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Objectives To describe the outcomes of early percutaneous coronary intervention (PCI) for the treatment of acute ST elevation myocardial infarction (STEMI) in a tertiary care cardiac centre in Colombo, Sri Lanka.Methods Medical records of 139 consecutive patients presenting to Cardiology Unit 5, National Hospital of Sri Lanka from March 2013 to June 2014 with acute STEMI, and treated with early PCI as a mode of reperfusion were reviewed. These patients were then followed up for 6 months to determine survival, targetvessel revascularization, in-stent thrombosis and other major adverse cardiac events (MACE).Results Of 139 patients, 116 (83.5%) were male. Mean age was 52.3±SD11.1 years. Eighty eight (63.3%) patients underwent primary PCI and 51 (36.7%) underwent rescue PCI. There were six deaths (4.3%). One occurred on-table and three occurred after discharge. Four patients who died had cardiogenic shock. Mean door-to-balloon (DTB) time was 147 minutes for the primary PCI patients who were transferred from ETU. At six months, of 106 patients who attended follow up, two had been re-hospitalised for heart failure but none underwent coronary artery bypass grafting (CABG).Conclusions This report from the national tertiary care cardiology referral centre in Sri Lanka, found that the study population was relatively younger, similar to other Asian countries. There was high rate of initial success (98.6%) and good short-term survival (95.7%), particularly in the subset presenting without cardiogenic shock (98.4%) despite the long DTB time. Loss to follow up at 6 months in this centre was 23.7% (33 patients).

In-hospital major adverse cardiac events (MACE) are similar in both rescue and primary intervention groups, supporting the former as a practical option for patients with no immediate access to PCI facilities.

Weekly dosing of thyroxine improves compliance. We aimed to evaluate efficacy and safety of once weekly dosing of thyroxine compared to daily dosing for maintenance therapy of hypothyroidism. Methods:This is a parallel-group, outcome-assessment-blinded, randomised, controlled clinical trial conducted at a tertiary care hospital in Sri Lanka. Those diagnosed with primary hypothyroidism and have achieved euthyroidism with a stable dose of daily thyroxine for at least 3-months were recruited. Intervention group (IG) received seven times the regular dose once weekly. Control group (CG) received regular dose daily. Echocardiogram, blood pressure (BP), heart rate (HR) and Hyperthyroid Symptom Score (HSS) were assessed 4-6 hours after the first dose of thyroxine and at 12-weeks. Thyroid functions were assessed at 12-weeks. Results:Number recruited was 32 to IG(women:96.9%;mean-age:47.9±9.2years) & 24 to CG(women: 95.8%;mean-age:50.7±11.2years). Median thyroxine dose was 525mg once weekly in the IG & 75mg daily in the CG. Proportion of patients in euthyroid state at 12-weeks was not different between the groups (IG-84.4%, CG-83.3%, p = 0.57). There was no difference in the thyroid function tests at 12-weeks (mean TSH: IG-2.SµIU/mL, CG-2.lµIU/mL, p=0.348; mean free T4: IG-1.2ng/ dL,CG-1.3ng/ dL,p=0.

Aneurysms of sinus of valsalva are rare cardiac abnormalities1. Following rupture it presents with acute heart failure. Definitive treatment is surgical or device closure 2. A 25-year-old female presented with decompensated cardiac failure following a ruptured sinus of valsalva aneurysm (RSOVA). She underwent percutaneous device closure at the Cardiology Unit of the National Hospital of Sri Lanka (NHSL) and had an uneventful follow up for one year. This is the first successful closure of a RSOVA by a Sri Lankan team of cardiologists. The procedure is safe and feasible and can be performed with available facilities in selected patients.