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OPD Services

The Out Patient Department delivers first contact care to the care recipients. Services provided ranges from primary care, emergency care and first contact specialist care services..

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Specialist Care Services

Information on the wide range of specialist care services, there history, evolution, future and how to obtain these services..
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Clinic Services

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Other Services

Information on Special units, paramedical units and other ancillary units providing services for the care recipients..

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What is Clinical Neurophysiology…?

It is diagnostic speciality which has evolved from neurology. It is mainly focused on recording and clinically interpreting electrical activity from the brain, spinal cord, peripheral nerves and muscles to diagnose disorders of the central and peripheral nerves systems.

Clinical Neurophysiologist is a specialized consultant neurophysician who performs electro diagnostic tests; interpret results in a correct clinical context providing accurate diagnoses

 

What are the tests performed…?

Electromyography (EMG), Nerve conduction studies (NCS)

They are diagnostic tests of peripheral nerve system, especially useful in diagnosing diseases in nerve roots, plexuses, peripheral nerves and muscles. These tests also help to localise the lesion site, exclude alternate diagnoses, reveal unsuspected diagnoses, and assess severity, time frame and prognosis of lesions.

Eg: -

  • Radiculopathies

  • Nerve Injuries

  • Entrapment neuropathies – carpal tunnel syndrome

  • Peripheral neuropathies – axonal, demyelinating neuropathies

  • Muscle diseases – myopathies

Electroencephalography (EEG)

It records the electrical activity of the brain using scalp electrodes. It is mainly useful in diagnosing and evaluation seizures. It is also used to diagnose sleep disorders, coma, encephalitis, encephalopathy and neurodegenerative diseases.

Video EEG Telemetry Monitoring

Long term monitoring of EEG with video recording to evaluate undiagnosed seizure like events and screening for epilepsy surgery.

Evoked Potential Studies

There are electrical potentials produced by nervous system in response to specific stimuli.

Eg:-

  • Visual evoked potentials
  • Auditory evoked potentials
  • Somatosensory evoked potentials

They are used for diagnosis of diseases affecting respective sensory pathways.

Botulinum toxin clinic

Evaluation and injection of Botulinum toxin for various movement disorders and spasticity due to stroke, cerebral palsy etc.

Annual Statistics

Service

Number of Patients per year

Special NCS / EMG

3600

Carpal Tunnel Syndrome

4800

Evoked Potential Studies

720

Botulinum Toxin Therapy

120 to 180

Standard EEG Recording

4800

Prolonged Video EEG Monitoring

120

EEG Reporting from NHSL & Other Hospitals

3000


How to make a referral

The referral could be made by any consultant through a government hospital. The referral should indicate the patient’s identification details, the clinic or BHT number relevant brief clinical summary, differential diagnosis or clinical question that needs to be answered by the study and the consultant’s signature.


Clinical Neurophysiology Unit, National Hospital of Sri Lanka

The Clinical Neurophysiology Unit of Institute of Neurology, NHSL is the only such unit in the country. It provides comprehensive neurophysiology services to patients with various neurological as well as non-neurological disorders. Main interactions are with neurology, neurosurgery, ophthalmology, otolaryngology, orthopaedic & paediatric units as well as with intensive care units. It serves other hospitals in the country including the hospitals of three armed forces and the police.

The unit commenced in year 2000 when Dr. Sudath Gunasekera was appointed the first Consultant Neurophysiologist, NHSL. There are grade medical officers, nursing and paramedical staff to provide the services.

Services

  1. Nerve conduction tests (NCS), electromyography (EMG) and other related tests.

These tests are provided for patients with disorders in the peripheral nervous system. Special clinics are conducted daily for complicated cases. A separate clinic is conducted for patients with Carpal Tunnel Syndrome since the number of such patients is high. Urgent tests are arranged when necessary, especially for patients with traumatic and non-traumatic acute weakness.

  1. Evoked potential studies

These are available for visual (VEP), auditory (BSER) as well as somatosensory (SSEP) modalities. These are done according to international standards.

BSER threshold tests are done for hearing screening which is particularly useful in children for early detection of hearing impairment. Clinical Neurophysiology unit of NHSL was the first to introduce this test in Sri Lanka under accurate standards and so far provided this service to a large number of patients.

  1. Electroencephalography (EEG)
  1. Standard EEG recording services are provided to patients from NHSL as well as other hospitals which do not have such facilities. All the EEGs are provided with a report by Consultant Neurophysiologist. In addition, EEGs done in other hospitals are also undertaken for reporting by Consultant Neurophysiologist upon requests. Lady Ridgeway Hospital and Mental Hospital in particular receive such services from our unit on a regular basis.

