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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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 Sri Lanka guidelines for the management of hepatic metastases from colorectal cancer.(The Sri Lanka Journal of Surgery., 2018) Dharmapala, A.D.; Siriwardana, R.C.; Chan, A.; Adair, A.; Shrikhande, S.; Jeyarajah, R.; Jegatheeswaran, S.; Jagannath, P.; Siriwardhane, M.; Sivaganesh, S.; Pathirana, A.A.; Siriwardena, A.K.ABSTRACT: Guidelines to manage liver metastases were developed at a meeting jointly organized by the Sri Lanka Hepato Pancreato Biliary Association (SLHPBA) and the International Hepato Pancreato Biliary Association (IHPBA). Existing evidence was used in the development of guidelines, as recommended by the AGREE II consortium. Guidelines are provided for diagnosis, pre-operative workup, multi-disciplinary team review, surgery, anaesthesia, post-operative care and follow up. Consideration was given to the limitations of facilities available in the country.Item SLHPBA Guidelines for the management of hepatocellular carcinoma in Sri Lanka - consensus statement(College of Surgeons of Sri Lanka, 2018) Siriwardana, R.C.; Pathirana, A.A.; Siriwardana, A.K.; Espat, N.J.; Anya AdiarItem Resection of the large bowel suppresses hunger and food intake and modulates gastrointestinal fermentation(John Wiley & Sons, 2016) Hettiarachchi, P.; Wickremasinghe, A.R.; Frost, G.S.; Deen, K.I.; Pathirana, A.A.; Murphy, K.G.; Jayaratne, S.D.OBJECTIVE: To assess appetite and gut hormone levels in patients following partial (PR) or total resection (TR) of the large bowel. METHODS: A comparative cross sectional study was carried out with healthy controls (n = 99) and patients who had undergone PR (n = 64) or TR (n = 12) of the large bowel. Participants consumed a standard (720 kcal) breakfast meal at 0830 (t = 0) h followed by lactulose (15 g) and a buffet lunch (t = 210 min). Participants rated the subjective feelings of hunger at t = -30, 0, 30, 60, 120, and 180 min. Breath hydrogen (BH) concentrations were also evaluated. In a matched subset (11 controls, 11 PR and 9 TR patients) PYY and GLP-1 concentrations were measured following breakfast. The primary outcome measure was appetite, as measured using visual analogue scales and the buffet lunch. The secondary outcome was BH concentrations following a test meal. RESULTS: PR and TR participants had lower hunger and energy intake at the buffet lunch meal compared to controls. PR subjects had higher BH concentrations compared to controls and TR subjects. BH levels correlated with circulating GLP-1 levels at specific time points. CONCLUSIONS: PR or TR of the large bowel reduced feelings of hunger and energy intake, and PR increased gastrointestinal fermentation.