Sri Lanka Journal of Forensic Medicine Science Law最新文献

{"title":"Characteristics associated with successful treatment outcome in children with overweight and obesity at a tertiary care clinic in Sri Lanka","authors":"G. Vidanapathirana, N. S. Vidanapathirana, S. Tennakoon, D. V. K. Kiridana","doi":"10.4038/sljm.v32i1.365","DOIUrl":"https://doi.org/10.4038/sljm.v32i1.365","url":null,"abstract":"Background: Lack of response to childhood obesity management programmes is a global concern. Western studies show that the age and the body mass index of the child at the commencement of the treatment, frequency of clinic visits and parental level of education affect the outcome of such treatment programmes.Objectives: To identify factors associated with z-BMI reduction in children with overweight or obesity who underwent a 6-month clinic-based obesity management programme.Methods: A retrospective analysis of medical records was carried out on children between 2 and 15 years of age who had undergone a weight management programme of 6 months duration at the Teaching Hospital, Peradeniya between 2017 and 2020. Reduction in z-BMI was considered as the successful treatment outcome. Anthropometric, demographic and lifestyle factors at the first and the last visits were extracted and described using means with 95% confidence intervals. Adherence to treatment was evaluated under the categories of diet, physical activity and behavioural modification. Logistic regression was applied to create a model that explains the effect on the treatment outcome.Results: Out of 401 subjects, 94 (23.44%) completed follow up. Eighty subjects (85.1%) achieved a mean z-BMI reduction of 1.981±0.584.The Logistic regression returned a model with screen time as the only statistically significant explanatory variable for changes in BMI. Compared to no screen time those with screen times of over 4 hours were 5.85 (CI 1.25 – 27.28) times more likely to have a negative response.Conclusion: Strategies to minimize screen time are needed to enhance the effectiveness of weight management interventions.","PeriodicalId":53258,"journal":{"name":"Sri Lanka Journal of Forensic Medicine Science Law","volume":"220 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89124196","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":"Usefulness of HbA1C in differentiating Gestational Diabetes Mellitus and preexisting Diabetes Mellitus in the early stages of pregnancy","authors":"P. B. Renz, Gabriela, Cavagnolli, L. Weinert","doi":"10.4038/sljm.v32i1.352","DOIUrl":"https://doi.org/10.4038/sljm.v32i1.352","url":null,"abstract":"Introduction: Diabetes mellitus in pregnancy can cause several complications for the mother and the neonate if left untreated. This study identifies the proportion of undiagnosed pre-existing diabetic pregnant women and the necessity of doing an HbA1C test in the first trimester for its diagnosis.Methodology: Pregnant women in the first trimester without a history of hypertensive disorders, Diabetes Mellitus in their previous pregnancies were recruited for the studies. Then blood samples were withdrawn from them to perform OGTT and the HbA1C test on booking visit (8-12 weeks of gestation). The results were used to diagnose and find the proportions of pregnant women with pre-existing diabetes mellitus and gestational diabetes mellitus.Results: The HbA1C test was done for 428 pregnant women and among them, 25 (5.8%) had levels above ≥ 48 mmol/mol (6.5%) and were diagnosed with pre-existing diabetes. Of the 428 pregnant women, only 267 attended the OGTT. Among the 267 pregnant women, 15 had HbA1C levels equal to or more than 6.5% and they were identified to have pre-existing diabetes. Pregnant women diagnosed with gestational diabetes were 34 and the HbA1C of these women was <6.5%. However, the 15 pregnant women who were diagnosed with preexisting diabetes were not identified with gestational diabetes from the OGTT.Conclusion: HbA1C can be used as a useful tool for screening pre-existing diabetes during pregnancy. Due to the high prevalence of pregnant women with pre-existing diabetes (5.8%) found in this study, it can be recommended to perform a HbA1C test at the booking visit to identify high-risk, pregnant women.","PeriodicalId":53258,"journal":{"name":"Sri Lanka Journal of Forensic Medicine Science Law","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90650325","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":"Non-Alcoholic fatty liver disease and metabolic syndrome in patients with HIV/AIDS and its correlation with antiretroviral therapy and severity of disease","authors":"Pankaj Gupta, S. Tyagi, S. Mathews, R. Saini, H. Sesama, A. Chugh, K. Singh, M. Chawla","doi":"10.4038/sljm.v32i1.348","DOIUrl":"https://doi.org/10.4038/sljm.v32i1.348","url":null,"abstract":"Introduction: Metabolic syndrome (MetS) and Non-alcoholic fatty liver disease (NAFLD) are two major causes of morbidity in chronic HIV infected patients on antiretroviral therapy (ART). This study was done on HIV infected individuals by comparing ART naive patients with patients on different ART regimens and evaluating the effect of ART on Metabolic syndrome