B. Balagobi, Sarma S. Thuraisamy, B. Sathesan, D. Gamlaksha, M. Ladsiyan, R. Shangarie, S. Sivanujan
: Urological malignancies remains been various establish the characteristics of January 2018 renal carcinoma and mean age was 53.9 years. The male to female ratio was 2:3. 80% were clear cell renal cell carcinoma, 70% were localized. Eighty percentage diagnosed cancers had stage equal or less than T2. Nearly 3.7% of the patients had penile cancers. All of them were squamous cell carcinoma while 66.7% diagnosed cancers had stage equal or less than T2. Prostate carcinoma was the most common urological malignancy identified in this study. Most of the renal and penile carcinoma was diagnosed at early stages in contrast with bladder and prostate carcinoma.
{"title":"Clinicopathological profile of urological malignancies at Teaching Hospital in Jaffna Peninsula of Northern Sri Lanka","authors":"B. Balagobi, Sarma S. Thuraisamy, B. Sathesan, D. Gamlaksha, M. Ladsiyan, R. Shangarie, S. Sivanujan","doi":"10.4038/jmj.v33i2.133","DOIUrl":"https://doi.org/10.4038/jmj.v33i2.133","url":null,"abstract":": Urological malignancies remains been various establish the characteristics of January 2018 renal carcinoma and mean age was 53.9 years. The male to female ratio was 2:3. 80% were clear cell renal cell carcinoma, 70% were localized. Eighty percentage diagnosed cancers had stage equal or less than T2. Nearly 3.7% of the patients had penile cancers. All of them were squamous cell carcinoma while 66.7% diagnosed cancers had stage equal or less than T2. Prostate carcinoma was the most common urological malignancy identified in this study. Most of the renal and penile carcinoma was diagnosed at early stages in contrast with bladder and prostate carcinoma.","PeriodicalId":280534,"journal":{"name":"Jaffna Medical Journal","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124384704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Thivacaren, A. A. A. Suramiya, A. Paherathy, A. Arasalingam
: A rare case of sporadic Gower Laing: Early adult-onset distal myopathy type III (MDP I) presenting to a medical ward in northern Sri Lanka is presented here. A 39-year-old female present with difficulty in walking from age 10 and was investigated leading to the above diagnosis. This is a rare autosomal dominant distal myopathy and there have been no similar cases reported from the Northern Province of Sri Lanka, as well as in Sri Lanka.
{"title":"Gower laing: Early adult onset distal myopathy type III (MPD I): a case report","authors":"S. Thivacaren, A. A. A. Suramiya, A. Paherathy, A. Arasalingam","doi":"10.4038/jmj.v33i2.143","DOIUrl":"https://doi.org/10.4038/jmj.v33i2.143","url":null,"abstract":": A rare case of sporadic Gower Laing: Early adult-onset distal myopathy type III (MDP I) presenting to a medical ward in northern Sri Lanka is presented here. A 39-year-old female present with difficulty in walking from age 10 and was investigated leading to the above diagnosis. This is a rare autosomal dominant distal myopathy and there have been no similar cases reported from the Northern Province of Sri Lanka, as well as in Sri Lanka.","PeriodicalId":280534,"journal":{"name":"Jaffna Medical Journal","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123675702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. M. C. R. Karunatilaka, H. Hewageegana, W. Perera
Strongyloides stercoralis is a soil-transmitted nematode endemic throughout tropical and subtropical regions. Although most of the healthy infected individuals are asymptomatic, it can be life-threatening for immunocompromised patients and is responsible for a wide range of symptoms including chronic diarrhea. Hence, it is vital to have high suspicion and routine screening for immunosuppressed patients in these endemic regions. We report a case of chronic diarrhea due to Strongyloides stercoralis infection in a 55-year-old man who was on dialysis for end-stage Chronic Kidney Disease (CKD). The patient was initially managed as culture-negative continuous ambulatory peritoneal dialysis (CAPD) peritonitis. Later a thorough examination of his stools revealed Strongyloides stercoralis rhabditiform larvae, after which he was treated with albendazole. However, he eventually died of CKD. Therefore, we emphasize the need for a thorough examination of stools with a high degree of suspicion in chronic diarrheas, particularly in immunocompromised patients.
