Journal of the Postgraduate Institute of Medicine最新文献

{"title":"Jejunal adenocarcinoma in a young female patient – Case Report","authors":"A. Abayasinghe, W G P Kanchana, L. Chathuranga, G. Indika, W. Alwis, M. Dias","doi":"10.4038/JPGIM.8306","DOIUrl":"https://doi.org/10.4038/JPGIM.8306","url":null,"abstract":"Introduction The duodenum and the small intestine comprise about 75% of the digestive tract but the incidence of neoplastic lesions is extremely low, especially compared to that of the large intestine which accounts for only a quarter of the length of the small bowel. A variety of tumours, both malignant and benign, are reported from the small intestine, accounting for 2-5% of the neoplasms in the gastrointestinal tract [1,2,3]. The commonest type of primary malignant neoplasm of the small intestine is carcinoid (35%-42%) followed by adenocarcinoma (30%-40%), lymphoma (15%-20%) and sarcoma (10%-15%) [4,5]. More than 50% of the adenocarcinomas are found in the duodenum and the incidence drops along the rest, being about 27% in the jejunum and only around 10% in the ileum [5].","PeriodicalId":425054,"journal":{"name":"Journal of the Postgraduate Institute of Medicine","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126400758","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":"Secondary chondrosarcoma from a solitary osteochondroma of the fibula head: a case report","authors":"K. Kuruwitaarachchi, D. Munidasa","doi":"10.4038/JPGIM.8307","DOIUrl":"https://doi.org/10.4038/JPGIM.8307","url":null,"abstract":"Introduction Osteochondromas are the most common primary, benign tumors of the bone. They account for nearly 35% of all primary benign bone tumors [1,2]. Osteochondroma is a disease of the young and usually presents during the second and third decades of life. Malignant transformation is considered as a serious complication of an osteochondroma. Less than 1% of all osteochondromas undergo malignant transformation into secondary chondrosarcoma and literature reporting such cases is rare. In fact, no such cases have been reported in Sri Lanka. In this report, we discuss the surgical management and outcome of chondrosarcoma secondary to osteochondroma of the proximal fibula.","PeriodicalId":425054,"journal":{"name":"Journal of the Postgraduate Institute of Medicine","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121187467","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":"Atypical patterns of breathing in critically ill: adjuncts to prognostication?","authors":"B.M Munasinghe","doi":"10.4038/JPGIM.8321","DOIUrl":"https://doi.org/10.4038/JPGIM.8321","url":null,"abstract":"We present a case of an uncommon type of breathing witnessed in a mechanically ventilated 11-year-old child who presented following sudden loss of consciousness. He was found to have a large diffuse sub-arachnoid haemorrhage which was not amenable to surgical intervention. Thus, neuroprotective ventilation was continued. Sedation was withheld 48 hours later, to assess the Glasgow coma scale (GCS). His arterial O 2 and CO 2 tensions, acid-base status, electrolytes, glycaemic levels and other metabolic parameters were optimized. Another 72 hours later, with a respiratory trigger of 1 l/min, on synchronized-intermittent mandatory ventilatory mode, a peculiar type of spontaneous breathing","PeriodicalId":425054,"journal":{"name":"Journal of the Postgraduate Institute of Medicine","volume":"62 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133139125","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":"Typhus pneumonitis – A rare and life-threatening complication of scrub typhus","authors":"S. Thanancheyan, N. Selvaratnam, A. Muthulingam, S. Uthayakumaran, Ghetheeswaran Srivickneswaran","doi":"10.4038/JPGIM.8300","DOIUrl":"https://doi.org/10.4038/JPGIM.8300","url":null,"abstract":"Corresponding Author: Sanchayan Thanancheyan, E-mail: <sanchai1990@gmail.com > https://orcid.org/0000-0001-6906-385X Submitted: 14 Oct 2020, Accepted revised version: 24 Nov 2020, Published: 31 Mar 2021 Competing Interests: Authors have declared that no competing interests exist © Authors. This is an open-access article distributed under a Creative Commons Attribution-Share Alike 4.0 International License (CC BY-SA 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are attributed and materials are shared under the same license.","PeriodicalId":425054,"journal":{"name":"Journal of the Postgraduate Institute of Medicine","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132365441","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":"Comparative analysis of Sri Lankan and Indian Food Acts: legislative consistencies and inconsistencies","authors":"C. A. Hettiarachchi","doi":"10.4038/JPGIM.8290","DOIUrl":"https://doi.org/10.4038/JPGIM.8290","url":null,"abstract":"Background and Objectives All people have a right to access safe food as unsafe food leads to undesirable health consequences. Therefore, countries enact legislation to ensure food safety. The Food