Several attempts have been made previously to differentiate β-thalassaemia trait (BTT) from other microcytic anaemias using formulae with red cell (RC) parameters. Presently available formulae have low sensitivity and specificity. We wanted to develop a more precise algorithm, which could be used in situations where the gold-standard test for thalassaemia diagnosis: the high performance liquid chromatography (HPLC) is not available. The study was carried out prospectively from November 2008 to March 2010 from randomly collected blood samples with a mean cell volume (MCV) of less than 80 fL. HbA2 measured by HPLC was used to diagnose BTT. We used Fishers stepwise linear discriminant function analysis to develop an algorithm with RC parameters. Calculated new index Thal-index was then subjected to receiver operating characteristic curve analysis to identify best cutoff to discriminate BTT from other microcytic blood films. Software was developed to predict the BTT status (BTT prediction.exe). New index, referred to as the Thal-index, was calculated using discriminant function analysis and is given as Thal-index=[(0.615¥MCV) +(0.518¥mean corpuscular hemoglobin)+ (0.446¥red cell distribution width)]. A value of 59 for Thal-index has 90% sensitivity and 85% specificity for differentiating BTT from other microcytic anaemias. This showed better sensitivity and specificity compared to other formulae presently used (i.e., Mentzer in Eshani, et al.). Our study gives a better answer to set-up where HPLC is not available. Although this cannot replace HPLC, BTT prediction.exe is useful to predict instantly and is the first ever computer program available for this function.

Tamil translation of ICIQ-FLUTS retained the psychometric properties of the original English questionnaire and will be an invaluable tool to detect LUTS among Tamil-speaking women.

Introduction: Hypertensive disorders in pregnancy are an important cause of maternal mortality in Sri Lanka. Gestational hypertension (GH)/Pre-eclampsia (PEC) and threatened miscarriage (TM) share common pathophysiological mechanisms. This study was conducted to determine the association between TM and development of GH/PEC. Methodology:A case control study was conducted at Castle Street Hospital for Women, Sri Lanka from May 2014 to May 2015. Cases consisted of patients with GH/PEC and compared with age and parity matched controls. A systematic random sampling method was used. Similar number of cases and controls were compared while each group consisted of 245 subjects. Data was obtained from medical records. Patients aged 20-35 years were included and medical disorders other than GH/PEC were excluded.Results: There were 245 subjects in each group of the study. Among the cases, 56% had GH and the rest had PEC. There were 25 patients had a history of TM in the study population. About 6.5% of cases had a history TM, while only 3.6% of controls had TM. There is also a significant risk of developing PEC in a patient who had a history of threatened miscarriage (OR 3.31,. Moreover the patients who had a history of TM tend to develop GH or PEC early, within 20-32 weeks of gestation (OR 11.49,). As we identified, 62% of patients who had TM developed GH/PEC early (from 20 to 32 weeks) but among the cases who had no history of TM, only 12% developed GH/PEC between 20 to 32 weeks of gestation (O.R. 20.7 (5.66 to 91.96). There is a significant risk of developing severe GH/PEC in the group of patients who had a history of TM (OR 8.59,. Eighty one percent (81%) of the cases, who had a history of TM, developed severe and moderate GH/PEC rather than mild. But the majority (63%) of the cases, who had no history of TM, developed mild GH/PEC (O.R. 7.6 (2.00 to 42.55).Conclusions: Shared pathophysiological mechanisms of GH/PEC and TM may explain the observed association between these obstetric complications. Early onset, severe GH/PEC in cases with TM suggests temporality and a biological gradient which favors causality.

Backgrounds: Induction of labor is a common practice. In women with immature cervix, PGE2 is commonly used for pre-induction. We hypothesized that PGE2 1.5 mg may be equally effective to PGE2 3 mg in multiparous women for labor induction. The present effort was an attempt to compare the efficacy and effects of pre-induction cervical ripening with PGE2 3 mg vs. 1.5 mg in multi-parous mothers (2nd and 3rd Pregnancy) at 40 weeks. Methods: A double-blind randomized controlled trial was carried out at Castle Street Hospital for Women, Colombo, Sri Lanka. Study subjects consisted of women with singleton pregnancy (no cesarean history) admitted for delivery at 40 weeks of their 2 nd or 3rd pregnancy. PGE2 1.5 mg vs. 3 mg PGE2 vaginal tablet were used for treatment (n = 173) and control (n = 170) groups, respectively. Cervical ripening and maternal, fetal complications were observed. Unfavorable cervices were induced with the same PGE2 dose in the following day. Results: Study group, compared with the control group, achieved the same rate of favorable cervices in 1st and 2nd cycles (63.5% vs. 64%, respectively). Both groups showed the same rate of cervical dilatation achievement, and admissions to Special Care Baby Unit. Study group showed significantly less maternal complications (4% and 11%, respectively: p = 0.01). Conclusion: PGE2 of 1.5 mg is equally effective in achieving favorable cervices, adequate cervical dilatation with minimum maternal complications compared to the usual 3 mg dose in multiparous low-risk women.

Cardiovascular and psychiatric diseases are leading causes of morbidity and mortality worldwide. Cardiovascular adverse events related to psychopharmacology have been well-known for decades. They increase the cardio-metabolic risk factor profile. Obesity, hypertension, diabetes mellitus (DM), and dyslipidemia are highly prevalent among patients with psychiatric disorders. Clozapine and olanzapine are known to cause severe hypertriglyceridemia. Drugs, such as aripiprazole, clozapine, olanzapine, and ziprasidone, increase the prevalence of hypertension, and atypical antipsychotics are known to cause orthostatic hypotension. The most common and popular arrhythmia, Torsades de pointes, due to QT prolongation, is a known side effect of typical and atypical antipsychotics. Sudden deaths, myocarditis, and cardiomyopathies are other common cardiac side effects of psycopharmacotherapy. Thus, pharmacovigilance is more important for both psychiatrists and cardiologists/physicians when evaluating patients with these common presentations and not to miss the etiological agents.