University of Peradeniya

About: University of Peradeniya is a education organization based out in Kandy, Sri Lanka. It is known for research contribution in the topics: Population & Poison control. The organization has 5970 authors who have published 7388 publications receiving 197002 citations.

Long term outcome of acute kidney injury due to leptospirosis? A longitudinal study in Sri Lanka

Abstract: Leptospirosis is an important zoonotic disease of variable severity and is a common cause of acute kidney injury (AKI) in tropics. However the knowledge on long term renal outcome in leptospirosis is scarce. This study aims to assess the long-term renal outcome of AKI caused by leptospirosis. Hospital records of patients who had developed AKI following leptospirosis (Serologically confirmed) presented to two Teaching Hospitals in Kandy district over 3 years from 2007 were studied. A total of 44 patients were included and they had been followed up at least for one year in out patient clinics with regular assessment including renal status. Renal histology was studied in two patients. The primary outcome measure was normalization of renal function at one year. Of the 44 patients, 31 were in the risk and injury stage (Group 1), and the rest of them were in the failure stage (Group 2) under RIFLE criteria. Of group 2 patients, 11 had abnormal renal functions on discharge. Their mean serum creatinine and GFR values on discharge were 392 mmol/l and 20 ml/min/1.73 m2. Other two patients had full renal recovery whilst in the hospital. Nine in the group 2 required renal replacement therapy by means of peritoneal dialysis, intermittent haemodialysis or haemofiltration. Seventeen out of the total had persistently abnormal renal functions on discharge. Of them 13 recovered their renal functions to normal. Four patients (9%) who belonged to group 2, had persistently abnormal renal functions after first year compatible with stage 3 chronic kidney disease (CKD). Renal histology of two patients showed tubulointerstitial lymphocyte infiltrate, tubular atrophy and interstitial fibrosis. The long term renal outcome of AKI following leptospirosis is satisfactory as only 9% of patients had abnormal renal functions compatible with early stage of CKD. Even among them, advanced CKD or dialysis dependency had not been observed.

Antimycotic Agents in Oral Candidosis: An Overview: 1. Clinical Variants

Abstract: The advent of the human immunodeficiency virus and the increasing prevalence of immunocompromised individuals in the community have resulted in a resurgence of opportunistic infections, including oral candidoses. Despite the availability of a number of effective antimycotics for the management of oral candidoses, therapeutic failure is not uncommon. Further, the presence of many clinical variants of oral candidosis, both new and old, may confound the unwary clinician and complicate its management. These problems have been partly circumvented by the introduction of the triazole group of antimycotics, which initially appeared to be highly effective. However, an alarming increase in organisms resistant to triazoles has been reported recently. In this paper we provide an overview of clinical variants of oral candidosis. A second paper will discuss recent advances in the usage of antimycotics in the management of this condition.

Water Quality in the Dry Zone of Sri Lanka - Some Interesting Health Aspects

Abstract: Dental fluorosis and kidney diseases are commonly observed in many parts of the dry zone of Sri Lanka, notably in the North Central Province. Chronic Renal failure (CRF) ,has recently shown a marked increase in some areas in the Anuradhapura and Polonnaruwa districts. Geochemically , the groundwater in these areas is generally of the Na/K type with the C1- sub-type predominating possibly due to the increasing drought conditions and salt build up. The Total Dissolved Solids (TDS) and the electrical conductivity are also correspondingly high. A unique feature of the dry zone is that in a large number of areas, the fluoride levels in the groundwater are higher than the recommended danger levels of the World Health Organization (WHO), and in some wells values as high as 10 mg/l F- have been recorded. The WHO stipulates that a F - concentration of 1.5 rnd is the upper limit. The abundance of fluoride in the groundwater and the higher intake of water have resulted in dental fluorosis being largely prevalent in children. It is also presumed that skeletal fluorosis is more common than hitherto believed. Though the incidence of CRF is increasing, the exact cause of the disease is not known to any degree of certainty. Since the affected people are mostly from the farming community, the contamination of drinking water possibly by agrochemicals is considered a possibility. Among the other possibilities are: (a) the use of inferior quality aluminium vessels which may react with fluoride (b) genetic factors (c) alcohol consumption (d) deficiency of some essential trace nutrients (e) excess of a toxic trace element (0 some organic matter in the water. The abundance of high fluoride in all areas and total dissolved solids in the groundwater, and the high saline nature of the water may well turn out to be a major factor in the incidence of CRF. Studies carried out on the health effects of excess fluoride in drinking water have indicated the detrimental effect it could have on the kidneys. However, this needs further investigations before any firm conclusions can be drawn. in contrast to the dry zone where evaporation and accumulation of salts on the surface have resulted in differing hydrogeochemical characteristics. These features are illustrated in figure 2. Approximately 75% of the population of Sri Lanka live in a rural environment with a close association with the immediate physical environment, obtaining their drinking water directly from the ground. The chemistry of the groundwater must therefore, have an important bearing on the health of the population.