Safety and Standards Act of 2006 is the main food law in India while in Sri Lanka it is the Food Act of 1980. A comparison of these two laws enables us to study better legal provisions and may help to improve the Sri Lankan food law in the future. Methods A comparative analysis was conducted using a check list which was developed based on the Indian Food Safety and Standards Act of 2006 and the Sri Lankan Food Act of 1980. Results The definition of food in the Indian act specifically includes certain food items while it excludes non-food items such as medicinal products; however, the definition in the Sri Lankan act is not that precise. Unlike in Sri Lanka, in India a Food Safety Officer - Indian food inspection officer – is specifically allocated for food safety activities and is directly monitored by a superior authority such as the Designated Officer and Commissioner of Food Safety, through legal provisions. Regulations concerning food premises in Sri Lanka are vague and contravene the primary act while such confusion is not present in the Indian law. In contrast to Sri Lankan law, Indian law permits the issuance of a Notice of Improvement without prosecution. In addition, imprisonment is compulsory as a penalty. Under the Indian law, It is a legal requirement to test food samples in an accredited laboratory but such a requirement is not found in Sri Lanka. Conclusions and Recommendations Several deficiencies are present in the Sri Lankan food law. Therefore, there is an opportunity for bringing about improvements through future amendments. The definition of ‘food’ and ‘food-medicine interface’ is not precise and needs to be revised. The efficiency of Authorized Officers is low in Sri Lanka and can be improved by allocating an Authorized Officer specifically for food safety activities, giving more authority for monitoring food safety to the Chief Food Authority and Food Authorities and by approving Veterinary Surgeons and appointing Additional Medical Officers of Health as Authorized Officers. Sri Lankan legal inconsistencies with regard to registration of food premises needs to be corrected and specialized food laboratories need to be accredited. Additionally, Sri Lankan Food Authorities should be given powers to issue notices for violations which do not directly affect human health.","PeriodicalId":425054,"journal":{"name":"Journal of the Postgraduate Institute of Medicine","volume":"100 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125580643","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":"Brachial artery thrombosis following multiple wasp stings","authors":"K. U. I. S. Gunathilake, M. I. M. Rifath, D. D. Ayeshmantha, J. Jayasinghe, A. Marasinghe","doi":"10.4038/JPGIM.8311","DOIUrl":"https://doi.org/10.4038/JPGIM.8311","url":null,"abstract":"Introduction Wasp stings are commonly encountered in general medical wards in Sri Lanka [1]. Wasps are categorised under the insect Order Hymenoptera, which comes under Phylum Arthropoda, and is the third largest of the insect orders [2]. Wasp stings may lead to serious health issues ranging from simple local reactions to life threatening systemic complications including anaphylaxis and arterial thrombosis. Vascular thrombosis is a rare manifestation of wasp venom thus only few cases have been reported in the literature. The pathophysiology of vascular thrombosis may include the vasoactive inflammatory and thrombogenic properties of venom as well as vascular spasm caused by the venom [2,3,4]. The reported cases of vascular thrombosis include cerebral artery thrombosis and ischaemic strokes, descending aortic thrombosis, coronary artery thrombosis and myocardial infarctions but never a brachial artery thrombosis, to the best of our knowledge [3,5,6,7].","PeriodicalId":425054,"journal":{"name":"Journal of the Postgraduate Institute of Medicine","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115655931","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":"Isolated oculomotor nerve palsy with pupillary dilatation: A rare presentation of internal carotid artery dissection","authors":"S. Thanancheyan, Ghetheeswaran Srivickneswaran, N. Selvaratnam, S. Uthayakumaran, S. Balakumar","doi":"10.4038/JPGIM.8305","DOIUrl":"https://doi.org/10.4038/JPGIM.8305","url":null,"abstract":"Corresponding Author: Sanchayan Thanancheyan, E-mail: <sanchai1990@gmail.com> https://orcid.org/0000-0001-6906-385X Received: 30 Oct 2020, Accepted 30 Nov 2020, Published: 30 Mar 2021 Competing Interests: Authors have declared that no competing interests exist © Authors. This is an open-access article distributed under a Creative Commons Attribution-Share Alike 4.is0 International License (CC BY-SA 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are attributed and materials are shared under the same license.","PeriodicalId":425054,"journal":{"name":"Journal of the Postgraduate Institute of Medicine","volume":"54 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128776737","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":"Substance