Browsing by Author "de Silva, L.D.R."

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Cardiovascular risk in a Sri Lankan community
(Sri Lanka Medical Association, 2008) Ranawaka, U.K.; Wijekoon, C.N.; Pathmeswaran, A.; de Silva, L.D.R.; Gunasekara, D.; Chackrewarthy, S.; Mizoue, T.; Kato, N.
OBJECTIVE: Identifying the cardiovascular disease (CVD) [coronary heart disease (CHD) and stroke] risk in a community is important in planning preventive strategies, but such data are lacking from Sri Lanka. We sought to describe the CVD and CHD risk in a Sri Lankan community. DESIGN, SETTING AND METHODS: A community survey was conducted in the Ragama Medical Officer of Health area (Ragama Health Study) involving individuals aged 35-65 years, selected by stratified random sampling. Their 10-year CVD and CHD risks were estimated using three widely used risk stratification ALGORITHMS: Framingham score, NCEP-ATP III (National Cholesterol Education Program – Adult Treatment Panel III), and Systematic Coronary Risk Evaluation (SCORE). Results: In the study population (n=2985), 54.5% were females, and the mean age [SD] was 52.4 [7.8] years. According to the Framingham (CHD risk), NCEP-ATP III (CHD risk) and SCORE (total CVD mortality risk) criteria, 11.5%, 37.2% and 9.7% respectively were classified as 'moderate or high risk'. Risks were not significantly different between sexes, except with NCEP-ATP III criteria (M- 54.1%, F- 21%, p55y- 38%, p55y- 64.7%, p<0.001; SCORE: <55y- 9.0%, >55y- 14.6%, P
Changes in erythrocyte glucose-6-phosphate dehydrogenase (G6PD) and reduced glutathione (GSH) activities in the development of senile and diabetic cataracts
(SEAMEO Regional Tropical Medicine and Public Health Project, 2008) Chandrasena, L.G.; de Silva, L.D.R.; de Silva, K.I.; Dissanayaka, P.; Peiris, H.
Oxidative and osmotic stress have been implicated in the pathogenesis of cataracts. Reactive oxygen intermediates (ROI) mediate peroxidation of membrane lipids and cause irreversible damage to lens proteins. The purpose of this study was to assess the changes in erythrocyte glucose- 6-phosphate dehydrogenase enzyme (G6PD) and reduced glutathione (GSH) levels in the development of senile and diabetic cataracts. The activity of erythrocyte G6PD and the concentration of GSH were measured to assess changes in oxidation-reduction status. The oxidation-reduction status of 26 non-diabetic non-cataract (control) subjects were compared with 24 diabetic non-cataract, 30 diabetic cataract and 28 non-diabetic cataract subjects. The results revealed that the GSH and G6PD levels of the subjects with senile cataracts were significantly lower than the subjects without cataracts. The present study reveals the risk of developing senile cataracts is associated with decreased levels of erythrocyte G6PD and GSH. In the formation of diabetic cataracts an adequate supply of NADPH (G6PD activity) is essential to produce osmotically active sorbitol in the lens
Evaluation of effectiveness of iron-folate supplementation and anthelmintic therapy against aneamia in pregnancy - a study in the plantation sector of Sri Lanka
(American Society of Clinical Nutrition, 1994) Athukorala, T.M.S.; de Silva, L.D.R.; Dechering, W.H.J.C.; Dissanayake, T.S.
Intervention measures against anemia available to plantation workers during pregnancy include fortified food supplements (thriposha) and iron-folate supplements containing 60 mg elemental Fe. The effectiveness of these intervention measures was studied in 195 subjects whose iron and nutritional status were assessed at < 24 and > 32 wk of gestation. Taking thriposha conferred no significant benefit on maternal nutritional status, probably because sufficient amounts were not consumed. An increase in the duration of iron-folate supplementation to > 17 wk caused a significant positive change (P < 0.01) in hemoglobin, whereas an increase in the dose frequency had no significant benefit. Anthelminthic therapy in addition to iron-folate supplements caused a significant positive change in hemoglobin (P < 0.001) and serum ferritin (P < 0.005) compared with no supplementation. Thus, anthelminthic therapy significantly increased the beneficial effects of iron supplementation on hemoglobin concentration and iron status.
Intestinal parasitoses and the nutritional status of Veddah children in Sri Lanka
(SEAMEO Regional Tropical Medicine and Public Health Project, 2004) Chandrasena, T.G.A.N.; Premaratna, R.; de Alwis, A.C.; de Silva, L.D.R.; Morel, R.P.; de Silva, N.R.
