Browsing by Author "Abeysuriya, V."

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Acute appendicitis in pregnancy
(Sri Lanka College of Obstetricians & Gynaecologists, 2023) Abeysuriya, V.; Dodampahala, H.S.; Chandrasena, L.
INTRODUCTION: The early diagnosis and management of appendicitis in pregnancy are essential in maternal and fetal morbidity and mortality. In this 20-year retrospective study, we aimed to assess the outcomes of pregnant patients diagnosed with acute appendicitis. METHODS: A single-center retrospective study was carried out. Randomly selected 2000 medical records of pregnant mothers referred as outpatients and hospitalized from 2002 to 2022 were retrieved. Six pregnant patients who were diagnosed and treated in Nawaloka Hospital with the diagnosis of acute appendicitis during 2002-2022 were examined retrospectively. Ethics Committee approval was received. No conflicting interest. RESULTS: The age range of our patients was 22 to 31 years, mean of 26± 3.4. The mean gestational week was 20±5.3 weeks, and most were in the second trimester 4 (68%). All patients were admitted with the complaint of abdominal pain, the majority of them had the right iliac fossa pain (RIF). All had elevated inflammatory markers. No computed tomography (CT) was performed. One patient was diagnosed clinically of having acute appendicitis without any imaging. Acute appendicitis was diagnosed in 3/5 patients who underwent ultrasound scan examination. The other two patients (one from 2nd trimester and one in the third trimester) were diagnosed with acute appendicitis on MRI examination. All patients underwent open appendectomy under general anaesthesia. No maternal or foetal morbidity or mortality was noted during pre or post-surgical and anaesthesia procedures. The mean hospital stay was 3.9±0.9 days. All appendixes were pathologically proven to have acute appendicitis. Except for minor superficial surgical site infection rest of the mothers and foetus had no morbidity or mortality recorded in the follow-up. CONCLUSION: Although appendicitis is not frequent during pregnancy, it is a disease that requires urgent surgical and obstetrics care for timely diagnosis and treatment.
Acute upper gastrointestinal haemorrhage in Sri Lankan adults--single unit experience
(Sri Lanka Medical Association, 2010) Navarathne, N.M.; Thoufeek, U. L.; Abeysuriya, V.; Ileperuma, A.
No Abstract Available
Age, sex variation among patients treated with percutaneous transluminal coronary angioplasty (PICA) in Sri Lanka: a retrospective study
(Sri Lanka Medical Association, 2014) Abeysuriya, V.; Chandrasena, L.G.; Kasturiratne, A.; Hettiarachchi, V.S.; Wickremasinghe, A.R.
INTRODUCTION AND OBJECTIVES: Coronary heart diseases (CHD) remain a major cause of death worldwide, ft is a growing burden for the Sri Lankan health sector. Age and sex has been identified as risk factors for CHD. The private health sector contributes significantly to curative care of CHD. The aim of this study was to determine the variation of age and sex of patients who have been treated with PTCA during the last decade at a private hospital in Colombo. METHODS: A retrospective study was conducted on patients treated with PTCA in a private hospital in Colombo from 2003 to 2013. Details of patients were extracted from medical records and age and sex variations were analyzed. RESULTS: 4578 patients (3315 men; 72.4%) were included. There was significant reduction in mean age at PTCA from 2003 to 2013 (p<0.01). Overall it had declined from 56.4 years (SD=10.5) in 2003 to 50.9 years (SD=12.4) in 2013. From 2003 to 2013 the mean ages of men had reduced by 7 years (p<0.01), while in females the mean age had reduced by 2.2 years (p<0.01) Male to female ratio was 2.58 in 2003 and 2.45 in 2013- Linear regression analysis showed that with each increment year the age at PTCA reduced by 0.54 years (95%Ci =0.64 to -0.44). CONCLUSIONS: Higher proportions of patients were men. Age at PTCA had decreased in both males and females. But sex ratio of patients had not significantly changed during the last decade.
Anatomical relations of the recurrent laryngeal nerve in thyroid dissection
(The College of Surgeons of Sri Lanka, 2023) Abeysuriya, V.; Anjula, S.A.P.D.
