Conference Papers
Permanent URI for this collectionhttp://repository.kln.ac.lk/handle/123456789/6561
This collection contains abstracts of conference papers, presented at local and international conferences by the staff of the Faculty of Medicine
Browse
33 results
Search Results
Item Prevalence of covishield COVID-19 vaccine (ChAdOx1 nCoV-19) adverse effects among health care workers in Sri Lanka(Elsevier, 2022) Manilgama, S.R.; Hettiarachchi, N.M.; Jayasinghe, K.I.; de Silva, S.; Wanigaratne, T.; Jayalath, T.; Bandusiri, R.P.; Suganthan, N.; Sudarshan, P.; Pathirage, M.; Rajaratnam, N.; Senaratne, G.; Rajapaksha, V.; Wickramasinghe, A.; Kulaweera, M.T.D.PURPOSEA Community vaccination programme is the best approach to combat COVID-19 pandemic. The first priority was given to the health care workers (HCWs) with the introduction of Indian Covishield (ChAdOx1 nCoV-19) vaccine to Sri Lanka since February 2021. An independent post-vaccine surveillance is important to identify the occurrence of adverse effects(A/E) in the population. METHODS & MATERIALSA multicentered cross-sectional survey was conducted in four provinces of Sri Lanka to estimate the prevalence of A/E after covishield vaccination A/E among HCWs after the first dose. A self-administered questionnaire was used to gather demographic data and A/E. Data was analysed using descriptive statistics. RESULTS Of 4834 participants, 3500(72.4%) were females. The median age was 42.23(SD±9.64) years. Only 0.8%(n=31) persons has had Covid infection in the past. 2.2% were breastfeeding mothers and 0.2% were pregnant ladies.87.4% of persons had at least one A/E and 53.1% had local A/E. Body aches(68.2%), headaches(63.8%), fever(58%), chills 51.4%), fatigue(41.2%), arthralgia(38.1%) and rigors (32%) were the most commonly reported systemic A/E. Most of the systemic A/E were more prevalent among the ≤42-year-old group, and females. Their duration was mainly 24 hours. Mean duration of onset of fever is 9.76 hours. Pain and redness at the site were the most commonly reported local A/E. All of the local A/E were more prevalent among the ≤42-year-old group and females. Mean duration of pain at the site is 4.47 hours. 1.7%(n=61) had reactions within first 20 minutes. 0.08%(n=4) developed anaphylaxis, 0.8%(n=31) had urticaria. 15.4% had at least one comorbidities but there were no significant association between having a comorbidity and developing systemic or local. 1.3% had history of drug or food allergies, they did not show significant relation to current vaccine induced allergies or anaphylaxis. 69.2% attended the routine work despite having minor A/E. 0.13%(n=7) were hospitalised and treated. 22.4% were stayed at home and rested for 24-48 hours due to A/E. CONCLUSION Eventhough more than 60% reported minor A/E, there were only a few serious A/E. A/E were more prevalent in younger age and females. Overall, the first dose of the Covishield vaccine was well-tolerated by HCWs.Item Premorbid blood pressure control of incident transient ischaemic attacks and strokes; prevalence and determinants; Analysis of individual patient data over 10 Years(Lippincott Williams & Wilkins, 2017) Mettananda, C.; Li, L.; Lau, G.; Wharton, R.; Bull, L.; McCulloch, E.; Welch, S.; Mehta, Z.; Silver, L.; Rothwell, P.; Oxford Vascular StudyBACKGROUND: Uncontrolled blood pressure is the most important modifiable risk factor for strokes. AIMS AND METHODS: We determined the prevalence and determinants of blood pressure control in patients with incident transient ischaemic attacks(TIA) and strokes from 2002-2012 in a population-based cohort(Oxford Vascular Study). Controlled blood pressure(BP) was defined as having BP<140/90mmHg and was studied in different cardiovascular risk groups according to the Framingham 10-year general cardiovascular risk(CV-Risk) predicted at time of event and 10years pre-event; low(≤ 10%), moderate(11-19%) and high(≥ 20%) risk. We also studied the associations of controlled BP adjusted for age and sex. RESULTS: Among 1741 patients with incident TIA/strokes, 1051 (60.4%) had known hypertension, of which 891 (84.8%) were on anti-hypertensive treatment. However, only 698 (40.1%) of all and 306 (29.1%) of treated patients had controlled BP. On predicted 10-year CV-Risk at event, 861 (72.5%) of 1188 (77.0%) in high risk group had known hypertension, of which 758 (88.0%) were on treatment. However, only 346 (29.1%) of all in high-risk group and 190 (25.1%) of treated high risk patients had controlled BP. In contrast, 120 (88.2%) of 136 (8.8%) in