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  1. Article ; Online: Functional recovery in cerebral palsy may be potentiated by administration of selective serotonin reuptake inhibitors.

    Budhdeo, Sanjay / Rajapaksa, Shabna

    Medical hypotheses

    2011  Volume 77, Issue 3, Page(s) 386–388

    Abstract: Cerebral palsy is a disorder of movement and posture caused by a non-progressive lesion to the brain. The incidence of cerebral palsy is over 2 per 1000 live births in Europe. Management of cerebral palsy is primarily supportive--none of the current ... ...

    Abstract Cerebral palsy is a disorder of movement and posture caused by a non-progressive lesion to the brain. The incidence of cerebral palsy is over 2 per 1000 live births in Europe. Management of cerebral palsy is primarily supportive--none of the current treatments offered attempt to correct the primary problem of a brain lesion. Neurological problems may be treated by upregulating cerebral plasticity. Evidence suggests that this is the mechanism of action of selective serotonin reuptake inhibitors (SSRIs) in the treatment of depression. Encouraging evidence of motor improvements in stroke patients treated with SSRIs suggest the possibility of similar improvements in cerebral palsy. Patients with less severe cerebral palsy show more evidence of plasticity than patients with more severe forms. Evidence should initially come from animal models, and thereafter case reports and case series in selected cases, before progression to large scale trials. SSRIs would have to be used in conjunction with cooling, which prevents secondary damage. Due consideration is needed to prevent harmful side-effects.
    MeSH term(s) Cerebral Palsy/drug therapy ; Humans ; Models, Biological ; Neuronal Plasticity/drug effects ; Serotonin Uptake Inhibitors/administration & dosage ; Serotonin Uptake Inhibitors/pharmacology ; Serotonin Uptake Inhibitors/therapeutic use ; Stroke/drug therapy
    Chemical Substances Serotonin Uptake Inhibitors
    Language English
    Publishing date 2011-09
    Publishing country United States
    Document type Journal Article
    ZDB-ID 193145-3
    ISSN 1532-2777 ; 0306-9877
    ISSN (online) 1532-2777
    ISSN 0306-9877
    DOI 10.1016/j.mehy.2011.05.026
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 1132: Show issues Location:
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  2. Article: Croup - assessment and management.

    Rajapaksa, Shabna / Starr, Mike

    Australian family physician

    2010  Volume 39, Issue 5, Page(s) 280–282

    Abstract: Background: Croup is a common childhood disease characterised by sudden onset of a distinctive barking cough that is usually accompanied by stridor, hoarse voice, and respiratory distress resulting from upper airway obstruction. The introduction of ... ...

    Abstract Background: Croup is a common childhood disease characterised by sudden onset of a distinctive barking cough that is usually accompanied by stridor, hoarse voice, and respiratory distress resulting from upper airway obstruction. The introduction of steroids in the treatment of croup has seen a significant reduction in hospital admissions and improved outcomes for children.
    Objective: This article discusses the key aspects of diagnosing croup and the evidence supporting the different treatment strategies.
    Discussion: The assessment of airway, breathing and circulation, focusing on airway, is paramount in treating croup. However, it is important to take care not to cause the child undue distress. In mild to moderate croup, give prednisolone 1.0 mg/kg and review in 1 hour. In severe or life threatening croup, give 4 mL of adrenaline 1:1000 (undiluted) via nebuliser and send immediately to hospital via ambulance.
    MeSH term(s) Administration, Inhalation ; Administration, Oral ; Australia ; Child ; Child, Preschool ; Croup/diagnosis ; Croup/mortality ; Croup/therapy ; Drug Therapy, Combination ; Emergencies ; Epinephrine/administration & dosage ; Female ; Follow-Up Studies ; Humans ; Male ; Oxygen Inhalation Therapy ; Prednisolone/administration & dosage ; Risk Assessment ; Severity of Illness Index ; Survival Rate ; Treatment Outcome
    Chemical Substances Prednisolone (9PHQ9Y1OLM) ; Epinephrine (YKH834O4BH)
    Language English
    Publishing date 2010-05
    Publishing country Australia
    Document type Journal Article ; Review
    ZDB-ID 423718-3
    ISSN 0300-8495
    ISSN 0300-8495
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Meningococcal sepsis.

    Rajapaksa, Shabna / Starr, Mike

    Australian family physician

    2010  Volume 39, Issue 5, Page(s) 276–278

    Abstract: Background: Meningococcal disease remains a significant illness with an overall mortality of around 8%. The majority of deaths occur in the first 24 hours, before the commencement of specialist care. Missing a diagnosis of meningococcal disease is a ... ...

