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Bandara H, Madegedara D. Exploring bilateral pneumothorax leading to a rare diagnosis in a young lady. Respirol Case Rep 2023; 11:e01180. [PMID: 37303312 PMCID: PMC10251254 DOI: 10.1002/rcr2.1180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 05/30/2023] [Indexed: 06/13/2023] Open
Abstract
Bilateral pneumothorax is a rare occurrence and vigilant clinical examination is mandatory to suspect that during the presentation. This case illustrates a young lady presented with bilateral pneumothorax, new identification of lung cysts and chylous pleural effusion leading to diagnosis of lymphangioleiomyomatosis.
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Affiliation(s)
- Harshana Bandara
- Respiratory Medicine UnitNational Hospital of KandyKandySri Lanka
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Madamarandawala P, Rajapakse S, Gunasena B, Madegedara D, Magana-Arachchi D. A host blood transcriptional signature differentiates multi-drug/rifampin-resistant tuberculosis (MDR/RR-TB) from drug susceptible tuberculosis: a pilot study. Mol Biol Rep 2023; 50:3935-3943. [PMID: 36749527 DOI: 10.1007/s11033-023-08307-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 01/27/2023] [Indexed: 02/08/2023]
Abstract
BACKGROUND Tuberculosis (TB), caused by the bacterium Mycobacterium tuberculosis is one of the top thirteen causes of death worldwide. The major challenge to control TB is the emergence of drug-resistant tuberculosis (DR-TB); specifically, multi-drug resistant TB which are resistant to the most potent drugs; rifampin and isoniazid. Owing to the inconsistencies of the current diagnostic methods, a single test cannot identify the whole spectrum of DR-TB associated mutations. Recently, host blood transcriptomics has gained attention as a promising technique that develops disease-specific RNA signatures/biomarkers. However, studies on host transcriptomics infected with DR-TB is limited. Herein, we intended to identify genes/pathways that are differentially expressed in multi-drug/rifampin resistant TB (MDR/RR-TB) in contrast to drug susceptible TB. METHOD AND RESULTS We conducted blood RNA sequencing of 10 pulmonary TB patients (4; drug susceptible and 6; DR-TB) and 55 genes that were differentially expressed in MDR/RR-TB from drug-susceptible/mono-resistant TB were identified. CD300LD, MYL9, VAMP5, CARD17, CLEC2B, GBP6, BATF2, ETV7, IFI27 and FCGR1CP were found to be upregulated in MDR/RR-TB in all comparisons, among which CLEC2B and CD300LD were not previously linked to TB. In comparison pathway analysis, interferon alpha/gamma response was upregulated while Wnt/beta catenin signaling, lysosome, microtubule nucleation and notch signaling were downregulated. CONCLUSION Up/down-regulation of immunity related genes/pathways speculate the collective effect of hosts' attempt to fight against continuously multiplying DR-TB bacteria and the bacterial factors to fight against the host defense. The identified genes/pathways could act as MDR/RR-TB biomarkers, hence, further research on their clinical use should be encouraged.
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Affiliation(s)
- Pavithra Madamarandawala
- Molecular Microbiology & Human Diseases Project, National Institute of Fundamental Studies, Hantana Road, Kandy, 20000, Sri Lanka
| | - Sanath Rajapakse
- Department of Molecular Biology and Biotechnology, Faculty of Science, University of Peradeniya, Peradeniya, 20400, Sri Lanka
| | - Bandu Gunasena
- National Hospital for Respiratory Diseases, Welisara, 11010, Sri Lanka
| | - Dushantha Madegedara
- Respiratory Diseases Treatment Unit, General Teaching Hospital, Kandy, 20000, Sri Lanka
| | - Dhammika Magana-Arachchi
- Molecular Microbiology & Human Diseases Project, National Institute of Fundamental Studies, Hantana Road, Kandy, 20000, Sri Lanka.
