Duplication of the gallbladder: An intraoperative finding during laparoscopic cholecystectomy.

Introduction: Duplication of the gallbladder is a rare congenital malformation associated with the development of cholelithiasis. It increases the risk of iatrogenic bile duct injury during cholecystectomy and can lead to symptom recurrence if missed. Although preoperative imaging is helpful, detection rates are around 50 %.

Pyrexia With Pancytopenia: An Uncommon Presentation of Kikuchi Disease.

Kikuchi-Fujimoto disease is a rare systemic illness commonly affecting young females with a higher tendency to occur in the Asian population. Clinical presentation varies with most patients presenting with fever and cervical lymphadenopathy. The patient discussed in this case report presented to a tertiary care hospital in Sri Lanka with a fever for two weeks and palpable cervical lymphadenopathy.

A rare case of acute myocardial infarction with heart failure following hump-nosed viper bite in a Sri Lankan female.

Background: Hump-nosed viper (Hypnale species) bites are an important cause of mortality and morbidity in southern India and Sri Lanka, accounting for 27 and 77% of venomous snake bites, respectively. Previously, we knew them to be moderately venomous snakes, primarily causing local envenomation. However, recent reports have indicated severe systemic envenomation incidents, which include hemostatic dysfunction, microangiopathic hemolysis, kidney injury, myocardial toxicity, and even death.

Multiple schwannomas of bilateral posterior tibial nerves - A case report and review of literature.

Introduction: Schwannoma is a type of slow growing benign nerve sheath tumor arising from Schwann cells. Peripherally, they are found in association with the ulnar, sciatic and posterior tibial nerves. Peripheral schwannomas, neurofibromas and malignant PNSTs are collectively grouped as peripheral nerve sheath tumors.

Sequential pulmonary functions in survivors of leptospirosis pulmonary haemorrhage syndrome: a prospective cohort study.

Background: Leptospirosis, a spirochaete infection, can lead to Leptospirosis Pulmonary Haemorrhage Syndrome (LPHS), which requires intensive care admission and has a high mortality. Although data on short-term outcomes are available, the long-term respiratory sequelae of LPHS survivors are not known. We aimed to identify the post-discharge pulmonary functions and functional limitations in survivors of LPHS.

Unravelling a mystery of hypokalemic hypertension- a rare case report of a reninoma.

Background: Reninoma is a rare cause of secondary hypertension, which can be cured with surgery if identified early before any target organ damage occurs. It leads to hypokalaemia and hypertension and typically responds well to treatment with renin-angiotensin-aldosterone system blockers. However, confirmation of the diagnosis and the localisation of this rare culprit lesion can be challenging.

An Atypical Case of Acute Pulmonary Embolism in a Sri Lankan Patient With Acute Severe Pancreatitis With Heterozygosity for the SPINK 1 Mutation.

Acute pancreatitis is a disease characterized by local destruction of the pancreatic gland due to premature activation of pancreatic enzymes within the acinar cells. Tissue damage can activate an inflammatory cascade, which can lead to systemic complications. Although vascular complications are uncommon, they significantly contribute to mortality and morbidity.

Regional hotspots for chronic kidney disease: A multinational study from the ISN-GKHA.

Chronic kidney disease (CKD) disproportionately affects certain populations as demonstrated by well-established subnational geographic hotspots of CKD in Central America and South Asia. Using data from the third iteration of the International Society of Nephrology Global Kidney Health Atlas (ISN-GKHA), we aimed to systematically identify sub-national geographic or population clusters with high prevalence of CKD. The ISN-GKHA survey was conducted from July to September 2022, and included questions regarding whether a regional CKD hotspot existed in the respondents' country and possible contributors.

Tracheobronchial amyloidosis following COVID-19 infection.

Deposition of amyloid proteins in extracellular space can occur due to uncontrolled inflammatory processes. Tracheobronchial amyloidosis (TBA) is a rare form of such disease. A 68-year-old woman was evaluated for chronic cough following a COVID-19 infection.

Nine fatal cases of dengue: a case series from an intensive care unit in Sri Lanka.

