Introduction: Introduction: Malnutrition is a serious unresolved nutritional problem amongst dialysis patients associated with increased mortality and morbidity and prevalence differs according to dialysis modalities. This study compared protein- energy malnutrition (PEM) prevalence in haemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) patients. Methods: A total of 155 HD and 90 CAPD patients were enrolled. PEM prevalence was determined using body mass mdex (BMI), serum albumin, Dialysis Malnutrition Score (DM5) and dietary intake. Results: CAPD patients had significantly higher BMI (24.1 � 4.8 kg/m2 vs. 22.7 � 4.8 kg/m2 p=O.024) and mid-arm muscle area (32.1 � 12.4 cm2 vs. 29.5 � 15.9 cm2 p=O.044) than HD patients. They also had significantly lower serum albumin (31 � 5 g/L vs. 35 � 6 g/L; p5 years were independent risk factors of PEM hi dialysis patients. Conclusion: Periodic nutritional assessments, education and dietary counseling should be emphasised in these patients as a preventive measure of PEM.

Background and Objective: Epilepsy and depression are interlinked and lead to an increased risk of suicidal ideation and suicide. Although depression is a significant risk factor for suicidal ideation in epilepsy patients, epilepsy itself is independently associated with suicidal ideation. There are various other factors related to epilepsy that further increase this risk. Methods: We conducted a study of suicidal-ideation amongst epilepsy patients in our centre. Demographic data and clinical history were obtained while suicidal ideation was determined using the Columbia Suicide Severity Rating Scale (C-SSRS). Beck’s Depression Inventory–II (BDI-II) was used to identify presence of depression. Results: We recruited 80 patients with epilepsy and an equal number of controls. Epilepsy patients were more likely to be depressed with a mean BDI-II score of 9.09 ±6.48 compared to controls who has a mean score of 5.56 ±4.56. The proportion of epilepsy patients with suicidal ideation was 33.75% vs. 5.00% in the control group (p<0.001). Epilepsy patients were 9.68 times more likely to have suicidal ideation compared to controls: OR 9.68 (95% CI 3.19, 29.28). Amongst epilepsy patients, those with suicidal ideation were more likely to be on 3 or more anti-epileptic drugs (10.00% vs. 6.25%, p=0.016), with a higher seizure frequency (11.25% vs. 2.50%, p=0.004) and higher incidence of previous head surgery (10.00% vs. 5.00%, p=0.022). Conclusion: Suicidal ideation was significantly prevalent amongst epilepsy patients especially in patients with frequent seizures, use of > 3 anti-epileptic drugs or prior head surgery. Our findings suggest that assessment of suicidal ideation is pertinent in high-risk epilepsy patients and should be routinely carried out in the clinical setting.

Stiff person syndrome is a rare neurologic disorder characterised by rigidity of the truncal and proximal limb muscles with intermittent superimposed spasms. It’s unique because it lacks similarity to any other neurologic disorder. Possibly tetanus is the closest related condition with both inhibiting central gamma-aminobutyric (GABA) systems. Stiff person syndrome is extremely rare with less than 20 cases reported from South Asia which has a population of nearly 2 billion. In its classic form, it is associated with the presence of high titres of glutamic acid decarboxylase (GAD) antibodies. Paraneoplastic stiff person syndrome comprising of around 5% of the patients has been reported with malignancies of the breast, colon, lung, thymus and Hodgkin’s lymphoma. Antibodies against amphiphysin and gephyrin are detected in paraneoplastic stiff person syndrome. We report a 58 year old Sri Lankan male with stiff person syndrome with a high GAD antibody titre and classical electromyographic changes, who was found to have an underlying carcinoid tumour. We postulate that stiff person syndrome was a paraneoplastic phenomenon secondary to the carcinoid in this case. Although neurological syndromes such as sensory neuropathy, limbic encephalitis and, myelopathy have been described as paraneoplastic features in carcinoid, we believe this is the first report of stiff person syndrome associated with carcinoid tumour.