Browsing by Author "Salgado, L.S.S."

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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.
Anatomical variations of the vasculature in suprarenal glands in Sri Lankans
(College of Surgeons of Sri Lanka, 2007) Salgado, L.S.S.; Abeysuriya, V.; Kumarage, S.K.
INTRODUCTION: Anatomical variations of vascular patterns in the suprarenal glands have not been very well studied..METHOD: A descriptive study was performed in 40 human cadavers to identify the anatomical variations in the vasculature of the suprarenal gland. RESULTS: Superior, middle and inferior groups of arteries supplied the suprarenal glands, superior and inferior groups were present in all while the middle group was found in only 94.5%. The superior group had 3 arteries in males and 4 in females on each side. The middle had 01 artery on each side in both sexes. The inferior group had 2 arteries in males and 1 in females on each side. The superior group originated from the posterior branch of the ipsilateral inferior phrenic artery in 85.5% +/- 6.3 on the right and 82% +/- 7.5 on the left. With regard to the middle group, the aortic origin was the most frequent; 55.4%+/- 8.1 on the right and 44.6%+/- 8.1 on the left. The origin of the middle group from the trunk of the inferior Phrenic artery on both sides were, 25.6%+/-8.4 on the right and 38.57% +/- 8.6 on the left. The arteries of the inferior group arose from the ipsilateral renal artery in 75% +/- 8.5 on the right and 53% +/- 8.7 on the left. CONCLUSION: The most number of variations were found in relation to the middle group of suprarenal arteries, whilst superior and inferior groups were constant.
Beware of Variations in Bile Duct and Arterial Anatomy During Laparoscopic Cholecystectomy; An Intr-operative and Cadaveric Study
(University of Kelaniya, 2007) Abeysuriya, V.; Deen, K.I.; Salgado, L.S.S.; Kumaragae, S.K.
Introduction: Comprehensive knowledge, realization of the frequency and multiplicity of abnormalities of the extrahepatic biliary tree are requisites for safe laparoscopic cholecystectomy (LC). Material and methods: Descriptive-prospective cross sectional study W'\S performed in 200 patients, who underwent LC for symptomatic gall bladder (GB) disease and 60 dissected cadavers, to observe variations in GB, cystic duct (CD), cystic artery (CA) and Calot's triangle. Ethical approval was obtained. Results: No abnormality was seen in the gallbladder in 258 (99.2%). Two (1 %) Patients, had abnormalities in the gallbladder. Those were septate and bipolar. Four cadavers (6.6 %) had abnormalities of the cystic duct; 2 absent CD, 1 hepato-cystic duct, 2 with two cystic ducts. The cystic duct was seen to form a classical Calot's triangle in 249(96%). In 11, (5(0.25%) patients, 6(10%) cadavers) the CD was abnormal; 8(73%) had flathorizontal path and 3(27%) were parallel to CBD. The average length of the CD was 3 em in 47 cadavers. Short (<3cm) and long CD (>3cm) were found in 8/60(13.3 %) and 5/60(8.3 %) respectively. In 148(57 %) the right hepatic artery (RHA) was medial to the CHD. In 107(41 %), the RHA was in the triangle of Calot's and in 5(patients 2, cadaver 3) the RHA crossed over the CHD. 231(89%) Of the cystic arteries had no variations. In 29(11 %) (patients 17, cadavers 12) we found abnormalities; 13(5 %) had two cystic arteries, 13(5 %) cystic arteries were anterior to the CHD and 3(1 %) cystic arteries were anterior to cystic duct. Conclusion: The biliary and hepatic arteries had significant variations whilst gallbladder and cystic duct positions were relatively constant in laparoscopic cholecystectomy. Awareness of the variations in the extra hepatic biliary system and related vasculature will prevent the iatrogenic injury. 143
Can we improve the criteria for selection of medical students in Sri Lanka?
(Sri Lanka Medical Association, 2010) de Silva, N.R.; Salgado, L.S.S.; Fernando, G.M.O.; Liyanage, P.L.C.K.; Hewage, S.N.; Pathmeswaran, A.