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Madegedara D, Perera B, Senevirathna S, Darmadasa S, Lakmi S, Nawerathna I, Basnayake L. Prevalence of Latent Tuberculosis in Patients with Chronic Kidney Disease of Non Diabetic Origin in Central Sri Lanka. Epidemiology 2020. [DOI: 10.1183/13993003.congress-2020.1672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Seneviratne S, Madegedara D, Edirisinghe R, Perera B, Basnayake L, Dharmadasa S, Nawarathne I, Wijerathne P, Luckmy A. A study on prevalence of latent tuberculosis in prison inmates of a single outdoor prison in central Sri Lanka. Tuberculosis (Edinb) 2020. [DOI: 10.1183/13993003.congress-2020.511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Ekanayake A, Madegedara D, Chandrasekharan V, Magana-Arachchi D. Respiratory Bacterial Microbiota and Individual Bacterial Variability in Lung Cancer and Bronchiectasis Patients. Indian J Microbiol 2019; 60:196-205. [PMID: 32255852 DOI: 10.1007/s12088-019-00850-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Accepted: 12/06/2019] [Indexed: 12/01/2022] Open
Abstract
Respiratory bacterial microbiota plays a key role in human health. Lung cancer microbiome is a significant yet an understudied area while bronchiectasis microbiome is often studied. We assessed the bacterial microbiota in the upper and lower respiratory tract of the patients with lung cancer and bronchiectasis against a healthy group and their variations in individuality. 16S rRNA gene based metagenomic sequencing was used to detect entire bacterial community along with conventional aerobic bacterial culturing. In comparison to healthy, increased bacterial diversity was observed in diseased population. Abundance of more than 1% was considered and bacteria were identified in 97% similarity. Only lung cancer patients exhibited bacteria specific to the disease: Corynebacterium tuberculostearicum and Keratinibaculum paraultunense. However, Enterococcus faecalis and Delftia tsuruhatensis were also observed limited to lung cancer and bronchiectasis respectively, in less than 1% but supported with bacterial culturing. In conclusion the disease condition and intra-group variability should be considered in future with larger cohorts to understand individual patient variability highlighting the social habits and gender of the individual.
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Affiliation(s)
- Anuradha Ekanayake
- 1Molecular Microbiology and Human Diseases, National Institute of Fundamental Studies, Kandy, 20000 Sri Lanka
| | | | | | - Dhammika Magana-Arachchi
- 1Molecular Microbiology and Human Diseases, National Institute of Fundamental Studies, Kandy, 20000 Sri Lanka
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Kim WJ, Gupta V, Nishimura M, Makita H, Idolor L, Roa C, Loh LC, Ong CK, Wang JS, Boonsawat W, Gunasekera KD, Madegedara D, Kuo HP, Wang CH, Wang C, Yang T, Lin YX, Ko FWS, Hui DSC, Lan LTT, Vu QTT, Bhome AB, Ng A, Seo JB, Lee BY, Lee JS, Oh YM, Lee SD. Identification of chronic obstructive pulmonary disease subgroups in 13 Asian cities. Int J Tuberc Lung Dis 2019; 22:820-826. [PMID: 29914609 DOI: 10.5588/ijtld.17.0524] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is a heterogeneous condition that can differ in its clinical manifestation, structural changes and response to treatment. OBJECTIVE To identify subgroups of COPD with distinct phenotypes, evaluate the distribution of phenotypes in four related regions and calculate the 1-year change in lung function and quality of life according to subgroup. METHODS Using clinical characteristics, we performed factor analysis and hierarchical cluster analysis in a cohort of 1676 COPD patients from 13 Asian cities. We compared the 1-year change in forced expiratory volume in one second (FEV1), modified Medical Research Council dyspnoea scale score, St George's Respiratory Questionnaire (SGRQ) score and exacerbations according to subgroup derived from cluster analysis. RESULTS Factor analysis revealed that body mass index, Charlson comorbidity index, SGRQ total score and FEV1 were principal factors. Using these four factors, cluster analysis identified three distinct subgroups with differing disease severity and symptoms. Among the three subgroups, patients in subgroup 2 (severe disease and more symptoms) had the most frequent exacerbations, most rapid FEV1 decline and greatest decline in SGRQ total score. CONCLUSION Three subgroups with differing severities and symptoms were identified in Asian COPD subjects.
