Browsing by Author "Welikala, N."

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Challenges faced in establishing a pediatric liver transplant program in a lower‐middle‐income country with free healthcare service
(Wiley, 2024) Fernando, M.; Tillakaratne, S.; Gunetilleke, B.; Liyanage, C.; Appuhamy, C.; Weerasuriya, A.; Uragoda, B.; Welikala, N.; Ranaweera, L.; Ganewatte, E.; Dissanayake, J.; Mudalige, A.; Siriwardana, R.
ABSTRACT: BACKGROUND: Liver transplant is the cure for children with liver failure. Sri Lanka is a lower-middle-income country with a predominant free, state health system. Pediatric liver transplant program in Sri Lanka is still in the budding state where the initial experience of the program is yet to be documented. METHODS: A retrospective review was performed including the clinical characteristics of all pediatric liver transplant recipients of Colombo North Centre for Liver Diseases since the inception of the program from June 2020 to May 2023. RESULTS: There were 14 PLT performed in 3 years. The median recipient age and weight were 8 years (6 months–15 years) and 23.3 kg (6.4–49.2), respectively. The majority were boys (64%). All were from low-income backgrounds. Indications for LT were acute liver failure (5/14), decompensated chronic liver disease (5/14), and acute on chronic liver failure (4/14). Underlying liver diseases were Wilson disease (6/14), autoimmune liver disease (3/14), biliary atresia (2/14) and progressive familial intrahepatic cholestasis type 3 (1/14), and unknown etiology (2/14). The majority were living donor liver transplants (86%). Of the living donors, 42% (5/12) were Buddhist priests. There were three immediate deaths and two late deaths. The 3-month survival was 78%, and overall survival was 64%. Living donor transplants carried a higher success rate (92%) compared to diseased donor transplants (0%; 2/2). CONCLUSIONS: Initial experience of pediatric liver transplant program of Sri Lanka is promising despite being established in a free healthcare system amidst the crisis circumstances.
Development of a hydroponic test system for rapid screening of plant growth promoting microorganisms.
(International Research Symposium on Pure and Applied Sciences, 2017 Faculty of Science, University of Kelaniya, Sri Lanka., 2017) Perera, U. I. D.; Imasha, M. I. N.; Welikala, N.
Plant-growth-promoting microorganisms (PGPMs) have become increasingly important in the agricultural production of many crops. It is envisioned that in the not too distant future, PGPMs will begin to replace the use of chemicals in agriculture, horticulture, silviculture, and environmental cleanup strategies. Nutrient mobilization, stimulation of root growth, enhanced resistance to environmental stress factors are discussed as possible mechanisms of plant growth promotion. The development of rapid screening tests to demonstrate the principle effectiveness of biofertilizers prior to set-up of laborious pot or field experiments is urgently required. In this study, a hydroponic-test system for rice plant was developed and verified to evaluate the effectiveness of plant growth promoting diazotrophic bacterial strains. Seven putative plant growth promoting diazotrophic bacterial (PGPB) strains (IN003, IN006, IN007, INS008, INS009, INS015, INS018) were tested as parameters based on their biochemical characteristics such as nitrogen fixation, acid and gas production, production of ammonia from urea using germination rate, average root and shoot length, average dry/fresh weight of roots and shoots, number of roots and average coleoptile length. The experiment was designed with three replicates. Hoagland’s solution was used as a hydroponic culture. Nitrogen-free broth media was used to grow diazotrophic bacterial strains. Equal volumes of bacterial cultures grown overnight were used as the inoculum. Rice seeds were inoculated for 6 hours before germination by immersing rice seeds in broth cultures and seeds treated with heat killed bacterial strains were used as a control. Seed trays with equal volume of Hoagland’s solution were used to grow the germinated rice seeds after inoculation. After 12 days of culture period, germination rate of rice seeds, number of roots, shoot length, root length, dry/fresh weight of shoots, and dry/fresh weight of roots, average length of coleoptile of the rice seedlings were measured. Inoculation of seeds with plant growth promoting bacteria did not show significant increase (p ≤0.05) in the germination rate of rice seeds compared to the control seeds. Strains INS015 and INS018 showed a significant increase (p ≤0.05) in shoot root dry/fresh weights compared to other strains. The highest average shoot length (0.23 ± 3.4×10-2) m was recorded in seeds treated with bacterial stain INS015. The results of this study indicate that certain plant growth promoting bacterial strains used in this study can promote the growth and vigor of rice seedlings which benefit early seedling development consequently the crop growth and development. Hydroponic test system is an effective and rapid method to study the effect of plant growth promoting bacteria on the growth and vigor of rice seedlings.
