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1.
Indian Heart J ; 2018 May; 70(3): 350-352
Article | IMSEAR | ID: sea-191619

ABSTRACT

Objectives Physical inactivity is associated with high cardiovascular risk. The purpose of this study was to study physical activity levels of patients with acute coronary syndrome (ACS). Methodology A total of 504 patients, from the Professorial Unit of the Colombo South Teaching Hospital completed the International Physical Activity Questionnaire (IPAQ). IPAQ is a validated questionnaire used internationally to objectively measure physical activity. Both the total volume and the number of sessions of activity are included in the IPAQ. Populations are divided into three levels based on physical activity levels: low, moderate and high activity. Results Out of 504 patients, 128 (25.1%) were highly active, 87 (17.1%) were minimally active and 289 (56.7%) were found be inactive. When considering mets per week 134 (26.3%) spent less than 1000 mets/week. Physical activity levels of men and women were similar (p = 0.06). There was a no significant association between body mass index (BMI) with total IPAQ score (p = 0.11). There was no difference in the physical activity levels of patients presenting with different types of ACS: ST-Elevation Myocardial Infarction (STEMI), non-ST-elevation myocardial infarction (NSTEMI) or unstable angina (UA) (p = 0.36). The activity levels did not affect the severity of ACS assessed by Thrombolysis In Myocardial Infarction (TIMI) scores. (NSTEMI/UA p = 0.24, STEMI p = 0.10). Conclusion In Sri Lanka, a majority of patients with ACS were physically inactive. Physical inactivity is one of the remediable major risk factors of ACS and an active life style should be promoted.

3.
Ceylon Med J ; 2005 Sep; 50(3): 106-9
Article in English | IMSEAR | ID: sea-49194

ABSTRACT

OBJECTIVE: This open label, parallel group, prospective cohort study investigated the efficacy of rivastigmine treatment on activities of daily living (ADL) in patients with mild to moderate Alzheimer's disease (AD) and the possible benefits of this therapy on caregiver stress levels. METHODS: Thirty eight consecutive patients with mild to moderate AD were recruited; 22 received rivastigmine 3-6 mg twice daily (treatment group) for 20 weeks. Sixteen patients who did not receive rivastigmine served as the control group. The 17-item ADL Index was used to assess ADL and to determine the presence of functional deterioration. Caregivers were evaluated with the Caregiver Stress Scale (CSS). Each patient was required to have a committed caregiver and all caregivers were interviewed and administered the ADL Index and the Caregiver Stress Scale (CSS) at the start of treatment (week 0) and at the end of 20 weeks of treatment (week 20). RESULTS: Patients in the control group showed a significant decline in ADL Index score at 20 weeks compared to rivastigmine-treated patients (difference in mean ADL Index score = 8.5; p < 0.001). At week 20, mean change from baseline scores for CSS total and individual domain scores were better for caregivers in the treatment group than those in the control group (CSS total mean difference = 19.2). CONCLUSION: We conclude that treatment of AD patients with rivastigmine for 20 weeks produces a significant improvement in patient ADL functioning, and lower levels of caregiver stress.


Subject(s)
Adult , Aged , Alzheimer Disease/diagnosis , Caregivers/psychology , Dose-Response Relationship, Drug , Drug Administration Schedule , Female , Follow-Up Studies , Humans , Male , Middle Aged , Phenylcarbamates/administration & dosage , Probability , Prospective Studies , Quality of Life , Reference Values , Risk Assessment , Severity of Illness Index , Single-Blind Method , Sri Lanka , Stress, Psychological , Treatment Outcome
5.
Ceylon Med J ; 2002 Jun; 47(2): 48-9
Article in English | IMSEAR | ID: sea-47209

