Browsing by Author "Ranasinha, C."

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The association between respiratory symptoms and gastro-oesophageal reflux events
(Research Symposium 2009 - Faculty of Graduate Studies, University of Kelaniya, 2009) Amarasiri, W.A.D.L.; de Silva, H.J.; Ranasinha, C.
Introduction: The oesophagus and the airways have a common origin. Abnormal gastroooesophageal reflux (GOR) may predispose to genesis of respiratory symptoms. This association has not been reported previously in Sri Lanka. Aims: To describe the association between reflux events and respiratory symptoms in a cohort of adult asthmatics in Sri Lanka. Methods: 30 stable, mild asthmatics (American Thoracic Society criteria) underwent dual-sensor oesophageal pH monitoring. Respiratory symptoms (cough, wheeze, difficulty in breathing, chest tightness) experienced during monitoring were recorded. Respiratory symptoms were correlated with reflux events by reviewing diary events and oesophageal pH tracings. A reflux episode was defined as a drop in pH to values <4 lasting> 4 seconds. A respiratory symptom was considered as associated with a reflux episode if it occurred 2 minutes prior to or after a reflux episode. Results: 50% of the asthmatics complained of one or more respiratory symptoms during the 24- hour recording period. Of 102 respiratory symptoms recorded, 73 were cough, 23 were wheezing and 5 were episodes of chest tightness. None experienced difficulty in breathing. 93% of coughs, 81 % of wheezes and all episodes of chest tightness were reflux-associated. In most cases reflux episodes preceded respiratory symptoms. There was no statistically significant difference in any oesophageal monitoring parameter between asthmatics with and without respiratory symptoms. Conclusion: Asthmatics experience respira~ory symptoms during reflux events. The deve:lopment of respiratory symptoms during an episode of acid reflux or within 2 minutes thereafter suggests that it is probably GOR that triggers asthma.
A critical reading of the novel, Mama Raththriya Wemi (I am the night): A blend of Tolstoyan and Dosteovskian identities of the novel
(University of Kelaniya, 2011) Ranasinha, C.
The novel as a literacy genre mainly splits its identity into two, namely Tolstoyan and Dosteovskian identities. Tolstoyan identity refers to story–telling, explicating of incidents, events, setting, etc. with rich textual admirations. Dosteovskian way of weaving of the story generally includes conversations and vast pieces on sentimental expressions and reveals internal voices of characters and does not pay much attention to settings and atmosphere. Both these identities comply with the generic identity of the novel with settings, point of views, styles, diction, and characterization, the integral parts of the texts and postulate them more or less in them. Tolstoy dominates several elements and Dosteovsky does in some others, because they present distinctive insights and particular philosophies. This paper theoretically focuses on the two identities in critically reading the Sinhala novel, Mama Raththriya Wemi by Hemerathna Liyanaracchi. The story of Mama Raththriya Wemi is a well-organized narrative with many poignant events and complex character development. Sapumal Bandara, the protagonist, a mathematics teacher of a Maha Vidyalaya near Colombo considers himself as a monkey because of his disfigured face and suffers his entire life with this mental agony. Having lost his chance to be an engineer, he joins a Maha Vidyalya as a teacher and falls in love with a very young girl student in his school who also stays in his boarding place. The novel ends with a tragic act of suicide by the protagonist while the last chapter depicts his madness in highly imaginative and also symbolic and figurative language. The novel is also significant for its narration, which finds confluences of Western and Eastern philosophical discourses referring mainly to the Buddha and Fredrick Neitsche.
Inhaled beclomethasone in the treatment of early COVID-19: a double-blind, placebo-controlled, randomised, hospital-based trial in Sri Lanka
(BMJ Publishing Group Ltd, 2023) Mettananda, C.; Peiris, C.; Abeyrathna, D.; Gunasekara, A.; Egodage, T.; Dantanarayana, C.; Pathmeswaran, A.; Ranasinha, C.
OBJECTIVES: To study if early initiation of inhaled beclomethasone 1200 mcg in patients with asymptomatic, mild or moderate COVID-19 reduces disease progression to severe COVID-19. DESIGN: Double-blinded, parallel-groups, randomised, placebo-controlled trial. SETTING: A hospital-based study in Sri Lanka. PARTICIPANTS: Adults with asymptomatic, mild or moderate COVID-19, presenting within the first 7 days of symptom onset or laboratory diagnosis of COVID-19, admitted to a COVID-19 intermediate treatment centre in Sri Lanka between July and November 2021. INTERVENTIONS: All participants received inhaled beclomethasone 600 mcg or placebo two times per day, for 10 days from onset of symptoms/COVID-19 test becoming positive if asymptomatic or until reaching primary endpoint, whichever is earlier. PRIMARY OUTCOME MEASURE: Progression of asymptomatic, mild or moderate COVID-19 to severe COVID-19. SECONDARY OUTCOME MEASURES: The number of days with a temperature of 38°C or more and the time to self-reported clinical recovery. RESULTS: A total of 385 participants were randomised to receive beclomethasone(n=193) or placebo(n=192) stratified by age (≤60 or >60 years) and sex. One participant from each arm withdrew from the study. All participants were included in final analysis. Primary outcome occurred in 24 participants in the beclomethasone group and 26 participants in the placebo group (RR 0.90 ; p=0.763). The median time for self-reported clinical recovery in all participants was 5 days (95% CI 3 to 7) in the beclomethasone group and 5 days (95% CI 3 to 8) in the placebo group (p=0.5). The median time for self-reported clinical recovery in patients with moderate COVID-19 was 5 days (95% CI 3 to 7) in the beclomethasone group and 6 days (95% CI 4 to 9) in the placebo group (p=0.05). There were no adverse events. CONCLUSIONS: Early initiation of inhaled beclomethasone in patients with asymptomatic, mild or moderate COVID-19 did not reduce disease progression to severe COVID-19. TRIAL REGISTRATION NUMBER: Sri Lanka Clinical Trials Registry; SLCTR/2021/017.
