Nalika Lakmali, Ranga Chamara, Tiron Chathuranga, Meththananda Herath
Recurrent Kikuchi Fujimoto Disease (KFD) with neurological manifestations is a rare entity. It usually presents with fever and cervical lymphadenopathy. Diagnosis is based on clinical grounds and typical histological findings of lymph node biopsy. Mostly KFD is self-limiting. Treatment with non-steroidal anti-inflammatory drugs or steroids may be needed in severe recurrent disease.We report a case of recurrent KFD in a 28-year-old male presenting with aseptic meningitis who has a family history of KFD.
{"title":"Recurrent Kikuchi Fujimoto Disease with Aseptic Meningitis and Familial Occurrence: A Rare Presentation","authors":"Nalika Lakmali, Ranga Chamara, Tiron Chathuranga, Meththananda Herath","doi":"10.4038/amj.v17i3.7775","DOIUrl":"https://doi.org/10.4038/amj.v17i3.7775","url":null,"abstract":"Recurrent Kikuchi Fujimoto Disease (KFD) with neurological manifestations is a rare entity. It usually presents with fever and cervical lymphadenopathy. Diagnosis is based on clinical grounds and typical histological findings of lymph node biopsy. Mostly KFD is self-limiting. Treatment with non-steroidal anti-inflammatory drugs or steroids may be needed in severe recurrent disease.We report a case of recurrent KFD in a 28-year-old male presenting with aseptic meningitis who has a family history of KFD.","PeriodicalId":30600,"journal":{"name":"Anuradhapura Medical Journal","volume":" 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139136013","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}
In the rapidly evolving landscape of healthcare, innovation and technology have emerged as the pillars that strengthen medical education and patient care. One powerful tool that has revolutionized the way medical professionals train and practice is simulation. The role of simulation in community medicine has grown significantly, transcending traditional medical education. It’s potential to enhance training, promote interdisciplinary collaboration, test interventions, address health disparities, and nurture leadership is immense. Embracing simulation as a core component of public health education and practice can lead to more resilient and proactive community health systems, better equipped to safeguard the well-being of populations in the face of evolving health threats. Community medicine, in particular, stands to benefit significantly from the role and uses of simulation. This paper explores the evolving role and uses of simulation in community medicine and its potential to shape the future of public health.
{"title":"Empowering public health practitioners: Widening horizons of simulation in community medicine","authors":"Imran Khan, Neha Priyanka","doi":"10.4038/amj.v17i3.7800","DOIUrl":"https://doi.org/10.4038/amj.v17i3.7800","url":null,"abstract":"In the rapidly evolving landscape of healthcare, innovation and technology have emerged as the pillars that strengthen medical education and patient care. One powerful tool that has revolutionized the way medical professionals train and practice is simulation. The role of simulation in community medicine has grown significantly, transcending traditional medical education. It’s potential to enhance training, promote interdisciplinary collaboration, test interventions, address health disparities, and nurture leadership is immense. Embracing simulation as a core component of public health education and practice can lead to more resilient and proactive community health systems, better equipped to safeguard the well-being of populations in the face of evolving health threats. Community medicine, in particular, stands to benefit significantly from the role and uses of simulation. This paper explores the evolving role and uses of simulation in community medicine and its potential to shape the future of public health.","PeriodicalId":30600,"journal":{"name":"Anuradhapura Medical Journal","volume":"113 31","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139135432","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}
There has been an epidemic of Chronic Kidney Disease of Unknown Etiology (CKDu) affecting the agricultural communities in Sri Lanka, spanning three decades. The main pathological finding has been chronic interstitial nephritis. This narrative review focuses on the efficacy of Reverse Osmosis (RO) technology in purifying water and its impact in reducing CKDu. PubMed, Cochrane and Google Scholar were used to search for peer-reviewed articles from 2000 to 2023. The themes that emerged from the literature review were validated through the opinions of key informants and subject matter experts.There were anecdotal, as well as some research evidence to indicate that RO-treated water is efficacious in preventing and slowing down the progression of CKDu. This relationship needs further investigation with well-designed prospective studies. The literature review also revealed many social, technical and environmental issues related to the use of RO machines. Despite the potential benefits of RO machines, these issues must be resolved in order to prevent serious problems in the future.In conclusion, this review underscores the need for further research, interventions and regulatory measures related to the use of RO machines to reshape the CKDu trajectory in Sri Lanka.
