive strategy of self-harm and other common problems in adolescents: low and lower middle-income country perspective","authors":"P. Pushpakumara","doi":"10.4038/amj.v13i1.7665","DOIUrl":"https://doi.org/10.4038/amj.v13i1.7665","url":null,"abstract":"","PeriodicalId":30600,"journal":{"name":"Anuradhapura Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42085828","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":"Repeated heating of edible oils: effects on polyphenolic content and antioxidant capacity","authors":"N. Weerakoon, S. Senadheera, I. Jayawardhana","doi":"10.4038/amj.v13i1.7655","DOIUrl":"https://doi.org/10.4038/amj.v13i1.7655","url":null,"abstract":"Dietary free radicals carry significant health risks. Antioxidant capacity and total phenolic content of seven edible oil types [coconut oil-I (loosely packed-wholesale), coconut oil-II (pure, sold in bottles), olive oil, soya oil, sunflower oil, palm","PeriodicalId":30600,"journal":{"name":"Anuradhapura Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44898239","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}