Browsing by Author "Gunawardena, S."

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Autonomic functions and gastric motility in children with functional abdominal pain disorders
(WJG Press, 2019) Karunanayake, A.; Rajindrajith, S.; de Silva, H.A.; Gunawardena, S.; Devanarayana, N.M.
BACKGROUND: Abdominal pain-predominant functional gastrointestinal disorders (AP-FGIDs) are the most common cause of recurrent abdominal pain in children. Despite its high prevalence, the underlying pathophysiology of this condition is poorly understood. AIM: To assess the role of gastric dysmotility and autonomic nervous system dysfunction in the pathophysiology of AP-FGIDs. METHODS: One hundred children, fulfilling Rome III criteria for AP-FGIDs, and 50 healthy controls, aged 5 to 12 years, were recruited after obtaining parental consent. All patients were investigated for underlying organic disorders. Gastric motility and cardiovascular autonomic functions were assessed using validated non-invasive techniques. RESULTS:The main gastric motility parameters assessed (gastric emptying rate [45.7 vs 59.6 in controls], amplitude [48.7 vs 58.2], frequency of antral contractions [8.3 vs 9.4], and antral motility index [4.1 vs 6.4]) were significantly lower in children with AP-FGIDs (P < 0.05). The post-prandial antral dilatation at 1 min after the test meal significantly correlated with the severity of abdominal pain (P < 0.05). Assessment of autonomic functions in AP-FGID patients showed neither a significant difference compared to the control group, nor a correlation with gastric motility abnormalities (P > 0.05). The duration of pain episodes negatively correlated with the parasympathetic tone (maladaptive parasympathetic tone) (P < 0.05).CONCLUSION: Children with AP-FGIDs have abnormal gastric motility but normal cardiovascular autonomic functions. There is no relationship between abnormal gastric motility and autonomic functions. The pathogenesis of AP-FGIDs is not related to cardiovascular autonomic dysfunction.
Difficulties faced by Undergraduates of Local Universities in reading for their degrees in English medium
(Department of English, Faculty of Humanities, University of Kelaniya, Sri Lanka, 2016) Sathanandan, R.; Situbandara, S.N.B.A.; Gunasinghe, D.P.D.D.; Gunasekara, M.S.T.; Navarathne, D.M.A.S.; Gunawardena, S.
The difficulty faced by undergraduates reading in English medium is a recurrent issue in Sri Lanka. After one’s tertiary education the next step is occupation. In the present context it is important for everyone to be well versed in English. Even after thirteen years of school education, most of the students have not yet gained the required proficiency in English. Until now the reasons behind this issue and solutions have not been found out. A questionnaire was distributed amongst 40 students of three faculties, including close-ended and open-ended questions in Sinhala and English. During the process of this research many articles were dwelt upon with regard to this topic, which helped in understanding the underlying causes to this impending issue. Focus was also given on the socio-economical background of the students and the methodology of lectures. The data collected from the questionnaire helped in understanding the following; most students in local universities are accustomed to their vernacular language and are unfamiliar with English. It is during lectures that they are taught in English, which many students fail to handle due to their unfamiliarity of the language. As a result many students fail their degree or lose interest in the subject. It was recommended by the students themselves that improved teaching methods must be conducted from their primary education. Language must not be a barrier for education.
The effect of 6-week core stability training on core endurance and physical performance in professional rugby players: A randomized controlled pilot study
(Nepal Journal online, 2021) Senavirathna, C.S.; Mallawaarachchi, A.P.; Karunanayake, A.L.; Gunawardena, S.
BACKGROUND: Core stability training (CST) is used to enhance sports performance. The relationship between core endurance and physical performance in rugby players had not been evaluated before in Asia. AIMS AND OBJECTIVES: This study aims to determine the effects of a 6-week specific CST program on the core endurance and physical performances (speed, upper body power, lower body power, and agility) following a CST intervention in male rugby players. MATERIALS AND METHODS: Professional rugby players (n=8, intervention and n=8, control) were randomly selected. Mean (SD) age, height and weight of intervention group were 25.25 (2.4) years, 1.64 (0.03) m, and 69.6 (14.9) kg, respectively. In the control group, corresponding values were 29.75 (4) years, 1.66 (0.04) m, and 72.3 (19.1) kg, respectively. Intervention group was trained CST sessions complementary to the usual physical training, 3 times/week for 6 weeks. The control group followed the usual physical training. Subjects were tested for four physical performances (using 40 m sprint, vertical jump, 3 kg medicine ball put, and agility T tests) and four core endurance tests (back extension, abdominal fatigue [AF], and left and right bridges). RESULTS: AF, left bridge, right bridge, and total core endurance were significantly increased in the intervention group (P=0.028, P=0.006, P= 0.008, and P=0.001, respectively). Agility and AF were increased significantly in the control group (P=0.048, P=0.027). The right side bridge endurance (P=0.024) was significantly increased in the intervention group compared to the control group. CONCLUSION: The results suggest that the CST improves core endurance without improving physical performances in rugby players
Extrathymic T cells in human malaria patients
(Elsevier, 1998) Watanabe, W.; Weerasinghe, A.; Miyaji, C.; Sekikawa, H.; de Silva, N.R.; Gunawardena, S.; Ratnayake, H.; Kobayashi, J.; Thoma, H.; Sato, Y.; Abo, T.
