Browsing by Author "Dissanayake, A.S."

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Chronic alcoholism and esophageal motor activity: a 24-h ambulatory manometry study
(Blackwell Scientific Publications, 2006) Ferdinandis, T.G.H.C.; Dissanayake, A.S.; de Silva, H.J.
BACKGROUND: Stationary esophageal manometry has shown esophageal motor abnormalities in patients with chronic alcoholism. The abnormalities identified in different studies are not consistent. Twenty-four hour ambulatory esophageal manometry enables monitoring of esophageal motor activity under a variety of physiological conditions and gives a more complete assessment. METHOD: Twenty-four hour ambulatory esophageal manometry and pH-metry were performed using a combined pH and pressure catheter. Subjects with chronic alcoholism with no other illness and not in withdrawal were studied with age- and sex-matched healthy controls. Autonomic nerve functions tests were performed in all subjects. RESULTS: Twenty-three chronic alcoholic subjects and 12 control subjects completed the study. The median ethanol consumption was 95 g/day (range 75 -175 g/day) for 12 years (range 5-30 years) among alcoholic subjects. Eight alcoholic subjects had heartburn and regurgitation but none had dysphagia. Ten (43%) alcoholic subjects had autonomic neuropathy and four (17%) had increased gastroesophageal acid reflux. Lower esophageal sphincter hypertension was observed in alcoholic subjects with autonomic neuropathy. Esophageal body motility parameters (i.e. frequency, duration, amplitude and percentage of peristaltic waves) were not significantly different between alcoholic subjects and controls. CONCLUSIONS: Results of ambulatory esophageal manometry on subjects with chronic alcoholism seem to indicate that long-term ethanol intake has no major effects on esophageal motor activity other than lower esophageal sphincter hypertension among those with alcoholic autonomic neuropathy
Coconut fats
(Sri Lanka Medical Association, 2006) Amarasiri, W.A.D.L.; Dissanayake, A.S.
In many areas of Sri Lanka the coconut tree and its products have for centuries been an integral part of life, and it has come to be called the "Tree of life". However, in the last few decades, the relationship between coconut fats and health has been the subject of much debate and misinformation. Coconut fats account for 80% of the fat intake among Sri Lankans. Around 92% of these fats are saturated fats. This has lead to the belief that coconut fats are 'bad for health', particularly in relation to ischaemic heart disease. Yet most of the saturated fats in coconut are medium chain fatty acids whose properties and metabolism are different to those of animal origin. Medium chain fatty acids do not undergo degradation and re-esterification processes and are directly used in the body to produce energy. They are not as 'bad for health' as saturated fats. There is the need to clarify issues relating to intake of coconut fats and health, more particularly for populations that still depend on coconut fats for much of their fat intake. This paper describes the metabolism of coconut fats and its potential benefits, and attempts to highlight its benefits to remove certain misconceptions regarding its use.
Correlation between medical students approach to learning and per-formance in physiology examinations
(University of Kelaniya, Sri Lanka, 2004) Devanarayana, N.M.; Medagoda, K.; Rodrigo, U.; Jayasuriya, I.; Dissanayake, A.S.
Abstract available
Effect of carbohydrates meals for varying consistency on gastric myoelectrical activity
(Singapore Medical Association, 2002) Ferdinandis, T.G.H.C.; Dissanayake, A.S.; de Silva, H.J.
BACKGROUND: There is at present no agreement on the type of test meal to be used when performing EGG. To our knowledge the response of thestomach to high carbohydrate isocaloric meals of different consistencies has not been formally assessed. AIM: To study 1) the effects of high carbohydrate meals of varying consistency on EGG activity; and 2) the effects of increasing the calorie content of a meal without changing its consistency and composition on the postprandial EGG. SUBJECTS: Eighteen healthy volunteers, six males (age: 21-35 year, weight: 45-60 kg) and 12 females in the follicular phase of the menstrual cycle (age: 24-30 years, weight: 45-55 kg). METHODS: Following an overnight fast subjects were given three high carbohydrate, low fat, isocaloric meals (165-170 kcal) of different consistencies (solid, semisolid, liquid), on three separate days in a random order. The liquid and semisolid meals were equal in volume (200 ml) while the volume of the solid meal was smaller. One hour EGG recordings were done in the fasting and fed states in each subject. As a second step, ten of the above volunteers (taken randomly) were given the solid test meal on a separate day after increasing the calorie content of the meal to 350 kcal. RESULTS: The power of the EGG at the dominant frequency significantly increased after solid (175 kcal meal: fasting 49 +/- 12 dB vs. fed 57 +/- 13 dB; p < 0.05, 375 kcal meal: fasting 48.5 +/- 12.9 dB vs fed 58.1 +/- 11.7 dB) and semisolid (fasting 50 +/- 12 dB vs. fed 55 +/- 13; P < 0.05). The increase in power was not significantly different when fed with solids and semisolids. There was no statistically significant change in EGG power during the first 15 or 60 minutes after the liquid meal. Feeding showed no significant effect on the dominant frequency and the percentage of 2-4 cpm waves of the EGG with any of the three types of test meals. CONCLUSIONS: Solid and semisolid meals high in carbohydrate and low in fat are capable of inducing a significant increase in the EGG power in normal subjects. Isocaloric solid and semisolid meals have similar effects on gastric slow wave activity. EGG appears unaffected by the liquid meal. Therefore only an increase in the power of the EGG can be regarded as normal if a high carbohydrate solid or a semisolid meal is given as the test meal when performing an EGG.