Background: The case fatality rate of untreated dengue is 20%; it can be reduced to less than 1% with optimal management. The leading causes of death in dengue patients are shock, bleeding, and acute liver injury. We describe the clinical features of patients who died of dengue and discuss the therapeutic challenges and pitfalls of complicated dengue.

Impostor phenomenon and self- reported satisfaction among medical and surgical postgraduate trainees in Sri Lanka.

Background: Psychological phenomena such as impostor phenomenon (IP) and low work-related satisfaction increase the risk of burnout among medical professionals. The prevalence of these contributory risk factors among South Asian medical professionals has not been examined thus far. This study aims to assess the prevalence, severity and associations of IP, including self-reported satisfaction with training, in a cohort of postgraduate doctors in Sri Lanka.

Feasibility of implementing a communication board to improve communication interactions of mechanically ventilated patients in intensive care units at one Sri Lankan hospital - A pilot randomised controlled trial.

Objective: To evaluate the feasibility of implementing a communication board in intensive care units in terms of participant recruitment and retention, intervention fidelity, and ability to collect patient outcome data.

Design: A prospective, two-arm, unblinded, pilot randomised controlled trial.

Research Methodology: Adult, conscious, mechanically ventilated intensive care patients were recruited between August and November 2023.

Role of Obeticholic Acid, a Farnesoid X Receptor Agonist, in Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-analysis.

Obeticholic acid (OCA) has emerged as a promising drug in the management of nonalcoholic fatty liver disease (NAFLD). This meta-analysis aimed to analyse the therapeutic effect of OCA on NAFLD. Randomized controlled trials (RCTs) involving patients with NAFLD receiving OCA in the intervention arm and placebo in the control arm were searched throughout the electronic databases.

Emerging Digital Technologies Used for Fall Detection in Older Adults in Aged Care: A Scoping Review.

Objective: To explore a comprehensive overview of digital technologies used for fall detection in older adults, categorizing the types, functions, and usability of these systems.

Design: A scoping review was conducted to search across 5 databases [Embase, Medline (OVID), CINAHL, Coherence and IEEE Explore] from January 2013 to September 2023.

Setting And Participants: Studies in older adults living in nursing homes, care homes, residential homes, respite care homes, and all skilled and ambulatory care facilities (without context restrictions).

Impulse control disorders and other non-motor symptoms in Sri Lankan patients with Parkinson's disease.

The impact of non-motor symptoms is often overlooked in favour of the motor symptoms when managing Parkinson's disease resulting in suboptimal patient outcomes. This study aimed to characterise the non-motor symptoms of Parkinson's disease in a cohort of Sri Lankan patients with a special focus on the impulsive control disorders and other compulsive behaviours (ICDs-CB) that had not been previously studied in this population. All patients with idiopathic Parkinson's disease followed up at the National Hospital of Colombo, Sri Lanka were included.

Evaluation of automatic tube current modulation in a CT scanner using a customised homogeneous phantom.

The introduction of automatic tube current modulation (ATCM) has resulted in complex relationships between scanner parameters, patient body habitus, radiation dose, and image quality. ATCM adjusts tube current based on x-ray attenuation variations in the scan region, and overall patient dose depends on a combination of factors. This work aims to develop mathematical models that predict CT radiation dose and image noise in terms of attenuating diameter and all relevant scanner parameters.

Rituximab induced cerebral venous sinus thrombosis in a patient with anti-N-methyl-D-aspartate receptor-antibody encephalitis: a case report and review of literature.

Background: Cerebral venous sinus thrombosis has not been reported in anti-N-methyl-D-aspartate receptor-antibody encephalitis in the absence of an underlying thrombotic state while rituximab induced cerebral venous sinus thrombosis is rarely reported. We report a patient with anti-N-methyl-D-aspartate receptor-antibody encephalitis without a prothrombotic state who developed cerebral venous sinus thrombosis following rituximab treatment.

Case Presentation: A 15-year-old Sri Lankan girl who had been in remission following an episode of anti-N-methyl-D-aspartate receptor-antibody encephalitis 2 years ago, presented with a relapse of anti-N-methyl-D-aspartate receptor-antibody encephalitis characterized by recurrent seizures, mutism, and cognitive abnormalities.