Browsing by Author "Nanayakkara, S"
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Item Clinical features of systemic lupus erythematosus in Sri Lankan patients: results from a lupus clinic.(2000-12-11) Galapatthy, P; Wazeel, A N; Nanayakkara, S; Sheriff, ROBJECTIVES: To find the common clinical features, pattern of visceral involvement, treatment received and outcome in patients diagnosed as having systemic lupus erythematosus (SLE) on American Rheumatological Association (ARA) criteria. SETTING: Clinic for patients referred or admitted to the University Medical Unit, National Hospital of Sri Lanka, Colombo, with diagnosed or suspected SLE. DESIGN AND METHODS: A prospective descriptive study. Clinical features of patients collected at time of registration in the clinic were maintained in a database. Patients were followed up prospectively and changes recorded. Data were analysed after 3 years of follow up. RESULTS: Of the 111 patients registered during this period, 96 (86%) were clinically diagnosed as having SLE. Of these, 77 patients (80%) satisfied ARA criteria for diagnosis of SLE. 72 were females (93%). The mean age of patients who satisfied the ARA criteria was 32 years (range 11 to 58), and the mean duration of disease 7 years (range 1 to 15). The commonest presentation was with mucocutaneous features (98%) and alopecia in 87%. Systemic features were found in 92% of patients. 67 (87%) of patients had visceral involvement with 60 (78%) having it at time of diagnosis. 53 (69%) had renal, 42 (54%) haematological, 33 (42%) neurological, 12 (16%) cardiac and 8 patients pulmonary involvement. Five patients died during the 3-year follow up and 2 developed chronic renal failure. Three patients underwent successful pregnancy after diagnosis of SLE. CONCLUSIONS: Our study confirmed the wide variability of clinical features seen in SLE. Alopecia and visceral involvement were common in Sri Lankan patients.Item First reported case of rabies in a horse in Sri Lanka.(1997-06-01) Wimalaratne, O; Nanayakkara, SItem An Immunogenicity study to compare the two accepted regimen of intradermal rabies post exposure therapy in healthy adults(Post Graduate Institute of Medicine, Colombo: PGIM., 1998) Nanayakkara, SThis is the first study done in Sri Lanka to compare the two WHO accepted ID-PET schedules("2 site" ID and "8 site" ID schedules).Fifty healthy adults with minor exposures to rabies infection were randomly selected from the anti rabies clinic in the NHSL.Twenty five of them were inoculated the "2 site" ID schedule and the rest the " 8 site " ID schedule.Three samples of blood were collected from each patient on day 0 (prior to vaccine therapy), day 7 and day 120 (30 days after the completion of vaccine course) to compare the rabies neutralizing antibodies.This was done by using a tissue culture neutralization test- rapid fluorescent focus inhibition test (RFFIT).The result of this study showed that both these schedules are immunogenic.Sixty percent of the patients who were administered the " 8 site" ID schedule when compared to the "2 site" ID schedule (29.2 per cent),produced rabies neutralizing antibodies above the WHO recommended minimum protective level of 0.5 IU/ml serum by the 7 th day following the first does of vaccination.By using this highly immunogenic and economical method of ID anti rabies vaccine therapy,we are able to give sri lanka patients a safe anti rabies PET while saving large amounts of foreign exchange to Sri Lanka.Item Short term outcome, complications and average direct cost in managing extremely low birth weight infants in a tertiary care centre in Sri Lanka.(2012-10) Nelumdeniya, U B; De Silva, P S; Nanayakkara, S; Sridharan, S; Srirathnakumar, K; Abeysirigunawardena, R C; Marasinghe, S SIntroduction: Data on cost, short term complications and outcome of Sri Lankan extremely low birth weight (ELBW) babies is largely unavailable. Objective: To determine the cost, selected short term complications (surfactant treated and untreated) and short term outcome of ELBW infants in a tertiary care unit in Sri Lanka. Design, setting and method: A descriptive longitudinal study was carried out at Castle Street Hospital for Women over a 6 month period on all ELBW infants, excluding babies who were born after less than 23 completed weeks of gestation and babies who were transferred from the unit. Results: During the study period there were 39 ELBW babies. Ranges of birth weights and maturity were from 540g to 980g (mean 853g) and from 25 weeks to 34+3days respectively. Fifty one percent were small for gestational age. Survival rate was 76.9% at discharge. Hospital stay, intensive care unit stay, duration of mechanical ventilation and supplemental oxygen were 60.6, 13, 3.5 and 9.0 days per survivor respectively. Direct cost per survivor was SLR 82,207. Incidences of complications were 19.4% intraventricular haemorrhage, 8.3% necrotising enterocolitis, 22.2% pulmonary air leak, 11.1% pulmonary haemorrhage and 2.7% patent ductus arteriosus. Average weight gain on discharge was 5.2g/kg/day. Conclusions: Overall survival rate was 77%. IVH was significantly less in surfactant treated babies.