Effect of pollution on health of residents in an industrial area in Sri Lanka
(American Medical Association, 2002) Premaratna, R.; Pathmeswaran, A.; Chandrasekara, B.; Dissanayake, A.S.; de Silva, H.J.
The authors conducted a cross-sectional comparative prevalence study to evaluate the effect of pollution on individuals who lived in an industrial zone in Sri Lanka. In this study, 81 male and female children who were 1-12 yr of age and 158 adults (51 males, 107 females) in the industrial zone were matched with 73 children (32 males, 41 females) and 146 adults (58 males, 88 females), respectively, who lived in a nonindustrialized area and whose ages were similar to those of the exposed individuals. The authors used a pretested questionnaire and a detailed clinical examination, including peak expiratory flow rate measurements, to assess the prevalence of illness. Children in the industrial area were 2.3 times more likely to have unexplained episodic cough (95% confidence interval [CI] = 0.98, 10.3) and 2.8 times more likely to have rhinitis (95% CI = 1.1, 7.1). The adult population was 2.1 times more likely to have unexplained episodic cough (95% CI = 1.13, 7.09), 3.7 times more likely to have unexplained headaches (95% CI = 2.2, 6.3), and adults had a significantly greater reduction in expiratory flow (peak expiratory flow rate = 446 - 92x [industrial area] + 91x [male] - 0.8x [years lived in the area]).
Effect of virgin coconut oil supplementation on cognition of individuals with mild-to-moderate alzheimer's disease in Sri Lanka (VCO-AD study): A randomized placebo-controlled trial
(IOS Press, 2023) Fernando, M.G.; Silva, R.; Fernando, W.M.A.D.B.; de Silva, H.A.; Wickremasinghe, A.R.; Dissanayake, A.S.; Sohrabi, H.R.; Martins, R.N.; Williams, S.S.
BACKGROUND: Virgin coconut oil (VCO) is a potential therapeutic approach to improve cognition in Alzheimer’s disease (AD) due to its properties as a ketogenic agent and antioxidative characteristics. OBJECTIVE: This study aimed to investigate the effect of VCO on cognition in people with AD and to determine the impact of apolipoprotein E (APOE) ɛ4 genotype on cognitive outcomes. METHODS: Participants of this double-blind placebo-controlled trial (SLCTR/2015/018, 15.09.2015) were 120 Sri Lankan individuals with mild-to-moderate AD (MMSE = 15-25), aged > 65 years, and they were randomly allocated to treatment or control groups. The treatment group was given 30 mL/day of VCO orally and the control group, received similar amount of canola oil, for 24 weeks. The Mini-Mental Sate Examination (MMSE) and Clock drawing test were performed to assess cognition at baseline and at the end of the intervention. Blood samples were collected and analyzed for lipid profile and glycated hemoglobin (HbA1 C) levels.∥ RESULTS: There were no significant difference in cognitive scores, lipid profile, and HbA1 C levels between VCO and control groups post-intervention. The MMSE scores, however, improved among APOE ɛ4 carriers who had VCO, compared to non-carriers (2.37, p = 0.021). APOE ɛ4 status did not influence the cognitive scores in the control group. The attrition rate was 30%.∥ CONCLUSION: Overall, VCO did not improve cognition in individuals with mild-to-moderate AD following a 24-week intervention, compared to canola oil. However, it improved the MMSE scores in APOE ɛ4 carriers. Besides, VCO did not compromise lipid profile and HbA1 C levels and is thus safe to consume.
Electrogastrographic observations in healthy adults
(Sri Lanka Medical Association, 1998) Ferdinandis, T.G.H.C.; Dissanayake, A.S.; de Silva, H.J.
