Saroj Jayasinghe

• MBBS (Colombo), MD (Colombo), FRCP (Lond), FCCP, MD (Bristol), PhD (Col)FNASSL Fellow of the International Science Council
• Professor at University of Colombo

There are uprising trends to use traditional medicinal interventions in treating chronic diseases such as osteoarthritis. Therefore, this study aimed to systematically review the scientific literature on different Traditional Medicine interventions for osteoarthritis. This systematic review was conducted by searching PubMed, Scopus and Science for...

3D reconstruction of the liver for volumetry is important for qualitative analysis and disease diagnosis. Liver volumetry using ultrasound (US) scans, although advantageous due to less acquisition time and safety, is challenging due to the inherent noisiness in US scans, blurry boundaries, and partial liver visibility. We address these challenges b...

Global rates of armed conflicts have shown an alarming increase since 2008. These conflicts have devastating and long-term cumulative impacts on health. The overriding aim in these conflicts is to achieve military or political goals by harming human life, which is the antithesis of the moral underpinnings of the health professions. However, the pro...

South Asia is one of the most populous regions of the world. At present, South Asians make up more than 25% of the world’s population but little effort has been dedicated to studying trends and etiological factors driving aging and aging-related conditions in this part of the world. Even less characterization has been done on brain-related conditio...

Clinicians employ two main cognitive approaches for diagnoses, depending on their expertise. Novices typically use linear hypothetico-deductive methods, while experts rely more on intuitive pattern recognition. These closely correspond to System 1 and System 2 thinking described in behavioral economics. We propose that complex cases additionally re...

Introduction: Training of health human resources is an integral component of strengthening health systems. In Bhutan, the postgraduate training programme commenced in 2014 and the undergraduate programme is scheduled to begin in 2024.Methods: The curriculum was drafted by a team of experts and reviewed over multiple rounds with medical educators, h...

COVID-19 affected Sri Lanka from early 2020, a time of considerable ignorance accompanied by wide media coverage of a devastating epidemic in Italy and Europe. Many were attracted to complementary and alternative medicine (CAM) or traditional medicine (TM) in this desperate situation. Several preparations were claimed to be effective against COVID-...

The city of Colombo has been the commercial capital of Sri Lanka for over two centuries. The city borders the sea and monsoonal rains cause periodic flooding. The large Kelani River marks its northern borders and there are multiple waterways within the city. The river is the major source of water for the city. The city’s border with the Indian ocea...

Citrate is widely used as an anticoagulant for platelet function tests (PFTs). Due to an intrinsic inhibitory effect of citrate on platelet function, hirudin is used as an alternative. However, studies comparing the effect of these anticoagulants on rotational thromboelastometry (ROTEM) platelet whole blood impedance aggregometry in thrombocytopeni...

Mental models of health and illness used during clinical practice are predominantly based on reductionism and mechanistic explanations. Systems thinking offers a more holistic conceptualization by viewing the human body to consist of several closely linked organ systems, constantly interacting with each other and embedded in, and ‘open’ to, the ext...

The intensity and range of health challenges that people in cities are facing has increased in recent years. This is due in part to a failure to adequately adapt and respond to emergent and expanding global systemic risks, but also to a still-limited understanding of the profound impacts of complexity on urban health. While complexity science is in...

Background: Kidney disease is known to be associated with Staphylococcus aureus carriage among patients. This may lead to higher rates of infection. At present, there are no local studies on this population. Therefore, we aimed to compare carriage rates of Staphylococcus aureus among patients with and without chronic kidney disease and assess assoc...

Patients with end stage organ failure suffer from a range of clinical symptoms including breathlessness. The latter is a multidimensional symptom, consisting of affective as well as physical aspects. We intend to describe the management of breathlessness outside of the context of the primary disease and describe the inputs of a Palliative Care Team...

Background Knee osteoarthritis (KOA) is the most common form of arthritis, causing disability and impaired quality of life especially in the elderly. Sri Lankan traditional medicine (STM) is widely used to treat OA, but no clinical trial evaluated on STM regimens for KOA to discuss their safety and efficacy in the treatment. The aim of this study i...

