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Publications (85)
This Laboratory Guide defines basic semen analysis concepts, provides clinically essential reference values, and elucidates the often-subtle relationships between many sperm characteristics and their relevance for clinical diagnosis. The guide offers a step-wise approach to every aspect of semen analysis and clarifies many sperm characteristics. Th...
Indiscriminate use of antibiotics has led to the emergence of antibiotic resistance in hospital settings. Awareness of local antimicrobial resistance patterns is essential for prudent empirical therapy of urinary tract infections. This study describes the uropathogens isolated, their antibiotic sensitivity patterns and associated factors in adult i...
Subfertility is a significant global reproductive health challenge affecting approximately 1 in 6 individuals worldwide. Despite having a comprehensive healthcare system, Sri Lanka still faces challenges in providing timely and effective fertility care. We propose integrating Community Health Workers (CHWs) into the healthcare system to address the...
Feasibility of Community Healthcare Workers Facilitated Fertility Care in Northern Sri Lanka.
Introduction
Subfertility poses a significant global reproductive health challenge, impacting couples' mental,
social, and economic well-being. In low- and middle-income countries, subfertility affects
approximately 16.5% of the population. Studies in S...
FEASIBILITY OF COMMUNITY HEALTHCARE WORKERS FACILITATED FERTILITY CARE IN NORTHERN SRI LANKA.
Introduction
Subfertility poses a significant global reproductive health challenge, impacting couples' mental, social, and economic well-being. In low- and middle-income countries, subfertility affects approximately 16.5% of the population. Studies in Sr...
Introduction: The academic performance of students in medical school is affected by multiple student factors. Understanding these determinants is essential for educators to devise interventions that can help students manage stress and improve their academic performance. Objectives: The aim of this study is to identify the effect of students' socioe...
Keywords: Lower urinary tract symptoms, benign prostatic obstructions, international prostate symptoms score, quality of life. Abstract Introduction Lower Urinary Tract Symptoms (LUTS) greatly affect men's quality of life, often resulting from benign prostatic obstruction. Therefore, the study aimed to assess the severity of LUTS associated with de...
Introduction
Urolithiasis, a common urological disorder affecting the global population, demonstrates geographical diversity due to factors such as water quality, climate variations, health conditions, and dietary habits. This study, conducted in Northern Sri Lanka, examines urinary stone compositions and assesses the prevalence of metabolic disord...
Purpose: The objective of this study was to compare the sperm counting efficacy of the less expensive Shukratara sperm counting chamber with the widely accepted Makler counting chamber. Methods: Frozen sperm samples from 70 men were thawed and the sperm concentration determined using both counting chambers respectively. Capsule: The counting effica...
Background Timely and safe elective health care facilitates return to normal activities for patients and prevents
emergency admissions. Surgery is a cornerstone of elective care and relies on complex pathways. This study aimed to
take a whole-system approach to evaluating access to and quality of elective health care globally, using inguinal hernia...
Introduction
De la Chapelle Syndrome, also known as 46 XX disorders, is a genetic condition that affects sexual development and presents challenges, in physical, hormonal, and genetic aspects.
Case presentation
This case study explores a 42-year man with de la Chapelle Syndrome who experienced primary subfertility for eight years. The patient demo...
Background. Assessing the level of knowledge of anatomy of undergraduate students four years after their primary anatomy training will give a better indication as to which system of teaching is more effective. We aimed to ascertain which method was more effective at establishing a core of anatomy knowledge that could be recalled after a considerabl...
Background
Assessing the level of knowledge of anatomy of undergraduate students four years after their primary anatomy training will give a better indication as to which system of teaching is more effective. We aimed to ascertain which method was more effective at establishing a core of anatomy knowledge that could be recalled after a considerable...
Introduction and importance
Adrenal myelolipomas are uncommon benign tumors of the adrenal gland. It has various other sites of origin.
Case presentation
A 51-year-old male with elevated serum creatinine and an incidentally discovered adrenal mass underwent right adrenalectomy for an adrenal myelolipoma, a benign tumor with fat and haematopoietic...
Purpose: The objective of this study was to compare the sperm counting efficacy of the less expensive Shukratara sperm counting chamber with the widely accepted Makler counting chamber. Methods: Frozen sperm samples from 70 men were thawed and the sperm concentration determined using both counting chambers respectively. Capsule: The counting effica...
It is apparent that sperm parameters like concentration, motility and morphology are not definitive/adequate fertility measures as sperm is a heterogeneous mixture, and sperm quality is determined by only what is visible in the microscopic field. Objective was to assess the quality variation among different aliquots of an ejaculate and present a co...
