Browsing by Author "de Silva, T."

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Combination of cycle threshold time, absolute lymphocyte count and neutrophil:lymphocyte ratio is predictive of hypoxia in patients with SARS-CoV-2 infection
(Royal Society of Tropical Medicine and Hygiene, 2022) Abeysuriya, V.; Seneviratne, S.L.; de Silva, A.P.; Mowjood, R.; Mowjood, S.; de Silva, T.; de Mel, P.; de Mel, C.; Chandrasena, L.; Wijesinha, R.S.; Fernando, A.; de Mel, S.
Background: There is currently no clinically validated biomarker to predict respiratory compromise in sudden acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Cycle threshold time (Ct), absolute lymphocyte count (AL) and neutrophil:lymphocyte ratio (NLR) have been previously evaluated for this purpose. We hypothesized that the combination of these parameters at presentation may be predictive of hypoxia (oxygen saturation <92%). Methods: Data were collected on 118 patients with SARS-CoV-2 infection between May 2020 and April 2021. Demographics, clinical parameters and laboratory and radiological investigation results were recorded. Respiratory compromise (RC) was defined based on symptoms and signs, hypoxia and chest X-ray abnormalities. Results: RC occurred in 61 (51.7%) of patients. The Ct, AL and NLR at median day 3 of illness were significantly different between patients with and without RC (Ct, RC vs not: 19.46±2.64 vs 22.62±3.37, p=0.0001; AL, RC vs not: 531.49±289.09 vs 764.69±481.79, p=0.0001; NLR, RC vs not: 3.42±0.75 vs 2.59±0.55, p=0.0001). Receiver operating characteristics analysis showed that a Ct <19.9, AL <630.8×103/μL and NLR >3.12 at median day 3 of symptoms was predictive of hypoxia on day 7 of illness (area under the curve 0.805, sensitivity 96.7%, specificity 69.1%). The predictive value for the parameters combined was significantly superior to their individual predictive power. Conclusions: Ct, AL and NLR used in combination on day 3 of symptoms are predictive of hypoxia on day 7 of SARS-CoV-2 illness.
English language and its usage among the youth
(Department of English, Faculty of Humanities, University of Kelaniya, Sri Lanka, 2016) de Silva, T.
There have been many researches done on the use of English language by the youth of Sri Lanka and for what purposes they find it necessary to learn English as a language in a rapidly globalizing world. Most studies show that the youth find it crucial to have a good English knowledge to increase their employment opportunities in the corporate sector. This study explores the practical aspects and difficulties of learning good English by the youth and it also depicts the perception of the youth and how they think that this gap between the corporate sector and the youth should be bridged and how the youth can be more aligned with the globalizing world even though Sri Lanka is still a growing country. In conclusion it was discovered that the youth find it more fitting to have a practical learning experience when trying to use English.
Geographically regulated designs of incidence surveys can match the precision of classical survey designs whilst requiring smaller sample sizes: the case of snakebite envenoming in Sri Lanka
(BMJ Publishing Group Ltd, 2022) Ediriweera, D.S.; de Silva, T.; Kasturiratne, A.; de Silva, H.J.; Diggle, P.
BACKGROUND: Snakebite envenoming is a neglected tropical disease. Data from the worst affected countries are limited because conducting epidemiological surveys is challenging. We assessed the utility of inhibitory geostatistical design with close pairs (ICP) to estimate snakebite envenoming incidence. METHODS: The National Snakebite Survey (NSS) in Sri Lanka adopted a multistage cluster sampling design, based on population distribution, targeting 1% of the country's population. Using a simulation-based study, we assessed predictive efficiency of ICP against a classical survey design at different fractions of the original sample size of the NSS. We also assessed travel distance, time taken to complete the survey, and sensitivity and specificity for detecting high-risk areas for snake envenoming, when using these methods. RESULTS: A classical survey design with 33% of the original NSS sample size was able to yield a similar predictive efficiency. ICP yielded the same at 25% of the NSS sample size, a 25% reduction in sample size compared with a classical survey design. ICP showed >80% sensitivity and specificity for detecting high-risk areas of envenoming when the sampling fraction was >20%. When ICP was adopted with 25% of the original NSS sample size, travel distance was reduced by >40% and time to conduct the survey was reduced by >75%. CONCLUSIONS: This study showed that snakebite envenoming incidence can be estimated by adopting an ICP design with similar precision at a lower sample size than a classical design. This would substantially save resources and time taken to conduct epidemiological surveys and may be suited for low-resource settings.
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.
Postdischarge outcomes of COVID-19 patients from South Asia: a prospective study
(Royal Society of Tropical Medicine and Hygiene, 2022) Abeysuriya, V.; Seneviratne, S.L.; de Silva, A.P.; Mowjood, R.; Mowjood, S.; de Silva, T.; de Mel, P.; de Mel, C.; Wijesinha, R.S.; Fernando, A.; de Mel, S.; Chandrasena, L.
