Browsing by Author "Hasan, R."

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Accessory muscle in the flexor compartment of the forearm: A case report
(Book of Abstracts, Annual Research Symposium 2019, 2014) Hasan, R.; Fernando, E.D.P.S.; Salvin, K.A.; Dilshani, W.M.S.; Niwunhella, N.A.D.P.; Perera, A.A.M.M.S.L.; Wijesundara, W.M.R.D.
A wide array of supernumerary and accessory musculature has been described in anatomical, surgical and radiological literature. Awareness of potential muscular variations is essential for anatomists, surgeons and clinicians in numerous areas of medical field.
Anatomical dimension of the Caudate lobe of the liver
(University of Kelaniya, 2011) Widanagama, M.A.; Prabodha, L.B.L.; Palahepitiya, K.N.; Nanayakkara, B.G.; Ilayperuma, I.; Hasan, R.
On the posterior surface of the liver, the Caudate lobe lies between the inferior vena cava and the fissure for the ligamentum venosum. It is connected to the right lobe of the liver by the Caudate process. However, functionally it belongs to the left lobe. In left hepatic lobectomy, the left lobe together with most of the Caudate lobe is removed. Furthermore, the diameters of right lobe and Caudate lobe have been used to distinguish between the normal and cirrhotic livers. This study was carried out to establish the anatomical dimensions of the Caudate lobe in a group of adult Sri Lankans. A total of 26 apparently healthy livers obtained from formalin fixed cadavers were studied. The Caudate lobe was measured along its maximum antero-posterior and transverse diameters using a sliding caliper capable of measuring to the nearest 0.01 mm. Maximum transverse diameter of the right lobe of the liver was taken to compare the ratio between the right lobe and the Caudate lobe. The mean maximum antero-posterior and transverse diameters of the Caudate lobe was 51.6 ± 4.6 mm and 27.6 ± 4.5 mm respectively. The transverse diameter of the right lobe was 85.05± 13.2 mm. The mean ratio of the transverse diameter of the Caudate lobe to that of the right lobe was found to be 0.32 ± .06. The results of the study demonstrate the anatomical dimensions established for the Caudate lobe for a group of adult Sri Lankan population. These data will facilitate in improving the outcome of surgical procedures of the liver.
Anatomical dimensions of the portal vein: A cadaver study
(12th Annual Research Symposium, University of Kelaniya, 2011) Pinsara, G.H.M.; Palahepitiya, K.N.; Nanayakkara, B.G.; Ilayperuma, I.; Hasan, R.
The portal vein is formed by union of the superior mesenteric and splenic veins. It lies in front of the inferior vena cava and runs vertically upwards in the free edge of the lesser omentum finally reaching the porta hepatis. In liver transplantation and pancreatectomy, a length of portal vein is removed for anastomose with the recipient vessels. A complete knowledge of the anatomic variations in portal venous anatomy is an essential prerequisite for the outcome of these procedures. Despite the significance of the portal vein little is known about its dimensions in Sri Lankans. The present study was undertaken to investigate the diameter and length of portal vein in a group of adult Sri Lankan population and to compare the results with other published data. The characteristics of cadavers including age, gender, weight and height were recorded. A total of twenty four apparently healthy livers obtained from cadavers were utilized. The diameter of the portal vein at a predetermined sites and the length up to the porta hepatis were recorded. All measurements were taken using a sliding caliper capable of measuring to the nearest 0.01 mm. Results were expressed as mean ± SD. Statistical analysis was performed using the t test. P value <0.05 was considered statistically significant. Portal vein anatomy was normal and mono-pad in all cases studied. The mean diameter of the portal vein at the porta hepatis was found to be 8.96±1.26mm and the mean length was 8.28±2.33cm. The results indicated that in our study population, the portal veins are longer but their diameters were smaller than when compared with the reported measurements in the anatomy texts. These may be attributed to racial differences. Precise knowledge of the expected normal portal vein diameter at a given anatomic location is the first step towards developing a quantitative estimate of the severity of the portal vein abnormalities. This study provides a reference data set for adult Sri Lankans against which to compare the diameters of the portal vein in various pathological conditions.
