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Search Results: 1 - 10 of 13 matches for " Jeevagan Vijayabala "
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Acute ischemic stroke following Hump-nosed viper envenoming; first authenticated case
jeevagan Vijayabala,Chang Thashi,Gnanathasan Christeine
Thrombosis Journal , 2012, DOI: 10.1186/1477-9560-10-21
Abstract: Hump-nosed pit viper (Genus Hypnale) is a medically important venomous snake in Sri Lanka and Southwestern India which causes significant morbidity and mortality. Envenoming of this snake results in hemostastic dysfunction, thrombotic microangiopathy, acute kidney injury and death. This case describes an authenticated first case of ischemic stroke in a 65 year old male following envenoming by H.hypnale in Sri Lanka.
Addressing the relationship between cardiac hypertrophy and ischaemic stroke: an observational study
Rodrigo Chaturaka,Weerasinghe Sajitha,Jeevagan Vijayabala,Rajapakse Senaka
International Archives of Medicine , 2012, DOI: 10.1186/1755-7682-5-32
Abstract: Introduction Research over the last decade has recognized left ventricular hypertrophy as a risk factor for major cardiovascular events including stroke. While cardiac magnetic resonance imaging is the best modality to quantify left ventricular hypertrophy, echocardiographic calculation of left ventricular mass index is a reasonable alternative. Methods We carried out a hospital based prospective study to identify the prevalence of left ventricular hypertrophy, assessed using echocardiography, in patients presenting with ischaemic strokes. This is the first study that attempted to quantify this issue in a cohort of Sri Lankan patients. The study was carried out in the National Hospital of Sri Lanka over a period of 6 months. Results A total of 55 patients (44 males, 80%) (mean age: 62.3, range: 48–82 years) with ischaemic strokes were studied. Of them, only 38 could be mobilized to measure the height and weight to calculate the left ventricular mass index. Of the rest, only one person had the electrocardiographic criteria for left ventricular hypertrophy. Of the 38 patients evaluated, 29 (76.3%) had left ventricular hypertrophy while 19 (50%) had severe hypertrophy. Discussion and conclusions The rates of left ventricular hypertrophy reported in similar studies in other countries vary between 25-62%. Given the high prevalence of left ventricular hypertrophy reported in this study and its recognition as a risk factor for stroke recently, together with the availability of effective treatment for risk reduction, the cost effectiveness of population screening should be evaluated. Further studies are planned in this regard.
Pancreatitis and myocarditis followed by pulmonary hemorrhage, a rare presentation of leptospirosis- A case report and literature survey
Ranawaka Nuwan,Jeevagan Vijayabala,Karunanayake Panduka,Jayasinghe Saroj
BMC Infectious Diseases , 2013, DOI: 10.1186/1471-2334-13-38
Abstract: Background Leptospirosis is a potentially fatal disease which can cause multi-organ dysfunction. It can rarely present as acute pancreatitis. This is the first ever report of leptospirosis presenting with acute pancreatitis and myocarditis followed by diffuse pulmonary hemorrhages to the best of our knowledge. Case presentation A 15-year-old South Asian boy presented with high grade fever, epigastric discomfort and was anicteric on admission. He developed tachycardia, transient hypotension, changes of electro-cardiogram and positive troponin I suggestive of myocarditis. Acute pancreatitis was diagnosed with 12 fold high serum amylase and with the evidence of computerized tomography. Then he developed diffuse pulmonary hemorrhages and later acute renal failure. Leptospirosis was confirmed by positive leptospira IgM, negative IgG and strongly positive Microscopic Agglutination Test. Other possible infective and autoimmune causes were excluded. Patient recovered completely with antibiotics and the supportive care. Conclusion This case illustrates diagnostic difficulties especially in resource poor settings where leptospirosis is common. Additionally it highlights the fact that leptospirosis should be considered in patients presenting with pancreatitis which can be complicated with myocarditis and diffuse pulmonary hemorrhages. We hypothesize that Toll like receptors may play a role in such systemic involvement.