{"title":"Efficacy of Reverse Osmosis in Reducing Chronic Kidney Disease of Unknown Etiology in Sri Lanka: A Narrative Review","authors":"Vinuri Goonesinghe, Sarath Gunatileka","doi":"10.4038/amj.v17i3.7815","DOIUrl":"https://doi.org/10.4038/amj.v17i3.7815","url":null,"abstract":"There has been an epidemic of Chronic Kidney Disease of Unknown Etiology (CKDu) affecting the agricultural communities in Sri Lanka, spanning three decades. The main pathological finding has been chronic interstitial nephritis. This narrative review focuses on the efficacy of Reverse Osmosis (RO) technology in purifying water and its impact in reducing CKDu. PubMed, Cochrane and Google Scholar were used to search for peer-reviewed articles from 2000 to 2023. The themes that emerged from the literature review were validated through the opinions of key informants and subject matter experts.There were anecdotal, as well as some research evidence to indicate that RO-treated water is efficacious in preventing and slowing down the progression of CKDu. This relationship needs further investigation with well-designed prospective studies. The literature review also revealed many social, technical and environmental issues related to the use of RO machines. Despite the potential benefits of RO machines, these issues must be resolved in order to prevent serious problems in the future.In conclusion, this review underscores the need for further research, interventions and regulatory measures related to the use of RO machines to reshape the CKDu trajectory in Sri Lanka.","PeriodicalId":30600,"journal":{"name":"Anuradhapura Medical Journal","volume":"115 35","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139134255","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}
Anjana Silva, K. Weerakoon, Janaka Pushpakumara, Sampath C. Paththinige
No abstract available
没有可用的摘要
{"title":"Outstation state medical faculties in Sri Lanka: nobody’s children when it comes to sustainability!","authors":"Anjana Silva, K. Weerakoon, Janaka Pushpakumara, Sampath C. Paththinige","doi":"10.4038/amj.v17i2.7787","DOIUrl":"https://doi.org/10.4038/amj.v17i2.7787","url":null,"abstract":"No abstract available","PeriodicalId":30600,"journal":{"name":"Anuradhapura Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49096034","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. Maduranga, D. Jayarathne, K. Thebuwana, L. Wijekoon, V. Mendis, H. Senanayake, S. Siribaddana
Hemophagocytic lymphohistiocytosis (HLH) is a rare severe inflammatory syndrome of excessive cytokine production. A 16-year-old girl presented with hyperacute liver failure due to idiopathic HLH. Liver failure due to HLH is uncommon, and survival in an adult after hyperacute liver failure is rare. Early diagnosis of the disease and timely treatment with plasma exchange followed by immunosuppressive therapy were associated with the survival of this patient.
{"title":"Successful early plasma exchange therapy in hemophagocytic lymphohistiocytosis due to hyperacute liver failure; A case report and review of published cases.","authors":"K. Maduranga, D. Jayarathne, K. Thebuwana, L. Wijekoon, V. Mendis, H. Senanayake, S. Siribaddana","doi":"10.4038/amj.v17i2.7754","DOIUrl":"https://doi.org/10.4038/amj.v17i2.7754","url":null,"abstract":"Hemophagocytic lymphohistiocytosis (HLH) is a rare severe inflammatory syndrome of excessive cytokine production. A 16-year-old girl presented with hyperacute liver failure due to idiopathic HLH. Liver failure due to HLH is uncommon, and survival in an adult after hyperacute liver failure is rare. Early diagnosis of the disease and timely treatment with plasma exchange followed by immunosuppressive therapy were associated with the survival of this patient.","PeriodicalId":30600,"journal":{"name":"Anuradhapura Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42739689","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}
Diaphragmatic hernia is a condition where the abdominal contents can protrude into the thorax. Despite their rarity, hernia-related complications can have fatal results if treated late. In literature, the hernial contents of the stomach, spleen, pancreatic tail, small intestine, and colon are frequently mentioned.We describe a case of a 33-year-old patient who had a diaphragmatic hernia that was undetected. The patient complained of severe epigastric pain and abdominal pain, which was later determined to be an ischemic gastric perforation. Then total gastrectomy and esophago-jejunostomy along with repair of the diaphragmatic defect was performed.This case illustrates the necessity of having a high degree of suspicion and early discovery of a diaphragmatic hernia for improved patient outcome.
