EVALUATION OF URBAN AIR POLLUTION COST A CASE STUDY IN THE COLOMBO CITY

Air pollution is arguably the most important. in terms of economics cost, of thevarious types of pollution caused by transport and industrial activities and itseffects have been widely studied in other countries. However, direct studies havenot been undertaken to measure the economics cost of air pollution in Sri Lanka.Concern for air pollution in Sri Lanka is focused mainly in Colombo. AlthoughColombo air pollution level is less than many Asian countries, recent monitoringresults show that air pollution from particulate matter and Sulfur is well above theWHO recommended levelThe contingent valuation method was used to estimate the air pollution cost anddata was collected from a contingent valuation survey carried out in the Fort andPettah areas. Respondents' willingness to pay values were obtained for ahypothetical market presented. The results were consistent with the economictheory. Aggregated cost of air pollution for the country was Rs.55 million peryear. This value may help cost benefit analysis of air quality managementprogrammes and other related development policy and programs in Sri Lanka.

Co-Amoxiclav Induced Immune Haemolytic Anaemia: A Case Report

Drug-induced immune haemolytic anaemia (DIIHA) is extremely rare. We herein report a case of DIIHA due to co-amoxiclav. A 53-year-old male being treated for left-sided pyelonephritis with intravenous co-amoxiclav developed symptoms and signs of anaemia on the third day of treatment. He was found to have evidence of haemolysis with a positive Coombs test and IgG antibodies and C3d. Co-amoxiclav was identified as the probable culprit, using the Naranjo adverse drug reaction probability scale. Upon discontinuation of the drug and blood transfusion, the patient’s haematological parameters stabilised. Steroids were not required in the treatment. Diagnosis of DIIHA is made through a history of intake of co-amoxiclav, clinical and laboratory features of haemolysis, and a positive Coombs test. An autoantibody screen is most commonly negative. It is essential for clinicians to be aware about this rare complication caused by commonly prescribed drugs and be able to accurately diagnose and initiate treatment

Evaluation of teaching and learning in family medicine by students: A Sri Lankan experience

Background: Family Medicine occupies a prominent place in the undergraduate curriculum of the Faculty of Medicine, University of Kelaniya, Sri Lanka. The one month clinical attachment during the fourth year utilizes a variety of teaching methods. This study evaluates teaching learning methods and learning environment of this attachment. Methodology: A descriptive cross sectional study was carried out among consenting students over a period of six months on completion of the clinical attachment using a pretested self administered questionnaire. Results: Completed questionnaires were returned by 114(99%) students. 90.2% were satisfied with the teaching methods in general while direct observation and feed back from teachers was the most popular(95.1%) followed by learning from patients(91.2%), debate(87.6%), seminar(87.5%) and small group discussions(71.9%). They were highly satisfied with the opportunity they had to develop communication skills (95.5%) and presentation skills (92.9%). Lesser learning opportunity was experienced for history taking (89.9%), problem solving (78.8%) and clinical examination (59.8%) skills. Student satisfaction regarding space within consultation rooms was 80% while space for history taking and examination (62%) and availability of clinical equipment (53%) were less. 90% thought the programme was well organized and adequate understanding on family medicine concepts and practice organization gained by 94% and 95% of the students respectively. Conclusions: Overall student satisfaction was high. Students prefer learning methods which actively involve them. It is important to provide adequate infra structure facilities for student activities to make it a positive learning experience for them

A feasibility study for the establishment of a national wildlife health centre in Sri Lanka

Summary Sri Lanka is a tropical nation within a zoogeographic zone that is at high risk for infectious disease emergence. In 2010, a study was conducted on the feasibility of enhancing capacity in Sri Lanka to manage wildlife diseases through the establishment of a national wildlife health centre. The Canadian Cooperative Wildlife Health Centre was assessed as a potential model for adaptation in Sri Lanka. Interviews and group meetings were conducted with potential key participants from the Sri Lankan Departments of Wildlife Conservation and Animal Production and Health, and the Faculty of Veterinary Medicine and Animal Science of the University of Peradeniya. In addition, site visits were made to potentially participating facilities and the literature on best practices in building scientific capacity was consulted. With strategic enhancements in education and training, additional personnel, improvements in transportation and diagnostic facilities, and central coordination, Sri Lanka appears very well positioned to establish a sustainable wildlife health centre and programme

