Sri Lankan family members should be educated further about normal patterns of milk production during the postpartum period. The authors recommend that PIM be included in screening tools for postpartum depression in Sri Lanka.

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Burkholderia cepacia complex (BCC) is an opportunistic pathogen in immunocompromised patients and well distributed in the natural environment. Nosocomial outbreaks of BCC are due to contaminated solutions and medical devices. However, in Sri Lanka, there have been no nosocomial outbreaks of BCC reported in the past. We report here an outbreak investigation of bacteraemia due to BCC in the wards and ICUs of the National Hospital of Sri Lanka (NHSL) during the period of August 14 th 2017 to September 13 th 2017 which an extensive investigation traced to a contaminated nebulizer solution of a particular brand of ipratropium bromide. The blood culture isolates from the patients with bacteraemia and from the particular nebulizer solution were found to be identical and confirmed as BCC. There had been outbreaks in other hospitals with the same organism in the recent past but they were not able to find the common source for the outbreak. The incident was reported officially to the relevant authorities and other hospitals, and an alternative agent for the use of nebulization was strongly recommended to prevent further cases immediately.

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Background:Ischemic Heart Disease(IHD) characterized by atheroma formation, is a leading contributor for the rising disease burden of chronic non-communicable diseases in Sri Lanka. Even though excessive salt-consumption has been attributed with hypertension, documented literature is scarce on exploring its direct association with atheroma formation with primary data. Coronary-Artery- Bypass-Grafting(CABG) is done as a tertiary preventive measure for IHDs. The aim was to estimate the sodium-intake and to describe the association of salt consumption and atheroma formation among preoperative patients undergoing CABG at Sri Jayewardenepura General Hospital, Sri Lanka.MethodsA descriptive cross-sectional study was done on a calculated sample size of 213 participants who were awaiting CABG at SJGH. An interviewer-administered Additional file 1 was used, and dietary intake of sodium was calculated with food-frequency tables and web-based tools. A data extraction form was used and details regarding Coronary arterial segments with atheroma formation were obtained from angiogram reports. After exploring the normality, Spearman-correlation-coefficient and Mann-Whitney-U tests were used to explore associations of atheroma formation. Independent association of sodium-intake and Coronary arterial segments affected with atheroma was explored with multiple-logistic regression. ResultsThe sample was with a male preponderance(male to female ratio=3:1). Comorbidities were observed in a notable proportion: diabetes(47%), dyslipidemia(40%), hypertension(56%). The median(IQR) of BMI and waist circumference were 25.00(23.00-27.00)kg/m2 and 87.00(82.00-91.00)cm. The median(IQR) sodium-intake was 5875.50(4905.25-7091.25)mg. All participants (n=210) had a sodium intake of more than 2000mg/day. Sodium intake(rs=0.599,p<0.001) and BMI(rs=0.634,p=0.034) were significantly associated with atheroma segments whereas age, gender, diabetes, hypertension, dyslipidemia, waist circumference was not(p>0.05). Sodium intake was found to be an independent predictor of affecting “5 or more segments” when multiple logistic regression was applied(OR= 2.25,CI=1.41 to 3.61). Conclusions and RecommendationsThe daily intake of sodium by a regular person is more than the dietary recommendations in the study sample. Salt intake reflected by sodium intake seemingly increase the risk of atheroma formation in more coronary segments irrespective of age, sex as well as several known disease conditions and risk factors. More research must be promoted with analytical approaches in proving this hypothesis.