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Jayasundara J.A.S.B.,National Hospital of Sri Lanka | de Silva W.M.M.,Colombo South Teaching Hospital
Annals of the Royal College of Surgeons of England | Year: 2013

Traditionally, all cholecystectomy specimens resected for symptomatic cholelithiasis were sent for histological evaluation. The objectives of such evaluation are to confirm the clinicoradiological diagnosis, identification of unsuspected findings including incidental gallbladder malignancy, audit and research purposes, and quality control issues. Currently, there is a developing trend to consider selective histological evaluation of surgical specimens removed for clinically benign disease. This article discusses the need for routine or selective histopathological evaluation of gallbladder specimens following cholecystectomy. Although several retrospective studies have suggested selective histological evaluation of cholecystectomy specimens performed for symptomatic cholelithiasis, the evidence is not adequate at present to recommend selective histological evaluation globally. However, it may be appropriate to consider selective histological evaluation on a regional basis in areas of extremely low incidence of gallbladder cancer only after unanimous agreement between the governing bodies of surgical and histopathological expertise. Source


Danansuriya M.N.,Family Health Bureau | Wijewardena R.R.K.,Colombo South Teaching Hospital
Sri Lanka Journalof Child Health | Year: 2013

Objective: To assess the usage pattern of child health development record (CHDR) as an information source by the mothers of children aged 6-24 months admitted to a ward in Lady Ridgeway Hospital (LRH) and to assess their level of knowledge and practices on infant and young child feeding (IYCF). Method: A cross-sectional study was conducted in a paediatric ward in LRH from 1st February to 31st August 2009 on mothers with children aged 6-24 months. Feeding patterns, maternal knowledge on messages given in CHDR and selected sociodemographic factors were examined using a pretested interviewer-administered questionnaire. Association of feeding practices and sociodemographic characteristics were analyzed using non parametric tests. Ethical approval was granted by the ethical review committee of LRH. Results: Of the 300 mothers administered questionnaires 5 were excluded due to incomplete data. Of the 295 mothers included in study, 36% had passed GCE ordinary level. Of the children, 72% started complementary feeding after 6 months. Nearly 50% of children had satisfactory diet in terms of quality, quantity and frequency. Maternal IYCF knowledge was significantly associated with maternal educational level and reading of CHDR feeding instructions. Conclusion: Mothers have an acceptable level of knowledge on IYCF and satisfactory level of usage of CHDR as an information source. Reading CHDR has a significant impact on higher maternal IYCF knowledge and better IYCF practices. Source


Marasinghe J.P.,Colombo South Teaching Hospital
The journal of obstetrics and gynaecology research | Year: 2011

A 29-year-old pregnant woman presented with fever, right hypochondrial pain and fatigability at 29 weeks of gestation. Dengue hemorrhagic fever was diagnosed based on clinical, hematological and serological features. However, ultrasound scanning was suggestive of acute acalculous cholecystitis. The patient was managed symptomatically and made a good recovery 8 days following onset of fever. This is the first case of acute acalculous cholecystitis coinciding with dengue hemorrhagic fever reported during pregnancy from an endemic country in Asia. The possible viral and host factors for the development of such a severe form of disease and preventive measures are discussed. © 2011 The Authors. Journal of Obstetrics and Gynaecology Research © 2011 Japan Society of Obstetrics and Gynecology. Source


Yudhishdran J.M.,National Hospital of Sri Lanka | Navinan R.,National Hospital of Sri Lanka | Jeyalakshmy S.,Colombo South Teaching Hospital | Ratnatilaka A.,National Hospital of Sri Lanka
BMC Research Notes | Year: 2015

Background: Psoriasis is no longer viewed as an isolated dermatological ailment and instead is considered a systemic disease. The extension of this spectrum has heightened the known risk of morbidity and mortality due to the involvement of cardiovascular system and the risk of venous thrombosis. A number of cases have reported the increased occurrence of deep vein thrombosis and pulmonary embolism in the background of psoriasis, however portal vein thrombosis has not been reported to date. We report an index case of chronic portal vein thrombosis in a diagnosed patient with psoriasis. Case presentation: A 67-year-old South-Asian female previously diagnosed and treated for psoriasis presented with a four month history of abdominal pain associated with abdominal distension. Clinical examination revealed an enlarged spleen and free fluid in the abdomen. Imaging with ultrasonography and computed tomography of the abdomen revealed features compatible with chronic portal vein thrombosis with cavernous transformation. Conclusion: This case highlights the importance of having clinical awareness of occurrence of thrombosis in patients with psoriasis. Typical symptoms favoring thrombosis should prompt thorough investigation to exclude this rare yet possible complication in patients with psoriasis, including that of portal vein thrombosis. Prophylaxis with anticoagulation still lacks strength of evidence to be justified in psoriasis. The exact pathogenesis of venous thromboembolism in psoriasis is still unexplained and further studies are needed to clarify the causal association. © 2015 Yudhishdran et al.; licensee BioMed Central. Source


Senanayake N.P.,General Sir John Kotelawala Defence University | Chandrasiri N.S.,Colombo South Teaching Hospital
Sri Lanka Journalof Child Health | Year: 2015

Introduction: Urinary tract infections (UTIs) are an important cause of morbidity and mortality in children. Objective: To determine the common bacterial pathogens causing UTI in children less than 12 years old and their antimicrobial susceptibility patterns at the Colombo South Teaching Hospital, Sri Lanka. Method: A prospective study was done by analyzing records of urine samples received at the Department of Microbiology, Colombo South Teaching Hospital, from 1st May 2011 to 30th April 2012. Urine samples were inoculated on Cystine Lactose Electrolyte Deficient agar, according to standard operating procedures. The isolates were initially identified by Gram staining and colony characteristics. Gram positive organisms were further identified by catalase, coagulase and bile-aesculin tests. Lactose fermentation or non-lactose fermentation (NLF) of Gram negative organisms was recorded. The NLF isolates were further identified by oxidase, urease and Kleigler Iron Agar tests. Antibiotic susceptibility tests were carried out using the Stokes method. Results: A total of 2620 urine samples was analyzed. Of the 426 (16.3%) pure growths, Gram negative isolates of bacteriuria (>105 colony forming units/ml of urine) and Gram positive isolates of bacteriuria (>104 colony forming units/ml of urine) were found in 264 (62%) and 56 (13.1%) patients respectively. The female: male ratio of the total positive samples was 2.1:1. LF and NLF Coliforms (excluding Proteus, Providencia, and Morganella spp.) were isolated in 142 (33.3%) and 68 (16%) samples respectively. Proteus spp. were isolated in 43 (10.1%) samples 38 (88.4%) of which were identified in males. The sensitivity of LF Coliforms to nitrofurantoin, cephalexin and ampicillin was 83.9%, 57.4% and 11.3% respectively. The sensitivity of NLF Coliforms to nitrofurantoin, cephalexin and ampicillin was 85.3%, 36.8% and 7.4% respectively. Conclusions: Enterobacteriaceae were the predominant pathogens causing UTI in our population and showed high resistance against ampicillin and cephalexin. Proteus infections were predominant in males. Source

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