Papers by Amitha Fernando
Journal of the Neurological Sciences, Nov 30, 2023
Journal of the Neurological Sciences, Nov 30, 2023
Journal of Medical Case Reports, Jun 24, 2023
Background Infection due to the SARS-CoV-2 virus can have a wide range of presentations from asym... more Background Infection due to the SARS-CoV-2 virus can have a wide range of presentations from asymptomatic/ mildly symptomatic to severe disease with multiorgan failure. Fever is a common symptom. But hyperpyrexia defined as temperature > 41.5 °C is not usual in COVID-19. Case presentation A 24-year-old previously well Sri Lankan female in the 24th week of gestation of her first pregnancy presented with fever and shortness of breath. She was confirmed to have coronavirus disease-2019 (COVID-19). History was suggestive of late presentation on approximately the eighth day of the illness. She had rapidly deteriorating hypoxia due to COVID pneumonia requiring mechanical ventilation two days after the admission. There was evidence of cytokine storm without any secondary bacterial infection. She received glucocorticoids, tocilizumab, and intravenous antibiotics. Although she initially showed mild improvements, she subsequently developed high-grade fever with the axillary temperature rising to 41.7 °C starting from the seventh day of admission. There were no causative medicines or risk factors to explain hyperpyrexia. She died on the ninth day of admission. Conclusions There are no reports of patients developing this complication during pregnancy. The pathophysiology of this rare life-threatening complication remains elusive. Detailed reporting and in-depth analysis of such patients will facilitate the understanding of the associations and successful management of these patients.
BMC Public Health, Dec 13, 2022
Background: Data on adult asthma is scarce in Sri Lanka. The objective of this study was to estim... more Background: Data on adult asthma is scarce in Sri Lanka. The objective of this study was to estimate the prevalence of asthma and its symptoms in adult Sri Lankans. Methods: A cross-sectional study using a translated version of the European Community Respiratory Health Survey screening questionnaire on subjects ≥ 18 years from 7 provinces in Sri Lanka was conducted. The asthma was defined as "wheezing in the past 12 months (current wheeze)", self-reported asthma attack in the past 12 months or on current asthma medication use. Results: Among 1872 subjects (45.1% males, 48.8% between 18-44 years of age), the prevalence of current wheeze was 23.9% (95%CI: 22.0%-25.9%), self-reported asthma was 11.8% (95%CI: 10.3%-13.2%) and current asthma medication use was 11.1% (95% CI: 9.6%-12.5%). The prevalences were higher in adults > 44 years, 31.4% positively responded to any of the above questions (95%CI: 29.3%-33.4%) and 60.9% of current wheezers did not report having asthma whilst 38.2% used asthma medication. Among current wheezers, 80.1% had at least one other symptom, cough being the commonest. Those with no current wheeze, self-reported asthma and on current asthma medication use, 30%, 35.9% and 36.6%, respectively, reported at least one other symptom. Smokers comprises 22% current wheezers, 20.6% of self-reported asthmatics and 18.7% of current asthma medication users. Conclusions: The prevalence of asthma in Sri Lankan adults is higher than the other South Asian countries and higher in the older age group. A significant percentage of symptomatic individuals did not report having asthma or being on medication.
The Journal of the Japanese Association for Chest Surgery, 2016
Poster Presentation Abstract (PP49), 124th Annual Scientific Sessions, Sri Lanka Medical Associat... more Poster Presentation Abstract (PP49), 124th Annual Scientific Sessions, Sri Lanka Medical Association, 2011 Colombo, Sri Lanka
Respirology, 2019
Background and Aims: Chronic dry cough is reported to occur in about 25% of patients following lu... more Background and Aims: Chronic dry cough is reported to occur in about 25% of patients following lung cancer surgery. There are several reports that it may be caused mainly by stimulation of C-fibres, which are widely distributed to the lower trachea and bronchi. However, the mechanism of the chronic cough following lung resection is still unclear. Our aim is to examine the factors that affect chronic cough following lung resection. Methods: Clinicopathologic data from 52 patients who underwent lobectomy for lung cancer were collected. The duration of observation was more than 1 year from the day of surgery. Results: A total of 52 patients met inclusion criteria, including 14 right upper lobectomy, 7 right middle lobectomy, 11 right lower lobectomy, 8 left upper lobectomy, 12 left lower lobectomy. In 17 patients, mediastinal lymph node resections were performed. Chronic cough following lung resection was observed in 18 patients (34.6%), including 15 female
Advances in Diagnostic Techniques in Sleep Disorders, 2019
Introduction: Obstructive sleep apnoea (OSA) is the commonest sleep related breathing disorder wo... more Introduction: Obstructive sleep apnoea (OSA) is the commonest sleep related breathing disorder worldwide, but there is only limited community level data on the risk of OSA from South Asian countries. Aims and objectives: This study assessed the community prevalence of persons at high-risk for OSA among Sri Lankan adults. Methods: A randomly selected sample of adults from 7 (out of 9) provinces of Sri Lanka was screened using the Berlin Questionnaire (BQ). BQ has 3 categories related to snoring severity (category 1), excessive day time somnolence (category 2) and history of hypertension or obesity (category 3). Individuals were classified as high or low risk according to the category score. Results: One thousand six hundred and eight adults (46.2% male) were screened, and 270 were classified as high risk for OSA {16.8%; 95% CI 14.9%-18.6% (15.1% in males; 18.3% in females, p >0.05)}. Of the high risk individuals, 239 (88.5%) were category 1 positive, 142 (52.6%) category 2 positiv...