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Affiliation(s)
- W J Kim
- Department of Internal Medicine, Kangwon National University, Chuncheon, Korea
| | - V Gupta
- Department of Internal Medicine, Kangwon National University, Chuncheon, Korea, Adesh Institute of Medical Sciences and Research, Bathinda, India
| | - M Nishimura
- Division of Respiratory Medicine, Department of Internal Medicine, Hokkaido University Hospital, Sapporo, Japan
| | - H Makita
- Division of Respiratory Medicine, Department of Internal Medicine, Hokkaido University Hospital, Sapporo, Japan
| | - L Idolor
- Section of Respiratory Services and Physical Therapy and Rehabilitation Lung Center of the Philippines, Quezon City
| | - C Roa
- College of Medicine and Philippine General Hospital, University of the Philippines, Manila, The Philippines
| | - L-C Loh
- Department of Medicine, Penang Medical College, Penang, Malaysia
| | - C-K Ong
- Department of Medicine, Penang Medical College, Penang, Malaysia
| | - J-S Wang
- Taipei Medical University, Taipei, Taiwan
| | - W Boonsawat
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - K D Gunasekera
- Central Chest Clinic, National Hospital of Sri Lanka, Colombo
| | - D Madegedara
- Respiratory Disease Treatment Unit, Teaching Hospital Kandy, Kandy, Sri Lanka
| | - H-P Kuo
- Department of Thoracic Medicine, Chang Gung Memorial Hospital, Taipei, Taiwan
| | - C-H Wang
- Department of Thoracic Medicine, Chang Gung Memorial Hospital, Taipei, Taiwan
| | - C Wang
- Department of Respiratory and Critical Care Medicine, Beijing China-Japan Friendship Hospital, Beijing
| | - T Yang
- Department of Respiratory and Critical Care Medicine, Beijing China-Japan Friendship Hospital, Beijing
| | - Y-X Lin
- Beijing Institute of Respiratory Medicine, Department of Respiratory and Critical Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing
| | - F W S Ko
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
| | - D S C Hui
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
| | - L T T Lan
- Respiratory Care Center, University Medical Center, Ho Chi Minh City, Viet Nam
| | - Q T T Vu
- Respiratory Care Center, University Medical Center, Ho Chi Minh City, Viet Nam
| | - A B Bhome
- Indian Coalition of Obstructive Lung Diseases Network, Pune, Maharashtra, India
| | - A Ng
- Department of Respiratory and Critical Care Medicine, Tan Tock Seng Hospital, Singapore
| | - J B Seo
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul
| | - B Y Lee
- Division of Allergy and Respiratory Diseases, Soon Chun Hyang University Hospital, Seoul
| | - J S Lee
- Department of Pulmonary and Critical Care Medicine and Clinical Research Center for Chronic Obstructive Airway Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Y-M Oh
- Department of Pulmonary and Critical Care Medicine and Clinical Research Center for Chronic Obstructive Airway Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - S-D Lee
- Department of Pulmonary and Critical Care Medicine and Clinical Research Center for Chronic Obstructive Airway Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Mendis C, Thevanesam V, Kumara A, Wickramasinghe S, Madegedara D, Gamage C, Gordon SV, Suzuki Y, Ratnatunga C, Nakajima C. Insight into genetic diversity of Mycobacterium tuberculosis in Kandy, Sri Lanka reveals predominance of the Euro-American lineage. Int J Infect Dis 2019; 87:84-91. [PMID: 31299365 DOI: 10.1016/j.ijid.2019.07.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 06/24/2019] [Accepted: 07/01/2019] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE Sri Lanka is a country where the molecular epidemiology of Mycobacterium tuberculosis (MTB) is poorly explored. Therefore, this study was performed to identify circulating lineages/sub-lineages of MTB and their transmission patterns. METHODS DNA was extracted from 89 isolates of MTB collected during 2012 and 2013 from new pulmonary tuberculosis patients in Kandy, Sri Lanka and analyzed by spoligotyping, large sequence polymorphism (LSP), mycobacterial interspersed repetitive unit-variable number tandem repeat (MIRU-VNTR) typing, and drug resistance-associated gene sequencing. RESULTS The predominant lineage was lineage 4 (Euro-American, 45.9%), followed by lineage 1 (Indo-Oceanic, 29.4%), lineage 2 (East-Asian, 23.5%), and lineage 3 (Central-Asian, 1.2%). Among 26 spoligotype patterns, eight were undesignated or new types and seven of these belonged to lineage 4. Undesignated lineage 4/SIT124 (n=2/8) and SIT3234 (n=8/8) clustered together based on 24-locus MIRU-VNTR typing. The dominant sub-lineage was Beijing/SIT1 (n=19), with the isoniazid resistance katG G944C mutation (Ser315Thr) detected in two of them. CONCLUSIONS The population structure of MTB in Kandy, Sri Lanka was different from that in the South Asian region. The clonal expansion of locally evolved lineage 4/SIT3234 and detection of the pre-multidrug resistant Beijing isolates from new tuberculosis patients is alarming and will require continuous monitoring.
