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 Sexual practices, knowledge and usage of contraceptives among adolescents and young adults(Sri Lanka College of Obstetricians and Gynaecologists, 2008) Herath, H.M.R.P.; Dissanayake, D.M.A.B.; Hilmi, M.A.M.; Pathmeswaran, S.; Fernando, W.S.; Wijesinghe, P.S.INTRODUCTION: Adolescence is a critical period of development, as important behaviour patterns are learnt during this period. The sexual debut in Sri Lankan schooling adolescents has been reported as 15.3 years for males and 14.4 for females. Furthermore a significant difference in the prevalence of heterosexual experience among the two sexes have been reported(14% among boys Vs 2% among girls). In 2001, of the pregnant women who received antenatal care from public health midwives, 7.8% were teenagers. Interestingly 22.2% of maternal deaths due to illegal abortions were in this age group during 1996. Thus the situation demands research into sexual practices and strategies to increase the contraceptive uptake by teenagers. OBJECTIVES: To describe and compare the sexual practices. knowledge and usage of contraceptives by the adolescents and young adults with different educational backgrounds. METHOD: Study was a cross sectional descriptive study done involving subjects of three different educational levels i.e. students of universities and technical colleges and employees of garment factories. Data were collected with a pretested self administered questionnaire. RESULTS: Data of 1258 subjects were analyzed. Of them 23% were garment factory workers, 38.2% were technical college students and 38.8% were university students. Females consisted 58.9% of the population. The mean age for males and females were 20.5 years and 20.7 years respectively. The mean age of first sexual relationship of males and females were at 17.65 and 19.44 years respectively (p<.001). Out of the total population 17% of females and 33.5% of males were sexually active. Sexual relationships were reported by 51.7% of garment factory employees, 19.4% technical college students and 12.3% of university students. Majority of male garment factory workers ("90 %) were sexually active. Of the 166 sexually active males 19.3% had sexual relationship with commercial sex workers. Out of the 172 people who have not used modern contraceptives during heterosexual relationships, 32% has used natural family planning. Significantly larger proportion (21.7%) of garment factory workers compared to other settings believed that IUCD would protect them from HIV infection. Of the study population 24.9% of females and 71.2% of males knew barrier methods would minimize the risk of development of HIV. With regard to primary source of information regarding contraceptive methods, 24.2 % and 23.4% of subjects reported school and news papers, while 28.4% felt that information from parents as the least important source. Of the people who selected school as their main source of information, only 41.4% knew barrier methods could protect them from HIV. Majority preferred instructions from school and special health clinics on contraceptive usage. CONCLUSIONS: Teenage and young adult males have their first sexual relationship at an earlier age than female counterparts. A larger proportion of garment factory employees are sexually active compared to students of technical colleges and universities. Significant proportion of males of the age group had their first relationship with commercial sex workers. The knowledge about different contraceptive methods among this population is inadequate. More emphasis should be given to the preferred media by the adolescents and young adults in educating them on contraceptive methods.Item Semen ph in infertile males and its association with semen parameters(Sri Lanka College of Obstetricians and Gynaecologists, 2005) Dissanayake, D.M.A.B.; Palihawadana, T.S.; Amarasena, J.M.T.; Fernando, W.S.INTRODUCTION: Assessment of pH of the ejaculate is part of the basic seminal fluid analysis. The WHO defines the reference range for seminal fluid pH to be 7.2 or more. In practise we have observed that the pH is commonly in the alkaline range in patients with normal as well as abnormal seminal parameters. Furthermore, there are many others who question the reference range defined by the WHO, and claim it to be too low. Objective: To define the range of pH in seminal fluid in a infertile male population and to assess the association it shows to seminal fluid parameters. METHOD: Seminal fluid analysis including pH assessment was done on 168 males who sought infertility treatment at the university infertility clinic, at teaching hospital, Ragama. The pH was assessed within 30 minutes from collecting the sample using a pH meter. The seminal fluid analysis was done according to the WHO criteria. Log inversion of pH was done prior to calculation ofmeans. Results: The mean (±SD) pH of the sample population was 7.70 (±0.25) with a minimum of 6.78 and a maximum of 8.52. Only five patients (3%) had a pH less than 7.2. The distribution of the pH showed a 5" percentile value of 7.37 and a 95 'percentile of8.21.Thirty four percent (n=57) of subjects