low risk group had controlled BP. Risk stratification without scoring for BP showed consistent results except the number in high-risk group dropped to 863 (55.9%). Analysis with CV-risk 10years pre-event also showed similar trends. Age(adjusted OR=0.97, 95%CI=0.97-0.98, p<0.001), high CV-risk at event/10years pre-event (0.97, 0.95-0.99, p<0.013, 0.95-0.99, p=0.008), being treated for hypertension(0.43, 0.35-0.52, p<0.001), BMI≥ 30Kg/m2(0.72, 0.55-0.92, p=0.010) and high total cholesterol(0.91, 0.84-0.99, p<0.026) were negatively associated with controlled BP. However history of atrial fibrillation(1.35, 1.03-1.77, p=0.030) and physical dependency(modified-Rankin-Scale>2; 1.54, 1.15-2.06, p<0.001) were positively associated with controlled BP. CONCLUSIONS: Premorbid blood pressure control in patients with incident TIA/strokes was inadequate especially in high-risk patients. Controlling BP to targets in elderly and high CV-risk patients would be important in reducing incident TIA/strokes.Item Correlates of serum homocysteine in a Sri Lankan population(American Association For Clinical Chemistry, 2010) Chackrewarthy, S.; Wijayasinghe, Y.S.; Gunasekera, D.; Wickremasinghe, R.; Kato, N.Correlates of total serum homocysteine concentration in a Sri Lankan population BACKGROUND: Hyperhomocysteinemia, a possible risk factor for vascular disease occurs at a higher prevalence in South Asian countries. Serum homocysteine concentrations are influenced by genetic, nutritional and lifestyle factors. Correlates of total serum homocysteine concentration (tHcy) are not well characterized in the Sri Lankan population. Such information is important in developing therapeutic and preventative strategies. OBJECTIVE: To investigate the factors potentially associated with fasting levels of serum tHcy in a Sri Lankan population. METHODS: In a cross sectional study, 177 apparently healthy volunteers (91 men and 86 women) aged 38-65 years were selected from residents in an urban health administrative area. Individuals with a history of chronic disease and with any pharmacological treatment were excluded from the study. Information on diet, lifestyle factors and medical history were recorded. Anthropometric indices and blood pressure were measured according standard protocols. Fasting serum levels of tHcy, insulin, creatinine, folate and lipids were estimated using standard protocols. RESULTS: Fasting serum tHcy levels were higher in males than in females (geometric mean +/- SD, 13.75 mumol/l +/- 1.41 Vs. 9.58 mumol/l +/- 1.43, p<0.001) and were positively associated with age (r=0.204, p< 0.01) in both sexes. 32.3% of males and 10.3% of females had mild hyperhomocysteinemia (tHcy>15mumol/l). tHcy levels were significantly higher in smokers than in non-smokers (geometric mean +/- SD, 14.58 mumol/l +/- 1.44 Vs.12.71 mumol/l +/- 1.37, p<0.05) and in alcohol consumers than in non-consumers (geometric mean +/- SD, 14.53 mumol/l +/- 1.43 Vs.12.14 mumol/l +/- 1.32, p< 0.02). In males, tHcy levels were negatively related to serum insulin (r= -0.397, p<0.001) and BMI (r= -0.244, p <0.02) and positively related to serum creatinine (r=0.235, p<0.02). In females, there was a positive relationship between tHcy and systolic blood pressure (r= 0.239, p<0.02) but there was no significant correlation with serum insulin. In both sexes, serum tHcy levels strongly correlated with serum folate (r= -0.412, p<0.001). There were no significant associations between tHcy and serum lipids. Stepwise regression analysis confirmed the associations between tHcy and folate (p<0.001 in both sexes), insulin (p=0.026 in males) and creatinine (p=0.036 in males). CONCLUSION: Low intake of folate, alcohol consumption and smoking were associated with increased tHcy concentrations. Serum insulin and creatinine were independent correlates of tHcy in males, but not in females. Difference in tHcy levels between sexes may partly be attributed to differences in lean muscle mass and to a metabolic link between creatinine synthesis and homocysteine production. Insulin may regulate serum tHcy concentrations by homocysteine remethylation or by increasing homocysteine clearance.Item Clinical and histopathological characteristics of cutaneous leishmaniasis in a group of military personnel in Sri Lanka(American Society of Tropical Medicine and Hygiene, 2015) Manamperi, N.H.; Fernando, C.S.; Pathirana, A.; Abeyewickreme, W.; de Silva, V.C.; Karunaweera, N.D.Cutaneous leishmaniasis (CL) is a newly established vector-borne parasitic disease in Sri Lanka. Military