http://dr.lib.sjp.ac.lk/handle/123456789/5501 Wed, 07 Jan 2026 06:06:33 GMT 2026-01-07T06:06:33Z http://dr.lib.sjp.ac.lk/handle/123456789/6833 Managing DHF - The pitfalls & challenges Gunasekera, D. Attached Fri, 01 Jan 2016 00:00:00 GMT http://dr.lib.sjp.ac.lk/handle/123456789/6833 2016-01-01T00:00:00Z http://dr.lib.sjp.ac.lk/handle/123456789/6831 Near miss - A case of grade 4 temporal arachnoid cyst with obstructive hydrocephatus in a heonate Perera, T.M.R.; Wijesekara, D.S.; Kumarasiri, M.K.H.N.; Niwanthika, T.K.I.; Wettasinghe, C.A.; Siriwardana, H.D. Attached; Background - Arachnoid cysts are lined by arachnoid membranes and filled with cerebrospinal fluid. They are thought to occur as a result of maldevelopment of the arachnoid membrane or secondary to trauma or infection. Method - We report an 11 days old baby who presented with excessive crying, grunting and refusal of feeds over two days. Me is first born child to healthy non-consanguineous parents following an uneventful pregnancy and birth with birth Occipital-frontal circumference(OFC) o f 36cm.Parents have also noticed that his head was enlarging since birth. Examination revealed an irritable neonate with bulging anterior fontanelle, separated sutures, OFC of 39cm and right sided partial ptosis. Within few hours since admission, he had progressive opisthotonus and a respiratory arrest. He underwent immediate surgery which included insertion of left sided Ventricular-Peritoneal shunt and right sided Cysto-Peritoneal shunt. He made a successful recovery and now developing normal. Results - Non contrast CT brain on admission revealed an extensively large cyst arising from right middle cranial fossa compressing third ventricle resulting in gross hydrocephalus and midline shift. Conclusion - Postnatally, many arachnoid cysts are asymptomatic and remain quiescent for years, although Others expand and cause symptoms by compressing adjacent brain and/or expanding the overlying skull, rarely causing serious effects like cranial nerve involvement, bulbar symptoms and respiratory arrest. Fri, 01 Jan 2016 00:00:00 GMT http://dr.lib.sjp.ac.lk/handle/123456789/6831 2016-01-01T00:00:00Z http://dr.lib.sjp.ac.lk/handle/123456789/6830 Assesing parental knowledge, attitudes & practices regarding reconstitution, administration & storage of antibiotics Navarathnam, D.; Perera, T.M.R.; Suntharesan, J.; Wettasinghe, C.A.; Niwanthika, T.K.I.; Kumarasiri, M.K.H.N.; Siriwardana, H.D. Attached; Background - Antibiotics are frequently misused leading to drug resistance and concerns on reemergence of pre-Edward Jenner Era. There are misconceptions about appropriate usage, storage and reconstitution, and often being used without prescriptions. Method - Descriptive cross-sectional study carried out in teaching and private hospital setup by an interviewer-administered questionnaire from March to June 2016. Study population was 150 parents of children who have received oral antibiotic preparations. Results - Data analysis showed 88%, 10% and 2% used boiled cooled, mineral and tap water for reconstitution respectively. 18.7% and 74% used small measuring cup and mark on the bottle for measuring water respectively. When child refuses, 40% gave forcefully, 18.7% mixed with milk, 8% mixed with honey. Regarding storage, 59% stored in the fridge door, 16% in main compartment and 23%in room air. To measure the accurate amount 80% used measuring cup, 10.7% dropper, 6% home spoon (5ml tea spoon) and 3% used the lid of the bottle. 57% of children received antibiotic after meals and 30% before meals. 84.7% of parents knew nothing about side-effects and only 15 4% had some idea about side-effects. 24% gave antibiotics till the symptoms relieve and 74% follows doctor's instructions. 2% bought antibiotics without prescriptions and 1,3% used the same antibiotics if the sibling is ill. Conclusion & Recommendation - Among the parent population we studied, most bought antibiotics with prescription and followed doctors' instructions, yet without proper dosage and timing. Most of the parents knew how to reconstitute, but didn't know the proper storage methods. When children refuse majority have forcefully given, only few have mixed w ith pacifiers;Majority had no idea about side effects. Enhancing the parental knowledge regarding antibiotic usage is a mandate. Fri, 01 Jan 2016 00:00:00 GMT http://dr.lib.sjp.ac.lk/handle/123456789/6830 2016-01-01T00:00:00Z http://dr.lib.sjp.ac.lk/handle/123456789/6829 A case of hereditary heemorrhagic telangiectasia with cerebral arterio various maltotmation Suntharesan, J.; Perera, T.M.R.; Vipulaguna, V.D.; Wijesekara, D.S.; Wettasinghe, C.A.; Kumarasiri, M.K.H.N.; Niwanthika, T.K.I.; Siriwardana, H.D. Attached; Background - Hereditary haemorrhagic telangiectasia(HHT), also known as Osler-Weber-Rendu syndrome, a rare autosomal dominant disorder that affects blood vessels throughout the body and results in bleeding tendency. Forms of HHT include types 1, 2, 3 and juvenile polyposis/HHT syndrome. Its incidence is 1 in 5,000 to 10,000. M ethod - A 12-year-old boy who was investigated for epistaxis for 2 years of age, presented with worsening of epistaxis, throbbing type frontal headache over six months with a progressively increasing vascular birth mark over right upper limb. His mother and sister also had spontaneous epistaxis. Examination revealed a pinkish purple papular vascular malformation on medial side of upper limb with superficial telangiectatic vessels. There was telangiectasia on trunk, limbs and face. Rest of the examination was normal. Results - Basic hematology, chest X-ray and 2D echo were normal. Contrast CT brain and MRI brain revealed L/middle cerebral artery vascular malformation. Four vessel carotid angiogram revealed large L/parietal carotid AV fistula between l/m iddle cerebral artery and cortical veins with variceal enlargement. Child underwent open craniotomy and resection of AV fistula and had uneventful recovery. Conclusion - Diagnosis was made clinically on the basis of Curacao-criteria, established by the Scientific Advisory Board of the HHT Foundation, which are epistaxis, telangiectasia, visceral arteriovenous malformations and a first-degree relative who has HHT. Our case fulfilled the Curacao criteria. Current recommended treatment for arterio-venous Malformation (AVM) depends on its size and location. Interventional Radiologists offer nan-surgical treatm ent for AVM. invasive treatm ent of brain AVMs include endovascular embolization, surgical resection, and focal beam radiation alone or in combination. Fri, 01 Jan 2016 00:00:00 GMT http://dr.lib.sjp.ac.lk/handle/123456789/6829 2016-01-01T00:00:00Z