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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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 Assessment of exposure of gas station attendants in Sri Lanka to benzene, toluene and xylenes.(Amsterdam, Elsevier, 2019) Scheepers, P.T.J.; de Werdt, L.; van Dael, M.; Anzion, R.; Vanoirbeek, J.; Duca, R.C.; Creta, M.; Godderis, L.; Warnakulasuriya, D.T.D.; Devanarayana, N.M.ABSTRACT:Exposure to benzene, toluene and p-, m-, o-xylene (BTX) was studied in 29 gas station attendants and 16 office workers in Sri Lanka. The aim of this study was to assess the exposure level and identify potential exposure mitigating measures. Pre- and post-shift samples of end-exhaled air were collected and analysed for BTX on a thermal desorption gas chromatography mass spectrometry system (TD-GC-MS). Urine was collected at the same timepoints and analysed for a metabolite of benzene, S-phenyl mercapturic acid (SPMA), using liquid chromatography-mass spectrometry (LC-MS). Environmental exposure was measured by personal air sampling and analysed by gas chromatography flame ionization detection (GC-FID). Median (range) breathing zone air concentrations were 609 (65.1-1960) μg/m3 for benzene and 746 (<5.0-2770) μg/m3 for toluene. Taking into account long working hours, 28% of the measured exposures exceeded the ACGIH threshold limit value (TLV) for an 8-h time-weighted average of 1.6 mg/m3 for benzene. Xylene isomers were not detected. End-exhaled air concentrations were significantly increased for gas station attendants compared to office workers (p < 0.005). The difference was 1-3-fold in pre-shift and 2-5-fold in post-shift samples. The increase from pre-to post-shift amounted to 5-15-fold (p < 0.005). Pre-shift BTX concentrations in end-exhaled air were higher in smokers compared to non-smokers (p < 0.01). Exposure due to self-reported fuel spills was related to enhanced exhaled BTX (p < 0.05). The same was found for sleeping at the location of the gas station between two work-shifts. Benzene in end-exhaled air was moderately associated with benzene in the breathing zone (r = 0.422; p < 0.001). Median creatinine-corrected S-phenyl mercapturic acid (SPMA) was similar in pre- and post-shift (2.40 and 3.02 μg/g) in gas station attendants but increased in office workers (from 0.55 to 1.07 μg/g). In conclusion, working as a gas station attendant leads to inhalation exposure and occasional skin exposure to BTX. Smoking was identified as the most important co-exposure. Besides taking preventive measure to reduce exposure, the reduction of working hours to 40 h per week is expected to decrease benzene levels below the current TLV.Item Role of dipsticks in diagnosis of urinary tract infection in children: is it accurate enough(Sri Lanka College of Paediatricians, 2015) Fernando, C.M.P.; Galappaththi, A.G.A.R.; Punchihewa, P.M.G.; Karunaratne, G.K.D.; Warnakulasuriya, D.T.D.BACKGROUND:Urinary tract infection (UTI) is a common problem in childhood. Urine culture is the Gold standard for diagnosis. Dipstick tests for leucocyte esterase reaction (LE) and nitrites (N) are bedside tests useful in the diagnosis of UTI. Accuracy of above tests have been extensively investigated in other countries. No published data is available from Sri Lankan children up to date.OBJECTIVES:To study the diagnostic accuracy of dipstick tests in diagnosis of UTI in Sri Lankan children.DESIGN, SETTING AND METHOD:Descriptive, cross sectional study was conducted in a medical ward at Lady Ridgeway Hospital for Children. 300 children less than 12 years, clinically suspected of UTI were recruited. Dipstick tests (LE and N) and urine culture were performed.RESULTS:Of the 300 children, 118 (39.3%) had positive cultures (pure growth of bacteria >105 cfu/ml), 16 (54%) had negative cultures and 20 (6.7%) had mixed growth. Cultures with mixed growths were excluded and remaining 280 were analyzed. Mean age of the participants was 49 months (SD 41.3), 148 (53%) being males.Accuracy of dipsticks tests (LE and N) in detecting UTI was as follows. LE and N in combination had a sensitivity of 97.5%, specificity of 77.2%, positive predictive value (PPV) of 75.6% and negative predictive value (NPV) of 97.6%. LE alone showed a sensitivity of 96.6% specificity of 77.7%, PPV of 76% and NPV of 96.9%. Corresponding values for N alone were 78.8%, of 97.5%, 95.8% and 86.3% respectively.CONCLUSIONS:Leucocyte esterase reaction and nitrite test in combination showed promising results to detect UTI in children. LE was more sensitive and N was more specific.Item Ultrasonographic parameters of the liver, spleen and kidneys among a cohort of school children in the Gampaha district(Sri lanka Medical Association, 2015) Warnakulasuriya, D.T.D.; Peries, P.P.U.C.; Rathnasekara, Y.A.C.; Jayawardena, K.A.T.M.; Upasena, A.P.INTRODUCTION AND OBJECTIVES: Liver, spleen and kidney dimensions on uitrasonography vary with age, weight and ethnicity. Reference standards for these parameters in normal Sri Lankan children are not available. Our objective was to establish normative data for the longitudinal length of the liver, spleen and kidneys in healthy children living in the Gampaha District. METHOD: A total of 357 children between the ages of 5 to 12 years were selected from two randomly selected schools in the Gampaha District. A questionnaire was administered to the parents after obtaining informed written consent. Participants were screened for risk factors for organomegaly and were examined by a medical officer. Ultrasonographic assessment was done using a high resolution real-time scanner with a 3.5MHz convex transducer by a trained medical officer. Children with abnormalities in the Ultrasonographic appearance of organs were excluded. RESULTS: The study comprised 332 children (176 girls, 53%). There was no difference in organ dimensions between the two genders (p > 0.05). Body weight showed the best correlation with liver, spleen and kidney dimensions. Age significantly correlated with the longitudinal length of the liver and height significantly correlated with spleen length. Percentile graphs for the longitudinal length of the liver, spleen, right and left kidneys were developed in relation to body weight.