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Item type: Item , Sex-related disparities in hyperlipidaemia and cardiovascular risk in Sri Lanka: a cross-sectional study(BioMed Central, 2025-12) Mettananda, C.; Fernando, K.; Solangaarachchige, M.; Premaratna, R.; Mallawa, R.; Fernando, U.; Senaratne, A.; Perera, U.; Wickramasinghe, C.BACKGROUND: Nearly 80% of the world’s noncommunicable disease (NCD) burden comes from developing countries, where sex-related disparities in healthcare utilisation are common. However, studies on sex-related disparities in lipids and cardiovascular risk among South Asians are limited. This study aimed to investigate sex-related differences in the prevalence, management and outcome of lipids and related cardiovascular diseases (CVDs) among Sri Lankans to inform necessary improvements in preventing, diagnosing, and managing CVDs in females in Sri Lanka, a resource-limited South Asian setting. METHODS: Secondary data from the World Health Organisation’s STEPS survey-2021, a community-based cross-sectional study conducted across Sri Lanka from April to December 2021, were analysed. Hyperlipidaemia was defined as having a total cholesterol (TC) level ≥ 200 mg/dL or being on treatment for hyperlipidaemia. TC goal was defined as a TC level < 200 mg/dL. Rates of hyperlipidaemia prevalence, treatment uptake and TC target achievement were compared between males and females. Sex-related disparities in the associations of hyperlipidaemia and CVDs were assessed separately. RESULTS: The study sample consisted of 4,634 adults (62.8% female) with a mean age of 46 ± 13.7 years. The prevalence of hyperlipidaemia was higher in females (46.3%) than in males (36.4%, P < 0.001). Treatment uptake was not significantly different between females (25.2%) and males (23.6%, P = 0.467). Of those on treatment for hyperlipidaemia, the TC goal achievement was low in females (68.1%) compared to males (82.4%, P < 0.001). Females (4.9%) had a lower prevalence of established CVDs compared to males (10.9%, P < 0.001), but females with hyperlipidaemia had higher odds (OR 1.24, P = 0.038) of CVDs. CONCLUSIONS: Sri Lankan females had a higher prevalence and poorer control of hyperlipidaemia compared to males, despite no significant difference in treatment uptake. However, the presence of CVDs was higher among males and was independently associated with sex and hyperlipidaemia.Item type: Item , Evaluating the Interference of Residual 'Teepol' Detergent on Serum Electrolytes, Protein, and Cholesterol: An In-Vitro Study(Milano, Italy : IFFC, 2025-12) Fernando, K.; Jayasekara, D.; Welhenge, C.; Kulasinghe, M.; Silva, P.; Dayanath, B.K.T.P.INTRODUCTION: In low-resource settings, reusing blood collection tubes cleaned with detergents such as 'Teepol' is common due to economic constraints. However, residual detergent may interfere with biochemical assays. This study evaluated the effect of residual 'Teepol' on serum electrolyte, total protein, and cholesterol, with emphasis on direct ion-selective electrode (ISE) methods. METHOD: A controlled interference experiment was conducted using pooled human serum spiked with increasing concentrations of 'Teepol' (0%, 0.2%, 0.5%, and 1.0% v/v of original detergent). Serum sodium and potassium were measured using direct ISE (Ortho_Vitros® 4600), while total protein and cholesterol were measured via colorimetric methods (BS 800M). All analytes were tested in a single run to avoid inter-run variability. Statistical significance was assessed via Pearson correlation and comparison against 95% confidence intervals derived from quality control data. RESULTS: Serum sodium and potassium showed a concentration-dependent decline with increasing 'Teepol'. At 1.0%, sodium decreased by ~12% and potassium by ~43% compared to control, with values falling outside the 95% confidence intervals, confirming significant interference. Total protein and cholesterol measurements remained within expected analytical variation. Strong negative correlations were observed for sodium (R=-0.966) and potassium (R=-0.989) with 'Teepol' concentration (p< 0.05). CONCLUSION: Residual 'Teepol' ≥0.5% v/v significantly interferes with serum sodium and potassium measurements using direct ISE. These findings highlight the importance of strict tube-washing protocols or the use of disposable tubes for critical assays. Inconsistent cleaning practices in low-resource laboratories may allow such interference, posing a risk to result accuracy and clinical decision-making.Item type: Item , Oxidative Stress Associated with Chronic Occupational Exposure to Petroleum Hydrocarbons among Gas Station Attendants in Gampaha District, Sri Lanka(Mashhad University of Medical Sciences, 2025-12) Wickramasingha, B.; Jayasinghe, N.; Warnakulasuriya, T.; Medagoda, K.; Subasinghe, W.BACKGROUND: Gas station attendants (GSA) are at risk of adverse health outcomes due to chronic occupational exposure to petroleum hydrocarbons and poor occupational safety practices. In Sri Lanka, extended working hours, minimal use of personal protective equipment (PPE), and limited health surveillance exacerbate these risks. This study aimed to evaluate oxidative stress biomarkers and associated health risks among GSA in the Gampaha District. METHODS: A cross-sectional study was conducted among 25 exposed workers and 25 age-matched unexposed controls. Data on sociodemographic characteristics, occupational exposure history, lifestyle factors, and self-reported health symptoms were collected using a structured questionnaire. Blood