Colombo South Teaching Hospital

Colombo, Sri Lanka

Colombo South Teaching Hospital

Colombo, Sri Lanka
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Wanigasuriya R.U.,Colombo South Teaching Hospital | Gunaratne A.,Colombo South Teaching Hospital | Gunapala A.,Colombo South Teaching Hospital
Anaesthesia, Pain and Intensive Care | Year: 2017

Negative pressure pulmonary edema (NPPE) also known as post obstructive pulmonary edema is a potentially life threatening condition with a multifocal pathogenesis. Type 1 NPPE is due to forceful inspiratory effort in the context of an acute airway obstruction, while Type 2 NPPE occurs after relief of a chronic partial upper airway obstruction. Once developed, it impairs gas exchange and causes hypoxemia and if not treated prompdy may lead to respiratory failure. The diagnosis of negative pressure pulmonary edema is usually made on the basis of a history of a precipitating incident and symptoms. However, it is basically a diagnosis of exclusion. We present here a case of negative pressure pulmonary edema, which presented as acute left ventricular failure. The cause was eventually found to be acute airway obstruction due to an obstructive goiter precipitated by an upper respiratory tract infection.


Ranasinghe P.,University of Colombo | Ranasinghe P.,Industrial Technology Institute | Kaushalya M. Abeysekera W.P.,Industrial Technology Institute | Sirimal Premakumara G.A.,Industrial Technology Institute | And 3 more authors.
Pharmacognosy Research | Year: 2012

Background : Carica papaya L. fruit juice and leaf extracts are known to have many beneficial medical properties. Recent reports have claimed possible beneficial effects of C. papaya L. leaf juice in treating patients with dengue viral infections. This study aims to evaluate the membrane stabilization potential of C. papaya L. leaf extracts using an in vitro hemolytic assay. Materials and Methods: The study was conducted in between June and August 2010. Two milliliters of blood from healthy volunteers and patients with serologically confirmed current dengue infection were freshly collected and used in the assays. Fresh papaya leaves at three different maturity stages (immature, partly matured, and matured) were cleaned with distilled water, crushed, and the juice was extracted with 10 ml of cold distilled water. Freshly prepared cold water extracts of papaya leaves (1 ml containing 30 l of papaya leaf extracts, 20 l from 40% erythrocytes suspension, and 950 l of phosphate buffered saline) were used in the heat-induced and hypotonic-induced hemolytic assays. In dose response experiments, six different concentrations (9.375, 18.75, 37.5, 75, 150, and 300 g/ml) of freeze dried extracts of the partly matured leaves were used. Membrane stabilization properties were investigated with heat-induced and hypotonicity-induced hemolysis assays. Results: Extracts of papaya leaves of all three maturity levels showed a significant reduction in heat-induced hemolysis compared to controls (P < 0.05). Papaya leaf extracts of all three maturity levels showed more than 25% inhibition at a concentration of 37.5 g/ml. The highest inhibition of heat-induced hemolysis was observed at 37.5 g/ml. Inhibition activity of different maturity levels was not significantly (P > 0.05) different from one another. Heat-induced hemolysis inhibition activity did not demonstrate a linear dose response relationship. At 37.5 g/ml concentration of the extract, a marked inhibition of hypotonicity-induced hemolysis was observed. Conclusion: C. papaya L. leaf extracts showed a significant inhibition of hemolysis in vitro and could have a potential therapeutic effect on disease processes causing destabilization of biological membranes.


Abeygunasekera A.M.,Colombo South Teaching Hospital
The Ceylon medical journal | Year: 2016

The composition of renal stones varies widely among populations. The aim of our study was to determine the composition of staghorn renal stones using Fourier transform infrared (FTIR) spectroscopy in a cohort of Sri Lankan patients. Forty two staghorn calculi removed from kidneys of adult patients during open surgery were analysed. There were 32 men. Nineteen (45%) were calcium oxalate monohydrate (whewellite) stones. Stones containing a mixture of calcium oxalate and calcium hydroxyl phosphate (apatite) were found in 16 (38%). Only 4 (10%) staghorn calculi were coposed of struvite. Three (7%) were uric acid stones. So most staghorn renal stones in Sri Lanka are calcium oxalate. Contrary to the traditional view based on studies done in the western world, only 10% of staghorn calculi removed from patients in Sri Lanka are struvite or infection stones. This could be the reason for kidneys with staghorn calculi in Sri Lanka to retain their function.


Gurugama P.,Colombo South Teaching Hospital | Garg P.,Childrens Hospital at Westmead | Perera J.,University of Colombo | Wijewickrama A.,Infectious Diseases Hospital | Seneviratne S.,St. Mary's College
Indian Journal of Dermatology | Year: 2010

Dengue viral infections are one of the most important mosquito-borne diseases in the world. Presently dengue is endemic in 112 countries in the world. It has been estimated that almost 100 million cases of dengue fever and half a million cases of dengue hemorrhagic fever (DHF) occur worldwide. An increasing proportion of DHF is in children less than 15 years of age, especially in South East and South Asia. The unique structure of the dengue virus and the pathophysiologic responses of the host, different serotypes, and favorable conditions for vector breeding have led to the virulence and spread of the infections. The manifestations of dengue infections are protean from being asymptomatic to undifferentiated fever, severe dengue infections, and unusual complications. Early recognition and prompt initiation of appropriate supportive treatment are often delayed resulting in unnecessarily high morbidity and mortality. Attempts are underway for the development of a vaccine for preventing the burden of this neglected disease. This review outlines the epidemiology, clinical features, pathophysiologic mechanisms, management, and control of dengue infections.