Subfertility is a global problem affects around 48 million couples. It has impact on the social, cultural and financial aspects of the couple and their family. Compressive assessment and timely interventions are playing a key role to positively overcome the challenges. In low middle income countries like Sri Lanka has financial constrains to provid...
In the dynamic realm of healthcare, one constant remains unchanged: the need for precise and compassionate care during surgical procedures. Perioperative care, encompassing the preoperative, intraoperative, and postoperative phases, is a critical aspect of healthcare delivery that profoundly impacts patient outcomes. As healthcare workers, we are e...
Background: Rigid ureterorenoscopy (URS) stands as a highly successful treatment for ureteral stones. The current guidelines from the European Association of Urology (EAU) recommends selective double J (DJ) stent placement post-URS to mitigate major complications. However, in resource-limited hospital setups, executing selective stent placement pos...
Introduction
Emphysematous pyelonephritis is a severe kidney infection characterized by gas formation, predominantly affecting diabetic women. Symptoms include fever, pain, and nausea, requiring urgent and accurate management due to its potentially fatal nature.
Case presentation
This article reports a successful management of a case of bilateral...
Introduction: Renal cancer is a significant global cause of death and clear cell being the most common subtype. Bilateral synchronous renal cancers with different histologies are extremely rare and less reported. Managing bilateral renal cancer is challenging.
Clinical Presentation:
A 51-year-old woman with a history of hypertension and hypothyroi...
Introduction: Renal cancer is a relatively common form of cancer; however, squamous cell carcinoma of thekidney is extremely rare and it carries poor prognosis.
Clinical presentation: We present a rare case of renal squamous cell carcinoma that was manifested with the psoassign in a patient with a history of chronic staghorn calculus.
Discussion: S...
This is a cross sectional descriptive institutional based study to analyse the demographic, clinicopathological variations of prostate cancer in Northern srilanka.
Introduction: Lower Urinary Tract Symptoms (LUTS) are prevalent in both males and females, with males over 40 years being particularly affected. These symptoms can significantly impact patients' quality of life.
Objectives: The study aims to evaluate LUTS, associated sociodemographic and clinical factors in male patients.
Methods: This prospective...
Introduction: Prostate cancer is the second most common cancer among males all over the world in 2020. As per the global cancer observatory 1, 414, 259 (7.3%) cases were diagnosed in 2020 worldwide.
Objective: The study aims to analyse the variations in demographic and clinicopathological characteristics of prostate cancer in the Northern Provinc...
Introduction: Prostate cancer is the second most common cancer among males all over the world in 2020. As per the global cancer observatory 1, 414, 259 (7.3%) cases were diagnosed in 2020 worldwide. The study aims to analyse the variations in demographic and clinico-pathological characteristics of prostate cancer in the Northern Province.Methods: T...
Introduction:
Stauffer's syndrome is a rare paraneoplastic non metastatic hepatic dysfunction related to renal cell carcinoma. It is characterized by elevated alkaline phosphatase, erythrocyte sedimentation rate, a-2-globulin, y-glutamyl transferase, thrombocytosis, prolongation of prothrombin time and hepatosplenomegaly, in the absence of hepatic...
Introduction:
Primary urethral carcinoma is a rare disease with overall poorer outcomes in the past. It is relatively more uncommon in female sex.
Clinical presentation:
We present a case of a female with primary urethral carcinoma that presented atypically as a vulval mass without any features of storage, voiding lower urinary tract symptoms, o...
Asymptomatic bacteriuria (ASB) is diagnosed by the presence of a 10*5 colony-forming units (CFU) in the urine without any urinary symptoms. It commonly occurs in pregnancy with the incidence ranging from 2-10%. It poses a risk of progressing into pyelonephritis in pregnancy. Adverse fetal outcomes include preterm labor, neonatal sepsis, intrauterin...
Background: Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres.
Methods: This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published i...
Prostatitis is a common and important urological problem which affects men of all ages. It is a challenging condition to be diagnosed and treated. It is classified under four categories according to the National Institute of Health Classification (Category 1 - Acute bacterial prostatitis, Category 2- Chronic bacterial prostatitis, Category 3-Chroni...
Subfertility is an inability to achieve a clinical pregnancy after 1 year or more of unprotected sexual intercourse. It is a global problem with 48 million couples. Male subfertility has been considered as one of the primary factors of Subfertility. Thus, it influenced in infertile couples with 40% of the whole causes. So, it is fundamental to eval...
Introduction and importance
Generalized peritonitis following proximal ureteral rupture is a very rare complication. This is about a successfully managed case without open surgical intervention.
Case presentation
A lady in her 70s presented with generalized abdominal pain, high spiking fever and low urine output for 3 days. She was haemodynamicall...