INTRODUCTION : Electrogastrography (EGG) is a recently developed non invasive technique of recording gastric myoelectrical activity. Normal values of EGG parameters are yet to be clearly defined. There are suggestions that the values may vary due to factors such as gender and ethnicity. AIM : To determine normal values for several EGG parameters in healthy Sri - Lankan volunteers in the fasting and fed state, and we also hypothesized that, there are significant differences in these between the two sexes. METHOD : EGG was performed in 17 healthy volunteers, 8 males(age 21 -60 yr.) and 9 females(age 24 - 46 yr.) in the follicular phase for one hour each in the fasting and the fed states. Result were analyzed using the statistical package Epilnfo. RESULTS : The mean gastric electrical frequency was 2.65 + 0.67 cpm in the fasting and 2.69 + 0.75 in the fed state. The dominant frequency was in the 2 -4 cpm range in 15 (88.2%) subjects in the fasting and in 14(87.5%) in the fed state respectively. These differences were not statistically significant. Feeding caused an increase in the power of the dominant frequency by 19 - 4600 uV2 in 12(75%) subjects. The above results did not differ significantly between the two sexes. CONCLUSIONS : The dominant gastric electrical frequency in Sri Lankans was consistent with previously reported data from other countries. Increase in EGG power after a solid meal was confirmed by the study. Although a gender difference in EGG parameters has been reported previously, our reports failed to demonstrate such a difference.
Electrogastrography (EGG) and gastric motility: an investigation to evaluate gastric emptying in those who undergo oesophago -gastric anastomosis without a pyloroplasty
(Sri Lanka Medical Association, 1998) Samarasekera, D.N.; Suraweera, P.H.R.; de Silva, H.J.; Dissanayake, A.S.
INTRODUCTION: EGG is a non-invasive technique of recording gastric myoelectrical activity by placing electrodes on the abdomen. Objectives : The aim of this study was to assess the myoclcctrical activity of the stomach following ocsophago-gastric anastomosis without a pyloroplasty and also to correlate the values with those who develop symptoms of gastric stasis. DESIGN,SETTING AND METHODS : We present the initial results of an ongoing study. EGG results of six patients (M:F=5: 1) with carcinoma of the oesophagus who underwent transhiatal oesophagectomy were analysed. Mean age was 56y (range 45-76). EGG was performed preoperatively and three months after surgery using computerised digitrapher EGG (Syncctics, UK). One patient complained of symptoms of gastric stasis and reflux and did not respond to therapy with prokinetic agents. She underwent subsequent pyloroplasty and is asymptomatic at present. RESULTS : All patients showed normal preoperative myoelectrical activity (mean - + 131.17 mv) and motility. Postopcratively all patients showed bradygastria and low myoelectrical activity. Postoperative myoelectrical activity in the asymptomatic group showed a value which was positive (mean - +94.12mv) compared to the symptomatic patient who had a persistent mean negative value (- 89.34 mv). CONCLUSIONS : Persistent negative amplitude in the EGG postoperatively may indicate severe gastric stasis. This may be due to poor contractiliy of the denervatcd stomach in some patients. Therefore pyloroplasty should be considered before these patients develop complications of stasis and reflux.
Is problem based learning (PBL) a way forward in undergraduate medical education? Results of a pre & post PBL assessment?
(University of Kelaniya, Sri Lanka, 2003) Athukorala, A.D.S.P.K.; Devanarayana, N.M.; Medagoda, K.; Ferdinandis, H.; Dissanayake, A.S.; de Silva, D.C.
Abstracts available
Nutrition of patients with mild-to-moderate Alzheimers disease using the Mini Nutritional Assessment (MNA)
(Sri Lanka Medical Association., 2019) Fernando, M.G.; Silva, K.D.R.R.; de Silva, M.P.; Obadaarachchi, L.N.; Yalegama, L.L.W.C.; Dissanayake, A.S.; Williams, S.S.
INTRODUCTION & OBJECTIVES: Focus on the nutrition of patients with Alzheimer's disease is limited despite the need for optimization of overall patient health to improve well being and outcome. The objective of this study was to look at the nutrition and energy intake of patients with mild to moderate dementia. METHODS: Sixty patients with mild-to-moderate AD (Mini Mental State Examination score: 12-25; male:28; female: 32; age >65 years) were recruited from the clinics at the North Colombo Teaching Hospital, Ragama and Lanka Alzheimer's Foundation as part of the VCO-AD study, after informed consent. Baseline nutritional status was assessed by a Mini Nutritional Assessment (MNA) tool and dietary intake via a 24-hour dietary recall. RESULTS: The total energy intake of the study population (men: 1822±645 kcal/day, women: 1380±346 kcal/day) was lower than recommended standards. The percentage energy from fat, protein and carbohydrates (30.7±7.6%, 12.7±2.7%, and 56.8±8.7%, respectively) met recommendations. The energy intake from saturated fat (19.7±6.9%) however was higher than the recommendation. Vitamin C, D, E, folate, calcium, potassium, selenium and iodine intake (37.4±30.4 mg/day, 2.2±3.1 µg/day, 2.4±1.4 mg/day, 219±125 µ/day, 483.8±230.8 mg/day, 1853.9±590.8 mg/day, 38.1±22.7 µg/day, and 59.8±35.4 µg/day respectively) was lower than the estimated average requirements (EAR). MNA results showed that 20% were at risk of malnutrition. CONCLUSION: A higher saturated fat intake and lower vitamin intake were concerns in this population of patients with mild to moderate dementia.