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 Genetic Polymorphism in Pvmsp-3a. and Pvcs genes in Plasmodium vivax infections in Sri Lanka(Sri Lanka College of Microbiologists, 2008) Manamperi, A.; Fernando, D.; Mahawithanage, S.; Wickremasinghe, R*.; Bandara, A.; Wellawatta, C.; Hapuarachchi, C.; Abeyewickreme, W.; Wickremasinghe, R.INTRODUCTION: Plasmodim vivax malaria accounts for about 70% of all malaria infections in Sri Lanka. There is limited information on the genetic heterogeneity of P. vivax parasites in endemic areas of the country. OBJECTIVE: The objective of this study was to assess the potential of two P. vivax genes, Pvmsp-3v. and Pvcs. as genetic markers for their use in genotyping parasites collected from the field. METHOD: DNA was extracted from 12 Geimsa-stained P. vivax positive slides by phenol/chloroform method. A nested polymerase chain reaction (PCR) approach was adopted for both Pvmsp-3a and Pvcs genes. RFLP analysis ofPvmsp-la nested PCR products was carried out with Hha\ restriction enzyme. RESULTS AND DISCUSSION: Nested amplification of the marker genes resulted in 4 size variants for Pvcs (~ 600-750 bp) and 2 size variants for Pvmsp-3a (1.9 kb and 1.1 kb). Further, all PCR-RFLP products of Pvmsp-3a. Gene showed a major size polymorphism. Three samples showed evidence of infections with mixed genotypes and there was also evidence to identify a relapse infection. Analysis of these two genetic markers revealed 11 distinguishable variant types: 4 for Pvcs and 7 for Pvmsp-3a. CONCLUSIONS: The observed PCR and PCR-RFLP profiles of the Pvcs and Pvmsp-3& genes demonstrate that the P. vivax parasites in Sri Lanka were highly diverse despite the prevailing low transmission levels. It could be concluded that these two genes in combination could be considered suitable genetic markers to analyze P. vivax parasite dynamics in Sri Lanka.Item A study on anxiety and depression among military personnel injured in the war(Sri Lanka Medical Association, 2001) Ariyaratne, R.; Arulrajah, S.; Ariyananda, D.; Ariyaratne, J.; Athanayake, S.; Azhar, M.; Bandara, A.; Bandara, R.; Williams, S.S.; Kuruppuarachchi, K.A.L.A.OBJECTIVES: To determine the proportion of army personnel with symptoms of anxiety and depression following injuries on the battlefield and to identify associated factors. DESIGN, SETTING AND METHODS: We administered a pretested closed and open ended questionnaire and a validated Sinhala translation of the Beck Depression and Beck Anxiety Inventory to 128 injured soldiers at the Military Hospital in Colombo between 9th and 11th of December 1999. We excluded soldiers with head injuries or impaired consciousness and those blind or deaf. RESULTS: In terms of the Beck Depression Inventory 35.15% had scores for severe depression, 15,62% for moderate depression and 28.1% for mild depression. In terms of the Beck Anxiety Inventory 7.81% has scores for severe anxiety, 5.46% for moderate anxiety and 36.7% for mild anxiety. There was a significant association between severity of depression and anxiety (Chi square for linear trend =21.8, p < 0.001). We also found a significant association between severity of depression and thoughts of deserting the army (Chi square for linear trend = 10.674, pO.OOl and severity of depression and problems at work or in the family (Chi square for linear trend = 4.373. p < 0.05). Among those who scored for severe depression there was a suicidal risk in 42.33%. CONCLUSIONS: We found that the majority of injured soldiers had symptoms of depression and nearly half had symptoms of anxiety, There was a significant association between severity of depression and thoughts of deserting the army and problems at work or in the family. The suicidal risk among depressed patients was high.Item Screening of hepatitis C (HCV) antibody reactive donors by RT-PCR in a sample population of blood bank donors in Sri Lanka(Malaysian Society of Parasitology and Tropical Medicine, 2007) Manamperi, A.; Gunawardena, N.K.; Nugawela, P.; Bandara, A.; Wellawaththage, C.; Bindusara, R.M.; de Silva, H.J.; Abeyewickreme, W.The practice of screening donors for HCV antibodies has substantially lowered the risk of acquiring HCV infection from a transfusion. However, detection of