OBJECTIVE: To examine the validity of selected entry level characteristics in relation to the GCE Advanced Levei (AL) examination as predictors of performance of medical students. METHODS: Data on two consecutive batches of students at the Medical Faculty, Kelaniya University, were analysed. These included students' sex. AL attempt, AL z-score, English placement test marks on registration at the faculty, and aggregate marks at summadve examinations held in the 2nd (Phase I), 3rd and 4l (Phase II) years. The effect of predictor variables on medical school marks was assessed by multivariate analysis with causal path diagrams. RESULTS: The sample consisted of 294 students; 58.8% were females. Most had entered after the 2nd attempt (32% from 1s1, 48.3% from 2nd, 19.7% from 3rd attempt). The mean z-score was 2.017 (SD0.142). Mean English placement test mark was 59.1 (SD14.2). Mean marks in Phase I and II examinations were 54.3 (SD7.3) and 56.5 .(SD7.6) respectively. Significantly more males had entered after the 3rd attempt than females (27.2% of males, vs 14.5% of females, Pearson x2=0.027). Females did significantly better in English and in Phase I and II examinations. Path analysis showed that z-score, attempt and English placement test marks were all significant predictors of outcome at the First Examination. There was high correlation between performance at First and Second Examinations. CONCLUSION: Requiring prospective medical students to pass General English and restricting the number of attempts at the AL to two instead of three, will result in selection of medical students that perform better.
Characteristics of menarche in adolescent girls in Sri Lanka
(Faculty of Medicine, University of Kelaniya & Plan International, 2008) Salgado, L.S.S.; Abeysuriya, V.; Wickremasinghe, A.R.
INTRODUCTION: Menarche is an important biological milestone in girls. The age at attainment of menarche is important for implementing programmes to improve the life skills of girls. OBJECTIVE: To describe the characteristics of menarche, the factors influencing the onset of menarche and to describe the knowledge, beliefs and practices during menarche of adolescent girls in Sri Lanka. Methods: This cross sectional study was conducted among girls 10-16 years of age in four schools situated in the Ragama Medical Officer of Health (MOH) area. Six hundred and sixty two girls were randomly selected and data were collected using a pre-tested, self-administered questionnaire. RESULTS: The median age of our sample was 13 years (range 10-16 years); the mean and median ages of attaining menarche were 12,53 and 11,48 years respectively. The mean BMI of girls who had attained menarche was 17.6 (SEM 0.22) Kg/m2 and those who did not was 16.92 (SEM 0.32) Kg/m2. 47% of the girls had a menstrual cycle length of e" 29 days, 23.4% had irregular cycles and 59% reported that the duration of bleeding was 3-5 days. First borns reported a IcJwer mean age at menarche (12.34 years) than the later borns (12.6 years) (p=0.02). Girls from single child families, who were from higher social categories (Categories 1 & 2) and whose parents were educated beyond 0/L attained menarche earlier. 40.8% stated that menstrual blood is not dirty, 70% admitted that there was no prohibition of having cold or sour foods. The majority of the students had adequate knowledge regarding physical changes during menarche. Girls experienced negative emotions during menstruation. CONCLUSION: The median age of attaining menarche is 11.48 years. Girls experienced negative emotions during menstruation.
Chronic kidney disease of unknown aetiology: the tip of the iceberg?
(Ceylon Journal of Medical Science, 2018) Wijerathne, B.T.B.; Meier, R.J.; Salgado, L.S.S.; Rathnayake, G.K.; Kumara, S.S.; Agampodi, S.B.
No abstract available.
Comparison of undergraduate student performance in Anatomy practical examination after studying prosected anatomy specimens and after doing anatomy dissections
(University of Kelaniya, 2006) Karunanayake, A.L.; Salgado, L.S.S.; Pathmeswaran, A.
