Browsing by Author "Salgado, S."

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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 superficial palmar arch in Sri Lankans – A cadaveric study
(Research Symposium 2009 - Faculty of Graduate Studies, University of Kelaniya, 2009) Salgado, S.; Fernando, E.D.P.S.; Anuradha, W.K.; Nishantha, M.P.
Vasculature of the hand is one of the complex areas having a high degree of anatomical variations. It is very important to have an adequate knowledge of the arterial supply to the hand in this era of modern medical technology, as a significant number of surgical procedures such as radial arterial cannulation, radial forearm flap, and radial artery conduits in coronary artery grafting are carried out. Improvement of microsurgical techniques in reconstructive hand surgery also have made a necessity for better understanding of the vasculature of the hand. The superficial palmar arch provides the major blood supply to the hand along with the deep palmar arch and represents an important anastomosis between the ulnar and radial arteries. Objective: To study the variations of the superficial palmar arch in Sri Lankans compared to the classical description given in standard text books. Methodology: Eighteen hands from formalin preserved cadavers, both males and females of the ages between 30 to 80 years were dissected. Special attention was paid to trace the blood vessels supplying the thumb. Results: The superficial palmar arch is mainly formed by ulnar artery and some contribution from the radial artery. Two types of superficial palmar arches were described, as complete and incomplete. The classic superficial palmar arch was described as the direct continuity between the ulnar artery and the superficial palmar branch of radial artery which is considered as the sub group of complete type. In the incomplete type superficial palmar arch is formed only by the ulnar artery with some communications from the deeper palmar arch . According to the previous literature, complete type ranges from 80% to 90%. In our study 16 hands (89%) were with complete type and 02 (12%) were with incomplete type. However the anastomosis between radial and ulnar arteries were seen in all the specimens of our study. Classical palmar arch having a direct continuity between the ulnar artery and the superficial palmar branch of radial artery was found in 10 (55%) hands, in contrast to the 10% in the literature. Palmar type of median artery was noticed in 2 (12%) hands contributing to form the superficial palmar arch, in contrast to the 20% in literature. Although the sole blood supply to the thumb is by the princeps pollicis according to the standard text books, in our study it was found only in 6 (33%) specimens. The classical picture of the superficial palmar arch, with the princeps pollicis supplying the thumb was not seen in any of the specimens. Conclusion: Variations in the terminations of the radial and ulnar arteries are common. Since there are anastomoses between radial and ulnar arteries it may be safe to sacrifice any of the main arteries when performing surgical and medical interventions of the hand in the absence of vascular diseases.
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.
Approaches to the multiple choice questions in histology
(Authour, 2011) Salgado, S.
No abstract available
Course pattern of the muscular branch of the median nerve in Sri Lankans hand [[Curso del patrón del ramo muscular del nervio mediano de la mano en Sri Lankenses]
(Soc. Chilena Anatomia, 2009) Senanayake, K. J.; Salgado, S.; Fernando, R.
Transligamentous variant of the recurrent motor branch is having a higher risk of getting damage during both endoscopic and open carpal tunnel releases. The incidence of the transligamentous variant is about 7% to 80% world wide. This wide variation of the incidence could be due to the failure of identification of the distal edge of the flexor retinaculum from the obliquely oriented fascia that runs from the distal edge. We used two criteria to identify the distal edge; the abrupt change in the thickness of the flexor retinaculum and its colour change in cross section. The incidence of transligamentous variant is rare and the reported high incidence could be due to an error in identification of the distal edge of the flexor retinaculum as shown by Kosin (1998).
Does the position of external branch of superior laryngeal nerve change with the height of the patients and the length of the larynx
(Jaypee Publisher, 2012) Senanayake, K. J.; Fernando, R.; Salgado, S.; Jayanthi, M.