    Abstract Background: Meningococcal disease remains a significant illness with an overall mortality of around 8%. The majority of deaths occur in the first 24 hours, before the commencement of specialist care. Missing a diagnosis of meningococcal disease is a fear among health care practitioners.
    Objective: This article presents a guide to identifying the salient features of meningococcal sepsis and initial management strategies in the primary care setting.
    Discussion: Initial presentation is often nonspecific and therefore it is important to have a high index of suspicion in children presenting with fever, lethargy, myalgia, vomiting and headache. These children should be monitored and reviewed carefully. If a nonblanching rash develops, immediate treatment, liaison with a paediatric intensive care unit and urgent hospital transfer is required. Initial management involves assessment and regular review of airway, breathing and circulation. Antibiotics (preferably intravenous cephalosporin) should be administered before hospital transfer.
    MeSH term(s) Adult ; Anti-Bacterial Agents/therapeutic use ; Bacteremia/diagnosis ; Bacteremia/mortality ; Bacteremia/therapy ; Child ; Child, Preschool ; Combined Modality Therapy ; Critical Illness/therapy ; Early Diagnosis ; Emergency Treatment/methods ; Family Practice/standards ; Family Practice/trends ; Female ; Humans ; Infant ; Male ; Meningitis, Meningococcal/diagnosis ; Meningitis, Meningococcal/mortality ; Meningitis, Meningococcal/therapy ; Meningococcal Infections/diagnosis ; Meningococcal Infections/mortality ; Meningococcal Infections/therapy ; Monitoring, Physiologic/methods ; Practice Guidelines as Topic ; Prognosis ; Survival Analysis
    Chemical Substances Anti-Bacterial Agents
    Language English
    Publishing date 2010-05
    Publishing country Australia
    Document type Journal Article ; Review
    ZDB-ID 423718-3
    ISSN 0300-8495
    ISSN 0300-8495
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Identification of human parechovirus-3 in young infants within rural Victoria.

    Cooper, Monica Sophie / van Schilfgaarde, Katherine Diana / De Mel, Gihan Ruchira / Rajapaksa, Shabna

    Journal of paediatrics and child health

    2014  Volume 50, Issue 9, Page(s) 746–747

    MeSH term(s) Female ; Humans ; Infant ; Male ; Parechovirus ; Picornaviridae Infections/epidemiology ; Rural Population/statistics & numerical data ; Victoria/epidemiology
    Language English
    Publishing date 2014-09
    Publishing country Australia
    Document type Letter
    ZDB-ID 1024476-1
    ISSN 1440-1754 ; 1034-4810
    ISSN (online) 1440-1754
    ISSN 1034-4810
    DOI 10.1111/jpc.12704
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: The molecular basis for the thalassaemias in Sri Lanka.

    Fisher, Christopher A / Premawardhena, Anuja / de Silva, Shanthimala / Perera, Giathra / Rajapaksa, Shabna / Olivieri, Nancy A / Old, John M / Weatherall, David J

    British journal of haematology

    1999  Volume 121, Issue 4, Page(s) 662–671

    Abstract: The beta-globin gene mutations and the alpha-globin genes of 620 patients with the phenotype of severe to moderate thalassaemia from seven centres in Sri Lanka were analysed. Twenty-four beta-globin gene mutations were identified, three accounting for 84. ...

    Abstract The beta-globin gene mutations and the alpha-globin genes of 620 patients with the phenotype of severe to moderate thalassaemia from seven centres in Sri Lanka were analysed. Twenty-four beta-globin gene mutations were identified, three accounting for 84.5% of the 1240 alleles studied: IVSI-5 (G-->C) 56.2%; IVSI-1 (G-->A) 15.2%; and haemoglobin E (codon (CD)26 GAG-->GAA) 13.1%. Three new mutations were found; a 13-bp deletion removing the last nucleotide in CD6 to CD10 inclusively, IVSI-129 (A-->C) in the consensus splice site, and a frame shift, CD55 (-A). The allele frequency of alpha+ thalassaemia was 6.5% and 1.1% for -alpha3.7 and -alpha4.2 deletions respectively. Non-deletion alpha-thalassaemia was not observed. Triplicate or quadruplicate alpha-globin genes were unusually common. In 1.5% of cases it was impossible to identify beta-thalassaemia alleles, but in Kurunegala detailed family studies led to an explanation for the severe thalassaemia phenotype in every case, including a previously unreported instance of homozygosity for a quadruplicated alpha-globin gene together with beta-thalassaemia trait. These findings have implications for the control of thalassaemia in high-frequency populations with complex ethnic histories.
    MeSH term(s) Blotting, Southern ; Gene Frequency ; Globins/genetics ; Humans ; Mutation/genetics ; Sri Lanka/epidemiology ; alpha-Thalassemia/epidemiology ; alpha-Thalassemia/genetics ; beta-Thalassemia/epidemiology ; beta-Thalassemia/genetics
    Chemical Substances Globins (9004-22-2)
    Language English
    Publishing date 1999-08-11
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 80077-6
    ISSN 1365-2141 ; 0007-1048
    ISSN (online) 1365-2141
    ISSN 0007-1048
    DOI 10.1046/j.1365-2141.2003.04346.x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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