{"title":"A case of chronic diarrhea due to Strongyloides stercoralis in an immunocompromised patient","authors":"K. M. C. R. Karunatilaka, H. Hewageegana, W. Perera","doi":"10.4038/jmj.v33i2.142","DOIUrl":"https://doi.org/10.4038/jmj.v33i2.142","url":null,"abstract":"Strongyloides stercoralis is a soil-transmitted nematode endemic throughout tropical and subtropical regions. Although most of the healthy infected individuals are asymptomatic, it can be life-threatening for immunocompromised patients and is responsible for a wide range of symptoms including chronic diarrhea. Hence, it is vital to have high suspicion and routine screening for immunosuppressed patients in these endemic regions. We report a case of chronic diarrhea due to Strongyloides stercoralis infection in a 55-year-old man who was on dialysis for end-stage Chronic Kidney Disease (CKD). The patient was initially managed as culture-negative continuous ambulatory peritoneal dialysis (CAPD) peritonitis. Later a thorough examination of his stools revealed Strongyloides stercoralis rhabditiform larvae, after which he was treated with albendazole. However, he eventually died of CKD. Therefore, we emphasize the need for a thorough examination of stools with a high degree of suspicion in chronic diarrheas, particularly in immunocompromised patients.","PeriodicalId":280534,"journal":{"name":"Jaffna Medical Journal","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127963910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Sharmika, J. Nalayini, T. Peranantharajah, K. Ajantha
Marchiafava-Bignami disease (MBD) is a rare neuro degenerative disease characterized by demyelination of corpus callosum. Clinical diagnosis of MBD is challenging due to its nonspecific neurological manifestations. It’s promptly diagnosed by brain Magnetic Resonance Imaging (MRI). Prompt treatment with high dose thiamine could be lifesaving. Here we report a 68 year old male with chronic alcoholism who was diagnosed to have MBD and successfully treated with high doses of intravenous thiamine administration.
{"title":"Marchiafava- Bignami disease (MBD): A rare case report","authors":"S. Sharmika, J. Nalayini, T. Peranantharajah, K. Ajantha","doi":"10.4038/jmj.v33i2.141","DOIUrl":"https://doi.org/10.4038/jmj.v33i2.141","url":null,"abstract":"Marchiafava-Bignami disease (MBD) is a rare neuro degenerative disease characterized by demyelination of corpus callosum. Clinical diagnosis of MBD is challenging due to its nonspecific neurological manifestations. It’s promptly diagnosed by brain Magnetic Resonance Imaging (MRI). Prompt treatment with high dose thiamine could be lifesaving. Here we report a 68 year old male with chronic alcoholism who was diagnosed to have MBD and successfully treated with high doses of intravenous thiamine administration.","PeriodicalId":280534,"journal":{"name":"Jaffna Medical Journal","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121883396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chronic pancreatitis (CP) is a progressive inflammatory process that causes irreversible damage to the pancreas due to fibrosis and scarring. The incidence of CP varies among regions. Alcohol consumption and smoking are the main aetiological factors of CP. In addition, autoimmune diseases, hereditary and genetic factors, and tropical CP also contribute to this condition. Though no single mechanism has been shown to initiate CP pathogenesis, this disease ultimately results in fibrosis, scarring, and insufficiency in the pancreas. Chronic upper abdominal pain, steatorrhea, malnutrition, and diabetes mellitus are the main clinical features of CP. Detecting this disease at an early stage is difficult unless it is explicitly checked for due to strong suspicions. Nevertheless, pancreatic function tests, imaging, and endoscopy are used to diagnose CP. Pain management, exocrine supplementation, diabetic management, and endoscopic or surgical drainage and resection procedures are essential for managing CP. Early surgical intervention can improve the remaining pancreatic reserve, delay pancreatic failure, and improve the quality of life of patients with this disease.