Introduction: In the subject of Anatomy, students are expected to identify parts of the human body and their relationships to each other. This could be studied by dissecting human cadavers by students themselves according to the manual or using the already dissected/ “prosected” specimens. Prosected anatomy specimens are prepared by the staff. Objective: To compare the performance in anatomy practical examination (OSPE) of students who had studied prosected specimens with the students who did dissections. Method: A batch of students was divided into two groups by using random numbers. One group was given prosected specimens (prosection group) to study the pelvic walls and pelvic organs. The other group was given cadavers to dissect (dissection group) and study the same areas. Two weeks time period was given to both groups. At the end of two weeks both groups had to face an OSPE. The OSPE involved identifying structures in prosected specimens. None of the students had access to these specimens prior to the OSPE. Results were analysed using EPI6 statistical package. Results: Prosection group had 80 students. Dissection group had 72 students. Age range was 20 -28 years. Mean ages for both groups were 21.6 years. There were 43 (55%) and 34 (47%) females in prosection and dissection groups respectively. In prosection group 30 (38%) passed the practical test. In dissection group 14 (19%) passed the practical test. There was a significant difference (based on X2 test, P= 0.02) in the performance of these two groups. Conclusion: Prosection group performed significantly better than the dissection group. It is probable that when prosected specimens are used time used for dissecting can be used to identify and study structures.
The Distribution of the anal glands and the variable regional occurrence of fistula-in-ano: is there a relationship?
(Springer-Verlag, 2010) Abeysuriya, V.; Salgado, L.S.S.; Samarasekera, D.N.
BACKGROUND: Fistula in ano is a rather common condition, but the disease process is not yet fully understood. The aim of our study was to determine how the distribution of anal glands contributes to the variable occurrence of fistula-in-ano in the perineum. METHODS: we conducted a blinded two-phase prospective study. In the first phase, the perineum of the patients with primary fistulae was anatomically divided into right upper and lower and left upper and lower quadrants in the lithotomy position. The fistulae were classified according to what quadrant the external and internal openings and the tract pathway were in. In the second phase, using 10 human cadaver specimens, full thickness tissue samples were taken from each quadrant of the anus. Samples were histologically evaluated for the volume fractions of the anal glands in each quadrant. RESULTS: The new classification system we propose revealed that the largest number of fistulae 43% (17/39) were in the right lower quadrant, and 22% (9/39), 12% (5/39) and 8% (3/39) were in the left lower, right upper and left upper quadrants, respectively. It was also observed that 14% (5/39) of fistulae were in more than one quadrant. The volume fractions of each quadrant showed that the largest volume fraction of the anal glands was in the right lower quadrant (right lower quadrant: 0.64, left lower quadrant: 0.35, right upper quadrant: 0.26 and left upper quadrant: 0.22, P = 0.001). CONCLUSIONS: To the best of our knowledge, this is the first study that has objectively shown that the distribution of the anal glands is variable, and the highest density of anal glands is in the right lower quadrant of the anus. This variable distribution may be associated with the variable occurrence in fistula in ano.
The distribution of the anal glands and the variable regional occurrence of fistula-in-ano: is there a relationship?
(Springer Nature, 2010) Abeysuriya, V.; Salgado, L.S.S.; Samarasekera, D.N.
BACKGROUND: Fistula in ano is a rather common condition, but the disease process is not yet fully understood. The aim of our study was to determine how the distribution of anal glands contributes to the variable occurrence of fistula-in-ano in the perineum. METHODS: we conducted a blinded two-phase prospective study. In the first phase, the perineum of the patients with primary fistulae was anatomically divided into right upper and lower and left upper and lower quadrants in the lithotomy position. The fistulae were classified according to what quadrant the external and internal openings and the tract pathway were in. In the second phase, using 10 human cadaver specimens, full thickness tissue samples were taken from each quadrant of the anus. Samples were histologically evaluated for the volume fractions of the anal glands in each quadrant. RESULTS: The new classification system we propose revealed that the largest number of fistulae 43% (17/39) were in the right lower quadrant, and 22% (9/39), 12% (5/39) and 8% (3/39) were in the left lower, right upper and left upper quadrants, respectively. It was also observed that 14% (5/39) of fistulae were in more than one quadrant. The volume fractions of each quadrant showed that the largest volume fraction of the anal glands was in the right lower quadrant (right lower quadrant: 0.64, left lower quadrant: 0.35, right upper quadrant: 0.26 and left upper quadrant: 0.22, P = 0.001). CONCLUSIONS: To the best of our knowledge, this is the first study that has objectively shown that the distribution of the anal glands is variable, and the highest density of anal glands is in the right lower quadrant of the anus. This variable distribution may be associated with the variable occurrence in fistula in ano.
