PURSE 2013

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https://ir.lib.pdn.ac.lk/handle/20.500.14444/59

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Browsing PURSE 2013 by Author "Adikari, S. B."

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    Anatomical variations of the human vermiform appendix as observed during autopsies
    (The University of Peradeniya, 2014-07-04) Ekanayake, P. M. N. S.; Vadysinghe, A. N.; Senasinghe, P.; Adikari, S. B.
    The Human vermiform appendix is a vestigial structure, which shows extreme variability in its position and morphology. Varying symptoms of acute appendicitis reflects this variability of its relationship to the surrounding structures making the clinical presentation of appendicitis highly inconsistent. The retrocaecal position of the tip of the appendix, with the base connected to the postero-medial wall of the caecum is the commonest variation. The length of the appendix usually ranges from 7.5 - 10 cm in adults. Variations of meso-appendix and appendicular artery are also common. The objective of this study is to describe the anatomical variations of the healthy appendix in terms of morphology, position of the tip and the base, length, details of meso-appendix and appendicular artery. A sample of dead bodies of subjects over 18 years of age that underwent medico-legal autopsy by two consultant judicial medical officers between November 2011- November 2012 at the Teaching Hospital Peradeniya and Base Hospital, Nawalapitiya, were included in the study. Putrefied bodies, and those with abdominal pathology were excluded. The 60 subjects examined were between 19-88 years of age, with 39 males and 21 females. Mobile healthy appendices were observed in 58 of them. One case with an appendicular mass and another with absent appendix were excluded. Post-ileal appendices were found in 29 (50%) subjects, while 20 (34.5%) had retro-caecal appendices. Pelvic 7 (12.%), and para-caecal 2 (3.5%) were also detected, while no pre-ileal, sub-caecal or promonteric appendices were noted. The base of the appendices were found on the postero-medial wall of the caecum in 36 (62.07%), on the lower pole of the caecum in 18 (31%) and on the postero-lateral wall in 4 (6%) subjects. The length of the appendix varied from 3 -14 cm with a mean of 8.2 cm. The distance between the ileo-caecal valve to the base of the appendix varied from 1 - 6 cm with a mean of 2.8 cm. The distance between the edge of the meso-appendix and the tip of the appendix varied from 0 - 7 cm with the average being 1.23 cm. In 30 (51.7 %) of the subjects the meso-appendix continued to the tip of the appendix. The appendicular artery continued to the tip of the appendix in 37 (63.8%) subjects. The human appendix shows extreme anatomical variations. The post-ileal position was the commonest. The base of the appendix was commonly situated on the postero-medial wall of the caecum. The length of the appendix varied widely. In the majority, the meso-appendix and the appendicular artery continued to the tip of the appendix.
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    Clinical use of polymerase chain reaction based detection of Leishmania Spp. in the dianosis of cutaneous leishmaniasis
    (The University of Peradeniya, 2013-07-04) Atapattu, D. N.; Iddawela, W. M. D. R.; Adikari, S. B.; Rajapakse, R. P. V. J.; Wickramasinghe, W. D. S. J.; Samaraweera, S. S.; Senevirathne, N.; Perera, N.; Adicaram, D. R. S.; Jayawardana, G. J. K. A. A.; Dissanayake, D. M. H. N.; Bandara, D. R. L. N.; Wijesundara, N. L. S.; Nugawela, S.
    Sri Lanka is the newest reported focus of leishmaniasis in the Indian subcontinent and since 2001 there have been over 2500 clinically suspected cases referred for disease confirmation. Light microscopy remains the mainstay for diagnosis, but in spite of its wide use, as the sensitivity of microscopy is low, it can result in mismanagement of patients. The objective of this research was to study the clinical use of the polymerase chain reaction (PCR) in the diagnosis of cutaneous leishmaniasis (CL). The sensitivity of microscopy was compared with PCR amplification using a set of primers that amplified a 260-bp region in the genomic DNA of all old world Leishmania spp. The samples (n=31) were collected from patients clinically suspected of CL. The smears were stained with Giemsa and for PCR, DNA was extracted from skin scrapings. A diagnosis of CL was given if at least one of the two techniques produced positive findings. Of the sample, 64.5% were identified as CL positive by both tests. The sensitivity for microscopy and PCR were 70% and 80% respectively. PCR also detected 35% of themicroscopy negative patients. Three patients who had demonstrated negative results whenmicroscopy was repeated and two patients who were undergoing treatment for leprosy were also diagnosed positively by PCR. The PCR assay had a higher sensitivity for diagnosing CL when compared with microscopy and although time consuming and expensive, it can be recommended in those cases where microscopy is negative and the clinical diagnosis is doubtful