{"title":"Chronic pancreatitis - an update","authors":"S. Gobishangar","doi":"10.4038/jmj.v33i2.130","DOIUrl":"https://doi.org/10.4038/jmj.v33i2.130","url":null,"abstract":"Chronic pancreatitis (CP) is a progressive inflammatory process that causes irreversible damage to the pancreas due to fibrosis and scarring. The incidence of CP varies among regions. Alcohol consumption and smoking are the main aetiological factors of CP. In addition, autoimmune diseases, hereditary and genetic factors, and tropical CP also contribute to this condition. Though no single mechanism has been shown to initiate CP pathogenesis, this disease ultimately results in fibrosis, scarring, and insufficiency in the pancreas. Chronic upper abdominal pain, steatorrhea, malnutrition, and diabetes mellitus are the main clinical features of CP. Detecting this disease at an early stage is difficult unless it is explicitly checked for due to strong suspicions. Nevertheless, pancreatic function tests, imaging, and endoscopy are used to diagnose CP. Pain management, exocrine supplementation, diabetic management, and endoscopic or surgical drainage and resection procedures are essential for managing CP. Early surgical intervention can improve the remaining pancreatic reserve, delay pancreatic failure, and improve the quality of life of patients with this disease.","PeriodicalId":280534,"journal":{"name":"Jaffna Medical Journal","volume":"97 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134031323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mullerian agenesis with primary amenorrhea is a rare condition and uncommonly presented as primary subfertility. It is a complex defect in the female genital tract’s embryological development. We present a case report of a 34-year-old woman presented initially for primary subfertility management, and a systematic clinical approach such as history, examination and investigations (diagnostic laparoscopy) diagnosed Mullerian agenesis with normal development of other systems. After diagnosis, psychological counselling, vaginal dilators to improve her vaginal length and adoption were done with the multidisciplinary team approach. Community-based case study assessment and early detection of primary amenorrhea with available facilities in a low resource setting are essential elements for an early diagnosis and subsequent optimal outcomes.
{"title":"Late presentation of Mullerian agenesis as primary subfertility","authors":"Raguraman, Dilinika Mms","doi":"10.4038/jmj.v33i2.137","DOIUrl":"https://doi.org/10.4038/jmj.v33i2.137","url":null,"abstract":"Mullerian agenesis with primary amenorrhea is a rare condition and uncommonly presented as primary subfertility. It is a complex defect in the female genital tract’s embryological development. We present a case report of a 34-year-old woman presented initially for primary subfertility management, and a systematic clinical approach such as history, examination and investigations (diagnostic laparoscopy) diagnosed Mullerian agenesis with normal development of other systems. After diagnosis, psychological counselling, vaginal dilators to improve her vaginal length and adoption were done with the multidisciplinary team approach. Community-based case study assessment and early detection of primary amenorrhea with available facilities in a low resource setting are essential elements for an early diagnosis and subsequent optimal outcomes.","PeriodicalId":280534,"journal":{"name":"Jaffna Medical Journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130903089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. W. Gnanathayalan, T. Peranantharajah, T. Sooriyakumar
Hemophagocytic lymphohistiocytosis(HLH) is a rare, potentially lethal condition due to dysfunctional immune response causing severe inflammatory syndrome. Epstein-Barr virus (EBV) – induced HLH is a form of secondary HLH, a very serious presentation of an otherwise benign viral infection. Here we present a case of 31 year old previously healthy male with prolonged fever and constitutional symptoms, eventually diagnosed to have HLH secondary to EBV infection. He had refractory response to treatment regimen of etoposide and dexamethasone followed by Rituximab therapy and succumbed to septic shock.
