Attempted one anastomosis gastric bypass converted to a sleeve gastrectomy in an adult patient with asymptomatic intestinal malrotation: A case report.

Unexpected encounters during surgery for obesity such as midgut malrotation cause specific technical challenges to the surgeon. We present a rare case of asymptomatic complete intestinal malrotation midway during a one anastomosis gastric bypass procedure. A 62-year-old male with a body mass index of 49 kg/m and metabolic syndrome was planned for one anastomosis gastric bypass.

Translation, cross-cultural adaptation, and validation of the Duke Activity Status Index (DASI) to Sinhala language.

Background: Duke Activity Status Index (DASI) is a widely used tool to assess functional capacity among patients, but there is no Sinhala version validated for patients in Sri Lanka. This study aimed to cross-culturally adapt and test the validity and reliability of the Sinhala version of DASI (DASI-S).

Methods: The translation and cross-cultural adaptation of the DASI questionnaire were conducted following the standard guidelines.

Neoadjuvant Chemoradiation for Rectal Cancer Achieves Satisfactory Tumour Regression and Local Recurrence - Result of a Dedicated Multi-disciplinary Approach from a South Asian Centre.

Background: Pre-operative long-course chemoradiotherapy (CRT) for rectal cancer has resulted in improvement in rates of restorative rectal resection and local recurrence by inducing tumour downstaging and downsizing. Total mesorectal excision (TME) is a standardised surgical technique of low anterior resection aimed at the prevention of local tumour recurrence. The purpose of this study was to evaluate tumour response following CRT in a standardised group of patients with rectal cancer.

A comprehensive review on electrospun nanohybrid membranes for wastewater treatment.

Electrospinning, being a versatile and straightforward method to produce nanofiber membranes, has shown significant advancement in recent years. On account of the unique properties such as high surface area, high porosity, mechanical strength, and controllable surface morphologies, electrospun nanofiber membranes have been found to have a great potential in many disciplines. Pure electrospun fiber mats modified with different techniques of surface modification and additive incorporation have exhibited enhanced properties compared to traditional membranes and are even better than the as-prepared electrospun membranes.

A novel structure for online surgical undergraduate teaching during the COVID-19 pandemic.

Background: The Covid-19 pandemic necessitated the delivery of online higher education. Online learning is a novel experience for medical education in Sri Lanka. A novel approach to undergraduate surgical learning was taken up in an attempt to improve the interest amongst the students in clinical practice while maximizing the limited contact time.

Place for elective cholecystectomy for patients with severe thalassaemia: a retrospective case control study.

Objective: At present, cholecystectomy is carried out for thalassaemia patients with gall stone disease only if they develop symptoms of cholecystitis, except in the rare instance where an un-inflammed gall bladder is removed simultaneously with splenectomy. We carried out this retrospective analysis of case records to examine if patients with thalassaemia have a higher rate of peri operative complications compared to non-thalassaemics with gall stone disease, warranting a change of policy to justify elective cholecystectomy.

Results: Case records of 540 patients with thalassaemia were retrospectively analysed of which 98 were found to have gallstones.

Effect of natural curcuminoids-intercalated layered double hydroxide nanohybrid against Staphylococcus aureus, Pseudomonas aeruginosa, and Enterococcus faecalis: A bactericidal, antibiofilm, and mechanistic study.

The study aimed to determine the antibacterial/antibiofilm effect and mechanism of interaction of curcuminoids-intercalated Mg/Al layered double hydroxide (curcuminoids-LDH) against three different bacteria. Antimicrobial effect of curcuminoids-LDH nanohybrid was investigated against P. aeruginosa, S.

Local infiltration versus laparoscopic-guided transverse abdominis plane block in laparoscopic cholecystectomy: double-blinded randomized control trial.

Background: Transverse abdominal plane block (TAP) is a new technique of regional block described to reduce postoperative pain in laparoscopic cholecystectomy (LC). Recent reports describe an easy technique to deliver local anesthetic agent under laparoscopic guidance.

Methods: This randomized control trial was designed to compare the effectiveness of additional laparoscopic-guided TAP block against the standard full thickness port site infiltration.

Colorectal cancer burden and trends in a South Asian cohort: experience from a regional tertiary care center in Sri Lanka.

Objective: Colorectal cancer (CRC) burden is increasing in the south Asian region due to the changing socio-economic landscape and population demographics. There is a lack of robust high quality data from this region in order to evaluate the disease pattern and comparison. Using generalized linear models assuming Poisson distribution and model fitting, authors describe the variation in the landscape of CRC burden along time since 1997 at a regional tertiary care center in Sri Lanka.

Overall Survival of Elderly Patients Having Surgery for Colorectal Cancer Is Comparable to Younger Patients: Results from a South Asian Population.

Introduction: There has been a continuous debate on whether elderly patients with colorectal cancer (CRC) fair worse. The aim of this study is to assess the thirty-day mortality (TDM) and overall survival (OS) of elderly patients undergoing surgery for CRC.

Method: OS between two groups (≥70 versus <70 years) having surgery for CRC was analyzed.

A Survey of Knowledge and Practices of Transfusion Medicine Among Post Intern Doctors in Specialized Hospital in Sri Lanka.

Background: Knowledge of transfusion medicine is the key element of better transfusion practices. This deficit observed at the blood bank end on daily basis exposing the patients for redundant risk. We assessed the knowledge of transfusion medicine among post intern doctors.

Comparison of hazard of death following surgery for colon versus rectal cancer.