The Department of Medicine, Faculty of Medicine, Sabaragamuwa University of Sri Lanka was established in 2021. The first batch of medical students will face the final MBBS in 2024. This booklet is prepared for medical students to gain an understanding of the formative and summative assessments that they will encounter. It is also a guide to the tra...

Drainage of a pleural effusion is done either by inserting an intercostal tube or by aspirating pleural fluid using a syringe. The latter is a time-consuming and labour-intensive procedure. The serious complications of pleural aspiration are the development of a pneumothorax and re-expansion pulmonary oedema. We describe an observation made during...

Background: Buddhist-derived meditation is a well-known phenomenological practice that enhances overall well-being of individuals. However, broad and less-rigorous criteria in recruiting suitable meditation practitioners affect the reliability of results obtained through meditation research. Therefore, we aimed at developing an instrument to identi...

Background: Infrastructure, equipment and staff constraints are often cited as barriers to the recognition and rescue of deteriorating patients in resource-limited settings. The impact of health-system organisation, decision-making and organisational culture on recognition of deterioration is however poorly understood. This study explores how healt...

Students of the Faculty of Medicine, Sabaragamuwa University of Sri Lanka, study Geriatric Medicine as a separate appointment of one week at Teaching Hospital, Rathnapura. During this period, they will be attached to a general medical ward under the Consultant Physician appointed by the Ministry of Health. This workbook in Geriatric Medicine is com...

Background: The critical phase of dengue carries a high risk of bleeding. Associations of coagulation test parameters and the risk of bleeding in the critical phase is unclear. This study examines the association of rotational thromboelastometry (ROTEM delta and ROTEM platelet) with bleeding risk of patients with dengue in the critical phase. Met...

Abstract Background Dengue and diabetes are major health concerns in many low and middle income counties in the tropics and subtropics. Identifying the risk of diabetes on the clinical presentations and outcomes of dengue infection is of high relevance. However the current epidemiological evidence is very limited. Therefore we explored the morbidit...

Rhizomatic thinking is used to complement mechanistic models or systems thinking in understanding the COVID-19 pandemic. Virus mutations, vaccination rates, human mobility, and variable immune responses are leading to the emergence of complex spatial and temporal patterns of spread. Contributory factors include changing human mobilities, and urban-...

Background Osteoarthritis (OA) has become a burden globally for the healthcare sector due to its high prevalence and incidence. Among that Knee Osteoarthritis (KOA) is the most common form of arthritis causing disability and impaired quality of life especially in elderly. Currently pharmacological, non-pharmacological and surgical measures are cons...

The short appointment in Dermatology will give you the opportunity to study Dermatology with exposure to specific case scenarios in more detail. This workbook is prepared to provide guidance to the students during the Dermatology appointment to cover the essential areas expected from an undergraduate. You are expected to learn the management plans...

Introduction: Lymphoproliferative disorders are commonly associated with paraneoplastic manifestations which might precede the onset of the neoplasm. Therefore, high index of suspicion in at-risk populations can help early detection of the lymphoma.Case history: A young female presented with anaemia and diarrhoea eighteen months after the kidney tr...

This workbook is prepared to provide guidance to undergraduate medical students during the Endocrinology appointment to cover the essential areas expected from an undergraduate. You are expected to learn the management plans in further detail. This includes the investigation, treatment of common medical conditions, and management of common emergenc...

This workbook is prepared to provide guidance to the students during the Gastroenterology appointment to cover the essential areas expected from an undergraduate. You are expected to learn the management plans in further detail. This includes the investigation, treatment of common medical conditions, management of common emergencies, which are esse...

This workbook is prepared to provide guidance to the students during the Emergency Medicine appointment to cover the essential areas expected from an undergraduate. You are expected to learn the management plans in further detail. This includes the investigation, treatment of common medical emergencies, which are essential clinical topics for an in...

The Workbook in Rheumatology and Rehabilitation is compiled to guide and assist undergraduate medical students to acquire essential knowledge and skills in these disciplines to be able to work in medical wards as intern house officers. This Workbook is a joint effort between the academic staff of the Department of Medicine, Sabaragamuwa University...

This workbook is prepared to provide guidance to the students during the Neurology appointment to cover the essential areas expected from an undergraduate. You are expected to learn the management plans in further detail. This includes the investigation, treatment of common medical conditions, management of common emergencies, which are essential c...