INTRODUCTION: Recurrent laryngeal nerve (RLN) palsy is one of the major complications thyroidectomy. Visualization of the anatomical relations of the RLN with branches of the inferior thyroid artery (ITA) remains essential for preservation of RLNs. Suspensory ligament of Berry, inferior horn of the thyroid cartilage is considered as other important landmarks for safe thyroidectomy. The objective of this study was to describe the various anatomical relations of the RLN during thyroid dissection. METHODS: An observation cadaveric study was conducted by simple random sampling of 35 cadavers with a total of 70 RLNs over a one-year period, from June 2022 to June 2023. The cadavers that had thyroidotomies and goitres were excluded from the study. RESULTS: The majority of RLNs in this series had a retrovascular course (with respect to the ITA or its branches): 57% on the right and 68.6% on the left. The course of 64/70 of the dissected nerves was posteromedial to the suspensory ligament of Berry, while the other 6 nerves passed between the fibres of this ligament. All RLNs penetrated the larynx by passing posteriorly to the inferior horn of the thyroid cartilage on both sides. No case of non-recurrent laryngeal nerve was observed. CONCLUSION: This preliminary study illustrates the numerous anatomical variants of the RLN with respect to the ITA and its branches. The RLN mainly has a retrovascular course on both the right and the left sides.
Anatomical variations of the musculocutaneous nerve - A cadaveric study
(College of Surgeons of Sri Lanka, 2015) Padeniya, A.G.P.M.; Salgado, L.S.S.; Hasan, R.; Fernando, E.D.P.S.; Ranaweera, R.M.S.L.; Abeysuriya, V.; Karunanayake, A.L.; Salvin, K.A.; Siriwardana, S.A.S.R.; Balasooriya, B.M.C.M.; Alahakoon, A.M.D.K.
INTRODUCTION: The musculocutaneous (MC) nerve commences from the lateral cord of the brachial plexus, passes inferolaterally and pierces the coracobrachialis while innervating it. It then descends between biceps and brachialis muscles, innervating both and continues as the lateral cutaneous nerve of the forearm. Few studies have been done with regard to variations in origin, course, branching pattern, termination and communications of the MC nerve. These variations are important for anatomists, clinicians, anesthetists and surgeons to avoid unexpected complication as these variations have clinical significance during the surgical procedures and in diagnostic clinical neurophysiology. Therefore the aim of this paper was to study the anatomical variations of the MC nerve. MATERIAL AND METHODS: This descriptive cross sectional study was carried out in the Department of Anatomy, Faculty of Medicine, University of Kelaniya. Dissections were carried out on 50 upper limbs of 25 cadavers to record anatomical variations of the MC nerve. RESULTS: MC nerve was present only in 46(92%) upper limbs. Of the 46 upper limbs where the MC was present, one (2%) did not pierce the coracobrachialis. Communications were seen between MC and median nerve in 06(13%) samples of which 1(17%) was proximal and 5(83%) were distal to the point of entry of the MC into the coracobrachialis and in 4(9%) upper limbs MC nerve rejoins with the median nerve. CONCLUSIONS: It is evident that significant anatomical variations of the MC nerve exist in our study. These variations emphasize the complexities and irregularities of this anatomical structure with regard to surgical approaches.
Anatomical variations of the vasculature in suprarenal glands in Sri Lankans
(College of Surgeons of Sri Lanka, 2007) Salgado, L.S.S.; Abeysuriya, V.; Kumarage, S.K.
INTRODUCTION: Anatomical variations of vascular patterns in the suprarenal glands have not been very well studied..METHOD: A descriptive study was performed in 40 human cadavers to identify the anatomical variations in the vasculature of the suprarenal gland. RESULTS: Superior, middle and inferior groups of arteries supplied the suprarenal glands, superior and inferior groups were present in all while the middle group was found in only 94.5%. The superior group had 3 arteries in males and 4 in females on each side. The middle had 01 artery on each side in both sexes. The inferior group had 2 arteries in males and 1 in females on each side. The superior group originated from the posterior branch of the ipsilateral inferior phrenic artery in 85.5% +/- 6.3 on the right and 82% +/- 7.5 on the left. With regard to the middle group, the aortic origin was the most frequent; 55.4%+/- 8.1 on the right and 44.6%+/- 8.1 on the left. The origin of the middle group from the trunk of the inferior Phrenic artery on both sides were, 25.6%+/-8.4 on the right and 38.57% +/- 8.6 on the left. The arteries of the inferior group arose from the ipsilateral renal artery in 75% +/- 8.5 on the right and 53% +/- 8.7 on the left. CONCLUSION: The most number of variations were found in relation to the middle group of suprarenal arteries, whilst superior and inferior groups were constant.
