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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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 Symptomatology of COVID-19 - Lessons from a meta-analysis across 13 countries(Manipal College of Medical Science Pokhara,Nepal, 2021) Gamakaranage, C.; Hettiarachchi, D.; Ediriweera, D.; Jayasinghe, S.Background: COVID-19 pandemic has resulted in varying clinical manifestations and mortality rates. There is no consensus on the symptomatology that would guide researchers and clinicians. Aims and Objectives: The objective was to identify symptoms and their frequencies of COVID-19 with a meta-analysis of studies from several countries. Materials and Methods: Data sources: A systematic review using PubMed and Google Scholar data sources and reference tracing were used to identify 7176 articles. Eligibility criteria: Suitable articles were selected manually with selection criteria and 14 original articles included in meta-analysis. Data abstraction and analysis: PRISMA guidelines used for data abstraction and a table was generated by feeding it with numbers and proportions of each symptom described. A meta-analysis was carried out using random effect models on each symptom separately across the studies and their prevalence rates and 95% confident intervals were calculated. Results: Selected 14 studies, either cross-sectional or cohort studies are analyzed. There were 2,660 confirmed cases of COVID-19. The majority were from China (n=2,439, 91.7%) and remainder from the Netherlands, Italy, Korea, and India and one article from Europe. There were a total of 32 symptoms identified from the meta-analysis and additional 7 symptoms were identified from reference searching. The most common symptoms were (prevalence >50%): fever (79.56%, 95% CI: 72.17–86.09%), malaise (63.3%, 95% CI: 53.1–73.0%), cough (56.7%, 95% CI: 48.6–64.6%), and cold (55.6%, 95% CI: 45.2–65.7%). Symptoms of intermediate incidence (5–49%) were anosmia, sneezing, ocular pain, fatigue, sputum production, arthralgia, tachypnea, palpitation, headache, chest tightness, shortness of breath, chills, myalgia, sore throat, anorexia, weakness, diarrhea, rhinorrhea, dizziness, nausea, altered level of consciousness, vomiting, and abdominal pain. Rare symptoms (<5%): tonsil swelling, hemoptysis, conjunctival injection, lymphadenopathy, and rash. Conclusion: We found (25/32, from meta-analysis) symptoms to be present in ≥5% of cases which could be considered as “typical” symptoms of COVID-19. The list of symptoms we identified is different from those documents released by the WHO, CDC, NHS, Chinese CDC, Institute Pasteur and Mayo Clinic. The compiled list would be useful for future researchers to document a comprehensive picture of the illness.Item High prevalence of overweight/obesity in urban Sri Lanka: findings from the Colombo urban study.(Hindawi Limited, 2019) Somasundaram, N.; Ranathunga, I.; Gunawardana, K.; Ahamed, M.; Ediriweera, D.; Antonypillai, C.N.; Kalupahana, N.BACKGROUND:South Asian countries face a double burden of malnutrition characterized by high prevalence of underweight, overweight, and obesity. Understanding the distribution of this public health problem is important to tailor targeted interventions for communities. The objective of the current study was to find out the prevalence of obesity in urban Sri Lanka and to identify sociodemographic factors associated with it. METHODS:Adult males and females residing in an urban government division of the Colombo District in Sri Lanka were included in this study (Colombo Urban Study). Stratified simple random sampling was used to select a sample of 463 from the total population. Sociodemographic data using an interviewer-administered questionnaire, anthropometric measurements, and serum samples were obtained for investigations. RESULTS: When the global BMI cutoffs were applied, the community prevalences of underweight, normal weight, overweight, and obesity were 7.7%, 39.6%, 37.0%, and 15.8%, respectively. When the Asian BMI cutoffs were applied, the respective prevalences were 7.7%, 26.8%, 34.3%, and 31.2%. The community prevalence for abdominal obesity was 58.1% when using Asian cutoffs. Females had a higher prevalence of both obesity and abdominal obesity. There was an ethnic difference in obesity rates with Moors having the highest rates (65.5%) followed by Sinhalese (52.3%) and Tamils (40.2%). The highest obesity prevalence was observed in the most educated group. Multiple regression analysis showed that high BMI was associated with female gender and family history of hypertension. Serum LDL negatively associated with BMI while the strength of this relationship was impacted by serum HBA1c levels. Finally, serum triglyceride level showed positive association with BMI, and the effect was more marked in Moors compared to Sinhalese. CONCLUSION:Two-thirds of adults in the studied urban population were overweight or obese. This highlights the urgent need for interventions to curb this epidemic. The gender, ethnic differences in obesity, its associations with educational status, and the interactions with metabolic comorbidities indicate that these interventions may need to be targeted towards different groups in the population.Item Prevalence of vitamin D deficiency/insufficiency and its metabolic associations in an urban setting in Sri Lanka: Data from Colombo Urban study(Endocrine Society of Sri Lanka, 2019) Subasinghe, C. J.; Gunawardana, K.; Ediriweera, D.; Somasundaram, N.P.INTRODUCTION: Vitamin D deficiency is a commonly prevalent, but less attended problem in Asia. Vit D status has many metabolic associations. We designed this community-based study to describe the prevalence of vitamin D deficiency/insufficiency and its metabolic associations in Sri Lankan population. METHODS: A representative sample aged 18 years and above was included. Demographic, anthropometric, and social details were recorded using a standard proforma. Blood analysis was done for vitamin D status, and other metabolic parameters. Prevalence was estimated using weighted age standardized calculations. Multiple logistic regression analyses were used to study associations to vitamin D status. RESULTS: Cumulative community prevalence of Vit D deficiency and insufficiency was 90.2%. Prevalence was highest among young and females. Obese had significantly lower vitamin D levels. According to the linear regression, Moors showed a significantly lower Vit D levels compared to Sinhalese while Triglyceride levels showed an inverse association with Vit D levels. Dysglycaemia was not associated with Vit D deficiency. DISCUSSION: Very high prevalence of Vit D problem was anticipated on clinical grounds and this is comparable with regional data. High prevalence among young needs early attention to avoid future poor bone health outcomes. Moor ethnicity shows high rates due to many known factors. Obesity is an emerging health problem in the country and co existent Vit D deficiency would increase its burden. CONCLUSION: Vitamin D deficiency and insufficiency and other metabolic problems are highly prevalent in this population. Causative factors and consequences of this problem should be further researched to plan strategies to replete the Vit D and prevent this problem.