Young-Onset Diabetes in Sri Lanka: Experience From the Developing World.

Young-onset diabetes (YOD) is characterised by unique diagnostic and management challenges more pronounced in resource-limited settings like Sri Lanka. We aimed to ascertain the prevalence, patterns and characteristics of YOD in Sri Lanka and describe the state of care. Retrospective review of baseline data of all patients enrolled in the prospective multicentre Database for Young-Onset Diabetes, Sri Lanka (DYOD-SL), was performed, from April 2021 to April 2023.

Rapid supervised levothyroxine absorption test in refractory hypothyroidism: suggestion for assessing absorption using two blood samples in low-resource settings.

Refractory hypothyroidism is associated with high morbidity and increased healthcare expenditure. In general, the use of the levothyroxine absorption test looks promising in evaluating refractory hypothyroidism but has shown significant variability in protocols in multiple settings. We intended to assess the usefulness of the levothyroxine absorption test in a low-resource setting and to assess the factors associated with refractory hypothyroidism.

Neurological disorders associated with COVID-19 in Sri Lanka.

Background: Neurological manifestations of SARS-CoV-2 infection have been reported from many countries around the world, including the South Asian region. This surveillance study aimed to describe the spectrum of neurological disorders associated with COVID-19 in Sri Lanka.

Methods: COVID-19 patients manifesting neurological disorders one week prior and up to six weeks after infection were recruited from all the neurology centres of the government hospitals in Sri Lanka from May 2021 - May 2022.

Future of medical research in Sri Lanka: amidst economic chaos.

Sri Lanka is facing an economic crisis and medical research is significantly affected at present with researchers facing many obstacles. Urgent remedial measures are required to overcome the current situation if medical research is to continue in Sri Lanka.

Effects of fungicide chlorothalonil on freshwater plankton communities: a microcosm study.

Direct and indirect effects of the fungicide chlorothalonil on aquatic plankton community structure were investigated by exposing plankton to chlorothalonil concentrations of 0.010, 0.025, 0.

Batch and fixed bed sorption of low to moderate concentrations of aqueous per- and poly-fluoroalkyl substances (PFAS) on Douglas fir biochar and its FeO hybrids.

Per- and poly-fluoroalkyl substances (PFAS) can cause deleterious effects at low concentrations (70 ng/L). Their remediation is challenging. Aqueous μg/L levels of PFOS, PFOS, PFOSA, PFBS, GenX, PFHxS, PFPeA, PFHxA, and PFHpA (abbreviations defined in Table 1) multi-component adsorption (pH dependence, kinetics, isotherms, fixed-bed adsorption, regeneration, complex matrix) was studied on commercial Douglas fir biochar (BC) and its FeO-containing BC.

What drives the pesticide user practices among farmers in tropical regions? A case study in Sri Lanka.

Pesticides are widely used in tropical regions of the world, and therefore explorations of user practices and drivers of pesticide usage among farmers are important for sustainable agriculture. Therefore, perceptions, knowledge, and drivers leading to the practices of pesticide use among farmers were explored using a semi-structured questionnaire survey using 246 farmers in upcountry vegetable growing areas and low country field crop cultivation areas in tropical Sri Lanka. The study revealed a significant increase in pesticide usage in upcountry vegetable growing areas.

Effect of acid modified tea-waste biochar on crop productivity of red onion (Allium cepa L.).

Biochar has widely been utilized as an agricultural soil amendment owing to its enhanced surface properties and cost-effectiveness. In the present work, the influence of tea waste biochar (TWBC) upon acid modification on Allium cepa L. (red onion) growth has been studied.

Laparoscopic Bilateral Adrenalectomy in a Young Female Patient with Recurrent Cushing's Disease.

Introduction: Synchronous bilateral adrenalectomy is undertaken less often due to numerous perioperative challenges and rare circumstances of patients needing this procedure. Bilateral adrenalectomy is an important second-line option for patients with persistent or recurrent hypercortisolism following transsphenoidal surgery for Cushing's disease. Here, we present a challenging case of synchronous laparoscopic bilateral adrenalectomy for a young female patient with recurrent Cushing's disease and fertility wishes.

Predicting survival in malignant pleural mesothelioma using routine clinical and laboratory characteristics.

Introduction: The prognosis of malignant pleural mesothelioma (MPM) is poor, with a median survival of 8-12 months. The ability to predict prognosis in MPM would help clinicians to make informed decisions regarding treatment and identify appropriate research opportunities for patients. The aims of this study were to examine associations between clinical and pathological information gathered during routine care, and prognosis of patients with MPM, and to develop a 6-month mortality risk prediction model.

Biochar based sorptive remediation of steroidal estrogen contaminated aqueous systems: A critical review.

Remediation of steroidal estrogens from aqueous ecosystems is of prevailing concern due to their potential impact on organisms even at trace concentrations. Biochar (BC) is capable of estrogen removal due to its rich porosity and surface functionality. The presented review emphasizes on the adsorption mechanisms, isotherms, kinetics, ionic strength and the effect of matrix components associated with the removal of steroidal estrogens.

Seeking the unseen: Localization and surgery for an occult sporadic insulinoma.

Insulinomas are rare pancreatic neuroendocrine tumours and the commonest cause for endogenous hyperinsulinaemic hypoglycemia. Small tumours are not easily detected by conventional cross-sectional imaging making localization prior to surgical removal a challenge. Selective arterial calcium stimulation is an invaluable adjunct to localization in such circumstances.