Anatomy of Inferior Mesenteric artery: A cadaveric study
(Anatomical Society of Sri Lanka, 2024) Abeysuriya, V.; Hewawardhane, S.
Introduction: A comprehensive knowledge of the varied anatomy of the inferior mesenteric artery (IMA) can be important in surgeries in the region of the colon and rectum. Methods: We analyzed 50 fresh cadavers in the department of Anatomy, Faculty of Medicine Ragama from 2022 to 2024. Latarjet’s classification was used for the IMA branching pattern. The anatomical relationships of the IMA left colic artery (LCA), sigmoidal artery (SA), and superior rectal artery (SRA) were observed, and the length from the origin of the IMA to the point of branching into the LCA or common trunk of LCA and SA was measured. The relationship between LCA and inferior mesenteric vein (IMV) was also observed. The data was presented as the value / percentage. Results: Majority showed Type A branching pattern 35/50 (70%). The respective lengths from the origin of the IMA to the beginning of LCA were measured and expressed as (mm) (mean ± SD) for each type; Type A 33.4 ± 4.7, Type B 36.5 ± 5.4, Type C 39.2 ± 8.6. The number of LCA under IMV in type A (51%); type B (54%); type C (62%) respectively. There was no statistically significant difference among the three types. Conclusion: Our study showed that type A branching pattern of LCA was the commonest. It is also observed that almost similar incidence of LCA traversing above and beneath the IMV.
Anatomy of the pancreatic vasculature:respect of the duodenum preserving resection of head of pancreas
(College of Surgeons of Sri Lanka, 2008) Salgado, S. S.; Abeysuriya, V.; Pathirana, A.
INTRODUCTION: Duodenum preserving resection of the head of the pancreas is performed mostly in chronic pancreatitis. Knowledge of precise anatomy of the pancreaticoduodenal region especially of the pancreaticoduodenal arteries, which provide blood to the duodenum, is mandatory for safe surgery. MATERIALS AND METHODS: Twenty human cadavers (age 56-87 years) of both sexes (10 males: 10 females) were studied with relevance to the anatomy of the head of the pancreas and duodenum in relation of the regional vascular arcades.RESULTS: The gastroduodenal artery (GDA) originates 3.7cm (3.1cm 5.1cm) from celiac trunk from the common hepatic artery. The Emergence of anterior superior pancreaticoduodenal artery (ASPA) was at 3.4cm (2.9cm - 4.2cm) of the origin of the gastroduodenal artery. After departing from gastroduodenal artery ASPA runs downwards along the medial side of the 2nd part of the duodenum and turned to the posterior aspect of the pancreas to join the anterior inferior pancreaticoduodenal artery (AIPA). Arcade formation between the ASPA and AIPA was found in all cadavers. Posterior superior pancreaticoduodenal artery (PSPA) originates 2.1 cm (1.8cm-2.8cm) from the origin of the gastroduodenal artery. PSPA form an arterial arcade with the branches of the posterior inferior pancreaticoduodenal artery. Posterior vascular arcade always located posterior to the common bile duct. Anterior and posterior vascular arcades were 0.35cm (0.32 cm 0.43cm) and 0.24 cm (0,21 cm 0.34cm) medial to the medial border of the duodenum respectively. CONCLUSION: In duodenal preserving pancreatic surgery, the knowledge of this complex vascularization will help to preserve arterial arcades around head of the pancreas while performing pan create cto my.
Assessment of 'nucleation time' as a predictor of cholelithiasis
(Lippincott Williams And Wilkins, 2008) Abeysuriya, V.; Deen, K.I.; Kumarage, S.K.; Navarathne, N.M.
