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Arambewela L.S.R.,Industrial Technology Institute | Arawwawala L.D.A.M.,Industrial Technology Institute | Kumaratunga K.G.,Food Control Laboratory | Dissanayake D.S.,Industrial Technology Institute | And 2 more authors.
Pharmacognosy Reviews | Year: 2011

Piper betle is an economically important plant cultivated in Sri Lanka. Although more than 12 cultivars of betel are reported in Sri Lanka, very few scientific investigations have been carried out on them. Studies on the chemical constituents indicated that safrole is the major constituent, followed by chavibitol acetate, in the essential oil of common betel leaves of Sri Lanka. Investigations on the bioactivities of P. betle revealed the presence of antimicrobial, insecticidal, antioxidant, antinociceptive, antidiabetic and gastroprotective activities. In addition, P. betle was found to be safe in terms of hepatotoxicity, renotoxicity, hematotoxicity, gross morphology, weights of organs, stress or aversive behaviors in rats. The above findings indicate the vast potential of P. betle yet to be harnessed for the benefit of mankind and the betel industry of Sri Lanka. Source

Wijekoon C.N.,University of Kelaniya | Wijekoon P.W.M.C.S.B.,Colombo North Teaching Hospital
Southeast Asian Journal of Tropical Medicine and Public Health | Year: 2010

Acute pancreatitis is an uncommon manifestation of dengue fever. Here we present a 47 year old male with dengue hemorrhagic fever who presented with acute pancreatitis and associated hyperglycemia. To our knowledge, this is the first reported case of dengue complicated with acute pancreatitis from South Asia. Source

Niloofa R.,University of Colombo | Fernando N.,University of Colombo | De Silva N.L.,University of Colombo | Karunanayake L.,Medical Research Institute | And 8 more authors.
PLoS ONE | Year: 2015

Background: Leptospirosis is diagnosed on clinical grounds, and confirmed by microscopic agglutination test (MAT). IgM-ELISA (Serion-Virion) and immunochromatography test (Leptocheck-WB) are two immunodiagnostic assays for leptospirosis. Their sensitivity, specificity and applicability in Sri Lanka have not been systematically evaluated. Methods: Clinically diagnosed leptospirosis patients (n = 919) were recruited from three hospitals in the Western Province of Sri Lanka, during June 2012 to December 2013. MAT, IgM-ELISA and Leptocheck-WB were performed on all patient sera. MAT titer of ≥400 in single sample, four-fold rise or seroconversion ≥100 in paired samples were considered as positive for MAT. For diagnostic confirmation, MAT was performed during both acute and convalescent phases. Anti-leptospiral IgM ≥20 IU/ml and appearance of a band in the test window were considered as positive for IgM-ELISA and Leptocheck-WB test respectively. Patients with an alternative diagnosis (n = 31) were excluded. Data analysis was performed using two methods, i) considering MAT as reference standard and ii) using Bayesian latent class model analysis (BLCM) which considers each test as imperfect. Results: MAT, IgM-ELISA and Leptocheck-WB positivity were 39.8%, 45.8% and 38.7% respectively during the acute phase. Acute-phase MAT had specificity and sensitivity of 95.7% and 55.3% respectively, when compared to overall MAT positivity. IgM-ELISA and Leptocheck-WB had similar diagnostic sensitivity when compared with acute-phase MAT as the gold standard, although IgM-ELISA showed higher specificity (84.5%) than Leptocheck-WB (73.3%). BLCM analysis showed that IgM-ELISA and Leptocheck-WB had similar sensitivities (86.0% and 87.4%), while acute-phase MAT had the lowest sensitivity (77.4%). However, acute-phase MAT had high specificity (97.6%), while IgM-ELISA and Leptocheck-WB showed similar but lower specificity (84.5% and 82.9%). Conclusions: Both IgM-ELISA and Leptocheck-WB shows similar sensitivities and specificities. IgM-ELISA may be superior to MAT during the acute phase and suitable for early diagnosis of leptospirosis. Leptocheck-WB is suitable as a rapid immunodiagnostic screening test for resource limited settings. © 2015 Niloofa et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Source

Mettananda S.,University of Kelaniya | Fernando A.D.,University of Kelaniya | Ginige N.,Colombo North Teaching Hospital
Journal of Medical Case Reports | Year: 2013

Introduction. Posterior reversible encephalopathy syndrome is an extremely rare radiological diagnosis that has not been reported previously in association with acute liver failure. Case presentation. A 6-year-old Sri Lankan girl developed acute liver failure with severe hepatic encephalopathy due to sodium valproate. She was successfully treated medically with N-acetylcysteine and L-carnitine. During recovery she again developed features of encephalopathy and had repeated convulsions associated with moderate hypertension. The diagnosis of posterior reversible encephalopathy syndrome was made on clinical and radiological grounds and she showed a gradual improvement with control of blood pressure. Conclusions: This report adds to the evidence behind treatment of valproate-induced acute liver failure with N-acetylcysteine and L-carnitine and illustrates a rare but interesting association between acute liver failure and posterior reversible encephalopathy syndrome. © 2013 Mettananda et al.; licensee BioMed Central Ltd. Source

Frez M.L.F.,University of the Philippines at Manila | Asawanonda P.,Chulalongkorn University | Gunasekara C.,Colombo North Teaching Hospital | Koh C.,Koh Skin Specialist Clinic | And 5 more authors.
Journal of Dermatological Treatment | Year: 2014

Background: International consensus statements on the management of scalp psoriasis are available, but no such recommendations exist for Asia. Methods: The Asia Scalp Psoriasis Study Group (ASPSG) met in May 2011 to review the epidemiologic pattern of scalp psoriasis in Southeast Asia and to develop Asia-specific recommendations for its management. Results: The overall prevalence of psoriasis in Asia is <0.3%, but 75-90% have scalp involvement, whether isolated or with lesions elsewhere, which can negatively impact quality of life (QoL). Treatment decisions should be based primarily on objective disease severity, but should also take account of patient QoL. Psychosocial support and more aggressive treatment should be offered to all patients with moderate to severe QoL impairment. Topical therapy is indicated first-line in all patients, with combination therapy (corticosteroid + calcipotriol), more occlusive formulations, keratolytics, and very potent corticosteroids for patients needing greater or faster efficacy. Systemic therapies, light or laser treatments should be reserved for patients with severe and recalcitrant disease. Conclusions: The ASPSG recommends a patient-centered approach to scalp psoriasis management, consistent with the international consensus statements. Asian physicians should also consider patient QoL, prior treatment response, formulation preferences, likely adherence, cost, time available for self-management, and potential adverse events. © 2014 Informa Healthcare USA on behalf of Informa UK Ltd. Source

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