When the external branch of superior laryngeal nerve (EBSLN) crosses the superior thyroid artery closer to thyroid upper pole, the EBSLN has a higher risk of getting damaged. Its anatomical position in relation to thyroid upper pole may vary with changing the height of patient and the length of larynx. We intended to test this hypothesis and predict the risk. Thirty cadavers of both sexes are dissected (29-87 years, mean 69). One cadaver excluded due to a goiter and five nerves were damaged during dissection. Therefore, 53 nerves were studied. The distance from upper pole of thyroid to the point where the nerve crosses the superior thyroid artery (TS) was measured. Cadaver length (CL), cricothyroid length (CT) and the cricohyoid length (CH) measured to the closest millimeter. Correlation of TS with CL, CT and CH was measured. The mean distance from the upper pole of the thyroid to the point where EBSLN crosses superior thyroid artery was 6.24 mm (SD 5.94). On right side, the mean distance was 4.03 mm (SD 5.34) and, on the left, 8.37 mm (SD 5.7 mm). The difference between two means was significant at 0.05 (t = 2.82, p = 0.007). There was a strong correlation between distance from the upper pole of the thyroid to the point where the nerve crosses the superior thyroid artery with CL (r = 0.98). There was moderate correlation with the CT and CH lengths (r = 0.55, 0.58 respectively). The position of EBSLN in relation to thyroid upper pole is strongly correlated with the height of the patient. The EBSLN crosses superior thyroid artery more closely to thyroid upper pole in right side.
General embryology for medical students
(Authour, 2008) Salgado, S.
No abstract available
Glossary of common medical terms
(Authour, 2009) Salgado, S.
No abstract available
Hemoglobin A1c values in CKDu endemic and non endemic regions of Sri Lanka
(Elsevier Science Publishers, 2017) Wijerathne, B.; Meier, R.; Salgado, S.; Agampodi, S.
Hepaticocystic duct and a rare extra-hepatic cruciate arterial anastomosis: a case report
(BioMed Central, 2008) Abeysuriya, V.; Salgado, S.; Deen, K.I.; Kumarage, S.K.
INTRODUCTION: The variations in the morphological characteristics of the extra-hepatic biliary system are interesting. CASE PRESENTATION: During the dissection of cadavers to study the morphological characteristics of the extra-hepatic biliary system, a 46-year-old male cadaver was found to have drainage of the common hepatic duct drains directly into the gall bladder neck. The right and left hepatic ducts were not seen extra-hepatically. Further drainage of the bile away from the gallbladder and into the duodenum was provided by the cystic duct. Formation of the common bile duct by the union of the common hepatic duct and cystic duct was absent. Further more the right hepatic artery was found to be communicating with the left hepatic artery by a "bridging artery" after giving rise to the cystic artery. An accessory hepatic artery originated from the "bridging artery" forming a "cruciate" hepatic arterial anastomosis. CONCLUSION: Combination of a Hepaticocystic duct and an aberrant variation in the extra-hepatic arterial system is extremely rare.
Interaction between pericytes and endothelial cell of foetal capillaries in hypertensive placentae
(Sri Lanka Medical Association, 1998) Salgado, S.; Angunawela, P.; Sirisena, J.; de Tissera, A.
INTRODUCTION : Pericytes and endothelial cells are known to possess direct contacts in many parts of the vascular tree. Pericytes are known to have modulating effects on endothelial cell growth and differentiation. It is possible that some pericytes are a source of new endothelial cell. OBJECTIVES : Information regarding the ultrastructural changes of foetal capillaries of hypertensive placentae is lacking. Therefore we studied the foetal capillaries of hypertensive placentae to ascertain any significant ultrastructural interaction between pericytes. endothelial cells and basement membrane. METHOD : Placental tissue from 15 pregnant mothers with a blood pressure of 140/90 or more and 10 normal mothers who had normal full term deliveries were studied. Fresh placentae were examined and 2mm sized pieces were taken from central foetal and fixed in 2% gluteraldehyde for eletron microscopic studies. RESULTS : All hypertensive placentae showed a number of pericytic processes, which was significantly higher than in normal placentae. (P<0.001). Both frequency and complexity of direct connections between endothelial cells and pericytes appear to be increased in foetal capi 1 laries of hypertensive placentae . Basement membranes of foetal capillaries in 9 hypertensive placentae showed marked thickening. CONCLUSIONS : There was complexed interaction between endothelial cells and pericytes of foetal capillaries of hypertensive placentae.