Jayasundara J.A.S.B.,National Hospital of Sri Lanka | Jayasundara J.A.S.B.,Colombo South Teaching Hospital | 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.


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.


Marasinghe J.P.,Colombo South Teaching Hospital | Condous G.,University of Sydney | Seneviratne H.R.,University of Colombo | Seneviratne H.R.,De Soysa Hospital for Women | Marasinghe U.,Colombo South Teaching Hospital
Acta Obstetricia et Gynecologica Scandinavica | Year: 2011

A prospective observational study was performed to evaluate the performance of a modified uterine compression suturing technique for the management of refractory post partum hemorrhage (PPH) at two leading tertiary referral centers in Colombo, Sri Lanka. An modified anchored B-Lynch suture was done in 17 women with PPH due to uterine atony. In 13 of the women (76%), bleeding was arrested and the uterus conserved. Four women (24%) did not respond to the anchored compression sutures, necessitating emergency post partum hysterectomy. Mean age was 31.2 years. Nine of the women (53%) were primiparous and eight (47%) parous. Mean estimated blood loss was 1994 ml (range 1200-3300 ml). This newly modified anchor B-Lynch compression suture appeared effective in controlling about 75% of PPH due to uterine atony, which allowed uterine conservation. This simple modification can provide a first line surgical step to control PPH. © 2011 The Authorsa Acta Obstetricia et Gynecologica Scandinavica © 2011 Nordic Federation of Societies of Obstetrics and Gynecology.


Abeysekera W.Y.M.,Colombo South Teaching Hospital | De Silva W.D.D.,Colombo South Teaching Hospital | Pinnaduwa S.S.,Colombo South Teaching Hospital | Banagala A.S.K.,Colombo South Teaching Hospital
High Altitude Medicine and Biology | Year: 2012

Abeysekera, W.Y.M., W.D.D. de Silva, S.S. Pinnaduwa, and A.S.K. Banagala. Acute Massive Splenic Infarction with Splenic Vein Thrombosis Following Altitude Exposure of a Sri Lankan Male with Undetected Sickle Cell Trait. High Alt Med Biol 13:288-290, 2012. - Even though sickle cell disease is not common in Sri Lanka, we report an acute splenic infarction at high altitude of a Sri Lankan male with previously undetected sickle cell trait (SCT). This is the first time such a case is reported from the South Asian region. Early recognition of this hematological condition would simplify the management of acute splenic infarction in these patients, avoiding irreversible surgery. © Copyright 2012, Mary Ann Liebert, Inc. 2012.


Habaragamuwa B.W.P.,Colombo South Teaching Hospital | Piyasiri G.,Colombo South Teaching Hospital
Sri Lankan Journal of Anaesthesiology | Year: 2011

Background The purpose of this retrospective case review was to identify different patterns of clinical presentation of severe leptospirosis, and to find out any correlation between organ specific complication/s and outcome of the patients. Method Leptospirosis patients who were admitted to the intensive care unit (ICU) at the Colombo South Teaching Hospital during August to September 2008 were included. Organ specific involvement in six organs (heart, lung, kidney, liver, vascular, brain and spinal cord) was recorded. One score was given to each organ involvement. Score was recorded on admission and during ICU stay. Outcome of the patient was recorded as either discharged or died in the ICU. Results Renal, hepatic and haematological involvement was found in all patients. 13(65%) patients died and 7(35%) patients were discharged to the ward. All patients with four organ involvement were survived. All patients with six organ involvement died in the intensive care unit. 8(80%) patients died and 3(20%) patients survived among patients with five organ involvement. Four or more organs were affected on admission to ICU in patients who died and only three organs were affected in discharged patients. Conclusion Outcome of severe leptospirosis was not determined by the involvement of renal, hepatic and haematological systems. Five or more organ involvement was associated with increased mortality. Combination of cardiac and respiratory system involvement or involvement of central nervous system was associated with bad outcome. Seeking critical care management at three organ involvement stage would improve the outcome of the patients.


Sinhabahu V.P.,Colombo South Teaching Hospital | Sathananthan R.,Colombo South Teaching Hospital | Malavige G.N.,University of Sri Jayawardanapura
BMC Research Notes | Year: 2014

Background: Dengue in pregnancy is associated with many maternal and foetal outcomes including perinatal transmission of dengue infection. Case Presentation: A baby was born by emergency caesarean section due to foetal distress and meconium stained liquor, to a 27-year old primi-gravidae, Sinhalese female, who was febrile during and 2 days prior to labour. The baby had evidence of respiratory distress due to meconium aspiration and was cared for in the special care baby unit for 3 days. On the 4th day he developed fever and serial blood counts showed a gradual rise in the haematocrit (>20% of baseline value) and lowering of platelet counts. The baby was treated for sepsis and as Sri Lanka was experiencing a massive dengue epidemic was also tested for dengue. His dengue NS1 antigen test was strongly positive and the dengue IgM antibodies weakly positive on day 3 of illness. The mother was positive for both dengue IgM and IgG antibodies. Conclusion: Although rare, vertical transmission of the dengue virus has been reported and the baby most likely developed dengue due to perinatal transmission of dengue.

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