An anatomical study of the tarsal tunnel: A cadaveric study
(University of Kelaniya, 2011) Karunanayake, A.; Hasan, R.; Salgado, S.; Salvin, K.A.; Fernando, P.; Ranaweera, L.; de Alwis, R.P.; Herath, S.; Senadipathy, C.; Mahawaththa, T.; Fernado, E.; Ilayperuma, I.
Tarsal tunnel is a passage formed between the flexor retinaculum and the underlying tarsal bones. Tendons of tibialis posterior, flexor digitorum longus, flexor hallucis longus and the neurovascular bundle of the posterior compartment of the leg pass through this tunnel in separate fascial compartments. To relieve symptoms and signs of Tarsal tunnel syndrome, orthopedic surgeries and anesthetic nerve blocks are used. Therefore, knowing the anatomy of the tarsal tunnel is important to understand and manage conditions related to this region. The aim of this study, is to describe the morphology and its possible variations in a Sri Lankan population compared to what is described in standard anatomy text books. A descriptive study was carried out by dissecting 28 human cadavers available in the Department of Anatomy, University of Kelaniya. Typical anatomy was observed in 26 cadavers (92.85%) where tibialis posterior (TP), flexor digitorum longus (FDL),neurovascular bundle and flexor hallucis longus (FHL) were in separate compartments anterior to posterior respectively. In one cadaver (3.57%) FDL and FHL were in a single compartment. In another cadaver (3.57%) bifurcation of the tendon of flexor digitorum longus was observed passing through a separate compartment posterior to neurovascular bundle. Even though the majority of the results were in agreement with the typical description of the anatomy of the tarsal tunnel, a certain degree of variability was observed in this area. This knowledge will be of use to clinicians involved in procedures related to the tarsal tunnel.
Anatomical variations of the common peroneal nerve (cpn) and the deep pereoneal nerve (dpn) in the lateral compartment of the leg: A cadaveric study
(College of Surgeons of Sri Lanka, 2015) Salgado, L.S.S.; Karunanayake, A.L.; Hasan, R.; Salvin, K.A.; Fernando, E.D.P.S.; Ranaweera, M.S.L.; Padeniya, A.G.P.M.; Senevirathne, S.P.; Ranaweera, K.R.K.L.K.
INTRODUCTION: The aim of this study is to demonstrate anatomy of CPN and DPN in the lateral compartment and identify high risk area/s which is important in high tibial osteotomy, in total knee arthroplasty, in external fixation of leg and CPN decompression surgery. MATERIAL AND METHODS: Thirty cadaveric legs (female-14, male-16) were dissected to demonstrate the bifurcation of the CPN and the exit point of the DPN from the lateral compartment. The ethical clearance was obtained. RESULTS: None of the specimens showed bifurcation of the CPN proximal to the apex of the fibular head. Musculoaponeurotic fibular arch at the entrance to the fibular tunnel was confirmed in all specimens. The mean distance from the apex of the fibular head to the opening of the fibular tunnel was 28.4mm (SEM±1.4mm). Of 30 specimens respectively 21(70%), 7(23.33%) and 2(6.66%) had bifurcation vertically distal to, on and proximal to the entry point with the average of 8.0mm and 12.0mm from the entry point. Eleven legs had muscular branches of the DPN in the lateral compartment of the leg. The mean exit point of the DPN/its longest muscular branch was observed 66.5mm (SEM±2.6mm) distal to the apex of the fibular head. CONCLUSIONS: Variations of the CPN bifurcation in relation to the fibular tunnel and muscular branches of the DPN in the lateral compartment were observed. From the apex of the fibular head, distance of 25.6mm-71.6mm was identified as the high risk area for surgeries involving in the upper part of the lateral compartment.
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.