Factors associated with osteoporosis among a sub-urban Sri Lankan population
(Research Symposium 2009 - Faculty of Graduate Studies, University of Kelaniya, 2009) Karunanayake, A.L.; Pinidiyapathirage, J.; Salgado, L.S.S.
Introduction : Risk factors for osteoporosis can vary from country to country. Objective: To determine the association between osteoporosis and age, physical activity, body mass index (BMI), smoking, alcohol consumption, consumption of milk, level of education and income in a sample of sub-urban Sri Lankan adults. Methodology: A descriptive cross sectional study involving 22 grama niladari divisions of the Ragama MOH area was conducted from March to October 2007. A randomly selected sample of 700 adults, in the age group of 35-64 years, were invited to participate in the study. A structured interviewer administered questionnaire was used to collect demorgraphic data and details of risk factors. Bone mineral density (BMD) was measured with a peripheral Dexa scan. A BMD of < -2.5 was considered as having osteoporosis. Result: Of the 700 subjects studied, 60% (n=421) were females. Using logistic regression analysis, age >50 years (OR 3.5 95% CI 1.9-6.2), female sex (OR 12.2 95% CI 4.8-30.9), low level of education (OR 1.8 95% CI 1.1-2.8), low BMI (OR 3.5 95% CI 1.7-7.3) and smoking (OR 5.8 95% CI 1.9-17.2) had a significant association with osteoporosis. Conclusion: Age, sex, level of education, nutritional status and regular smoking showed a significant association with osteoporosis.
Histological and ultra-structural changes in enpothelial cells of the placenta in hypertensive disorders of pregnancy
(Sri Lanka Medical Association, 2000) Salgado, L.S.S.; Angunawela, P.; Tissera, A.; Sirisena, J.
INTRODUCTION: The maternal syndrome of pre-eclampsia is thought to result from a generalized vascular endothelial cell disturbance caused by a circulating factor probably derived from the placenta. Objective: Study the histological and ultra-structural changes of endothelial cells, so that the contribution of these changes to the pathogenesis of hypertensive disorders of pregnancy can be understood. METHOD: Placentae of 150 normal pregnancies and 200 hypertensive disorders of pregnancy were selected for this study. Tissue from the fetal surface was obtained for microscopic examination. Electron microscopic examination was done on 20 normal placentae and 30 placentae from hypertensive disorders of pregnancy. RESULTS: Histologically there were no significant changes in the normal group and in the group with hypertensive disorders of pregnancy. Ultra-structurally significant changes were observed in golgi bodies, mitochondria, pinocytotic vesicles, rough endoplasmic reticulum, glycogen and interaction with pericytic processes in the endothelial cells of the placentae with hypertensive disorders of pregnancy when compared to normal placentae. CONCLUSIONS: Significant changes were observed in endothelial cells at the ultrastructural level in the placentae of women with hypertensive disorders of pregnancy.
Morphological characteristics of appendix vermiformis in human: a pilot study to establish regional norms with special interest on its position
(Sri Lanka Medical Association, 2007) Salgado, L.S.S.; Abeysuriya, V.; Kumarage, S.K.; Rupasinghe, D.K.
INTRODUCTION: Regional variations of morphology of the appendix vermiformis have been observed, especially with reference to its position, but due to the scarcity of scientific studies on its regional anatomy, achieving norms for its morphology is difficult. OBJECTIVE: To describe morphological characteristics of human cadaveric appendices. Design, setting and methods: A descriptive, prospective, cross sectional study was carried out among 30 patients who underwent laparoscopic appendicectomy in Colombo North Teaching Hospital, and 60 dissected cadavers in Departments of Anatomy in the Medical Faculties of Ragama and Sri Jayewardenepura. Results: The mean length of appendix was 65mm, ranging from 35mm to 110mm. 96.6% (58/60) of appendices were attached to the postero-medial surface and 3.4%(2/60) to the apex of the cecum. In all cadavers, the shape of the cecum was found to be ampullary. The mean outer diameter of appendices were 5.2mm, ranging from 3mm to 10mm. 41.6% (22/90) were retrocecal, 6.6% (6/90) pelvic (subcecal and promonteric 3.3% each), and 51.6% (46/90) were ileal (consisting 30% (27/90) post ileal and 21.6% (19/90) pre-ileal). 96.6% (58/60) of appendices were supplied by the inferior division of ileo-cecal artery, and 1.6% (1/60) by the posterior cecal artery. The mean distance between the opening of the appendix to cecum and to the opening of ileo cecal opening was 2i.2mm (range 13mm to 24mm). The mean length of the appendicular artery was 35mm (range 25mm to 40mm). CONCLUSION: Regional variations of morphological characteristics of appendix are numerous, especially with regard to its position. Therefore to establish norms for a population, further extensive studies are needed.
