Journal/Magazine Articles
Permanent URI for this collectionhttp://repository.kln.ac.lk/handle/123456789/13
This collection contains original research articles, review articles and case reports published in local and international peer reviewed journals by the staff members of the Faculty of Medicine
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Item Short-term pain trajectories in patients with knee osteoarthritis(Wiley on behalf of the Asia Pacific League of Associations for Rheumatology, 2022) Atukorala, I.; Downie, A.; Pathmeswaran, A.; Deveza, L.M.A.; Chang, T.; Zhang, Y.; Hunter, D.J.Aim: It is unknown if pain in knee osteoarthritis (KOA) follows distinct patterns over the short term. Therefore, the aim of this study was to identify whether persons with a previous history of KOA pain fluctuations have distinct trajectories of pain over 90 days and to examine associations between baseline characteristics and pain trajectories. Method: People with a previous history of KOA were selected from a web-based longitudinal study. Baseline variables were sex, age, being obese/overweight, years of KOA, knee injury, knee buckling, satisfactory Lubben Social Support Score, pain and stress scales, Intermittent Constant Osteoarthritis Pain Score (ICOAP), medication use, and physical activity. Participants completed a Knee Injury and Osteoarthritis Outcomes Score (KOOS) pain subscale (KOOS-p, rated 0 = extreme to 100 = no knee problems) at 10-day intervals for 90 days. Short-term KOOS-p trajectories were identified using latent growth mixture modeling and the baseline risk factors for these pain trajectories were examined. Results: Participants (n = 313) had a mean age of 62.2 (SD ± 8.1) years and and a body mass index of 29.8 (SD ± 6.6) kg/m2 . The three-class latent growth mixture modeling quadratic model with best fit indices was chosen (based on lowest sample-size-adjusted Bayesian Information Criterion, high probability of belonging, interpretability). Three distinct pain trajectory clusters (over 90 days) were identified: low-moderate pain at baseline with large improvement (n = 11), minimal change in pain over 90 days (n = 248), and moderate-high pain with worsening (n = 46). Higher ICOAP (intermittent scale), perceived stress, negative affect score, and knee buckling at baseline were associated with a worse knee pain trajectory (P < 0.05). Conclusions: Persons with KOA showed unique short-term pain trajectories over 90 days, with distinct characteristics at baseline associated with each trajectory.Item Can pain flares in knee osteoarthritis be predicted?(:Taylor & Francis-Informa Healthcare, 2021) Atukorala, I.; Pathmeswaran, A.; Makovey, J.; Metcalf, B.; Bennell, K.L.; March, L.; Chang, T.; Zhang, Y.; Hunter, D.J.OBJECTIVES: This study examined whether risk factors for knee osteoarthritis (KOA) pain such as age, gender, body mass index (BMI), baseline pain, and other putative risk factors for knee osteoarthritis pain flares (KOAF) (e.g. knee buckling, injury, mood/stress/social support scores, and footwear) could predict KOAF. METHOD: People with KOA and previous history of KOAF were selected from a 3-month web-based longitudinal study. KOAF was defined as an increase of ≥ 2 points on a numeric rating scale (compared with background pain) which resolved within 20 days. Predictors assessed at baseline were gender, age, duration of KOA, BMI, pain, knee injury (7 days before), knee buckling (2 days before), Lubben Social Support, Knee Injury and Osteoarthritis Outcome Score, Intermittent and Constant Osteoarthritis Pain score (ICOAP), Positive/Negative Affect Score, and footwear stability/heel height. Outcome was occurrence of any KOAF during the ensuing 30 days. The combined ability of the above variables to predict occurrence of any KOAF was evaluated by multiple logistic regression with a 10-fold cross-validation method to build and internally validate the model. Variables that assessed similar domains were eliminated using receiver operating characteristics curve assessment for best fit. RESULTS: Complete data were available for 313 people (66.6% female, mean ± sd age 62.3 ± 8.2 years, BMI 29.7 ± 6.5 kg/m2). Increasing age, years of osteoarthritis, BMI, background/worst levels of pain, knee injury, knee buckling, ICOAP, and footwear category/heel height significantly predicted the occurrence of KOAF during the following 30 