Conference Papers
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This collection contains abstracts of conference papers, presented at local and international conferences by the staff of the Faculty of Medicine
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Item 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.Item 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.Item 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.