Inhaled beclomethasone in the treatment of early COVID-19: a phase 2, double-blind, placebo-controlled, randomised trial
(The College, 2023) Mettananda, C,; Peiris, C.; Abeyrathna, D.; Gunasekera, A.; Egodage, T.; Danthanarayana, C.; Pathmeswaran, A.; Ranasinha, C.
No abstract available
The intellectual identities of Cumaratunga and Ra. Tennakoon
(Faculty of Humanities, University of Kelaniya, Sri Lanka, 2016) Ranasinha, C.
This paper attempts to discuss the methods that were formulated to edit and interpret Sinhalese messenger poetries by Ra. Tennakoon (1899-1965) and Cumaratunga Munidasa (1887-1944). The methodology is to select a few texts of the two poets focusing on the theme and compare the texts considering several points. The points can be introduced as significant features in providing interpretations for Sinhalese messenger poetry. This is textual based research and the selected texts will be examined in the author’s own perspectives and reveal the insights. Cumaratunga Munidasa and Ra. Tenakoon were classical instances for Sinhalese studies in 20 th century Sri Lanka. They were members of Hela Hawula, an organization founded in 1941to enrich and enhance the Sinhalese language and identity in their own philosophy and intellectual activities. Cumaratunga was founder and leader of the organization. Cumaratunga provided interpretation for five messenger poems and they are Peacock message (Mayura Sandesa), Pigeon message (Parawi Sandesa), Starling message (Salalihini Sandesa) and Parrot message (Gira Sandesa).Tennakoon selected Swan, (It means Hansa), Parrot (Gira),Cuckoo (Kowul), Starling (Salalihini),Pigeon (Parawi) and Rooster (Sawul) messengers. In this study two texts are particularly selected. The texts are Starling and Parrot massages. These texts are compared in relation to their exegetical approaches for the texts. Attention is paid to investigate how Cumaratunga and Tennakoon have formulated the law of the etymology and linguistic elements of the words and their meanings and how they have deployed the folklore, mythologies and various social and cultural concepts in their exegetical works. As persons who came from the same school, they had their own intellectual identities. Those identities are examined referring to their philological and other ways for interpretation. The author also explores this historical background and the exegetical methodology of Cumaratunga and Tennakoon.
Validation of a Gastro-oesophageal Reflux Disease (GERD) Specific Screening Instrument for Epidemiological Purposes
(University of Kelaniya, 2007) Amarasiri, W.A.D.L.; Pathmeswaran, A.; Ranasinha, C.; de Silva, H.J.
Introduction: The prevalence of GERD is increasing worldwide: the community prevalence in Sri Lanka is not known. Objectives : To develop a practical clinical score to screen for GERD in the community and assess whether a score using both symptom frequency and severity correlates better to an objective measure of GERD than one using only symptom frequency. Methodology : 100 patients (endoscopy positive - which included patients with all grades of oesophagitis) and 150 controls (comparable in age and gender) faced a GERDspecific interviewer-administered questionnaire assessing seven upper gastro-intestinal symptoms. Each symptom was graded using Likert scales for frequency (4-items) and severity (5-items) and two scores were generated. Score 1 being the sum of frequency of symptoms while score 2 was the sum of products of frequency and severity of each. All patients then underwent 24-h ambulatory pHmetry. Both symptom scores were compared against 24-h pHmetry parameters as it is considered the gold standard to diagnose GERD. Cut-off values were determined by receiver-operating characteristic curves. Results : For both scores, mean scores of cases were significantly higher than controls (p=O.OOO). The cut-off score for score 1 was 2': 10.50 (sensitivity 92.0 %; specificity 78.7 %; area under the curve- 0.937). The cut-off score for score 2 was 2': 12.50 (sensitivity 90.0%; specificity 78.0%; area under the curve - 0.929). Both showed high reproducibility (Intra class correlation coefficient score1: 0.94 and score2: 0.82). There was good correlation between both symptom scores and 24-h pHmetry parameters (Spearman rank correlation, p=0.01), but score 2 showed a significantly better correlation. Conclusion: Our GERD questionnaire is valid, reproducible and showed better correlation with an objective test when both severity and frequency of symptoms were scored than frequency alone.