personnel have an occupational risk for CL due to being stationed in endemic areas and exposure to vectors outdoors. This study describes the clinical and histopathological features of CL in a group of military personnel. Thirty five patients with smear positive for Leishmania amastigotes were included, their data analyzed for clinical features and skin biopsies processed routinely for histology, examined at a conference microscope and classified into 4 groups using modified Ridley criteria for Leishmaniasis as: I-parasitized macrophages with variable lymphocytes and plasma cells; II-parasitized macrophages with lymphocytes, plasma cells and ill formed histiocytic granulomata; III-a mixture of macrophages (with or without parasites), lymphocytes, plasma cells and epithelioid granulomata; IV-epithelioid granulomatous response with a few lymphocytes and plasma cells but no amastigotes. Lesions were categorized by duration, as acute (< 6 months) or chronic (> 6 months). Study group composed of all males with a mean age of 32.6 years (range 22-47) and lesion duration of 5.6 months (range 1-24). Number of lesions varied from 1 to 6 with majority (71.4%, n= 25) having a single lesion. Nodular (37.1%, n=13) and nodulo-ulcerative (25.7%, n=9) lesions in upper limbs (68.6%, n=24) was the commonest presentation. Twenty nine (82.9%) of the biopsies were positive also by histology. Twenty two (62.9%) were acute and 13 (37.1%) chronic. Group I, II, III and IV patterns were seen in 14 (40%), 12 (34.3%), 5 (14.3%) and 4 (11.4%) respectively and 9 (40.9%), 9 (40.9%), 2 (9.1%) and 2 (9.1%) of acute lesions and 5 (38.5%), 3 (23.1%), 3 (23.1%) and 2 (15.4%) of chronic lesions respectively. Necrosis was not seen in any of the lesions. Majority in this group of military personnel with CL had single lesions affecting the upper limbs and sought treatment within 2 years of appearance of lesions. The histological picture varied from diffuse infiltration of parasitized macrophages admixed with chronic inflammatory cells to ill-formed histiocytic granulomata.Item The Prevalence of asthma in Sri Lankan adults((Wiley Blackwell Scientific Publications, 2016) Amarasiri, D.L.; Undugodage, U.C.M.; Silva, H.K.M.S.; Sadikeen, A.; Gunasinghe, W.; Fernando, A.; Wickremasinghe, A.R.; Gunasekera, K.D.BACKGROUND AND AIMS: Data on adult asthma is scarce in Sri Lanka. The objective of this study was to estimate the prevalence of asthma and related symptoms amongst adults in the general population. METHODS: A multi-centered, cross-sectional study was conducted using an interviewer-administered translated version of the screening questionnaire of the European Community Respiratory Health Survey from June to December 2013 in 7 provinces of Sri Lanka. Subjects were selected randomly from different regions by stratified sampling. The prevalence of asthma was defined as "wheezing in the past 12 months (current wheeze)", 'self-reported attack of asthma in the past 12 months' or 'current asthma medication use'. RESULTS: The study comprised 1872 subjects (45.1% males, 48.8% aged18-45 years) of which 12.2% were current smokers. In the total population, the prevalence of current wheeze was 23.9% (95% CI: 22.0%-25.9%), of self-reported asthma was 11.8% (95% CI: 10.3%- 13.2%) and of current asthma medication use was 11.1% (95% CI: 9.6%- 12.5%). The prevalence of asthma according to a positive response to either of the above questions was 31.4% (95% CI: 29.3%-33.4%) The prevalence of symptoms was higher in adults aged >45 years. Of those with current wheeze, 60.9% denied a diagnosis of asthma and only 38.2% admitted to use of asthma medication. In those with current wheeze, wheezing was the only symptom in 19.9% whereas 80.1% had at least one other respiratory symptom (tightness of chest, cough or shortness of breath) of which cough was the most common symptom. In those without current wheeze, self-reported asthma and current asthma medication use, 30%, 35.9% and 36.6% respectively had at least one other respiratory symptom. CONCLUSIONS: The prevalence of asthma in Sri Lankan adults is high in comparison with global data. A significant percentage of symptomatic individuals deny having asthma and are not on medication.Item Incidence, prevalence and demographic and life style risk factors for obesity among urban, adult Sri Lankans: a community cohort follow-up study(Sri Lanka Medical Association, 2017) Niriella, M.A.; de Silva, S.T.; Kasturiratne, A.; Kottachchi, D.; Ranasinghe, R.M.A.G.; Dassanayake, A.S.; de