Primary hyperparathyroidism (PHPT) typically presents with hypercalcaemia and skeletal changes but rarely causes haematological manifestations. We present a case report of a 66-year-old woman presented with refractory pancytopenia and bone marrow fibrosis. She was found to have hypercalcaemia and elevated parathyroid hormone (PTH), with a parathyroid adenoma. She was started on vitamin D supplementation and referred for surgical resection of the adenoma.
We report a 46-year-old male presenting with fever, jaundice, myalgia, and acute kidney injury following exposure to contaminated water, suggestive of severe leptospirosis. Clinical course was complicated by gram-negative urosepsis secondary to obstructive uropathy, refractory shock, and acute respiratory distress syndrome. Management included timely initiation of antibiotics and escalation, ureteric stenting under transfusion support for source control, invasive ventilation with lung-protective strategies, and careful hemodynamic monitoring. Multidisciplinary collaboration and prompt source control facilitated recovery. This case underscores the importance of early recognition of multi-organ involvement and overlapping infections in endemic, resource-limited settings to optimize outcomes in severe leptospirosis.
Introduction: Understanding polycystic ovarian syndrome (PCOS), its symptoms, and consequences is crucial for early treatment and the prevention of future major issues. The exact cause of PCOS remains unknown, making it challenging for physicians to provide an accurate diagnosis.Objectives: This study aims to evaluate the awareness of the prevalence and features of PCOS among female university students in Peradeniya, Sri Lanka.Methodology: A descriptive-cross-sectional study was conducted among female undergraduate university students in Peradeniya, Sri Lanka. A random sampling method was used. Self-administered questionnaires were administered, which included demographic data and questions related to awareness, such as symptoms, complications, and specific control measures. All responses were compiled into an Excel spreadsheet and analyzed using SPSS 25. All information was presented as percentages. The mean pain score and standard deviation were calculated, and statistically significant differences (P<0.005) were reported.Results: The overall degree of awareness is relatively low (<40%), excluding the symptom of an irregular menstrual cycle. While the internet is the most commonly used method (49%), students who acquired knowledge from health care practitioners scored higher (17.56±3.719). The highest mean awareness score was reported by students in the medical faculty (18.22±5.345). There was a significant difference in mean scores based on the field of study and information sources (P<0.05).Conclusions: Female undergraduate students at the University of Peradeniya have a significant knowledge gap regarding PCOS. Awareness programs should be enhanced by involving qualified parties specializing in relevant subjects through Google and social media.
Snakebite is a neglected tropical disease affecting underprivileged farming communities in rural tropics and subtropics, causing significant morbidity and mortality. While acute effects of envenoming are well-known, information on long-term consequences remains scarce, despite the public health importance of the issue. Therefore, we explored the existing knowledge about the long-term effects of snake envenoming in the global literature by conducting a scoping review, which revealed that existing literature on snakebite predominantly relies on retrospective associations between envenoming and clinical outcomes, often without precise offending snake species authentication, comprehensive documentation of acute management, or baseline clinical data. Consequently, they could not provide a detailed picture of the long-term clinical epidemiology of envenoming. To overcome these gaps, we prospectively followed up snakebite patients to determine the true prevalence, severity, clinical progression, and risk factors of long-term effects of snakebites using a cohort of snakebite patients admitted to the Teaching Hospital, Anuradhapura, Sri Lanka. Based on a prospective study conducted at one and four-years post-envenoming, long-term musculoskeletal impairments appear to be infrequent and less severe among snakebite survivors in rural Sri Lanka. In contrast, a substantial proportion of individuals report persistent, non-specific systemic and oral symptoms, with the prevalence increasing over time after the bite. In the same two groups of patients, renal functions showed no significant association between snakebite or snakebite-associated AKI, with the development of CKD, or CINAC on review, though microalbuminuria was common. Serum sickness was reported in only 4% of the patients after discharge, despite high rates of acute adverse reactions to antivenom. Meanwhile, a significant number of viper bite patients leave the hospital with mild persistent local effects, which commonly leads them to seek further treatment, emphasizing the need for post-discharge follow-up of snakebite survivors.
