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SLMANEWS
Contents
THE OFFICIAL NEWSPAPER OF THE SRI LANKA MEDICAL ASSOCIATION
August, 2014 Volume 07 Issue 06
President's Column
Page No. President's Message
Strategies to Control a Resurgence of Tuberculosis in Sri Lanka SLMA Health Run & Walk 2014
2 2-5 6
127 Anniversary International Medical Congress of the SLMA
7-13
Prize Winners
14-15
th
Doctors Emerge Victorious
15
Our Advertisers SLMA news Editorial Committee-2014 Editor-In-Chief: Dr. Indika Karunathilake Deputy Editor: Dr. Dinesha Jayasinghe Committee: Dr. Ruvaiz Haniffa Dr. Navoda Atapattu Dr. Ashwini De Abrew Dr. Indira Kahawita Dr. Shihan Azeez Dr. Chiranthi Liyanage Editorial assistance: Dr. Ruchira Sanjaya
GlaxoSmithKline Pharmaceuticals. Durdans Hospital Nivasie Developers Malabe (Pvt) Ltd St.anthony's Consolidated (pvt) Ltd Gvr lanka (pvt) ltd Asiri Surgical Hospital PLC International Institute of Health Sciences Astron Ltd. Tokyo Cement Company (Lanka) Plc. Emerchemie NB (Ceylon) Ltd.
Official Newsletter of The Sri Lanka Medical Association. Tele : +94 112 693324 E mail - slma@eureka.lk
Dr. Palitha Abeykoon MD, MMed President, Sri Lanka Medical Association, No.06, Wijerama Mawatha, Colombo 07, Sri Lanka
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This Source (Pvt.) Ltd etc., No 3/1, Rajakeeya Mawatha, Colombo 07, Sri Lanka Tele: +94 113 054140 viduranga@thissource.com
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August, 2014
President's message FROM THE PRESIDENT… The most significant event last month was of course the International Medical Congress which by all accounts was a great success. Being the most important event in the annual SLMA calendar the Congress always consumes a great deal of time and energy of the Council, the members and all our well wishers. The organization of the rich academic programme was a real challenge but the experience and the organizational capability of the highly committed team led by Dr. Indika Karunathilake, Vice President, SLMA, accomplished this monumental task with a high degree of professionalism. The comments and feedback from both our local as well as the international faculty and participants has been very positive and satisfying. The Run and Walk and the mammoth tasks of resource mobilization and logistics management were in the very capable hands of the teams coordinated by Dr. Lasantha Malavige, Vice President, SLMA and Dr. Ruvaiz Haniffa, Secretary, SLMA, and they had made sure that nothing was found wanting. The Doctors’ Concert this year, organized by Prof. Vajira HW Dissanayake and Dr. Preethi Wijegoonewardene, with dedicated support from Dr Christo Fernando, was a great hit and it was a humbling experience for me to appreciate the
amount of novelty and effort that all of them had invested in it. For example the quality of the band and the brilliant performance of the team from Galle were beyond imagination. All of them had the spontaneous support of the seniors and the Council Members who undertook an enormous amount of work that made all of us genuinely proud of our Association this year too. Of course behind all these efforts was our own SLMA office team, efficiently managed by Mr. Rajasingham, who went beyond the call of duty at all times to ensure that all went according to plan. All of them deserve our highest praise and thanks. After all of this work related to the Congress one would expect that the Council as well as our members and well wishers would be having a well deserved break. But this in by no means the case, the pace of work in the SLMA has not slowed down to any discernible extent. The SLMA continues to be busy and engaged in a variety of activities, routine as well as new and innovative ones. SLMA is a noble journey and not a destination….. We also had the pleasure of defeating the Bar Association of Sri Lanka in the Annual cricket encounter for the first time since the inception of this tournament. Our congratulations go to the team and to the two Indikas, man-
ager, Dr. Indika Karunathilake, and the coach, Mr. Indika de Saram. We have now planned the rest of the Calendar of Events for the outstation meetings, including the Foundation Sessions which will be held in Kandy on the 16th and 17th of October, jointly with the Kandy Society of Medicine. It is my earnest hope that as many of our members as possible will join in these meetings and that we will be able to go to Kandy in a large representation. Just two days ago we had the privilege of hosting the Hon Minister of Science and Technology who shared with a very appreciative group his vision for science and technology development in Sri Lanka. The priorities in health technology development were also presented by the Chair of the theme group, Prof. Narada Warnasuriya. Our immediate observation is that the Hon Minister seems to have grasped the basic issues in science and technology related to health and is making a serious attempt to address them. We will report on the developments as they unfold.
