Clinico-demographic characterization of Cutaneous leishmaniasis in patients reporting to two hospitals in Matara and Hambantota districts, Sri Lanka

Background: Cutaneous leishmaniasis (CL) is an established disease in Sri Lanka.Objectives: This study aimed to characterize clinico-demographic pattern of CL, in patients reported to District General Hospital (DGH) Matara and Base Hospital (BH) Tangalle, which report about 100 new cases monthly.Methods: Clinico-demographic findings of 47 CL confirmed patients (>18 years; Slit skin smears (SSS) and/or PCR positive) from preliminary data of a cross sectional study carried out at DGH Matara and BH Tangalle from August/2018 to January /2019 were analysed. Interviewer administered questionnaire was used to gather the demographic data.Results: Median age was 43 years. Out of the 13 cases from DGH Matara, four reported from Urugamuwa and one each from other areas of the district. Of the 34 cases from BHTangalle, 12 were from Beliaththa. Eight SSS negatives became PCR positive and one PCR negative was SSS positive. Majority of the lesions were single (n=40, 85.1%), non-tender (n=38, 80.8%), non-itchy (n=34, 72.3%) and small (< 2cm, n=36, 76.6%) ulcerated nodules (n=14, 29.8%) in upper limbs (n=25, 53.1%) with parasitic grading of 1+ (n=20, 42.5%). Nine patients reported persistent itching without any evidence of secondary pathology. Clinical evidence of secondary bacterial infection presented in four patients and out of them, two had painful lesions. Thirty two lesions were <4 months duration. In addition to ulcerated nodules and plaques, three out of nine papules were ulcerated within 4 months’ by history. Two patients had a family member with CL.Conclusions: Ulceration of papules is a novel observation. Urugamuwa is a possible emerging focus of CL in Matara where Dickwella is the known hot spot. Beliathta could be a main disease focus in Hambantota. This preliminary study based on a smaller sample size needs to be validated with a bigger sample size

Emotional feelings experienced by medical students at cadaver dissections

Introduction: Human cadaver dissection is central in medical teaching/learning in initial years of medical undergraduates and there are varieties of mixed feelings/emotional reactions experienced when exposed to human cadavers. Adverse physical and psychological effects to human dissection have been reported particularly with European, American and Canadian students, 25.2% experiencing depression and nightmares. Objective: To assess the emotional feelings experienced by medical students at cadaver dissection Methods: Two hundred and eighty-five(285) students of FMS, USJP of 2006/2007 and 2009/2010 A/L intake completed a simple self administered questionnaire regarding emotional feelings experienced at cadaver dissections. Results: Majority 63.5% (181/285)] of students were apprehensive in handling/dissecting the cadaver when they entered the dissecting hall for the first time.  52.3% (149/285) considered the cadaveric dissections stimulating, 64.6%(184/285) challenging, 50.5%(144/285) enjoyable and 57.8%(165/285) as an informative environment. Female medical students were 3.3 times more worried than peer male students when entering the dissecting room.  54.7 %(156/285) students felt that an interaction with anatomy staff explaining/ mentally preparing for dissections prior to entering the dissecting hall would lessen the emotional impact and reduce anxiety. Percentage 53.3 (152/285) considered cadaver dissection based teaching as an important educational and emotional skill training method, and 83.5%(238/285) considered it to be helpful in future surgical skills. Conclusions: Although the majority of medical students are initially apprehensive towards dissections they realize the value of dissections as an educational, emotional and surgical skills training method. The initial adverse emotional reactions to cadaver dissections are relatively less than the documented European, American and Canadian figures.

An evidence of variation of Prostate and Urinary bladder morphometrical measurements of Sri Lankans from standard Western values

Objective: To compare age related normal Sri Lankan prostate values with western values.  To compare the age related Post void residual volume(PVR) of urinary bladder of Sri Lankan individuals with Western values. Method: Prostate gland (Height, Length, width, volume) and Urinary bladder(Pre void, PVR, Posterior  bladder wall thickness) measurements were taken by abdominal ultrasonography in 140 patients who underwent ultrasonography for non prostatic problems. Results: Average age was 45.79±14.01 years ranging from 16 to 85. Prostate volume ranged from 6.10 to 55.65ml with a mean of 19.04ml±7.44(Western value(WV)- 31.4ml). Mean prostate height, length and width were 2.86cm±0.44, 3.48cm±0.44 and 3.45cm±0.40 respectively. Significant Spearmen’s correlation was found between prostate volume and age (0.491,p<0.001) but not with weight(p>0.1), height(p>0.1) or body surface area(BSA)(p>0.1) of the individual. Patients were grouped in 10years period ranging from 20s to 80s. Mean prostate volume below 30years was 13.61ml±3.76 which rose upto 22.95ml±5.84(WV-32.8ml) in individuals more than 80years. PVR ranged from 0 ml to 110.25ml with a mean of 24.10ml. Mean PVR in individuals below 30years was 20.80ml which rose upto 61.75ml in more than 80years where as western values were 20-30ml. Spearman’s correlation between age and PVR was significant(0.456,p<0.01). Conclusion: Significant positive correlation was found between prostate volume and age but not with weight, height or BSA of the individual. PVR of Sri Lankan is higher than that of western value although Sri Lankan prostate volume is less than the western values. This may lead to under diagnosing BPH in Sri Lankan setup

A Plant-Produced Pfs25 VLP Malaria Vaccine Candidate Induces Persistent Transmission Blocking Antibodies against Plasmodium falciparum in Immunized Mice

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