Silva, A.P.; Pathmeswaran, A.; Wickremasinghe, A.R.; Kato, N.; de Silva, H.J.INTRODUCTION & OBJECTIVES: Obesity is a global problem. Data from the South Asian region is limited. METHODS: In a cohort follow-up study we investigated obesity among urban, adult, Sri Lankans (35-64y; selected by age-stratified random sampling from Ragama-MOH area; initial screening 2007; re-evaluation 2014). On both occasions structured interview, anthropometry, liver ultrasound, biochemical and serological tests were performed. Total body fat (TBF) and visceral fat percentage (VFP) were assessed by impedance in 2014. General-obesity (GO) was BMI>25kg/m2. Central-obesity (CO) was waist circumference (WC)>90cm males and WC>80cm females. Multinomial logistic regression was fitted to assess associations. RESULTS: In 2007 (n=2967), 614 (20.7%) were overweight [51.9%-women], 1161(39.1%) had GO [65.9%-women] and 1584(53.4%) had CO [71%-women]. Females (p<0.001), raised-TG (p<0.001), low-HDL (p<0.001), diabetes (p<0.001), hypertension (p<0.001), NAFLD (p<0.001), and low household income (p<0.001) were significantly associated with prevalent GO and CO respectively. Additionally, increased-age (p=0.05), low-educational level (p<0.001) and unhealthy eating (p<0.001) were associated with prevalent CO. Inadequate physical activity was not associated with either. 2137 (72%) attended follow-up in 2014. Of those who were initially non-obese who attended follow-up, 189/1270 (14.9%) [64% women] had developed GO (annual-incidence 2.13%) and 206/947 (21.9%) [56.3% women] had developed CO (annual incidence 3.12%) after 7 years. TBF and VFP significantly correlated with incident GO and CO (p<0.001). Female gender (OR-1.78, p<0.001; 2.81, p<0.001) and NAFLD (OR-2.93, p<0.001; OR-2.27, p<0.001) independently predicted incident GO and CO respectively. CONCLUSION: The prevalence and incidence of GO and CO were high in this cohort. Both incident GO and CO were strongly associated with female gender and NAFLD.Item Prevalence of irritable bowel syndrome in an urban adult Sri Lankan population(Sri Lanka Medical Association, 2016) Rishikesavan, V.; de Silva, A.P.; Niriella, M.A.; Mendis, W.A.S.; Ruston, S.M.; Pathmeswaran, A.; de Silva, H.J.INTRODUCTION AND OBJECTIVES: The community prevalence of irritable bowel syndrome (IBS) globally varies from 10 to 25%. Telephone interviews have been widely used to collect data. There is limited data on community prevalence of IBS in South Asia. Objective of the study was to determine the community prevalence of IBS and its subtypes in an urban adult Sri Lankan population. METHOD: The study was conducted in the Ragama medical officer of health (MOH) area. Householders lists of 22 Grama Niladari divisions were used for balanced random sampling. Individuals aged between 18-65 years (stratified into three groups: 18-33, 34-49, 50-65) were included. A random sample of households was selected and the person who had the closest birthday was selected from each household. A telephone interview was conducted. IBS and its subtypes [constipation predominant (IBS-C), diarrhea predominant (IBS-D), mixed (IBS-M)] were defined according to Rome III criteria. RESULTS: 504/1407(35.8%) of selected households were contactable. Of 504 persons invited to participate 500(99.2%) responded [277-females, mean (SD) age: 42.37 (13.2) years]. The overall prevalence of IBS was 18/500 (3.6%) [13-males(5.83%), 5-females(1.81%); p=0.017]. There was significant difference in prevalence among age groups for males (least among 34-49 years; p=0.024) but not for females (p=0.665). Of the males with IBS, 2(15.38%), 5(38.46%) and 6(46.15%) had IBS-D, IBS-C and IBS-M, respectively. Of the females with IBS, 2 (40%), 1(20%) and 2(40%) had IBS-D, IBS-C and IBS-M, respectively. CONCLUSIONS: Using accepted criteria, the overall community prevalence of IBS was low in this population, with a significant male predominance, and IBS-M being the commonest subtype.Item The Prevalence of reflux oesophagitis in adult asthmatics(Wiley- Blackwell, 2009) Amarasiri, L.; Ranasinha, C.D.; de Silva, H.J.BACKGROUND/PURPOSE: Asthma and gastro-oesophageal reflux disease are known to be associated. The severity of asthma is related to the degree of reflux. This relationship has been little studied in South Asia. METHODS: Thirty asthmatics underwent a reflux symptom assessment using a validated questionnaire assessing 7 upper gastro-intestinal (UGI) symptoms graded on a 5-point Likert scale (Amarasiri LD 2009). They further underwent UGI endoscopy. RESULTS: All asthmatics had mild stable asthma. 