{"title":"Pneumoperitoneum due to a missed diaphragmatic hernia","authors":"A. R. M. Isthiyak, A. Banagala, Amila Jayasekara","doi":"10.4038/amj.v17i2.7760","DOIUrl":"https://doi.org/10.4038/amj.v17i2.7760","url":null,"abstract":"Diaphragmatic hernia is a condition where the abdominal contents can protrude into the thorax. Despite their rarity, hernia-related complications can have fatal results if treated late. In literature, the hernial contents of the stomach, spleen, pancreatic tail, small intestine, and colon are frequently mentioned.We describe a case of a 33-year-old patient who had a diaphragmatic hernia that was undetected. The patient complained of severe epigastric pain and abdominal pain, which was later determined to be an ischemic gastric perforation. Then total gastrectomy and esophago-jejunostomy along with repair of the diaphragmatic defect was performed.This case illustrates the necessity of having a high degree of suspicion and early discovery of a diaphragmatic hernia for improved patient outcome.","PeriodicalId":30600,"journal":{"name":"Anuradhapura Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42780719","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}
This report presents findings on the prevalence of "period poverty" in Sri Lanka, which refers to inadequate financial resources, cultural stigma, and limited menstrual hygiene resources that affect the management of menstruation. We conducted a cross-sectional study in 2010, in the Anuradhapura district with 539 pregnant women, collecting data on their menstrual history, health-seeking behaviour, blood loss, and access to sanitary products. Our results show that 137 (25.4%) of the women reported menstrual issues, and only 68 (12.6%) of them sought medical care. Furthermore, 139 (25.7%) of the participants reported a menstrual blood loss of more than 80ml. Of the participants, 98 (18.2%) had used "old clothes" as a sanitary product during their lifetime, highlighting the lack of access to proper menstrual hygiene products. We found that inadequate sanitary facilities were associated with low education, low income, living in remote MOH areas, and moor ethnicity. Given the current economic hardships faced by Sri Lanka as a country, the study on period poverty gains a greater relevance, emphasizing the need of addressing the financial burden of menstrual hygiene products. We recommend comprehensive reproductive health education for adolescent girls and women, as well as efforts to reduce the financial burden of menstrual hygiene products, to improve the management of menstruation for women in Sri Lanka.
{"title":"Period poverty in rural Sri Lanka; Understanding menstruation hygiene and related health issues to empower women.","authors":"Ayesh Hettiarachchi, T. Agampodi, S. Agampodi","doi":"10.4038/amj.v17i2.7759","DOIUrl":"https://doi.org/10.4038/amj.v17i2.7759","url":null,"abstract":"This report presents findings on the prevalence of \"period poverty\" in Sri Lanka, which refers to inadequate financial resources, cultural stigma, and limited menstrual hygiene resources that affect the management of menstruation. We conducted a cross-sectional study in 2010, in the Anuradhapura district with 539 pregnant women, collecting data on their menstrual history, health-seeking behaviour, blood loss, and access to sanitary products. Our results show that 137 (25.4%) of the women reported menstrual issues, and only 68 (12.6%) of them sought medical care. Furthermore, 139 (25.7%) of the participants reported a menstrual blood loss of more than 80ml. Of the participants, 98 (18.2%) had used \"old clothes\" as a sanitary product during their lifetime, highlighting the lack of access to proper menstrual hygiene products. We found that inadequate sanitary facilities were associated with low education, low income, living in remote MOH areas, and moor ethnicity. Given the current economic hardships faced by Sri Lanka as a country, the study on period poverty gains a greater relevance, emphasizing the need of addressing the financial burden of menstrual hygiene products. We recommend comprehensive reproductive health education for adolescent girls and women, as well as efforts to reduce the financial burden of menstrual hygiene products, to improve the management of menstruation for women in Sri Lanka.","PeriodicalId":30600,"journal":{"name":"Anuradhapura Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42909750","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}
P. Abeyrathna, Tharindu Nadeesha, Nuwani Malika, Nawoda Wijerathna, S. Agampodi
Introduction: Dermatological conditions are non-life-threatening but cause serious psychological stress among the young population. This study was conducted to determine the prevalence of selected self-reported dermatological conditions and their impact on university students.Methods: A descriptive cross-sectional study was conducted in three faculties of the Rajarata University of Sri Lanka. A minimum of 200 undergraduates were selected from each faculty from simple random sampling. A validated, self-administered questionnaire was used in Sinhala English and Tamil all as e-forms and papers to assess the common dermatological complaints, duration, and associated psycho-social effects.Results: Among 614 participants, 400 (65%) females and 214 (35%) males were included. More than half of the participants (n=326, 53%) reported a dermatological complaint during their