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Article ; Online: Dengue and leptospirosis infection during the coronavirus 2019 outbreak in Sri Lanka.

Niriella, M A / Ediriweera, D S / De Silva, A P / Premarathna, B H R / Jayasinghe, S / de Silva, H J

Transactions of the Royal Society of Tropical Medicine and Hygiene

2021 Volume 115, Issue 9, Page(s) 944–946

Abstract: A significant decrease in dengue fever cases and a contrasting increase in leptospirosis cases were reported for the second quarter of 2020 compared with 2019 in Sri Lanka. In the absence of significant environmental and weather-related differences to ... ...

Abstract	A significant decrease in dengue fever cases and a contrasting increase in leptospirosis cases were reported for the second quarter of 2020 compared with 2019 in Sri Lanka. In the absence of significant environmental and weather-related differences to account for these changes in incidence, we investigated the possibility that the effects of the COVID-19 pandemic on public health, social behaviour and the restrictions imposed during the lockdown influenced the fluctuations in dengue and leptospirosis infections.
Language	English
Publishing date	2021-04-05
Publishing country	England
Document type	Journal Article
ZDB-ID	441375-1
ISSN	1878-3503 ; 0035-9203
ISSN (online)	1878-3503
ISSN	0035-9203
DOI	10.1093/trstmh/trab058
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Article ; Online: COVID-19 and gastroenterology: clinical insights and recommendations for gastroenterology care providers.

Niriella, M A / De Silva, A P / Liyanage, K I / Sarin, S K / de Silva, H J

Scandinavian journal of gastroenterology

2020 Volume 55, Issue 8, Page(s) 1005–1011

Abstract: While the COVID-19 pandemic evolves, we are beginning to understand the role the gastrointestinal tract plays in the disease and the impact of the infection on the care of patients with gastrointestinal (GI) and liver diseases. We review the data and ... ...

Abstract	While the COVID-19 pandemic evolves, we are beginning to understand the role the gastrointestinal tract plays in the disease and the impact of the infection on the care of patients with gastrointestinal (GI) and liver diseases. We review the data and understanding around the virus related to the digestive tract, impact of the pandemic on delivery of GI services and daily gastroenterology clinical practice, and the effects on patients with pre-existing GI diseases.
MeSH term(s)	COVID-19 ; Communicable Disease Control/organization & administration ; Coronavirus Infections/epidemiology ; Coronavirus Infections/prevention & control ; Female ; Gastroenterology/organization & administration ; Gastrointestinal Diseases/diagnosis ; Gastrointestinal Diseases/epidemiology ; Gastrointestinal Diseases/therapy ; Health Personnel/organization & administration ; Health Services Accessibility/statistics & numerical data ; Humans ; Infection Control/organization & administration ; Male ; Pandemics/prevention & control ; Pandemics/statistics & numerical data ; Patient Care Team/organization & administration ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/prevention & control ; Practice Guidelines as Topic ; United States
Keywords	covid19
Language	English
Publishing date	2020-07-10
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	82042-8
ISSN	1502-7708 ; 0036-5521
ISSN (online)	1502-7708
ISSN	0036-5521
DOI	10.1080/00365521.2020.1789896
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Article: Clinical research during the COVID-19 pandemic: Gastroenterology researchers' perspective

Niriella, M. A. / De Silva, A. P. / De Silva, H. A. / De Silva, H. J.

Frontline Gastroenterology

Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #835502
Database	COVID19

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Article ; Online: Changing phenotype, early clinical course and clinical predictors of inflammatory bowel disease in Sri Lanka: a retrospective, tertiary care-based, multi-centre study.

Niriella, M A / Liyanage, I K / Kodisinghe, S K / De Silva, A P / Jayatissa, A V G A M / Navarathne, N M M / Peiris, R K / Kalubovila, U P / Kumarasena, S R / Jayasekara, R W / de Silva, H J

BMC gastroenterology

2021 Volume 21, Issue 1, Page(s) 71

Abstract: Background: Inflammatory bowel disease (IBD) is increasing in the Asia-Pacific region, with changes in disease phenotype and course. We aimed to assess the changing phenotypes of IBD over ten years, describe the early clinical course (ECC) and identify ... ...