Integrated school-based surveillance for soil-transmitted helminth infections and for lymphatic filariasis in Gampaha district, Sri Lanka
(American Society of Tropical Medicine and Hygiene, 2013) Gunawardena, N.K.; Gunawardena, S.; Kahathuduwa, G.; Karunaweera, N.D.; de Silva, N.R.; Ranasinghe, U.S.; Rao, R. U.; Rebollo, M.; Weil, G. J.
The Sri Lankan Anti-Filariasis Campaign (AFC) conducted 5 rounds of annual mass drug administration (MDA) with albendazole and DEC in 2002-2006 in 8 districts that were endemic for lymphatic filariasis (LF) (target population approximately 10 million). AFC conducted transmission assessment surveys (TAS) in 2012, about 6 years after the last round of MDA. This study explored the practicality of integrating surveillance for soil transmitted helminth (STH) infections with TAS for LF in Gampaha district (population 2.3 million). The district was divided into two Evaluation Units (EUs), coastal and inland. Each TAS tested 1st and 2nd grade school children drawn from 30 randomly selected schools (N=1,462 inland, 1,642 coastal). Tests included the ICT card test for filarial antigenemia (performed by AFC personnel) and the Kato-Katz test for detection of STH ova (performed by university personnel). ICT rates were 0% and 0.1% (0.01-0.3% CI) in the inland and coastal EUs, respectively. These results suggest that LF transmission rates are very low in Gampaha District. The STH survey was conducted at the same time as the TAS in the inland EU (955 stools from 1,211 children) and several weeks after the TAS in the coastal EU (927 stools from 1,586 children). STH infection rates and stool sample participation rates were 0.8% and 79% in the inland EU and 2.8% and 58% in the coastal EU. Most of the STH infections detected were lowintensityTrichuris (present in 73% of positive stools). The low STH rates are probably due to the country’s national school deworming program (mebendazole in grades 1, 4, and 7) and relatively good sanitation in Gampaha district. The cost for STH testing was approximately $5,000 per EU. These results suggest that it is feasible for national NTD programs to integrate school based surveillance for STH and LF. Further work is needed to streamline procedures and to determine optimal sampling strategies for STH surveys, because these may not require as many samples or sampling sites as TAS.
Integrated school-based surveillance for soil-transmitted helminth infections and lymphatic filariasis in Gampaha district, Sri Lanka
(American Society of Tropical Medicine and Hygiene, 2014) Gunawardena, S.; Gunawardena, N.K.; Kahathuduwa, G.; Karunaweera, ND.; de Silva, N.R.; Ranasinghe, U.B.; Samarasekara, S.D.; Nagodavithana, K.C.; Rao, R.U.; Rebollo, M.P.; Weil, G.J.
We explored the practicality of integrating surveillance for soil-transmitted helminthiasis (STH, assessed by Kato-Katz) with transmission assessment surveys for lymphatic filariasis (LF) in two evaluation units (EUs) in Gampaha district, Sri Lanka (population 2.3 million). The surveys were performed 6 years after five annual rounds of mass drug administration with diethylcarbamazine and albendazole. Each transmission assessment survey tested children (N = 1,462 inland EU; 1,642 coastal EU) sampled from 30 primary schools. Low filarial antigenemia rates (0% and 0.1% for the inland and coastal EUs) suggest that LF transmission is very low in this district. The STH rates and stool sample participation rates were 0.8% and 61% (inland) and 2.8% and 58% (coastal). Most STH detected were low or moderate intensity Trichuris trichiura infections. The added cost of including STH testing was ∼$5,000 per EU. These results suggest that it is feasible to integrate school-based surveillance for STH and LF
Randomized controlled clinical trial on value of domperidone in functional abdominal pain in children
(Lippincott Williams & Wilkins, 2018) Karunanayake, A.; Devanarayana, N.M.; de Silva, A.; Gunawardena, S.; Rajindrajith, S.