university period and 277 reported a recurrent dermatological problem. Self-reported acne was the most reported (n=325) and diagnosed psoriasis (n=2) was the least reported condition of interest. Pityriasis versicolar prevalence was significantly highest among males (n=257) and dandruff was commonest among females (n=178).The study has shown significant self-reported distress associated with dermatological conditions which make 89.7% of participants think dermatological conditions as something to worry about, p<0.005. Common responses for dermatological conditions were self- medication (n=200, 32.5%) and consultation of any doctor (n=342, 55%)Conclusion: Higher prevalence of dermatological conditions among university students should be addressed during health interventions. Psycho-social effects which can lead to personal and academic distress need to be intervened carefully to improve the quality of life
{"title":"Common dermatological complaints and their psychosocial impact: a descriptive cross-sectional study among undergraduates of an outstation university of Sri Lanka.","authors":"P. Abeyrathna, Tharindu Nadeesha, Nuwani Malika, Nawoda Wijerathna, S. Agampodi","doi":"10.4038/amj.v17i2.7730","DOIUrl":"https://doi.org/10.4038/amj.v17i2.7730","url":null,"abstract":"Introduction: Dermatological conditions are non-life-threatening but cause serious psychological stress among the young population. This study was conducted to determine the prevalence of selected self-reported dermatological conditions and their impact on university students.Methods: A descriptive cross-sectional study was conducted in three faculties of the Rajarata University of Sri Lanka. A minimum of 200 undergraduates were selected from each faculty from simple random sampling. A validated, self-administered questionnaire was used in Sinhala English and Tamil all as e-forms and papers to assess the common dermatological complaints, duration, and associated psycho-social effects.Results: Among 614 participants, 400 (65%) females and 214 (35%) males were included. More than half of the participants (n=326, 53%) reported a dermatological complaint during their university period and 277 reported a recurrent dermatological problem. Self-reported acne was the most reported (n=325) and diagnosed psoriasis (n=2) was the least reported condition of interest. Pityriasis versicolar prevalence was significantly highest among males (n=257) and dandruff was commonest among females (n=178).The study has shown significant self-reported distress associated with dermatological conditions which make 89.7% of participants think dermatological conditions as something to worry about, p<0.005. Common responses for dermatological conditions were self- medication (n=200, 32.5%) and consultation of any doctor (n=342, 55%)Conclusion: Higher prevalence of dermatological conditions among university students should be addressed during health interventions. Psycho-social effects which can lead to personal and academic distress need to be intervened carefully to improve the quality of life","PeriodicalId":30600,"journal":{"name":"Anuradhapura Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49361518","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}
Myxedema coma is an extreme manifestation of hypothyroidism presenting with altered level of consciousness, hypothermia, bradycardia, hypotension, hypoglycemia, and hypoventilation. It is an endocrine emergency. Now it has become a rare presentation due to early detection and treatment of hypothyroidism. The common precipitating factors like sepsis, myocardial infarction, hypothermia, sedative medications, and surgery should be addressed in a poorly controlled hypothyroid patient as early as possible. Treatment with high dose thyroid hormones and steroids should be started on clinical suspicion even before the laboratory confirmation. We present a case of an 85-year-old woman who presented to the emergency room with one day history of reduced level of consciousness, found to have bradycardia and hypothermia. Her symptoms significantly improved with oral levothyroxine therapy.
{"title":"Myxedema Coma: A rare presentation of hypothyroidism","authors":"Sahanie Liyanaarachchi, C. Perera","doi":"10.4038/amj.v17i2.7756","DOIUrl":"https://doi.org/10.4038/amj.v17i2.7756","url":null,"abstract":"Myxedema coma is an extreme manifestation of hypothyroidism presenting with altered level of consciousness, hypothermia, bradycardia, hypotension, hypoglycemia, and hypoventilation. It is an endocrine emergency. Now it has become a rare presentation due to early detection and treatment of hypothyroidism. The common precipitating factors like sepsis, myocardial infarction, hypothermia, sedative medications, and surgery should be addressed in a poorly controlled hypothyroid patient as early as possible. Treatment with high dose thyroid hormones and steroids should be started on clinical suspicion even before the laboratory confirmation. We present a case of an 85-year-old woman who presented to the emergency room with one day history of reduced level of consciousness, found to have bradycardia and hypothermia. Her symptoms significantly improved with oral levothyroxine therapy.","PeriodicalId":30600,"journal":{"name":"Anuradhapura Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42154605","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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