Anomalies of the Lumbrical Muscles of the Hand
(University of Kelaniya, 2012) Ranaweera, L.; Hasan, R.; Salgado, S.; Karunanayake, A.; Salvin, K.A.; Fernando, P.; Fernando, E.; Wijesooriya, P.; Vithanage, S.
Introduction:The human hand occupies a unique position in evolution. The lumbrical muscles, one of the major constituents of intrinsic musculature in hand, play significantly greater role in the precision movements of the fingers. There are four cylindrical lumbrical muscles which rise from the four tendons of flexor digitorumprofundus (FDP) in the hand and pass along the radial side of the corresponding metacarpophalangeal joint to insert into the dorsal digital expansion of the medial four fingers. The first and second lumbricals are unipennate while the third and fourth lumbricals are bipennate. Anomalies of the attachments of the lumbricals are not uncommon and have a significant value in the design of surgical procedures. Objectives: To study the possible variations of lumbrical muscles and also document a relevant Sri Lankan study. Methodology:This research was carried out as a descriptive study in19 preserved human hands in the Departments of Anatomy, University of Kelaniya, Ragama. Results: In 9 (47.4%) hands the lumbricals were normal. Regarding the proximal attachments, the third lumbrial was unipennate in 3 (15.7%) whereas same architecture for the fourth lumbrical encountered was 2 (10.5%). Moreover, it was found that 1 (5.3%) of the second lumbricals was bipennate. Regarding the distal attachments, the split insertion of the third lumbrial and fourth lumbrical were observed as 2 (10.5%) and 1 (5.3%), respectively. Interestingly, 1 (5.3%) of the third lumbricals was inserted on the medial side of the middle finger. Conclusion: In our preliminary studyof lumbrical muscles of the hand, it was apparent that majority of the observations are comparable to previous research, while there were a higher percentage of proximal attachment variations than distal attachment variations in the study group.
Conducting viva voce examinations during preclinical years in the faculty of medicine, University of Kelaniya: Is it of relevance?
(Book of Abstracts, Annual Research Symposium 2018, 2014) Hasan, R.; Perera, A.A.M.M.S.L.; Wijesundara W M R D; Dilshani, W.M.S.; Niwunhella, N.A.D.P.; Salvin, K.A.; Fernando, E.D.P.S.
Viva voce (vivas) or oral examinations are an integral part of medical education. During a viva the examiner is given the opportunity to assess the candidate�s knowledge and ability to respond under pressure. For medical students vivas are an opportunity to develop verbal and presentation skills. Vivas were part of the preclinical examinations held in the Faculty of medicine Ragama prior to the introduction of the new curriculum. This research was carried out in order to identify the opinion of lecturers on reintroduction of vivas for preclinical examinations.
Coracobrachialis muscle: morphology, morphometry and gender differences
(Springer, 2016) Ilayperuma, I.; Nanayakkara, B.G.; Hasan, R.; Uluwitiya, S.M.; Palahepitiya, K.N.
PURPOSE:Coracobrachialis (CBM) is a complex muscle with a wide range of variations in its morphology and innervation. The goal of this study was to elucidate the morphology, morphometry, gender differences of CBM and precise anatomical position of the musculocutaneous nerve (MCN) with reference to surrounding anatomical landmarks in an adult Sri Lankan population. METHOD: Cadaveric upper limbs (n = 312) were examined for the proximal and distal attachments, length, width, thickness of CBM and its relationship with the MCN. RESULTS: The CBM originated from the tip of the coracoid process of the scapula and lateral, posterior and medial aspects of the tendon of short head of biceps brachii. Gender differences were observed in all morphometrical parameters of CBM. In 83.33 %, MCN perforated the CBM. In 50 % the MCN pierced the middle one-third of CBM while none pierced the lower one-third. The distance from the coracoid process to the point of entry of MCN into CBM (distance P) was 50.62 mm. A positive correlation was observed between the arm length and distance P indicating that arm length provides an accurate and reliable means of gauging the distance P of an individual. CONCLUSION: The present study provides new evidence pertaining to the origin of CBM. Further, it was revealed that the predicted distance P of any upper extremity can be calculated by dividing the arm length by 5. Precise anatomical location of MCN in relation to CBM using unequivocal and well-defined anatomical landmarks will be imperative in modern surgical procedures.