INTRODUCTION: In the formation of gallstones, crystal nucleation is a key step, which is followed by precipitation and gradual growth of cholesterol crystals. MATERIALS AND METHODS: A case-control study was carried out among 60 patients (30 patients, 14 males and 16 females, median age of 36 years, range 33-71 years, body mass index (BMI)=25.1+/-0.33 kg/m, who underwent laparoscopic cholecystectomy; 30 control individuals, 15 males and 15 females, median age of 38 years, range 33-70 years, BMI=24.5+/-0.23 kg/m, who underwent laparotomy and who had normal ultrasound scans of the gallbladder and no demonstrable stones). Bile aspirated from the common bile duct was ultrafiltered and anaerobically incubated at 37 degrees C. Incubated bile was examined daily by polarized light microscopy, for appearance of cholesterol crystals. Nucleation time (NT) of bile was assessed as the time taken for the first crystals to appear under polarized light microscopy. RESULTS: Age and BMI of control individuals were not different to those of cases studied. The overall mean NT was significantly shorter in patients versus controls (mean NT+/-SEM: patients, 1.76+/-0.2 days; vs. controls, 12.74+/-0.4 days, P=0.001). Of control individuals, females demonstrated a shorter NT compared with males (mean NT+/-SEM: females, 11.4+/-0.36 days; vs. males, 14.1+/-0.46 days, P=0.006). In contrast, there was no sex difference in NT in patients (mean NT+/-SEM: females, 1.7+/-0.24 days; vs. males, 1.8+/-0.2 days, P=0.7). CONCLUSION: NT in control individuals without gallstones was significantly prolonged compared with the NT in patients with established gallstone disease. Among the control individuals, females had a significantly shorter NT than males. Hence, the assessment of NT is predictor of cholelithiasis.
ASSOCIATION BETWEEN CAROTID ARTERY INTIMA AND MEDIA THICKNESSES (CIMT) AND RISK OF CORONARY HEART DISEASE (CHD) IN A SELECTED SRI LANKAN POPULATION
(2024) Abeysuriya, V.
Introduction: Carotid artery Intima Media Thickness (CIMT) is an important biomarker for assessing coronary heart disease (CHD) risk. Despite its importance, the application of CIMT in South Asian populations remains under-explored. In this study, a systematic review and meta-analysis of global literature on CIMT to clarify its demographic and regional variation was conducted, and CIMT values were assessed in a specific Sri Lankan cohort. Methods: Phase 1 involved a systematic review and meta-analysis conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the Meta-analysis of Observational Studies in Epidemiology (MOOSE) criteria. A comprehensive search for relevant studies was performed to evaluate the global applicability of CIMT as a prognostic tool for CHD risk. Phase 2 comprised a comparative study conducted from November 2019 to October 2020 at Nawaloka Hospital PLC in Colombo. This phase examined two cohorts of participants aged 40–74 years: those with coronary heart disease (CHD) (n=338) and those without (non-CHD) (n=356). Data collection included socio-demographic information, anthropometric measurements, clinical evaluations, biochemical analyses, and CIMT assessments. The original Framingham Risk Scores (oFRS) and recalibrated Framingham Risk Scores (rFRS) were calculated for the non-CHD group. Results: There were significant differences in mean CIMT between the CHD and non-CHD cohorts, with notable variations across WHO regions. After adjusting for age, region, and ultrasound equipment, the CHD group exhibited a significantly thicker mean CIMT. Segment-specific CIMT variations were also observed. A total of 694 participants (male n=399, 57.5%) were enrolled, with a mean age of 60.2 (±9.86) years. The composite mean CIMT for the CHD group was significantly greater than that of the non-CHD group. Statistical evaluations indicated disparities in participant distribution across 10-year CHD risk categories based on both oFRS and rFRS, with the rFRS model classifying individuals into lower risk categories compared to the oFRS. Conclusions: CIMT measurements are influenced by regional, age, sex, and disease-specific factors. CIMT was higher in subjects with CHD as compared to the control group and increased with higher CHD risk groups. The rFRS model consistently classified subjects in lower risk categories as compared to the oFRS.
Beware of Variations in Bile Duct and Arterial Anatomy During Laparoscopic Cholecystectomy; An Intr-operative and Cadaveric Study
(University of Kelaniya, 2007) Abeysuriya, V.; Deen, K.I.; Salgado, L.S.S.; Kumaragae, S.K.