ABSTRACT

OBJECTIVES: To study the safety of low dose subcutaneous adrenaline given as prophylaxis against acute adverse reactions to anti-venom serum (AVS) in patients bitten by snakes. METHODS: Patients admitted with snakebite envenoming who satisfied inclusion criteria were given 0.25 ml of 1:1000 adrenaline subcutaneously immediately before administration of AVS. They were observed for adverse effects, and pulse and blood pressure (BP) were monitored. RESULTS: 51 patients [35 males, mean age 34.8 years (SD 14)] were included in the study. Adverse reactions to AVS occurred in 15 (29.4%) patients. There was one death from suspected cerebral haemorrhage, and 3 (5.9%) patients developed small haematomas at the subcutaneous injection site. There were no significant changes in mean pulse or BP following administration of subcutaneous adrenaline. CONCLUSIONS: Low dose subcutaneous adrenaline did not cause significant changes in pulse rate or BP. Although the death was unlikely to be directly related to subcutaneous adrenaline, we suggest further studies on the safety of this prophylactic treatment before its routine use.


Subject(s)
Adrenergic Agonists/administration & dosage , Adult , Antivenins/adverse effects , Epinephrine/administration & dosage , Female , Humans , Injections, Subcutaneous , Male , Prospective Studies , Snake Bites/drug therapy
6.
Ceylon Med J ; 2001 Mar; 46(1): 19-20
Article in English | IMSEAR | ID: sea-47812

ABSTRACT

AIM: Data on stroke subtypes in Sri Lanka are limited, mainly due to the unavailability of brain imaging facilities in most government hospitals. In two leading private hospitals in Colombo, a high proportion of stroke patients have computerised tomography (CT) scanning. Hence we studied stroke patients admitted to these two hospitals to determine the stroke subtypes. METHODS: A prospective study of 103 consecutive first ever stroke patients who were under the care of the first author during the period 15 May 1995 to 30 August 1996 were studied. Diagnosis of stroke was made according to the WHO definition, and transient ischaemic attacks (TIA) were not included. The pathological subtype was confirmed by CT scan in 99 patients. RESULTS: The age of the patients ranged from 37 to 94 years (mean 64.5). 87 patients were over the age of 50 years. The proportion of pathological subtypes confirmed by CT scanning was cerebral infarction (CI) 74.7%, intracerebral haemorrhage (ICH) 19.1% and subarachnoid haemorrhage (SAH) 62.2%. Of the infarcts 31 (42%) were cortical, 30 (41%) lacunar, 12 (16%) cerebellar and brainstem, and 1 (1.3%) was a border zone infarct. CONCLUSION: Direct comparisons with stroke subtypes seen in other countries are not valid due to differences in methodology. In developed countries in the West cerebral infarcts account for about 80% of all first ever strokes and of these 13 to 21% are lacunar strokes. Countries in the East (e.g. Japan and Hong Kong) have reported a higher proportion of haemorrhages (27% of first ever strokes in Hong Kong). In Sri Lanka the proportion of stroke subtypes seem to be intermediate between these countries in the West and East. Lacunar strokes are commoner in Sri Lanka than in other countries.


Subject(s)
Adult , Age Distribution , Aged , Aged, 80 and over , Cerebral Hemorrhage/complications , Cerebral Infarction/complications , Female , Hospitalization/statistics & numerical data , Hospitals, Private , Humans , Male , Middle Aged , Prospective Studies , Sri Lanka/epidemiology , Stroke/classification , Subarachnoid Hemorrhage/complications , Tomography, X-Ray Computed
7.
Ceylon Med J ; 2000 Jun; 45(2): 65-8
Article in English | IMSEAR | ID: sea-48632