Isolated pulmonary veno-occlusive disease and pulmonary arterial thrombosis in systemic sclerosis – a lethal combination
Arun Jeevagan
International Medical Case Reports Journal , 2010, DOI: http://dx.doi.org/10.2147/IMCRJ.S10890
Abstract: olated pulmonary veno-occlusive disease and pulmonary arterial thrombosis in systemic sclerosis – a lethal combination Case report (3368) Total Article Views Authors: Arun Jeevagan Published Date May 2010 Volume 2010:3 Pages 49 - 53 DOI: http://dx.doi.org/10.2147/IMCRJ.S10890 Arun Jeevagan General Medicine, Ipswich NHS Hospital, UK Background: Isolated pulmonary hypertension secondary to systemic sclerosis is not uncommon. Our patient with systemic sclerosis presented with a very aggressive form of pulmonary hypertension due to a lethal combination of pulmonary veno-occlusive disease (PVOD) and pulmonary arterial thrombosis. This combined presentation has never before been reported in medical literature. Case report: A 75-year-old woman with a 4-month history of atypical chest pains was admitted with a 3-week history of worsening symptoms of shortness of breath, reduced exercise tolerance, and bilateral pitting edema. On examination she had thickened skin in her hands, telangiectasia on her face, maculopapular rash in her legs, raised jugular venous pressure, and bilateral pitting edema. Her autoimmune profile revealed positive anticentromere antibodies, and her echocardiogram showed right ventricular systolic pressure of 91 mmHg. She also had renal impairment secondary to hypoperfusion. A diagnosis of isolated pulmonary hypertension secondary to limited systemic sclerosis was made. As she was clinically improving on slow diuretic infusion and awaiting transfer to a specialist center for management of pulmonary hypertension, our patient died due to cardiopulmonary arrest. Her postmortem revealed that she died of a combination of PVOD and pulmonary arteriopathy due to thrombosis. Conclusion: This is clearly a unique case both in presentation and difficulty of management. Pulmonary vasodilators used in therapy of pulmonary arteriopathy can be detrimental in patients with PVOD. There is no definitive investigation, curative treatment, or management, that exists for a combination of PVOD and pulmonary arteriopathy due to thrombosis secondary to systemic sclerosis.
Overlap of primary biliary cirrhosis and primary sclerosing cholangitis – a rare coincidence or a new syndrome
Arun Jeevagan
International Journal of General Medicine , 2010, DOI: http://dx.doi.org/10.2147/IJGM.S11201
Abstract: lap of primary biliary cirrhosis and primary sclerosing cholangitis – a rare coincidence or a new syndrome Case report (4416) Total Article Views Authors: Arun Jeevagan Published Date May 2010 Volume 2010:3 Pages 143 - 146 DOI: http://dx.doi.org/10.2147/IJGM.S11201 Arun Jeevagan General Medicine, Ipswich NHS Hospital, Ipswich, UK Background: Overlap syndrome has been introduced to the field of hepatology to describe the coexistence of two or more autoimmune hepatic conditions in the same individual. This is a rare clinical case of a patient diagnosed with primary biliary cirrhosis (PBC) who later developed primary sclerosing cholangitis (PSC). This is a unique case as no other cases with a similar pattern have been reported. Overlap syndrome does not include the coexistence of PBC and PSC as a distinctive syndrome so far. Case report: A middle-aged woman suffering from PBC for 17 years got admitted with clinical and biochemical features of cholestatic syndrome. A provisional diagnosis of worsening PBC was proved wrong by magnetic resonance cholangiopancreatography, which revealed typical benign stricture and dilatation of common bile duct with typical beading appearance suggestive of PSC. The patient was stented and treated with an increased dose of ursodeoxycholic acid (UDCA) which improved the symptoms and the biochemical picture. Conclusion: This is a clear overlap of PBC–PSC. It is very difficult to say whether it is a rare coincidence or a new overlap syndrome, but there are no clear guidelines for management of these patients. Currently, the treatment involves endoscopic duct dilatation, UDCA, and regular follow-ups to rule out hepato-biliary tumor occurrence.
