Klebsiella pneumoniae liver abscess: a case report.

Background: Liver abscess has formerly been a polymicrobial infection. Currently, liver abscess due to Klebsiella pneumoniae is increasingly reported, predominantly in Southeast Asia for unknown reasons. Liver abscess due to Klebsiella pneumonia has never been previously reported in Sri Lanka.

Clinical validity and diagnostic accuracy of the Maslach Burnout Inventory-Student Survey in Sri Lanka.

Background: Absence of context-specific clinically validated cut-off values for assessing burnout as a dichotomous phenomenon has hindered the progress of student burnout research with regard to quantifying the magnitude of the problem. Hence, the present study was aimed at developing clinically validated cut-off values and evaluating the diagnostic accuracy of the Sinhala translation of the 15-item Maslach Burnout Inventory-Student Survey (MBI-SS) in assessing burnout among collegiate cycle students in Sri Lanka.

Methods: This prospective validation study was conducted among 194 grade thirteen students in the Kurunegala district, Sri Lanka.

Validity and reliability of the Maslach Burnout Inventory-Student Survey in Sri Lanka.

Background: With ever increasing educational expectations and demands, burnout has emerged as a major problem negatively affecting the wellbeing of different student populations. Even though the validity of the Maslach Burnout Inventory-Student Survey (MBI-SS) is widely assessed across the globe, there is a paucity of related literature in the South Asian settings. Hence, this study was aimed at assessing the factorial structure, validity, and reliability of the MBI-SS among collegiate cycle students in Sri Lanka.

Thailand orthohantavirus infection in patients with chronic kidney disease of unknown aetiology in Sri Lanka.

Chronic kidney disease of unknown aetiology (CKDu) reported in Sri Lanka and other countries is a mysterious and serious disease. Recently, we reported a high seroprevalence of antibodies to a hantavirus antigen among CKDu patients in Girandurukotte, Badulla district, Sri Lanka. However, the type of hantavirus with which the residents were infected was not determined.

A case report of dengue haemorrhagic fever during the peripartum period: challenges in management and a case of vertical dengue transmission.

Background: Incidence of Dengue infection is on the increase in Sri Lanka with it being associated with significant maternal and neonatal morbidity in pregnancy.

Case Presentation: A 33-year-old pregnant woman at 38 weeks of gestation, presented with acute onset of fever, was later diagnosed with Dengue illness. Due to the emergence of warning symptoms and signs and rapidly dropping platelet count, the baby was delivered by urgent caesarian section.

Acute Ascending Flaccid Paralysis Secondary to Multiple Trigger Factor Induced Hyperkalemia.

Background: Acute flaccid paralysis is an uncommon, but potentially life threatening, sequel of severe hyperkalemia. Reported primary aetiologies include renal failure, Addison's disease, potassium sparing diuretics, potassium supplements, and dietary excess. Coconut water, when consumed in excess, has been reported to cause severe hyperkalemia.

Identification of chronic obstructive pulmonary disease subgroups in 13 Asian cities.

Background: Chronic obstructive pulmonary disease (COPD) is a heterogeneous condition that can differ in its clinical manifestation, structural changes and response to treatment.

Objective: To identify subgroups of COPD with distinct phenotypes, evaluate the distribution of phenotypes in four related regions and calculate the 1-year change in lung function and quality of life according to subgroup.

Methods: Using clinical characteristics, we performed factor analysis and hierarchical cluster analysis in a cohort of 1676 COPD patients from 13 Asian cities.

Validity and reliability of the Utrecht Work Engagement Scale-Student Version in Sri Lanka.

Objective: The present study was aimed at assessing the validity and the reliability of the Sinhala version of the Utrecht Work Engagement Scale-Student Version (UWES-S) among collegiate cycle students in Sri Lanka.

Results: The 17-item UWES-S was translated to Sinhala and the judgmental validity was assessed by a multi-disciplinary panel of experts. Construct validity of the UWES-S was appraised by using multi-trait scaling analysis and exploratory factor analysis (EFA) on data obtained from a sample of 194 grade thirteen students in the Kurunegala district, Sri Lanka.

Fever of unknown origin in a male patient with systemic lupus erythematosus.

Background: Systemic lupus erythematosus (SLE) is an inflammatory autoimmune disorder which is uncommon in men. It has a wide variety of clinical presentations.

Case Report: We report a 21-year-old male presented with one month history of fever, loss of appetite, weight loss and reduced hair growth with an examination revealing an oral ulcer, cervical and axillary lymphadenopathy simulating hematological malignancy.

First experience of cadaveric renal transplantation in Sri Lanka.

Objectives: To analyse the outcome of 50 consecutive cadaveric renal transplants performed in Sri Lanka.