Many pitfalls in diagnosis of acute intermittent porphyria: a case report

Abstract Background Acute intermittent porphyria is a rare autosomal dominant disorder caused by a deficiency of the enzyme, hydroxymethylbilane synthase. Recognition of acute neurovisceral attacks can be difficult due to the nonspecific nature of symptoms. Case presentation We report a case of 33-year-old male patient who presented with recurrent episodes of severe abdominal pain, nausea, vomiting, constipation and numbness of bilateral lower limb extremities. These nonspecific neurovisceral attacks were subject to medical and surgical misdiagnoses of acute appendicitis, sinus tachycardia, renal calculi, drug-induced acute interstitial nephritis and two episodes of partial intestinal obstruction. The sixth acute attack raised the suspicion of an acute porphyria. Watson and Schwartz test was positive for porphobilinogen in urine. Mutation analysis by DNA sequencing of the extracted DNA of the proband revealed a previously reported missense mutation, c.517C>T encoding p.R173W in the HMBS gene, confirming the diagnosis of Acute Intermittent Porphyria. Four out of five family members who underwent targeted mutation analyses were mutation-positive. Conclusion The most common clinical presentation of Acute Intermittent Porphyria is abdominal pain with neurovisceral manifestations which are common to several medical, psychiatric and surgical pathologies. This leads to underdiagnosis and misdiagnosis of this disorder, incorrect management, and severe complications. Therefore, a high index of suspicion and awareness of front line laboratory investigations are important for diagnosis. Definitive diagnosis enables implementation of strategies to prevent acute attacks, and also triggers genetic testing and genetic counseling of at-risk family members

Plasmodium falciparum Malaria Elicits Inflammatory Responses that Dysregulate Placental Amino Acid Transport

Placental malaria (PM) can lead to poor neonatal outcomes, including low birthweight due to fetal growth restriction (FGR), especially when associated with local inflammation (intervillositis or IV). The pathogenesis of PM-associated FGR is largely unknown, but in idiopathic FGR, impaired transplacental amino acid transport, especially through the system A group of amino acid transporters, has been implicated. We hypothesized that PM-associated FGR could result from impairment of transplacental amino acid transport triggered by IV. In a cohort of Malawian women and their infants, the expression and activity of system A (measured by Na+-dependent 14C-MeAIB uptake) were reduced in PM, especially when associated with IV, compared to uninfected placentas. In an in vitro model of PM with IV, placental cells exposed to monocyte/infected erythrocytes conditioned medium showed decreased system A activity. Amino acid concentrations analyzed by reversed phase ultra performance liquid chromatography in paired maternal and cord plasmas revealed specific alterations of amino acid transport by PM, especially with IV. Overall, our data suggest that the fetoplacental unit responds to PM by altering its placental amino acid transport to maintain adequate fetal growth. However, IV more profoundly compromises placental amino acid transport function, leading to FGR. Our study offers the first pathogenetic explanation for FGR in PM

WHO Public Health Research Agenda for Managing Infodemics

An “infodemic” is an overabundance of information – some accurate and some not – that occurs during an epidemic. It spreads between humans in a similar manner to an epidemic, via digital and physical information systems. It makes it hard for people to find trustworthy sources and reliable guidance when they need it. An infodemic is propagated by the fundamentally interconnected ways in which information is disseminated and consumed: through social media platforms, online and through other channels. In the context of the COVID-19 pandemic, it is exacerbated by the global scale of the emergency. During epidemics, more so than in normal times, people need accurate information so that they can adapt their behaviour and protect themselves, their families and their communities against infection. Infodemics affect citizens in every country and addressing them is a new and centrally important challenge in responding to disease outbreaks. The current COVID-19 infodemic, given its scale and profile, is an important opportunity to find and adapt new preparedness and response tools.peer-reviewe

Fungal diversity notes 1387–1511: taxonomic and phylogenetic contributions on genera and species of fungal taxa