A Rare Presentation of Coinfection: Dengue Virus and Hepatitis A Virus.

Dengue fever caused by dengue virus is a common tropical infection transmitted by the mosquitos and . Four strains of the genus flavivirus is responsible for the epidemics of varying severity. Hepatitis A caused by hepatitis A virus is spread by faecal-oral route.

Microwave and open vessel digestion methods for biochar.

Digestion of biomass derived carbonaceous materials such as biochar (BC) can be challenging due to their high chemical recalcitrance and vast variations in composition. Reports on the development of specific sample digestion methods for such materials remain inadequate and thus require considerable attention. Nine different carbonaceous materials; slow-pyrolyzed tea-waste and king coconut BC produced at 300 °C, 500 °C and 700 °C, sludge waste BC produced at 700 °C, wet fast-pyrolyzed Douglas-Fir BC and steam activated coconut shell BC have been tested to evaluate a relatively fast and convenient open-vessel digestion method using seven digestion reagents including nitric acid (NA), fuming nitric acid (FNA), sulfuric acid (SA), NA/SA, FNA/SA, NA/HO and SA/HO mixtures.

Removal of Arsenic(III) from water using magnetite precipitated onto Douglas fir biochar.

Magnetic FeO/Douglas fir biochar composites (MBC) were prepared with a 29.2% wt. FeO loading and used to treat As(III)-contaminated water.

Glyphosate's Synergistic Toxicity in Combination with Other Factors as a Cause of Chronic Kidney Disease of Unknown Origin.

Chronic kidney disease of unknown etiology (CKDu) is a global epidemic. Sri Lanka has experienced a doubling of the disease every 4 or 5 years since it was first identified in the North Central province in the mid-1990s. The disease primarily affects people in agricultural regions who are missing the commonly known risk factors for CKD.

Recovery of the Hypothalamo-Pituitary-Adrenal Axis After Transsphenoidal Adenomectomy for Non-ACTH-Secreting Macroadenomas.

Context: Secondary adrenal insufficiency is a potential complication of transsphenoidal adenomectomy (TSA). Most centers test recovery of the hypothalamo-pituitary-adrenal (HPA) axis after TSA, but, to our knowledge, there are no data predicting likelihood of recovery or the frequency of later recovery of HPA function.

Objective: To assess timing and predictors of HPA axis recovery after TSA.

The influence of three acid modifications on the physicochemical characteristics of tea-waste biochar pyrolyzed at different temperatures: a comparative study.

Tea-waste is an abundant feedstock for producing biochar (BC) which is considered to be a cost effective carbonaceous adsorbent useful for water remediation and soil amendment purposes. In the present study, tea-waste BC (TWBC) produced at three different temperatures were subjected to nitric, sulfuric and hydrochloric acid modifications (abbreviated as NM, SM and HM respectively). Characteristics of the raw and modified BC such as ultimate and proximate analyses, surface morphology, surface acidity and functionality, point of zero charge, cation exchange capacity (CEC) and thermal stability were compared to evaluate the influence of pyrolysis temperature and of modifications incorporated.

Sorptive removal of toluene and m-xylene by municipal solid waste biochar: Simultaneous municipal solid waste management and remediation of volatile organic compounds.

The remediation of volatile organic compounds (VOCs) from aqueous solution using Municipal solid waste biochar (MSW-BC) has been evaluated. Municipal solid waste was pyrolyzed in an onsite pyrolyzer around 450 C with a holding time of 30 min for the production of biochar (BC). Physiochemical properties of BC were assessed based on X-Ray Fluorescence (XRF) and Fourier transform infra-red (FTIR) analysis.

Early specialist palliative care on quality of life for malignant pleural mesothelioma: a randomised controlled trial.

Purpose: Malignant pleural mesothelioma (MPM) has a high symptom burden and poor survival. Evidence from other cancer types suggests some benefit in health-related quality of life (HRQoL) with early specialist palliative care (SPC) integrated with oncological services, but the certainty of evidence is low.

Methods: We performed a multicentre, randomised, parallel group controlled trial comparing early referral to SPC versus standard care across 19 hospital sites in the UK and one large site in Western Australia.

Physical activity levels of patients prior to acute coronary syndrome - Experience at a tertiary care hospital in Sri Lanka.

Objectives: Physical inactivity is associated with high cardiovascular risk. The purpose of this study was to study physical activity levels of patients with acute coronary syndrome (ACS).

Methodology: A total of 504 patients, from the Professorial Unit of the Colombo South Teaching Hospital completed the International Physical Activity Questionnaire (IPAQ).

Outpatient Talc Administration by Indwelling Pleural Catheter for Malignant Effusion.

Background: Malignant pleural effusion affects more than 750,000 persons each year across Europe and the United States. Pleurodesis with the administration of talc in hospitalized patients is the most common treatment, but indwelling pleural catheters placed for drainage offer an ambulatory alternative. We examined whether talc administered through an indwelling pleural catheter was more effective at inducing pleurodesis than the use of an indwelling pleural catheter alone.

Coexistence of Primary Hyperaldosteronism and Graves' Disease, a Rare Combination of Endocrine Disorders: Is It beyond a Coincidence-A Case Report and Review of the Literature.

Background: Primary hyperaldosteronism is a known cause for secondary hypertension. In addition to its effect on blood pressure, aldosterone exhibits proinflammatory actions and plays a role in immunomodulation/development of autoimmunity. Recent researches also suggest significant thyroid dysfunction among patients with hyperaldosteronism, but exact causal relationship is not established.