20 of the 30 asthmatics had apositive GORD symptom score. 27 asthmatics consented to UGI endoscopy. The grade of oesophagitis was classified using Savary Miller criteria. 10 of the 27 asthmatics had evidence of mucosal damage (see Table 1). There was no correlation between the grade of oesophagitis and the GORD score (r = 0.025; P = 0.896, Spearman Rank correlation). CONCLUSIONS: The prevalence of reflux oesophagitis in asthmatics was 37%. There was no association of severity of oesophagitis with symptoms. Both these findings are consistent with the global data, but have not previously been described in a South Asian population.Item Prevalence of asthma and atopy among primary school children(Sri Lanka Medical Association, 2001) Karunasekera, K.A.W.; Perera, K.P.J.INTRODUCTION : Prevalence of asthma and atopy among school children in Sri Lanka is not known. Objectives : To estimate prevalence of asthma and atopy in children between 5-11 years and to determine the influence of sex and age on the prevalence of asthma. METHODS: A total of 2043 children between 5-11 years of 3 mixed schools in Gampaha district were screened for symptoms of asthma and atopy using a questionnaire in August 1998. Diagnosis of asthma was based on the presence of 3 symptoms of the following 5 in the preceding 12 months; cough at night, breathlessness, wheezing, persistent cough more than a week after common cold and cough and/or chest tightness during or after playing. Chi squared test and Chi squared test for trend were used for analysis. RESULTS: Prevalence of asthma symptoms were cough at night 22.1%, breathiessness 17.2%, wheezing 22.6%, persistent cough after common cold 29.9% and cough or chest tightness with playing 11%. Prevalence of asthma based on questionnaire was 17.1 %, allergic rhinitis 10% and eczema 2.5%. The prevalence of asthma in males was not significantly different from that of females (p=0.4). There was a decreasing trend of the prevalence of asthma with increasing age. This trend was significant in girls (p= 0.01) but not in boys. CONCLUSIONS: Nearly one fifth of primary school children suffer from asthma and 10% have allergic rhinitis. There was no significant gender difference in Jhe prevalence of asthma in primary school children. There was a decreasing trend of the prevalence of asthma with increasing age in girls but not in boys.Item Epidemiology of cyclical vomiting syndrome in a cohort of Sri Lankan children(The Korean Society of Neurogastroenterology and Motility, 2013) Devanarayana, N.M.; Rajindrajith, S.BACKGROUND/AIMS: Cyclic vomiting syndrome (CVS) is characterised by recurrent episodes of intense nausea and vomiting or unremitting retelling lasting for hours to days. Very little is known of its epidemiology in paediatric age group. The aims of this study were to assess the prevalence, clinical profile and risk factors of CVS m Sri Lankan children and adolescents. METHODS: This is a school-based cross sectional survey conducted in 8 randomly selected schools in 4 randomly selected provinces of Sri Lanka. Data were collected using a validated, self-administered questionnaire, which consisted of 3 parts; part 1 - socio-demographic data, part 2 - data on stressful and adverse life events, part 3 - Rome III questionnaire (self report form for children above 10 years) which was translated and validated for Sri Lankan children. It was administered in an examination setting and collected on the same clay. Trained research assistants were present during filling the questionnaire to verify doubts. CVS was diagnosed using Rome III criteria. RESULTS: A total of 2,163 children were recruited for the study (male 1189 (54.9%), age range LO to 16 years, mean 13.4 years, SD 1.8 years). In this study, CVS was seen in 18 (0.8%). There was no gender difference in prevalence of CVS (boys 1.0% vs. girls 0.6%, P > 0-05). A significantly higher prevalence of CVS was observed in children exposed to recent stressful life events such as being bullied at school (3.4% vs. 0.7% in not exposed), major illness in a close family member (1.9% vs. 0.6%), hospital-ization of the child for other illness (2.2% vs. 0.7%), frequent punishment by parents (3.3% vs. 0.7%) and domestic violence (2.9% vs. 0.8%). No association observed between CVS, and age, socio-economic status, family size and birth order. CONCLUSIONS; The prevalence of cyclic vomiting syndrome among Sri Lankan children and adolescents is 0.8%. This condition is more common in those exposed to emotional stress.