The Effects of abnormal prolactin levels on semen parameters on male white rats.
(Quest Journals Inc., 2016) Hasan, R.; Wijesinghe, J.A.A.S.
INTRODUCTION:High prolactin levels drastically inhibit sperm production and its quality. The role of high prolactin levels on the male reproductive system has not been completely elucidated and thus its exact role in male factor infertility remains unclear. Hence this study was carried out in order to establish its effects. OBJECTIVE:To determine the effects of prolactin levels on semen parameters of male white rats. METHODOLOGY: A case control study was carried out in the Animal house of the Faculty of Medicine, University of Ruhuna, Sri Lanka. Ethical consent was obtained from the Ethical review committee, Faculty of Medicine, University of Ruhuna. 10+/- 2 week old, 200+/-10 g weighted Wistar strain male white rats weregrouped as G1-G6, with 30 rats per group. They were maintained in separately labeled cages at room temperature of 28+/- degrees Celsius. Hyperprolactinemia was induced in G3, G4 and G5 by using oral largactil a daily dose of 10mg/kg in two divided doseson G3, and subcutaneousinjections of fluphenazine in adose of 0.42mg/kg and 0.84mg/kg on G4and G5 respectively given as single doze in the morning. Hypoprolactinaemia was induced in G2 by using oral bromocriptine in a daily dose of 4.65mg/kg in two divided doses. After 100 days PR Llevels were assayed together with a BSA assessment on each of the groups. Results were compared with corresponding control groups and with each of the groups. RESULTS: The difference between the experimentally obtained values and corrected values for the serum PRL concentrations in the G2 which was administered bromocriptine to induce hypoprolactinaemia was found to be highly significant with compared to the control group by student’s t-test. The difference between the experimentally obtained values and corrected values for the serum PRL concentrations in the G3, G4, G5 which was administered largactil, low dose fluphenazine, high dose fluphenazine respectively to induce hyperprolactinaemia was found to be highly significant with compared to the control group by student’s t-test. Mortality, morphology, cell counts per field and the concentration of sperms seems to affected by serum PRL levels. A correlation between different PRL levels and the semen parameters was evident as those with high PRL levels show more abnormal basic semen analytical parameters while those with a moderate rise of PRL levels and hypoprolactinaemic rats show better basic semen analytical parameters. CONCLUSIONS: The level of serum PRL in white male rats has an effect on semen parameters. The level of effect is proportionate to the level of serum PRL. It is clearly evident that mortality, morphology, cell counts per field and the concentration of sperms are affected by PRL. Thus abnormal PRL levels appear to exert an effect on the spermatogenetic cycle.
Experience on endoscopic management of Iatrogenic bile duct injuries following laparoscopic cholecystectomy
(Quest Journals Inc., 2016) Hasan, R.; Abeysuriya, V.; Navarathne, N.M.M; Wijesinghe, J.A.A.S.
