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Biomedical subjects

P C Gunasekera

Publications and source records attributed to P C Gunasekera.

11 recordsLinked to original sources
PubMed1998

Spontaneous hepatic rupture in pregnancy.

Spontaneous hepatic rupture in pregnancy is rare and associated with significant maternal morbidity and mortality. It has been reported in association with severe pregnancy-induced hypertension and HELLP (haemolysis elevated liver enzymes low platelets) syndrome. New imaging techniques enable early diagnosis, and in those with subcapsular haematomas, conservative management. Surgical intervention is necessary in capsular rupture with haemodynamic instability. We here report three fatal cases and discuss the diagnosis and management.

Adult↗
PubMed1997

Glove failure: an occupational hazard of surgeons in a developing country.

Financial constraints necessitate the reuse of gloves after autoclaving in Sri Lanka. The incidence of glove failure following elective surgery for gynaecological malignancies was studied. Punctures were located by filling gloves with water. The perforation rate was 194/654 (29.6%). Coincidentally, well-fitting gloves were unavailable during part of the study. The puncture rate was significantly higher (P < 0.01) during this period. Defects were found in 12.75% of gloves prepared for reuse. The rate of perforations per operation was 72/88 (81.8%). This increased to 32/32 (100%) when ill-fitting gloves were used, compared with 40/56 (71%) when the proper sizes was available. 6% of new gloves had punctures. In 29 (14.9%) instances the surgical team was aware of glove failure. Factors contributing to glove fragility were: purchase of inferior quality gloves; reuse; shortage of appropriate glove sizes; and imprecision of the test for perforations prior to autoclaving. Health administrators in developing countries should purchase good-quality disposable gloves, and replenish stocks in time.

Accidents, Occupational↗
PubMed1990

Large loop excision of the transformation zone (LLETZ) compared to carbon dioxide laser in the treatment of CIN: a superior mode of treatment.

A series of 199 patients with histologically confirmed cervical intraepithelial neoplasia (CIN) grade II or III were allocated by hospital number to receive out-patient treatment by carbon dioxide laser vaporization or large loop excision of the transformation zone (LLETZ). All patients received local anaesthesia. The women in the LLETZ group experienced less post operative haemorrhage, less discomfort, operative time was greatly reduced, and histological material was available for confirmation of the diagnosis. There was no significant difference in recurrence of CIN after treatment between the two groups. At 6 month follow-up, recurrence rates of 8.2% (CIN II) and 7.5% (CIN III) were observed in the laser-group and 5% (CIN II) and 5.3% (CIN III) in the LLETZ group. Further advantages of LLETZ are reduced capital expenditure and no hazard to the eyesight of the surgeon, but laser treatment is preferable in patients with widespread vaginal involvement.

Adolescent↗