Subfertility is an emerging health problem in Sri Lanka, associated with many factors. Most subfertility issues can be dealt with excellent efficacy of early detection and management. The unavailability of the prevalence and associated subfertility factors in the Jaffna district paved the way for conducting a community-based cross-sectional descrip...
Introduction: Incidence of urolithiasis is rising worldwide and increasingly Ureteroscopy (URS) coupled with laser fragmentation is being used safely within the day surgery setting for ureteral and renal stone management. This study is to explore whether URS guided lithotripsy could be delivered effectively as a day surgery procedure. Method: Retro...
Introduction: Urolithiasis is the most prevalent surgical disorder of urinary tract in Asia. The prevalence of urolithiasis varies with demographic factors. There are many treatment options feasible. The specific treatment approach depends on composition, location, size of the stones and preferences of the patients and hospital capability. Objectiv...
Refractory hypertension is a challenge in End Stage Renal Disease (ESRD) patients who are on regular hemodialysis, despite the use of novel antihypertensive agents and tailor-made dialysis prescriptions. Bilateral nephrectomy seems to be a forgotten option. We present a case history of 16 year old boy who underwent open bilateral nephrectomy as a r...
Prostate cancer is one of the most frequent cancers in males and commonly a disease of the older population, but it is increasingly seen among older adolescents and young adults. The common sites of metastasis of prostatic carcinoma are bones and regional lymph nodes. Testicular metastasis from prostatic carcinoma is an infrequent presentation. We...
Introduction and importance
Renal biopsy performed in native or transplanted kidney is considered a safe procedure. However, as it is an invasive procedure bleeding related complications do occur. Bleeding complications such as macroscopic hematuria, renal hematoma, blood transfusion, and rarely nephrectomy and death have been reported in various s...
Purpose: Benign Prostatic Hyperplasia (BPH) is an important cause of morbidity for ageing men worldwide. However, the available study is limited on the natural history of BPH and dynamics of Prostate-Specific Antigen (PSA) in Sri Lankan population. This study aimed to assess the relationship between serums Prostate Specific Antigen (PSA), prostate...
SARS-CoV-2 has been associated with an increased rate of venous thromboembolism in critically ill patients. Since surgical patients are already at higher risk of venous thromboembolism than general populations, this study aimed to determine if patients with peri-operative or prior SARS-CoV-2 were at further increased risk of venous thromboembolism....
Background: Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling.
We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications afterelective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohortstudy including patients undergoing elective surgery in October 2020. Isolation was defined as the periodbefore surgery during which patient...
The present article reports 18-year-old boy came to the urology clinic with perineal discomfort and a few episodes of incomplete emptying of the bowel for two months. He did not claim any symptoms related to his voiding or ejaculation. The abdominal and external genitalia examination was regular. He had average prostate size on digital rectal exami...
Purpose: The ureteral stent is an essential in various urological procedures. Therefore, choosing an ideal ureteral stent is central to minimizing the incidence of stent related complications. This study aim was to identify the average length of ureteral in adult population as it would help to opt for optimal stenting according to the variability o...
Varicocele is primarily tortuous dilation of the internal spermatic vein [ISV] and pampiniform plexus in the scrotum. It’s the most common correctable cause of infertility. It has a higher prevalence in primary and secondary infertility in men. In this article, we reviewed the advantages and disadvantages of microscopic intermediate sub inguinal [M...
Introduction and importance
Inflammatory myofibroblastic tumour (IMT) is a rare tumour with malignant potential and has been described in many major organs with the most frequent site being the lungs. However, bladder is an extremely rare location. IMT presents a unique diagnostic challenge because of the characteristics it shares with malignant ne...
Urological malignancies remains significant health hazards over the years. Prostate cancer is the commonest cancer in male worldwide. There have been various studies done in other parts of Sri Lanka to establish the characteristics of urological malignancies. But the data from Jaffna is lacking. This study was a retrospective cross-sectional study....
Von Hippel-Lindau [VHL] syndrome is a hereditary multisystem cancer syndrome characterized by a wide range of benign and malignant tumours. Renal neoplasms are the commonest solid organ malignancies associated with VHL seen in 25-45% of patients. Management of renal tumours is determined by multiple tumour related and patient-related factors and de...
SARS-CoV-2 has been associated with an increased rate of venous thromboembolism in critically ill patients.Since surgical patients are already at higher risk of venous thromboembolism than general populations, thisstudy aimed to determine if patients with peri-operative or prior SARS-CoV-2 were at further increased risk ofvenous thromboembolism. We...