Once again thanks and best wishes to everyone. Dr. Palitha Abeykoon President, SLMA
STRATEGIES TO CONTROL A RESURGENCE OF TUBERCULOSIS IN SRI LANKA Summary of the Symposium on Tuberculosis held on the 21st of May 2014. Compiled by Dr Mario Alles, Demonstrator, Department of Microiology, Faculty of Medicine, Colombo and Professor Jennifer Perera, Chairperson, Communicable Diseases Subcommittee of SLMA
Resource persons: Dr Sudath Samaraweera, Deputy Director, National Programme for Tuberculosis Con2
trol and Chest Diseases; Dr Geethal Perera, Consultant Respiratory Physician, Base Hospital, Puttalam; Dr Dhammika Vidanagama, Consultant Microbiologist, National TB Reference Laboratory.
The burden of tuberculosis Tuberculosis is a disease that con-
tinues to be a health burden and commonly targets the poorest communities in the world. The financial and social consequences of the disease have the ability to create a catastrophic impact on the individual, family and community. Contd. on page 03
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Contd. from page 02
STRATEGIES ... In the early 1900’s a very high notification rate of tuberculosis across the world was observed which declined at a steady rate, and this decline is more significant in developed countries as opposed to developing nations. In addition to the improved socio-economic status, the introduction of anti-tuberlculous chemotherapy in the 1940’s, followed closely by the advent of BCG vaccination has aided in this drastic drop in the TB notification rate. Currently more than 1/3 of the world’s population is infected with tuberculosis. In 2012 it was estimated that there were 8.6 million incident cases, with an estimated 1.3 million deaths occurring as a result of the disease. An estimated 450,000 cases were reported to be multi drug resistant (MDR) TB (resistance to at least both isoniazid and rifampicin). Countries such as China and India which suffer from overcrowding and poverty carry majority of the burden of TB and its drug resistance. The lowest incidence rates are reported from the developed nations. Most TB cases and related deaths occur among men. Even so, it is the 3rd most common cause of disease related deaths among women worldwide. The disease is also common among children.
In the South East Asian region it is reported that there are about 3.5 million incident cases of TB. An estimated 89,000 are MDR TB cases with some countries even reporting extensive drug resistant (XDR) TB (MDR TB with resistance to any fluoroquinolone and at least one of the three second line injectable drugs). Sri Lanka however carries the second lowest burden of TB in the region after Maldives.
In Sri Lanka, for the year 2013, the
estimated incidence and prevalence rates of TB were 66 per 100,000 population and 109 per 100,000 population respectively, with a mortality rate of 1.1 per 100,000 population. A case detection rate of 70.5% was recorded
while a total case notification rate of 46.5 per 100,000 population was seen. 66% of the cases were males while the majority of the cases fell in to the 55-64 years age group. There is a considerable district variation with regard to case finding rates. These variations could be attributed to population density, capacity to detect new cases, etc. It is of concern that while the average number of MDR cases detected annually between 2005 and 2013 is 9
which include diagnosis, monitoring response to treatment, participation in surveillance, and providing help in selecting effective treatment regimens (eg: in MDR TB cases). The tuberculosis laboratory network in Sri Lanka consists of a National TB Reference Laboratory, district chest clinic laboratories and microscopy centres.
