Browsing by Author "Devi, S."

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Causes, complications and short-term outcome of acute Kidney injury in a resource-limited setting
(SAGE-Hindawi Access to Research, 2024-12) Herath, N.; De Silva, S.; Liyanage, P.; Kumara, S.; Devi, S.; Abeysekara, V.; Mallawarachi, R.; Perera, S.; Karunathilaka, I.; Samarasinghe, S.; Weerakoon, K.
AIMS The outcome of acute kidney injury (AKI) depends on causes, patient factors and care received. We studied the causes, complications and 90-day outcomes of patients with AKI at a tertiary referral centre in Sri Lanka. METHODS Patients aged 18 years or older with AKI referred to nephrology services were analysed retrospectively. AKI severity was assessed using the KDIGO classification. Information was gathered from hospital and clinic records. RESULTS Of the 464 patients studied, 262 (56.5%) were males. The mean age of the study sample was 57.04 (SD 16.85) years. The majority (212-45.69%) were discharged with normal renal functions, 173 (37.28%) were discharged with impaired functions, and 79 (17.03%) died during hospital stay. There were 377 patients at 3 months follow-up; 331 (87.8%) had normalised renal function, 40 (10.6%) had not recovered fully and 6 (1.6%) had succumbed. Progression of AKI to chronic kidney disease or death was significantly high in patients aged > 60 years (p=0.017). More severe AKI was associated with type 2 diabetes (p=0.0042), hypertension (p < 0.0001) and multiple comorbidities (p=0.0014). Persons with no comorbidities had less severe AKI (p=0.0004). Even in the early stages of AKI, there was significantly high mortality (11% in AKI stages 1 and 2) which doubled in stage 3 (22%). Mortality was low in patients with prerenal causes of AKI (OR: 0.59, 95% CI: 0.35-0.99 and p=0.047). CONCLUSIONS AKI in elderly and comorbid patients has high morbidity and mortality. Identification of individuals who are at high risk of developing AKI is important for its prevention, early diagnosis and proper treatment. Limitations in infrastructure, manpower, local research, reporting and recording of AKI are key challenges in providing optimal care for AKI in Sri Lanka.
Prediction equation for physical activity energy expenditure in 11-13-year-old Sri Lankan children
(MDPI Publishing, 2023) Dabare, P.; Wickramasinghe, P.; Waidyatilaka, I.; Devi, S.; Kurpad, A.V.; Samaranayake, D.; de Lanerolle-Dias, M.; Wickremasinghe, R.; Hills, A.P.; Lanerolle, P.
This study aimed to develop a regression equation to predict physical activity energy expenditure (PAEE) using accelerometry. Children aged 11-13 years were recruited and randomly assigned to validation (n = 54) and cross-validation (n = 25) groups. The doubly labelled water (DLW) technique was used to assess energy expenditure and accelerometers were worn by participants across the same period. A preliminary equation was developed using stepwise multiple regression analysis with sex, height, weight, body mass index, fat-free mass, fat mass and counts per minute (CPM) as independent variables. Goodness-of-fit statistics were used to select the best prediction variables. The PRESS (predicted residual error sum of squares) statistical method was used to validate the final prediction equation. The preliminary equation was cross-validated on an independent group and no significant (p > 0.05) difference was observed in the PAEE estimated from the two methods. Independent variables of the final prediction equation (PAEE = [0.001CPM] - 0.112) accounted for 70.6% of the variance. The new equation developed to predict PAEE from accelerometry was found to be valid for use in Sri Lankan children.
Validation of accelerometer-based energy expenditure equations using doubly-labelled water technique in 11-13 year-old Sri Lankan children
(Sri Lanka College of Paediatricians, 2021) Dabare, P.M.; Wickramasinghe, P.; Waidyatilaka, I.; Devi, S.; Kurpad, A.V.; Samaranayake, D.; de Lanerolle-Dias, M.; Wickremasinghe, R.; Hills, A.P.; Lanerolle, P.
INTRODUCTION: Accelerometer based prediction equations are used to calculate physical activity energy expenditure (PAEE) among children. Currently, accelerometer-derived PAEE prediction equations validated against a criterion method do not exist for Sri Lankan children. Objective: To assess the validity of published prediction equations to estimate PAEE in Sri Lankan children against the doubly labelled water (DLW) technique. Method: Ninety-six children aged 11-13 years from an urban area of Sri Lanka were included in the study. Energy expenditure was assessed using the DLW technique over 10 days and participants wore ActiGraph accelerometers during the same period. Correlation between the measured and predicted PAEE was assessed by the Pearson correlation coefficient. Validity of equations was assessed by the paired t-test and the level of agreement using the Bland Altman analysis. Results: Predicted PAEE values were significantly (p<0.05) correlated with the measured PAEE except for the equations of Treuth and Schmitz. Prediction equations of Ekelund, Freedson, Mattock and Zhu significantly overestimated measured PAEE (p<0.05) whereas, Trost and Puyau equations significantly underestimated PAEE. A wide limit of agreement with a large mean bias was observed in all estimated PAEE, except for the equation of Zhu. Conclusions: Existing accelerometer-based PAEE equations have low accuracy in predicting PAEE in Sri Lankan children.