Introduction: Comprehensive knowledge, realization of the frequency and multiplicity of abnormalities of the extrahepatic biliary tree are requisites for safe laparoscopic cholecystectomy (LC). Material and methods: Descriptive-prospective cross sectional study W'\S performed in 200 patients, who underwent LC for symptomatic gall bladder (GB) disease and 60 dissected cadavers, to observe variations in GB, cystic duct (CD), cystic artery (CA) and Calot's triangle. Ethical approval was obtained. Results: No abnormality was seen in the gallbladder in 258 (99.2%). Two (1 %) Patients, had abnormalities in the gallbladder. Those were septate and bipolar. Four cadavers (6.6 %) had abnormalities of the cystic duct; 2 absent CD, 1 hepato-cystic duct, 2 with two cystic ducts. The cystic duct was seen to form a classical Calot's triangle in 249(96%). In 11, (5(0.25%) patients, 6(10%) cadavers) the CD was abnormal; 8(73%) had flathorizontal path and 3(27%) were parallel to CBD. The average length of the CD was 3 em in 47 cadavers. Short (<3cm) and long CD (>3cm) were found in 8/60(13.3 %) and 5/60(8.3 %) respectively. In 148(57 %) the right hepatic artery (RHA) was medial to the CHD. In 107(41 %), the RHA was in the triangle of Calot's and in 5(patients 2, cadaver 3) the RHA crossed over the CHD. 231(89%) Of the cystic arteries had no variations. In 29(11 %) (patients 17, cadavers 12) we found abnormalities; 13(5 %) had two cystic arteries, 13(5 %) cystic arteries were anterior to the CHD and 3(1 %) cystic arteries were anterior to cystic duct. Conclusion: The biliary and hepatic arteries had significant variations whilst gallbladder and cystic duct positions were relatively constant in laparoscopic cholecystectomy. Awareness of the variations in the extra hepatic biliary system and related vasculature will prevent the iatrogenic injury. 143
Biliary microlithiasis, sludge, crystals, microcrystallization, and usefulness of assessment of nucleation time
(Elsevier, 2010) Abeysuriya, V.; Deen, K.I.; Navarathne, N.M.
BACKGROUND: The process of microcrystallization, its sequel and the assessment of nucleation time is ignored. This systematic review aimed to highlight the importance of biliary microlithiasis, sludge, and crystals, and their association with gallstones, unexplained biliary pain, idiopathic pancreatitis, and sphincter of Oddi dysfunction. DATA SOURCES: Three reviewers performed a literature search of the PubMed database. Key words used were "biliary microlithiasis", "biliary sludge", "bile crystals", "cholesterol crystallisation", "bile microscopy", "microcrystal formation of bile", "cholesterol monohydrate crystals", "nucleation time of cholesterol", "gallstone formation", "sphincter of Oddi dysfunction" and "idiopathic pancreatitis". Additional articles were sourced from references within the studies from the PubMed search.RESULTS: We found that biliary microcrystals account for almost all patients with gallstone disease, 7% to 79% with idiopathic pancreatitis, 83% with unexplained biliary pain, and 25% to 60% with altered biliary and pancreatic sphincter function. Overall, the detection of biliary microcrystals in gallstone disease has a sensitivity ranging from 55% to 87% and a specificity of 100%. In idiopathic pancreatitis, the presence of microcrystals ranges from 47% to 90%. A nucleation time less than 10 days in hepatic bile or ultra-filtered gallbladder bile has a specificity of 100% for cholesterol gallstone disease.CONCLUSIONS: Biliary crystals are associated with gallstone disease, idiopathic pancreatitis, sphincter of Oddi dysfunction, unexplained biliary pain, and post-cholecystectomy biliary pain. Pathways of cholesterol super-saturation, crystallisation, and gallstone formation have been described with scientific support. Bile microscopy is a useful method to detect microcrystals and the assessment of nucleation time is a good method of predicting the risk of cholesterol crystallisation.
A cadaveric study on superior hypogastric plexuses
(The College of Surgeons of Sri Lanka, 2024) Abeysuriya, V.; Akalanka, H.G.L.; Kumarage, S.
