Continuation of Dual Antiplatelet Therapy in a Patient with a Coronary Artery Stent with Dengue Hemorrhagic Fever: A Clinical Conundrum.

Severe thrombocytopenia with impairment of the activity of platelets and impairment of blood clotting occurs in dengue hemorrhagic fever (DHF). Continuation of dual antiplatelet therapy in such patients can result in life-threatening hemorrhages. On the other hand, withholding of antiplatelets in a patient undergone coronary stenting lately can lead to stent thrombosis, resulting in myocardial infarctions and sudden cardiac death.

An Atypical Case of Rickettsial Spotted Fever Myocarditis Mimicking Weil's Disease.

A 65-year-old previously healthy male presented to us on the fourth day of a febrile illness with headache, arthralgia, myalgia, nausea, cough, chest pain, sore throat, and passing of watery stools and dark urine with a history of exposure to leptospirosis during a dengue outbreak. On examination, there was dehydration and hypovolemia, and an ultrasound scan revealed capillary leakage. His liver transaminases, serum creatine, blood urea, C-reactive protein, and neutrophil percentage were high, and thrombocytopenia was present.

The correlation between local weather and leptospirosis incidence in Kandy district, Sri Lanka from 2006 to 2015.

: Leptospirosis is an important public health problem in Sri Lanka. Most people become infected by contact with leptospires in soil and in surface water. Survival of leptospires in the environment depends upon the moisture in soil, humidity, temperature and surface water.

An Atypical Clinical Manifestation of a Hump-Nosed Pit Viper Envenomation.

Envenomations by hump-nosed pit vipers (HNVs) are frequent in Sri Lanka and in South India. Until recently, HNV was considered a moderately venomous snake. Here, we report a case of a previously healthy female developing all the known serious complications, plus some previously unreported complications following a HNV envenomation.

An Analysis of a Dengue Outbreak at a Large Hospital and Epidemiological Evidence for Nosocomial Dengue.

Reports on dengue outbreaks at hospitals are extremely rare. Here the authors analyze a dengue outbreak at the Teaching Hospital-Kandy (THK), Sri Lanka. Our hypothesis was that the present outbreak of dengue was due to nosocomial infections.

The association between local meteorological changes and exacerbation of acute wheezing in Kandy, Sri Lanka.

Background: Severe wheezing is a common medical emergency. Past studies have demonstrated associations between exacerbation of wheezing and meteorological factors and atmospheric pollution. There are no past studies from Sri Lanka that analyzed correlation between daily multiple meteorological variables and exacerbation of wheezing.

Two Atypical Cases of Hantavirus Infections from Sri Lanka.

There are two categories of hantaviruses resulting in two distinct illnesses. The Old World (Asia and Europe) viruses give rise to hemorrhagic fever with renal syndrome (HFRS), and the New World (Americas) viruses cause hantavirus pulmonary syndrome (HPS). Hantavirus infections have very similar clinical pictures and epidemiology to leptospirosis.

A vegetable-induced hemolytic crisis in a G6PD deficient person: a case report.

Background: Hemolysis can occur in people with G6PD deficiency under oxidative stress. Acalypha indica is a tropical plant used as a medicinal plant as well as a vegetable. There are a few reported cases of Acalypha indica ingestion induced hemolysis in G6PD deficient people.

Concurrent methicillin-resistant Staphylococcus aureus septicemia and pyomyositis in a patient with dengue hemorrhagic fever: a case report.

Background: Concurrent presence of dengue hemorrhagic fever (DHF), tropical pyomyositis and septicemia due to methicillin-resistant Staphylococcus aureus (MRSA) in a previously healthy person has never been reported. These three conditions even individually are potentially fatal. "Here we describe a case of a patient contracting dengue and developing DHF along with concurrent pyomyositis likely to be due to MRSA, leading to MRSA septicemia with abscesses formed by MRSA".

Atorvastatin-Diltiazem Combination Induced Rhabdomyolysis Leading to Diagnosis of Hypothyroidism.

Statins and hypothyroidism, independently, can rarely cause rhabdomyolysis. The combination of them especially with concurrent intake of drugs such as diltiazem increases the risk of rhabdomyolysis. Hashimoto's encephalopathy is a rare condition associated with Hashimoto's thyroiditis and some patients with that can present with a stroke like picture.

An unusual presentation of a stroke in a developing country: a case report.

Background: Patients often, but not always, present with features that allow easy differentiation between traumatic brain injury and a stroke. Early diagnosis and appropriate treatment are crucial for a good outcome in both. Millions of people worldwide climb coconut and other trees without any protective gear.

A dengue infection without bleeding manifestations in an adult with immune thrombocytopenic purpura.

Background: Dengue is the most prevalent and fast spreading arboviral infection affecting people. No specific drug is available to treat dengue. Thrombocytopenia with potential of serious hemorrhages is one of the hall mark features of dengue.

Multisystem failure and death due to extensive hemorrhaging and brain herniation subsequent to a bite by an unidentified snake.

Background: Snakebites cause considerable morbidity and mortality in tropical and subtropical countries even though existing treatment methods can prevent most deaths if presentation occurs early to hospitals. Envenomation by unidentified snakes is common in central Sri Lanka. Management of such patients is challenging especially if presentation is late.

The correlation between dengue incidence and diurnal ranges of temperature of Colombo district, Sri Lanka 2005-2014.

Background: Meteorological factors affect dengue transmission. Mechanisms of the way in which different diurnal temperatures, ranging around different mean temperatures, influence dengue transmission were published after 2011.

Objective: We endeavored to determine the correlation between dengue incidence and diurnal temperature ranges (DTRs) in Colombo district, Sri Lanka, and to explore the possibilities of using our findings to improve control of dengue.

The interrelationship between dengue incidence and diurnal ranges of temperature and humidity in a Sri Lankan city and its potential applications.

Background: Temperature, humidity, and other weather variables influence dengue transmission. Published studies show how the diurnal fluctuations of temperature around different mean temperatures influence dengue transmission. There are no published studies about the correlation between diurnal range of humidity and dengue transmission.

A study of the correlation between dengue and weather in Kandy City, Sri Lanka (2003 -2012) and lessons learned.

Background: Weather variables affect dengue transmission. This study aimed to identify a dengue weather correlation pattern in Kandy, Sri Lanka, compare the results with results of similar studies, and establish ways for better control and prevention of dengue.

Method: We collected data on reported dengue cases in Kandy and mid-year population data from 2003 to 2012, and calculated weekly incidences.