INTRODUCTION: Clinically significant bile leaks due to iatrogenic bile duct injuries following laparoscopic cholecystectomy is not infrequent. Endoscopic procedures have become the treatment of choice for the management of biliary leakage following iatrogenic bile duct injuries. GENERAL OBJECTIVE: To assess the therapeutic outcome of endoscopic therapy of the patients who had iatrogenic biliary injury and biliary leakage following laparoscopic cholecystectomy. METHODS: Prospective descriptive study was performed on32 patients who underwent therapeutic endoscopic procedures for iatrogenic injuries following laparoscopic cholecystectomy for symptomatic gall stone disease in the National Hospital of Sri Lanka. Bile leaks were diagnosed by the presence of persistent abdominal pain, jaundice with cholangitis, abdominal distension and persistent bile flow to the skin surface through and around the existing drains. All the patients underwent abdominal ultra-sonography or CT scan. The presences of bile leaks were confirmed by ERCP. RESULTS: Patients who had bile leaks were diagnosed by, persistent abdominal pain 30 % (9/30), jaundice with cholangitis 6.6% (2/30), abdominal distension 16.6% (5/30), and persistent bile flow to the skin surface through and around the existing drains, 46.6%(14/30). The median duration between initial surgery and detection of bile leak was 3 days (range 0-12 days). Twenty-three patients 76.6% had high-grade bile leaks and 7(23.4%) had low-grade leaks. The iatrogenic bile duct injuries were; cystic duct injuries 10(33.3%) (3 high grade: 7 low grade bile leaks), the common bile duct injuries 16(53.3%) and the right hepatic duct injuries 4(13.3%). All patients were subjected to therapeutic procedures, which consisted of Sphincterotomy with stone extraction followed by biliary stenting (10 patients), Sphincterotomy with biliary stenting (15 patients) and Sphincterotomy alone (5 patients). Bile leaks stopped in all patients at a median of 4 days (range 2-14 days) after endoscopic interventions. Drains were removed at a median duration of time of 6 days (range 5-16 days) after endoscopic procedures. Stents were removed at a 6-8 weeks’ interval. Three (3/6) who had low-grade cystic duct bile leaks, who underwent Sphincterotomy alone, had mean 3.6±0.88SEM days for complete cessation of bile leakage from the drains. Other three patients (3/6) who underwent Sphincterotomy and stent placement had mean of 3.0±0.57SEM days cessation of bile leakage (P=0.52, t-test). All high-grade bile leak (3/10) patients were offered Sphincterotomy and stent placement and had mean 6.8±0.5SEM days for complete cessation of bile leakage from the drains. CONCLUSIONS: Iatrogenic bile duct injuries occur commonly in the common bile duct. Residual stones are found in one-third of cases. No significant difference in healing was seen between the patients who had low-grade bile leaks due to cystic duct injuries and whom were offered either Sphincterotomy alone and Sphincterotomy and stenting.
Histological analysis of chronic inflammatory patterns in the gall bladder
(International Organization of Scientific Research (IOSR), 2016) Hasan, R.; Abeysuriya, V.; Hewavisenthi, J.; Wijesinghe, J.A.A.S.
INTRODUCTION: Cholecystectomy is a common surgical procedure. Inflammatory disease is the most common pathology of the gallbladder. OBJECTIVE: To assess the different morphological changes of chronic cholecystitis in cholecystectomy specimens. METHODS: Thirty histological specimens from cholecystectomies from patients clear clinical history of biliary lithiasis were histologically evaluated with Haematoxylin-Eosinstaining. Three samples were obtained from fundus, middle third and the neck respectively from each gallbladder. RESULTS: 76% of the specimens had metaplastic epithelial changes. Hyperplasia showed a positive correlation (1.0000) with chronic inflammation. Regenerative morphology of epithelial cells was found in 73% of the cases. Regenerative epithelium showed a positive correlation (1.0000) with presence of neutrophils and was significantly associated with mucosal erosions (P=0.005). Fibrosis was observed in all cases (26% mild, 62% moderate, 12% severe). Moderate degree showed a positive correlation (0.999) with severe chronic inflammation. Activity was present in 29% of the cases. Muscular thickness was considered mild in 55% of cases, moderate in 37%, and severe in 8%. Adipose tissue deposits were mild in 47% of cases, moderate in 38%, and severe in 15%. Evolution of the chronic inflammatory cholecystitis was observed in four stages. Initial stage is characterized by mild fibrosis, often with cellular foci, admixed with granulation type tissue in superficial portions of the wall, mild to moderate mononuclear infiltrate and absence of Rockitansky Aschoff sinus(RAS). The second stage consisted of moderate fibrosis and inflammatory infiltrate, often with mild amounts of adipose tissue with RAS extending in to one-third of the length of the specimen. The third stage showed severe fibrosis and chronic inflammation, with moderate to severe adipose tissue deposits with RAS extending in to two-third of the length. The final stage was that of severe fibrosis, often laminated, with reduction of adipose tissue, a moderate to severe inflammatory infiltrate with RAS extending almost entire length of the specimen. CONCLUSION: Staging of chronic inflammatory changes in the gallbladder might help in evaluation of the cholecystectomy specimen, to give a rational, systematic, and reproducible diagnosis of different patterns of the inflammatory process.