Increasing prevalence of endemic chronic kidney disease of unknown etiology (CKDu) in Sri Lanka is a major health problem since the 1990s. Despite numerous studies on CKDu, research groups have been unable to develop a comprehensive approach to mitigate the disorder, and thereby to identify research gaps. We conducted a systematic literature review...

Racial bias and language discrimination are recognized in the health sector in countries such as Sri Lanka. This may extend to images used in health communication and educational literature. We analyzed the racial and ethnic representation in a sample of newspapers and websites related to health obtained over a period. Most of the human figures in...

Background: COVID-19 pandemic has resulted in varying clinical manifestations and mortality rates. There is no consensus on the symptomatology that would guide researchers and clinicians. Aims and Objectives: The objective was to identify symptoms and their frequencies of COVID-19 with a meta-analysis of studies from several countries. Materials...

Cardiovascular diseases(CVDs) are the world's leading cause of death. Endothelial Dysfunction is an early stage of cardiovascular diseases and can effectively be used to detect the presence of the CVDs, monitor its progress and investigate the effectiveness of the treatment given. This study proposes a reliable approach for the screening of endothe...

Introduction and Objectives: Early identification of cardiovascular disease risks has been a promising solution to take preventive precautions. Vasodilatory endothelial dysfunction has been recognized as a potential precursor for early detection of CVD risks using non-invasive physiological parameters with artificially induced reactive hyperemia. T...

This workbook in venereology is compiled to help undergraduate medical students acquire essential knowledge and skills expected from an undergraduate when they qualify to work in medical wards as intern house officers. Thus, the workbook will guide the student during their venereology short appointment.

The current rapid, often unplanned urbanisation across Asia has wide-ranging economic, environmental, health, and social impacts. In an attempt to document the implications of this demographic transition, the Journal of Cities & Health in collaboration with the International Society for Urban Health (ISUH) launched a special issue. This special iss...

This workbook in Palliative Medicine is compiled to help students achieve essential knowledge and skills in the subject, identification of physical, social, psychological and spiritual suffering of patients due to illnesses and caregivers. It also helps to achieve knowledge and skills, on assessment of these patients in order to relieve / minimize...

Background and study aims: Osteoarthritis (OA) has become a burden globally for the healthcare sector due to the number of people developing or living with the condition. Knee osteoarthritis (KOA) is the most common form of arthritis causing disability and impaired quality of life especially in the elderly. The WHO report on priority diseases and...

Background Erythrocyte pyruvate kinase is expressed under the control of the PKLR gene located on chromosome 1q21. Pyruvate kinase catalyzes the final steps of the glycolytic pathway and creates 50% of the red cell total adenosine triphosphate. Pyruvate kinase deficiency is the commonest glycolytic defect causing congenital non-spherocytic hemolyti...

This workbook in oncology is compiled to help undergraduate medical students achieve the essential knowledge and skills in oncology, expected from an undergraduate when they qualify to work in medical wards as intern house officers. Thus, the workbook will guide the student during their oncology clinical appointment.

Students of the Faculty of Medicine, Sabaragamuwa University of Sri Lanka, study cardiology as a separate cardiology appointment of 2 weeks at the Teaching Hospital Ratnapura. During this period, they will be attached to the cardiology unit under the consultant cardiologist(s) appointed by the Ministry of Health. This workbook in cardiology is comp...

Students of the Faculty of Medicine, Sabaragamuwa University of Sri Lanka, study Pulmonology as a separate appointment of 2 weeks, at the Respiratory Unit, Teaching Hospital, Rathnapura and District Chest Clinic, Rathnapura During this period, they will be supervised by the Consultant Pulmonologist appointed to Teaching Hospital, Rathnapura by the...

Students of the Faculty of Medicine, Sabaragamuwa University of Sri Lanka, study nephrology as a separate appointment of one week at Teaching Hospital Ratnapura. During this period, they will be attached to the nephrology unit under the consultant Nephrologist appointed by the Ministry of Health. This workbook in nephrology is compiled to help stud...

In Sri Lanka there are specific families: “Weda Parampara '', who practice their own treatment methods with the use of specific remedies. They have a long history of use in disease prevention and treatment, particularly for chronic diseases like Joint disorders, Sandiroga. The aim of this study was to find out current practices and knowledge on San...

