Browsing by Author "Perera, G.L.R.S."

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Anthropometric patterns among patients with chronic mechanical low back pain
(Sri Lanka Medical Association, 2014) Perera, G.L.R.S.; Wijayaratne, L.S.; Senarath, U.; Dissanayake, P.H.; Karunonayake, A.L.; Dissanayake, V.H.W.
INTRODUCTION AND OBJECTIVES: Anthropometric parameters may have an association with chronic mechanical low back pain (CMLBP). Our aim was to evaluate the anthropometric patterns; body mass index (BMI), waist circumference (WCJ and waist to height ratio (WHtR) among patients with CMLBP. METHODS: A total of 519 patients with CMLBP were recruited from a cohort of patients attending the rheumatology clinic at the National Hospital of Sri Lanka. Anthropometric parameters were measured using recommended techniques. Independent samples t test and one way ANOVA were used to compare the means of anthropometric parameters. The means of BM1, WC of the patients were compared with means of a national representative sample of Sri Lankan adults. Asian anthropometric cut offs were used to define obesity and abdominal obesity. RESULTS: 372 (71.7%) were females and mean age was 49.64 years (50=1.81). The mean BMI was 26.31 kg/m2 ($0=4.77), WC 85.98cm (50=10.65) and WHtR 0.56 (SD=0.08). Females had significantly higher BMI 27.24 kg/m2 ($0=4.68), WC 86.84cm (SD=10.59) and WHtR 0.577 (50=0.072) compared to males' BMI 23.95 kg/m2, SD=4.14), WC 83.79cm, (50=10.51) and WHtR 0.512 ($0=0.661) (p<0.05). Mean BMI, WC and WHtR increased with age (/xQ.OOl). CMLBP patients had high BMI and WC compared to the national representative sample of Sri Lankan adults (p<0.001). Females had more obesity and abdominal obesity compared to males (p<0.001). CONCLUSIONS: High BMI and WC were seen in patients with CMLBP and the values increased with age. Females were obese and had high abdominal obesity, which may have contributed to CMLBP.
Association between pain and disability in patients with chronic mechanical low back pain
(Sri Lanka Medical Association, 2015) Perera, G.L.R.S.; Wijayaratne, L.S.; Senarath, U.; Dissanayake, P.H.; Karunanayake, A.L.; Dissanayake, V.H.W.
INTRODUCTION AND OBJECTIVES: Low back pain is the leading cause of years lived with disability in developed countries as well as in South Asian countries. The aim of this study is to evaluate the association between the intensity of pain and disability in patients with chronic mechanical low back pain (CMLBP) who attended the rheumatology clinic, National Hospital of Sri Lanka (NHSL). METHOD: This is a descriptive study on 675 patients with CMLBP who attended the rheumatology clinic, NHSL, from May 2012 to May 2014, recruited according to inclusion and exclusion criteria. Intensity of pain was measured using the 101-point numerical pain rating scale (NRS) and the disability was measured using the modified Oswestry Disability Index (MODI). A multiple linear regression model adjusted for age, gender, level of education, duration and frequency of pain and duration of treatment was used to assess the association between the intensity of pain and disability. RESULTS: Majority (482, 71.4%) were females. Mean age was 49.19 ± 11.75 years. Mean score for NRS was 46.79 ± 20.38 and for MODI was 31.77 ± 14.16, while 84.3% had daily pain. Intensity of pain was positively associated with the disability (p<0.01) and the standardized regression coefficient was +0.627 after adjusting for confounders. Frequency of pain, female gender and aging were positively associated with disability (p<0.05) while level of education, and durations of pain and treatment did not reach significant level. Conclusion: Intensity of pain explains 63% of the disability associated with CMLBP. Frequency of pain, female gender and age were also associated with disability.
Variants of acan gene associate with severity of lumbar disc degeneration
(Sri Lanka Medical Association, 2016) Perera, G.L.R.S.; Wijayaratne, L.S.; Senarath, U.; Dissanayake, P.H.; Karunanayake, A.L.; Dissanayake, V.H.W.
INTRODUCTION AND OBJECTIVES: Structural integrity of aggrecan (coded by ACAN gene) plays a major role in lumbar disc degeneration (LDD). Single nucleotide polymorphisms (SNPs) of ACAN gene have been implicated in LDD. The study aimed to determine the associations between SNPs of ACAN gene and the severity of disc space narrowing (DSN) and osteophytes (OS) of lumbar spine in patients with chronic mechanical low back pain (CMLBP). METHOD: A descriptive cross-sectional study was carried out on 120 patients with CMLBP. Lateral lumbar X-rays were assessed for severity of DSN and OS using a semiquantitative scores (grade 0-3). Twenty-seven exonic SNPs of the ACAN gene were genotyped on a Sequenom mass array iPLEX platform. Multiple linear regression analysis was carried out adjusting for age and body mass index. RESULTS: Mean age was 51.46 ± 10.43 years. 82 (68.3%) were females. 30 (25%) were obese. 31 (25.8%) and 47 (39.2%) had grade 1 DSN and AOS respectively, while 42 (35%) and 13 (10.8%) had grade ≥ 2 DSN and AOS, respectively. “A” allele of rs2882676 (regression coefficient (β) = -0.25, p<0.03), “A” allele of rs1042630 (β = -0.28, p<0.01) and “T” allele of rs1042631 (β = -0.28, p<0.02) were negatively associated with the severity of DSN. “T” allele of rs16942341 (β = 0.4, p<0.02) and “G” allele of rs28407189 (β = 0.4, p<0.02) were positively associated with the severity of AOS. CONCLUSION: SNPs of ACAN gene are associated with severity of degenerative changes of the lumbar spine.