An effective DNA extraction protocol for Santalum album (Sandalwood) of Sri Lanka
(Research Symposium on Pure and Applied Sciences, 2018 Faculty of Science, University of Kelaniya, Sri Lanka, 2018) Perera, U. I. D.; Welikala, N.
Isolation of genomic DNA is the primary step in studying molecular aspects in any organism. But, this is challenging in medicinal plants due to the presence of higher amounts of polyphenols and secondary metabolites. In this study we modified a CTAB extraction protocol to isolate pure and high yield genomic DNA from Sandalwood (Santalum album), which is an important medicinal plant in Sri Lanka. As to best of our knowledge this is the first genetic study on Sandalwood in Sri Lanka. There are number of DNA isolation kits for plant DNA extraction, but they are too expensive and the manual protocols available give poor DNA yields of low quality. The present method is a cheap manual DNA isolation protocol and can be used for isolation of high quality and high yield DNA from young leaves of Santalum album. DNA yields and purity were estimated by spectrophotometry, gel electrophoresis and PCR amplification. The CTAB method was modified by varying the concentrations of Polyvinylpyrrolidone (PVP) (1.0%, 2.0%, 3.0%), β-mercaptoethanol (0.2%, 0.4%, 0.6%, 0.8%), NaCl (1.0M, 1.4M, 1.8M), CTAB (1.0%, 2.0%, 3.0%) in the extraction buffer and changing the incubation times. The modified conditions in the CTAB protocol includes; 0.8% β-mercaptoethanol, 3% PVP, 1.0 M NaCl and overnight incubation at -20 0C after addition of isopropanol. The values of average purity (OD 260/280) (1.72 ± 0.04) and average yield (0.88 ± 0.02 μg/mL) of isolated DNA using this method exceed the values obtained from previously reported methods. The isolated genomic DNA was successfully amplified using ITS1/ITS4 and ITS4/ITS5 primer pairs and produced clear and strong PCR bands with 800 bp in size. Therefore, this method can be used as a tool in molecular studies of Sandalwood.
Fifty liver transplants: a single centre experience of haemodynamic management in liver transplantation for cirrhosis [part 1]
(College of Surgeons of Sri Lanka, 2021) Gunetilleke, B.; Ranamuni, R.; Jayaweera, D.; Welikala, N.; Kerner, V.; Munasinghe, N.; Withanage, R.; Wickremasinghe, N.; Hewage, S.; Wijesuriya, N.; Rodrigo, U.; Mudalige, A.; Fernando, M.; Hettiarachchi, D.; Dissanayake, J.; Niriella, M.; Dassanayake, A.; Thilakaratne, S.; de Silva, J.; Siriwardana, R.; WIjesuriya, R.; Liyanage, C.
ABSTRACT: Cirrhosis with end stage liver disease (ESLD) is a leading cause of non-communicable disease related deaths in Sri Lanka. Liver transplantation is the only curative treatment for patients with ESLD. The complex multisystem involvement and unique cardiovascular profile characteristic of ESLD present formidable challenges during liver transplantation. Management of the rapid and varied hemodynamic changes during surgery requires an in depth understanding of the physiological effects of each intervention. Based on the current literature and the experience gained at our center during the management of 50 liver transplants, we present optimization strategies and perioperative hemodynamic interventions which we use to ‘Fast track’ recovery following liver transplantation. KEYWORDS: Liver transplantation, cirrhosis, non-alcoholic fatty liver disease, alcohol related liver disease
Fifty liver transplants: a single centre experience of haemodynamic management in liver transplantation for cirrhosis [part 2]
(The College of Surgeons of Sri Lanka, 2021) Gunetilleke, B.; Ranamuni, R.; Jayaweera, D.; Welikala, N.; Kerner, V.; Hettiarachchi, D.; Munasinghe, N.; Withanage, R.; Wickremasinghe, N.; Hewage, S.; Fernando, M.; Hettiarachchi, D.; Niriella, M.; Dassanayake, A.; Thilakaratne, S.; Wijesuriya, R.; Liyanage, C.; Siriwardana, R.; Dissanayake, J.; Wijesuriya, N.; Rodrigo, U.; Rodrigo, U.; Mudalige, A.; de Silva, J.