Sputum smear microscopy for
acid fast bacilli (AFB) is the primary di-
Figure 1: Trends in TB in Sri Lanka (Source NPTCCD)
per year, so far in 2014 (with less than half the year passed) 8 MDR TB cases have already been reported. This may be due to increased incidence of MDR TB or improved laboratory services. Another point of concern is that while the estimated number of TB cases in Sri Lanka for the year 2013 was 13475, the actual number of detected TB cases was 9010. This could be due to several reasons such as limited access to health care facilities, failure to use available health care services, failure in diagnosing the disease, increased numbers of primary defaulters, patients that are detected and treated but not registered, etc.
Diagnosis of tuberculosis The diagnosis of TB always begins with a high clinical suspicion. Good quality specimens with an adequate volume are of utmost importance in arriving at a Microbiological diagnosis. The laboratory has several roles to play with regard to TB control
agnostic tool for tuberculosis. The only limitation with this method is that for the detection of bacilli a routine concentration of 10,000 AFB/ml per specimen is needed.
Figure 2: Sputum microscopy
Advancements in microscopic techniques have given rise to the concept of fluorescent LED microscopy which gives a higher detection rate. Examination by mycobacterial culture is the gold standard of TB diagnosis. Contd. on page 04
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August, 2014 Contd. from page 03
STRATEGIES ... However due to the long turnaround time of culture results, it does not always aid in the clinical management of a patient suspected to have TB. It requires specialized media and skilled laboratory personnel and specific infrastructure facilities. Nevertheless mycobacterial culture is useful in the smear negative patient, sputum non converters and in high risk groups (eg: HIV positive patients, drug addicts, contacts of MDR TB patients). Mycobacterium tuberculosis is routinely cultured on the Lowenstein Jensen egg based culture medium. However, the use of liquid culture media is becoming increasingly popular since growth is significantly faster and up to 20% more sensitive than solid culture systems. Two automated liquid culture systems have been approved by the WHO: The BACT/ALERT 3D mycobacteria detection system which is based on detection of CO2 as an indicator of bacterial growth and Mycobacteria growth indicator tube (MGIT) which contains modified Middlebrook
broth with a fluorescent based O2 sensor. The detected mycobacteria could be either M. tuberculosis complex or non tuberculous mycobacteria. Certain biochemical tests such as the catalase test and nitrate reduction test could be used for species differentiation.
Drug susceptibility testing is
needed to detect MDR TB cases. Currently the proportion method on the Lowenstein Jensen medium is used for this purpose.
The advancements in molecular diagnostics could be applied to many different spheres in the management of TB, such as detection of the organism, culture identification, identification of drug resistance, etc. However, the sensitivity of detection of the organism still cannot be matched to that of mycobacterial culture and therefore molecular diagnostic methods should not be used alone to diagnose TB. ‘GeneXpert MTB/ RIF’ is an integrated hands-free sputum processing and real time PCR system used to simultaneously detect M. Tuberculosis DNA and rifampicin resistance.This method is currently used mainly for MDR TB suspect categories, HIV positive TB suspects and on CSF samples of suspected TB meningitis patients. In advanced, microscopy-positive disease, a molecular line probe test could be used directly on sputum to detect M. Tuberculosis complex and resistance to rifampicin and isoniazid within a period of one day.
Treating the TB patient
Figure 3: Culture of M. tuberculosis
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Tuberculosis is no doubt a difficult disease to treat due to various reasons; low efficacy of most antibiotics against slow growing organisms, the ability of the mycobacterium cell to be dormant and thus rendering itself resistant to many antibiotics, the
presence of a lipid rich cell wall that is impermeable to many drugs, the intracellular nature of a substantial proportion of organisms combined with the poor penetration of chemotherapeutic agents, the ability of the organism to develop resistance to any single drug, the presence of caseation and fibrosis obstructing the blood supply to the necrotic area, etc. Treating patients diagnosed to have TB is even more difficult as a result of prolonged treatment schedules, side effects of medication, co-morbidities of the patient, the presence of social constraints and the residual disability often left even following successful treatment. The cost of treatment of TB is also high, mainly due to the prolonged treatment schedule, with drug susceptible TB cases taking 6-12 months and MDR TB cases taking up to 2 years to cure. The BCG vaccine was the earliest pharmacological discovery with regard to TB (1908-1920). Ever since the discovery of rifampicin in 1963 there has been no further progress in the development of new drugs. In the 1970’s combination treatment with rifampicin and isoniazid was adopted as the international regime for treatment of TB. The advent of fixed dose combinations has managed to reduce the pill burden and thereby improve patient compliance. First line drugs or essential anti TB drugs (isoniazid, rifampicin, pyrazin-
amide, ethambutol, streptomycin) are highly efficacious, have an acceptable toxicity profile and are used routinely.
