A. Weerasinghe

Young strokes in Sri Lanka: an unsolved problem.

Stroke in young adults is more common in India and Sri Lanka and the reasons for this are not well understood. The current study was conducted to elucidate the risk factors and radiologic features in young people (age < 45 years) with ischemic stroke. Sociodemographic data, stroke risk factor information, and laboratory investigations were recorded in 41 cases with first-ever ischemic stroke. Most common risk factors for stroke in the 15- to 45-year-old age group were: hypertension, 8 (21%); family history of stroke, 7 (18%); transient ischemic attack, 6 (16%); hyperlipidemia, 3 (8.0%); and diabetes, two (5%). Age group younger than 15 years included 3 girls and one had a mass attached to the posterior mitral valve leaflet. Our observations underscore the importance of the presence of hypertension, family history of stroke, and transient ischemic attack in young adults and thus to adopt preventative strategies.

Impact of helminth infection on childhood allergic diseases in an area in transition from high to low infection burden

Background The effect of helminth infections on allergic diseases is still inconclusive. Furthermore, the effect of helminth infections on childhood allergic diseases in a tropical area where prevalence of helminth infections has undergone dramatic changes is not well documented. Objective To investigate the relationship between allergic diseases and helminth infection in a cohort of schoolchildren in an area that has undergone dramatic changes in intensity of helminth infections. Methods Children attending grade 5 were recruited from 17 schools in Western Province of Sri Lanka. They were assessed for allergic diseases using the International Study of Asthma and Allergies in Childhood questionnaire. Their serum total IgE (tIgE) and allergen-specific IgE (sIgE) for five common aeroallergens were measured by ImmunoCAP® method and stools were examined for the presence of helminth infections. Results A total of 640 children (mean age 10 years) were recruited to the study. Of them, 33.7% had evidence of allergic disease and 15.5% had helminth infections. Majority of infections (68.9%) were of low intensity. A significant relationship between allergic disease and helminth infections was not observed, however, a trend toward protective role of helminth infections against allergic diseases was noted. Multivariate analysis showed helminth infections to be an independent predictor of high tIgE levels whereas allergic disease was not. Allergic sensitization (atopy) was a significant risk factor for allergic disease only among non-infected children (odds ratio 3.025, p = 0.022) but not in infected children. The ratio of sIgE to tIgE was higher in non-infected children. Conclusion Though not significant, a reduced risk of allergy in helminth-infected children was observed in this population. A Decrease in intensity of helminth infections may have contributed to the reduced capacity of immune-modulation by helminths in this paediatric population.

Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), first reported case from Sri Lanka

Disrupted-In-Schizophrenia (DISC1) is a candidate susceptibility gene for major psychiatric diseases including schizophrenia, depression and bipolar disorder, while biological roles of the DISC1 protein have not yet been fully explained. In the present study, a 129 substrain-specific 25-bp deletion in exon 6 of Disc1 that introduces a termination codon at exon 7 and abolishes production of the full-length protein was transferred to the C57BL/6J genetic background. We used behavioral assays to assess Disc1-deficient mice for depression-like behaviors. Immobility time in the forced swimming test and the tail suspension test was comparable between wildtype and Disc1-null mice. Brain sections of Disc1-deficient mice were examined in the microscopy. Gross brain morphology appeared normal in Disc1-null mice. Immunofluorescent staining was performed to compare the expression pattern of DISC1-related proteins in wild-type and Disc1-deficient mice. Further analysis of mice carrying the 129 substrain-derived deletion variant might help to explain how DISC1 variation contributes to susceptibility in humans.