Cardiac arrest and atrial fibrillation in a patient after hump-nosed pit viper (Hypnale hypnale) bite.

A 42-year-old previously healthy male patient died 16 days after a proven hump-nosed pit viper (Hypnale hypnale) envenoming due to multi-organ failure. On admission he had cardiac arrest that recovered from cardiopulmonary resuscitation then developed atrial fibrillation which was reverted to normal rhythm by application of synchronized electrical cardioversion. He also had persistent coagulopathy and thrombotic microangiopathy comprising the triad of microangiopathic haemolysis, acute kidney injury and thrombocytopenia.

Circulating odd-chain saturated fatty acids were associated with arteriosclerosis among patients with diabetes, dyslipidemia, or hypertension in Sri Lanka but not Japan.

The differences in the morbidity and mortality of cardiovascular diseases between Sri Lankan and Japanese populations might be explained by the differences in their diet, especially fat. To test the hypothesis that the fatty acid (FA) compositions differ between Sri Lankan and Japanese populations and that high concentrations of n-3 polyunsaturated FAs and linoleic acid are associated with a low level of arteriosclerosis, the authors compared the circulating FA compositions between Sri Lankan and Japanese populations and examined the association of the circulating FA composition with arterial stiffness in each population. The study participants were patients with diabetes, dyslipidemia, or hypertension in Sri Lanka (n = 100) or Japan (n = 236).

Human infection with sub-periodic Brugia spp. in Gampaha District, Sri Lanka: a threat to filariasis elimination status?

Background: Post-mass drug administration (MDA) surveillance during the lymphatic filariasis (LF) elimination program in Sri Lanka, revealed the re-emergence of brugian filariasis after four decades. This study was done with the objectives of investigating the epidemiology and age-specific vulnerability to infection. Surveillance was done using night blood smears (NBS) and the Brugia rapid test (BRT), to detect microfilaria (MF) and anti-Brugia IgG4 antibodies in blood samples collected from an age-stratified population enrolled from two high-risk study areas (SA)s, Pubudugama and Wedamulla in the Gampaha District.

Rare Presentation of Refractory Thrombotic Thrombocytopenic Purpura: Jejunal Stricture.

Thrombotic thrombocytopenic purpura is a rare thrombotic disease characterized by episodes of thrombocytopenia and microangiopathic hemolytic anemia due to disseminated microvascular thrombosis. Thrombotic thrombocytopenic purpura was first described in 1924 by Moschowitz as a disease presenting with a pentad of signs and symptoms (anemia, thrombocytopenia, fever, hemiparesis and hematuria). Previous studies have described atypical manifestations of thrombotic thrombocytopenic purpura such as hemolysis, anemia and thrombosis.

Acute disseminated melioidosis giving rise to pneumonia and renal abscesses complicated with thrombotic thrombocytopenic purpura in a post partum woman: a case report.

Background: Melioidosis is an established endemic infection in Sri Lanka, caused by Burkholderia pseudomallei, a gram negative bacterium distributed in saprophytes in soil and surface water. Main mode of transmission is via percutaneous inoculation. Pneumonia is the most common presentation in acute disease.

Efficacy, Safety and Cost-Effectiveness of Thermotherapy in the Treatment of Induced Cutaneous Leishmaniasis: A Randomized Controlled Clinical Trial.

causes cutaneous leishmaniasis (CL) in Sri Lanka. Standard treatment is multiple, painful doses of intralesional sodium stibogluconate (IL-SSG). Treatment failures are increasingly reported, hence the need to investigate alternatives.

Unusual acute lupus hemophagocytic syndrome - a test of diagnostic criteria: a case report.

Background: Hemophagocytic lymphohistiocytosis is an aggressive life-threatening syndrome of excessive immune activation. Hemophagocytic lymphohistiocytosis due to systemic lupus erythematosus is described as acute lupus hemophagocytic syndrome. Acute lupus hemophagocytic syndrome presenting with negative antinuclear antibody is uncommon.

Application of a real time Polymerase Chain Reaction (PCR) assay for the early diagnosis of human leptospirosis in Sri Lanka.

Leptospirosis has a major impact on health in Sri Lanka but is probably grossly under-recognized due to difficulties in clinical diagnosis and lack of diagnostic laboratory services. The objective of this study was to establish and evaluate a SYBR Green-based real-time Polymerase Chain Reaction (rt-PCR) assay for early, rapid and definitive laboratory diagnosis of leptospirosis in Sri Lanka. The rt-PCR assay was established and analytical specificity and sensitivity were determined using reference DNA samples.

Use of Social Media in Facilitating Health Care Research Among Nursing and Allied Health Undergraduates in Sri Lanka.