More and more second line anti TB agents are being introduced with certain older drugs (eg: aminoglycosides such as kanamycin and amikacin) being replaced with newer ones (eg: quinolones). Another category of 3rd line anti TB drugs has also been introduced which includes clofazimine, linezolid, clarithromycin, etc. Contd. on page 05
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Contd. from page 04
STRATEGIES ...
Figure 4: Gene Xpert MTB/RIF 1
When considering the TB drug development pipeline, the drugs undergoing clinical trials can be divided in to 2 categories, one being existing drugs redeveloped or repurposed for TB and the other being new drugs developed specifically for TB. In the continuing efforts to develop the optimum treatment regimen for TB, several new treatment modalities such as bedaquiline and delamanid have come into the lime light.
Surgery which was once quite
popular in the management of TB, but later died out following the advent of anti-TB drugs, has once again resurrected itself as a treatment modality in the case of drug resistant TB. However, good quality research is needed to prove its efficacy. Although important drug interactions occur between the drugs that are a part of these therapies, it is proven that the concomitant use of anti-retroviral therapy during treatment of drug-susceptible pulmonary TB improves survival rates in HIV-infected individuals. A balance of host and M. tuberculosis factors can lead to excess, but ineffective, host inflammatory responses leading to tissue destruction.
Host-directed adjunct therapies
could reduce destructive inflammatory responses, augment protective immunity to enhance disease resolution, improve treatment outcomes and reduce
duration of therapy. Examples include non steroidal anti-inflammatory drugs, phosphodiesterase inhibitors, tyrosine kinase inhibitors, modulators of signal transduction pathways of the host, etc. Other adjunct immunotherapies such as mycobacterial-specific antibodies, mycobacterial antigens or whole-cell inactivated environmental mycobacterial preparations, cytokines such as interleukins and interferons as well as prostaglandin E2 inhibitors are also being studied as treatment modalities.
DOTS or Directly Observed Treatment, Short course, is the cor-
nerstone of TB treatment. This broad concept includes, political commitment with increased and sustained financing, case detection through quality-assured bacteriology, standardized treatment with supervision and patient support, effective drug supply and management, and monitoring and evaluation. At the same time it should be always evident that not the disease but the patient should be treated. This includes treatment of disease complications such as adverse effects of drugs, bronchiectasis and haemoptysis, as well as other co-morbid conditions the patient might have such as HIV, diabetes mellitus etc.
Challenges and constraints It is interesting to note that while the Western Province has been the most
accessible region in the country to implement TB control strategies it is this very region that reports the highest number of TB cases in Sri Lanka. Another challenge is reaching out to the so called unreached populations which report a high number of TB cases such as the plantation sector, prisons and migrant populations (which include internally displaced persons, returning migrants and migrant laborers). The rise of TB/HIV co-infection as a result of increased numbers of HIV infected individuals in the country, the rapid growth of other groups at high risk of acquiring TB such as diabetics, the lack of human resources to aid in the struggle against TB, the stigma surrounding the disease and the unchanging percentage of TB related deaths are some of the other issues that need to be addressed. Apart from this poor coordination between the public and private health sectors, scarcity of new diagnostic technologies, lack of adequate social motivation, problems with DOTS provision, lack of social benefits towards patients and inadequacy in taking measures to ensure their financial sustainability all pose a substantial threat to the smooth functioning of the National TB control program. If and when these challenges are overcome, the goal of eliminating tuberculosis by 2050 would certainly become achievable.
