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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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 Translation, cross-cultural adaptation, and validation of the duke activity status index (DASI) to Sinhala language(BioMed Central, 2024) Ranasinghe, C.; Kariyawasam, K.; Liyanage, J.; Walpita, Y.; Rajasinghe, U.; Abayadeera, A.; Chandrasinghe, P.; Gunasekara, M.; Kumarage, S.; De Silva, M.; Ranathunga, K.; Deen, K.; Ismail, H.BACKGROUND Duke Activity Status Index (DASI) is a widely used tool to assess functional capacity among patients, but there is no Sinhala version validated for patients in Sri Lanka. This study aimed to cross-culturally adapt and test the validity and reliability of the Sinhala version of DASI (DASI-S).METHODS The translation and cross-cultural adaptation of the DASI questionnaire were conducted following the standard guidelines. It was pre-tested on ten pre-operative patients and further modified. The construct validity and reliability of DASI-S were evaluated by administering the modified final DASI-S, which comprised 12 items, along with the physical functioning sub-scale of the 36-item short-form health survey (SF-36), consisting of 10 items to eighty-one patients who were awaiting non-cardiac surgeries at university surgical wards, National Hospital of Sri Lanka (NHSL), and Colombo North Teaching Hospital (CNTH), Sri Lanka. Reliability was assessed through Cronbach alpha, while the validity was evaluated using factor analysis and Spearman's correlation. The ethical approval was obtained from the Ethics Review Committee, Faculty of Medicine, University of Colombo, Sri Lanka.RESULTS The mean age of the participants was 46.2 (± 16.6) years and the majority were females (54.3%). The mean height, weight, and body mass index of the sample were 160.5 (± 9.6) cm, 60.3 (± 11.9) kg, and 23.4 (± 4.5) kgm-2 respectively. The Cronbach's alpha coefficient for the internal consistency of DASI-S was 0.861. The concurrent validity of DASI-S was substantiated by positively correlating (p < 0.01, rs = 0.466) with the physical sub-scale of SF-36. There was a significant difference (p < 0.01) in the total score of DASI-S between the two age groups.CONCLUSIONS Sinhala version of the DASI appears to be a valid, reliable and easy-to-administer tool to assess functional capacity among patients who are awaiting non-cardiac surgeries.Item North Colombo diverticular disease snap shot audit (VISTA study): a collaborative research initiative(The College of Surgeons of Sri Lanka, 2023) Chandrasinghe, P.; Ediriweera, E.P.D.S.; Niriella, M.; Ranwaka, C.; Fernando, A.; Gunawardena, H.; Kumarage, S.INTRODUCTION Diverticulosis and diverticular disease (DD) is a common occurrence in clinical practice in the local setting with a lack of documented literature. A snapshot audit was conducted at North Colombo Teaching Hospital (NCTH) to ascertain the disease burden in clinical practice as a pilot study to assess feasibility and response rate for a nation wide snapshot audit. METHODOLOGY All surgical and gastroenterology units at NCTH were requested to enter the data between 1st January 2022 to 30th of June 2022 on all patients presenting with DD or those detected with diverticulosis during screening colonoscopy. Prospective data collection was done using RedCap© data capturing platform. RESULTS Out of the 8 units invited (general surgery – 5, GI surgery – 1, gastroenterology – 2), 5 units participated (general surgery – 2, GI surgery – 1, gastroenterology – 2); response rate is 62%. A total of 46 patient records (median age- 68 years; range 29- 86; female 51%) were received within 6 months. Of the total 54.3% had symptomatic uncomplicated diverticular disease (SUDD) while 33% were detected with diverticulosis at screening. Only 13% (n=6) required inward care (bleeding – 3, diverticulitis – 2, perforation – 1) and detected using colonoscopy in 4 and CT scan in 2. In the DD group, 20% (6/31) had complicated DD while 80% had Symptomatic Uncomplicated Diverticular Disease (SUDD). CONCLUSION In this pilot study, a majority of the patients with DD presented with SUDD while around 20% came with complicated DD. The response rate from collaborators was satisfactory. The secure online database usage is feasible and will be used for a national level study in the future to assess the disease burden in the healthcare setting in Sri Lanka.Item First series of laparoscopic sleeve gastrectomy in Sri Lanka-technical feasibility and outcome in a resource poor setting in asia.(New York; Springer, 2014) Wijeratne, T.K.; Bulugahapitiya, U.; Kumarage, S.; Rajaratnam, H.INTRODUCTION: Morbid obesity and metabolic syndrome are emerging as a major health issues in developing South Asian countries. Laparoscopic Sleeve Gastrectomy (LSG) has been introduced to this region with excellent out comes in controlling morbid obesity and metabolic syndrome. OBJECTIVE(S): Assess the technical feasibility and outcome of LSG as a surgical procedure in a resource poor country in south Asia where Bariatric surgery is still a novel concept. METHOD(S): Prospective Analytical study of the first 15 patients who underwent LSG in a tertiary care hospital in Sri Lanka over 2 years. All data on pre operative, surgical and post operative follow up were recorded in a pre-designed research Performa and all patients were followed up for a minimum period of 6 months by Surgical and Endocrine team. All Surgeries were performed by the same surgeon and the surgical team using total Laparoscopic technique using a 40 F Gastric bougie to standardize the Sleeved stomach. There were 14 females and one male in the study group. Weight range was from 83 to 167 kg with a mean weight of 106.2 kg. Average BMI 45 kg/m2 Results: There were no major complications. The percentage excess weight loss during first 3 months was 28.8 % and at 6 months 42.3 %. Resolution of comorbidities especially Diabetes and Metabolic Syndrome was excellent and one out of two patients who had surgery for subfertility conceived during study period. CONCLUSION(S): LSG can be performed safely in a resource poor setting in south Asia and is effective as a Bariatric surgical procedure for Sri Lankan population.