This article is the 13th contribution in the Fungal Diversity Notes series, wherein 125 taxa from four phyla, ten classes, 31 orders, 69 families, 92 genera and three genera incertae sedis are treated, demonstrating worldwide and geographic distribution. Fungal taxa described and illustrated in the present study include three new genera, 69 new species, one new combination, one reference specimen and 51 new records on new hosts and new geographical distributions. Three new genera, Cylindrotorula (Torulaceae), Scolecoleotia (Leotiales genus incertae sedis) and Xenovaginatispora (Lindomycetaceae) are introduced based on distinct phylogenetic lineages and unique morphologies. Newly described species are Aspergillus lannaensis, Cercophora dulciaquae, Cladophialophora aquatica, Coprinellus punjabensis, Cortinarius alutarius, C. mammillatus, C. quercoflocculosus, Coryneum fagi, Cruentomycena uttarakhandina, Cryptocoryneum rosae, Cyathus uniperidiolus, Cylindrotorula indica, Diaporthe chamaeropicola, Didymella azollae, Diplodia alanphillipsii, Dothiora coronicola, Efibula rodriguezarmasiae, Erysiphe salicicola, Fusarium queenslandicum, Geastrum gorgonicum, G. hansagiense, Helicosporium sexualis, Helminthosporium chiangraiensis, Hongkongmyces kokensis, Hydrophilomyces hydraenae, Hygrocybe boertmannii, Hyphoderma australosetigerum, Hyphodontia yunnanensis, Khaleijomyces umikazeana, Laboulbenia divisa, Laboulbenia triarthronis, Laccaria populina, Lactarius pallidozonarius, Lepidosphaeria strobelii, Longipedicellata megafusiformis, Lophiotrema lincangensis, Marasmius benghalensis, M. jinfoshanensis, M. subtropicus, Mariannaea camelliae, Melanographium smilaxii, Microbotryum polycnemoides, Mimeomyces digitatus, Minutisphaera thailandensis, Mortierella solitaria, Mucor harpali, Nigrograna jinghongensis, Odontia huanrenensis, O. parvispina, Paraconiothyrium ajrekarii, Parafuscosporella niloticus, Phaeocytostroma yomensis, Phaeoisaria synnematicus, Phanerochaete hainanensis, Pleopunctum thailandicum, Pleurotheciella dimorphospora, Pseudochaetosphaeronema chiangraiense, Pseudodactylaria albicolonia, Rhexoacrodictys nigrospora, Russula paravioleipes, Scolecoleotia eriocamporesi, Seriascoma honghense, Synandromyces makranczyi, Thyridaria aureobrunnea, Torula lancangjiangensis, Tubeufia longihelicospora, Wicklowia fusiformispora, Xenovaginatispora phichaiensis and Xylaria apiospora. One new combination, Pseudobactrodesmium stilboideus is proposed. A reference specimen of Comoclathris permunda is designated. New host or distribution records are provided for Acrocalymma fici, Aliquandostipite khaoyaiensis, Camarosporidiella laburni, Canalisporium caribense, Chaetoscutula juniperi, Chlorophyllum demangei, C. globosum, C. hortense, Cladophialophora abundans, Dendryphion hydei, Diaporthe foeniculina, D. pseudophoenicicola, D. pyracanthae, Dictyosporium pandanicola, Dyfrolomyces distoseptatus, Ernakulamia tanakae, Eutypa flavovirens, E. lata, Favolus septatus, Fusarium atrovinosum, F. clavum, Helicosporium luteosporum, Hermatomyces nabanheensis, Hermatomyces sphaericoides, Longipedicellata aquatica, Lophiostoma caudata, L. clematidis-vitalbae, Lophiotrema hydei, L. neoarundinaria, Marasmiellus palmivorus, Megacapitula villosa, Micropsalliota globocystis, M. gracilis, Montagnula thailandica, Neohelicosporium irregulare, N. parisporum, Paradictyoarthrinium diffractum, Phaeoisaria aquatica, Poaceascoma taiwanense, Saproamanita manicata, Spegazzinia camelliae, Submersispora variabilis, Thyronectria caudata, T. mackenziei, Tubeufia chiangmaiensis, T. roseohelicospora, Vaginatispora nypae, Wicklowia submersa, Xanthagaricus necopinatus and Xylaria haemorrhoidalis. The data presented herein are based on morphological examination of fresh specimens, coupled with analysis of phylogenetic sequence data to better integrate taxa into appropriate taxonomic ranks and infer their evolutionary relationships. © 2021, MUSHROOM RESEARCH FOUNDATION