  2. Prolonged video EEG monitoring is also carried out. This is the first ever video EEG monitoring facility with expertise in the procedure and interpretation. The majority of patients who undergo this test are those lined up for epilepsy surgery for which this test is essential.  We played a key role in establishment of epilepsy surgery services in Sri Lanka.

    In additional short term monitoring is provided for diagnostic purposes. Some studies for sleep disorders (Multiple Sleep Latency Test) is also carried out.

  1. Intraoperative Monitoring

This is provided when necessary for epilepsy surgeries and spinal surgeries. The number is limited due to limitations of staff and equipment.

  1.  Botulinum Toxin Therapy Clinic

A specialized clinic for botulinum toxin therapy is conducted every fortnight. This serves to provide botulinum toxin injection for patients with various movement disorders ranging from hemi facial spams and Writer’s cramps to laryngeal spasmodic dysphonia. Some of these patients are given the injection under EMG guidance.

  1. Evaluation of cases of Acute Flaccid Paralysis reported to National Polio Expert Committee.

Neurophysiological evaluation of majority of such cases is done in the neurophysiology unit. Consultant Neurophysiologist also takes part in the committee meeting as a member.

Teaching and Training

We take part in the process of postgraduate medical education by training pre-MD postgraduate students in medicine and paediatrics. We have also taken part in training post MD Senior Registrars in Clinical Neurophysiology, Neurology and Paediatric Neurology.

This unit houses the EEG Technologist Training School of the Ministry of Health. Coordination of their programme including conducting practical hands on training as well as lectures are done by this unit.

Examinations for trainee EEG technologists and efficiency bar examinations for EEG technologists are conducted in this unit under the supervision of Ministry of Health.

Statistics

Service

Number of Patients per month

Special NCS / EMG

300

Carpal Tunnel Syndrome

400

Evoked Potential Studies

60

Botulinum Toxin Therapy

10 to 15

Standard EEG Recording

400

Prolonged Video EEG Monitoring

10

EEG Reporting from NHSL & Other Hospitals

250

A large number of patients are referred from armed forces and police for various nerve injuries sustained  at the battle front. They are given priority. Presently about 50% of special NCS / EMG tests done are for these patients. These tests cannot be done at those hospitals since necessary equipment or expertise is not available.

The number of patients seen is very large, similar to other clinics in Sri Lanka. This is several times more than that of a clinic in a developed country.

Any other information

Botulinum Toxin injection Tuesday [ Once in 02 Week ] 8.00 a.m Neuro Building E.M.G Room
Special Nerve Conduction Clinic & E.M.G Clinic Monday |Tuesday| Wednesday| Thursday | Friday| Saturday 8.00 a.m. Neuro Building
B.S.E.R.(Brain Stem Auditary Evoke potential Clinic)
S.E.P.(Somato Sensary ) & V.E.P.(Visual Evoke Potential )
Monday| Tuesday | Wednesday| Thursday |Friday 12.30 p.m Neuro Building E.M.G Room
C.T.S (Carpal Tunnel Syndrome )   Monday|Tuesday|Wednesday|Thursday 11.30 a.m Neuro Building E.M.G Room

 


History

Department of microbiology at NHSL was established in 1970s by two Consultant Pathologists Dr. Doris Peiris and Dr. H.R. Wickramasinghe. In 1981 Dr. S.D. Athukorala was appointed as the first permanent Consultant Clinical Bacteriologist to the department of microbiology. On his retirement in mid 2005 Dr. Mrs. Philomina Chandrasiri was appointed as the second Consultant Microbiologist and she served till early 2013.

The infection control unit was established in 1987 under the leadership of Dr. S.D. Athukorala, Consultant Clinical Bacteriologist and Mrs. Chandra Gunawathie was the first Infection Control Nursing Officer appointed to the infection control unit.

The department of microbiology and infection control is a well recognized unit in Sri Lanka

Services

It is well equipped to provide microbiology culture, direct microscopy and antibiotic susceptibility testing in microbiological samples namely blood and all sterile fluids namely cerbro-spinal fluid, peritoneal fluid, pleural fluid, aspirates from sterile sites, heart valves, pus aspirates, respiratory samples, urine, faeces, throat swabs, wound cultures, tissue biopsy samples, screening and surveillance cultures as appropriate according to standardized and quality controlled methodology.

The department participates in the External Quality Assessment (EQA) programmes conducted by the Medical Research Institute and the NPTCCD (National Programme for Tuberculosis and Chest Diseases)

Department is an approved  training centre for both undergraduates from the faculty of medicine and post graduate trainee medical officers in different disciplines including clinical microbiology. It is an approved training centre for medical laboratory technologists too.

Department conducts research in relation to medical microbiology and infection control aspects as a single centre and also in collaboration with other institutes and some of them have been published and presented in local and international gatherings.

