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  1. Article ; Online: Establishing a novel partnership model to deploy health services for children with autism in a low-resource setting - experience from Sri Lanka.

    Sivayokan, Bhavana / Sivayokan, Sambasivamoorthy / Kumanan, Thirunavukarasu / Sathiadas, Gitanjali / Sreeharan, Nadarajah

    The Lancet regional health. Southeast Asia

    2023  Volume 17, Page(s) 100255

    Abstract: Sri Lanka is representative of challenges faced by low-income and middle-income countries, including the rise in the prevalence of autism and the lack of sufficient autism-specific services in the state sectors. The experience in establishing a Center to ...

    Abstract Sri Lanka is representative of challenges faced by low-income and middle-income countries, including the rise in the prevalence of autism and the lack of sufficient autism-specific services in the state sectors. The experience in establishing a Center to provide services for children with autism in Northern Sri Lanka is described. Funding and resourcing were accessed through an innovative partnership-based public/non-governmental organisation/charity model, where service-based outcomes were the main objectives. This model, incorporating state institutions, local and international charity organisations, and volunteers, devised a bespoke approach to care provision using the available resources under the clinical supervision of a consultant psychiatrist and the administrative purview of the Regional Director of Health Services. The evolution of this Center into a Learning Health System is described, reflecting how a minimalistic partnership approach focused on the integration of existing organisations and services could be a feasible model for the delivery of high-quality healthcare in low-resource settings.
    Language English
    Publishing date 2023-07-29
    Publishing country England
    Document type Journal Article ; Review
    ISSN 2772-3682
    ISSN (online) 2772-3682
    DOI 10.1016/j.lansea.2023.100255
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: The optic fundus of secondary polycythaemia.

    Kumanan, Thirunavukarasu / Malaravan, Muthusamy

    The journal of the Royal College of Physicians of Edinburgh

    2020  Volume 50, Issue 2, Page(s) 171–172

    MeSH term(s) Female ; Fundus Oculi ; Humans ; Polycythemia ; Polycythemia Vera ; Uterus
    Language English
    Publishing date 2020-08-18
    Publishing country Scotland
    Document type Case Reports
    ZDB-ID 2866363-9
    ISSN 2042-8189 ; 0953-0932
    ISSN (online) 2042-8189
    ISSN 0953-0932
    DOI 10.4997/JRCPE.2020.222
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 3088 -Suppl.-: Show issues Location:
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  3. Article: Potential Drug-Drug Interactions Among Hospitalised Elderly Patients in Northern Sri Lanka, A Lower Middle-Income Country: A Retrospective Analysis.

    Navaratinaraja, Thiyahiny S / Kumanan, Thirunavukarasu / Siraj, Suthasini / Sreeharan, Nadarajah

    Drugs - real world outcomes

    2022  Volume 10, Issue 1, Page(s) 83–95

    Abstract: Background and objectives: Elderly individuals are more vulnerable to potential drug-drug interactions (pDDIs) as age-related physiological changes, polypharmacy and hospitalisations are known to increase the risk of pDDIs. The aims of this study were ... ...

    Abstract Background and objectives: Elderly individuals are more vulnerable to potential drug-drug interactions (pDDIs) as age-related physiological changes, polypharmacy and hospitalisations are known to increase the risk of pDDIs. The aims of this study were to assess the impact of hospitalisation and other associated factors on pDDIs in elderly patients, in a resource-limited setting.
    Methods: This is a retrospective analysis of data of elderly patients (aged ≥ 65 years) admitted to the medical units of Jaffna Teaching Hospital. Preadmission and post-admission data were collected from clinic and hospital records, respectively. The British National Formulary was used to identify and categorise pDDIs. Point prevalence of pDDIs in elderly patients and the total number of pDDIs before and after hospitalisation were estimated. Factors contributing to pDDIs were determined by univariate and multivariable logistic regression.
    Results: Two hundred and eighty-eight hospitalised elderly patients with a median age of 71 years (interquartile range 67-76 years) showed a significant increase in the prevalence of pDDIs post-admission compared with the preadmission values (77.1% vs 61.5%; p < 0.001) associated with an increase in total pDDIs (377 vs 488; p < 0.001) where the majority (> 75%) were potential pharmacodynamic interactions. An unadjusted analysis showed a significant association between pDDI and polypharmacy [taking five or more medications] (odds ratio [OR] = 14.17; 95% confidence interval [CI] 7.41-27.10), the presence of more than three underlying medical conditions (OR 4.14; 95% CI 1.70-10.06), ischaemic heart disease (OR 3.25; 95% CI 1.78-5.94) and asthma (OR 8.14; 95% CI 2.46-26.88). However, when adjusted for confounders only polypharmacy (OR 14.10; 95% CI 6.50-30.60) and the presence of underlying asthma (OR 11.61; 95% CI 2.82-47.85) were associated with pDDIs.
    Conclusions: The prevalence of pDDIs among elderly patients was high and increased with hospital admissions. Polypharmacy and relevant comorbidities were contributory factors. Increased awareness of the potential for pDDIs through appropriate training and simple measures including a proper drug history, creating a bespoke pDDI list and frequent medication reviews by healthcare professionals would help to mitigate pDDIs in resource-limited and technology-limited settings.
    Language English
    Publishing date 2022-11-15
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2806600-5
    ISSN 2198-9788 ; 2199-1154
    ISSN (online) 2198-9788
    ISSN 2199-1154
    DOI 10.1007/s40801-022-00333-3
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  4. Article ; Online: Isolataed Severe Methaemoglobinaemia

