Augmentative and alternative communication tools for mechanically ventilated patients in intensive care units: A scoping review.

Objectives: The aim of this scoping review was to understand the extent and type of evidence on augmentative and alternative communication tools used with mechanically ventilated patients in the intensive care unit.

Review Method Used: This scoping review was conducted using Arksey and O'Malley's methodological framework, followed by PAGER (Patterns, Advances, Gaps, Evidence for practice and Research recommendations) framework to provide a structured approach to analysis of reviews.

Data Sources: In December 2021, six electronic databases-CENTRAL, CINAHL, Embase, Medline (Ebscohost), PyscINFO, and Web of Science-were searched.

The first genetically authenticated case of Leber hereditary optic neuropathy in Sri Lanka: a case report and review of the literature.

Introduction: Leber hereditary optic neuropathy is a genetic disease of mitochondrial inheritance characterized by bilateral irreversible vision loss, predominantly affecting males. We report the first genetically authenticated Sri Lankan case of Leber hereditary optic neuropathy, illustrating its characteristic features of male predominance and variable penetrance.

Case Presentation: A 15-year-old previously healthy Sri Lankan boy presented with painless progressive vision loss in his right eye, followed by vision loss in his left eye within 3 months.

A study of acromegaly-associated headache with somatostatin analgesia.

The aim of this study is to characterise somatostatin analogue-responsive headache in acromegaly, hitherto not systematically documented in a significant cohort. Using the UK pituitary network, we have clinically characterised a cohort of 18 patients suffering from acromegaly-related headache with a clear response to somatostatin analogues. The majority of patients had chronic migraine (78%) as defined by the International Headache Society diagnostic criteria.

Dose reference level based on size-specific dose estimate (SSDE) and feasibility of deriving effective body diameter using tube current and time product (mAs) for adult chest and abdomen computed tomography (CT) procedures.

This study aimed to establish dose reference level (NDRLSSDE) based on size-specific dose estimate (SSDE) derived using effective diameter (Deff) for adult chest and abdomen computed tomography (CT) procedures and to explore the feasibility of drivingDeffusing the product of tube current and time (mAs). In this retrospective study, dose data, scan parameters and patient body dimensions at the mid-slice level from 14 CT units (out of 63 total) were extracted. Additionally, the mAs values of the axial slice at the same-location where the diameter measurements were made (mAs) were recorded.

Breast cancer in lactating mothers: A case series of delayed diagnosis.

Introduction And Importance: Due to pregnancy related changes in the breast, a breast feeding mother as well as the health care professionals may attribute a change in the breast for lactation resulting in a delay in evaluation and diagnosis. We report a cases series of delayed diagnosis of breast cancer during lactation in three young patients from a developing country who had sought medical attention on time but was unfortunately diagnosed late.

Presentation Of Case: We report three breast feeding mothers aged 38-39 years presenting with breast lump and edema.

Proliferative epithelial changes in tumour adjacent tissue in Sri Lankan women with breast carcinoma: do morphological changes support molecular models of breast carcinogenesis?

Background: The multistep molecular model of breast carcinogenesis is based on the oestrogen receptor(ER) status of the tumour. Its two main arms comprise ER-positive and ER-negative breast carcinomas(BCa), which are associated with Nottingham grade(NG) of the tumour and different proliferative epithelial changes. According to the model, columnar cell lesions(CCL), lobular carcinoma in-situ(LCIS) and atypical ductal hyperplasia(ADH), low-grade ductal carcinoma in-situ (LG-DCIS) are associated with low grade ER-positive tumours and microglandular adenosis (MGA), pleomorphic LCIS(PLCIS), high-grade DCIS(HG-DCIS) are associated with ER-negative high grade tumours.

Infarct Like Necrosis of Colorectal Liver Metastasis Without Chemotherapy: A Rare Phenomenon.

Usual type necrosis (UN) and infarct like necrosis (ILN) occur in CRLMs. ILN is a rare form of necrosis in colorectal liver metastases which is usually seen following chemotherapy. De novo occurrence of ILN is a very rare phenomenon.

A case report on secondary mesentero-axial gastric volvulus.

Mesentero-axial gastric volvulus is a rare presentation to a surgical casualty unit with sinister complications and significant mortality and morbidity. Clinical assessment should be done with high suspicion in the case of an associated anatomical defect. Accurate diagnosis and timely intervention would drastically reduce morbidity and mortality.

Prevalence of asthma and its symptoms in Sri Lankan adults.

Background: Data on adult asthma is scarce in Sri Lanka. The objective of this study was to estimate the prevalence of asthma and its symptoms in adult Sri Lankans.  METHODS: A cross-sectional study using a translated version of the European Community Respiratory Health Survey screening questionnaire on subjects ≥ 18 years from 7 provinces in Sri Lanka was conducted.

A rare case of acute liver failure with intrahepatic cholestasis due to dengue hemorrhagic fever: CytoSorb® and plasma exchange aided in the recovery: case report.

Background: Dengue haemorrhagic fever is a severe form of acute dengue infection characterized by leakage of plasma through capillaries into body spaces resulting in circulatory insufficiency leading to shock. Despite varying degrees of liver involvement occurring in acute dengue infection, intrahepatic cholestasis is very rare in the literature with only two cases reported so far. We report a challenging case of a middle-aged woman with DHF complicated by acute liver failure, coagulopathy, acute renal failure and prolonged intrahepatic cholestasis.

Empagliflozin in South Asians with type 2 diabetes: Real world data on effects on cardiometabolic parameters, safety and determinants of response to therapy from a diabetes practice in Sri Lanka.

Aims: SGLT2 inhibitors provide cardiovascular and renal protection in people with type 2 diabetes (T2DM). Real-world data on their effect on improving glucose and cardiovascular risk factors, and adverse effects in South Asians are limited.

