Browsing by Author "Atulugama, N."

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Epidemiology of goitres in Sri Lanka - results of a community based study
(Sri Lanka Medical Association, 2008) Fernando, R.; Pathmeswaran, A.; Edirisinghe, D.; Abeysinghe, S.; Atulugama, N.; Bandara, D.; Premathileke, M.
BACKGROUND: lodization of salt was made mandatory in Sri Lanka in 1995. Data on the current prevalence and geographic distribution of goitre among the general population is not available. Objectives: To describe the epidemiology of goitre in the population over the age of 10 years in Sri Lanka DESIGN, SETTING AND METHODS: The country (excluding the Northern Province) was divided into 6 ecological zones based on annual rainfall and altitude. From each zone, 18 Grama Niladhari (GN) areas were selected, using the probability proportionate to size (PPS) technique. First household to be sampled was selected at random from the list maintained by the midwife and all eligible people in the house were sampled. The closest household, next to the index household,, was visited and sampling carried out next. The process was repeated until 50 subjects were sampled in a GN area. Each subject was examined by at least two researchers for the presence of a goitre. RESULTS: Total of 5200 subjects were assessed. 66 %( 3,433) were females. Mean (SD) age 36.3(17.3) years. 425 subjects had a goitre. The distribution of goitres according to the WHO categorization - Grades 1, 2, 3 and 4 was 18.6, 68.0, 12.5 and 0.9 percent respectively. Adjusted (age and zone) prevalence among females and males was 11.2% and 2.3% respectively. Adjusted (age and sex) prevalence (95% CI) in the different zones varied between 5.34% in the intermediate zone-south to 7.93% in the wet zone-hills. Overall adjusted prevalence was 6.8% (6.0-7.6). CONCLUSIONS: The prevalence of goitres is 6.8%. There is definite female preponderance. No obvious goitre belt can be discerned.
FNAC in the 'field'- a new experience
(Sri Lanka Medical Association, 2008) Fernando, R.; Hewavisenthi, J.; Pathmeswaran, A.; Edirisinghe, D.; Abeysinghe, S.; Atulugama, N.; Bandara, D.; Premathileke, M.
BACKGROUND: Fine needle aspiration cytology (FNAC) is an important diagnostic test in thyroid diseases. It usually is undertaken at a hospital or laboratory setup. As part of an islandwide field based study, FNAC was undertaken in the field. Literature review revealed that FNAC accuracy rate was around 65-70% in most Centres with full-fledged facilities. OBJECTIVES: To determine the effectiveness of FNAC done in the field DESIGN, SETTING AND METHODS: Informed written consent was obtained and the goitre was delineated with a marker pen. FNAC was carried out by a trained team member in the standard manner. Four slides were prepared from each patient. All slides were processed and examined by a cytologist RESULTS: 308 FNAC were done. 226 FNAC were diagnostic (73.36%) and 82(26.64%) were non diagnostic. 62(23.8%) showed benign cells only. The pathological entities detected were: 112 (49.5%) auto immune thyroiditis, 32 (14.1%) colloid storing nodules, 14(6.1%) colloid storing nodules with autoimmune thyroiditis, 5 (2.2%) follicular lesions and one toxic lesion. There were no significant complications noted in any of the patients. CONCLUSIONS: Field FNAC has a high diagnostic accuracy if done by a trained person. It is a safe procedure in the field.
Short and medium term glycaemic control after pancreaticoduodenectomy
(College of Surgeons of Sri Lanka, 2016) Siriwardana, R.C.; Bandara, L.M.P.M.; Atulugama, N.; Gunetilleke, M.B.; Ekanayake, C.S.
Introduction: Perioperative outcomes of pancreaticoduodenectomy (PD) have improved over the years. Glycaemic control in longterm survivors is a matter of concern. Materials and methods: 48 surviving patients of 66 patients who underwent Whipple surgery from 2011 to 2015 were evaluated. Patients with recurrences, who had chemotherapy within three months and patients who had not completed a minimum six months follow-up were excluded. 25 patients were selected. Patients' demographic data, HbA1c level, fasting blood sugar level, physical activity index and waist to hip ratio were calculated. Volume of the pancreatic specimen was calculated. Non diabetics underwent oral glucose tolerance test (OGTT). Results: There were 6 (24%) pre-existing diabetics, 3 new onset diabetics and two patients with impaired glucose tolerance (20%). Median preoperative BMI, body fat distribution, calculated median pancreatic volumes resected or underlying pancreatic pathology did not differ in diabetic and non-diabetic groups. In non-diabetics, HbA1c level or two hour OGTT did not associate with age, preoperative BMI, waist to hip ratio and resected pancreatic volumes. Conclusion: Significant proportion of patients develop diabetes immediately after PD. Reliable prediction of this group pre-operatively is difficult due to many interacting, confounding factors. They need close monitoring in immediate perioperative period.
Thyroid volume in a cohort of Sri Lankan patients: a preliminary report
(Sri Lanka Medical Association, 2010) Fernando, R.; Bandara, D.M.S.M.; de Silva, A.; Renuka, M.D.S.; Atulugama, N.
No Abstract Available