Obliterative endarteritis in placentae and hypertensive disorders of pregnancy: a case control study
(Sri Lanka Medical Association, 2008) Salgado, L.S.S.; Casather, D.M.; Abeysuriya, V.
OBJECTIVE: Obliterative endarteritis in placenta is known to interrupt the fetal circulation in hypertensive disorders related to pregnancy. DESIGN, SETTING AND METHODS: Case control study was performed among 196 pregnant mothers (median age of 29 years, range 15-42 years) with hypertensive disorders complicating pregnancy and 150 normal mothers (median age 28 years; range 15-41 years). Mothers who had blood pressure of 140/90 mmHg or above on admission and remaining above that level after 24 hours of admission, mothers with diastolic blood pressure of 110 mmHg on admission, eclamptic mothers and known hypertensive mothers who are currently on antihypertensive drugs were included. All cases were classified as essential hypertension, pregnancy induced hypertension (PIH), pre-eclamptic toxaemia (PET), severe pre-eclamptic toxaemia and eclampsia. Haematoxyiin and Eosin stained placental tissue sections were visualized under light microcopy. Presence of Obliterative endarteritis was confirmed by the swelling, proliferation of endothelial cells, thickening of the basement membrane and fibromuscular sclerosis of the vessel wall. RESULTS: In controls, 61/150 (40.7 %) and in cases, 150/196 (76.5%) had endarteritis (P=0.001). Among the cases, placentae in mothers with essential hypertension, PIH and PET showed endarteritis in 24/34 (70.6 %), 73/93 (75.3%) and 29/37 (78.4 %) respectively. 24/32 (75%) placentae of mothers with severe pre-eclapmtic toxaemia and eclampsia had endarteritis (severe vs. non-severe hypertensive disorders, P=0.2). CONCLUSION: The incidence of Obliterative endarteritis in placenta is common in hypertensive disorders, but showed no significant difference with the different types of hypertensive disorders.
Position and morphology of the appendix vermiformis in Sri Lankans
(College of Surgeons of Sri Lanka, 2007) Salgado, L.S.S.; Abeysuriya, V.; Kumarage, S.K.; Rupasinghe, D.K.
INTRODUCTION: The vermiform appendix varies in length and opens into the posteromedial wall of the caecum, 2cm below the ileo caecal valve. While the position of its base is constant in relation to the caecum, the appendix itself may lie in a variety of positions. OBJECTIVE: To describe the morphological characteristics of the appendix among Sri Lankans. METHOD: A prospective study was carried out among 30 patients who underwent laparoscopic appendicectomy in Colombo North Teaching Hospital and 60 dissected cadavers in the departments of Anatomy at Ragama and Sri Jayewardenepura. While the intra-abdominal position of the appendix was assessed in both laparoscopic appendicectomy patients and the dissected cadavers, the other morphological characteristics were assessed only in the cadavers. RESULTS: The mean length of the appendix was 65mm, (range 35 to 110mm). The base of the appendix opened into the posteromedial wall of the caecum in 96.6% (58/60) and into the apex of the caecum in 3.4% (2/60). The mean outer diameter of the appendix was 5.2mm (range3 to 10mm). The position of the appendix was found to be retrocaecal in 24.4% (27/90), pelvic in 6.6% (6/90), and ileal in 51.6% (46/90) comprising 30% (27/90) post-ileal and21.6%(19/90)pre-ileal. The blood supply of the appendix was the inferior division of the ileo caecal artery in 96.6% (58/60) and the posterior caecal artery in 1.6% (1/60). The mean distance between the base of the appendix and the ileocaecal valve was 21.2 mm, varying from 13 mm to 24mm. CONCLUSION: The frequency of the various positions of the appendix in our study population was different to the reported data. The ileal position of the appendix was the most common and the pelvic position the least common.
