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 Seizure patterns, preconception care and pregnancy outcomes in women with epilepsy in a tertiary care hospital(Journal of the Ceylon College of Physicians, 2020) Motha, M.B.C.; Palihawadana, T.S.; Jayasinghe, C.; Ranawaka, U.K.INTRODUCTION AND OBJECTIVES: Data on epilepsy in pregnancy is limited from South Asia and other resource-limited countries. We sought to describe seizure patterns, preconception care and pregnancy outcomes in women with epilepsy attending a Sri Lankan tertiary care hospital. METHOD: All pregnant women with epilepsy admitted to University Obstetrics Unit, Colombo North Teaching Hospital during the period January 2017 February 2020 were recruited. Data were collected by a single physician using an interviewer-administered questionnaire. RESULTS: Out of 9520 pregnant women screened, 63 had a history of epilepsy (prevalence 6.6/1000); 46% generalized epilepsy, 22.2% focal epilepsy. Of 38 women on antiepileptics at conception, only 44.7% were given folic acid 5 mg preconceptionally. 42.9% were seizure free over preceding 2 years. Majority (55%) had a seizure during current pregnancy (average number of seizures per patient: 1s1 trimester 1.85, 2nd trimester 2.2, 3rd trimester 2.95, postpartum 2.5). 18.4% of seizure events were attributed to sleep deprivation, and 2.7% to unsatisfactory drug compliance. 81.6% were on monotherapy at conception and 18.4% were on two antiepileptic. 22.2% had a hypertensive disorder of pregnancy and 9.5% spontaneous premature delivery. 33.3% underwent caesarian delivery. 1.58% each had a stillbirth and neonatal death. Low birth weight was seen in 42.9%. Major congenital malformations were found in 11.1% of newborns. CONCLUSIONS: Pre-conceptional folic acid coverage was poor. Seizures occurred in more than half of the women and were more common in third trimester and postpartum. Rates of hypertensive disorders, caesarean deliveries, low birth weight and congenital malformations were high.Item Prevalence of obesity and its associations among adolescents: an urban community-based birth cohort study(Sri Lanka Medical Association, 2017) Niriella, M.A.; de Silva, S.T.; Ediriweera, D.S.; Kasturiratne, A.; Jayasinghe, C.; Rajindrajith, S.; de Silva, A.P.; Pathmeswaran, A.; de Silva, H.J.INTRODUCTION & OBJECTIVES: Community based data on childhood obesity is lacking. We investigated the community prevalence and associations for adolescent obesity. METHODS: Fourteen-year-olds (Year-2000 birth-cohort), from Ragama MOH area were included. Demographic and life style data was collected. Standard blood biochemistry was performed. Physical activity (PA) and sedentary time (ST) were assessed using the short version of the International Physical Activity Questionnaire (IPAQ). Body mass index (BMI), waist circumference (WC) and blood pressure were measured. Total body fat (TBF%) was measured using impedance method. Multiple logistic regression was used to assess relationships between demography, life style habits, anthropometry, TBF% and biochemistry with obesity. RESULTS: A total of 508 [261 (51.6%)-girls, median birth weight-2.9 (IQR: 2.6-3.2) kg, 9 (1.78%) had maternal gestational diabetes (GDM), with median age of menarche-12 [IQR: 11-13] years] participated in the study. 61 (12.0%) had general obesity (GO) (BMI>age-sex equivalent of 23kg/m2) [33 (11.4%)-girls, 28 (12.7%)-boys; p=0.76]. 136 (27.0%) had central obesity (CO) (WC>cut-off for age and sex) [97 (37.3%)-girls, 39 (16.0%)-boys; p<0.01]. Median TBF% was 19.4 (IQR: 14.2-23.5). 