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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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 Alpha thalassaemia and extended alpha globin genes in Sri Lanka(Elsevier-Academic Press, 2013) Suresh, S.; Fisher, C.; Ayyub, H.; Premawardhena, A.; Allen, A.; Perera, A.; Bandara, D.; Olivieri, N.; Weatherall, D.The α-globin genes were studied in nine families with unexplained hypochromic anaemia and in 167 patients with HbE β thalassaemia in Sri Lanka. As well as the common deletion forms of α(+) thalassaemia three families from an ethnic minority were found to carry a novel form of α(0) thalassaemia, one family carried a previously reported form of α(0) thalassaemia, --(THAI), and five families had different forms of non-deletional thalassaemia. The patients with HbE β thalassaemia who had co-inherited α thalassaemia all showed an extremely mild phenotype and reduced levels of HbF and there was a highly significant paucity of α(+) thalassaemia in these patients compared with the normal population. Extended α gene arrangements, including ααα, αααα and ααααα, occurred at a low frequency and were commoner in the more severe phenotypes of HbE β thalassaemia. As well as emphasising the ameliorating effect of α thalassaemia on HbE β thalassaemia the finding of a novel form of α(0) thalassaemia in an ethnic minority, together with an unexpected diversity of forms of non-deletion α thalassaemia in Sri Lanka, further emphasises the critical importance of micro-mapping populations for determining the frequency of clinically important forms of the disease.Item Dietary goitrogens and prevalence of goitre in Sri Lanka(The College of Surgeons of Sri Lanka, 2011) Pinto, M. D. P.; Fernando, R.; Pathmeswaran, A.; Premathilake, M.; Fernando, T.; Edirisinghe, D.; Bandara, D.; Athulugama, N.; Abeysinghe, S.OBJECTIVE: To assess the relationship between dietary goitrogens and the prevalence of goiter. METHODS:A descriptive cross-sectional study on the prevalence of goitre was conducted involving all areas of the country, except North and Batticaloa district from December 2006 to June 2007. A pre-tested interviewer administered questionnaire was used on all participants as a screening tool. Consumption of 6 possible dietary goitrogens was assessed. Sufficient frequency of consumption was taken as consumption >3 times a week. Pearson's chi-square test was used to analyze the significance of dietary goitrogens to the prevalence of goiter. RESULTS: 5200 participants were assessed (n=5200) island wide and 426 were detected with goitre. Mean age for occurrence of goitre was 36.3(+_17.3) years. Frequency of consumption of these food items was low, none being higher than 10% among the 5200 participants. Consumption of each goitrogen was as follows; Cabbage "[2.9%], Lima beans [9.9%], Kurakkan (Millet) [4%], Turnip [2.9%], Manioc(Cassava) [2.2%] and Peanuts [5.5%]. All six dietary goitrogens showed no significant association with the occurrence of goitre (p<0 05).CONCLUSION:Dietary goitrogens do not appear to have an association with prevalence of goitre in this cohort. As this cohort is a representative sample, dietary goitrogens are unlikely to be associated with prevalence of goitre in Sri Lanka.Item Quality of life and psychological morbidity among children with transfusion dependent thalassaemia and their parents(Sri Lanka Medical Association, 2018) Mettananda, S.; Pathiraja, H.; Peiris, R.; Bandara, D.; de Silva, T.U.N.; Mettananda, K.C.D.; Premawardhena, A.INTRODUCTION AND OBJECTIVES: Thalassaemia is a chronic illness which requires life-long supportive care. We aim to describe quality of life and psychological morbidity among children with transfusion-dependent thalassaemia and their parents.METHODS: This case-control study was conducted from September to December 2017. All patients with transfusion-dependent thalassaemia aged 2-18 years attending three largest thalassemia centers of Sri Lanka (Kurunegala, Anuradhapura and Ragama) were recruited as cases Children without chronic diseases admitting to same hospitals for acute non-life threatening illnesses were recruited as controls. Data were collected using an interviewer-administered questionnaire with validated questionnaires to measure quality of life (PedsQL 4.0 Generic core scales) and psychological morbidity (Strengths and difficulties questionnaire) of children and depressive symptoms of parents (Centre for epidemiological studies depression scale). Ethical approval was obtained from Ethics Committee of University of Kelaniya. RESULTS: 321 (male-46.4%; mean age-9 9±4 2years) cases and 194 (male-47.4% mean age- 8.9±3 7years) controls were recruited Mean quality of life score was significantly lower in cases (72.6±12.0%) compared to controls (88.6±11.6%), (p<0 001) Prevalence of psychological issues were significantly higher among patients with thalassaemia compared to controls in emotional (17 6% vs 0%; 2=32.8, p<0 001), conduct (18.6% vs 0 6%;2=35.4, p<0 001), hyperactive (9 5% vs 0%; 2=18 9 p<0.001) and peer relationship (14.4% vs 2 5%; 2=15 7 p<0 001) domains Significantly higher proportion of mothers of cases reported depressive symptoms compared to controls (40 1% vs 8.9%; 2=57 0 p<0.001).CONCLUSION: Patients with transfusion-dependent thalassaemia experience a poor quality of life and are victims of psychological and behavioural problems compared to their peers. Similarly, mothers of children with thalassaemia have higher prevalence of depression Psychological support should be an essential component in management of thalassaemia