Methods: We retrospectively analyzed clinical, demographic, anthropometric and biochemical data among adults with T2DM, commenced on empagliflozin and followed up for at least one month in a diabetes clinic in Colombo.

A case report of subacute thyroiditis after inactivated SARS-CoV-2 vaccine.

Subacute thyroiditis is an inflammatory thyroid disorder. It is often triggered following viral infections. Amid the current COVID-19 pandemic, several cases of subacute thyroiditis were reported worldwide related to SARS-CoV-2 infection and vaccines.

Higher Risk of Acute Respiratory Distress Syndrome and Risk Factors among Patients with COVID-19: A Systematic Review, Meta-Analysis and Meta-Regression.

Objective: To estimate the global risk and risk factors associated with acute respiratory distress syndrome (ARDS) among patients with COVID-19: Design: A systematic review, meta-analysis and meta-regression.

Setting And Participants: Hospitals or nursing homes and patients with acute respiratory distress syndrome after COVID-19.

Methods: The literature review was systematically conducted on Embase, MEDLINE, CINAHL, and Web of Science, in addition to manual searches and reference list checking from 1 January 2019 to 2 March 2022.

Evaluation of socio-demographic and clinical characteristics of PCOS patients attending a tertiary care institute in Colombo.

Background And Objectives: Polycystic ovary syndrome (PCOS) is a common endocrine disorder with heterogeneous aetiology. It is characterized by irregular menses and or oligo/anovulation, hyper-androgenism, and polycystic ovaries. The prevalence and diagnosis of PCOS changes depending on which clinical criteria are utilized to confirm the diagnosis.

Clinical Presentation and Genetic Heterogeneity Including Two Novel Variants in Sri Lankan Patients With Infantile Sandhoff Disease.

Infantile Sandhoff Disease (SD) is a subtype of GM2 gangliosidosis, which is never been reported in Sri Lanka. Data of eight children, who were diagnosed with SD during the period of 2017 to 2021, were analyzed retrospectively. The aim of this study was to analyze genotypic and phenotypic variations of native SDs.

All in a scent - naphthalene dependence confined to pregnancy: a case report.

Background: Inhalant or volatile substance use is a health issue with significant medical and psychiatric sequelae. Inhalants or volatile substances are volatile organic substances found in domestic and commercial products which are inhaled to obtain pleasurable effects. They are easily accessible, cheap, and legal.

Spontaneous omental infarction: A rare case of acute abdomen.

Omental infarction is a rare but a sinister cause of acute abdomen. Preoperative diagnosis is challenging due to its rare nature. It poses nonspecific abdominal signs that can be easily mistaken with other more common intra-abdominal pathologies.

Dynamic changes in quality of life, psychological status, and body image in women who underwent a mastectomy as compared with breast reconstruction: an 8-year follow up.

Background: Surgical decisions and methods of surgery highly influence long term QoL for breast cancer (BC) survivors. This study is aimed towards an exploration of the dynamic changes in quality of life (QoL), anxiety/depression status, and body image (BI) among women with BC who received a mastectomy compared with those receiving breast reconstruction (BR) within an 8-year follow-up period.

Methods: Women with major BC surgeries were invited to complete the World Health Organization Quality of Life-Brief (WHOQOL-BREF), the European quality of life five dimensions questionnaire (EQ-5D), and a body image scale within 8 years of surgery.

Patients' knowledge about medicines improves when provided with written compared to verbal information in their native language.

Background: Patient's knowledge on the medicines prescribed is vital in reducing medication errors and improving adherence and patient satisfaction. This study assessed the patients' knowledge on medicines prescribed and compared improvement following verbal or written information given in patients own language.

Methods: Seventy-five trainee pharmacists randomised to verbal or written groups, provided information to consecutive consenting patients attending medical and surgical clinics in the outpatient department of National Hospital of Sri Lanka.

Parent perspectives on augmentative and alternative communication in Sri Lanka.

Parental support is an important part of introducing an augmentative and alternative communication (AAC) system to a child. Professionals providing AAC services to children with complex communication needs should practice family-centered service provision. The aim of this study was to explore Sri Lankan parents' perspectives on AAC and their lived experiences.

Parathyroid carcinoma during pregnancy: a novel pathogenic CDC73 mutation - a case report.

Background: Parathyroid carcinoma is an uncommon cause of PTH-dependent hypercalcemia. Only a handful of cases have been reported of parathyroid carcinoma during pregnancy.

Case Presentation: Twenty-four - Year - old female presented with proximal myopathy was found to have hypercalcemia.

Adaptation and Validation of a Sinhala version of the Radbound Oral Motor Inventory (ROMP) for Parkinson's disease.

Background: The Radboud Oral Motor Inventory for Parkinson's disease (ROMP) is a patient-rated assessment measuring patients' perceptions of speech, swallowing, and saliva control among patients with idiopathic Parkinson's disease (IPD).

Objective: The present study was carried out to adapt and validate the Sinhala version of the ROMP questionnaire in a Sinhala-speaking patient cohort diagnosed with IPD.

Materials And Methods: The study population consisted of patients diagnosed with IPD attending a tertiary care neurology clinic at the National Hospital of Sri Lanka.

Endoscopic Retrograde Cholangiopancreatography in Children: Feasibility, Success, and Safety with Standard Adult Endoscopes and Accessories.

Purpose: The role of endoscopic retrograde cholangiopancreatography (ERCP) in the management of hepatobiliary and pancreatic diseases in the pediatric population was not well defined until recently. Our aim was to determine the feasibility, outcomes, and safety of ERCP in a local pediatric population, particularly using standard adult endoscopes and accessories.

Methods: This retrospective study was conducted at the National Hospital of Sri Lanka.