Jaffna Teaching Hospital is a government hospital in Jaffna, Sri Lanka. It is the leading hospital in the Northern Province and the only hospital in the province controlled by the central government in Colombo. The hospital is the only teaching hospital in the Northern Province. The hospital is the main clinical teaching facility for the University of Jaffna's Faculty of Medicine. As of 2010 it had 1,228 beds.As well as general medical and surgical care the hospital provides a wide variety of healthcare services including cardiology, diabetic, dentistry, dermatology, family planning, gynaecology, neurology, obstetrics (ante-natal), oncology, ophthalmology, orthopaedics, otolaryngology (ENT), paediatrics and psychiatry. The hospital also has an emergency department, an intensive care unit, a premature baby unit, a primary health care unit, a pathological laboratory and a blood bank service.In 2010 the hospital had 111,129 in-patient admissions, 268,922 out-patient visits and 476,616 clinic visits.
Background The appendix is a vermiform structure with a variable position, length, and thickness. Imaging plays a critical role in diagnosing an inflamed appendix, with non-contrast computed tomography (NCCT) being an effective modality when ultrasound is inconclusive. This study evaluates the visibility and anatomical characteristics of a normal appendix using NCCT. Methods This retrospective descriptive study was conducted in the Radiology Unit of Teaching Hospital Jaffna, in Jaffna, Sri Lanka, from September 2023 to February 2024, following approval from the Institutional Ethical Review Committee of the hospital. Two hundred individuals were evaluated (past appendectomy patients were excluded). IBM SPSS Statistics software, version 26 (IBM Corp., Armonk, NY, USA) was used, with significance assessed at P ≤ 0.05. Results Males were 64.5%. The visibility rate was 89%. The most common positions were retrocecal (27.5%), retroileal (22%), and pelvic (21.5%). The mean length was 7.5 cm, with a base diameter of 6.6 mm, a mid-section of 6.2 mm, and a tip of 5.8 mm. Mean wall thickness was 2.6 mm, fecoliths were found in 15% of cases, and the mean distance of the base from McBurney's point was 3.32 cm. Conclusion NCCT can be used to assess the morphology, position, and presence of fecolith in equivocal cases of suspected appendicitis when ultrasound is inconclusive and contrast is contraindicated. The appendicular diameter and wall thickness can be used as evidence of inflammation. McBurney's point is a reliable anatomical guide during open appendicectomies. The presence of a fecalith itself is not a reliable indicator of appendicitis.
T-cell acute lymphoblastic leukaemia (T-ALL) is an aggressive haematological malignancy that frequently presents with mediastinal masses, lymphadenopathy, or bone marrow failure. Presentation with cardiac tamponade due to pericardial effusion is uncommon and can be life-threatening. We report a 19-year-old man with no previously known medical illness, who presented with progressive exertional dyspnoea, pleuritic chest pain, orthopnoea, and dysphagia of one week duration. Clinical and imaging findings revealed massive pericardial effusion with impending tamponade, necessitating urgent pericardiocentesis. Laboratory evaluation showed marked leucocytosis with lymphocytic predominance and thrombocytopenia. Bone marrow biopsy and flow cytometry confirmed the diagnosis of T-ALL. This case highlights the importance of considering haematological malignancy in young patients presenting with pericardial effusion and emphasises the need for prompt recognition and multidisciplinary management to prevent fatal outcomes.
INTRODUCTION:Early diagnosis and treatment of atrial fibrillation (AF) are crucial to reduce AF-related complications and associated healthcare costs. In low-resource settings, digital health technologies could help achieve this; however, costs of different screening strategies are key for policy change. METHODS:This decision-tree model representing the Sri Lankan public health system perspective used prevalence data from a community-based cross-sectional study of 10 000 individuals aged ≥50 years in Northern Province, Sri Lanka. Participants were screened for AF using AliveCor, a handheld single-lead ECG device. Three screening strategies (systematic, opportunistic and targeted) were compared against each other. The incremental cost-effectiveness ratio (ICER) is presented, representing the incremental total aggregated cost between screening strategies divided by the incremental number of new detected AF cases to generate a cost per additional new AF cases detected for a 1-year time horizon. RESULTS:Systematic screening detected 48 new AF cases, and the targeted screening detected 47. Systematic screening was more expensive (Sri Lankan rupees (Rs) 698 422; US$2123) for 10 000 screened individuals compared with targeted screening (Rs 492 002; US$1496) for 7780 screened individuals. Opportunistic screening was the cheapest strategy (Rs 360 617; US$1096) for screening 6556 individuals; however, only 30 new AF cases were identified. The ICER of targeted screening was lower compared with opportunistic screening (Rs 7729; US$23 per additional detected AF case) whereas the ICER of systematic screening compared with opportunistic screening was higher at Rs 18 767 (US$57) per detected AF case. When the systematic screening strategy was compared with targeted screening, the cost per additional detected AF case increased to Rs 206 420 ($628). CONCLUSION:Targeted screening with AliveCor was the most cost-effective strategy. Systematic screening, while having similar effectiveness, was not cost-effective due to the high additional costs to detect just one further case. These findings support integrating targeted screening into Sri Lanka's primary care pathways.
Early and accurate detection of liver disease is crucial for better patient outcomes, especially in Sri Lanka and other developing regions where the prevalence of alcoholic liver disease (ALD) and metabolic-associated fatty liver disease (MASLD), formerly known as non-alcoholic fatty liver disease (NAFLD), is increasing. This study introduces a machine learning framework for automated classification using clinical and biochemical data from 538 individuals, comprising healthy controls, patients with ALD, and patients with MASLD, collected at Jaffna Teaching Hospital and Kilinochchi General Hospital, Sri Lanka. Data preprocessing involved iterative imputation, winsorization for outliers, mutual information/Random Forestbased feature selection, standardization, and SMOTE balancing. Thirteen machine learning models were evaluated, consisting of classical classifiers and, additionally, ensemble-based methods, for binary (liver disease vs. healthy) and multi-class (ALD vs. MASLD vs. healthy) classification tasks. The Multi-Layer Perceptron achieved an accuracy of 94.4 % for binary classification, while Gradient Boosting attained 91.7 % accuracy in the multi-class setting. A soft-voting ensemble combining the three best-performing models further enhanced robustness. High ROC-AUC values and SHAP-based analysis confirm strong predictive performance and interpretable, clinically meaningful feature contributions. Overall, the proposed framework provides a reliable and interpretable tool for early liver disease screening using readily accessible clinical and biochemical features, with strong potential for clinical deployment.
Foreign body aspiration is a leading cause of accidental morbidity and mortality in children under 3 years of age. Organic foreign bodies such as peanuts pose a particularly high risk due to their hygroscopic nature and tendency to cause airway inflammation. We report a fatal case of delayed airway obstruction in an 18-month-old female child following peanut aspiration, initially presenting with transient choking that appeared to resolve. The child subsequently developed acute respiratory distress several hours later and died despite hospital admission. Autopsy revealed a peanut lodged in the right main bronchus with hyperinflation of the right lung. This case highlights the deceptive clinical course of foreign body aspiration, the dangers of delayed presentation and the need for heightened clinical suspicion even when initial symptoms subside.