    Gajawathana Sakthilingham / Ragupathy Ambalavanar / Kumanan Thirunavukarasu / Kiruththihan Ananthasayanan

    International Journal of Medical Reviews and Case Reports, Vol 3, Iss

    A Rare Presentation Of Indoxacarb Poisoning

    2019  Volume 6

    Abstract: Indoxacarb pesticide ingestion in humans is associated with multiple complications such as methaemoglobinaemia, acute kidney injury, rhabdomyolysis, acute respiratory distress syndrome and seizures. Among those, methaemoglobinaemia s common. Here we ... ...

    Abstract Indoxacarb pesticide ingestion in humans is associated with multiple complications such as methaemoglobinaemia, acute kidney injury, rhabdomyolysis, acute respiratory distress syndrome and seizures. Among those, methaemoglobinaemia s common. Here we present a case of deliberate ingestion of indoxacarb pesticide causing methaemoglobinaemia. Early recognition and prompt treatment with methylene blue has made complete recovery without any significant morbidity.
    Keywords Methaemoglobinaemia ; indoxacarb ; methylen blue ; Medicine ; R
    Language English
    Publishing date 2019-06-01T00:00:00Z
    Publisher Bulgarian Association of Young Surgeons
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article: Dengue fever complicated with acute liver failure: A case report of expanded dengue syndrome and literature review.

    Suganthan, Navaneethakrishnan / Sakthilingham, Gajawathana / Kumanan, Thirunavukarasu

    SAGE open medical case reports

    2020  Volume 8, Page(s) 2050313X20913428

    Abstract: Dengue is the most common arboviral disease, the presentation of which ranges from asymptomatic illness to dengue shock syndrome. Liver is the most common organ affected in dengue, and liver involvement is asymptomatic in majority. Dengue fever is a rare, ...

    Abstract Dengue is the most common arboviral disease, the presentation of which ranges from asymptomatic illness to dengue shock syndrome. Liver is the most common organ affected in dengue, and liver involvement is asymptomatic in majority. Dengue fever is a rare, but a leading cause for acute liver failure in endemic regions. Here, we report a case of a 34-year-old male ethanol user (16 units per week), presented with typical features of dengue infection, which was confirmed serologically, complicated with acute liver failure without clinical, radiological or laboratory evidence of plasma leakage. He was managed with intravenous fresh frozen plasma and N-acetyl cysteine along with other recommended supportive therapies for acute hepatic failure. He made an uneventful recovery.
    Language English
    Publishing date 2020-03-20
    Publishing country England
    Document type Case Reports
    ZDB-ID 2736953-5
    ISSN 2050-313X
    ISSN 2050-313X
    DOI 10.1177/2050313X20913428
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  6. Article: Rhabdomyolysis and acute kidney injury associated with thiocyclam hydrogen oxalate (Evisect) poisoning.

    Suganthan, Navaneethakrishnan / Manmathan, Rasaiah / Kumanan, Thirunavukarasu

    SAGE open medical case reports

    2020  Volume 8, Page(s) 2050313X20954942

    Abstract: Thiocyclam hydrogen oxalate (Brand name: Evisect) is an insecticide with anti-cholinergic and cholinergic properties. Although there are few case reports and a case series of human toxicity of nereistoxin analogue insecticide such as cartap hydrochloride ...

    Abstract Thiocyclam hydrogen oxalate (Brand name: Evisect) is an insecticide with anti-cholinergic and cholinergic properties. Although there are few case reports and a case series of human toxicity of nereistoxin analogue insecticide such as cartap hydrochloride poisoning published in the literature, poisoning with thiocyclam hydrogen oxalate (Evisect), an another analogue of nereistoxin with its own molecular formula is only heard in animals, such as Nubian goats. Herein, we report a patient presented with rhabdomyolysis and acute kidney injury without significant symptoms of acute cholinergic syndrome following self-ingestion of thiocyclam hydrogen oxalate (Evisect) and he made an uneventful recovery with prompt supportive care.
    Language English
    Publishing date 2020-09-02
    Publishing country England
    Document type Case Reports
    ZDB-ID 2736953-5
    ISSN 2050-313X
    ISSN 2050-313X
    DOI 10.1177/2050313X20954942
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  7. Article ; Online: Amoebic liver abscess: a neglected tropical disease.

