Medicine
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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty
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Item Spirometry reference norms for 13-14 year old Sri Lankan children(Sri lanka Medical Association, 2015) Gunasekera, K.D.; Amarasiri, W.A.D.L.; Fernando, E.A.C.; Warnakulesuriya, D.T.D.; Undugodage, U.C.M.; Wickremasinghe, A.R.INTRODUCTION AND OBJECTIVES: Reference norms have only been reported for Peak Expiratory Flow Rate (PEFR) in Sri Lankan children. The aim of this study was to construct prediction equations for spirometry in Sri Lankan children aged 13-14 years. METHOD: Spirometry was performed in 2078 Sri Lankan healthy children (1023 boys (49.2%) and 1055 (50.8%) girls) of 13-14 years of age according to American Thoracic Society guidelines. Forced Vital Capacity (FVC), Forced Expiratory Volume in the first second (FEVi), PEFR and Forced Mid-Expiratory Flow Rates (FEF25-75%) were measured. Correlation coefficients were established between each parameter and standing height, weight, and age. The functions were regressed over all possible combinations of variables separately for boys and girls. RESULTS: There were significant correlations between spirometry parameters and height and weight in both genders. There were significant correlations between age and PEFR, FEF25 and FEF50 in males and age and FEVi, PEF and FEF25-75% in females. The prediction equations in males for FVC: 0.047 height + 0.0007 age - 4.66; for FEVi: 0.041 height + 0.016 age - 4.22; for PEFR: 0.074 height + 0.123 age - 7.59 and FEF25-75%: 0.042 height -i-0.066 age-4.36. The equations in females for FVC: 0.028 height + 0.031 age - 2.36; for FEVi: 0.027 height + 0.047 age - 2.57; for PEFR: 0.038 height + 0.159 age - 2.93 and FEF25-75%: 0.029 height + 0.136 age-3.18. CONCLUSION: Height, weight and age influence ventilatory parameters and could be used to formulate prediction equations for spirometry in Sri Lankan children.Item Oesophageal dysfunction in asthmatics(Sri Lanka Medical Association, 2010) Amarasiri, W.A.D.L.; Pathmeswaran, A.; Ranasinha, C.D.; de Silva, H.J.INTRODUCTION: Gastro-oesophageal reflux (GOR) predisposes to respiratory symptoms through reflex vagal activity. Asthmatics have oesophageal hypomotility and vagal hyperactivity. Whether this oesophageal hypomotility is primary or secondary to damage from GOR is unclear. METHODS: 30 mild, stable asthmatics (ATS criteria) and 30 healthy volunteers underwent 24-hour ambulatory oesophageal pH monitoring, manometry, autonomic function testing and GORD symptom assessment and gastroscopy. A vagal score using 3 tests (valsalva manouvre, heart rate response to deep breathing and to standing from supine position) was correlated with oesophageal function parameters. Respiratory symptoms during pH monitoring were correlated with reflux events. RESULTS: Asthmatics (mean age 34,8y; 60% female) had more frequent GORD symptoms than controls (mean age 30.9y; 50% female). 10/27 asthmatics had oesophageal mucosal damage, 22/30 showed hypervagal response, none had a hyperadrenergic response. 14/30 asthmatics had ineffective oesophageal motility. Higher GOR-score asthmatics had significantly fewer peristaltic contractions and more simultaneous contractions than controls, and higher oesophageal.acid contact times than those with lower scores. All reflux parameters were significantly higher and acid clearance time prolonged in asthmatics than controls. There was no correlation of vagal function with oesophageal function parameters. 50% of the asthmatics complained of respiratory symptoms during pH monitoring, and reflux episodes usually preceded respiratory symptoms. CONCLUSION: Asthmatics have abnormal oesophageal motility and pathological GOR which usually precede respiratory symptoms. There was no vagal dysfunction, and the vagal function score did not correlate with oesophageal motility parameters. Peristaltic dysfunction may be secondary to damage due to gastro-oesophageal reflux.Item Coconut fats(Sri Lanka Medical Association, 2006) Amarasiri, W.A.D.L.; Dissanayake, A.S.In many areas of Sri Lanka the coconut tree and its products have for centuries been an integral part of life, and it has come to be called the "Tree of life". However, in the last few decades, the relationship between coconut fats and health has been the subject of much debate and misinformation. Coconut fats account for 80% of the fat intake among Sri Lankans. Around 92% of these fats are saturated fats. This has lead to the belief that coconut fats are 'bad for health', particularly in relation to ischaemic heart disease. Yet most of the saturated fats in coconut are medium chain fatty acids whose properties and metabolism are different to those of animal origin. Medium chain fatty acids do not undergo degradation and re-esterification processes and are directly used in the body to produce energy. They are not as 'bad for health' as saturated fats. There is the need to clarify issues relating to intake of coconut fats and health, more particularly for populations that still depend on coconut fats for much of their fat intake. This paper describes the metabolism of coconut fats and its potential benefits, and attempts to highlight its benefits to remove certain misconceptions regarding its use.