Faculty of Medicine
http://ir.lib.ruh.ac.lk/xmlui/handle/iruor/7347
2024-03-29T11:49:08ZApplicability of Western protocols in resource-limited setting: Real-world data of long-term outcome of intensive treatment of adult acute myeloid leukaemia in Sri Lanka
http://ir.lib.ruh.ac.lk/xmlui/handle/iruor/16330
Applicability of Western protocols in resource-limited setting: Real-world data of long-term outcome of intensive treatment of adult acute myeloid leukaemia in Sri Lanka
Hewamana, S.; Kandabadage, L.; Skandarajah, T.; Pieris, N.; Perera, E.; Harischandra, M.; Wijewickrama, A.; Wickramaratne, K. A. C.; Somasundaram, G.; Srinivasan, V.; Somiah, S.; Jayawardena, P.; Perera, M.; Gunasekera, D.; Jayasinghe, C.; Constantine, G.; Munasinghe, S.; De Silva, C.; Wijesiriwardena, B.; Balawardena, J.
There are no published data on long-term survival and applicability of treatment protocols from developed countries in acute myeloid leukaemia (AML) in Sri Lanka. Eighty-seven AML patients were reviewed; there were 56 newly diagnosed patients between 18 and 65 years. Thirty-one out of 33 who started treatment achieved complete remission after first cycle of treatment. The induction mortality was one of 33. Twelve out of 20 patients who completed treatment are alive at the time of analysis. The estimated 5-year overall survival rate is 0.629. Strict infection control and treatment and superior clinical experience may have contributed towards better outcome.
2021-05-13T00:00:00ZScreening for beta-thalassemia trait; applicability of red cell indices and parameters - A study in Sri Lanka
http://ir.lib.ruh.ac.lk/xmlui/handle/iruor/16320
Screening for beta-thalassemia trait; applicability of red cell indices and parameters - A study in Sri Lanka
Wickramaratne, K. A. C.; Wijewickrama, D. C.
Objective: Red cell indices and parameters are used to screen beta-thalassemia trait
(BTT). Different red cell indices and formulae used to discriminate BTT in different
populations show inconsistent results.
Methods: A retrospective study was performed to assess reliability of 11 red cell
indices, parameters and formulae in differentiating BTT from non-BTT in a cohort of
individuals referred for confirmation of BTT.
Results: Of 111 individuals, 79 were females and 32 were males. Of the total, 89
were confirmed to have BTT by Hb A2 quantification. The mean age of the group
was 29.9 ± 19.2 years. The mean Hb concentration, MCV and MCH in BTT group
were 10.45 ± 1.6 g/dL, 62.1 ± 5.4 fl, and 19.7 ± 1.7 pg, respectively. The mean red
cell count in BTT group was 5.3 ± 0.8 × 109
/L while in non BTT group it was 4.7 ±
0.7 × 109
/L. The highest specificity (86.4%) was shown by Sirdah, Sriwastava and
England and Fraser indices, but their sensitivities were 61.8%, 57.3%, and 32.6%. The
lowest number of false positives (n = 3, 13.6%) was shown by Srivastava, Sirdah and
England and Fraser indices. Shine and Lal index showed 100% sensitivity and NPV
and 12 false positives. MCV and MCH showed results similar to Shine and Lal index
with 16 false positives each.
Conclusion: Use of Shine and Lal index in screening programs of BTT is superior to
all the other indices and formulae. To confirm the findings of this study, further studies
are recommended to be carried out in Sri Lanka on different ethnicities.
2021-01-01T00:00:00ZUse of patient data in calculation of reference intervals for complete blood count parameters; how reliable?
http://ir.lib.ruh.ac.lk/xmlui/handle/iruor/16319
Use of patient data in calculation of reference intervals for complete blood count parameters; how reliable?
Wickramaratne, K. A. C.; Wijewickrama, D. C.
Calculation of reference intervals (RI) for each quantitative test for the population served is mandatory in clinical care. Standard method of calculation of RI is costly and tedious. Literature show success in using patient data in calculating RI for some tests but, those related to complete blood count (CBC) are sparse. Therefore, this study was conducted to assess the applicability of stored patient data of CBC in calculating RI as a less costly and reliable method. A retrospective cross-sectional study was performed using a large database of CBC reports of adults (18-60 years) in a hospital laboratory. Data were grouped in to patients and routine health checkup category and then partitioned according to gender. Data were refined using clinically relevant criteria and statistical tools to harness reference data sets for each parameter. RI were calculated using standard statistical methods. Obtained values were compared with those in the literature and of the manufacturer. All data sets showed Gaussian distribution. The RI calculated using patient data showed no clinically significant differences when compared with those of the healthy subjects, manufacturer and literature. When appropriate selection criteria and statistical tools are applied, large patient databases can be used to calculate RI for CBC parameters.
2021-07-27T00:00:00ZDirect and indirect costs for hospitalized patients with dengue in Southern Sri Lanka
http://ir.lib.ruh.ac.lk/xmlui/handle/iruor/15843
Direct and indirect costs for hospitalized patients with dengue in Southern Sri Lanka
Weerasinghe, N. P.; Bodinayake, C. K.; Wijayaratne, W. M. D. G. B.; Devasiri, I. V.; Dahanayake, N. J.; Kurukulasooriya, M. R. P.; Premamali, M.; Sheng, T.; Nicholson, B. P.; Ubeysekera, H. A.; De Silva, A. D.; Østbye, T.; Woods, C. W.; Tillekeratne, L. G.; Nagahawatte, A. De Silva
Background
The Southern Province of Sri Lanka is endemic with dengue, with frequent outbreaks and occurrence of severe disease. However, the economic burden of dengue is poorly quantified. Therefore, we conducted a cost analysis to assess the direct and indirect costs associated with hospitalized patients with dengue to households and to the public healthcare system.
Methods
From June 2017–December 2018, we prospectively enrolled children and adults with acute dengue hospitalized at the largest, public tertiary-care (1800 bed) hospital in the Southern Province, Sri Lanka. We administered a structured questionnaire to obtain information regarding direct costs spent by households on medical visits, medications, laboratory testing, and travel for seeking care for the illness. Indirect costs lost by households were estimated by identifying the days of work lost by patients and caregivers and school days lost by children. Direct hospital costs were estimated using gross costing approach and adjusted by multiplying by annual inflation rates in Sri Lankan rupees and converted to US dollars.
Results
A total of 1064 patients with laboratory-confirmed dengue were enrolled. The mean age (SD) was 35.9 years (15.6) with male predominance (66.2%). The mean durations of hospitalization for adults and paediatric patients were 3.86 (SD = 1.51) and 4 (SD = 1.32) days, respectively. The per-capita direct cost borne by the healthcare system was 233.76 USD, and was approximately 14 times greater than the per-capita direct cost borne by households (16.29 USD, SD = 14.02). The per-capita average number of loss of working days was 21.51 (SD = 41.71), with mean per-capita loss of income due to loss of work being 303.99 USD (SD = 569.77), accounting for over 70% of average monthly income. On average, 10.88 days (SD = 10.97) of school days were missed due to the dengue episode. School misses were expected to reduce future annual income of affected children by 0.44%.
Conclusions
Dengue requiring hospitalization had a substantial economic burden on the public healthcare system in Sri Lanka and the affected households. These findings emphasize the importance of strengthening dengue control activities and improved use of hospital-based resources for care to reduce the economic impact of dengue in Sri Lanka.
2022-05-16T00:00:00Z