PLOS ONE, 2021
End TB strategy by the WHO suggest active screening of high-risk populations for tuberculosis (TB... more End TB strategy by the WHO suggest active screening of high-risk populations for tuberculosis (TB) to improve case detection. Present study generates evidence for the effectiveness of screening patients with diabetes mellitus (DM) for Pulmonary TB (PTB). A study was conducted among 4548 systematically recruited patients over 45 years attending DM clinic at the National Hospital of Sri Lanka. The study units followed an algorithm specifying TB symptom and risk factor screening for all, followed by investigations and clinical assessments for those indicated. Bacteriologically confirmed or clinically diagnosed PTB were presented as proportions with 95% CI. Mean (SD) age was 62·5 (29·1) years. Among patients who completed all indicated steps of algorithm, 3500 (76·9%) were investigated and 127 (2·8%) underwent clinical assessment. Proportion of bacteriologically confirmed PTB patients was 0·1% (n = 6,95%CI = 0·0–0·3%). None were detected clinically. Analysis revealed PTB detection rates...
Genitourinary tuberculosis is a challenging clinical entity which can affect the entire male geni... more Genitourinary tuberculosis is a challenging clinical entity which can affect the entire male genital tract. Seventy-five- year old male presented with a testicular lump masquerading a testicular malignancy. Histological and microbiological examination of testicular biopsy specimens established the diagnosis of tuberculosis. Isolated testicular tuberculosis is rarely reported. High degree of clinical suspicion and histological sampling are paramount important in the process of diagnostic evaluation.
Oral Presentation Abstract (APSR6-0399), 21st Congress of the Asian Pacific Society of Respirolog... more Oral Presentation Abstract (APSR6-0399), 21st Congress of the Asian Pacific Society of Respirology (APSR 2016), November 12–15 2016, Bangkok, Thailand
Introduction: Lower respiratory tract infections (LRTIs) remain the deadliest communicable diseas... more Introduction: Lower respiratory tract infections (LRTIs) remain the deadliest communicable disease around the world. This study was conducted to identify the bacterial etiology of LRTIs among patients who attended the Central Chest Clinic in city of Colombo, Sri Lanka and their antibiotic susceptibility profile to enable clinicians to take decisions on effective empirical antibiotics. Methods: Sputum samples were collected from 1,372 patients over the age of 18 years with suspected LRTIs during the year 2015. The samples were collected and processed according to standard laboratory procedures at the microbiology laboratory of the Medical Research Institute of Sri Lanka. Results: Most of reports (58%) were from patients diagnosed with infective exacerbations of chronic lung diseases. Out of all sputum cultures processed, 404 (29.4%) resulted positive for pathogenic bacterial organisms. Coliforms (n = 176, 43.6%), and Pseudomonas aeruginosa (n = 117, 29%) were the most common isolated...
Sarcoidosis and tuberculosis are chronic granulomatous diseases with predominant pulmonary involv... more Sarcoidosis and tuberculosis are chronic granulomatous diseases with predominant pulmonary involvement. Simultaneous occurrence of sarcoidosis and tuberculosis is a rarely encountered clinical entity. We present two Sri Lankan males with coexisting bacteriologically confirmed tuberculosis and histologically diagnosed sarcoidosis. Careful and timely commencement of anti-tuberculous treatment followed by steroids treatment for sarcoidosis lead to improvement of both conditions. These cases are reported to describe the dilemmas in diagnosis and management of this underrecognized clinical entity.
Respirology, 2019
Case Description: Mr. A is a 65-year-old Chinese man, neversmoker, who was referred for evaluatio... more Case Description: Mr. A is a 65-year-old Chinese man, neversmoker, who was referred for evaluation of cough when exposed to cold air and mild exertional dyspnoea (MRC dyspnoea scale 2). He is a Taxi driver by occupation, an avid martial art practitioner and is relatively
Respirology, 2019
Case Description: Mr. A is a 65-year-old Chinese man, neversmoker, who was referred for evaluatio... more Case Description: Mr. A is a 65-year-old Chinese man, neversmoker, who was referred for evaluation of cough when exposed to cold air and mild exertional dyspnoea (MRC dyspnoea scale 2). He is a Taxi driver by occupation, an avid martial art practitioner and is relatively
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Papers by Amitha Fernando