Implications of prolactin abnormalities on the male reproductive tract and male factor infertility
(Quest Journals Inc., 2016) Hasan, R.; Wijesinghe, J.A.A.S.
INTRODUCTION: A significant proportion of male population suffer from Male Factor Infertility (MFI) due to prolactin abnormalities. OBJECTIVE: To establish the role of prolactin on the male reproductive system. METHODOLOGY: A case control study was carried out to determine the effects of prolactin abnormalities in otherwise normal 297 males with infertility after obtaining an informed written consent. Each of the participants was subjected to a Basic Seminal Fluid Analysis(BSA) and an endocrine profile (Follicular Stimulating Hormone, Luteinizing Hormone, Testosterone and Prolactin levels). An age, Sex, height and weight matched voluntary control group was recruited for comparison. None of the cases had any medical or surgical disorder or occupational hazardous exposure which related to infertility. RESULTS: Among the controls mean age 33.2 years+/-5.2, body mass index 21.4+/- 1.39Kgm-2, sperm count 34 x 106, number of children fathered 2+/-1, Serum prolactin level 6.78+/- 2.92mg/ml. Of the case group 28/297 were hyperprolactinemic while 1/297 was hypoprolactinaemia. All the hyperprolactinemic patients had oligospermia, abnormal morphology of sperms, with reduced viability of the sperms. 26/28 Subjects with hyperprolactinaemia had markedly low testosterone levels. The only subject with hypoprolactinaemia had normal testosterone levels. FSH and LH levels were normal in all the participants. 29 subjects with abnormal prolactin levels were followed up for 12 months. 28 patients with hyperprolactinaemia were given oral bromocriptine (2.5mg twice daily). The response with bromocriptine was assessed with repeated Basic Semen Analysis. After 3 months of therapy 19/29 cases showed an improved response to the drug while 4/28 responded after 6 months of treatment. 1/28 took 1 year to show a response. 2 of the cases showed some improvement which fell short of normal BSA parameters. CONCLUSIONS: Prolactin abnormalities affects male reproductive system and semen parameters. Further studies should be carried out to find the exact mechanism of prolactin on the male reproductive system.
Incidence of pyramidalis muscle
(University of Kelaniya, 2011) Rajawasam, P.P.; Prabodha, L.B.L.; Gamage, U.; Nanayakkara, B.G.; Ilayperuma, I.; Hasan, R.
Pyramidalis is a triangular muscle that lies in front of the lower part of rectus abdominis muscle within the rectus sheath. This muscle is known to vary considerably in size and present either unilaterally or bilaterally. A large number of studies supports the racial variation in its occurrence. This preliminary study was carried out to investigate the incidence of pyramidalis muscle and also to establish its anatomical dimensions in a sample group of Sri Lankans. A total of forty two cadavers were studied during the routine gross anatomy dissections. The presence or absence of the muscle either bilaterally or unilaterally was noted on visual inspection. The maximum length and width of the pyramidalis was measured using a sliding caliper capable of measuring to the nearest 0.01mm. Pyramidalis was present bilaterally in 85.71% and absent in 14.28% of the subjects. The maximum length of the muscle was 6.24 ± 0.12 cm on right side and 7.09 ± 0.20 cm on left side. The maximum width was 1.32 ± 0.14 cm on right side and 1.52 ± 0.18 cm on left side. Bilateral variation in the dimensions of the muscle was statiscally significant. The occurrence of pyramidalis muscle was established for a group of adult Sri Lankan population. Our results reveal there is a racial trend in the incidence of pyramidalis muscle between Sri Lankan and other races such as black and white populations.