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August, 2014
SLMA Health Run & Walk
A
mongst the proud institutions that have enriched and enhanced our nation’s health the Sri Lanka Medical Association stands one of the oldest. Celebrating its
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127th anniversary, and for the 3rd consecutive year, the ‘SLMA health Run and Walk-Run for a Healthier Tomorrow’ was organized in order to promote an ac-
tive lifestyle for a healthier tomorrow. It was held on 13th of July 2014 starting from the BMICH front lawn. The 3km health run started at 6.30am followed by the health walk. Over 500 participants participated in the run and over 2000 participated in the walk. Prior to the run and the walk warm up sessions were held. The run and walk was followed by a yoga session and physiotherapy was given to those who required by the students and graduates of the Allied Health Sciences Unit, Faculty of Medicine,
University of Colombo. The occasion was graced by the Hon. Minister of Health Maiithripala Sirisena. Secretary of Health, Mrs. Sudharma Karunarathna and Director General of Health Services, Dr. P. G. Mahipala were also among the keen participants. Gift packs were given to all the runners and valuable prizes were given to the winners of the run. In addition, a free health check including lung function tests, and snacks and drinks were provided to all participants.
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August, 2014
127th Anniversary International Medical Congress of the Sri Lanka Medical Association
T
he 127th Anniversary International Medical Congress of the Sri Lanka Medical Association was held on from the 15th to 18th July, 2014 at the Bandaranaike Memorial International Conference Hall, Colombo. The sessions were preceded by the SLMA Walk & Run on the 13th and the pre congress workshops on
14th and 15th.
• Road Traffic Injuries
Seven pre-congress workshops were held on seven different fields, on
• Seminar on “The Aging Heart in Health and Disease”
• Global Burden of Disease • SLMA – WHO – ASCEND Joint Symposium on Research Needs in NCDs: Opportunities and Barriers • Creating an inclusive community for people with disabilities in Sri Lanka; the role of the health sector
• Advances in Immunology: Implications for Vaccination • SASSM & SLMA Sexual Medicine Conference The workshops were well attended by over 420 participants and more than 50 resource persons shared their expertise and experiences.
Contd. on page 08
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127th Anniversary...
The inauguration of the main congress was held on the 15th July, 2014 at the BMICH. The chief guest was His Excellency the President of the Democratic Socialist Republic of Sri Lanka, Mahinda Rajapakse, while Professor Tissa Kappagoda, Director of Cardiac Rehabilitation Program, Director of the Coronary Heart Disease Reversal Program, Sacramento, USA, was the
Guest of Honour. It was a special occasion as it was after more than three decades that a Head of State graced the Inauguration of the SLMA sessions as the Chief Guest. Further the re-launch of “A History of Medicine in Sri Lanka”, a book by Dr CG Uragoda, reprinted by the SLMA, took place during the inauguration ceremonies, as Dr Uragoda himself presented the
newly printed book to His Excellency, the President and other guests. The Hon. Minister of Health, Maithripala Sirisena was also present at the occasion. The much revered SLMA oration 2014 was delivered by Prof Nimal Sananayake, Emeritus Professor of Medicine, University of Peradeniya, on “Hallucinations: tele-creations of the haunted mind”.
Contd. on page 09
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Contd. from page 08
127th Anniversary...