Globally, an estimated one million deaths occur annually due to complications of cirrhosis. Cirrhosis with end stage liver disease [ESLD] is a leading cause death due to non- communicable diseases in Sri Lanka. Non-alcoholic fatty liver disease [NAFLD] and alcohol related liver disease [ARLD] are the principal causes of ESLD due to cirrhosis in Sri Lanka. Liver transplantation remains the only curative treatment for such patients. Multiorgan dysfunction and hemodynamic instability characteristic of ESLD adds to the complexity of perioperative care in liver transplantation. Maintenance of stable hemodynamics including optimal hemostasis forms the core of the anaesthetic strategy in liver transplantation.
Isolation and characterization of endophytic diazotrophic Bacillus bacteria from rice and its potential as a biofertilizer
(Institute of Biology, Sri Lanka, 2013) Gunawardana, L.A.H.N.; Jayasundara, J.M.C.N.; Welikala, N.
Isolation and characterization of plant-growth promoting endophytic diazotrophic bacteria from traditional and new improved rice varieties grown under organic conditions
(The Institute of Biology, Sri Lanka, 2016) Kumarapeli, K.A.D.V.; Welikala, N.
Isolation and partial characterization of plant growth promoting endophytic diazotrophic bacteria from selected rice cultivars
(The Institute of Biology, Sri Lanka, 2016) Nasla, M.R.F.; Welikala, N.
Molecular confirmation of the presence of E. coli in shallow well water
(Institute of Biology, Sri Lanka, 2012) Athukorala, A.V.A.P.; Welikala, N.
Optimizing intraoperative haemodynamics and haemostasis to enhance recovery after liver transplantation for cirrhosis in adults
(College of Anaesthesiologists of Sri Lanka, 2022) Gunetilleke, B.; Welikala, N.; Ranamuni, R.; Jayaweera, D.; de Silva, T.; Amerasinghe, O.; Liyanage, C.; Dissanayake, J.; Appuhamy, C.; Fernando, M.; Thilakarathne, S.; Dassanayake, A.; Niriella, M.; Siriwardana, R.; Gilbert-Kawai, E.
Cirrhosis with end stage liver disease is a leading cause of non-communicable disease related deaths in Sri Lanka. Liver transplantation remains the only curative treatment for such patients. Multi-organ dysfunction characteristic of end stage liver disease, surgical and anaesthetic factors, quality of the graft, coagulopathy and haemodynamic instability, all lead to the complexity of the perioperative care for liver transplant. Aggressive management focused particularly on maintaining intra-operative haemodynamic stability and optimizing haemostasis, directly impacts successful patient outcomes and forms the core of the anaesthetic strategy.
Rapid and low cost DNA extraction procedure for PCR-based detection of pathogenic organisms I environmental waters
(Institute of Biology, Sri Lanka, 2011) Jayawardhane, J.R.K.N.; Deshapriya, N.; Welikala, N.
Viscoelastic haemostatic test based management of coagulopathy in liver transplantation for cirrhosis
(Sri Lanka College of Haematologists, 2021) Gunetilleke, B.; Welikala, N.; Görlinger, K.
Management of coagulopathy is an important consideration in the management of liver transplantation (LT) for end stage liver disease due to cirrhosis. Blood loss and the volume of blood products transfused are key determinants of outcome following liver transplantation. Cirrhosis has traditionally been associated with hypocoagulability and haemorrhage. Greater understanding of the normal haemostatic processes and the derangement associated with cirrhosis has resulted in the concept of rebalanced haemostasis in cirrhosis. This rebalancing and reduction of haemostatic reserves results in an unpredictable and often pro thrombotic haemostatic state in cirrhosis. The predictive value of standard tests of coagulation is diminished in cirrhosis. In contrast, viscoelastic haemostatic tests have demonstrated superior diagnostic and bleeding predicting capabilities in cirrhosis. Bleeding management protocols including viscoelastic haemostatic test-based algorithms have reduced transfusion requirements without an increase in the incidence of bleeding or thrombotic complications in liver transplantation.