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Affiliation(s)
- Charitha Mendis
- Division of Bioresources, Hokkaido University Research Center for Zoonosis Control, Sapporo, Japan; Department of Medical Laboratory Science, Faculty of Allied Health Sciences, University of Peradeniya, Sri Lanka
| | - Vasanthi Thevanesam
- Department of Microbiology, Faculty of Medicine, University of Peradeniya, Sri Lanka
| | - Athula Kumara
- Department of Microbiology, Faculty of Medicine, University of Peradeniya, Sri Lanka
| | - Susiji Wickramasinghe
- Department of Parasitology, Faculty of Medicine, University of Peradeniya, Sri Lanka
| | | | - Chandika Gamage
- Department of Microbiology, Faculty of Medicine, University of Peradeniya, Sri Lanka
| | - Stephen V Gordon
- School of Veterinary Medicine, University College Dublin, Belfield, Dublin, Ireland; Global Station for Zoonosis Control, Hokkaido University Global Institute for Collaborative Research and Education, Sapporo, Japan
| | - Yasuhiko Suzuki
- Division of Bioresources, Hokkaido University Research Center for Zoonosis Control, Sapporo, Japan; Global Station for Zoonosis Control, Hokkaido University Global Institute for Collaborative Research and Education, Sapporo, Japan
| | - Champa Ratnatunga
- Department of Microbiology, Faculty of Medicine, University of Peradeniya, Sri Lanka.
| | - Chie Nakajima
- Division of Bioresources, Hokkaido University Research Center for Zoonosis Control, Sapporo, Japan; Global Station for Zoonosis Control, Hokkaido University Global Institute for Collaborative Research and Education, Sapporo, Japan.
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Weerasekera D, Pathirane H, Madegedara D, Dissanayake N, Thevanesam V, Magana-Arachchi DN. Evaluation of the 15 and 24-loci MIRU-VNTR genotyping tools with spoligotyping in the identification of Mycobacterium tuberculosis strains and their genetic diversity in molecular epidemiology studies. Infect Dis (Lond) 2019; 51:206-215. [PMID: 30689510 DOI: 10.1080/23744235.2018.1551619] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND The transmission dynamics of Mycobacterium tuberculosis (Mtb) using various genotyping tools has been studied globally and a particular tool for genotyping Mtb is the mycobacterial interspersed repetitive units-variable number tandem repeats (MIRU-VNTR). Tuberculosis (TB) remains an important public health problem worldwide and Sri Lanka being a country of tourist destination; because of major development projects undergoing, it has a high proportion of tourists and immigrants from Asia and Europe that are characterized with highest TB incidences and drug-resistant clinical isolates. Hence, in order to address the question of Mtb genetic diversity, we investigated the discriminatory power of both MIRU-VNTR typing of 15 and 24 loci with spoligotyping to differentiate Mtb isolates. METHOD Acid-fast bacilli positive sputum samples (n = 150) from first visit patients were collected. Decontamination of sputum and extraction of genomic DNA were carried out using standard techniques. The isolates were characterized by MIRU-VNTR for both the 15 and 24 loci and spoligotyping. RESULTS In our study population, MIRU-VNTR 15 and 24 loci did not show a significant difference among the identified M. tuberculosis strains. However, MIRU 24 loci yielded an additional strain LAM, which is of T1 origin. 15 loci strain grouping had more clusters of strains grouped together while 24 loci differentiated the same cluster of strains into distinct strain types. CONCLUSION We conclude that the use of 15-locus MIRU-VNTR typing is sufficient for a first-line epidemiological study to genotype M. tuberculosis, but the additional discriminatory power of 24 loci MIRU-VNTR has been able to differentiate samples within highly homologous groups.