Abstract	Background: Inflammatory bowel disease (IBD) is increasing in the Asia-Pacific region, with changes in disease phenotype and course. We aimed to assess the changing phenotypes of IBD over ten years, describe the early clinical course (ECC) and identify the clinical predictors (CP) of poor outcomes among a large, multi-centre, cohort of Sri Lankan IBD patients. Methods: We included patients [diagnosed between June/2003-December/2009-Group-1(G1), January/2010-June/2016-Group-2(G2)] with ulcerative colitis (UC) and Crohn disease (CD) from five national-referral centres. Changing phenotype from G1 to G2, ECC (disease duration < 3-years) and CP of poor outcomes (disease duration ≥ 1-year) was assessed. Poor outcomes were complicated-disease (CompD-stricturing/penetrating-CD, extensive-UC/pancolitis, perforation/bleeding/colectomy/malignancy) and treatment-refractory disease (TRD-frequently-relapsing, steroid-dependent/refractory and biologic use). Results: 375 (UC-227, CD-148) patients were recruited. Both G1/G2 had more UC than CD (77% vs 23%, 54.5 vs 45.5 respectively, p < 0.01). Increase of CD from G1-to-G2 was significant (23-45.4%, p < 0.001). In both groups, left-sided colitis (E2) and ileo-colonic (L3)/non-stricturing, non-penetrating disease behaviour (B1) CD predominated. Extensive-colitis (E3) (36.4% vs 22.7, p < 0.05) and stricturing-CD (B2) (26.1% vs 4.0%, p < 0.01) was commoner in G1. ECC was assessed in 173-patients (UC-94, CD-79). Aggressive disease behaviour and TRD were low among both UC and CD. Immunomodulator use was significantly higher among CD than UC (61.5% vs 29.0% respectively, p < 0.01). Anti-TNF use was low among both groups (UC-3.2%, CD-7.7%). Disease complications among UC [bleeding (2.1%), malignancy-(1.1%), surgery-(2.1%)] and CD [stricture-(3.9%), perforation-(1.3%), malignancy-(1.3%), surgery-(8.9%)] were generally low. CPs were assessed in 271-patients (UC-163, CD-108). Having a family history of IBD (for UC), extraintestinal manifestation (EIM), severe disease at presentation, being in younger age categories and severe disease at presentation, (for both UC and CD) predicted poor outcomes. Conclusion: There was an increase in CD over time without change in disease phenotype for both UC and CD. A relatively benign ECC was observed. Family history (UC), EIMs (UC/CD), severe disease at presentation (UC/CD), younger age (CD/UC) CPs of poor outcomes.
MeSH term(s)	Colitis, Ulcerative/drug therapy ; Colitis, Ulcerative/epidemiology ; Humans ; Inflammatory Bowel Diseases/drug therapy ; Inflammatory Bowel Diseases/epidemiology ; Phenotype ; Retrospective Studies ; Sri Lanka/epidemiology ; Tertiary Healthcare ; Tumor Necrosis Factor-alpha
Chemical Substances	Tumor Necrosis Factor-alpha
Language	English
Publishing date	2021-02-16
Publishing country	England
Document type	Journal Article ; Multicenter Study
ISSN	1471-230X
ISSN (online)	1471-230X
DOI	10.1186/s12876-021-01644-5
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Article: Acute Dermato-Lymphangio-Adenitis Following Administration of Infliximab for Crohn's Disease.

Liyanage, I K / Niriella, M A / de Silva, A P / de Silva, N / de Silva, H J

ACG case reports journal

2019 Volume 6, Issue 6, Page(s) e00075

Abstract: Tumor necrosis factor-α inhibitor (TNF-α) is frequently used for Crohn's disease and other autoimmune conditions. Increased risk of infection is an accepted adverse effect of TNF-α, and routine screening for potential infections are carried out before ... ...

Abstract	Tumor necrosis factor-α inhibitor (TNF-α) is frequently used for Crohn's disease and other autoimmune conditions. Increased risk of infection is an accepted adverse effect of TNF-α, and routine screening for potential infections are carried out before initiation of therapy. We report the case of a patient who developed a localized painful swelling near the injection site, which was diagnosed as acute dermato-lymphangio-adenitis due to filarial infection. This adds to the limited number of case reports on parasitic complications following TNF-α therapy.
Language	English
Publishing date	2019-06-25
Publishing country	United States
Document type	Case Reports
ZDB-ID	2814825-3
ISSN	2326-3253
ISSN	2326-3253
DOI	10.14309/crj.0000000000000075
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Article ; Online: Volatile anaesthesia and peri-operative outcomes related to cancer: a feasibility and pilot study for a large randomised control trial.