Department of microbiology works closely with the infection control unit of the hospital which too is headed by the Consultant Clinical Microbiologist as the technical head of the unit.


Present Team

Microbiology team

The team included dedicated group of staff members from medical, technical and support staff who give tireless service in order to issue timely and quality microbiology reports for better patient care.

They provide a vital service in clinical care for the battle against infections.

Team is headed by the Consultant Clinical Microbiologist, Dr (Mrs) Geethika Patabendige.

Medical staff in the department of microbiology includes Senior Registrars, Registrars undergoing clinical training in medical microbiology and other disciplines on rotational basis and four Medical Officers in microbiology.

The technical team includes Senior Medical Laboratory Technologist and eleven Medical Laboratory Technologists.

Support staff includes two orderlies and five assistant staff members.

Infection control unit team:

The team included dedicated group of staff members from medical, nursing and support staff who play a vital role in providing the patients and staff members with safer healthcare. 

Infection control unit team includes Dr. Geethika Patabendige, Consultant Clinical Microbiologist as the head of the department, two infection control medical officers, Infection Control Nursing Sister and thirteen Infection Control Nursing Officers and one support staff member.


Tasks

Microbiology

Timely issuing of technically and clinically validated microbiology reports

The department of microbiology processes around 16,000 to 20,000 blood cultures, 6,400 sterile fluid cultures, 30,000 urine cultures, 21,000 pus cultures, 12,000 respiratory sample cultures, 3,000 surveillance cultures, 50,000 antibiotic susceptibility testing and 10,000 smears for Acid Fast Bacilli ( AFB) annually. To carry out the above tasks microscopy, plating on culture media, broth inoculations and biochemical testing have to be carried out. Twenty four thousand Gram stains, 90,000 plating on culture media, 20,000 broth inoculations and 30,000 biochemical testings’ including rapid manual identifications are done annually at the department of microbiology.

Providing advice on collection and transport of microbiological specimens and suggesting further testing when required

Providing antimicrobial ad infection control advice to all ICUs, HDUs, wards and units

Authorization of antimicrobial agents as required

Attending to referrals for antimicrobial and infection control advice from all specialized areas namely general medicine and surgery, orthopaedic surgery, cardiology, urology, GU surgery, cardiothoracic surgery, emergency care and accident service, neurosurgery, neurology, dialysis and transplantation.

Sending appropriate samples and isolates for reference testing to Medical Research Institute and NPTCCD reference laboratory for Tuberculosis culture and automated PCR (GeneXpert)

Undergraduate and post graduate training and other training as required

Evaluation of consumables and equipment for registration and for tenders which are submitted by the CDDA and SPC

Being resource persons in educational workshops 

Representing committees related to microbiology at the Ministry of Health

 

Infection control

General infection control activities at NHSL and outside whenever necessary

Specialized infection control activities such as theatre commissioning, recommissioning and designing and expert microbiological advice on designing specialized and other units at NHSL and outside whenever necessary

Healthcare associated infections (HAI) surveillance

Training staff and patients

Conducting infection control audits and related research

Accidental exposure reporting and management

Vaccination of patients and staff members

Epidemiological services – notification, dengue e. surveillance, dengue sentinel site surveillance, ILI surveillance, AFP surveillance

Outbreak detection and management

Representing National advisory committee on infection control at the Ministry of Health


How to Obtain the Services

In order to obtain services from the department of microbiology and infection control contact over the telephone on 0112691111 extension 2473. 2474, 2923 and 2647

Future plans

Expanding the microbiological services to include mycological and molecular biological services with the provision of necessary resources through the ministry of health and other funding institutes.

Establishing a better laboratory information system and networking so that the units would be able to access the results with minimum delay

Obtaining laboratory accreditation to the microbiology laboratory

Further improving the infection control services to safeguard the lives of patients and staff members


Microbiology

Infection Control


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FaLang translation system by Faboba

Welcome to National Hospital

Centre of Excellence in Health Care.

The National Hospital situated in Colombo in a 32 acre block of land is the largest teaching hospital in Sri Lanka and the final referral centre in the country consisting of 3000 beds. it is the training centre for under graduates and post graduate trainees of the Faculty of Medicine. The nursing training school, Colombo, PBS, and Schools of Radiography, Pharmacy, Cardiograph, physiotherapy and occupational therapy are also affiliated to the National Hospital.

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Message from His Excellency Maithripala Sirisena 
President Democratic Socialist Republic of Sri Lanka

The National Hospital of Sri Lanka is truly deserving of this message of felicitation and encouragement on this 150th Anniversary of service to the people of Sri Lanka.

 
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Deputy Minister

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Secretary of Health

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