Regulation of the medical profession in Sri Lanka: reform is urgently needed

Silva, Nilanthi de; Silva, Harendra de

doi:10.4038/cmj.v64i3.8949

Cited by 3 publications

(3 citation statements)

References 3 publications

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“…Hump-nosed pit vipers are the most common cause of all snakebites in Sri Lanka 2,3 and account for 22 to 77% of all snakebites. 4,5 Of these 3 species, H hypnale is widely distributed and recorded the most frequent bites, followed by H zara and H nepa , respectively.…”

Section: Introductionmentioning

confidence: 99%

Microangiopathic Hemolytic Anemia Following Three Different Species of Hump-Nosed Pit Viper (Genus: Hypnale) Envenoming in Sri Lanka

Rathnayaka

Ranathunga²,

Kularatne

et al. 2018

Wilderness & Environmental Medicine

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There are 3 species of hump-nosed pit vipers in Sri Lanka: Hypnale hypnale, Hypnale zara, and Hypnale nepa. The latter 2 are endemic to the country. Microangiopathic hemolytic anemia (MAHA) is a known complication of hump-nosed pit viper bites. It was previously documented as a complication of general viper bites and not species specific. We report a series of 3 patients who developed MAHA after being bitten by each species of hump-nosed pit viper. The first patient was bitten by H hypnale and developed a severe form of MAHA associated with acute kidney injury and thrombocytopenia falling into the category of thrombotic microangiopathy. The other 2 developed MAHA that resolved without any complications.

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Section: Introductionmentioning

confidence: 99%

Microangiopathic Hemolytic Anemia Following Three Different Species of Hump-Nosed Pit Viper (Genus: Hypnale) Envenoming in Sri Lanka

Rathnayaka

Ranathunga²,

Kularatne

et al. 2018

Wilderness & Environmental Medicine

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“…The rise of Sinhala-Buddhist nationalism at that time was primarily led by Anagarika Dharmapala, who bred opposition toward Muslims—especially the traders, naming them as enemies of the Sinhalese by religion, race, and language (Bartholomeusz, 1999). This commercial rivalry, which was the key source of tensions between the Sinhalese and the Muslims at the elite level, became more pronounced as “Indian” Muslims or coast Moors, who mainly lived in the central and western provinces, as they were referred to “were tenacious in asserting their trading interests more vociferously than the indigenous Muslims” (de Silva, 1973: 390–391). The Coast Moors were largely, as the terminology stated, those living on the coast as traders.…”

Section: Sri Lankan Muslims: Identity Formation and Political Choice ...mentioning

confidence: 99%

Some Critical Notes on Sri Lankan Muslim Religious Identity Formation, Conservatism, and Violent Extremism

Imtiyaz

Saleem²

2022

Journal of Asian and African Studies

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A new wave of attacks by Sinhala-Buddhist extremist elements against the Muslim community in Sri Lanka started following the brutal end of the ethnic civil war between the Liberation Tigers of Tamil Eelam (LTTE) and the Sinhala-Buddhist-dominated Sri Lanka security forces in 2009. Easter Sunday terrorist attacks in 2019 by some Muslims polarized Sri Lanka and contributed to the compromise of the country’s security. Sri Lankan Muslims often claim they are a peaceful community and thus have no serious interests in violent mobilization. But the evidence would basically contradict Muslims’ claim of a peace-loving community. The Easter Sunday terrorist attacks did not take place in any vacuum. This paper will situate some key developments in the violent mobilization of Sri Lanka during the war against the LTTE. The primary goal of such an attempt is to read the growing religious conservative and violent trends among Muslims between 1977 and 2009. In understanding the growing religious conservative trends, an understanding is attempted to situate a later propensity for violence within the community that would manifest itself with the 2019 Easter Sunday attacks. Interviews were conducted with members of the Islamic Dawah organizations and Muslim youth who were formerly associated with violent groups in the Eastern Province to understand the ground reality. The period of 1977–2009 is important as the rise of religious conservatist influences in Sri Lanka mirrors the global transnational influences of Iran and Middle East Petro Dollars, especially Saudi Arabia. The article draws mainly on secondary sources. But to gain a better understanding of the ground reality, we spoke to a few Eastern Muslims between July 2016 and September 2021 at regular intervals.

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“…Hump-nosed pit vipers of the genus Hypnale are the most common cause of venomous snakebites in Sri Lanka, 1 accounting for 22 to 77% of all snakebites. 2,3 In Sinhala the hump-nosed viper is known as Kunakatuwa , denoting the necrotic effect of its bite, or Polonthelissa , referring to the viper with an upturned snout (“hump”).…”

Section: Introductionmentioning

confidence: 99%

Thrombotic Microangiopathy, Hemolytic Uremic Syndrome, and Thrombotic Thrombocytopenic Purpura Following Hump-nosed Pit Viper (Genus: Hypnale) Envenoming in Sri Lanka

Rathnayaka

Ranathunga²,

Kularatne

2019

Wilderness & Environmental Medicine

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Thrombotic microangiopathy (TMA), which includes the spectrum of hemolytic uremic syndrome and thrombotic thrombocytopenic purpura, is an uncommon complication of hump-nosed pit viper envenomation. We describe 4 cases of TMA following hump-nosed pit viper (Hypnale spp) bites in Sri Lanka. The first case is a typical TMA that spontaneously resolved with supportive treatments. The second and third cases are related to hemolytic uremic syndrome complicated with acute kidney injury that required hemodialysis. The fourth case is thrombotic thrombocytopenic purpura associated with acute kidney injury that required hemodialysis and therapeutic plasma exchange. For each patient we describe the circumstances of the bite, clinical features, laboratory findings, and management.

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Regulation of the medical profession in Sri Lanka: reform is urgently needed

Cited by 3 publications

References 3 publications

Microangiopathic Hemolytic Anemia Following Three Different Species of Hump-Nosed Pit Viper (Genus: Hypnale) Envenoming in Sri Lanka

Microangiopathic Hemolytic Anemia Following Three Different Species of Hump-Nosed Pit Viper (Genus: Hypnale) Envenoming in Sri Lanka

Some Critical Notes on Sri Lankan Muslim Religious Identity Formation, Conservatism, and Violent Extremism

Thrombotic Microangiopathy, Hemolytic Uremic Syndrome, and Thrombotic Thrombocytopenic Purpura Following Hump-nosed Pit Viper (Genus: Hypnale) Envenoming in Sri Lanka

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