Intorduction: Prognosis in cancer is usually assessed by use of Kaplan-Meier survival function estimate curves, which reflect survival, or the proportion of patients that will remain alive after a particular event at a given time. By contrast, hazard function represents the proportion expected to be deceased among those surviving at a given time after an event. Objectives To evaluate survival and hazard of death, in patients with colon cancer (CC) and rectal cancer (RC), as indices of prognosis.

Natural curcuminoids encapsulated in layered double hydroxides: a novel antimicrobial nanohybrid.

Currently, there is an increased scientific interest to discover plant based drug formulations with improved therapeutic potential. Among the cornucopia of traditional medicinal plants, Curcuma longa rhizomes have been used as a powerful antibacterial and antifungal agent. However, its practical applications are limited due to its instability under thermal and UV radiation and its low bioavailability and the extensive procedures needed for isolation.

The possible advantages of cryoprecipitate prepared from fresh frozen plasma from blood stored for 24 hours.

Background: To compare the coagulation-factor profile of cryoprecipitate produced from fresh frozen plasma from whole blood (WB) stored for 24 hours at room temperature (24CP) with that of standard cryoprecipitate (CP).

Methods: We collected 80 units of WB from healthy volunteers, of which 20 units were of each blood group. Each unit of blood was divided into 2 parts.

Total number of lymph nodes harvested is associated with better survival in stages II and III colorectal cancer.

Background: Lymph node status is important in staging colorectal cancer (CRC). Presence of metastatic nodes differentiates stage III from stage II. The role of adjuvant therapy is still unclear in stage II CRC.

Pre-operative hypoalbuminaemia predicts poor overall survival in rectal cancer: a retrospective cohort analysis.

Background: Serum albumin is a marker of nutrition and inflammation. It has recently emerged as a predictor of outcome after surgery for rectal cancer. Our aim was to evaluate if pre-operative serum albumin would predict survival after resection for rectal cancer.

Proximal and distal rectal cancers differ in curative resectability and local recurrence.

Aim: To evaluate patients with proximal rectal cancer (PRC) (> 6 cm up to 12 cm) and distal rectal cancer (DRC) (0 to 6 cm from the anal verge).

Methods: Two hundred and eighteen patients (120 male, 98 female, median age 58 years, range 19-88 years) comprised 100 with PRC and 118 with DRC. The proportion of T1, T2 vs T3, T4 stage cancers was similar in both groups (PRC: T1+T2 = 29%; T3+T4 = 71% and DRC: T1+T2 = -31%; T3+T4 = 69%).

Uses of a familial adenomatous polyposis registry.

Objectives: To improve the prognosis of patients with familial adenomatous polyposis (FAP) by early diagnosis and prophylactic treatment through a coordinated FAP register.

Design: The establishment and descriptive analysis of the prospective database of the FAP registry.

Setting: University surgical unit, Colombo North Teaching Hospital Ragama, Sri Lanka.

Idiopathic pancreatitis is a consequence of an altering spectrum of bile nucleation time.

Background: The pathogenesis of idiopathic pancreatitis (IP) remains poorly understood. Our hypothesis is that IP is a sequel of micro-crystallization of hepatic bile.

Methods: A prospective case control study compared 55 patients; symptomatic cholelithiasis - 30 (14 male, median age 36 years; mean BMI - 25.

Young patients with colorectal cancer have poor survival in the first twenty months after operation and predictable survival in the medium and long-term: analysis of survival and prognostic markers.

Objectives: This study compares clinico-pathological features in young (<40 years) and older patients (>50 years) with colorectal cancer, survival in the young and the influence of pre-operative clinical and histological factors on survival.

Materials And Methods: A twelve year prospective database of colorectal cancer was analysed. Fifty-three young patients were compared with forty seven consecutive older patients over fifty years old.

Synchronous liver metastasis in colorectal cancer in Sri Lanka.

Objective: To assess the incidence of synchronous colorectal liver metastasis in patients referred to a tertiary referral center in Sri Lanka and to evaluate the differences in the clinicopathological features of patients with and without synchronous metastasis.

Methods: Records of 438 patients were retrospectively analyzed. Patients were classified into metastatic group (n = 34, 8%) and non metastastatic group (n = 404, 92%).

Laparoscopy as a diagnostic and therapeutic option in evaluating chronic unexplained right iliac fossa pain.

Background: Management of chronic right iliac fossa (CRIF) pain is poorly documented in literature. No guidelines are available on the best therapeutic approach.

Method: Patients presenting from October 2007 to August 2009 with pain persisting or recurring in right lower abdomen over a period of 6 weeks or more were assessed.

Assessment of 'nucleation time' as a predictor of cholelithiasis.

Introduction: In the formation of gallstones, crystal nucleation is a key step, which is followed by precipitation and gradual growth of cholesterol crystals.

Materials And Methods: A case-control study was carried out among 60 patients (30 patients, 14 males and 16 females, median age of 36 years, range 33-71 years, body mass index (BMI)=25.1+/-0.

Prevalence of colorectal cancer and survival in patients from the Gampaha District, North Colombo region.

Introduction: The prevalence and survival of colorectal cancer in Sri Lankans has not been previously reported. We did a retrospective and a prospective survey, in the region of North Colombo, Sri Lanka between 1992 and 2004. The aim was to study cancer burden, sites of colorectal cancer and survival after surgery.

Biofeedback with and without surgery for fecal incontinence improves maximum squeeze pressure, saline retention capacity and quality of life.

Introduction: Fecal incontinence (FI) impairs quality of life. We performed an audit of biofeedback (BFB) in management of patients with FI.

Methods: Fifty patients (median [range] age 30 [4-77] years; 28 men) who received BFB for median (range) of 15 weeks (4-28), either postoperatively (n=39), or as the sole treatment (n=11) were evaluated.