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Biomedical subjects

D Fernando

Publications and source records attributed to D Fernando.

At least 19 recordsLinked to original sources
PubMed2004

Single and serial measurements of cardiac troponin I in asymptomatic patients on chronic hemodialysis.

AIMS: Coronary artery disease is the major cause of death in patients with end-stage renal failure on dialysis. This study aimed to assess the predictive value of a single cardiac troponin I (cTnI), and also the kinetics of serial values. METHODS: Since cTnI is a potential biomarker of cardiac outcome, the present study examined single cTnI measurements (n = 88 patients) and its predictive value for future cardiac events, and a kinetic substudy of serial weekly cTnI measured for 8 weeks (n = 57) in a group of patients on hemodialysis. RESULTS: Single cTnI measurements: 9 patients (10.2%) had a detectable cTnI at baseline and 79 patients (89.8%) had a negative baseline cTnI. There were no significant differences in age, sex, history of ischemic heart disease, diabetes, smoking or dyslipidemia between patients with detectable and negative cTnI. At the end of 9 months, the rate of combined primary endpoints, which included myocardial infarction, cardiac death and cardiac revascularization, was significantly higher in the patients with a detectable baseline cTnI (55.6%), compared to patients with a negative cTnI (6.3%) (p = 0.0007). Serial weekly cTnI measurements: significant fluctuations in cTnI were noted over time; 27% of patients with an undetectable cTnI measured at baseline had subsequent detectable levels in the serial follow-up. CONCLUSION: A single detectable cTnI in asymptomatic patients on hemodialysis defines patients at high risk of future cardiac events. However, the incidence of detectable cTnI levels is markedly increased when serial weekly measurements are performed. The clinical significance of detectable serial measurements of cTnI is the focus of ongoing studies.

Coronary Artery Disease↗
PubMed2002

Prevalence of Helicobacter pylori in Sri Lanka as determined by PCR.

Fifty-seven Sinhalese patients were investigated for the presence of Helicobacter pylori by PCR. A prevalence of 70.1%, with 47.5% positive for cagA, was demonstrated. The most common vacA allele was s1am1. There was no significant association between either the s1 allele or the cagA allele and severe gastroduodenal disease. There was an association between the s1 allele and the cagA locus.

Adolescent↗
PubMed2001

Pattern of accidents and injuries involving three-wheelers.

OBJECTIVE: To study the pattern of injuries and some causative factors of three-wheeler related accidents. DESIGN: Prospective descriptive study. SETTING: Accident unit, Colombo South Teaching Hospital, Kalubowila. METHODS: One hundred patients admitted to Colombo South Teaching Hospital with three-wheeler related accidents were interviewed, examined within 24 hours of admission and followed up by using a standard questionnaire. Detailed descriptions of the accident and the types of injuries were recorded. RESULTS: 54 accidents took place during daytime 07.00 h to 19.00 h) and the passengers were the commonest victims (40%). Soft tissue injury was the commonest injury observed (75%). The second commonest type of injury was long bone fractures (21%). Toppling due to a sudden turn of the vehicle accounted for 30% of accidents. Of 28 drivers in the study group, 25 admitted breaking the handle-lock to increase the vehicle's turning angle. Toppling due to a sudden turn was identified as the cause of the accident in all those who had interfered with the handle-lock. At the time of the accident, 89% of the drivers and 28.1% of pedestrians were under the influence of alcohol. Alcohol was related to 67.4% of the night accidents. CONCLUSIONS: Alcohol consumption was recognised as a major contributory factor, in particular for night accidents. A strong association was observed between mechanical alteration of the vehicle's handle-lock and the risk of accident. Introduction of legislation to prohibit handle-lock alteration and strict implementation of the law regarding driving under the influence of alcohol would help to reduce three-wheeler related accidents.

Accidents, Traffic↗
PubMed2000

Selective enzyme-mediated extraction of capsaicinoids and caratenoids from chili guajillo puya (Capsicum annum L.) using ethanol as solvent.

The selective extraction of capsaicinoids and carotenoids from chili guajillo "puya" flour was studied. When ethanol was used as solvent, 80% of capsaicinoids and 73% of carotenoids were extracted, representing an interesting alternative for the substitution of hexane in industrial processes. Additionally, when the flour was pretreated with enzymes that break the cell wall and then dried, extraction in ethanol increased to 11 and 7% for carotenoid and capsaicinoid, respectively. A selective two-stage extraction process after the treatment with enzymes is proposed. The first step uses 30% (v/v) ethanol and releases up to 60% of the initial capsaicinoids, and the second extraction step with industrial ethanol permits the recovery of 83% of carotenoids present in the flour.

