The Sri Jayewardenepura General Hospital (SJGH) is a government owned, not for profit tertiary care institute which was gifted by the people of Japan, honoring the late President His Excellency J.R. Jayawardana. Established under the provision of parliament Act number 54 of 1983 and has been managed by a board of members since its inception on the 17th of September 1984.It is located in Sri Jayewardenepura, the capital of Sri Lanka, on nearly 30 acres of beautifully landscaped garden with serene nature. This state of the art green conceptual hospital maintains and preserves its environmental policies thoroughly for sustainable development. Eco-friendly hospital environment of SJGH has a nurturing, therapeutic effect and this helps to reduce patients' anxiety and stress, accelerate recovery, shorten hospitalizations, and promote a sense of well-being while uplifting the tranquility of the staffThis multi-specialty tertiary care Centre, offers a comprehensive full spectrum of care for the last 37 years, ranging from minor ailments to complex brain and heart surgeries at a substantially low cost. With over 1000 beds, our in-ward patient care facility is classified into three classes. Class 1 with en-suite room facility with all necessary amenities, class two consist of six bedded cubicles with one shared bathroom while the latter offers spacious non-congested separable beds with clean sanitary facilities. This allows the patient to conveniently choose their stay affordably as billing is itemized unlike in the for profit hospitals.
Background. Multiple endocrine neoplasia type 1 (MEN1) is a hereditary condition with an autosomal dominant inheritance, with a predisposition to both endocrine and non-endocrine tumours. MEN1-related tumours can appear as early as the age of five, with disease penetrance increasing with age. Offspring of a MEN1 parent shows a 50% probability of inheriting the MEN1-related gene mutation. A MEN1 diagnosis in a parent can lead to significant anxiety for both the diagnosed parent and their undiagnosed at-risk children. There is limited consensus specific for managing offspring of individuals diagnosed with MEN1. Objectives. This review aims to evaluate the existing literature on the outcomes of MEN1 syndrome in the offspring of affected patients, to identify gaps in current protocols and to suggest possible improvements. Methodology. A literature review was conducted to examine the outcomes and characteristics of the offspring of individuals diagnosed with MEN1. Results. Predictive testing and screening for organ involvement in MEN1 aid early diagnosis and timely interventions. DNA testing is recommended for children within the first decade of life, and screening for organ involvement should ideally begin at age 5 years for all MEN1 mutation carriers. Manifestations of MEN1 in younger children are different from those of affected adults. Conclusions. Standardised, internationally-accepted guidelines that provide specific recommendations for screening, diagnosis and treatment of offspring of adults diagnosed with MEN1 is a timely need. Furthermore, the absence of national and international data pooling across regions remains a serious limitation, impeding the ability to draw conclusions from larger, more representative patient populations.
Background. Multiple endocrine neoplasia type 1 (MEN1) is a hereditary condition with an autosomal dominant inheritance, with a predisposition to both endocrine and non-endocrine tumours. MEN1-related tumours can appear as early as the age of five, with disease penetrance increasing with age. Offspring of a MEN1 parent shows a 50% probability of inheriting the MEN1-related gene mutation. A MEN1 diagnosis in a parent can lead to significant anxiety for both the diagnosed parent and their undiagnosed at-risk children. There is limited consensus specific for managing offspring of individuals diagnosed with MEN1. Objectives. This review aims to evaluate the existing literature on the outcomes of MEN1 syndrome in the offspring of affected patients, to identify gaps in current protocols and to suggest possible improvements. Methodology. A literature review was conducted to examine the outcomes and characteristics of the offspring of individuals diagnosed with MEN1. Results. Predictive testing and screening for organ involvement in MEN1 aid early diagnosis and timely interventions DNA testing is recommended for children within the first decade of life, and screening for organ involvement should ideally begin at age 5 years for all MEN1 mutation carriers. Manifestations of MEN1 in younger children are different from those of affected adults. Conclusions. Standardised, internationally-accepted guidelines that provide specific recommendations for screening. diagnosis and treatment of offspring of adults diagnosed with MEN1 is a timely need. Furthermore, the absence of national and international data pooling across regions remains a serious limitation, impeding the ability to draw conclusions from larger, more representative patient populations.