Overlap of primary biliary cirrhosis and primary sclerosing cholangitis – a rare coincidence or a new syndrome
Arun Jeevagan
International Journal of General Medicine , 2010,
Abstract: Arun JeevaganGeneral Medicine, Ipswich NHS Hospital, Ipswich, UKBackground: Overlap syndrome has been introduced to the field of hepatology to describe the coexistence of two or more autoimmune hepatic conditions in the same individual. This is a rare clinical case of a patient diagnosed with primary biliary cirrhosis (PBC) who later developed primary sclerosing cholangitis (PSC). This is a unique case as no other cases with a similar pattern have been reported. Overlap syndrome does not include the coexistence of PBC and PSC as a distinctive syndrome so far.Case report: A middle-aged woman suffering from PBC for 17 years got admitted with clinical and biochemical features of cholestatic syndrome. A provisional diagnosis of worsening PBC was proved wrong by magnetic resonance cholangiopancreatography, which revealed typical benign stricture and dilatation of common bile duct with typical beading appearance suggestive of PSC. The patient was stented and treated with an increased dose of ursodeoxycholic acid (UDCA) which improved the symptoms and the biochemical picture.Conclusion: This is a clear overlap of PBC–PSC. It is very difficult to say whether it is a rare coincidence or a new overlap syndrome, but there are no clear guidelines for management of these patients. Currently, the treatment involves endoscopic duct dilatation, UDCA, and regular follow-ups to rule out hepato-biliary tumor occurrence.Keywords: primary biliary cirrhosis, primary sclerosing cholangitis, hepatic overlap syndrome
Isolated pulmonary veno-occlusive disease and pulmonary arterial thrombosis in systemic sclerosis – a lethal combination
Arun Jeevagan
International Medical Case Reports Journal , 2010,
Abstract: Arun JeevaganGeneral Medicine, Ipswich NHS Hospital, UKBackground: Isolated pulmonary hypertension secondary to systemic sclerosis is not uncommon. Our patient with systemic sclerosis presented with a very aggressive form of pulmonary hypertension due to a lethal combination of pulmonary veno-occlusive disease (PVOD) and pulmonary arterial thrombosis. This combined presentation has never before been reported in medical literature.Case report: A 75-year-old woman with a 4-month history of atypical chest pains was admitted with a 3-week history of worsening symptoms of shortness of breath, reduced exercise tolerance, and bilateral pitting edema. On examination she had thickened skin in her hands, telangiectasia on her face, maculopapular rash in her legs, raised jugular venous pressure, and bilateral pitting edema. Her autoimmune profile revealed positive anticentromere antibodies, and her echocardiogram showed right ventricular systolic pressure of 91 mmHg. She also had renal impairment secondary to hypoperfusion. A diagnosis of isolated pulmonary hypertension secondary to limited systemic sclerosis was made. As she was clinically improving on slow diuretic infusion and awaiting transfer to a specialist center for management of pulmonary hypertension, our patient died due to cardiopulmonary arrest. Her postmortem revealed that she died of a combination of PVOD and pulmonary arteriopathy due to thrombosis.Conclusion: This is clearly a unique case both in presentation and difficulty of management. Pulmonary vasodilators used in therapy of pulmonary arteriopathy can be detrimental in patients with PVOD. There is no definitive investigation, curative treatment, or management, that exists for a combination of PVOD and pulmonary arteriopathy due to thrombosis secondary to systemic sclerosis.Keywords: pulmonary veno-occlusive disease, pulmonary arterial hypertension, systemic sclerosis, pulmonary arteriopathy with thrombosis
Ozone Therapy in Dentistry
Ramachandran Sudarshan,G Sree Vijayabala
Arsiv Kaynak Tarama Dergisi , 2013,
Abstract: With the advancements in the field of dentistry, new treatment protocols are budding day by day to combat human ailments in a much natural better and simpler way. One such advancement is the application of ozone in dentistry. Ozone is a natural element protects us from ultraviolet rays. It has several properties including analgesics, immunostimulant and antimicrobial properties. In Dentistry its uses are abundance from gingival diseases, infection control, temporomandibular disorders, radiation and chemotherapy induced mucositis, lichen planus etc. Researchers believe that this therapy is in state of equilibrium with benefit and drawback. This review throws light on the history, properties, methods of administration, uses in the field of medicine and dentistry, toxicity, contraindications of ozone. [Archives Medical Review Journal 2013; 22(1.000): 45-54]
Fabry Disease
Ramachandran Sudarshan,G Sree Vijayabala
Arsiv Kaynak Tarama Dergisi , 2013,
Abstract: Fabry s disease is a X linked Lysosomal storage disorder caused by a defect in α-galactosidase enzyme. This defect causes accumulation of lipids progressively in the vasculature and internal organs resulting in multiple complications and life threatening situation. It is characterized by pain, neurological, gastrointestinal, renal, cardiovascular, dermatological, rheumatological and oral manifestations. This review renders the pathophysiology, clinical features, diagnostic criteria s, differential diagnosis and management. This review also portrays the recent advancements that have been proposed for the management for this disorder. [Archives Medical Review Journal 2013; 22(1.000): 141-151]
Oral Precancer and Cancer
Ramachandran Sudarshan,G. Sree Vijayabala
Cukurova Medical Journal , 2013,
Abstract: Oral cancer is a well known disorder causing mortality. Even though many etiological factors have been proposed, but it is mainly due to tobacco (smoking and smokeless form). This tobacco has several carcinogenic substances which results in the formation of cancer. We represent a male patient 60 years of age with Oral cancer in the left vestibule induced due to smokeless tobacco. It was associated with leukoplakia in the left buccal mucosa. [Cukurova Med J 2013; 38(2.000): 342-344]
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