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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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 Nutrition of patients with mild-to-moderate Alzheimers disease using the Mini Nutritional Assessment (MNA)(Sri Lanka Medical Association., 2019) Fernando, M.G.; Silva, K.D.R.R.; de Silva, M.P.; Obadaarachchi, L.N.; Yalegama, L.L.W.C.; Dissanayake, A.S.; Williams, S.S.INTRODUCTION & OBJECTIVES: Focus on the nutrition of patients with Alzheimer's disease is limited despite the need for optimization of overall patient health to improve well being and outcome. The objective of this study was to look at the nutrition and energy intake of patients with mild to moderate dementia. METHODS: Sixty patients with mild-to-moderate AD (Mini Mental State Examination score: 12-25; male:28; female: 32; age >65 years) were recruited from the clinics at the North Colombo Teaching Hospital, Ragama and Lanka Alzheimer's Foundation as part of the VCO-AD study, after informed consent. Baseline nutritional status was assessed by a Mini Nutritional Assessment (MNA) tool and dietary intake via a 24-hour dietary recall. RESULTS: The total energy intake of the study population (men: 1822±645 kcal/day, women: 1380±346 kcal/day) was lower than recommended standards. The percentage energy from fat, protein and carbohydrates (30.7±7.6%, 12.7±2.7%, and 56.8±8.7%, respectively) met recommendations. The energy intake from saturated fat (19.7±6.9%) however was higher than the recommendation. Vitamin C, D, E, folate, calcium, potassium, selenium and iodine intake (37.4±30.4 mg/day, 2.2±3.1 µg/day, 2.4±1.4 mg/day, 219±125 µ/day, 483.8±230.8 mg/day, 1853.9±590.8 mg/day, 38.1±22.7 µg/day, and 59.8±35.4 µg/day respectively) was lower than the estimated average requirements (EAR). MNA results showed that 20% were at risk of malnutrition. CONCLUSION: A higher saturated fat intake and lower vitamin intake were concerns in this population of patients with mild to moderate dementia.Item Metformin: use as a pharmacological agent in management of childhood obesity(Sri Lanka Medical Association, 2016) Warnakulasuriya, L.S.; Fernando, M.A.M.; Adikaram, A.V.N.; Thawfeek, A.R.M.; Anurasiri, W.M.L.; Silva, K.D.R.R.; Sirasa, M.S.F.; Samaranayake, D.; Wickramasinghe, V.P.INTRODUCTION: Childhood obesity-related metabolic derangements are increasing among South Asian populations. Dietary and physical activity plans have limited effect. OBJECTIVES: This study aims to assess effectiveness of metformin against placebo in management of childhood obesity among 8-16 year-old children in Gampaha District. METHOD: A triple-blinded control trial was conducted in a sample of 150 obese school children. After 12-hour overnight fast, blood was drawn for fasting blood glucose (FBS) and lipid profile. 2-hour OGTT was done. Anthropometry, fat mass (FM) and blood pressure were measured. Children randomly received either age-adjusted dose of metformin or placebo, with advice on diet and physical activity. Anthropometry and blood investigations were repeated at 6 and 12 months. Mean difference in outcome measures, adjusted for baseline values were compared between the two groups using ANOVA. RESULTS: There were 84/150 boys and 25 (16.7%) had metabolic syndrome. A statistically significant adjusted mean reduction was observed in metformin group compared to placebo, in weight (-0.991 vs 1.394, p=0.000), BMI-SDS (-0.287 vs -0.116, p=0.000), percentage FM-SDS (-0.092 vs 0.016, p=0.04), systolic BP (-0.415 vs 0.015, p=0.015), total cholesterol (-36.48 vs -27.32, p=0.001), LDL (-26.06 vs -17.22, p=0.001) and hsCRP(-0.143 vs 0.008, p=0.013) at six months, and in BMI-SDS (-370 vs -0.222, p=0.001), WC-SDS (-0.473 vs -0.337, p=0.018), systolic BP (-0.834 vs -0.477, p=0.023) and triglycerides (-29.30 vs-12,72, p=0.019) at 12 months. CONCLUSIONS: Metformin compared to placebo has beneficial effects on anthropometric and metabolic indicators in the management of childhood obesity.