Impact of histopathological parameters in prognosis of oral squamous cell carcinoma.

Objective: Squamous cell carcinomas comprise approximately 90% of all oral malignancies. There is a wide geographical variation in the incidence of oral cancer, with South and South East Asia (SSEA) accounting for almost two third of new cases. The prognosis of oral cancer is influenced by a vast array of factors including demographic, clinical, histopathological and molecular factors.

Effect of different forms of coconut on the lipid profile in normal free-living healthy subjects: A randomized controlled trial (Phase II).

Background: It has been postulated that the lipid effects of coconut could be mediated by its fatty acids, fiber and lysine/arginine ratio. Hence, the lipid effects of coconut oil could be different from the effects of the kernel flakes or milk extract because the constituents could be different in each coconut preparation. The present research investigated the lipid effects of different modes of coconut used in food preparation.

Management, characteristics and outcomes of patients with acute coronary syndrome in Sri Lanka.

Background: Ischaemic heart disease is the leading cause of in-hospital mortality in Sri Lanka. Acute Coronary Syndrome Sri Lanka Audit Project (ACSSLAP) is the first national clinical-audit project that evaluated patient characteristics, clinical outcomes and care provided by state-sector hospitals.

Methods: ACSSLAP prospectively evaluated acute care, in-hospital care and discharge plans provided by all state-sector hospitals managing patients with ACS.

The effect of thriphala, a herbal Ayurveda formulation, on serum lipids, in patients on a maintenance dose of atorvastatin for hyperlipidaemia: a randomized controlled trial.

Introduction: Thriphala, a herbal medicinal formulation, is a bedrock of Ayurveda therapeutics with many postulated benefits.

Objectives: We performed a clinical trial to test the effects of Swastha Thriphala®, a proprietary preparation of thriphala, on serum lipid parameters in patients receiving atorvastatin.

Methods: Consenting adults receiving a maintenance dose of atorvastatin 10mg (Atorlip®) daily from a clinic of the Institute of Cardiology, National Hospital of Sri Lanka for lipid regulation, were randomly assigned, after counselling, to receive either the proprietary herbal medicinal product Swastha Thriphala® (Treatment Group, n= 101) or a placebo (Control Group n= 97), at the stipulated dose daily, for three calendar months.

Leg edema with (S)-amlodipine vs conventional amlodipine given in triple therapy for hypertension: a randomized double blind controlled clinical trial.

Background: Leg edema is a common adverse effect of dihydropyridine Calcium Channel Blockers (CCB) that may need dose reduction or drug withdrawal, adversely affecting the antihypertensive efficacy. Leg edema is reported to occur less often with (S)-amlodipine compared to conventional racemic amlodipine. We aimed to find the incidence of leg edema as a primary outcome and antihypertensive efficacy with (S)-amlodipine compared to conventional amlodipine.

Intralesional corticosteroids as a treatment for restricted mouth opening in oral submucous fibrosis.

Objectives: Oral submucous fibrosis (OSF) is a chronic debilitating disease of the oral mucosa, associated with an increased risk of malignancy. The primary objective of this study was to evaluate the effectiveness of intralesional corticosteroid injection as a treatment modality for OSF. We also studied the correlation between the treatment outcome and a number of individual variables.

Oral submucous fibrosis: a historical perspective and a review on etiology and pathogenesis.

Oral submucous fibrosis (OSF) is a chronic, insidious disease characterized by progressive submucosal fibrosis of the oral cavity and the oropharynx. People affected by this disease mostly live in south Asia, but migrants from these countries to the United States and Europe may present with OSF. We provide a historical background of the disease, and the objective of this review is to update the current knowledge on the etiology and etiopathogenesis of OSF.

Oral submucous fibrosis: review on mechanisms of malignant transformation.

Research studies focusing on various aspects of carcinogenesis in the background of fibrosis have advanced significantly in the recent past, allowing us to understand the mechanisms involved in malignant transformation of oral submucous fibrosis (OSF), the most prevalent potentially malignant oral disorder in South Asia. The role of areca nut as a carcinogen has been proven beyond doubt, with a large number of animal studies demonstrating its carcinogenicity, mutagenicity, and genotoxicity. Studies on the molecules implicated in cell cycle regulation, hypoxia, processes leading to DNA double-strand breaks, senescence, and many other pathways related to carcinogenesis have shown ample evidence for the malignant transformation in OSF induced by areca nut.

A re-audit of the management of gonorrhoea.

A re-audit of the management of gonorrhoea was undertaken in 2014. Six out of nine auditable outcomes were met in the second audit (2014) compared with three out of eight in the first audit (2012). The new measures that were introduced following the original audit may have helped to improve outcomes.

Knowledge assessment regarding secondary prevention of coronary heart disease--a multi centre survey.

Background: Cardiovascular Disease (CVD) is a major cause of mortality worldwide. Control and reduction of cardiovascular risk factors such as elevated blood pressure, high cholesterol levels, excess of body weight, smoking and lack of exercise can contribute to a reduction of CVD mortality.

Methods: A standardized questionnaire was administered to all medical officers willing to participate in the study, who were working in the Cardiology Units all over Sri Lanka to assess the source of continuous medical education, attitudes on secondary prevention, barriers to secondary prevention and knowledge assessment of secondary prevention of cardiovascular diseases.

A case of pseudocyanosis.

Cyanosis is an ominous physical sign indicating significant cardiac or respiratory disease. However, bluish discolouration mimicking cyanosis could occur in methaemoglobinaemia. The clinical implications being very different, it is important that the aetiology of bluish discolouration of tissues is correctly identified.

Impact of a traditional dietary supplement with coconut milk and soya milk on the lipid profile in normal free living subjects.

Background. The effects of coconut fat and soya fat on serum lipids are controversial. This study was designed to investigate the lipid effects of coconut milk and soya milk supplementation on the lipid profile of free living healthy subjects.

Precipitant profile of acute heart failure: experience of a tertiary level cardiac centre in Sri Lanka.

Introduction And Objectives: Heart failure (HF) is a common cause of hospitalisation in most countries. Data on acute precipitants of HF and hospitalisation is not available in Sri Lanka.

Background And Methods: A prospective study of 100 sequential admissions with HF to the cardiology unit (National Hospital of Sri Lanka) to describe the precipitants and clinical outcome of HF.

A case series of the management of symptomatic azole-resistant candida.

Patients with symptomatic azole-resistant Candida albicans or non-albicans candida are difficult to manage. Treatment is largely anecdotal due to the relatively small number of patients. We present six case reports which highlight our own observation in clinical practice including four patients who were treated successfully with topical amphotericin B/flucytosine vaginal gel for 14 days (Stoke-on-Trent formula).

Performance against local service quality indicators: re-setting the indicators.

Local service quality indicators (SQIs) both for genitourinary medicine and HIV were drafted following patient and public involvement in 2009. At that time there were few published data to help in setting some of the original SQIs. Our clinical performance was audited against these SQIs in 2009 and subsequently re-audited in 2010 and 2011.

Patient-delivered partner therapy in the UK: what do patients think?

The aim of this study was to determine the proportion of genitourinary (GU) medicine patients attending a mixed urban/rural clinic who would welcome patient-delivered partner therapy (PDPT) as a partner management option. Five hundred patients completed the questionnaire. Acceptability of traditional partner referral was 87% (435), partner referral with infection specific guidance was 82% (411) and PDPT was 81% (405).