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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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 Epidemiology of goitres in Sri Lanka - results of a community based study(Sri Lanka Medical Association, 2008) Fernando, R.; Pathmeswaran, A.; Edirisinghe, D.; Abeysinghe, S.; Atulugama, N.; Bandara, D.; Premathileke, M.BACKGROUND: lodization of salt was made mandatory in Sri Lanka in 1995. Data on the current prevalence and geographic distribution of goitre among the general population is not available. Objectives: To describe the epidemiology of goitre in the population over the age of 10 years in Sri Lanka DESIGN, SETTING AND METHODS: The country (excluding the Northern Province) was divided into 6 ecological zones based on annual rainfall and altitude. From each zone, 18 Grama Niladhari (GN) areas were selected, using the probability proportionate to size (PPS) technique. First household to be sampled was selected at random from the list maintained by the midwife and all eligible people in the house were sampled. The closest household, next to the index household,, was visited and sampling carried out next. The process was repeated until 50 subjects were sampled in a GN area. Each subject was examined by at least two researchers for the presence of a goitre. RESULTS: Total of 5200 subjects were assessed. 66 %( 3,433) were females. Mean (SD) age 36.3(17.3) years. 425 subjects had a goitre. The distribution of goitres according to the WHO categorization - Grades 1, 2, 3 and 4 was 18.6, 68.0, 12.5 and 0.9 percent respectively. Adjusted (age and zone) prevalence among females and males was 11.2% and 2.3% respectively. Adjusted (age and sex) prevalence (95% CI) in the different zones varied between 5.34% in the intermediate zone-south to 7.93% in the wet zone-hills. Overall adjusted prevalence was 6.8% (6.0-7.6). CONCLUSIONS: The prevalence of goitres is 6.8%. There is definite female preponderance. No obvious goitre belt can be discerned.Item Epidemiology of hypertension in an urban population of Sri Lanka(Sri Lanka Medical Association, 2011) Kasturiratne, A.; Pinidiyapathirage, M.J.; Pathmeswaran, A.; Kato, N.; Wickremasinghe, A.R.; de Silva, H.J.INTRODUCTION AND OBJECTIVES: To describe the epidemiology of hypertension in 35-64 year old adults resident in Ragama Medical Officer of Health area in the Gampaha district, Sri Lanka. Methods: The Ragama Health Study is conducted in the Ragama MOH area of the Gampaha district. An age- stratified random sample of 2986 adults between 35-64 years of age, were screened for cardiovascular risk factors. Socio-demographic and risk factor related data were obtained by structured interview. Anthropometric and blood pressure measurements were obtained and relevant biochemical investigations were conducted. RESULTS: The prevalence of hypertension (systolic > 139 mm Hg and/or diastolic > 89 mm Hg) in 2986 participants (males 45%), was 30.4% (27.8% in males; 32.5% in females). 31.8% (n=288) were previously undetected. Of the known hypertensives, 19.5% were not on anti-hypertensive medication and only 32.1% were controlled (defined by systolic <140 mm Hg and diastolic <90 mm Hg). Factors associated with hypertension in both males and females were body mass index, waist circumference, fasting blood glucose and serum triglycerides. CONCLUSIONS: The prevalence observed is comparable to the prevalence of developed countries with relatively older populations. A considerable proportion of known hypertensives are not on treatment and the observed poor control indicates problems in drug compliance. Interventions targeting lifestyle modification and drug compliance are essential to control adverse outcomes of hypertension.Item Epidemiology of goitre in Sri Lanka in the post-iodization era(Sri Lanka Medical Association, 2015) Fernando, R.; Pathmeswaran, A.; Pinto, M. D.INTRODUCTION: Previous studies of goitre in Sri Lanka proposed the presence of a goitre belt, which was refuted subsequently. Epidemiology of goitre in the post iodization era needs re-evaluation. Objectives To describe the epidemiology of goitre in Sri Lanka. METHODS: A descriptive cross-sectional study was conducted in designated zones except in conflict areas in 2006/2007. An interviewer administered questionnaire was used and patients were evaluated clinically, biochemically and cytologically. RESULTS: Among 5200 participans 426 had goitre. Mean age was 36.3 (SD 17.3) years. Goitre was commonest in the age group 40-49 years with a female pre-ponderance. The prevalence was similar in all zones with pockets of high prevalence in each zone. Overall islandwide adjusted prevalence was 6.8% (95% CI = 6.0-7.6). CONCLUSIONS: There was no identifiable goitre belt.There were pockets of high prevalence in all zones. Goitre remains a public health issue despite universal iodization.Item Epidemiology of irritable bowel syndrome in children and adolescents in Asia(Lippincott Williams and Wilkins, 2015) Devanarayana, N.M.; Rajindrajith, S.; Pathmeswaran, A.; Abeygunasekara, C.; Gunawardena, N.K.; Benninga, M.A.OBJECTIVES: Several cross-sectional surveys have been conducted to study the prevalence of irritable bowel syndrome (IBS) in children. The aim of the present study was to conduct a systematic review and a meta-analysis of published literature to estimate the prevalence of IBS among Asian children. METHOD: A computer-assisted search of MEDLINE, EMBASE, PsycINFO, and regional databases of Asia was carried out. Selected articles were reviewed in depth and data were extracted. Pooled prevalence, sex differences, and 95% confidence intervals were calculated. Heterogeneity of the studies was assessed using the I(2) test. RESULTS: A total of 16 cross-sectional studies that reported prevalence of IBS (in children and adolescents) and qualified to be included were taken into the final analysis containing 38,076 patients. Selected studies are from China, Korea, Japan, Iran, Sri Lanka, and Saudi Arabia. Studies showed a marked heterogeneity with I(2) of 98.59 (P < 0.0001). Prevalence of IBS ranges from 2.8% to 25.7%, with a pooled prevalence of 12.41% (95% confidence interval 9.87-14.95). Prevalence risk ratio of girl:boy is 1.39. Prevalence of subtypes is diverse and varies between studies. CONCLUSIONS: The published data indicate that IBS is a significant problem among Asian children and adolescents. Female sex predisposes children and adolescents to develop IBS.