Introduction:
Zinner’s syndrome is a rare congenital malformation that includes
a seminal vesicle cyst, ejaculatory duct obstruction, and homolateral renal agenesis. This is the first reported case report in Sri Lanka under this entity.
Case history:
We present a case of a healthy 25-year-old unmarried male who experienced perineal pain and few...
Here we report the case of a 47-year-old male who presented with storage lower urinary tract symptoms associated with non-specific lower abdominal pain for one month duration. Contrast-enhanced computed tomography of abdomen and pelvis revealed a 6 cm tumour at the dome and left side anterior wall of the bladder. He underwent laparotomy and partial...
We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications afterelective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohortstudy including patients undergoing elective surgery in October 2020. Isolation was defined as the periodbefore surgery during which patient...
Introduction and importance
Post-surgical Page kidney due to large renal hematoma following percutaneous nephrolithotomy (PCNL) is a rare significant complication that may lead to loss of a kidney.
Case presentation
A 50-year-old lady underwent elective left side PCNL for a 3 cm renal pelvis stone, and one week later, she presented back with a mas...
Background: Two groups of medical students in their final year were tested on the key concepts of gross anatomy using a question paper that included true false type questions and identification of anatomical line diagrams. These two batches of students followed a dissection based curriculum and a newly introduced prosections based curriculum at the...
Background: Associated risk factors for renal cell carcinoma (RCC) include smoking, obesity, hypertension, and diabetes mellitus (DM). Studies on their role in Sri Lankan patients are sparse. The aims were to determine the risk factors for RCC in a cohort of Sri Lankan patients.
Peri-operative SARS-CoV-2 infection increases postoperative mortality. The aim of this study was to determine the optimal duration of planned delay before surgery in patients who have had SARS-CoV-2 infection. This international, multicentre, prospective cohort study included patients undergoing elective or emergency surgery during October 2020. Su...
Management of renal malignancies in Von Hippel Lindau (VHL) is challenging. We present six patients (mean age= 35.1 years (range:24-54), males=5) with VHL syndrome with multiple bilateral renal malignancies and the lessons learnt during their management.. Number of tumours at the time of presentation ranged from 1 to 6, while number of new lesions...
Emphysematous pyelonephritis(EPN) is a potentially fatal manifestation of necrotizing infection of renal parenchymal tissues and perirenal tissues with gas formation in renal system. Its clinical significance due to its diagnostic difficulty on clinical grounds, rapid progression and the demand for the invasive management strategies in short term n...
Although certain characteristics of renal cell carcinoma (RCC) seen in Sri lanka are different to the developed world and incidence is rising, no data on oncological outcome and patient survival are avaialble. A hospital-based cohort study was done in a tertiary referral centre over a period of eight years (2012-2019). A total of 285 newly diagnose...
We present a case of delayed diagnosis of ureteric injury, complicated by a large, life threatening retroperitoneal abscess, that was managed without surgical intervention.
Introduction
Haemospermia is an alarming symptom for ordinary members of the public. The worry become greater as it has been described as a warning sign of a prostate cancer in the media.
Objectives
The aim of the study was to identify the aetiological factors and outcome of haemospermia in a cohort of patients.
Methods
All patients with newly di...
Objective
Although medical expulsive therapy (MET) is shown to be effective for ureteric calculi, the optimum duration and the stone size suitable for MET are not well established yet. The objectives of the study were to determine the optimum duration and maximum stone size suitable for MET. ResultsAll patients with radiologically confirmed uncompl...
Chyluria, commonly seen in south Asian countries, is mainly a manifestation of lymphatic filariasis as a result of infestation with Wuchereria bancrofti, although many other causes can contribute. Many patients can be effectively treated with dietary modifications and drug therapy. The most widely used drug is diethyl carbamazine. The recurrences a...
Objective To identify the clinico-pathological profile of urological malignancies treated in the urology unit of a tertiary care hospital in Sri Lanka. Materials and methods Data related to all newly diagnosed and histologically confirmed malignancies in a urology unit of a tertiary care hospital in Sri Lanka were recorded prospectively over a peri...
Background: Associated risk factors for renal cell carcinoma (RCC) include smoking, obesity, hypertension, and diabetes mellitus (DM). Studies on their role in Sri Lankan patients are sparse. The aims were to determine the risk factors for RCC in a cohort of Sri Lankan patients.
Methods: A hospital-based case–control study was done in a teaching ho...
Sri Lankan inpatients receive a discharge summary in English known as a diagnosis card. The authors investigated whether supplementing the diagnosis summary with native language improved patients' knowledge of illness and medication. Participants were 130 newly diagnosed patients with noncommunicable chronic diseases (92 men, 70.8%; 38 women, 29.2%...