Use Disorders and Their Correlates Among Inmates in a Sri Lankan Prison","authors":"A. Hapangama, Gayani Dasanayake, K. Kuruppuarachchi, A. Pathmeswaran, H. J. Silva","doi":"10.21203/RS.3.RS-238653/V1","DOIUrl":"https://doi.org/10.21203/RS.3.RS-238653/V1","url":null,"abstract":"\u0000 IntroductionSubstance abuse and dependence are common among prison populations. However, there is few data regarding this problem in Sri Lankan. Objective: To determine the prevalence of substance use disorders among inmates in a Sri Lankan prisonMethod: A semi- structured interviewer administered questionnaire and ICD 10 clinical diagnostic criteria were applied to 410 randomly selected male and female prisoners in minimum/medium security settings in the largest prison in Sri Lanka.Results: 75.6% (95% CI 71.2 – 79.5) of prisoners had lifetime substance use disorder while 24.4% (95% CI 20.2– 28.6) met criteria for current substance use disorder. 56.8% and 67 % of participants met criteria for lifetime alcohol and tobacco use disorders, respectively, while and 42 %and 25.6% had lifetime cannabis and opioid dependence, respectively. Factors significantly associated with lifetime substance use disorder were male gender, residence in an urban area, younger age and being unemployed or having only temporary employment. 23% of participants who met criteria for dependence were intravenous substance users.Conclusions: Services should be improved in the prison health system to minimize harm from substance use disorders.","PeriodicalId":425054,"journal":{"name":"Journal of the Postgraduate Institute of Medicine","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126835446","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":"Tuberous sclerosis complex: case report of a patient with epilepsy and chronic kidney disease","authors":"S. Thanancheyan, N. Selvaratnam, Ghetheeswaran Srivickneswaran, S. Uthayakumaran, Prasath Premkumar","doi":"10.4038/jpgim.8301","DOIUrl":"https://doi.org/10.4038/jpgim.8301","url":null,"abstract":"Introduction Tuberous sclerosis complex (TSC) is an autosomal dominant genetic disorder with a variable clinical presentation and severity. It is a multisystem disease, characterized by hamartomas in various organs, often involving the skin and central nervous system. TSC affects around one in every 6,000 to 10,000 people with equal distribution among sex and ethnic groups. Cutaneous involvement is the most striking finding, enabling early diagnosis and intervention in such cases [1]. However, it has a great phenotypical variability making it difficult to recognize in some instances [2].","PeriodicalId":425054,"journal":{"name":"Journal of the Postgraduate Institute of Medicine","volume":"52 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122420708","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":"Perceptions of the current COVID situation and health, social and economic impact of the current scenario among a rural setting in Anuradhapura district","authors":"P. Chulasiri, T. Ruwanpathirana, N. Gunawardena, Champika Wickramasinghe, Buddhi Lokuketagoda","doi":"10.4038/jpgim.8298","DOIUrl":"https://doi.org/10.4038/jpgim.8298","url":null,"abstract":"Background Sri Lanka used a holistic approach with many stringent measures to successfully control COVID-19. The paper provides a snapshot of a rural farming community’s understanding of COVID-19 and their experiences in relation to the efforts of the Government.  Methods A cross-sectional study among 731 farming adults in the Anuradhapura District with data collected through telephone interviews. Results One-third were 41-50 years of age (37.1%). Almost all identified the symptoms of COVID-19 (97%-96.7%) and main modes of spread (87.2%-97.5%) but the possibility of transmission by asymptomatic persons was less known (51.7%). A great majority (95%-98.8%) accurately identified the main methods of preventing COVID-19.  The most prevalent myths were consuming alcohol to prevent COVID-19 (84.5%) and children/young adults not being susceptible (83.6%). Television was the commonest source of information (96%). Social media was not popular. Two-thirds (66.2%) with non-communicable disease received medications delivered to their home during locked-down periods. No participant (0%) reported food shortages and primary/secondary school education had continued through print material delivered to homes.  One-third (35.2 %) were financially worse off and three-fourths (75.8%) were not able to continue farming activities due to lack of pesticides/insecticides (36.7%) and fertilizers (39.4%). Conclusions This rural farming community demonstrated a good understanding of COVID-19 and their experiences related to accessing essential health services were fair","PeriodicalId":425054,"journal":{"name":"Journal of the Postgraduate Institute of Medicine","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128345602","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}