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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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 Acute uterine inversion(Taylor and Francis Group, 2021) Padumadasa, S.; Gunawardana, K.No abstract availableItem 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.Item High prevalence of Diabetes Mellitus in Sri Lankan urban population – Data from Colombo Urban Study(Endocrine Society of Sri Lanka, 2019) Somasundaram, N.P.; Ranathunga, I.; Gunawardana, K.; Ediriweera, D.S.BACKGROUND: In recent decades, Sri Lanka has experienced rapid urbanization, with approximately 30% of the population currently residing in urban areas. We report the age- and sex-specific prevalence of dysglycaemia in an urban population in Colombo, Sri Lanka. METHODS: Using a stratified random sampling method, 463 subjects (139 men; 324 women) aged 18 years and above were included. Physical activity was quantified using international physical activity questionnaire (IPAQ). Bio impedence was used to estimate body fat. Insulin sensitivity was estimated using the HOMA calculations. Prevalence was estimated using weighted age standardized calculations. Multiple logistic regression analyses were used to study associations to diabetes and prediabetes. RESULTS: There were 124 adults in the 18-40 age group (70% female), 209 adults in the 41-60 age group (73% female) and 130 adults in the > 60 age group (63% female). The overall prevalence of diabetes was 27.6% (95% CI: 23.7-31.4). The prevalence of diabetes in those aged 18-40 was 12.4% (95% CI: 6.4 -18.4), 36.1% (95% CI: 29.8 – 42.4) in those aged 41 – 60 and 48.3% (95% CI: 40.7 – 55.8) in those aged >60. Pre-diabetes was detected in 30.3% (95% CI 25.9-34.8) of the population (with either an HbA1c of 5.7-6.4%, FPG of 110-125 mg/dl or 2 Hr PPG of 140-199 mg/dl). Cumulative prevalence of diabetes and pre-diabetes in the population was 57.9%. CONCLUSIONS: This urban study demonstrates that along with the changes in the socio-demographic status, the metabolic profile of the Sri Lankan adult has transformed, with a high prevalence of dysglycaemia and obesity.