The main congress this year, was a mammoth effort with four parallel sessions to address this years’ theme of “Globalizing the Paradox of Sri Lanka’s Health Achievements and Challenges”. The sessions were attended by over 1300 participants with more than 160 resource persons conducting lectures. This years’ Keynote Address was delivered by Dr. Firdosi Rustom Mehta, Country Representative, World Health Organization Country Office, Sri Lanka, on “Sri Lanka Paradox: time to celebrate and move forward”. The Sessions included 13 guest lectures and 31 symposia on topics spanning from infectious diseases, neurology, psychiatry and NCDs to medical education, public health and nano technology where
lectures were delivered by experts in respective fields, both local and overseas. The Prof NDW Lionel Memorial Oration was delivered by Prof Asita de Silva, Department of Pharmacology, Faculty of Medicine, University of Kelaniya, on “Generating evidence for clinical practice: the role of the clinical pharmacologist” while The SC Paul Oration on “Leishmaniasis: a newly established vector borne disease in Sri Lanka” was delivered by Dr Yamuna Deepani Siriwardana, Senior Lecturer, Department of Parasitology, Faculty of Medicine, University of Colombo. The Dr S Ramachandran Oration was delivered by Vidyajyothi Prof Rezvi Sheriff, Senior Professor of Medicine, University of Colombo
and Councilor – Sri Lanka Medical Council, on “Accreditation of medical schools (Local and Foreign) in Sri Lanka: Issues, concerns and possible solutions”. This year approximately 58 free papers and almost 100 posters were presented. A new addition to the 127th Anniversary Congress was the introduction of e-posters where the poster presentations were displayed on large LCD panels, covering presentations on eight different themes including pharmacology, psychiatry, genetics and public health. Contd. on page 10
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Contd. on page 12
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July, 2014 Contd. from page 11
127th Anniversary... The post congress workshops on the management of children with cerebral palsy Organized by the Disability Committee of the SLMA, were held on 21st and 22nd July at the Lady Ridgeway Hospital for Children, Colombo and on 24th and 25th at the Peradeniya
Teaching Hospital, Kandy. The Doctors’ Concert was held on the 16th of July at BMICH and was well attended and enjoyed by all who participated. A band comprising of doctors and those who took part in
the event showcased the immense talent that is around us. The banquet held on 18th July at the Waters Edge, Battaramulla, was a fitting conclusion for the 127th Anniversary International Medical Congress of the Sri Lanka Medical Association.
Contd. on page 13
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Contd. from page 12
127th Anniversary... From Doctors' Concert
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WINNERS OF THE PRIZES AND AWARDS 127TH ANNIVERSARY INTERNATION MEDICAL CONGRESS OF THE SLMA E M WIJERAMA PRIZE OP 25: A novel approach to evaluate changes in micro-vascular permeability and therapeutic targets in dengue infection KC Jeewandara1,2, D Gutowska-owsiak1, D Waithe3, RH Fernando1, S Fernando1, GN Malavige1,2, GS Ogg2 1
Centre for Dengue Research, Faculty of Medical Sciences, University of Sri Jayewardenepura
2
MRC Human Immunology Unit, University of Oxford, United Kingdom
3
Weatherall Institute of Molecular Medicine, Oxford, United Kingdom
S E SENEVIRATNA PRIZE OP 16: A randomised, double-blind, controlled clinical trial of S-amlodipine versus conventional amlodipine, to compare the incidence of leg oedema and antihypertensive efficacy in patients with hypertension P Galappatthy1, MIM Sabeer2, Y Waniganayaka2, TJ Wijetunga2, W Udawatta2, D Gunaratne2, GKS Galappatthy2, RAI Ekanayaka2 1
Department of Pharmacology, Faculty of Medicine, University of Colombo
2
Institute of Cardiology, National Hospital of Sri Lanka
H K T FERNANDO PRIZE OP 19: Is three doses of antibiotic therapy beneficial over single dose for appendicectomy
HKKT Duminda, MRM Ziyard, TM Samarasinghe District General Hospital, Negombo
PRIZE OP 12: Development and assessment of a psychological intervention for snakebite victims 0CA Wijesinghe1, SS Williams1, N Dolawatta1, AKGP Wimalaratne1, A Kasturiratne1, B Wijewickrema1, SF Jayamanne1, DG Lalloo2, GK Isbister3, A Dawson3, HJ de Silva1 1
Faculty of Medicine, University of Kelaniya