This study describes and compares the intestinal parasitoses and nutritional statuses of primary school children of Veddah (local indigenous population) and Sinhalese (more advanced society) in rural Sri Lanka. Children attending years 1-3 (age range 6-15 years) at Dambana Primary School (Veddah) and Wewatta Primary School (Sinhalese) were included in the study. Stools and blood samples were examined for evidence of intestinal parasites and anemia. The heights and weights of the children were measured and anthropometric indices calculated. There was a high prevalence of G. intestinalis and B. hominis (Giardia 7.8.percent and 6.2.percent; Blastocystis 17.2.percent and 17.3.percent at Dambana and Wewatta, respectively) in both communities, the predominant helminth being N. americanus (20.3.percent at Dambana and 14.8.percent at Wewatta; pgreater than 0.05). Other geohelminth infections were scarce in both communities. A greater proportion of boys than girls were underweight and stunted in both communities. Wasting and anemia was significantly high among the Veddah children.
Lipid parameters in young adults in Sri Lanka to identify high-risk persons for coronary heart disease
(University of Kelaniya, 2000) Chandrasena, L.G.; de Silva, K.I.; Wijesinghe, S.; de Silva, L.D.R.
Lipid profiles, anthropometry and dietary habits of adolescent school boys in Sri Lanka
(HEC Press, Australia, 1997) Athukorala, T.M.S.; de Silva, L.D.R.; Jayasinghe, K.S.A.
Serum lipid profiles, anthropometric parameters, dietary habits and smoking practice were determined in 637 adolescent school boys in the 10th to 13th year of school (mean age 16.7 ± 1.3 years), to determine the prevalence of risk factors for cardiovascular disease in later life. They all attended schools in Colombo, the capital city (n=416), and two other cities, Negombo and Kurunegala. Seven percent of the subjects had body mass index (BMI) values above a reference range (for age 14-16, > 23.5 kg/m2; older than 16 years > 24.5 kg/m2). The mean serum total cholesterol concentration was within the reference range (158.9± 27.2 mg/dL: 4.11± 0.70 mmol/L), but 16.5% had values >185 mg/dL. The percentages of subjects with high LDL (low density lipoprotein)cholesterol (>110 mg/dL) and apolipoprotein B (>85 mg/dL) concentrations were 21.9 % and 23.0% respectively, while low HDL (high density lipoprotein) cholesterol (<35 mg/dL) levels were noted in 27.3% of subjects. A significant (p<0.001) positive association was noted between serum total cholesterol concentration and BMI. There was no significant difference in the mean BMI or total cholesterol levels of subjects from the three areas in the age group 15-16.9 years. However, in the age group 17-18.9 years, subjects in the Kurunegala area had a lower prevalence of risk factors ie. significantly lower BMI and serum total cholesterol and apolipoprotein B concentrations than those in other areas. Overall, smoking prevalence was 4.5%, and higher in Colombo than in Negombo and Kurunegala. Further, the mean intake of cholesterol was significantly lower and the fibre intake was higher among subjects in Kurunegala, than those in other areas. Thirty two percent of subjects had a family history of coronary artery disease, hypertension or diabetes and these subjects had significantly higher BMI values than those who did not have a family history of the above diseases, but their lipid patterns were similar. Thus high BMI was a major factor leading to hypercholesterolaemi.
Micronutrient status of plantation workers in Sri Lanka during pregnancy and post partum
(Wiley-Blackwell Pub. Asia, 1996) de Silva, L.D.R.; Athukorala, T.M.S.
Iron, zinc and vitamin A status was assessed in 309 plantation workers during pregnancy and in a sub-sample of 108 subjects at 20 to 36 weeks postpartum and the birth weights of their newborn were noted. A significant positive correlation was noted between haemoglobin concentration at 10-26 weeks of gestation of anaemic mothers (n = 180) and birth weights of their new born. Depleted iron stores (serum ferritin < 12 micrograms/l) were noted in 33.3% of subjects at 10-26 weeks of gestation. There was no significant change in serum ferritin concentration at > 32 weeks of gestation. Iron deficiency persisted at 20-36 weeks postpartum. Marginal vitamin A deficiency was also noted, as, 46.2% and 15.6% of the subjects respectively, had low serum vitamin A levels in pregnancy and postpartum. Low serum zinc levels were noted only in pregnancy. Iron supplementation during pregnancy was only effective in preventing further deterioration in iron status and it should be continued for about 12 weeks after delivery
Nutritional status and productivity of Sri Lankan tea pluckers
(Sri Lanka Medical Association, 2004) de Silva, L.D.R.; Pathmeswaran, A.; de Silva, N.R.
No Abstract available
Nutritional status and productivity of Sri Lankan tea pluckers
(Sri Lanka Medical Association, 2003) Selvaratnam, R.R.; de Silva, L.D.R.; Pathmeswaran, A.; de Silva, N.R.