OBJECTIVES: The aim of the study was to evaluate the therapeutic effect of domperidone on children with abdominal pain predominant functional gastrointestinal disorders (AP-FGIDs). METHODS: One hundred children (aged 5-12 years) fulfilling Rome III criteria for AP-FGIDs were randomized into 8 weeks of domperidone or placebo treatment. Primary outcomes defined were cure and patient-reported general improvement. Secondary outcomes were reduction in the severity of abdominal pain and increase in gastric motility. Patients were followed up for 6 months. RESULTS: Eighty-nine (42 in placebo group, 47 in domperidone group) completed the trial at 8 weeks. Seventy-nine completed the 6-month follow-up. When primary outcomes were assessed at 8 weeks, 37 (74%) in the domperidone group and 25 (50%) in the placebo group showed patient-reported general improvement (P = 0.013), whereas no significant difference was observed in cure (22 [44%] vs 14 [28%] P = 0.09). At 6-month follow-up 30 (60%) in the domperidone group and 19 (38%) in the placebo group reported cure (P = 0.028), whereas 44 (88%) in the domperidone group and 33 (66%) in the placebo group showed patient-reported general improvement (P = 0.009). When assessing secondary outcomes at 8 weeks, the domperidone group reported significant reduction in the severity of abdominal pain (54.1% vs 24.7%, P = 0.008) and an increase in the antral motility index (27.5% vs 7.2%, P = 0.029). None of the patients reported intervention-related adverse effects. CONCLUSIONS: Domperidone may be a safe and effective therapeutic modality to achieve a lasting remission of symptoms in children with AP-FGIDs.
Reassessment of the prevalence of soil-transmitted helminth infections in Sri Lanka to enable a more focused control programme: a cross-sectional national school survey with spatial modelling
(Elsevier, 2019) Ediriweera, D.S.; Gunawardena, S.; Gunawardena, N.K.; Iddawela, D.; Kannathasan, S.; Murugananthan, A.; Yahathugoda, C.; Pathmeswaran, A.; Diggle, P. J.; de Silva, N.
BACKGROUND:In Sri Lanka, deworming programmes for soil-transmitted helminth infections became an integral part of school health in the 1960s, whereas routine antenatal deworming with mebendazole started in the 1980s. A 2003 national soil-transmitted helminth survey done among schoolchildren found an overall prevalence of 6·9%. In our study, we aimed to reassess the national prevalence of soil-transmitted helminth infections to enable implementation of a more focused control programme that targets smaller administrative areas at risk of continued transmission.METHODS:We did a cross-sectional, school-based, national survey using multistage stratified cluster sampling, covering all nine provinces as well as populations at high risk of soil-transmitted helminth infections living in urban slums and in plantation-sector communities. Our study population was children aged 5-7 years attending state schools. Faecal samples were collected and analysed with duplicate modified Kato-Katz smears. We modelled the risk of soil-transmitted helminth infection using generalised linear mixed-effects models, and we developed prevalence maps to enable informed decision making at the smallest health administrative level in the country.FINDINGS:Between Jan 23 and May 9, 2017, we recruited 5946 children from 130 schools; 4276 (71·9%) children provided a faecal sample for examination. National prevalence of soil-transmitted helminth infection was 0·97% (95% CI 0·63-1·48) among primary schoolchildren. Prevalence in the high-risk communities surveyed was higher than national prevalence: 2·73% (0·75-6·87) in urban slum communities and 9·02% (4·29-18·0) in plantation sector communities. Our prevalence maps showed that the lowest-level health administrative regions could be categorised into low risk (prevalence <1%), high risk (prevalence >10%), or intermediate risk (1-10%) areas.INTERPRETATION:Our survey findings indicate that the national prevalence of soil-transmitted helminth infection has continued to decline in Sri Lanka. On the basis of WHO guidelines, we recommend discontinuation of routine deworming in low-risk areas, continuation of annual deworming in high-risk areas, and deworming once every 2 years in intermediate-risk areas, for at least 4 years.FUNDING:Task Force for Global Health and WHO.
Use of fiber optic goniometer to objectively assess the angle and reflex time of knee jerk in professional rugby players
(Edizioni Minerva Medica, 2022) Senavirathna, C.S.; Gunawardena, S.; Karunanayake, A.L.; Mallawaarachchi, A.P.
BACKGROUND: Rugby, being a contact and collision game, results in sudden application of forces on lower limb muscles which may injure them unless an immediate reflex contraction of the muscle occurs. This study aimed to assess the knee jerk reflex parameters of professional rugby players. METHODS: Knee jerk parameters (latency, peak time, total duration, relaxation time and angle) of rugby players were assessed. The angle was measured by a bipolar joint angle sensor in the fiber optic goniometer. An electronic tendon hammer was used to elicit the knee jerk. These instruments were connected to a data acquisition hardware and data were recorded on LabChart 8 software (AD Instruments,Sydney,Australia).RESULTS: Mean (SD) of age, height, weight and BMI were 27.4 (3.9) years, 1.72 (0.07) m, 83.4 (14) kg and 27.8 (4.3), respectively (N.=59). There is no correlation between BMI and reflex parameters (P>0.05 for all parameters). Knee jerk parameters from left and right sides did not show a statistically significant difference (P>0.05). Similarly, there was no statistically significant difference between the dominant and non-dominant sides. Individual parameters measured in right side showed a significant correlation (P<0.01) to their counterparts from the left. Latency showed a negative correlation with other parameters from the same leg while other parameters showed a positive correlation between each other. CONCLUSIONS: A fiber optic electronic goniometer and an electronic tendon hammer along with data acquisition hardware and software can be used to objectively measure knee jerk parameters of rugby players.