http://repo.lib.jfn.ac.lk/ujrr/handle/123456789/7378 2026-04-04T13:39:45Z 2026-04-04T13:39:45Z Kumanan, T. Mathangi, N. Suganthan, N. Brammah, R.T. http://repo.lib.jfn.ac.lk/ujrr/handle/123456789/12411 2026-03-27T04:27:35Z 2026-01-01T00:00:00Z

Title: A rare case of occipital plexiform neurofibroma with skull erosions in neurofibromatosis type 1 Authors: Kumanan, T.; Mathangi, N.; Suganthan, N.; Brammah, R.T. Abstract: Plexiform neurofibromas are benign nerve sheath tumours commonly associated with neurofibromatosis type 1 (NF1). Plexiform neurofibromas of the scalp is a rare finding. Plexiform neurofibroma in the occipital region is even rarer. The commonest skull manifestations in neurofibromatosis involve the orbit, with very few reports about occipital defects. Magnetic resonance imaging (MRI) is the preferred modality to identify the lesion. It is usually managed by surgical excision, but recurrence has also been reported even after thorough removal. We present a case of a 52-year-old man with plexiform neurofibroma in the occipital region with skull erosions which is an extremely rare finding

2026-01-01T00:00:00Z Kumanan, T. Sobika, S. Suganthan, N. Sriluxayini, M. Gerald, S. http://repo.lib.jfn.ac.lk/ujrr/handle/123456789/12410 2026-03-27T04:17:02Z 2026-01-01T00:00:00Z

Title: Hereditary Haemorrhagic Telangiectasia: an Unusual Cause for a Quiescent Pulmonary Nodule Authors: Kumanan, T.; Sobika, S.; Suganthan, N.; Sriluxayini, M.; Gerald, S. Abstract: Hereditary haemorrhagic telangiectasia (HHT) is a rare autosomal dominant disorder with mucocutaneous telangiectasias and arteriovenous malformations (AVM). We report an asymptomatic patient with a pulmonary AVM (PAVM) found on routine imaging. He later disclosed recurrent childhood epistaxis and a family history suggestive of HHT. Imaging studies confirmed a large PAVM without other organ involvement. Early diagnosis and transcatheter embolisation helped prevent severe complications like stroke and haemorrhage. This case highlights the importance of exclusion of HHT as an important cause of an unexplained pulmonary shadow.

2026-01-01T00:00:00Z Pradeepan, J. Kumanan, T. Suganthan, N. Selvaratnam, G. Sujanitha, V. Brammah, R. Balendran, K. Pathmanathan, D. Rubakumar, D. Mohanathas, S. http://repo.lib.jfn.ac.lk/ujrr/handle/123456789/12183 2026-02-13T03:20:18Z 2025-01-01T00:00:00Z

Title: Knowledge, attitudes, and preferences regarding End-of-Life Care among older adults in a tertiary care centre, Northern Sri Lanka Authors: Pradeepan, J.; Kumanan, T.; Suganthan, N.; Selvaratnam, G.; Sujanitha, V.; Brammah, R.; Balendran, K.; Pathmanathan, D.; Rubakumar, D.; Mohanathas, S. Abstract: Introduction:End-of-life (EOL) care is a vital component of healthcare that emphasises comfort, dignity, and quality of life during the terminal stages of illness. Although its significance is widely recognised, awareness and understanding of EOL care remain limited in many low- and middle-income countries, including Sri Lanka. Improving knowledge and aligning care with patient preferences can help clinicians deliver patient-centred, culturally sensitive, and cost-effective interventions and inform policy development for EOL care frameworks. Objective: This study aimed to assess the knowledge, attitudes, and preferences regarding EOL care among older adults attending the medical outpatient department at the Teaching Hospital Jaffna, and to facilitate patient-centred, costeffective care planning. Methods: A descriptive cross-sectional study was conducted between November 2024 and January 2025 involving 510 patients aged 65 years and above. Data were collected using a pre-validated, self-administered questionnaire. Statistical analysis was performed using SPSS version 27 Results: The majority of participants were female (65.7%), with the largest proportion aged 70-79 years (56.3%). In terms of education, 80% of patients had formal education. Multimorbidity was prevalent, with 84.9% reporting three or more chronic conditions, notably hypertension (72.9%), diabetes mellitus (54.7%), and dyslipidaemia (51.2%). A large majority (90%) lived with family, suggesting strong family support. While 77.3% acknowledged the irreversible nature of chronic disease and 97% preferred comfort-focused management at terminal stages, only 23.5% were aware of palliative or EOL care concepts. Paradoxically, 71.6% desired continuation of treatment even if futile, and 86% favoured resuscitation and intensive care during terminal illness. Clear communication on disease progression was valued by 76.5%. Decision-making responsibility was seen as shared among patients (34%), families (34%), and physicians (32%). Most respondents (86.3%) found EOL care meaningful, and 89.2% were open to discussing EOL care with healthcare providers. Conclusion: Elderly patients with multimorbidity attending a tertiary care unit in the Northern region of Sri Lanka value communication and recognize the importance of EOL care but show limited awareness and mixed preferences, often favouring active medical interventions despite a desire for comfort. Better patient education and culturally sensitive dialogue are necessary to align EOL decisions with patient values and cultural context.

2025-01-01T00:00:00Z Sobika, S. Suganthan, N. Brammah, R.T. Sathiyareka, S. Malaravan, M. http://repo.lib.jfn.ac.lk/ujrr/handle/123456789/12182 2026-02-13T02:59:27Z 2025-01-01T00:00:00Z

Title: Reactive infectious mucocutaneous eruption: An uncommon dermatological manifestation of Mycoplasma pneumoniae: a case report Authors: Sobika, S.; Suganthan, N.; Brammah, R.T.; Sathiyareka, S.; Malaravan, M. Abstract: Mycoplasma pneumoniae is a common respiratory pathogen that causes a wide range of clinical manifestations, from mild upper respiratory tract infections to severe atypical pneumonia. Besides its pulmonary involvement, it can cause several extrapulmonary complications. Among these, dermatological manifestations such as Stevens-Johnson syndrome, erythema multiforme, and toxic epidermal necrolysis are well recognised. Reactive infectious mucocutaneous eruption is a relatively rare but notable manifestation. This case report describes a 35-year-old man who developed mucosal lesions involving the ocular, oral, and genital areas after a prodrome of respiratory symptoms. Laboratory tests confirmed a high antibody titre of Mycoplasma pneumoniae. While initial antibiotic therapy improved the respiratory symptoms, mucosal involvement persisted, necessitating the use of systemic corticosteroids, which led to a significant clinical improvement. This case highlights the importance of timely recognition and correct management of this uncommon manifestation of mycoplasma infection.

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