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Affiliation(s)
| | | | | | - Neranjan Dissanayake
- c Consultant Respiratory Unit , District General Hospital , Nuwara-Eliya , Sri Lanka
| | - Vasanthi Thevanesam
- d Department of Microbiology, Faculty of Medicine , University of Peradeniya , Peradeniya , Sri Lanka
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Amarasiri L, Gunasinghe W, Sadikeen A, Fernando A, Madegedara D, Wickramasinghe R, Gunasekera K. The prevalence of Chronic Obstructive Pulmonary Disease (COPD) in Sri Lanka:outcome of the BOLD study. Epidemiology 2017. [DOI: 10.1183/1393003.congress-2017.pa1212] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Keerthirathne TP, Magana-Arachchi DN, Madegedara D, Sooriyapathirana SS. Real time PCR for the rapid identification and drug susceptibility of Mycobacteria present in Bronchial washings. BMC Infect Dis 2016; 16:607. [PMID: 27782812 PMCID: PMC5080729 DOI: 10.1186/s12879-016-1943-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Accepted: 10/19/2016] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Mycobacteria have a spectrum of virulence and different susceptibilities to antibiotics. Distinguishing mycobacterial species is vital as patients with non-tuberculous mycobacterial (NTM) infections present clinical features that are similar to those of patients with tuberculosis. Thus, rapid differentiation of Mycobacterium tuberculosis complex from NTM is critical to administer appropriate treatment. Hence the aim of the study was to rapid identification of mycobacterial species present in bronchial washings using multiplex real time Polymerase Chain Reaction (PCR) and to determine the drug susceptibility in identified mycobacterial species. METHODS Sputum smear negative bronchoscopy specimens (n = 150) were collected for a period of one year, from patients attending the General Hospital Kandy, Sri Lanka. The specimens were processed with modified Petroff's method and were cultured on Löwenstein- Jensen medium. DNA, extracted from the mycobacterial isolates were subjected to a SYBR green mediated real time multiplex, PCR assay with primers specific for the M. tuberculosis complex, M. avium complex, M. chelonae-M.abscessus group and M. fortuitum group. DNA sequencing was performed for the species confirmation, by targeting the 16S rRNA gene and the drug susceptibility testing was performed for the molecularly identified isolates of M. tuberculosis and NTM. RESULTS The optimized SYBR Green mediated multiplex real-time PCR assay was able to identify the presence of genus Mycobacterium in 25 out of 26 AFB positive isolates, two M. tuberculosis complex, three M. avium complex and two isolates belonging to M. chelonae-M. abscessus group. DNA sequencing confirmed the presence of M. tuberculosis, M. chelonae-M. abscessus, M. intracellulare, M. avium, Rhodococcus sp. and M. celatum. Remaining isolates were identified as Mycobacterium sp. All the NTM isolates were sensitive to amikacin and seven were resistant to ciproflaxacin. Twenty two of the NTM isolates and the isolate Rhodococcus was resistant to clarithromycin. The two isolates of M. tuberculosis were sensitive to all first line anti tuberculosis drugs. CONCLUSION The optimized SYBR Green mediated multiplex real time PCR assay could be an effective tool for the rapid differentiation of pathogenic M. tuberculosis complex from the opportunistic nontuberculous mycobacteria and also it confirmed the presence of NTM in 15.3 % of the study population.
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Ratnatunga CN, Thevanesam V, Nandadeva D, Madegedara D, Athula Kumara K. Cross-sectional screening of healthcare workers at a regional chest clinic with an interferon gamma release assay: first report from Sri Lanka. ACTA ACUST UNITED AC 2015. [DOI: 10.1071/hi15002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Ratnatunga CN, Thevanesam V, Madegedara D, Dissanayake NLA, Kumara KA. T-SPOT. TB assay and tuberculin skin test for diagnosis and screening of tuberculosis: First report in a Sri lankan population. Asian J Med Sci 2015. [DOI: 10.3126/ajms.v7i1.12595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objective: Guidelines encourage evaluation of an Interferon Gamma Release Assay (IGRA) in the local setting, particularly in low/ middle income, Bacillus Calmette Guerin (BCG) vaccinated populations where the assays have shown variable utility. The TSPOT.TB assay and the Tuberculin Skin Test (TST) were compared in diagnosis of active tuberculosis (TB) and in contact screening in an adult Sri Lankan population.Methods: A prospective study including confirmed TB cases (n=75), controls (n-74) and close contacts of smear positive cases (n=27) was carried out at the regional Chest clinic in Kandy district. Clinical history and investigation findings, including TST results were recorded and the TSPOT.TB (Oxford Immunotec) performed.Results: The presence of diabetes and cavitation were significant predictors of TSPOT.TB positivity, while TST had no significant clinical predictors. In the diagnosis of active TB, TSPOT.TB sensitivity was 73.3% (95% CI, 58.6-84.6%) and a specificity was 72% (95% CI, 62.0-85.5%) while the TST sensitivity was 70.7% (95% CI, 54.2-83.3%) and specificity was 64.1% (95% CI, 49.7-76.5%). In contact investigation neither test showed an association with exposure level. Cost estimate was LKR 9400.00 per TSPOT.TB test compared to LKR 200.00 per TST. A high (21%) indeterminate result rate was seen with the TSPOT.TB assayConclusions: This study did not show any advantage in using TSPOT.TB over TST in this setting.Asian Journal of Medical Sciences Vol.7(1) 2015 14-19