Prevalence of osteoporosis and osteopenia in a sample of Sri Lankan adults
(University of Kelaniya, 2008) Karunanayake, A.L.; Salgado, L.S.S.; Premaratna, B.A.H.R.; Femando, S.; Herath, H.M.R.P.; Abeysuriya, V.; Kumarendran, B.; Mahavithanage, S.T.C.
Introduction: Osteoporosis is characterized by low bone mineral density and deterioration in the micro architecture of bone that increases its susceptibility to fracture. This condition is becoming increasingly common in our country in the elderly, especially in post menopausal women. Objective: To determine the prevalence of osteoporosis and osteopenia in a sample of Sri Lankan adults. Methodology: A descriptive cross sectional study was conducted at the Faculty of Medicine University of Kelaniya from July 2007 to October 2007. The study subjects were selected from 22 grama niladhari divisions of the Ragama MOH area. From each division males and females aged 35 to 64 years were randomly selected from the voters list and recruited for the study. A P-dexa scan was used to measure the BMD of the left middle finger. AT score of S-2.5 was considered as osteoporosis, >-2.5 to -1 as osteopenia. These two categories together were considered as low BMD. A T score of> -1 was considered normal. Results: There were 762 subjects with a mean age (SD) of 52.3 (7.5) comprising 61% females and 39% males. The prevalence of osteoporosis and osteopenia were 14% and 29% respectively. In subjects aged less than fifty years 9% of females and 3% of males had osteoporosis and 31% of females and 18% of males had osteopenia. In subjects aged fifty years or more 33% of females and 3% of males had osteoporosis and 38% of females and 21% of males had osteopenia. Conclusion: the prevalence of osteoporosis and osteopenia were higher among the females. The prevalence of osteoporosis among females aged over fifty years was markedly higher than the females who are less than fifty years.
Prevalence of osteoporosis in a sample of Sri Lankan urban population
(Sri Lanka Medical Association, 2008) Karunanayake, A.L.; Salgado, L.S.S.; Abeysuriya, V.; Fernando, S.; Herath, H.M.R.P.; Kumarendran, B.; Premaratna, B.A.H.R.; Mahawithanage, S.T.C.
BACKGROUND: Osteoporosis is characterized by low bone mineral density and deterioration in the micro architecture of bone. It predisposes individuals to increased risk of fractures of the hip, spine and other skeletal sites. Peripheral DEXA (P-DEXA) scans are ideal for mass screening of bone mineral density (BMD). OBJECTIVE: To determine the prevalence of osteoporosis and osteopenia in a sample of urban Sri Lankans. DESIGN, SETTING AND METHODS: A descriptive cross sectional study was conducted at the Faculty of Medicine, University ofKelaniya from July 2007 to October 2007. The study subjects were selected from 22 Gramasevaka Niladhari Divisions of the Ragama MOH area. From each division, people aged 35 to 65 years were randomly selected from the voters list and invited to participate in the study. A P-DEXA scan was used to measure the BMD of the left middle finger. A T score of <-2.5 was considered as osteoporosis, -1 to -2.5 as osteopenia. These two categories together were considered low BMD. A T score of > -1 was considered normal. RESULTS: There were 731 subjects with a mean age (SD) of 52.5 (7.5) comprising 60% females. The prevalences of osteoporosis and osteopenia were 14% and 29% respectively. 20% of females and 6% of males were affected with osteoporosis. The prevalence of osteoporosis was 7% among those <50 years and 20% among those >50 years. CONCLUSION: There was a high prevalence of low BMD in this urban population. Prevalence of low BMD was higher among females and those over fifty years.
A rare variation of hepatic artery arising from the left gastric artery in a Sri Lankan cadaver
(Research Symposium 2010 - Faculty of Graduate Studies, University of Kelaniya, 2010) Mallawaarachchi, Ranjan; Wimalarathne, Saranga; Fernando, E.D.P.S.; Salgado, L.S.S.