had a normal Seminal fluid analysis with regard to volume, concentration, motility and viability. Mean pH value showed a significant difference between the groups with a normal vs. abnormal volume of ejaculate, 7.75 vs. 7.59, P<0.05. Similar differences were not seen with any other semen parameter. Conclusion: The pH of ejaculate in this study sample is towards an alkaline range. Associations between semen pH and seminal parameters needs further study.Item A preliminary study on bacteriospermia in males of subfertile couples(Sri Lanka Medical Association, 2011) Abeysundara, I.D.H.P.K.; Dissanayake, D.M.A.B.; Wijesinghe, P.S.; Perera, R.R.D.P.INTRODUCTION AND OBJECTIVES: Bacteriospermia is common in subfertile men. Responsible organisms and their antibiotic sensitivity patterns vary between populations Aim of this study was to identify the types of bacteria and their ABST pattern among males of subfertile couples. METHODS: A descriptive cross sectional study was carried out. Semen samples of 105 males from subfertile couples were cultured in blood, chocolate and McConkey agar. Antibiotic sensitivity tests were done using the Clinical and Laboratory Standard Institute technique. RESULTS: Mean age of the study population was 32.77 yrs (rage 22-48 yrs), mean duration of subfertility was 3 yrs (Range 1-12 yrs). In 98 couples there was primary subfertility. Bacterial growth was noted in 63 samples. Positive cultures were found in 58.2% with primary subfertility and in 85.7% with secondary subfertility. A single organism was cultured in 44. Mltiple organisms were cultured in 19 samples. In 21 samples a significant growth of >104 of colony forming units were noted. Organisms found were Streptococci (n=28 out of them 8 were group D), coagulase negative Staphylococci (n=27), Diptheroids (n=T2), coliforms (n=7 of which 3 were Escherichia colt), Staphyhcoccus aureus (n^5), Acinetobacter (n=2), and Candida albicans (n=l). A single antibiotic or a combination which covers most organisms was not found. CONCLUSIONS: In this study population 20% had a significant bacterial growth. Organisms were found to have varied ABST patterns. The effect of bacteriospermia on subfertility needs further evaluation. Acknowledgements: This study was supported by National Research Council (09-69).Item Zinc levels in seminal plasma and its relationship with semen parameters in male partners of subfertile couples(Sri Lanka Association for the Advancement of Science, 2006) Dissanayake, D.M.A.B.Item Evaluation of reproductive hormone profile in relation to semen quality in male partners of subfertile couples(Sri Lanka Association for the Advancement of Science, 2007) Dissanayake, D.M.A.B.; Palihawadana, T.S.; Wijesinghe, P.S.; Ratnasooriya, W.D.; Wimalasena, S.The objective of the study was to assess the reproductive hormone profile of a Sri Lankan subfertile male population and to relate it to their semen parameters. Male partners of 152 subfertile couples who sought treatment at the subfertility unit of the department of Obstetrics and Gynaecology at the Faculty of Medicine, Ragama were included in the study. Serum samples were assayed for follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), Estradiol (E2) and testosterone (T) levels, using electrochemiluminescence immunoassay (ECLIA). A semen sample was obtained from each participant on the same day. Seminal fluid analysis was done according to the WHO guidelines. The mean (SEM) of FSH, LH, PRL, E2 and T levels of the males were 5.35 (0.53) mIU/mL, 6.20 (0.33) mIU/mL, 17.53 (0.60) ng/mL, 30.48 (1.80) pg/mL and 523.80 (14.74) ng/dL and the prevalence of abnormalities of these hormones were 9.8% (n=15), 5.9% (n=9), 13.15% (n=20), 0.6% (n=1) and 2.6% (n=4) respectively. Of the study population 20.3% (n=31) men had either single or combination of hormone abnormalities. When the mean hormone levels of the men with normal semen parameters were compared with those of men with abnormal semen parameters, none showed a statistically significant difference; FSH - 4.18 (2. 78) Vs 4.58 (3.15), LH - 5.90 (2.78) Vs 5.70 (2.36), PRL - 28.63 (14.96) Vs 17.59 (7.63) and T -551.39ñ208.17 Vs 515.73 (158.25). Mean (SD), FSH and LH levels were significantly higher among azoospermic participants compared with normozoospermics; 19.69 (9.93) Vs 4.18 (2.78) for FSH, 12.82 (11.82) Vs 5.90 (2.78) for LH, p<0.01). Similarly FSH and LH levels were significantly higher in severe oligospermic participants compared with the normozoospermics; 7.58 (4.34) Vs 4.18 (2.78) for FSH, and 6.96 (2.65) Vs 5.90 (2.78) for LH, p<0.05). The serum FSH level showed an inverse correlation with sperm concentration (r= -0.203, p<0.05) and total sperm count (r= -0.206, p<0.05). In conclusion, an endocrinopathy was present in up to 20% of this population. Abnormalities in Gonadotrophin levels were related with azoospermia and severe oligozoospermia. Serum FSH showed a negative correlation with the sperm concentration and the total sperm count. Other hormones failed to show a significant relationship with the semen parameters in this population. Acknowledgement: National Science Foundation research grant No. RG/2004/M/14