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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty

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    Hematology
    (Samudra Medical Publications, 2022) Mettananda, S.; Williams, S.
    No abstract available
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    Improving medical students' understanding of dementia using a movie ( The Father)
    (Taylor & Francis, 2023) Baminiwatta, A.; Fernando, R.; Williams, S.
    No abstract available
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    Clinical and laboratory evaluation of childhood anaemia
    (Sri Lanka College of Paediatricians, 2020) Mettananda, S.; Williams, S.
    No Abstract available.
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    Telepsychiatry' in the time of COVID-19: Overcoming the challenges
    (Wolters Kluwer Medknow Publications, 2020) Perera, S.R.; Gambheera, H.; Williams, S.
    ABSTRACT: Telepsychiatry, the application of telemedicine in the field of psychiatry is defined as the use of electronic communication and information technologies to provide or support clinical psychiatric care at a distance. COVID 19 and its implications related to physical distancing for patients and service providers has made tele-psychiatry and e-consultations an attractive option. Psychiatry, more than any other field in medicine stands to benefit through tele-psychiatry as a physical examination may not be always necessary to arrive at a diagnosis. Some have gone on to suggest that tele psychiatry is likely to replace in person psychiatric assessments pertaining to certain clinical situations. The article reviews the existing evidence for tele-psychiatry and addresses the challenges and pitfalls in the South Asian context. © 2020 Indian Journal of Psychiatry Published by Wolters Kluwer-Medknow.
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    Development of a model for a resource limited setting, to predict the presence of oesophageal varices among newly diagnosed patients with cirrhosis.
    (Sri Lanka Medical Association., 2019) Perera, K.; Kodisinghe, S.K.; Ediriweera, D.; Moratuwagama, H.M.D.; Williams, S.; Pathmeswaran, A.; Niriella, M.A.; de Silva, H.J.
    INTRODUCTION & OBJECTIVES: In cirrhosis upper-gastrointestinal-endoscopy (UGIE) identifies oesophageal varices (OV). UGIE is unavailable in most resource-limited settings. Therefore, we assessed prediction of presence OV using hematological parameters (HP) and Child-Turcott-Pugh (CTP) class. METHODS: A prospective study was carried out on consecutive, consenting, newly-diagnosed patients with cirrhosis, in the University Medical Unit, Colombo North Teaching Hospital, Ragama, from April 20 I 4-April 2016. All patients had UGIE to evaluate presence and degree of OV, prior to appropriate therapy. HP (FBC with indices using automated analyzer and peripheral blood smear using Leishmann stain) and CTP class were assessed. Linear logistic regression model was developed to predict OV using HP and CTP class. RESULTS: 54-patients with cirrhosis were included [14(26%), 24(44%) and 16(30%) belonged to CTP class A, B and C respectively]. 37 had varices [CTP-A 4/14(26.6%), CTP-B 19/24(79.2%), CTP-C 14/16(87.5%)] on UGIE. Generalized linear model fitting showed decreasing percentage of small platelets (%SP) (P=0.002), CTP-B (P=0.003) and CTP-C (P=0.003) compared to CTP-A had higher probability of having OV. The model predicts the log odds for having OV = - 0.189 - (0.046*%SP) + 2.9 [if CTP-B] + 3.7 [if CTP-C]. Based on ROC analysis, a model value >-0.19 was selected as the cutoff point to predict OV with 89%-sensitivity, 76%-specificity, 89% positive predictive value and 76%-negative predictive value. CONCLUSION: We constructed a model using %SP on peripheral blood smear and CTP class. This model can be used to predict the presence of OV, in newly diagnosed patients with cirrhosis, with high sensitivity and specificity, avoiding the need for initial UGIE.
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    Rethinking research on the social determinants of global mental health
    (Oxford, 2020) Rose-Clarke, K.; Gurung, D.; Brooke-Sumner, C.; Burgess, R.; Burns, J.; Kakuma, R.; Kusi-Mensah, K.; Ladrido-Ignacio, L.; Maulik, P. K.; Roberts, T.; Walker, I. F.; Williams, S.; Yaro, P.; Thornicroft, G.; Lund, C.