Background: Coronavirus disease 2019 (COVID-19) may cause clinical manifestations that last for weeks or months after hospital discharge. The manifestations are heterogeneous and vary in their frequency. Their multisystem nature requires a holistic approach to management. There are sparse data from the South Asian region on the outcomes of hospital-discharged COVID-19 patients. We assessed the posthospital discharge outcomes of a cohort of Sri Lankan COVID-19 patients and explored the factors that influenced these outcomes. Methods: Data were prospectively collected from patients who were discharged following an admission to the Nawaloka Hospital, Sri Lanka with COVID-19 from March to June 2021. At discharge, their demographic, clinical and laboratory findings were recorded. The patients were categorised as having mild, moderate and severe COVID-19, based on the Sri Lanka Ministry of Health COVID-19 guidelines. Following discharge, information on health status, complications and outcomes was collected through clinic visits and preplanned telephone interviews. A validated (in Sri Lanka) version of the Short Form 36 health survey questionnaire (SF-36) was used to assess multi-item dimensions health status of the patients at 1, 2 and 3 mo postdischarge. Results: We collected data on 203 patients (male, n=111 [54.7%]). The level of vaccination was significantly associated with disease severity (p<0.001). Early recovery was seen in the mild group compared with the moderate and severe groups. At 3 mo, on average 98% of mild and 90% of moderate/severe patients had recovered. Based on the SF-36, physical functioning dimensions, role limitation due to physical and emotional health, energy/ fatigue, emotional well-being, social functioning, pain and general health were significantly different in the moderate/severe vs mild COVID-19 groups at 1, 2 and 3 mo postdischarge (p<0.05). Twenty-three patients developed complications, of which the most common were myocardial infarction with heart failure (n=6/23; 26.1%), cerebrovascular accident (n=6/23; 26.1%) and respiratory tract infections (n=3/23; 13.01%) and there were six deaths. Conclusions: In our cohort, receiving two doses of the COVID-19 vaccine was associated with reduced disease severity. Those with mild disease recovered faster than those with moderate/severe disease. At 3 mo posthospital discharge, >90% had recovered.
Reliability and factor analysis of the Sinhalese version of the Liebowitz Social Anxiety Scale-Self Reported Version (LSAS-SR)
(Sri lanka Medical Association, 2015) Hapangama, A.; de Silva, T.; Kuruppuarachchi, K.A.L.A.; Wickremasinghe, A.R.; Williams, S.S.
INTRODUCTION AND OBJECTIVES: Despite being one of the most prevalent mental illnesses, lack of awareness and confusion with shyness contributes to under-diagnosis of social phobia. Our objective was to evaluate test-retest reliability, internal consistency and factor analysis of the Sinhalese version of LSAS-SR - which is widely used in the English speaking world as a screening tool for social phobia. METHOD: The established process of translation by bilingual professionals/ back translation to establish consistency was carried out. Face validity and cultural acceptability of the translation was established using the Delphi technique. Pilot evaluation was conducted and standard psychometric procedures were used to evaluate test- retest reliabilityand internal consistency. The subjects were 871 SriLankan university students. RESULTS: Prevalence of social phobia among study population was 9.2%.Pearson's correlation coefficient was 0.998, 0.994 and 0.993 for fear and avoidance subscales and total sore respectively (p<0.01). Cronbach's alpha for fear and avoidance subscales with total score for each subscale was 0.753 and 0.752 respectively. Cronbach's alpha of total score of each sub scale with total score of LSAS-SR was 0.722.Factor analysis resulted in 5 dimensions and these were: factor I - speaking in a group, factor II-activity in public, factor III - social interaction with unknown person, factor IV - attitude of disagreement/ disapproval and factor V - social interaction in leisure activity. CONCLUSION: The findings confirm that this Sinhalese version of LSAS-SR has similar test-retest reliability, internal consistency and factor analysis as the original instrument and can be usedto screen for social phobia in Sri Lanka.
The Significance of the Rhyme Scheme in Poetry Translation
(Faculty of Graduate Studies, University of Kelaniya, Sri Lanka, 2016) de Silva, T.
In poetry there is much focus on formal elements than one normally finds in prose. With regard to the translation of poetry, which has to be carried out with the intention of affecting the target audience in the same way that the original affects its first hearers, focus on both form and content is of paramount importance. However, it is generally believed that only rarely do both the content and the form of a poem are reproduced with equal focus in a translation, and that the formal elements are usually sacrificed for the content. This study, taking the above views as its basis, examines the significance of the formal element of the rhyme scheme in translating poetry. Data are collected by observing the manner in which the rhyme scheme has been negotiated in various poetry translations. According to the findings of this study, it is apparent that sacrificing the rhyme scheme is preferred by many translators as a way of making their task easier. However, this does not appear to be an always-go-to solution since there are poems in which the rhyme scheme plays an important role in reinforcing the content. On the other hand, despite the negative views on the reproduction of formal elements in a different language, it is perhaps an exaggeration to consider it an impossible task since there do exist poetry translations in which the exact rhyme scheme of the original has been maintained.