    Kumanan, Thirunavukarasu / Sujanitha, Vathulan / Sreeharan, Nadarajah

    The Lancet. Infectious diseases

    2020  Volume 20, Issue 2, Page(s) 160–162

    MeSH term(s) Animals ; Entamoeba histolytica/pathogenicity ; Humans ; Liver Abscess, Amebic/epidemiology ; Male ; Mice ; Neglected Diseases/epidemiology ; Prevalence ; Tropical Medicine/methods ; Virulence
    Language English
    Publishing date 2020-03-11
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2061641-7
    ISSN 1474-4457 ; 1473-3099
    ISSN (online) 1474-4457
    ISSN 1473-3099
    DOI 10.1016/S1473-3099(19)30696-6
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 5743: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  8. Article ; Online: The Impact of COVID-19 on the Delivery of Critical Health Care: Experience From a Non-High-Income Country.

    Kumanan, Thirunavukarasu / Rajasooriyar, Chrishanthi / Guruparan, Mahesan / Sreeharan, Nadarajah

    Asia-Pacific journal of public health

    2020  Volume 32, Issue 8, Page(s) 473–475

    Keywords covid19
    Language English
    Publishing date 2020-10-03
    Publishing country China
    Document type Journal Article
    ZDB-ID 1025444-4
    ISSN 1941-2479 ; 1010-5395
    ISSN (online) 1941-2479
    ISSN 1010-5395
    DOI 10.1177/1010539520963626
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 2802: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  9. Article: Kounis Syndrome and Multiorgan Failure Following Multiple Wasp Stings.

    Navaradnam, Piratheepan / Suganthan, Navaneethakrishnan / Kumanan, Thirunavukarasu / Sujanitha, Vathulan / Mayorathan, Uruthirapasupathi

    Cureus

    2021  Volume 13, Issue 4, Page(s) e14606

    Abstract: Wasp and bee stings are common in Sri Lanka, and systemic envenomation causes a spectrum of clinical manifestations that includes simple local allergic reaction to life-threatening multiple organ injury or failure. However, wasp toxin-induced acute ... ...

    Abstract Wasp and bee stings are common in Sri Lanka, and systemic envenomation causes a spectrum of clinical manifestations that includes simple local allergic reaction to life-threatening multiple organ injury or failure. However, wasp toxin-induced acute myocardial infarction is very rare in the literature. Here, we describe a pregnant lady with mass wasp stings who developed toxin-induced acute myocardial infarction with multiorgan injury. The treating physician should anticipate the complications of massive envenomation following multiple wasp stings.
    Language English
    Publishing date 2021-04-21
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.14606
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  10. Article ; Online: Nocturnal systolic blood pressure pattern of type 2 diabetic hypertensive men with erectile dysfunction: a cross sectional study from Northern Sri Lanka.

    Kumanan, Thirunavukarasu / Sujanitha, Vathulan / Rajeshkannan, Nadarajah / Nisahan, Balasingam

    BMC research notes

    2019  Volume 12, Issue 1, Page(s) 696

    Abstract: Objective: This small scale cross-sectional study was done to identify the common systolic blood pressure pattern (dipping or non-dipping) among type 2 diabetic men with coexisting hypertension and erectile dysfunction(ED). A recent study in the same ... ...

    Abstract Objective: This small scale cross-sectional study was done to identify the common systolic blood pressure pattern (dipping or non-dipping) among type 2 diabetic men with coexisting hypertension and erectile dysfunction(ED). A recent study in the same setting showed that prevalence of ED was high among diabetic men and co-existing hypertension was identified as an independent risk factor. There was a postulation about an association between ED and non-dipping nocturnal blood pressure pattern. So ambulatory blood pressure measurements (ABPM) was obtained for participants to test this prediction. Data was analysed using SPSS 25 Version.
    Results: Among 29 participants who underwent ABPM, 21 showed non-dipping pattern of nocturnal systolic blood pressure (72.4%; CI 54.3-86.3). Mean SBP of participants was 125.55 +_14.1 and Mean DBP was 81.5 + _12.82. There was no statistical difference observed in mean SBP and DBP between patients with dipping nocturnal SBP and non-dipping pattern (P > 0.05). Variability of SBP was high among the participants (Mean SD-11.96 +/_2.74) and DBP also showed relatively high variability (SD-9.28 +/_2.9). Mean dipping percentage of the SBP during sleep was 5.54 +/_6.66. A significant difference in heart rate (HR) between patients with non-dipping and dipping pattern was noted (P-0.034).
    MeSH term(s) Blood Pressure/physiology ; Blood Pressure Monitoring, Ambulatory/methods ; Blood Pressure Monitoring, Ambulatory/statistics & numerical data ; Circadian Rhythm/physiology ; Comorbidity ; Cross-Sectional Studies ; Diabetes Mellitus, Type 2/epidemiology ; Diabetes Mellitus, Type 2/physiopathology ; Erectile Dysfunction/epidemiology ; Erectile Dysfunction/physiopathology ; Heart Rate/physiology ; Humans ; Hypertension/epidemiology ; Hypertension/physiopathology ; Male ; Middle Aged ; Prevalence ; Risk Factors ; Sri Lanka/epidemiology ; Time Factors
    Language English
    Publishing date 2019-10-25
    Publishing country England
    Document type Journal Article
    ZDB-ID 2413336-X
    ISSN 1756-0500 ; 1756-0500
    ISSN (online) 1756-0500
    ISSN 1756-0500
    DOI 10.1186/s13104-019-4740-z
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