Background The COVID-19 pandemic is adversely impacting modern human civilization. A global view using a systems science approach is necessary to recognize the close interactions between health of animals, humans and the environment. Discussion A model is developed initially by describing five sequential or parallel steps on how a RNA virus emerge...

Although large piezoresistive sensor arrays are vital in obtaining 2D pressure distributions in many applications, they suffer from crosstalk forming parasitic parallel paths as a result of their generic shared row-column architecture. Existing software based algorithms and post processing is the industrially utilized crosstalk suppression mechanis...

COVID-19 has stressed healthcare systems across the globe. We present the experience of an intern medical officer working in a tertiary care hospital during the first wave of the pandemic in Sri Lanka. Her narrative describes how the stress of the pandemic brought into sharp focus the strengths and weaknesses in the health system. We suggest some s...

Sri Lanka, once a colony of Britain, gained independence in 1948. However, especially the health sector continues to use English as its main medium of communication. Such language bias leads to marginalization of those less fluent in English, and hinders achieving a higher level of health literacy. Discrimination of people or social groups based on...

A significant decrease in dengue fever cases and a contrasting increase in leptospirosis cases were reported for the second quarter of 2020 compared with 2019 in Sri Lanka. In the absence of significant environmental and weather-related differences to account for these changes in incidence, we investigated the possibility that the effects of the CO...

This is a workbook to guide medical students to understand the skills, attitudes and behaviors that they are expected to develop at the end of the first General Medicine appointment.

The article “Slum Health: Arrresting COVID-19 and Improving Well-Being in Urban Informal Settlements”, written by Jason Corburn et al.

Systemic diseases such as diabetes, hypertension, atherosclerosis are among the leading causes of annual human mortality rate. It is suggested that retinal and conjunctival vascular tortuosity is a potential biomarker for such systemic diseases. Most importantly, it is observed that the tortuosity depends on the thickness of these vessels. Therefor...

Dengue fever has a wide range of clinical manifestations from asymptomatic disease to complicated dengue haemorrhagic fever and dengue shock syndrome. Bleeding manifestations in dengue is well known but thrombotic events complicating dengue is uncommon. ST elevation myocardial infarction during dengue is rare and poses important management dilemma....

Dengue fever has a wide range of clinical manifestations from asymptomatic disease to complicated dengue haemorrhagic fever and dengue shock syndrome. Bleeding manifestations in dengue is well known but thrombotic events complicating dengue is uncommon. ST elevation myocardial infarction during dengue is rare and poses important management dilemma....

This brief essay places the work of Professor Siri Hettige in the context of understanding of social origins of health and disease. The origin of the term ‘social medicine’ dates to the French Revolution in 1848, which called for the medical profession to integrate knowledge in medical issues, population health, social factors and public policies....

Mind wandering (MW) is a very common cognitive activity of the human mind. In recent times studying its functional correlates have gained the attention of cognitive scientists and psychologists. Most studies have focussed on neurophysiological studies to model and explain it. The current article explores the phenomenological dimensions of MW and at...

We studied the clinical course and virus shedding of all patients referred to Welikanda Hospital, in one month. There were 53 positives for COVID-19 by PCR. 24 (45%) were male, with an age range of 11-94 years. Of these, 41 (77%) were asymptomatic, 9 had cough, 4 had sore throat and six had fever. Pulse, blood pressure, respiratory rate and capilla...

The COVID-19 pandemic has undoubtedly become an era-defining challenge for the entire world. It has implications not only in the public health sector but also in the global economy and political landscape. The prevention strategy that has been followed in Sri Lanka is unique. Early action taken by the government and the ministry of health, being on...

In this little book we explain in which health condition cities and people living in cities are in today, why health is a systemic concept and what we can gain from applying systems thinking to cities, what a systems approach to urban health means in general and specifically applied to urban health equity and we provide some examples of initiatives...

Chronic Interstitial Nephritis in Agricultural Communities (CINAC) continues to attract controversy in the scientific community. It was previously known as Chronic Kidney Disease of Unknown Etiology (CKDu) and is not associated with the common aetiological factors such as diabetes. There is general acceptance that it is an environmentally induced d...