samples were analyzed for oxidative stress biomarkers, including glutathione (GSH), 8-hydroxydeoxyguanosine (8-OHdG), and total antioxidant capacity (TAC), using enzyme-linked immunosorbent assay (ELISA). RESULTS: GSH levels were significantly higher among GSA (p = 0.043), indicating a potential early-phase compensatory antioxidant response to chronic petroleum vapor exposure. However, no statistically significant differences were found in TAC (p = 0.101) or 8-OHdG (p = 0.770) between exposed and control groups. Self-reported symptoms such as headaches, fatigue, memory disturbances, and respiratory complaints were more prevalent among the GSA. Alarmingly, PPE usage was extremely limited, with only 4% reporting access to masks and none to gloves, indicating a critical gap in occupational health protection. CONCLUSION: The findings indicate early biochemical signs of oxidative stress among gas station attendees, alongside poor adherence to occupational safety practices. Immediate implementation of regulatory interventions, including mandatory PPE provision and health education, is essential to reduce long-term health risks in this vulnerable workforce.Item type: Item , Fatal Trajectories: Identifying Key Predictors of Mortality After Femoral Fracture(The Library, University of Kelaniya, 2025-12) Jayapala, D.; Wijayawardhana, S.; Fernando, M.; Mathangasinghe, Y.Femur fractures contribute substantially to morbidity and mortality in both the young and elderly populations. The prevalence varies among studies, with the highest prevalence observed in the East Asian region. In order to focus on the prevention of femur fractures, a thorough understanding of the existing evidence is imperative. This scoping review seeks to identify and map the predictors of mortality associated with femur fractures. Our objective is to highlight existing knowledge gaps, support interdisciplinary collaboration, and inform the development of policies aimed at reducing mortality related to these injuries.Original observational studies published in English between January 1983 and April 22, 2025, were included. A comprehensive literature search was conducted using the keywords "Mortality", "Femoral Fractures", and "Prognosis". Search was limited to the PubMed (MEDLINE) database. Identified records were exported and screened independently by two reviewers—the initial screening of titles and abstracts for relevance, followed by full-text review of potentially eligible studies. Any discrepancies in study selection were resolved through discussion or, when necessary, consultation with a third reviewer.Fifty-four (54) eligible studies were included in the final scoping review. The fracture site described mostly was the hip in 23 (42.6%) of articles, followed by the neck of femur (NOF) in 16 (29.6%), and the proximal femur in 13 (24.1%). Shaft and distal femur fractures in only one article (1.9%). Most studies reported mortality outcomes at one year (32 studies; 59.3%). Demographic and patient-related factors, pre- and post-operative management-related factors were presented in the articles and summarised. While we have identified the scope of the factors that would predict the mortality following femur fractures, this scoping review did not include a formal critical appraisal of the included studies to assess the quality or risk of bias in individual studies. We recommend a comprehensive review with a meta-analysis.Item type: Item , Is size, morphology, site, and access scoring system consistent between endoscopists? Interobserver and intraobserver polyp assessment study(Stuttgart : Georg Thieme Verlag KG, 2025-12) Thoufeeq, M.; Thaika, A.; Moudhgalya, S.; Mundre, P.; Abeysuriya, V.; Nishad, N.BACKGROUND AND STUDY AIMS: This study aimed to evaluate interobserver and intraobserver agreement in Size/Morphology/Site/Access (SMSA) scoring among practicing endoscopists with varying levels of experience. PATIENTS AND METHODS: A total of 102 fully independent endoscopists participated in the study. Ten short video clips of colonic polyps of varying size and complexity were recorded using Olympus 290 colonoscopes and included white light, near focus, narrow band imaging, and chromoendoscopy where applicable. These videos were embedded in an online questionnaire. Endoscopists were asked to assign SMSA scores based on three variables-size, morphology, and access-with the site provided for standardization. A subgroup of five participants repeated the assessment after 2 to 3 weeks to evaluate intraobserver consistency. Data were analyzed using Fleiss' kappa via SPSS (v26), and Kappa interpretation followed the Landis and Koch classification. RESULTS: Overall interobserver agreement for SMSA level across all participants was fair (κ = 0.346). Among individual parameters, morphology had the highest agreement (κ = 0.505, moderate), followed by access (κ = 0.408, moderate) and size (κ = 0.241, fair). Subgroup analysis of experienced endoscopists (> 1000 lifetime colonoscopies) yielded slightly improved kappa values, with morphology still demonstrating the highest consistency. Intraobserver agreement showed moderate to almost perfect reliability for size (κ = 0.444 to 1.000) and moderate to substantial agreement for SMSA level (κ = 0.429 to 0.846). CONCLUSIONS: Morphology was the most consistently scored parameter. Although the SMSA tool remains valuable, efforts such as standardized training and simplification of variable categories may be warranted to improve interobserver consistency and enhance clinical-utility.