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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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 Anatomical variations of the common peroneal nerve (cpn) and the deep pereoneal nerve (dpn) in the lateral compartment of the leg: A cadaveric study(College of Surgeons of Sri Lanka, 2015) Salgado, L.S.S.; Karunanayake, A.L.; Hasan, R.; Salvin, K.A.; Fernando, E.D.P.S.; Ranaweera, M.S.L.; Padeniya, A.G.P.M.; Senevirathne, S.P.; Ranaweera, K.R.K.L.K.INTRODUCTION: The aim of this study is to demonstrate anatomy of CPN and DPN in the lateral compartment and identify high risk area/s which is important in high tibial osteotomy, in total knee arthroplasty, in external fixation of leg and CPN decompression surgery. MATERIAL AND METHODS: Thirty cadaveric legs (female-14, male-16) were dissected to demonstrate the bifurcation of the CPN and the exit point of the DPN from the lateral compartment. The ethical clearance was obtained. RESULTS: None of the specimens showed bifurcation of the CPN proximal to the apex of the fibular head. Musculoaponeurotic fibular arch at the entrance to the fibular tunnel was confirmed in all specimens. The mean distance from the apex of the fibular head to the opening of the fibular tunnel was 28.4mm (SEM±1.4mm). Of 30 specimens respectively 21(70%), 7(23.33%) and 2(6.66%) had bifurcation vertically distal to, on and proximal to the entry point with the average of 8.0mm and 12.0mm from the entry point. Eleven legs had muscular branches of the DPN in the lateral compartment of the leg. The mean exit point of the DPN/its longest muscular branch was observed 66.5mm (SEM±2.6mm) distal to the apex of the fibular head. CONCLUSIONS: Variations of the CPN bifurcation in relation to the fibular tunnel and muscular branches of the DPN in the lateral compartment were observed. From the apex of the fibular head, distance of 25.6mm-71.6mm was identified as the high risk area for surgeries involving in the upper part of the lateral compartment.Item Anatomical variations of the musculocutaneous nerve - A cadaveric study(College of Surgeons of Sri Lanka, 2015) Padeniya, A.G.P.M.; Salgado, L.S.S.; Hasan, R.; Fernando, E.D.P.S.; Ranaweera, R.M.S.L.; Abeysuriya, V.; Karunanayake, A.L.; Salvin, K.A.; Siriwardana, S.A.S.R.; Balasooriya, B.M.C.M.; Alahakoon, A.M.D.K.INTRODUCTION: The musculocutaneous (MC) nerve commences from the lateral cord of the brachial plexus, passes inferolaterally and pierces the coracobrachialis while innervating it. It then descends between biceps and brachialis muscles, innervating both and continues as the lateral cutaneous nerve of the forearm. Few studies have been done with regard to variations in origin, course, branching pattern, termination and communications of the MC nerve. These variations are important for anatomists, clinicians, anesthetists and surgeons to avoid unexpected complication as these variations have clinical significance during the surgical procedures and in diagnostic clinical neurophysiology. Therefore the aim of this paper was to study the anatomical variations of the MC nerve. MATERIAL AND METHODS: This descriptive cross sectional study was carried out in the Department of Anatomy, Faculty of Medicine, University of Kelaniya. Dissections were carried out on 50 upper limbs of 25 cadavers to record anatomical variations of the MC nerve. RESULTS: MC nerve was present only in 46(92%) upper limbs. Of the 46 upper limbs where the MC was present, one (2%) did not pierce the coracobrachialis. Communications were seen between MC and median nerve in 06(13%) samples of which 1(17%) was proximal and 5(83%) were distal to the point of entry of the MC into the coracobrachialis and in 4(9%) upper limbs MC nerve rejoins with the median nerve. CONCLUSIONS: It is evident that significant anatomical variations of the MC nerve exist in our study. These variations emphasize the complexities and irregularities of this anatomical structure with regard to surgical approaches.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 Consideration of the blood supply of the ileocecal segment in valve preserving right hemicolectomy(Alan R. Liss, Inc, 2009) Fernando, E.D.P.S.; Deen, K.I.The ileocecal valve (ICV) is known to control the flow of chyme and to prevent bacterial colonization of the small intestine. Preservation of this segment during right hemicolectomy is likely to prevent loss of its function. This study aimed at evaluating the arterial supply of the ICV to help preserve the valve during right hemicolectomy. Fifty-four fresh human cadavers (37 male, 17 female; median age: 54 years, range: 18-90 years) were studied after relatives gave written, informed consent. At postmortem, 20 cm of terminal ileum with the ileocecal segment and up to 20 cm of ascending colon were removed en bloc with its mesentery and blood supply. The ileocolic artery was cannulated and injected with 10 ml of water-soluble red dye under pressure. The arterial supply was dissected to demonstrate a pattern. In all, the ICV was supplied by the ileocolic artery, a branch of the superior mesenteric, which divided into an anterior and a posterior cecal artery. A marginal branch of the right colic was noted to contribute to ICV blood supply in only two (4%). Furthermore, study of the anastomosis at the ICV showed that the anterior cecal artery was present in all (100%), posterior cecal in 48 (89%), and recurrent ileal artery in 53 (98%). A rich anastomosis between vessels at the ICV; small "windows," short tributaries, were seen in 38 (70%), whereas a poor anastomotic network at the ICV; large "windows," long tributaries, between these vessels were seen in 12 (22%). In four (8%), we were unable to clearly determine between rich and poor anastomotic networks. Other variants included, absent posterior cecal artery in six (11%) and absent recurrent ileal artery in one (2%). The ICV has a predictable blood supply in the majority of patients. Preservation of the anterior cecal artery would ensure a vascularized ICV in right hemicolectomy.