OBJECTIVE: To assess the impact of nutritional status on productivity of tea pluckers. DESIGN: Cross-sectional, analytical. SETTING AND PARTICIPANTS OF STUDY: All tea pluckers in five divisions of a tea estate in Hatton. MEASUREMENTS: A dietary survey was conducted using the 24 h dietary recall method. Nutritional status was assessed by measurement of body mass index (BMI) and haemoglobin (Hb) levels, and faeces were examined for helminth ova. The daily weight of tea leaves plucked and the number of days worked by each woman during the preceding month were noted from production records. RESULTS: Three hundred and four women (mean age 37.8 years, SD 8.4) were examined. The majority (59.9%) had evidence of chronic energy deficiency (BMI < 18.5). Almost all (94.4%) were anaemic (Hb < 13.3 g/dl, altitude adjusted cutoff). Mean daily iron intake was 8.7 mg (SD 2.3 mg), 45.9% of the national recommended dietary allowance. Only 10.1% had hookworm infection, all of light intensity. Multivariate regression analysis showed that dietary iron intake, the number of children and the number of children below 5 years, but not hookworm infection, were independently associated with Hb (p < 0.05). There was a strong positive correlation between monthly productivity and Hb, but not with BMI. Variation in Hb levels accounted for 65% of variation in productivity (adjusted R2 = 0.651). CONCLUSIONS: Most of the study population had chronic energy deficiency and anaemia. Dietary inadequacy of iron is a much more important causative factor than hookworm infection. Productivity was strongly associated with the degree of anaemia but not with BMI.
Nutritional status and productivity of tea pluckers in Norwood Estate, Hatton
(Sri Lanka Medical Association, 2003) de Silva, N.R.; Selvaratnam, R.R.; Pathmeswaran, A.; de Silva, L.D.R.
OBJECTIVES: To determine the effect of nutritional status on the productivity of tea pluckers in Norwood estate. METHODS: All women tea pluckers of 5 randomly selected divisions of Norwood Estate in Bogawantalawa Plantations, Hatton were recruited. Nutritional status was assessed by measurement of Body Mass Index (BMI) and haemoglobin levels (Hb). The daily weight of tea leaves plucked, and the number of days worked by each woman during November and December 2001 were recorded. Productivity was calculated as average weight of tea leaves plucked per month. Data were analyzed using Epilnfo 6 and SPSS 10. RESULTS: A total of 304 women were recruited to the study. The majority (59.9%) had a low BMI (<18.5), while 76% were anaemic (Hb <12.0 g/dl). There was a statistically significant positive correlation between monthly productivity and Hb levels (Pearson's R = 0.81) but not with BMI. Different regression models were applied to the data to predict the monthly amount of tea plucked in kg. The simplest model using Hb as the only predictor variable revealed that variation in Hb level accounted for 65% of variation in productivity (adjusted R2=0.651). An increase in Hb by 1 g/dl was associated with an increase of 37 kg of tea leaves plucked per month. CONCLUSIONS: Decrease in haemoglobin levels is strongly associated with a decrease in individual productivity of female tea pluckers as indicated by the average weight of tea leaves plucked per month.
Prevalence of metabolic syndrome in a Sri Lankan community
(Sri Lanka Medical Association, 2008) Chackrewarthy, S.; Gunasekera, D.; de Silva, L.D.R.; Pathmeswaran, A.; Wijekoon, C.N.; Ranawaka, U.K.; Mizoue, T.; Kato, N.
OBJECTIVE: To estimate the prevalence of metabolic syndrome (MetS) in a Sri Lankan community. Limited information is available about MetS in Sri Lankans. DESIGN, SETTING AND METHODS: A total of 2948 individuals (1345 males and 1603 females) who participated in the Ragama Health Study comprised the study population. Prevalence of MetS was estimated using three widely used criteria: International Diabetes Federation (IDF), WHO and National Cholesterol Education Programme - Adult Treatment Panel III (NCEP-ATP III). RESULTS: Age and sex adjusted prevalence rates of MetS were 38.9%, 38.9% and 41.6% as defined by IDF, WHO and NCEP-ATP III respectively. Prevalence increased with age (for age groups 35-44, 45-54 and 55- 65 years respectively; IDF - 27.9%, 40,1%, 42.9% ; WHO - 28.7%, 43.2%, 52.6%; NCEP ATP III - 34.6%, 46.7%, 50.6%; P<0.001 in all). MetS was commoner in women (IDF - 45.8% Vs. 23.0%, P<0.001; WHO - 37.3% Vs. 40.5%, P>0.05; NCEP-ATP III - 49.8% Vs. 33.1%, P<0.001). Prevalence of central obesity (using Asian cutoff values) was higher in women. (70.8% Vs. 35.5%, P<0.001). CONCLUSION: Prevalence of MetS is high in this community. Preventive measures towards reducing trie risks associated with MetS should be promoted.