days, with an area under the curve of 0.73 (95% confidence interval 0.67-0.80). Conclusion: A combination of risk factors assessed at baseline, including exposures with potential to vary, successfully predicts the KOAF in the ensuing 30 days.Item A Descriptive study of knowledge, beliefs and practices regarding osteoporosis among female medical school entrants in Sri Lanka(BioMed Central Ltd., 2014) de Silva, R.E.E.; Haniffa, M.R.; Gunathillaka, K.D.K.; Atukorala, I.; Fernando, E.D.P.S.; Perera, W.L.S.P.BACKGROUND: Osteoporosis is a significant problem in rapidly ageing populations in Asian regions. It causes significant personal and societal impact and increases the burden on health care services. OBJECTIVES: Aim of this study is to determine the knowledge, beliefs and practices regarding osteoporosis amon young females entering medical schools in Sri Lanka. METHODS: This is a descriptive cross sectional study conducted amongst 186 female medical school entrants of th Faculties of Medicine, Universities of Colombo and Kelaniya from September to December 2010. A self administere questionnaire was used to assess knowledge, beliefs and practices on osteoporosis, including a food frequenc chart to assess the calcium intake. RESULTS: The mean age was 20.7 +/? 2.1 years. Majority of the participants (51.6%, n = 96) had an average scor (40? 60) on the knowledge test, while 40.8% (n = 76) had a poor score (<40). However, in depth knowledge o risk factors, and protective factors was lacking. Perceived susceptibility for osteoporosis was low with only 13.9 (n = 26) of women agreeing that their chances of getting osteoporosis are high. The mean calcium intake wa 528 mg/day and only 18.8% (n = 35) of the participants achieved the Recommended Daily Allowances (RDA) fo Calcium. Exercise was grossly inadequate in the majority and only 13.6%( n = 23) engaged in the recommende exercises. Only 3.8% (n =7) of the participants currently engaged in specific behaviours to improve bone healt while 10.8% (n = 20) had thought of routinely engaging in such behaviours. CONCLUSIONS: Although majority of participants had a modest level of knowledge on osteoporosis, there wer gaps in their knowledge in relation to risk factors, protective factors and on the insidious nature of osteoporosis Perceived susceptibility for osteoporosis was low. Practices towards preventing Osteoporosis were inadequate. © 2014 Ediriweera de Silva et al.Item Is being barefoot, wearing shoes and physical activity associated with knee osteoarthritis pain flares? Data from a usually barefoot Sri Lankan cohort(Oxford, 2021) Atukorala, I.; Pathmeswaran, A.; Batuwita, N.; Rajapaksha, N.; Ratnasiri, V.; Wijayaratne, L.; de Silva, M.; Chang, T.; Zhang, Y.; Hunter, D.J.AIM: To identify the association between hours of being barefoot/wearing footwear, physical activity (PA) and knee osteoarthritis pain flares (KOAF). METHODS: Persons with a diagnosis of knee osteoarthritis, who reported previous KOAF, were followed up in a 3 months long telephone-based case-crossover study. Exposures to risk factors were assessed every 10 days and whenever the participants experienced a KOAF. Conditional logistic regression examined associations of KOAF with following: hours of being barefoot/using footwear and PA performed (P < .05). RESULTS: There were 260 persons recruited, of whom 183 continued longitudinal follow up. Of them, 120 persons had at least one valid KOAF and control period. Participants were female (90%) with mean (SD) age and body mass index of 59.9 (7.0) years, 28.0 (5.0) kg/m2 respectively. Participants were barefoot for a mean duration of 12.7 hours (SD 4.6) and used footwear for 5.1 (SD 4.7) hours daily; 99% wore heel heights <2.5 cm. Duration of being barefoot, 1 and 2 days before, demonstrated reduced multivariate odds of KOAF (odds ratio [OR] = 0.85; 95% CI 0.80-0.90). Moderate PA performed 1, 2 days prior was associated with a significantly increased risk of KOAF (multivariate OR 4.29; 2.52-7.30 and OR 3.36; 2.01-5.61). Similarly, hours of using footwear 1 and 2 days before flare demonstrated increased odds of KOAF (OR 1.15; 1.07-1.23 and 1.10; 1.03-1.18). CONCLUSIONS: Increased duration of being barefoot 1 to 2 days before is associated with reduced risk of KOAF. Performing moderate PA 1 to 2 days before was associated with an increased risk of KOAF. KEYWORDS: knee osteoarthritis pain.