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Weerasekera D, Magana-Arachchi D, Madegedara D, Dissanayake N, Thevanesam V. Genetic diversity of Mycobacterium tuberculosis isolates obtained from three distinct population groups in the Central Province, Sri Lanka. Asian Pacific Journal of Tropical Disease 2015. [DOI: 10.1016/s2222-1808(14)60802-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Oh YM, Bhome AB, Boonsawat W, Gunasekera KD, Madegedara D, Idolor L, Roa C, Kim WJ, Kuo HP, Wang CH, Lan LTT, Loh LC, Ong CK, Ng A, Nishimura M, Makita H, Silverman EK, Lee JS, Yang T, Lin Y, Wang C, Lee SD. Characteristics of stable chronic obstructive pulmonary disease patients in the pulmonology clinics of seven Asian cities. Int J Chron Obstruct Pulmon Dis 2013; 8:31-9. [PMID: 23378753 PMCID: PMC3553655 DOI: 10.2147/copd.s36283] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Chronic obstructive pulmonary disease (COPD) is responsible for significant morbidity and mortality worldwide. We evaluated the characteristics of stable COPD patients in the pulmonology clinics of seven Asian cities and also evaluated whether the exposure to biomass fuels and dusty jobs were related to respiratory symptoms, airflow limitation, and quality of life in the COPD patients. METHODS This cross-sectional observational study recruited 922 COPD patients from seven cities of Asia. The patients underwent spirometry and were administered questionnaires about their exposure to cigarette smoking, biomass fuels, and dusty jobs in addition to respiratory symptoms and health related quality of life. RESULTS Of the patients, there appeared to be variations from city to city in the history of exposure to biomass fuels and dusty jobs and also in respiratory symptoms of cough, phlegm, wheeze, and dyspnea. These symptoms were more frequent in those COPD patients with a history of exposure to biomass fuels than without and those with a history of exposure to dusty jobs than without (P < 0.01 for all comparisons). Airflow limitation was more severe in those COPD patients with a history of exposure to biomass fuels than without (52.2% predicted versus 55.9% of post-bronchodilator forced expiratory volume in 1 second [FEV(1)], P = 0.009); quality of life was poorer in those with exposure to biomass fuels than without (40.4 versus 36.2 of the St George's Respiratory Questionnaire [SGRQ] total score, P = 0.001). Airflow limitation was more severe in those COPD patients with a history of exposure to dusty jobs than without (51.2% predicted versus 57.3% of post-bronchodilator FEV(1), P < 0.001); quality of life was poorer in those with dusty jobs than without (41.0 versus 34.6 of SGRQ score, P = 0.006). CONCLUSION In Asian cities, the characteristics of COPD patients vary and the history of exposure to biomass fuels or dusty jobs was related to frequency of symptoms, severe airflow limitation, and poor quality of life.
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Affiliation(s)
- Yeon-Mok Oh
- Department of Pulmonary and Critical Care Medicine and Clinical Research Center for Chronic Obstructive Airway Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Abstract
Rickettsial diseases are common in Srilanka. The spotted fever group of rickettsiae presents in many ways, including very severe disease causing significant morbidity and mortality. A regional variation of the Rickettsia conorii subspecies and differences in clinical presentations are reported. This case describes disseminated Rickettsia conorii infection in a pregnant woman presenting with endocarditis.
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Affiliation(s)
- N L A Dissanayake
- Senior Registrar in Respiratory Medicine, Teaching Hospital, Kandy, Sri Lanka
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Nishantha KMC, Madegedara D. Myasthenia gravis: a rare cause of orthopnoea due to bilateral diaphragmatic paralysis. Indian J Chest Dis Allied Sci 2011; 53:189-190. [PMID: 21838204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
A case of a 68-year-old patient with bronchial asthma who presented with orthopnoea and respiratory failure in supine position is presented.
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Affiliation(s)
- K M C Nishantha
- Respiratory Disease Research and Treatment Unit, Teaching Hospital, Kandy, Sri Lanka
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