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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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 Differentiation of human male germ cells from Wharton's jelly-derived mesenchymal stem cells(Korean Society for Reproductive Medicine, 2018) Dissanayake, D.M.A.B.; Patel, H.; Wijesinghe, P.S.OBJECTIVE: Recapitulation of the spermatogenesis process in vitro is a tool for studying the biology of germ cells, and may lead to promising therapeutic strategies in the future. In this study, we attempted to transdifferentiate Wharton's jelly-derived mesenchymal stem cells (WJ-MSCs) into male germ cells using all-trans retinoic acid and Sertoli cell-conditioned medium. METHODS: Human WJ-MSCs were propagated by the explant culture method, and cells at the second passage were induced with differentiation medium containing all-trans retinoic acid for 2 weeks. Putative germ cells were cultured with Sertoli cell-conditioned medium at 36℃ for 3 more weeks. RESULTS: The gene expression profile was consistent with the stage-specific development of germ cells. The expression of Oct4 and Plzf(early germ cell markers) was diminished, while Stra8 (a premeiotic marker), Scp3 (a meiotic marker), and Acr and Prm1 (postmeiotic markers) were upregulated during the induction period. In morphological studies, approximately 5% of the cells were secondary spermatocytes that had completed two stages of acrosome formation (the Golgi phase and the cap phase). A few spermatid-like cells that had undergone the initial stage of tail formation were also noted. CONCLUSION: Human WJ-MSCs can be transdifferentiated into more advanced stages of germ cells by a simple two-step induction protocol using retinoic acid and Sertoli cell-conditioned medium.Item Adolescent sexual practices and contraceptive usage(Faculty of Medicine, University of Kelaniya & Plan International, 2008) Herath, H.M.R.P.; Dissanayake, D.M.A.B.; Hilmi, M.A.M.; Pathmeswaran, A.; Wijesinghe, P.S.INTRODUCTION: Adolescence is a critical period of development, as adoption of unhealthy risk behaviours such as unprotected sex, smoking and drug abuse, avoiding contraceptive methods will lead to long standing health and socioeconomic consequences. Therefore information is needed about the sexual practices and contraceptive usage of adolescents and young adults to develop interventions in the community. This study was undertaken to describe and compare the sexual practices, knowledge and usage of contraceptives by adolescents and young adults in selected urban and rural settings.METHOD: This cross sectional descriptive study was conducted among young adults aged less than 21 years at the time of interview in three settings in both rural and urban areas. The study subjects were students from universities, technical colleges and garment factory workers representing both rural and urban areas. The data was collected using a pretested self administered questionnaire during June 2007 to August 2007. Information collected included marital status, gender and the level of education, first sexual relationship (age, partner, contraception used), current contraceptive practices and knowledge about contraceptive methods. The data was analysed using SPSS 10.1 statistical package. Informed consent was obtained from all participants. RESULTS : There were a total of 1258 subjects who had returned the completed questionnaires. Out of them there were 290 garment factory employees, 480 technical college students, and 488 university students. The percentage of females was 58.9%. The mean ages of the males and the females of the total population were 20.75(50 1.13) years and 20.55(SD 1.63) and it was similar in the three settings. The level of education was highest among the undergraduates lowest among garment factory workers. Out of the population 303 (24.1%) were sexually active. It was significantly higher among males {33.5%0 than females (17.0%). Both among male and females this trend was significantly more common among garment factory workers. Sexual activity of the unmarried and the premarital sexual practices of married subjects are shown in the table. 6. 17% of females and 33.5% of males were sexually active before marriage. 90% male garment factory workers were sexually active. In contrast the proportionItem A Study on Factors Associated with Clomifene Resistance in Infertile Women with WHO Group II Anovulation at a Teaching Hospital in Sri Lanka(Sri Lanka College of Obstetricians and Gynaecologists, 2014) Palihawadana, T.S.; Dissanayake, D.M.A.B.; Wijesinghe, P.S.; Seneviratne, H.R.Background: Anovulation is a common cause of infertility and induction of ovulation with oral agents such as clomifene is the treatment of choice in women with normogonadotropic anovulation. While such treatment is able to achieve ovulation in many, some women fail to respond thus termed as having clomifene resistance. Knowledge on factors associated with such resistance would enable us to counsel patients more accurately and offer alternative treatment modalities without undue delays. This study was aimed at identifying factors associated with clomifene resistance among infertile women with WHO group II anovulation at a teaching hospital in Sri Lanka. Method: A case control study was done at the Infertility clinic of the North Colombo teaching hospital, Ragama conducted by the department of obstetrics & Gynaecology of the University of Kelaniya. Women with WHO group II anovulation (n=128) were included and underwent induction of ovulation with clomifene citrate starting at a dose of 50mg per day, increased up to 150mg till ovulation was achieved. Those who fail to respond to a maximum dose of 150mg were termed as clomifene resistant. The factors known to be associated with clomifene resistance were compared between the two groups who responded and those who failed to respond. The study was registered with the Sri Lankan clinical trial registry maintained by the Sri Lanka Medical association. The study was funded by the National Science foundation of Sri Lanka through a research grant (Grant No: RG/2007/HS/08) Results: Ovulation was achieved in 77.3% (n=99) of subjects and therefore the prevalence of clomifene resistance was 22.8% (n=29). Among those who responded, 41 did so at a dose of 50mg per day while 40% did with 100mg, thus over 80% achieving ovulation at a dose of 100mg per day or less. The factors associated with clomifene resistance in this population included infertility of more than three years (OR 2.06, 95%CI 1.51-9.14), presence of hirsutism (OR 2.76, 95%CI 1.18-6.46), a higher AFC (16 vs 13, p=0.04), PCOS (OR 2.99, 95%CI 1.06-8.41) and an LH:FSH ratio of > 1(OR3.11, 95%CI 1.33-7.24). Other factors that have been described to be associated with clomifene resistance such as advanced age, a BMI > 25, and a higher ovarian volume did not show any significant associations in this study. Discussion: This study was able to identify factors associated with clomifene resistance in a local population. Most factors identified included clinical and laboratory findings of PCOS thus highlighting the limitations in treatment success of clomifene among women with PCOS. This information may be used in clinical practice to counsel patients prior to treatment or to consider other alternative treatment options such as Letrozole or gonadotropins. DOI: http://dx.doi.org/10.4038/sljog.v36i3.7715Item Zinc levels in seminal plasma and its relationship with semen parameters in male partners of subfertile couples(Sri Lanka Association for the Advancement of Science, 2006) Dissanayake, D.M.A.B.