ABSTRACT

OBJECTIVE: To record current practices in hospital management of snake bite, especially with regard to use of antivenom serum (AVS). METHODS: Management of all snake bite victims admitted to the four main hospitals of the Gampaha district was prospectively studied during a 5-month period. A pretested data collection sheet was used. Relevant information was obtained from patients, accompanying persons, medical staff and hospital records. RESULTS: 466 patients (M:F = 7:3; 402 adults and 64 children) were admitted following snake bite during the study. The offending snake was identified in 357 (76.6%) cases [172 (36.9%) by examining the dead snake, 185 by identification of the snake in a photograph]. 273 (76.5%) of the 357 admissions were due to hump nosed viper bite. AVS was given to 184 (39.5%) patients, including 99 (36.3%) with hump nosed viper bite. A sensitivity test of AVS was used in all 184 patients. Premedication with hydrocortisone and/or antihistamines before AVS infusion was given to 89 patients. Acute adverse reactions to AVS occurred in 102 (55.4%) patients given AVS. There was no significant difference in the rate of reactions whether premedication was given or not. CONCLUSION: Precise identification of the offending snake was not possible in many instances. Practices that are of no benefit in the treatment of snake bite are still widely used. Acute adverse reactions to AVS are common, and neither hydrocortisone nor antihistamines seem to be of benefit as prophylaxis. Evidence based management guidelines, especially with regard to AVS therapy, are urgently required.


Subject(s)
Adolescent , Adult , Aged , Anti-Inflammatory Agents/therapeutic use , Antivenins/administration & dosage , Child , Child, Preschool , Female , Histamine H1 Antagonists/therapeutic use , Humans , Hydrocortisone/therapeutic use , Infant , Male , Middle Aged , Prospective Studies , Snake Bites/therapy , Sri Lanka
9.
Ceylon Med J ; 1999 Jun; 44(2): 70-3
Article in English | IMSEAR | ID: sea-49036

ABSTRACT

INTRODUCTION: Cardiac effects following the bite of Burmese Russell's vipers and European vipers are well known. The question whether envenomation caused by Sri Lankan viper bites results in myocardial damage remains largely unanswered. The aim of this prospective study was to investigate whether myocardial damage occurs after Sri Lankan viper bites, using a highly specific and sensitive marker, troponin T. METHODS: 45 patients admitted after a definite viper bite [Russell's viper (RV), n = 13, hump-nosed viper (HNV), n = 32] were studied with regard to cardiac symptoms, ECG changes, and troponin T levels. There were no admissions with bites of other types of Sri Lankan vipers during the study period. RESULTS: Cardiac symptoms were present in a number of patients following the bite. Two patients had transient ECG changes. However, troponin T levels were not elevated in any of them. COMMENT: Myocardial damage does not seem to be an important feature of Sri Lankan Russell's and hump-nosed viper bites. This may be because of venom heterogeneity in vipers, that is based on their geographical distribution.


Subject(s)
Adult , Animals , Electrocardiography , Female , Humans , Male , Myocardial Infarction/blood , Prospective Studies , Russell's Viper , Snake Bites/complications , Sri Lanka/epidemiology , Troponin T/blood , Viper Venoms/toxicity , Viperidae
10.
Ceylon Med J ; 1999 Mar; 44(1): 11-3
Article in English | IMSEAR | ID: sea-48849

ABSTRACT

OBJECTIVE: To evaluate whether people who have committed parasuicide have low serum cholesterol concentrations. METHOD: All subjects admitted to the University Medical Unit, Ragama after parasuicide from 1.3.96 to 31.1.97 were matched for age, sex, presence of diabetes and arterial hypertension, substance abuse, body mass index and socioeconomic status with controls. Venous blood samples for cholesterol estimation were collected from parasuicides within 24 hours of admission. RESULTS: Analysis was done on 168 parasuicide patients [males 74; mean age for males 24 years (SD 6.2), females 19 years (SD 3.3)] and 168 matched controls. Of the parasuicide subjects, 33 had a psychiatric illness and 135 were considered to have impulsive personalities. The serum cholesterol level in parasuicide patients was not significantly different from that in controls. CONCLUSIONS: This study, the first from a developing country, did not show an association between low serum cholesterol concentrations and parasuicide.


Subject(s)
Adult , Case-Control Studies , Cholesterol/blood , Female , Humans , Male , Mental Disorders/blood , Prospective Studies , Self-Injurious Behavior , Sex Distribution , Sri Lanka/epidemiology , Suicide, Attempted/prevention & control , Violence
18.
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