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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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 Exploring the impact of occupational exposure: A study on cardiovascular autonomic functions of male gas station attendants in Sri Lanka(Wiley periodicals LLC on behalf of the physiological society and the American physiological society, 2024-10) Warnakulasuriya, T.; Medagoda, K.; Kottahachchi, D.; Luke, D.; Wadasinghe, D.; Rathnayake, P.; Ariyawansa, J.; Dissanayake, T.; Sandeepani, P.; De Silva, D.C.; Devanarayana, N.M.Fuel dispensing at fuel stations is performed manually by unprotected male gas station attendants in Sri Lanka, who have long working hours. These workers are exposed to hydrocarbon fuels associated with multiple health effects by modulation of the autonomic nervous system. This study was performed to determine cardiovascular autonomic functions among fuel pump attendants in Sri Lanka. Fuel pump attendants (n = 50) aged between 19 and 65 years were identified for the study from seven fuel stations. They were compared with age- and gender-matched controls (n = 46) without occupational exposure to fuel. A physical examination was performed before the autonomic function and heart rate variability (HRV) assessment. There were no significant differences in weight, height, or BMI between the study and the control populations (p > 0.05). Both the systolic blood pressure (SBP) (Mann Whitney U (MWU) = 743.5, p = 0.003) and diastolic blood pressure (DBP) (MWU = 686.5, p = 0.001) were significantly higher among the gas station attendants compared to controls. Valsalva ratio was significantly higher among the study group (MW U = 874.00, p = 0.043) compared to controls. The HRV analysis showed significantly higher SDNN and SD2 (MWU = 842.00, p = 0.034, and MWU = 843.50, p = 0.035 respectively) among the gas station attendants compared to controls. The changes to the cardiovascular autonomic parameters among those exposed to fuel vapor as a gas station attendant indicate an increase in sympathetic outflow to the vessels. In the occupational setting as fuel pump attendants need periodic monitoring.Item The effect of glycaemic control on neutralizing antibody response to COVID-19 among patients with type 2 diabetes mellitus in the Kurunegala district of Sri Lanka; A prospective cohort study(Endocrine Society of Sri Lanka, 2023) Kottahachchi, D.; Badanasinghe, N.; Samarathunga, P.; Sandeepani, P.; Cooray, S.; Warnakulasuriya, T.BACKGROUND: The antibody response following COVID-19 vaccination among patients with diabetes mellitus (DM) is of particular concern given the increased risk of severe disease in this population. The correlation between glycaemic control among persons with DM and the antibody response was not published in Asian populations. Hence, this study aimed to determine whether glycaemic control has an association with the development of an adequate antibody response for SARS-CoV-2 among patients with DM following the administration of two doses of the COVID-19 vaccine. METHODS: A prospective cohort study was carried out at three vaccination centers in the Kurunegala district from November 2021 to January 2022. Seventy-one patients with type 2 diabetes were recruited for this study and followed up on vaccination with the Sinopharm COVID-19 vaccine. HbA1 c levels at the first dose and after 6-8 weeks from the second dose of vaccine were analyzed. The neutralizing antibodies (NAbs) were analyzed using C Pass™ neutralizing antibody detection ELISA Kit following 6-8 weeks of the 2nd dose. RESULTS: The median (IQR) age of the total population (63.4% females) was 53 years (44.0-58.0) and they were diagnosed with diabetes for 6 years (3-11 years). The median first and second HbAlc values were 9.3% (7.2-10.7%) and 8.2% (7.1-10.2%) respectively. From the total population, only 66.2% developed protective levels of NAbs after 6-8 weeks of the second dose of the vaccine. The second HbAlc value was significantly lower compared to the first (z=-2.63, p=0.008). There was no significant difference in terms of sex, age, duration of diabetes, pre-vaccination HbAlc level, or HbAlc level 6-8 weeks after the vaccination among those who developed protective levels of antibodies and those who did not (p>0.05). There was no difference in sero-conversion depending on the abnormal HbAlc value (.28%) (1st HbAlc p=0.957, 2nd HbAlc p=0.360). Conclusion: We did not detect an association between glycaemic control and sero-conversion. However, 1/3rd of patients with diabetes did not have a protective level of NAbs following 2 doses of Sinopharm COVID-19 vaccination. Furthermore, glycaemic control did not deteriorate with COVID-19 vaccination.