Introduction Anatomical variations of the arterial supply of the liver are frequently found. The normal hepatic arterial anatomy as described in classic text books is only found in 52-80% of cases. Knowledge of the hepatic arterial anatomical variations are important for those surgeons who perform liver transplant and hepatobilliary operations, to prevent vascular damage while performing surgery. Objective To describe a rare variation of hepatic artery arising from the left gastric artery in a Sri Lankan cadaver. Methodology This variation was found when a dissection was performed on a 65 year old male cadaver with a weight of 73kg, for demonstration of the celiac trunk and its branches, at the anatomy dissection hall, Faculty of Medicine, Ragama. Results The hepatic artery was found to arise from the abnormally large left gastric artery of the celiac trunk and it was the only arterial supply of the liver. The splenic, left gastric and the gastro duodenal arteries were found to arise from the celiac trunk. Conclusion Knowledge of rare hepatic arterial variations is very important for hepatobiliary surgeons who perform frequent biliary tract operations and liver transplantations.
Selection of medical students in Sri Lanka: time to re-think criteria?
(Sri Lanka Medical Association, 2011) Hewage, S.N.; Salgado, L.S.S.; Fernando, G.M.O.; Liyanage, P.L.C.K.; Pathmeswaran, A.; de Silva, N.R.
OBJECTIVE: To examine the validity of selected entry level characteristics in relation to the GCE A/L examination as independent predictors of performance of students in medical school. METHODS : A retrospective, analytical study was done at the Faculty of Medicine, University of Kelaniya. Student characteristics at entry were described by sex, the average z-score, General English grade and attempt at GCE A/L examination, and average mark obtained at the English placement test on registration to medical school. Average marks at three summative examinations were used as indicators of performance in medical school. Multivariate analysis using multiple linear regression was carried out using these three outcome measures in relation to four entry point variables as predictors of performance in medical school. Causal path diagrams were constructed using standardised regression coefficients for the whole group and for male and female students separately. RESULTS: The A/L z-score, A/L attempt and English placement test marks were all significant predictors of outcome at the First Examination. Of the variables relating to the A/L examination, the attempt had a much higher path coefficient with performance at the First Examination than the A/L z-score, as did the English marks. Separate path analyses for male and female students showed that while the significance of the relationships remained the same, the magnitude of the correlation was different. CONCLUSIONS: Students who gain admission on their 3rd attempt at the AL examination fare much worse than those admitted to medical school on their 1st attempt. Differences between sexes in examination performance are probably linked to both A/L attempt and English language proficiency.
Variations in the topographical anatomy of the recurrent laryngeal nerve and the inferior thyroid artery
(Sri Lanka Medical Association, 2008) Subasinghe, T.V.; Salgado, L.S.S.; Fernando, R.; Abeysuriya, V.; Casather, D.M.; Willaraarachchi, W.A.M.A.
OBJECTIVE: Thyroidectomy is a commonly performed surgery. Comprehensive knowledge in anatomical variation of the inferior thyroid artery (ITA) in relation to the recurrent laryngeal nerve (RLN) is mandatory for safe thyroid surgery. Data on variations in Sri Lankans is incomplete. DESIGN, SETTING AND METHODS: Thirty cadavers (20 male:10 female; range 56-87 years) were dissected to study the anatomical variations of the ITA in relation to the RLN. RESULTS: In 22 cadavers the right ITA originated from thyrocervical trunk, and in 8 it was a branch of the transverse cervical artery. On left, ITA originated from the thyrocervical trunk in 26 and from the transverse cervical artery in 4 cadavers. Branching of the artery was extra-capsular in 22(72%) on the right and 23(75%) on the left. On the right, the RLN was seen posterior to all the extra-capsular divisions of the ITA in 18(60%) cadavers, while in 7(22%) it was anterior. In 5(18%) cadavers it was between the divisions of ITA. On the left, it was 28(95%) and 2(5%) respectively (Z=2.74, P=0.006). The right RLN was seen in the tracheo-oesophageal groove in 26 cadavers (85%), while in 4(15%) it was on the antero-lateral side of die trachea. On the left, all the recurrent laryngeal nerves was seen in the tracheo-oesophageal groove. CONCLUSION: The anatomical variation is common in relation to the right RLN. These have implications in thyroid surgery and follow up.