Dubowitz, J A / Cata, J P / De Silva, A P / Braat, S / Shan, D / Yee, K / Hollande, F / Martin, O / Sloan, E K / Riedel, B

Anaesthesia

2021 Volume 76, Issue 9, Page(s) 1198–1206

Abstract: Published data suggest that the type of general anaesthesia used during surgical resection for cancer may impact on patient long-term outcome. However, robust prospective clinical evidence is essential to guide a change in clinical practice. We explored ... ...

Abstract	Published data suggest that the type of general anaesthesia used during surgical resection for cancer may impact on patient long-term outcome. However, robust prospective clinical evidence is essential to guide a change in clinical practice. We explored the feasibility of conducting a randomised controlled trial to investigate the impact of total intravenous anaesthesia with propofol vs. inhalational volatile anaesthesia on postoperative outcomes of patients undergoing major cancer surgery. We undertook a randomised, double-blind feasibility and pilot study of propofol total intravenous anaesthesia or volatile-based maintenance anaesthesia during cancer resection surgery at three tertiary hospitals in Australia and the USA. Patients were randomly allocated to receive propofol total intravenous anaesthesia or volatile-based maintenance anaesthesia. Primary outcomes for this study were successful recruitment to the study and successful delivery of the assigned anaesthetic treatment as per randomisation arm. Of the 217 eligible patients approached, 146 were recruited, a recruitment rate of 67.3% (95%CI 60.6-73.5%). One hundred and forty-five patients adhered to the randomised treatment arm, 99.3% (95%CI 96.2-100%). Intra-operative patient characteristics and postoperative complications were comparable between the two intervention groups. This feasibility and pilot study supports the viability of the protocol for a large, randomised controlled trial to investigate the effect of anaesthesia technique on postoperative cancer outcomes. The volatile anaesthesia and peri-operative outcomes related to cancer (VAPOR-C) study that is planned to follow this feasibility study is an international, multicentre trial with the aim of providing evidence-based guidelines for the anaesthetic management of patients undergoing major cancer surgery.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Anesthesia, Inhalation/methods ; Anesthesia, Intravenous/methods ; Anesthetics, Inhalation ; Anesthetics, Intravenous ; Australia/epidemiology ; Double-Blind Method ; Feasibility Studies ; Female ; Humans ; Male ; Middle Aged ; Neoplasms/surgery ; Pilot Projects ; Postoperative Complications/epidemiology ; Propofol ; United States/epidemiology
Chemical Substances	Anesthetics, Inhalation ; Anesthetics, Intravenous ; Propofol (YI7VU623SF)
Language	English
Publishing date	2021-01-13
Publishing country	England
Document type	Journal Article ; Multicenter Study ; Randomized Controlled Trial
ZDB-ID	80033-8
ISSN	1365-2044 ; 0003-2409
ISSN (online)	1365-2044
ISSN	0003-2409
DOI	10.1111/anae.15354
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Article: Duodenal xanthelasmata

Piyarathna, T A / Niriella, M A / de Silva, A P / de Silva, H J

The Ceylon medical journal

2016 Volume 61, Issue 4, Page(s) 191

Language	English
Publishing date	2016--30
Publishing country	Sri Lanka
Document type	Case Reports
ZDB-ID	419365-9
ISSN	0009-0875
ISSN	0009-0875
DOI	10.4038/cmj.v61i4.8389
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Article: COVID-19 and gastroenterology: clinical insights and recommendations for gastroenterology care providers

Niriella, M A / De Silva, A P / Liyanage, K I / Sarin, S K / de Silva, H J

Scand J Gastroenterol

Abstract	While the COVID-19 pandemic evolves, we are beginning to understand the role the gastrointestinal tract plays in the disease and the impact of the infection on the care of patients with gastrointestinal (GI) and liver diseases. We review the data and understanding around the virus related to the digestive tract, impact of the pandemic on delivery of GI services and daily gastroenterology clinical practice, and the effects on patients with pre-existing GI diseases.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #638746
Database	COVID19

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Article ; Online: COVID-19 and gastroenterology

Niriella, M. A. / De Silva, A. P. / Liyanage, K. I. / Sarin, S. K. / de Silva, H. J.