INTRODUCTION The superior hypogastric plexus (SHP) is found around the level of aortic bifurcation. It is important in surgical procedures in the pelvis. Methods Ten (5; M & 5; F) fresh intact adult human cadavers were dissected. Following the initial dissection, all of them were further sectioned sagittal in the midline and separated in to half pelvises, and assessed. The study was carried out in the Department of Anatomy, Faculty of medicine Ragama, Sri Lanka from 2022 to 2024. The ethical clearance was obtained. RESULTS In all specimens, left connecting fibers from the inferior mesenteric plexuses (IMA) crossed the left common iliac artery and joining to the superior hypogastric plexuses. In 80%, right connecting nerve fibers from the inferior mesenteric plexuses crossed the right common iliac artery and joined the superior hypogastric plexus (SHP). Eighty percent of the specimens had, well-defined nerve strands, whereas 20% contained a delicate and irregular meshwork. In all of the specimens, the median root, or a nerve root from abdominal aortic plexus from the IMA were present. In 80% specimens, the SHP was located between the aortic bifurcation and the sacral promontory. In 20%, it extended across the pelvic brim and ended on the body of the S1 vertebra. CONCLUSION The majority of the SHP were located below the aortic bifurcation and had well-defined nerve strands, rest traversed the pelvic brim and terminated on the body of the S1 vertebra. Further larger sample studies are recommended.
The characteristics and long term outcome of patients with ST segment Elevation Myocardial Infarction (STEMI) following Percutaneous Transluminal Coronary Angioplasty (PTCA)
(University of Kelaniya, 2013) Abeysuriya, V.; Kasturiratne, A.; Chandrasena, L.G.; Hettiarachchi, V.S.; Wicremasinghe, A.R.
Introduction &Aims: To determine the characteristics and long term outcome of patients who had STEMI and were treated with PTCA. Method: A retrospective study was conducted among patients diagnosed with ST segment elevation myocardial infarction (STEMI) and treated with PTCA in a private hospital in Colombo from 1st January 2009 to 1st November 2012. Details of patients were abstracted from medical records of patients and the survival status, cause of death and date of death where relevant, were obtained from records, patients themselves or close relatives. Results: 197 patients (153 men; 77.7%) were enrolled. More than 50% had a history of diabetes, dyslipidemia or hypertension. Among the patients who had a history of smoking and alcohol consumption, 98% were men. 82.7 % (95% CI: 77.9% - 90.5%) of patients survived for 3 years. Based on Cox Proportional Hazardous model, site of arterial occlusion (proximal vs distal segment of left anterior descending artery [LAD] [HR 10.98; 95% CI: 1.096-110.205] was significantly associated with poor prognosis of patients. Low ejection fraction, not on regular medication and delay of more than 3 hours between onset to door time were independently (unadjusted) associated with poor long term outcome of patents who had coronary artery involvement other than the LAD artery. Conclusion: A high proportion of patients had traditional risk factors. The three year survival of patients was 83%. Patients with proximal LAD occlusion were 11 times more likely to die within 3 years of PTCA as compared to those who had a distal LAD occlusion.
Characteristics of menarche in adolescent girls in Sri Lanka
(Faculty of Medicine, University of Kelaniya & Plan International, 2008) Salgado, L.S.S.; Abeysuriya, V.; Wickremasinghe, A.R.
INTRODUCTION: Menarche is an important biological milestone in girls. The age at attainment of menarche is important for implementing programmes to improve the life skills of girls. OBJECTIVE: To describe the characteristics of menarche, the factors influencing the onset of menarche and to describe the knowledge, beliefs and practices during menarche of adolescent girls in Sri Lanka. Methods: This cross sectional study was conducted among girls 10-16 years of age in four schools situated in the Ragama Medical Officer of Health (MOH) area. Six hundred and sixty two girls were randomly selected and data were collected using a pre-tested, self-administered questionnaire. RESULTS: The median age of our sample was 13 years (range 10-16 years); the mean and median ages of attaining menarche were 12,53 and 11,48 years respectively. The mean BMI of girls who had attained menarche was 17.6 (SEM 0.22) Kg/m2 and those who did not was 16.92 (SEM 0.32) Kg/m2. 47% of the girls had a menstrual cycle length of e" 29 days, 23.4% had irregular cycles and 59% reported that the duration of bleeding was 3-5 days. First borns reported a IcJwer mean age at menarche (12.34 years) than the later borns (12.6 years) (p=0.02). Girls from single child families, who were from higher social categories (Categories 1 & 2) and whose parents were educated beyond 0/L attained menarche earlier. 40.8% stated that menstrual blood is not dirty, 70% admitted that there was no prohibition of having cold or sour foods. The majority of the students had adequate knowledge regarding physical changes during menarche. Girls experienced negative emotions during menstruation. CONCLUSION: The median age of attaining menarche is 11.48 years. Girls experienced negative emotions during menstruation.