molecular markers in blood is the most reliable means of diagnosing active viral infection. Molecular studies on HCV antibody reactive donors have not been previously performed in Sri Lanka. The present study was carried out to investigate the RNA positive rates in a sample population of anti-HCV antibody reactive blood donors in Sri Lanka, with a view of determining whether RT-PCR testing for HCV RNA should be carried out at the initial donor screening level. Eighty nine (89) HCV antibody reactive donors were tested for the presence of HCV RNA by RT-PCR (sensitivity 200 copies/ml) during the period October 2005 to May 2006. The 89 serology positive donors were initially detected by a third generation ELISA by routine screening of an initial pool of 26,176 blood donors. Of the 89 Anti-HCV antibody positive donors (0.34% of the total donor pool), 6 (0.023% of the total donor pool, and 6.74 % of antibody positive individuals) were positive for HCV RNA. The prevalence of HCVRNA positivity was low in this cohort of Sri Lankan blood donors. This is in keeping with the low prevalence of HCV infection in the community. Routine individual HCV-RNA screening of donors does not seem cost-effective in our setting. The RNA negative, antibody positive profiles reflect either false positive serology results or donors who have been exposed to HCV previously and subsequently resolved their infections.Item Application of nucleic acid technology (NAT) in the diagnosis of active viral replication in HBV and HCV infections and evidence for HBV surface antigen mutants(Sri Lanka Association for the Advancement of Science, 2008) Manamperi, A.; Gunawardene, Y.I.N.S.; Hapuarachchi, C.; Bandara, A.; Wellawaththage, C.; Abeyewickreme, W.; de Silva, J.Introduction: The community prevalence of Hepatitis B (HBV) and hepatitis C (HCV) infections, although considered low (< 1%) in Sri Lanka based on serological markers, pose a significant health threat to patients in high risk groups. The early diagnosis of active viral infection is crucial in such situations to prevent further transmission and to enable the clinicians to initiate successful therapeutic interventions. Objective: This study was carried out to investigate the usefulness of polymerase chain reaction (PCR) in the diagnosis of active viral replication in HBV and HCV infections. Methodology: All specimens from patients with serological evidence of hepatitis B (HBV surface antigen and/or antibodies for HBV core protein) or hepatitis C (antibodies for hepatitis C core protein-Anti-HCV) and referred to the Molecular Medicine Unit from May 2005 to May 2008 were analyzed by PCR and reverse-transcription PCR (RT-PCR) for HBV DNA (n=130) and HCV RNA (n=95) respectively. Results: Of the 130 patients tested, 57 (44%) were positive for HBV DNA. The positive group of patients included 10 renal transplant patients, 4 multiply transfused patients, 4 paediatric patients with lymphoma, and 1 patient with cirrhosis. Six HBV DNA positive patients had negative HBsAg serology profiles indicating the possibility of surface antigen mutant strains. The HBV DNA negative patients with positive serology profiles indicate sero-converted/ patients with resolved infections or false positive serology results. Of the 95 patients tested, 14 (15%) were positive for HCV RNA and included 3 paediatric patients with thalassaemia. HCV RNA negative, anti-HCV positive profiles reflect either false positive serology results (due to less specific antibody assays) or donors who have been exposed to HCV previously and subsequently resolved their infections. Conclusions: A major proportion of patients with serological markers for HBV have active viral infection whereas only relatively a minor proportion of patients with serological markers for HCV have active viral replication. We have also found the first possible evidence of hepatitis B surface antigen mutant strains. This underlines the importance of the nucleic acid based technology in the diagnosis and assessment of infection with or suspected to have hepatitis B or C infections. We also emphasize the importance of introducing NAT for screening donors for HBV DNA and HCV RNA to substantially lower the risk of acquiring HBV/HCV infection from a transfusion.