The Kidney : morphology and development
(Authour, 2009) Salgado, S.
No abstract available
A Methodical approach to medical terminology
(Authour, 2009) Salgado, S.; Athukorala, U. V.
No abstract available
Morphology of the Thyroid Gland and its common variations
(12th Annual Research Symposium, University of Kelaniya, 2011) Hasan; Rizvi; de Alwis, R.P.; Herath, S.; Senadipathy, C.; Mahawaththa, T.; Karunanayake, A.; Salvin, K.A.; Fernando, P.; Ranaweera, L.; Fernado, E.; Ilayperuma, I.; Salgado, S.
The thyroid gland is an endocrine gland located in the anterior triangle of the neck across the midline. Many pathological conditions such as tumours and inflammatory diseases are associated with the thyroid gland. The incidence of thyroid diseases, with or without an indication for surgical intervention is a common occurrence in clinical practice. Hence an in-depth knowledge of the morphology of the thyroid gland and its variation is of paramount importance to clinicians. Literature surveys carried out do not reveal adequate studies relevant to the morphology of the thyroid gland and its variations in a Sri Lankan population. The aim of the study is to identify the morphology of the thyroid gland and its possible variations in the Sri Lankan population. A descriptive study was carried out by dissecting 31 human cadavers (12 female and 19 male) aged between 35-80 years in the Department of Anatomy, University of Kelaniya. Measurements were taken with Vernier Caliper. The results show thirty one thyroid glands (62 sides) were observed and measurements were taken. Average length, width and thickness of the right lateral lobes were 4.11cm, 1.25cm and 1.95 respectively. Average length, width and thickness of the left lateral lobes were 4.02cm, 1.13cm and 2.05cm respectively. Pyramidal lobe was found in 12 thyroid glands (38.7%), of which 4 were in females and 8 in males. Of these 12, in 9 glands pyramidal lobe was arising from the left lobe (75%) and the rest from the isthmus(25%). Only 83.33% of pyramidal lobes were associated with levator glandulae thyroidae and the rest were independent. Levator glandulae thyroidae was observed in 10 glands (32.25%). In three glands (9.67%) isthmus was found to be absent. Significant gender difference was not identified in the dimensions of the gland. No significant difference in dimensions was observed when compared to western figures. Presence of the pyramidal lobe is not an uncommon finding. Therefore, having a sound knowledge in morphology of the thyroid may reduce the unwarranted outcomes in thyroid surgeries in Sri Lanka.
Neurovascular bundle of upper limb for medical undergraduates
(Salgado, S., 2009) Salgado, S.; Abeysuriya, V.
No abstract available
A Rare variant of the superficial ulnar artery, and its clinical implications: a case report
(BioMed Central, 2007) Senanayake, K. J.; Salgado, S.; Rathnayake, M. J.; Fernando, R.; Somarathne, K.
The superficial ulnar artery is a rare variation of the upper limb arterial system that arises from the brachial or axillary artery and runs superficial to the muscles arising from the medial epicondyle 123. The incidence is about 0.7 to 7% 145. In our routine dissections we found a superficial ulnar artery, which crossed the cubital fossa superficial to the bicipital aponeurosis making it highly vulnerable to intra-arterial injection. This is a rare variation that every medical and nursing staff member should know about.
Students’ perceptions and attitudes to drama in English language learning at the Faculty of Medicine, Ragama
(Research Symposium 2009 - Faculty of Graduate Studies, University of Kelaniya, 2009) Athukorala, V.U.; Edirisinghe, E.A.N.J.; Salgado, S.