and NAFLD.Method: It was a cross-sectional observational study done on 120 HIV infected individuals in a tertiary care centre in New Delhi. All cases with hypertension, diabetes, chronic kidney or liver disease, thyroid disorders or on any drugs except ART were excluded. The risk markers for metabolic syndrome were assessed and compared within groups on different ART regimens.Results: Metabolic syndrome and NAFLD were found to be significantly more in cases on ART as compared to ART naïve cases. Metabolic syndrome was found to be associated with type of ART protease inhibitors (ATV/r)> nonucleoside reverse transcriptase inhibitors (NNRTI) > no ART] and low CD4 cell counts (p=0.01). In those patients who were on ART, these parameters were found to be more in those on second line ART [i.e., protease inhibitor (PI)(ATV/r) based regimens] as compared to those on first line ART, [i.e., nonnucleoside reverse transcriptase inhibitors (NNRTI) based regimen]. 15% of cases on 2nd line ART (group C) had MetS as compared to 12.5% in those on 1st line ART (group B) and nil in ART naïve cases (group A). One third (34%) of all 120 cases were found to have NAFLD. A significantly higher number of cases (45%) in group C had NAFLD as compared to 32.5% in group B and 25% in group A respectively. Insulin resistance and metabolic risk markers were also significantly higher in cases on ART as compared to ART naïve.Conclusions: In HIV patients, the use of antiretroviral therapy (ART) is linked to an increase in the prevalence of metabolic risk factors, including insulin resistance, lipoatrophy and dystrophy, dyslipidaemia, and abnormalities of fat distribution. Although care of Opportunistic infections and recently CVD has received a lot of attention, it is equally important to address the metabolic abnormalities such as metabolic syndrome and NAFLD brought on by ART.","PeriodicalId":53258,"journal":{"name":"Sri Lanka Journal of Forensic Medicine Science Law","volume":"472 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78342020","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 rare presentation of Acute Abamectin poisoning under alcohol influence: A case series","authors":"S. Kajananan, S. Sivansuthan, R. Arujun","doi":"10.4038/sljm.v32i1.358","DOIUrl":"https://doi.org/10.4038/sljm.v32i1.358","url":null,"abstract":"Abamectin is a commonly used insecticide and anthelmintic. Human intoxication is uncommon but potentially fatal. We present the case of a 50-year-old man who developed hypotension, respiratory paralysis with aspiration, and myoclonus following self-ingestion of abamectin under alcohol influence. With supportive treatment, he completely recovered.","PeriodicalId":53258,"journal":{"name":"Sri Lanka Journal of Forensic Medicine Science Law","volume":"79 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80142915","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 neonate with metatropic dysplasia: A case report","authors":"M. Wettasinghe, N. Herath, E. Halangoda, N. Wickramasinghe","doi":"10.4038/sljm.v32i1.387","DOIUrl":"https://doi.org/10.4038/sljm.v32i1.387","url":null,"abstract":"Metatropic dysplasia is a rare form of skeletal dysplasia in which characteristic clinical and imaging features are found at birth. The short limbs with relatively long trunk seen in the neonatal period change to short trunk in childhood due to progressive kyphoscoliosis. This rare condition should be diagnosed in the neonatal period to avoid diagnostic dilemma in later life. A 2-day-old baby girl was referred for a skeletal survey study to diagnose the underlying skeletal dysplasia. The metatropic dysplasia was diagnosed based on plain radiographic findings. This case report highlights the characteristic radiographic findings of this rare disease entity.","PeriodicalId":53258,"journal":{"name":"Sri Lanka Journal of Forensic Medicine Science Law","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90061318","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":"Transfusion reaction: A blind spot in autopsy","authors":"S. Senavirathna, S. Wijerathne","doi":"10.4038/sljm.v32i1.370","DOIUrl":"https://doi.org/10.4038/sljm.v32i1.370","url":null,"abstract":"Although blood transfusion is generally safe, there are adverse events with varying severity even that can lead to death including Acute Haemolytic Transfusion Reaction (AHTR), anaphylaxis, bacterial sepsis, Transfusion Related Acute Lung Injury (TRALI) and Transfusion Associated Circulatory Overload (TACO). Transfusion Associated Graft vs Host Disease (TAGVHD) is a delayed type of reaction that can lead to death. Ascertaining the cause of death is complicated in such situations and multidisciplinary investigations are needed.Serological investigations should be performed in the transfusion laboratory to detect haemolysis, immunological incompatibility, and bacterial contamination. In the postmortem examination AHTR can be diagnosed with serological investigations and presence of incompatible red cells can be identified in postmortem tissue samples by immune-histochemical methods. Detection of HLA antibodies in the respiratory tract tissues and intended donor