IntroductionTo further advance our understanding of Muscular Dystrophies (MDs) and Spinocerebellar Ataxias (SCAs), it is necessary to identify the biological patterns associated with disease pathology. Although progress has been made in the fields of genetics and transcriptomics, there is a need for proteomics and metabolomics studies. The present study aimed to be the first to document serum metabolic signatures of MDs (DMD, BMD, and LGMD 2A) SCAs (SCA 1-3), from a South Asian perspective.MethodsA total of 28 patients (SCA 1-10, SCA 2-2, SCA 3-2, DMD-10, BMD-2, LGMD-2) and eight controls (aged 8–65 years) were included. Metabolomic analysis was performed by Ultrahigh Performance Liquid Chromatography-Tandem Mass Spectroscopy (UPLC-MS/MS), with support from the Houston Omics Collaborative.Results and discussionAmino acid metabolism was the primary altered super pathway in DMD followed by carbohydrate metabolism and lipid metabolism. In contrast, BMD and LGMD 2A exhibited a more prominent alteration in lipid metabolism followed by amino acid metabolism. In SCAs, primarily lipid, amino acid, peptide, nucleotide, and xenobiotics pathways are affected. Our findings offer new insights into the variance of metabolite levels in MD and SCA, with substantial implications for pathology, drug development, therapeutic targets and clinical management. Intriguingly, this study identified two novel metabolites associated with SCA. This pilot cross-sectional study warrants further research involving larger groups of participants, to validate our findings.
Background Cinnamon has been studied as a possible way to control blood glucose and serum cholesterol levels. However, there are no well-conducted randomized controlled trials that can accurately measure the lipid and glucose-lowering effects of Cinnamomum zeylanicum (C. zeylanicum) extract. This study primarily aimed to evaluate the effect of a standardized C. zeylanicum extract on serum low-density lipoprotein cholesterol (LDL-C) levels and secondarily on other lipid parameters (high-density lipoprotein cholesterol (HDL-C), total cholesterol and triglycerides), glucose levels, anthropometric measures, blood pressure, and safety outcomes in individuals with an LDL level between 100-190mg/dL. Materials and methods This was a randomized, double-blinded, placebo-controlled clinical trial. Participants were allocated to either C. zeylanicum extract or placebo group (1:1 allocation ratio). They were advised to take two capsules per day (1000 mg/day, a dose based on prior clinical studies suggesting potential efficacy and safety). Reduction in LDL-C at 12 weeks (from the baseline value) was compared between the two groups using ANCOVA. A complete-case analysis was adhered to in analyzing the outcome data. Results The mean age (SD) of the 150 participants was 50.4 (10.52) years, and 66% were females. Among the 127 participants assessed at 12 weeks, those in the C. zeylanicum extract arm had a lower LDL-C value than the placebo arm but the difference was not significant (the baseline adjusted mean difference was 6.05mg/dL; 95% CI: -2.43 to 14.52; p = 0.161). However, participants in the C. zeylanicum extract group showed significantly greater reductions in fasting blood sugar (FBS) levels (the baseline adjusted mean difference was 8.59mg/dL; 95% CI: 0.59 to 16.59; p = 0.036). There was a significant interaction effect between the supplement and participants’ glycemic status, with individuals with type 2 diabetes mellitus (T2DM) who received C. zeylanicum extract experiencing a notable reduction in FBS levels (standardized coefficient: -63, 95% CI: -102 to -25; p = 0.002). Conclusions C. zeylanicum extract did not have significantly reduce LDL-C but demonstrated a significant FBS-lowering effect, particularly in individuals with T2DM, with a favorable safety profile. Trials registration The trial was registered with the Sri Lanka Clinical Trials Registry: SLCTR/2021/011.
Chikungunya is a mosquito-borne viral infection. It causes mild fever, arthralgia, and rash in the majority of patients. Rarely, it can lead to serious cardiac complications such as myocarditis, primarily seen in patients with comorbidities. We present a 78-year-old elderly male with diabetes, hypertension, and dyslipidemia who presented with acute heart failure following a febrile illness. Initially, he was managed as an acute coronary syndrome. However, positive chikungunya IgM antibodies and a cardiac MRI demonstrating mid-wall and subepicardial late gadolinium enhancement confirmed chikungunya myocarditis. Chikungunya myocarditis is rare but can be seen in patients with comorbidities. Clinicians should maintain a high index of suspicion to diagnose myocarditis in patients with fever and cardiac symptoms. Early evaluation with imaging and serology will enable early diagnosis and help prevent adverse outcomes.