Capsaicin↗
PubMed2000

Comparison of some clinical and histological features of colorectal carcinoma occurring in patients below and above 40 years.

OBJECTIVE: To determine the clinicopathological features of colorectal malignancies in Sri Lankan patients aged 40 years or younger, and to compare them with those of older patients. METHODS: The clinicopathological features of 60 colorectal malignancies which occurred in patients aged 40 years or younger were compared with 245 malignant colorectal tumours in older patients. These tumours had been diagnosed at a University Department of Pathology over 15 years. RESULTS: 19.7% of colorectal malignancies occurred in patients aged 40 years or younger. (Male:Female ratio = 1.6:1). The mean duration from onset of symptoms to diagnosis was 4.2 months. There was no statistically significant difference between young and old patients in the presenting symptoms, site of tumour and Dukes' staging of colorectal malignancies. A statistically significant proportion of tumours in young patients was mucoid (13.3%) or signet ring cell (5%) type. 3.3% of young patients with colorectal carcinoma gave a family history of similar malignancy. A history of predisposing conditions (ulcerative colitis) was present in 3.3% of young patients. CONCLUSIONS: The clinical presentation of colorectal malignancies in Sri Lankan patients below 40 years of age does not differ from that in older patients. Mucoid and signet ring cell carcinomas are commoner in the young.

Adult↗
PubMed1998

Linking injection drug users to medical services: role of street outreach referrals.

Street outreach workers in HIV prevention have expanded their role to include referring injection drug users to medical services. However, little is known about whether drug users act on these referrals. The study discussed in this article examined the level of exposure to street outreach reported by injection drug users, the most common medical referrals acted on as a result of such contacts, and the predictors of acting on these referrals. Findings indicate that injection drug users with four or more contacts with street outreach workers during the preceding six months were more likely to report acting on referrals. To maximize the relevance of outreach for encouraging medical treatment, both street outreach workers and social workers in health care could benefit from cross training that focuses on strengthening the referral process.

Adult↗
PubMed1997

Leg wound infections associated with coronary revascularization.

BACKGROUND: Wound infections after saphenous vein harvest for coronary revascularization are common but they are infrequently examined. The aim of the present study was to investigate the risk factors for infection and the possible beneficial effects of saline lavage. METHODS: From April 1996 to July 1996, 152 consecutive patients who underwent saphenous vein harvest for coronary artery bypass graft were recruited. Factors that may influence infection rates were analysed. RESULTS: A total of 22 of the 125 (18%) patients included in the present study developed a wound infection. The length of the wound was the only variable found to have a statistically significant association with wound infection. In the analysis of patients with multiple leg wounds, the development of infection correlated with the absence of mechanical wash-out. CONCLUSION: The use of saline lavage may prevent wound infections by diluting the bacterial population prior to closure. The use of antiseptic or antibiotic lavage may offer an additional benefit.

Coronary Artery Bypass↗
PubMed1995

An electrophysiological investigation of the effects of cisplatin and the protective actions of dexamethasone on cultured dorsal root ganglion neurones from neonatal rats.

In this study we have investigated the acute and chronic effects of cisplatin on whole cell currents in cultured dorsal root ganglion neurones. Consistent with effects on action potentials measured under current clamp, acute (5 min) application of cisplatin (5 microM) attenuated voltage-activated potassium, and mixed cation currents by approximately 50% in both cases. Chronic treatment (5-7 days) of cultured neurones with 5 microM cisplatin also resulted in greatly reduced voltage-activated potassium currents (by 50%) and calcium currents (by 60%) compared to events recorded from neurones not treated with cisplatin. In contrast, the amplitude of inward cation current activated by hyperpolarization was doubled by 5-12 days treatment with cisplatin. Studies on action potential after-depolarizations and calcium-activated chloride currents suggest that cisplatin disturbs calcium homeostatic mechanisms. These observations may account for anode break spike excitation and the low efficiency with which cells buffer intracellular calcium following cisplatin treatment. Dexamethasone has been found to enhance the anti-emetic effects of 5-HT3 receptor antagonists in patients treated with cisplatin. For this reason the actions of dexamethasone were studied in combination with cisplatin treatment. Although acute application of dexamethasone (1-10 microM) produced transient depolarizations and bursts of action potentials, after 5 minutes application it had no effect on membrane potential, input resistance, or the properties of action potentials evoked by depolarizing current commands.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1995

A rare paratesticular pleomorphic rhabdomyosarcoma.

A paratesticular pleomorphic rhabdomyosarcoma occurring in a 81-year old man is reported. The unusual clinical presentation and pathological features and the differential diagnosis are discussed. Difficulties encountered in diagnosis are emphasised.

Aged↗