Morphological variations of cystic artery in triangle of calot in laparoscopic cholecystectomy: experience in tertiary care surgical unit in South Asian country.
(Quest Journals Inc., 2016) Abeysuriya, V.; Kumarage, S.K.; Hasan, R.; Wijesinghe, J.A.A.S.
INTRODUCTION: The knowledge and realization of the frequency and multiplicity of abnormalities of the cystic artery is a perquisite for safe laparoscopic cholecystectomy. OBJECTIVE: To describe the morphological characteristics of the cystic artery in the triangle of Calot. METHODS: Descriptive-prospective cross sectional study was performed in 200 patients, who underwent laparoscopic cholecystectomy for symptomatic gallbladder disease, to observe variations cystic artery. RESULTS: Eighty-nine percent (178/200) of the cystic arteries originated as a single artery from the right branch of the hepatic artery. Five percent (10/200) had two cystic arteries originating separately from right hepatic artery while 5 % (10/200) of cystic arteries passed anterior to the common hepatic duct and 1%(2/200) traversed over cystic duct. Majority, 41%(82/200) of the patients right hepatic artery was ling in the triangle of Calot’s. Two percent (4/200) of the patients had right hepatic artery running over the common hepatic duct. CONCLUSION: It has been observed that the variation of the cystic artery in the triangle of Calot is not infrequent and this knowledge will enhance the safe laparoscopic cholecystectomy.
Prolactin and male infertility
(Sri Lanka Medical Association, 2013) Hasan, R.; Weerasooriya, T.; Illeperuma, I.; Weerasinghe, W.S.; Withana, A.K.G.
INTRODUCTION AND OBJECTIVES: Male infertility due to endocrine disturbances is seen among 1% of couples seeking medical help for childlessness. Effects of prolactin on the male reproductive system are not fully understood. Objective was to determine prolactin level in healthy males with infertility. METHODS: A case control study recruited 297 males attending infertility clinics in a government or private institution over a period of 54 months. A detailed clinical assessment of reproductive health was carried out. All underwent a -basic seminal fluid analysis (BSA) and an endocrine profile consisting of FSH, LH, testosterone and prolactin (PRL) hormones carried out using the immulite random access chemiluminescent immunoassay method (normal range 2.5-17ng/ml). Age, weight and height matched volunteers comprised the control group. RESULTS: None of the cases had any anatomical, medical or surgical disorder which could account for the infertility. Among the controls, mean age was 33.2yrs ±5.2, BMI 21.04 kgm-2 ±1.39, BSA 34xl06± 7.87x106, number of children fathered 2 ±1, PRL 6.78ng/ml ±2.92. Twenty nine (9.76%) had abnormal PRL levels irrespective of serum testosterone level with a BSA sperm count < 20x106 and there were structural and functional abnormalities. Hyperprolactinaemic was seen in 28 and 26 had marked hypotestosteronaemia. FSH and LH were normal. CONCLUSIONS: Prolactin abnormalities affect the male reproductive system and semen parameters. Further studies should be carried out on PRL and male infertility
A Study on the effects of prolactin and Its abnormalities on semen parameters of male white rats.
(World Academy of Science, Engineering and Technology(WASET), 2014) Hasan, R.
Male factor infertility due to endocrine disturbances such as abnormalities in prolactin levels are encountered in a significant proportion. This case control study was done to determine the effects of prolactin on the male reproductive tract, using 200 male white rats. The rats were maintained as the control group (G1), hyporprolactinaemic group (G2), 3 hyperprolactinaemic groups induced using oral largactil (G3), low dose fluphenazine (G4) and high dose fluphenazine (G5). After 100 days, rats were subjected to serum prolactin (PRL) level measurements and for basic seminal fluid analysis (BSA). The difference between serum PRL concentrations of rats in G2, G3, G4 and G5 as compared to the control group were highly significant by students' t-test (p< 0.001). There were statistically significant differences in seminal fluid characteristics of rats with induced prolactin abnormalities when compared with those of control group (p value < 0.05), effects were more marked as the PRL levels rise.