Methods: This was a single-centre longitudinal cohort study conducted in the Nephrology and Kidney Transplant Unit, Teaching Hospital Kandy, Sri Lanka. Records of 50 Sri Lankan cadaveric renal transplant recipients from 7th December 2004 to 1st September 2013 were reviewed and categorized according to early graft function, cold ischaemia time and the duration of dialysis before surgery.

Unexpected sudden death in pregnancy - arrhythmogenic right ventricular cardiomyopathy/dysplasia: a case report.

Cardiovascular disease is an important contributor to maternal mortality in both developing and developed countries. Systematic search for cardiac disease is usually not performed during pregnancy despite hypertensive disease, undiagnosed pulmonary hypertension and cardiomyopathies being recognized as major health problems in these settings. This article reported a 27-year-old female who was normal on clinical examination and basic investigations, and on an antenatal visit was found collapsed in the toilet of her house and was pronounced dead on admission to hospital.

Multicentric Castleman disease of hyaline vascular variant presenting with unusual systemic manifestations: a case report.

Background: Castleman disease is a rare lymphoproliferative disorder presenting with localized or disseminated lymphadenopathy and systemic manifestations. It can be categorized in numerous ways, such as unicentric versus multicentric, histopathological variants (hyaline-vascular, plasma cell, and mixed), or subtypes based on causative viral infections (human immunodeficiency virus, human herpesvirus-8, or Kaposi sarcoma herpesvirus). Presentation ranges from asymptomatic to symptoms involving multiple organs.

Pre-natal diagnosis of thalassaemia in Sri Lanka: A ten year review.

Thalassaemia is the commonest monogenic disease in Sri Lanka, affecting over 3500 children and half-a-million thalassaemia carriers. This is a review of 82 amniocenteses performed from 2006 to 2016, in the largest prenatal diagnoses study for thalassaemia carried out in Sri Lanka. Amniocenteses were performed between 11 and 12 weeks of ultrasonically confirmed gestation, on mothers with previous thalassaemia major children pregnant for the second time and nulliparous thalassaemia trait women married to trait partners.

Characteristics of road traffic accident casualties admitted to a tertiary care hospital in Sri Lanka.

The mortality and morbidity of road traffic accidents (RTA) is increasing in the South Asian region, including Sri Lanka. Therefore, the demographic factors, types of vehicles involved, and the severity of injuries sustained in RTA was studied. Age, gender, and details of the incident of all patients admitted to hospital following a RTA, between January 2007 and August 2012, were obtained by interview.

A study on silicosis among employees of a silica processing factory in the Central Province of Sri Lanka.

Objectives: The silica industry is rapidly expanding in Sri Lanka. The main objective of this study was to assess the prevalence of silicosis among workers exposed to silica dust, and to describe the disease pattern of the affected. We also screened the affected workers for tuberculosis.

Septic embolization of left and right coronary arteries resulting in sudden death: A rare complication of infective endocarditis.

Bacterial endocarditis gives rise to a variety of complications due to local tissue damage, immunological phenomena, and embolic phenomena. Only a small number of cases of coronary embolization have been reported in infective endocarditis patients. This is a case of subacute bacterial endocarditis in a postpartum mother complicated by fatal left and right coronary artery embolization.

A case of Berardinelli-Seip syndrome presenting with cirrhosis.

Berardinelli-Seip congenital lipodystrophy (BSCL) is a rare autosomal recessive disorder of generalised lipoatrophy, characterised by the absence of functioning adipocytes, with lipid being stored in muscles, the liver and the pancreas. The usual presentation is in adulthood, with manifestations of insulin resistance, hypertriglyceridaemia and liver steatosis. Cirrhosis as the first presentation of BSCL in a young adult is rare.

Staging of lung cancer in a tertiary care setting in Sri Lanka, using TNM 7th edition. A comparison against TNM6.

Background: Lung cancer is a leading cause of cancer-related mortality in Sri Lanka and throughout the world. The latest staging system for lung cancer is the tumor node metastasis (TNM) 7th edition in which there are major changes to the previous version. The objective of our study was to find out the implications of TNM7th edition on lung cancer staging in a resource limited setting, and to compare it with the previous TNM 6th edition.

Predictors of the development of myocarditis or acute renal failure in patients with leptospirosis: an observational study.

Background: Leptospirosis has a varied clinical presentation with complications like myocarditis and acute renal failure. There are many predictors of severity and mortality including clinical and laboratory parameters. Early detection and treatment can reduce complications.

Evaluation of surveillance case definition in the diagnosis of leptospirosis, using the Microscopic Agglutination Test: a validation study.

Background: Leptospirosis is endemic in both urban and rural areas of Sri Lanka and there had been many out breaks in the recent past. This study was aimed at validating the leptospirosis surveillance case definition, using the Microscopic Agglutination Test (MAT).

Methods: The study population consisted of patients with undiagnosed acute febrile illness who were admitted to the medical wards of the Teaching Hospital Kandy, from 1st July 2007 to 31st July 2008.