INTRODUCTION The greatest challenge that majority of medical students face is the medium switch from their mother tongue to English. The purpose of this research is to explore perceptions and attitudes of the first year students towards drama as an English language learning tool. The dramas were used to assist them overcome their fear of language switch by establishing self-confidence while creating an interest in the use of English language. METHODOLOGY The participants in the research were randomly selected MBBS and SLT (Speech and Language Therapy) students. They were from diversified backgrounds with varying levels of English knowledge at entry level. The research was carried out in the form of questionnaires and interviews that took place before and after classroom practical sessions and also after stage performances at the end of the Intensive Courses of English in the year 2009. RESULTS Over 96% of students perceived situational dialogues/skits/playlets/dramas as a highly useful method since it made learning an interesting task and helped improve fluency, vocabulary and confidence. They claimed that it was an opportunity to develop their personality, to relieve stress and was also a platform to demonstrate their creativity and talents. Further, over 90% of students appreciated peer learning while the weaker students especially claimed that peer learning and group work reduced their anxiety and inhibitions towards the use of English language. CONCLUSION The research highlighted the use of drama activities in English language learning as a highly positive measure. The most important factor therefore is to explore the ways and means to help the students to sustain their newly created self confidence and interest throughout their stay in the university.
Surgical anatomy of the veins of the lower limb - a cadaveric study
(College of Surgeons of Sri Lanka, 2009) Salgado, S.; Abeysuriya, V.; Pathirana, A.
INTRODUCTION: With the advent of new surgical techniques, an adequate knowledge of precise anatomy of the venous system of the lower limb is important for safe surgery. The aim of this study is to provide some basic information for those who are interested in phlebology. MATERIALS AND METHODS: The anatomy of the superficial and deep veins of both lower limbs was studied in 20 human cadavers (age 42-72 years) of both sexes (12 males: 08 females). Great saphenous vein (GSV) and small saphenous vein (SSV) were traced from medial and lateral malleoli to the sapheno-femoral junction (SFJ) and saphenopopliteal junction (SPJ) respectively. The number of deep perforators was counted and measurements were taken from a fixed anatomical land mark. RESULTS: In both lower limbs of 17 cadavers (85%), the course of GSV was similar to the course described in the commonly used text books. Large tributary with a diameter similar to GSV at the SFJ was seen in 3 cadavers (15%). The point of entry of SSV into the popliteal vein varied greatly. In majority of cadavers the opening was at the level of the popliteal skin crease and in others it was either above or below this. Large deep perforators were found in the calf and thigh with irregularly distributed small perforators. CONCLUSION: A majority of individuals have the lower limb superficial venous pattern described in standard text books. However, a significant minority had variations, which could have important implications on the presentation and treatment of varicose
Tissue identification
(Authour, 2009) Salgado, S.
No abstract available
Utrastructural changes of foetal surface of the placenta in hypertensive disorders of pregnancy
(Sri Lanka Medical Association, 1997) Salgado, S.; Angunawala, P.; de Tissera, A.
OBJECTIVES : The pathogenesis of pregnancy induced hypertension and its relationship to pathological and ullrastructural changes of the placenta has not been adequately understood We studied placenta! (issue from foetal side to show whether there are any significant ullrastructural changes. This area of the placenta has not been studied previously. METHODS: Placenial tissue from 15 pregnant mothers with a persistent blixxi pressure of 140/90 or more, and 10 normal mothers who had normal full term deliveries were studied. Fresh placentae were examined macroscopically. 2mm sized section were taken from (lie central, foetal surface and fixed in 2% gluteraldehyde lor electron microscopic studies. RESULTS: 9 months had pregnancy induced hypertension without proteinuria, 3 had hypertension and proteinuria and oilier 3 had essential hypertension. All hypertensive placenta showed increased number of cytotrophoblast cells. Syncytiotrophoblast cells of the hypertensive placenta showed Jess number of lipoid droplets, compared to the controls. Syncliotrophoblast cells of the test group also showed short, blunt and swollen microvilli. All hypertensive placentae except one, showed thickened, laminated and irregular subirophoblasu'c basement membranes and increased amount of interestitial collagen in the villous stroma CONCLUSIONS: In electron microscopic study of normal and hypertensive placentae revealed that the placentas of hypertensive disoalers pregnancy is associated with increased number of cytotrophoblast cells, thickening of subtrophoblastic basement membrane, abnormal microvilli, and increased amunt on interestitial collagen