10 (2.0%) had abnormal TBF% [3 (1.1%)-girls, 7 (2.9%)-boys; p=0.21]. Those engaging in some-PA [below recommendation (duration<150 min/week) and recommended-PA [at or above recommendation (duration≥150 min/week)] among girls were 129 (49.4%) and 132 (50.6%) while among boys were 116 (48.1%) and 125 (51.9%) respectively. Those with ST≥4 hour, <4 hours for girls and boys were 63 (24.4%), 195 (75.6%) and 31 (12.7%), 213 (87.3%) respectively. HOMA-IR median was 120.3 (IQR: 86.2-173.8). On multiple logistic regression, birth weight (OR-1.01; p<0.01), age at menarche (OR-1.48; p<0.05), TBF% (OR-2.27; p<0.001) and HOMA-IR (OR-1.01; p<0.001) were significantly associated with CO while PA or ST were not. CONCLUSION: Central obesity among adolescent girls was significantly more than boys. Adolescent central obesity was associated with birth weight, age at menarche, adverse TBF% and insulin resistance.Item Prevalence and risk factors for metabolic syndrome among aging adults in an urban Sri Lankan population(Sri Lanka Medical Association, 2015) Kasturiratne, K.T.A.A.; Niriella, M.A.; de Silva, S.T.; Perera, K.R.; Subasinghe, S.K.C.E.; Kodisinghe, S.K.; Piyaratna, T.A.C.L.; Vithiya, K.; Kottachchi, D.; Ranawaka, U.K.; Jayasinghe, C.; Rajindrajith, S.; Dassanayake, A.S.; de Silva, A.P.; Pathmeswaran, A.; de Silva, H.J.INTRODUCTION AND OBJECTIVES: Metabolic syndrome (MetS) is assumed to be of high prevalence in the Asian region. However, its community prevalence and risk factors in South Asia is poorly studied. We determined the prevalence and risk factors for MetS among adults in an urban Sri Lankan population. METHOD: The study population consisted of 42-71 year old adults, selected by stratified random sampling from the Ragama Medical Officer of Health area. MetS was defined by the International Diabetic Federation criteria with ethnic specific cutoffs. Anthropometric measurements, blood pressure (BP) and body fat distribution estimates were made. Glycosylated hemoglobin, fasting serum lipids, serum alanine aminotransferase (ALT) and serum creatinine (SCr) with estimated glomerular filtration rate (eGFR) were determined. CKD was defined as GFR<60ml/min/1.72m2 (KDIGO/KDOQI classification), USS abdomen was performed to detect fatty liver and non-alcoholic fatty liver disease (NAFLD) was diagnosed on safe alcohol consumption (< 14 units/week for men, < 7 units/week for females) and absence of hepatitis B and C markers. RESULTS: 2155 (1244 [57.7%] women, mean age 59.2 years [SD, 7.7]) participated. 1014 (47.1%) [mean age 59.2 years (SD, 7.7), 256 (28.1%) men; 758 (60.9%) women] had MetS. On multivariate analysis female gender, abnormal total body fat and abnormal visceral fat level (>10%) and presence of NAFLD were independently associated with MetS. Age 65 or more, raised ALT and CKD were not associated with MetS. CONCLUSION: The prevalence of MetS among adults in this aging urban Sri Lankan community was high and is independently associated with female gender, abnormal body fat distribution and presence NAFLD.Item Developing a tool to screen for disability among pre-school children: preliminary results(Sri Lanka Medical Association, 2014) Perera, K.M.N.; Wijerathne, L.; Jayasinghe, C.; Kasturiratne, A.; Hettiarachchi, S.; Fonseka, R.; Jayasena, B.N.; Siriwardhena, D.; Godamunne, P.; Dahanayake, W.; Pathmeswaran, A.; Wickremasinghe, A.R.INTRODUCTION AND OBJECTIVES: To develop and validate a tool that can be used by pre-school teachers to identify disabilities in the pre-school age group. METHODS: A multidisciplinary team was formed and the initial tool was developed^ Consensual validity was achieved by using nominal group technique and the tool was pre-tested in the Ragama MOH area. To assure criterion validity, the tool was used to screen all the children in the pre-school age group (2-5 years) in an MOH area randomly selected from the Anuradhapura District. The screened positives .were referred to an expert panel for confirmation of diagnosis and follow-up if required. RESULTS: Thousand nine hundred children were invited for screening and 1536 participated (478 2-3 years, 495 3-years, 560 > 4 years of age) and 267 (17.4%) were referred to the expert panel. Out of the referrals, majority (38.9%) had multiple disabilities. Hearing and speech difficulties were seen in (29.6%). Psycho social problems (11.6%), disabilities and other diseases (19.8%) accounted for the rest. The response rate for confirmation by experts was 64%. The predictive value of a positive test was 79.5%. The prevalence of disabilities among the screened pre-school age group was 88 per 1000 (95% Cl= 74 to 103). CONCLUSIONS: This tool can be used to screen children in the pre-school age for disabilities.