investigations can confirm the diagnosis of TRALI. In a case of suspected bacterial contamination isolation of same organism in the postmortem blood and in the intended pack can conclude the diagnosis. In anaphylaxis, inflammation of the respiratory tract with eosinophilia can be seen and measuring the serum tryptase level is useful. In TAGVHD host tissue necrosis and lymphocyte infiltration are +seen and that can be confirmed by showing the DNA chimerism by PCR analysis.Further studies are recommended to establish protocols and guidelines for postmortem examination following a transfusion reaction.","PeriodicalId":53258,"journal":{"name":"Sri Lanka Journal of Forensic Medicine Science Law","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78720945","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":"Pinpointing the additive: A peculiar skin manifestation among intravenous drug injectors","authors":"B.M Munasinghe, S. Pranavan, U. Mayorathan","doi":"10.4038/sljm.v32i1.359","DOIUrl":"https://doi.org/10.4038/sljm.v32i1.359","url":null,"abstract":"No abstract available","PeriodicalId":53258,"journal":{"name":"Sri Lanka Journal of Forensic Medicine Science Law","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73069730","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":"General health characteristics, psychological stress of inmates and living environment of a main prison in Sri Lanka","authors":"C. Wickramatilake, B. D. De Silva, T. Nanayakkara, R. Nanayakkara, K. P. K. Gayashani","doi":"10.4038/sljm.v32i1.366","DOIUrl":"https://doi.org/10.4038/sljm.v32i1.366","url":null,"abstract":"Background: Prison inmates, a deprived community are a part of general population. Understanding of their health characteristics, psychological stress and living environment is important to upgrade the existing situation.Objectives: To describe sociodemographic data, general health characteristics, psychological stress of prison inmates and living environment of a main prison in Sri Lanka.Methods: This was a descriptive cross-sectional study conducted among prison inmates of a main prison in Southern Sri Lanka. A self-administered questionnaire, K10 psychological distress scale and a checklist formulated by International Committee of Red Cross for evaluating the living environment and medical records were used to collect data.Results: There were 845 inmates with a median age of 33 years and 576/845(68.1%) were below 40 years. Majority of them had received school education 816/845(96.6%) and 401/845(47.4%) were skilled workers. There were inmates with a past history of being 560/845(66.2%) smokers, 525/845(62.1%) alcohol, 107/845(12.6%) heroin and 143/845(16.9%) cannabis users. Diabetes mellitus, hypertension, ischemic heart disease, psychiatric disorders, asthma and trauma were reported in 72/845(8.5%), 60/845(7.1%), 27/845(3.2%), 148/845(17.5%), 46/845(5.4%) and 33/845(3.9%) inmates respectively and psychological stress was experienced by 265/845(31.3%). Less number of inmates had communicable diseases. Score of standards for living environment was 50.Conclusions: Inmates were from young working group of the community. Past history of psychoactive substance use was high. The proportion of inmates with non-communicable diseases was higher than communicable diseases. Living environment of the prison was at an acceptable level.","PeriodicalId":53258,"journal":{"name":"Sri Lanka Journal of Forensic Medicine Science Law","volume":"38 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81086517","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":"An undiscussed distribution of chest X-ray findings in pulmonary tuberculosis","authors":"H. Bandara, D. Dharmasena, T. Bandara, C. Rathnayake, T. Priyangika, T. P. S. Wickramasinghe, S. Liyanage, H. De Silva, S. Kularatne","doi":"10.4038/sljm.v32i1.378","DOIUrl":"https://doi.org/10.4038/sljm.v32i1.378","url":null,"abstract":"Chest X-Ray is a paramount important investigation in Pulmonary Tuberculosis (PTB). We here explain a common observation of distribution of X-Ray findings in PTB which has not been previously discussed. When the disease is bilateral and extensive, we have noted that in most of the patients the left lung is involved extensively while the right lung is less extensively involved with limitation to upper zone. The reverse pattern is rarely noted. The potential pathogenesis for this would be the differences of the anatomy of the bronchia tree, lymphatics, and the blood vessels.","PeriodicalId":53258,"journal":{"name":"Sri Lanka Journal of Forensic Medicine Science Law","volume":"48 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76096087","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":"Navigation through blood vessels - My journey in vascular surgery","authors":"MS Samarasinghe B MBBS","doi":"10.4038/sljm.v32i1.434","DOIUrl":"https://doi.org/10.4038/sljm.v32i1.434","url":null,"abstract":"No abstract available","PeriodicalId":53258,"journal":{"name":"Sri Lanka Journal of Forensic Medicine Science Law","volume":"64 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84899684","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}