Characteristics of patients admitted to an emergency treatment unit of a private sector hospital
(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2016) Abeysuriya, V.; Chandrasena, L.G.; Kasturiratne, A.; Senanayake, M.G.B.; Wickremasinghe, A.R.
BACKGROUND: Studies have highlighted that the private sector contributes a major share in outpatient healthcare and a small proportion in in-patient care in Sri Lanka. There is little or no information on private health sector emergency care. OBJECTIVES: To determine the socio-economic characteristics of patients admitted to an emergency treatment unit (ETU) in a private hospital in Colombo. METHODS: A descriptive cross sectional study was carried out on patients admitted to the ETU of a private hospital in Colombo from October 16th to December 15th 2015. Data were abstracted from medical records, verbal interviews, and the computerized data base maintained by the hospital. RESULTS: 2395 patients (1426 men; 59.2%) were admitted during the study period. The majority of patients were 61 to 70 years (30.4%). 80.3% were employed. 61.6% of patients had an insurance policy of which, 41.5% were private insurance policies. The monthly income ranged between Rs.15, 000 and Rs.150, 000 (mean Rs.43, 700±19,020). The commonest admissions were due to diseases of the digestive system (27.4%). Persons with an educational level of
Combination of cycle threshold time, absolute lymphocyte count and neutrophil:lymphocyte ratio is predictive of hypoxia in patients with SARS-CoV-2 infection
(Royal Society of Tropical Medicine and Hygiene, 2022) Abeysuriya, V.; Seneviratne, S.L.; de Silva, A.P.; Mowjood, R.; Mowjood, S.; de Silva, T.; de Mel, P.; de Mel, C.; Chandrasena, L.; Wijesinha, R.S.; Fernando, A.; de Mel, S.
Background: There is currently no clinically validated biomarker to predict respiratory compromise in sudden acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Cycle threshold time (Ct), absolute lymphocyte count (AL) and neutrophil:lymphocyte ratio (NLR) have been previously evaluated for this purpose. We hypothesized that the combination of these parameters at presentation may be predictive of hypoxia (oxygen saturation <92%). Methods: Data were collected on 118 patients with SARS-CoV-2 infection between May 2020 and April 2021. Demographics, clinical parameters and laboratory and radiological investigation results were recorded. Respiratory compromise (RC) was defined based on symptoms and signs, hypoxia and chest X-ray abnormalities. Results: RC occurred in 61 (51.7%) of patients. The Ct, AL and NLR at median day 3 of illness were significantly different between patients with and without RC (Ct, RC vs not: 19.46±2.64 vs 22.62±3.37, p=0.0001; AL, RC vs not: 531.49±289.09 vs 764.69±481.79, p=0.0001; NLR, RC vs not: 3.42±0.75 vs 2.59±0.55, p=0.0001). Receiver operating characteristics analysis showed that a Ct <19.9, AL <630.8×103/μL and NLR >3.12 at median day 3 of symptoms was predictive of hypoxia on day 7 of illness (area under the curve 0.805, sensitivity 96.7%, specificity 69.1%). The predictive value for the parameters combined was significantly superior to their individual predictive power. Conclusions: Ct, AL and NLR used in combination on day 3 of symptoms are predictive of hypoxia on day 7 of SARS-CoV-2 illness.
Composite carotid intima-media thickness as a risk predictor of coronary heart disease in a selected population in Sri Lanka
(Public Library of Science,, 2022) Abeysuriya, V.; Wijesinha, N.A.I.; Priyadharshan, P.P.; Chandrasena, L.G.; Wickremasinghe, A.R.