{"title":"A Fatal case of Epstein-Barr Virus-Induced Haemophagocytic Lymphohistiocytosis in a young male","authors":"S. W. Gnanathayalan, T. Peranantharajah, T. Sooriyakumar","doi":"10.4038/jmj.v33i2.138","DOIUrl":"https://doi.org/10.4038/jmj.v33i2.138","url":null,"abstract":"Hemophagocytic lymphohistiocytosis(HLH) is a rare, potentially lethal condition due to dysfunctional immune response causing severe inflammatory syndrome. Epstein-Barr virus (EBV) – induced HLH is a form of secondary HLH, a very serious presentation of an otherwise benign viral infection. Here we present a case of 31 year old previously healthy male with prolonged fever and constitutional symptoms, eventually diagnosed to have HLH secondary to EBV infection. He had refractory response to treatment regimen of etoposide and dexamethasone followed by Rituximab therapy and succumbed to septic shock.","PeriodicalId":280534,"journal":{"name":"Jaffna Medical Journal","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116520760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dengue is a mosquito borne febrile viral disease .Sri Lanka is an endemic area where the incidence was peak in 2017 and slightly decreased in 2020 (28.7%) because of preventive measures. Presentation can be asymptomatic or cause a spectrum of symptoms including undifferentiated viral fever, dengue fever, dengue haemorrhagic fever with or without shock and expanded dengue syndrome. We describe here a case of 48-years old man who presented to the emergency unit with three-day history of acute fever and prodromal features, subsequently diagnosed to have dengue haemorrhagic fever and it was complicated with psoas haemorrhage. Only limited cases were reported about spontaneous psoas muscle haemorrhage in dengue haemorrhagic fever in adult population.
{"title":"Dengue haemorrhagic fever complicated with spontaneous psoas haematoma requiring blood products","authors":"B. Sivakajani, S. Ghetheeswaran, T. Sanchayan","doi":"10.4038/jmj.v33i1.128","DOIUrl":"https://doi.org/10.4038/jmj.v33i1.128","url":null,"abstract":"Dengue is a mosquito borne febrile viral disease .Sri Lanka is an endemic area where the incidence was peak in 2017 and slightly decreased in 2020 (28.7%) because of preventive measures. Presentation can be asymptomatic or cause a spectrum of symptoms including undifferentiated viral fever, dengue fever, dengue haemorrhagic fever with or without shock and expanded dengue syndrome. We describe here a case of 48-years old man who presented to the emergency unit with three-day history of acute fever and prodromal features, subsequently diagnosed to have dengue haemorrhagic fever and it was complicated with psoas haemorrhage. Only limited cases were reported about spontaneous psoas muscle haemorrhage in dengue haemorrhagic fever in adult population.","PeriodicalId":280534,"journal":{"name":"Jaffna Medical Journal","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132516593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
When thinking of something that would kill millions of people, a pandemic is the greatest risk. The outbreaks hit much harder to the lowerincome nations, given the lack of access to basic health services, health infrastructure, and effective infection control mechanisms. In this context, ethical aspects related to equity in resource allocation, selective vaccination, clinical trials involving human subjects, limitation of personal freedom such as quarantine regulations, and so forth need to be addressed by the healthcare professionals. Therefore, a recognized clinical ethics scheme is imperative to balance individual and population rights during the response to an outbreak.
{"title":"Applying the code of medical ethics in the context of a pandemic: COVID-19 in Sri Lanka","authors":"K. M. C. R. Karunatilaka","doi":"10.4038/jmj.v33i1.115","DOIUrl":"https://doi.org/10.4038/jmj.v33i1.115","url":null,"abstract":"When thinking of something that would kill millions of people, a pandemic is the greatest risk. The outbreaks hit much harder to the lowerincome nations, given the lack of access to basic health services, health infrastructure, and effective infection control mechanisms. In this context, ethical aspects related to equity in resource allocation, selective vaccination, clinical trials involving human subjects, limitation of personal freedom such as quarantine regulations, and so forth need to be addressed by the healthcare professionals. Therefore, a recognized clinical ethics scheme is imperative to balance individual and population rights during the response to an outbreak.","PeriodicalId":280534,"journal":{"name":"Jaffna Medical Journal","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133372108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Efficient mentorship","authors":"M. G. Sathiadas","doi":"10.4038/jmj.v33i1.114","DOIUrl":"https://doi.org/10.4038/jmj.v33i1.114","url":null,"abstract":"","PeriodicalId":280534,"journal":{"name":"Jaffna Medical Journal","volume":"130 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121717048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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