Variations in the Termination of the Human Thoracic Duct
(University of Kelaniya, 2012) Hasan, R.; Salgado, S.; Karunanayake, A.; Salvin, K.A.; Fernando, P.; Ranaweera, L.; Vithanage, S.; Wijesooriya, P.; Ilayperuma, I.; Fernando, E.
Introduction: The mammalian thoracic duct is the main lymphatic channel which drains lymph from the distal extremities of the trunk, lower limbs and the left half of the proximal trunk. In humans, it runs a typical course commencing over the twelfth thoracic vertebra and ascends through the aortic orifice of the diaphragm. It inclines to the left at the level of the Sternal angle and terminates by draining into the left jugulosubclavian junction. Objectives: Variations from this typical course are not uncommon and have been the subject of extensive research. Knowledge of the possible variations in the thoracic duct would enable accurate thoraco- cervical surgery, thus preventing inadvertent damage to the thoracic duct and consequent leakage of chyle.This research is carried out with the aim ofenhancing the existing knowledge of the possible variations of termination of the human thoracic duct while also documenting a relevant Sri Lankan study. Methodology: This research was carried out as a descriptive study in36 preserved human cadavers in the Departments of Anatomy, the University of Kelaniya and the University of Ruhuna. Results: In 22 (61.11%) cadavers the thoracic duct drained into the left jugulosubclavian junction whereas in 11 (30.56%) cadavers it drained into the left subclavian vein. Moreover, in 2(5.56%) cadavers it drained into the left internal jugular vein. Interestingly, in 1 (2.77%) cadaver thoracic duct drained into both left subclavian vein and jugulosubclavian junction through the presence of a bifurcation. Conclusion: It was apparent that majority of the findings are comparable to previous research, while there were variations in the percentage incidence of the findings.
Variations of the Superficial Palmar Arch in a Sri Lankan Perspective: A Cadaveric Study
(Global Science and Technology Forum, 2014) Salgado, L.S.S.; Hasan, R.; Perera, A.A.M.M.S.L.; Wijesundara, W.M.R.D.; Anuradha, W.K.
INTRODUCTION: The blood supply of the hand is a complex and challenging area of study. The clinical importance of this area lies in the significant number of surgical procedures such as radial artery conduits in coronary artery bypass grafting (CABG), radial arterial cannulation and reconstructive surgery of the hand. Anatomical variations in the typical blood supply of the hand are common and are an area of extensive research. METHODOLOGY: This descriptive study was carried out in the dissecting theatres at the Department of Anatomy, Faculty of Medicine, University of Kelaniya on dissections carried out on 25 cadaveric hands. RESULTS: From the superficial palmar arches studied the following results were obtained. 88% were complete while 22% were incomplete. Specimens with contribution from both the radial and the ulnar arteries for the superficial palmar arches were 80%, while specimens with the contribution solely from the ulnar artery were 12%. 8% hands studied had contributions from the radial, ulnar and the median arteries. Three branches of the radial artery contribute to complete the superficial palmar arch. Of this 60% cadavers had the major contribution from the superficial palmar branch of the radial artery, 24% from the arteria princeps pollicis, and 16% from the first dorsal metacarpal artery. The contribution to the arterial supply of the radial side of the thumb was from the superficial palmar branch of radial artery in 80% of the cadavers while in 20% the contribution was from the arteria princeps pollicis. The contribution to the arterial supply of the ulnar side of the thumb was from the proper palmar digital artery arising from the superficial palmar arch in 44% hands and the contribution in 32% hands was from the arteria princeps pollicis while the contribution in 24% hands was from the first dorsal metacarpal artery. CONCLUSION: It is thus evident that significant anatomical variations of the superficial palmar arch exist in the Sri Lankan population. The arterial supply of the thumb also had significant changes compared to the descriptions given in standard text books.