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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty

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    Using red cell indices as a screening test for the detection of haemoglobin E trait in population screening for haemoglobin disorders
    (Sri Lanka Medical Association, 2005) Premawardhena, A.; Samarakoon, S.; Perera, U.; Samaranayake, R.; Arambepola, M.
    INTRODUCTION: When screening populations for haemoglobin E trait, which is found in up to 5% in some regions in Sri Lanka, some believe that the full blood count with red cell indices, demonstrating hypochromasia and microcytosis (MCV<80fl and MCH< 27pg), is not sensitive enough, as up to 5% may be missed. If this is true, more complicated and expensive tests will be necessary to detect Hb E trait. There are no studies which have attempted to test the efficacy of red cell indices as a screening test for Hb E trait in Sri Lanka AIMS: To test the sensitivity of the full blood count with red cell indices as a screening test for the detection of haemoglobin E trait MATERIALS AND METHODS: Individuals diagnosed to have Hb E trait by the usage of high performance liquid chromatography (HPLC) - (Bio Rad) had their red cell indices measured using an automated cell counter (Coulter, Act Diff III) RESULTS: 47 Individuals with Hb E trait were identified using HPLC analysis. 28 were females (59%). The haemoglobin levels ranged from 10.5 to 15.4 g/dl. (Mean 12.6). There was only one individual with an MCV of 80, whilst the rest had values below that. MCV values ranged from 58-80fl. There were 3 individuals with an MCH over 27 (27.4, 28.8 and 27.4). The individual with an MCV of 80 had an MCH of 27.4. CONCLUSIONS: In this ongoing study we found that by using a cutoff point for MCV at 80ft up to 2% of individuals with Hb E trait will be missed. As the screening test needs to be more sensitive than this, we suggest that by using a slightly higher cutoff point for the MCV (eg. 81 fl) we would still be able to detect individuals with Hb E trait using red cell indices, thus minimizing cost.
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    Pattern of physical growth during first six months of life among a cohort of babies living in Gampaha district, Sri Lanka
    (2013) Perera, P.; Fernando, M.; Mettananda, S.; Samaranayake, R.
    Introduction: Current WHO recommendation is to continue exclusive breast feeding (EBF) up to six months. Main concern regarding this recommendation is, whether EBF supports rapidly growing infant with adequate nutrition. Methods: A cohort of randomly selected new-borns was followed up at two, four and six months, to study feeding pattern and physical growth. Feeding practices and socio-demographic data were collected using an interviewer administered questionnaire. Weight & length were measured using standard techniques. Results: EBF rates were very high in this cohort of children. One main reason to stop EBF was growth faltering. Only some children showed a catch up growth by stopping EBF. At two, four and six months, weight faltering rates among EBF babies were, 11.1%, 20.1% and 13.2% respectively. Length faltering had a similar pattern, but with a higher rate at all ages. Conclusions: EBF up to six months did not cause growth faltering in the majority. In the majority, no identifiable cause for growth faltering was found. Possible genetic influence on growth faltering was not considered when stopping EBF
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