Scandinavian Journal of Gastroenterology

clinical insights and recommendations for gastroenterology care providers.

2020 Volume 55, Issue 8, Page(s) 1005–1011

Keywords	Gastroenterology ; covid19
Language	English
Publisher	Informa UK Limited
Publishing country	uk
Document type	Article ; Online
ZDB-ID	82042-8
ISSN	1502-7708 ; 0036-5521
ISSN (online)	1502-7708
ISSN	0036-5521
DOI	10.1080/00365521.2020.1789896
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Pre-event quality of life and its influence on the post-event quality of life among patients with ST elevation and non-ST elevation myocardial infarctions of a premier province of Sri Lanka.

Mahesh, P K B / Gunathunga, M W / Jayasinghe, Saroj / Arnold, S M / Haniffa, R / De Silva, A P

Health and quality of life outcomes

2017 Volume 15, Issue 1, Page(s) 154

Abstract: Background: Pre-event Quality of Life (QOL) reflects the true social circumstances in which people live prior to the onset of myocardial infarctions. It is believed to be a predictor of the post-event QOL. The aim of this study was to describe the pre- ... ...

Abstract	Background: Pre-event Quality of Life (QOL) reflects the true social circumstances in which people live prior to the onset of myocardial infarctions. It is believed to be a predictor of the post-event QOL. The aim of this study was to describe the pre-event QOL and its influence on the post-event Quality of Life among patients with ST elevation (STEMI) and Non-ST elevation myocardial infarctions (NSTEMI) using Short Form-36 (SF-36), a generic QOL tool with 8 domains. Documented literature is rare in this regard in Sri Lanka, which is a lower-middle-income country. Methods: A cross-sectional study with a 28-day post-discharge follow-up was carried out in 13 hospitals. Three hundred and forty-four patients who were diagnosed with STEMI or NSTEMI were recruited during the hospital stay. The pre-event QOL was measured using an interviewer-administered questionnaire which included the SF-36 QOL tool and medical details. Follow-up QOL was gathered using a questionnaire that was filled and posted back by participants. Of the recruited sample, 235 responded for the follow-up component. Analysis was conducted for associations between pre- and post-discharge QOL. Furthermore, comparisons were made between the STEMI and NSTEMI groups. Mann Whiney U test, Wilcoxon signed rank test and chi square test were used in the analysis. Results: The post-event QOL was lower in seven out of eight domains than the pre-event QOL (p < 0.05). The NSTEMI group had more risk factors and a significantly lower pre-event QOL for seven domains (p < 0.05), when compared to the STEMI group. For seven domains, the post-discharge QOL was not significantly different (p > 0.05) between the STEMI and NSTEMI groups. Post-discharge general-health QOL domain score was higher than the pre-MI score (p = 0.028) and was higher in the STEMI group compared to the NSTEMI group (p = 0.042). Regression analysis showed a significant beta coefficient between pre- and post-QOL for five domains in STEMI and for all domains in NSTEMI groups when adjusted for the disease severity. The R square values ranged from 12.3 to 62.3% for STEMI and 7.3 to 64.8% for NSTEMI. Conclusions: Pre-event QOL is lower in the NSTEMI group compared to the STEMI group. Patients do not regain the previous QOL within one month post-discharge. Post-discharge QOL can be predicted by the pre-event QOL for most domains.
MeSH term(s)	Aged ; Cross-Sectional Studies ; Female ; Humans ; Male ; Middle Aged ; Non-ST Elevated Myocardial Infarction/psychology ; Quality of Life ; Risk Factors ; ST Elevation Myocardial Infarction/psychology ; Sri Lanka ; Surveys and Questionnaires
Language	English
Publishing date	2017-08-01
Publishing country	England
Document type	Comparative Study ; Journal Article ; Multicenter Study
ZDB-ID	2098765-1
ISSN	1477-7525 ; 1477-7525
ISSN (online)	1477-7525
ISSN	1477-7525
DOI	10.1186/s12955-017-0730-9
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