A mentoring program was designed to promote conduction, completion and dissemination of undergraduate research among Nursing and Allied Health students in Sri Lanka. Several social media platforms were used; mainly the Facebook, YouTube and Google Hangouts. Knowledge sharing, interaction and collaboration were promoted.

Bilateral posterior fracture-dislocation of the shoulders following epileptic seizures: a case report and review of the literature.

Background: Bilateral posterior fracture-dislocation of the shoulders is an uncommon complication of grand mal seizures. We report a case of bilateral posterior dislocation of the shoulders with proximal humeral fractures following epileptic seizures. A posterior fracture-dislocation of the shoulder is very rare and can be caused by epileptic seizures, trauma, electrocution or electroconvulsive therapy.

Musculoskeletal symptoms, skin disorders and visual impairment among fishermen in the Divisional Secretariat Division of Kalpitiya.

Introduction: To describe musculoskeletal symptoms, skin disorders and visual impairment among fishermen in the Divisional Secretariat Division of Kalpitiya.

Methods: This was a community based descriptive cross sectional study conducted from August to October 2011. The sample consisted of 465 fishermen with ≥ 6 months experience in fishing selected using the cluster sampling technique.

Road traffic crashes, injury and fatality trends in Sri Lanka: 1938-2013.

Objective: To analyse trends in road traffic crashes, injuries and fatalities over 75 years in Sri Lanka.

Methods: Data on road traffic crashes, injuries and fatalities between 1938 and 2013 were obtained from the Police Statistics Unit. Rates per 100,000 population were calculated and trends were analysed using joinpoint regression analysis.

Factors associated with RTCs among for-hire three-wheeler drivers in Sri Lanka: a case-control study.

Objective: For-hire three-wheeler crashes are a growing burden in Sri Lanka. We conducted this study to examine the factors associated with road traffic crashes (RTCs) among for-hire three-wheeler drivers in Sri Lanka.

Methods: We conducted a case-control study in Kandy, Sri Lanka between August 2008 and March 2009.

Training Sri Lankan public health midwives on intimate partner violence: a pre- and post-intervention study.

Background: In many developing countries, intimate partner violence (IPV) training is not available for health providers. As a pioneer among developing countries, in 2009, the Sri Lankan Ministry of Health trained a group of community health providers known as public health midwives (PHMs) on IPV. We evaluated that training program's efficacy in improving PHMs' identification and management of IPV sufferers in Kandy, Sri Lanka.

Incidence and risk factors of falls among the elderly in the District of Colombo.

Objectives: To assess the incidence and risk factors of falls among the elderly in the District of Colombo.

Methods: Incidence of falls was assessed by a community based descriptive study with prospective follow up. Risk factors for falls were assessed by a nested case control study.

Low-dose oral mini-pulse dexamethasone therapy in progressive unstable vitiligo.

Background: The course of vitiligo is unpredictable. If the disease is spreading rapidly, the progression can be controlled with the use of systemic steroids daily or in pulsed form. The present study was planned to assess the efficacy of low-dose dexamethasone oral mini-pulse therapy in progressive unstable vitiligo.

Effect of age at onset on disease characteristics in vitiligo.

Background: Vitiligo is a multifactorial disease in which genetic, immunologic, and environmental factors play an important part. Late-onset vitiligo is a poorly defined entity.

Materials And Methods: Case records of patients who attended the pigmentary clinic at our institute from January 2001 to December 2010 were reviewed.

Dengue Viral Myositis Complicated with Rhabdomyolysis and Superinfection of Methicillin-Resistant Staphylococcus aureus.

Dengue is endemic in Sri Lanka and the physician should be aware of different and unusual presentation of the illness. Rhabdomyolysis is a well-known complication following many viral and bacterial infections; however, only a few cases have been reported with dengue viral infections. Further occurrence of coinfection by dengue and bacteria such as methicillin-resistant Staphylococcus aureus (MRSA) has been underestimated, and few reports have been published so far.

Head and neck cancer pain: systematic review of prevalence and associated factors.

Objectives: Pain is a major symptom in patients with cancer; however information on head and neck cancer related pain is limited. The aim of this review was to investigate the prevalence of pain and associated factors among patients with HNC.

Material And Methods: The systematic review used search of MEDLINE, EMBASE and CINAHL databases to December 2011.

Periodontal status and associated factors in 15-year-old Sri Lankans.

Aim: The aim of the present study was to determine the periodontal status and associated factors in 15-year-old Sri Lankans.

Methods: This was a cross-sectional study where the data were collected by means of a self-administered questionnaire and a clinical examination. A total of 400 15 year olds were selected using a two-stage cluster sampling technique from schools in the Nattandiya education division of the Puttalam district of Sri Lanka.