The ongoing COVID-19 outbreak that originated in the city of Wuhan, China, has caused a significant damage to the world population and the global economy. It has claimed more than 0.8 million lives worldwide, and more than 27 million people have been infected as of 07th September 2020. In Sri Lanka, the first case of COVID-19 was reported late Janu...

The COVID-19 pandemic has resulted in increasing number of infections and deaths every day. Lack of specialized treatments for the disease demands preventive measures based on statistical/mathematical models. The analysis of epidemiological curve fitting, on number of daily infections across affected countries, provides useful insights on the chara...

In order to bring the new coronavirus pandemic in the country under control, the government of Sri Lanka implemented a set of control strategies including social distancing, quarantine, lockdowns, travel restrictions, and isolation of villages. The aim of this study is to investigate the effectiveness of the overall control process with the aid of...

The COVID-19 pandemic caused by the SARS-CoV-2 virus has infected millions and overburdened the healthcare infrastructure globally. Recent studies show that the endothelial dysfunction caused by the virus contributes to its high morbidity and mortality. A parameter that can identify patients who will develop complications early will be valuable in...

Background: The first case of a coronavirus 2019 (COVID-19) infection in a Sri Lankan was reported on March 11, 2020. The situation in Sri Lanka changed with the rapid increase of personnel contracting COVID-19 in a naval base camp that housed more than 4000 people. This provided a unique opportunity to study the effectiveness of hydroxychloroquin...

Sponsorship of medical conferences by the pharmaceutical industry has led to many ethical issues, especially in resource-poor developing countries. The core issue in these instances is to reduce or avoid conflicts of interests (COIs). COI is a set of circumstances that creates a risk that professional judgment or actions regarding a primary interes...

Background: Burden of stroke is rising due to the demographic and epidemiological transitions in Sri Lanka. Assessment of success of stroke-management requires tools to assess the quality of life (QOL) of stroke survivors. Most of currently used QOL tools are developed in high-income countries and may not reflect characteristics relevant to resour...

effect of COVID-19 on routine healthcare: An experience of a tertiary care unit.

Introduction: Hereditary hemochromatosis is an inherited disorder of iron metabolism, characterized by excessive iron deposition in major organs of the body, leading to multi-organ dysfunction. It is a genetically heterogeneous disease caused by mutations in one or more different genes, the most common being mutations in the HFE gene. HFE heredita...

Background: COVID-19 pandemic has resulted in varying clinical manifestations and mortality rates. There is no consensus on the symptomatology that would guide researchers and clinicians. Objective: The objective of the study was to identify symptoms and their frequencies of coronavirus disease 2019 with a meta-analysis of studies from several coun...

Peripheral vascular flow in response to induced reactive hyperemia of the radial artery is used as a benchmark for non-invasive assessment of the endothelial function. As an alternative to standard modalities, this study investigates the suitability of impedance plethysmography to estimate peripheral vascular flow variations associated with the rea...

Background: COVID-19 pandemic has resulted in varying clinical manifestations and mortality rates. There is no consensus on the symptomatology that would guide researchers and clinicians. Objective: The objective was to identify symptoms and their frequencies of COVID-19 with a meta-analysis of studies from several countries. Data sources: A syst...

Objectives To compare carriage rates of Staphylococcus aureus in patients with and without chronic kidney disease (CKD) and identify associated factors. Results We enrolled 64 CKD (A-1 = 13, A-2 = 17, A-3 = 34) and 56 non-CKD controls (B). Patients were categorized as: stage 5 CKD on haemodialysis (A-1), stage 5 CKD not on haemodialysis (A-2), ren...

The informal settlements of the Global South are the least prepared for the pandemic of COVID-19 since basic needs such as water, toilets, sewers, drainage, waste collection, and secure and adequate housing are already in short supply or non-existent. Further, space constraints, violence, and overcrowding in slums make physical distancing and self-...

Background: The indigenous population in Sri Lanka called “Veddas” estimated to be around 0.05% of the total population in the island. This population is unique that they used to live mostly in jungles with primitive lifestyles. The objective was to study the cardiovascular risk factors in this indigenous (Vadda) community. Methods: A descriptive c...