Background: Segment-specific variations of carotid intima-media thickness (CIMT) have not been assessed in South Asian populations. The purpose of this study was to determine if segment-specific CIMTs or a composite-CIMT score is a better risk predictor of coronary heart disease in South Asian populations. Methods: A comparative prospective study was conducted from November 2019 to October 2020 in a hospital in Colombo, Sri Lanka. Based on pre-defined inclusion and exclusion criteria, cases (having a diagnosis of Coronary Heart Disease (CHD), n = 338) and controls (non-CHD group, n = 356) were recruited. Ultrasound examination of the common carotid (CCA), the carotid bulb (CB) and the internal carotid segments (ICA) of the carotid vessels was conducted by a radiologist, and CIMTs were measured. A composite-CIMT score defined as the average value of all six segments of the left and right sides was derived. Results: 694 participants were enrolled (male n = 399, 57.5%). The mean (±SD) age of the study sample was 60.2 (±9.86) years. There were variations in segment-specific values between the left and right vessels. The mean composite-CIMT value of the CHD group was significantly higher than that of the non-CHD group. A composite-CIMT score of 0.758 had a sensitivity of 98.4% and a specificity of 64.6% in distinguishing CHD from non-CHD groups (Area under the curve (AUC): 0.926). Conclusions: Carotid artery segment-specific CIMT variations were present in this population. The composite CIMT score is better than segment-specific CIMTs in predicting CHD and may be used to predict CHD in this population.
Consumption pattern of iodised salt in households and serum TSH levels among 5-9 year old children in the plantation sector of Sri Lanka
(Sri Lanka Medical Association, 2012) Abeysuriya, V.; Wickremasinghe, A.R.; Perera, P.J.; Kasturiratne, A.
INTRODUCTION: Salt is the main source of iodine in areas with high rainfall and iodine deficiency is the main cause of preventable hypothyroidism. Iodisation of salt increases iodine intake, but will depend on how salt is handled. This study was carried out to assess the pattern of salt consumption in the estate population and to ascertain the relationship between household salt iodine concentration and TSH levels in children. METHODS: A descriptive cross sectional study was carried out in 20 randomly selected estates in the Ratnapura district of Sri Lanka, from August to November 2009. 1683 households with at least one child between 5-9 years were surveyed to determine patterns of salt usage. A salt sample from each household was tested for adequacy of iodine (concentration ≥30ppm). In phase two, 519 children were randomly selected from these households and serum TSH levels were assayed. RESULTS: Salt powder (54.5%) was preferred to salt crystals. Salt crystals were washed before use in 20% households. Salt was kept away from the fire-place in 90.4% of households. Salt samples of 88.7% households had an adequate iodine concentration. Salt iodine concentration was significantly lower when salt was stored near a fire-place and washed before use (p<0.001). The median TSH level of children from households with adequate salt iodine concentrations was significantly lower than that of children from households with inadequate salt iodine concentration (p<0.001). CONCLUSIONS: A significant number of households did not have adequate iodine in salt samples probably due to inappropriate handling and storage. Consumption of salt low in iodine is associated with high serum TSH levels
Cut off value of TSH for early prediction of poor neurodevelopment of 5 to 9 year old children in Sri Lanka
(Sri Lanka Medical Association, 2012) Abeysuriya, V.; Perera, K.P.J.; Kasturiratne, A.; Wickremasinghe, A.R.
INTRODUCTION AND AIMS: To assess the relationship between TSH and neuro-development of children between 5- 9 years of age and to identify the cutoff value of TSH for early prediction of poor neuro developmental outcome. METHODS: A descriptive cross sectional study was carried out in 20 randomly selected estates in the Ratnapura district of Sri Lanka from August to December 2010. A validated neurodevelopment assessment tool was used to assess the neuro-development of 1683 randomly selected children. Neuro¬development was expressed as a General Quotient (GQ) score and a score <100 was identified as evidence of poor neuro-development Of 1683 children screened, 519 were randomly selected with consent from the parents; blood was assayed for TSH using the 3rd generation TSH Chemiluminescent immunometric assay. ROC curve analysis was used to find out the cut off value of TSH that best predicts poor neuro¬development in children. RESULTS: Of 519 children whose TSH levels were assayed, 494 had TSH levels within the normal range between 0.60 to 5.40 ulU/ml, of whom 16% had a GQ score <100. There was a significant association between TSH levels and neuro-development [p=0.0001). The best cutoff value of TSH to predict a GQ score <100 was 1.5 p.IU/ml. [Area under cure=73.4%, sensitivity= 97.0% and specificity =70.6%). CONCLUSIONS: The best cutoff value of TSH for prediction of poor neuro-development in children 5 to 9 years of age is 1.50 p.IU/ml.