2
Liverpool School of Tropical Medicine, United Kingdom South Asian Clinical Toxicology Research Collaboration
WILSON PEIRIS PRIZE
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BCM Wimalachandra1, MAK Dissanayake1, M Prabashika1, R De Silva2, LV Gooneratne1,2
Lanka: results of a national survey A Pathmeswaran1, A Kasturirartne1, NK Gunawardena1, BA Wijayawickrama1, SF Jayamanne1, DS Ediriweera1, G Isbister2, A Dawson2, DG Lalloo3, HJ de Silva1 1
Faculty of Medicine, University of Kelaniya
1
Department of Pathology, Faculty of Medicine, University of Colombo
2
South Asian Clinical Toxicology Research Collaboration (SACTRC), University of Peradeniya
2
AsiriGroup of Hospitals
3
Liverpool School of Tropical Medicine, Liverpool, United Kingdom
DAPHNE ATTYGALLE PRIZE FOR THE BEST PAPER IN CANCER
OP 52: Epidermal Growth Factor Receptor, Vascular Endothelial Growth Factor, Chemokine Receptor 4 and Vimentin expression as predictors of metastasis in colorectal carcinoma MIM De Zoysa1, DN Samarasekera1, LDJU
SPECIAL PRIZE IN CARDIOLOGY OP 16: A randomised, double-blind, controlled clinical trial of S-amlodipine versus conventional amlodipine, to compare the incidence of leg oedema and antihypertensive efficacy in patients with hypertension P Galappatthy1, MIM Sabeer2, Y Waniganayaka2, TJ Wijetunga2, W Udawatta2, D Gunara-
Senarath1, CB Reid2, MDS Lokuhetty1
tne2, GKS Galappatthy2, RAI Ekanayaka2
1
Faculty of Medicine, University of Colombo
2
Charles Drew Medical University, Los Angeles, USA
1Department of Pharmacology, Faculty of Medicine, University of Colombo
SIR FRANK GUNASEKERA PRIZE FOR THE BEST PAPER IN COMMUNITY MEDICINE
SIR NICHOLAS ATTYGALLE
3
OP 46: Immunophenotypic characterization of acute lymphoblastic leukemia in a flow cytometry reference centre in Sri Lanka
OP 5: Physical activity pattern and correlates among adults in the Colombo Municipal Council area, Sri Lanka AASH De Silva Weliange1, D Fernando1, J Gunatilake2 1
Faculty of Medicine, University of Colombo
2
University of Peradeniya
2Institute of Cardiology, National Hospital of Sri Lanka S RAMACHANDRAN PRIZE FOR THE BEST PAPER IN NEPHROLOGY OP 37: Geographical Determinants of Chronic Kidney Disease Patients in Polpithigama Medical Officer of Health Division PVDS Dharmagunawardene1, RMSK Rathnayake2, HMJR Herath3, R Vipulashantha4, WADV Weerathilake5,NR Abeynayake5
1 Education, Training and Research Unit, Ministry of Health
KUMARADASA RAJASURIYA PRIZE
2 Teaching Hospital, Kandy
FOR THE BEST PAPER IN TROPI-
3University of Sri Jayewardenepura
CAL MEDICINE
4 Office of Provincial Director of Health Services – North Western Province
OP 31 : Community incidence of snakebite and envenoming in Sri
5Wayamba University of Sri Lanka Contd. on page 15
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Contd. from page 14
Winners of the Prizes... SLMA PRIZE FOR THE BEST POSTER
PP 20: Decline of estimated glomerular
filtration rate in patients on long term lithium; a comparative study
1Department of Clinical Medicine, Faculty of Medicine, University of Colombo
C Rodrigo¹, NL de Silva¹, R Gunaratne¹, S
2Department of Psychological Medicine, Faculty of Medicine, University of Colombo
Rajapakse¹, V de Silva², R Hanwella²
DOCTORS EMERGE VICTORIOUS AT THE 6TH ANNUAL LAW MEDICAL CRICKET ENCOUNTER
D
octors handed out a thrashing to the lawyers at the 6th annual cricket encounter between Sri Lanka Doctors Cricket team and the Sri Lanka Lawyers Cricket team held at P. Sara international cricket stadium on 27th July 2014. Lawyers entered the game underestimating the doctors’ cricket team who had put up a strong team this year with the support of their coach and former Sri Lankan cricketer Mr. Indika De Serum. The doctors’ team captain Raijv Nirmalasingham called correctly at the toss and elected to field on a greenish P. Sara wicket with a healthy cloud cover. The decision was immediately rewarded by an outstanding spell of new ball bowling form the doctors’ opening bowler Thilina Samarasinghe who took two wickets in the first over of the match and went on to claim another two wickets during the opening spell to put the brakes on the lawyers scoring. Lawyers were never allowed to get off the blocks as spinners then kept the lid on scoring before cleaning up the tale to limit the lawyers’ team to a poultry 134 all out in 39.3 overs. Thilina samarasinghe finished with 4 wickets for 21 runs and Left arm spinner Kasun Wijegunawardane claimed 2 wickets for 12 runs.
Front Row- (From Left) Dr Gowribahan Thevarajah, Dr Indika Karunathilake, Dr Lahiru Senanayake(Vice Captain), Dr Palitha Abeykoon, Dr Rajiv Nirmalasingham (Captain), Dr Sritharan Ganeshamoorthy, Dr Ruviz Haniffa, Mr Indika De Serum Back Raw- (From Left) Dr Milinda Rodrigo, Dr Jalitha Liyanage, Dr Thilina Dhamsiri, Dr Charuka Kanakahewa, Dr Yasiru Godakanda, Dr Diluk Senadheera, Dr Thilina Samarasinghe, Dr Varuna Balasooriya, Dr Kasun Wijegunawardane, Dr Rusiru Jayathilake, Dr Dilshan Perera
runathilake, and the Secretary Dr. Ruviz Haniffa. The Chief Guest for the event was renowned sportsman and sports physician Dr. C Thurairaja.
With only 135 runs to chase, the doctors’ team cruised to victory in just 24 overs for the loss of three wickets and the only thing that looked threatening during the chase was the rain which halted the match several times. Opening batsman Thilina samarasinghe who was the wrecker-in-chief with the ball scored an unbeaten 76 runs to guide the doctors’ team to complete an outstanding match. Kasun Wijegunawardane also scored a quickfire 34 while Gowribahan Thevarajah scored 19. Most of the bowlers for the lawyers team came in to severe punishment from the doctors as none of the bowlers were allowed to settle in to a line and length. Thilina Samarasinghe was adjudged the Best bowler, Best batsman and the Man of the Match for his superb performance. The event was organized by the Sri Lanka Medical Association together with the doctors’ cricket team for the 6th consecutive year with the support of the SLMA President Dr. Palitha Abeykoon, Vice President Dr. Indika Ka-
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The Joint Commission International (JCI) HQ based in the United States of America has officially confirmed that Durdans Hospital has been accredited by JCl for conforming to the standard of a World-Class Healthcare Institution. In the history of Healthcare in Sri Lanka, Durdans Hospital becomes the first Healthcare institution to be endorsed by JCI which is considerede Gold Standard in Global Healthcare. Durdans Hospital has been awarded The Gold Seal of Approval for transforming patient safety and quality of care. JCI identifies measures, shares best practices and is an evaluator of most rigorous international standards in quality and patient safety. It provides leadership and innovative solutions to help Healthcare organisations across all settings to improve performance and outcomes. TM
Durdans is proud of its identity of being a true Sri Lankan Brand and in committing ourselves to taking Sri Lankan Healthcare to World-Class standards, so that our very own people receive the best. We believe this is a major achievement not only for Durdans but also for Sri Lankan Healthcare. We thank our loyal patrons for their continuous support.
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0112 558 100/ 0112 500 466/0112592 308
sales@tokyocement.lk
SLMANEWS
THE OFFICIAL NEWSPAPER OF THE SRI LANKA MEDICAL ASSOCIATION
If undelivered return to : Sri Lanka Medical Association. No. 6, Wijerama Mawatha, Colombo 7 Registered at the Department of Post Under No: QD/27/NEWS 2014