    No abstract available.
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    Potential of coconut oil and medium-chain triglycerides in the prevention and treatment of Alzheimer's disease
    (Elsevier Science Ireland, 2020) Chatterjee, P.; Fernando, M.; Fernando, B.; Dias, C.B.; Shah, T.; Silva, R.; Williams, S.; Pedrini, S.; Hillebrandt, H.; Goozee, K.; Barin, E.; Sohrabi, H.R.; Garg, M.; Cunnane, S.; Martins, R.N.
    ABSTRACT:Alzheimer's disease (AD) is the most common form of dementia. Currently, there is no effective medication for the prevention or treatment of AD. This has led to the search for alternative therapeutic strategies. Coconut oil(CO) has a unique fatty acid composition that is rich in medium chain fatty acids(MCFA), a major portion of which directly reaches the liver via the portal vein, thereby bypassing the lymphatic system. Given that brain glucose hypometabolism is a major early hallmark of AD, detectable well before the onset of symptoms, ketone bodies from MCFA metabolism can potentially serve as an alternative energy source to compensate for lack of glucose utilisation in the brain. Additionally, neuroprotective antioxidant properties of CO have been attributed to its polyphenolic content. This review discusses how the metabolism of CO and MCFA may aid in compensating the glucose hypometabolism observed in the AD brain. Furthermore, we present the current evidence of the neuroprotective properties of CO on cognition, amyloid-β pathogenicity, inflammation and oxidative stress. The current review addresses the influence of CO/MCFA on other chronic disorders that are risk factors for AD, and addresses existing gaps in the literature regarding the use of CO/MCFA as a potential treatment for AD. KEYWORDS: Alzheimer’s disease; Amyloid-β; Cerebral glucose hypometabolism; Coconut oil; Medium chain triglycerides.
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    Background radiation levels near a mineral sand mining factory in Sri Lanka: Correlation of radiation measurements with micronuclei frequency
    (Nuclear Technology Pub, 2020) Warnakulasuriya, T.; Williams, S.; Weerakkody, T.; Dabarera, M.; Rodrigo, K.; Waduge, V.A.; Ediriweera, D.; Siriwardena, N.; Wickremasinghe, R.
    ABSTRACT:Lanka Mineral Sands Ltd (LMS) is a company operating in Pulmoddai, Sri Lanka, mining for rare earth minerals along with monazite which contains thorium that emits ionizing gamma and alpha radiation on decay. The objective of the study was to determine the background radiation levels and selected radionuclides and then to correlate these levels with the frequency of micronuclei (MN) among persons residing in the vicinity of LMS. A cross-sectional study was conducted among persons of both sexes between 35 and 45 years of age residing in the vicinity of LMS. Background radiation measurements were obtained by a survey metre, and gamma spectrometry was done on soil samples. Five millilitres of venous blood was drawn for cytokinesis-blocked MN assay. Background radiation levels measured by the survey metre; 232Th, 226Ra and 210Pb mass activities in soil were highest in the samples collected from the LMS. The background radiation measurements positively correlated with MN frequency although the magnitude of the correlation was small (r = 0.176, p = 0.04). This implies that chronic long-term exposure to low-dose radiation may result in genotoxicity. Prospective large-scale studies are recommended to evaluate the long-term effect of exposure to low-dose radiation at Pulmoddai.
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    High-functioning autism in a Sri Lankan youth with High-functioning autism in a Sri Lankan youth with Langer-Giedion syndrome.
    (Lippincott Williams & Wilkins, 2018) Chandradasa, M.; Williams, S.
    The trichorhinophalangeal syndrome is a rare genetic disorder with a classical clinical triad of sparse hair, bulbous nose, and short digits. There are three known phenotypes, and the type II with exostoses in long bones is known as Langer-Giedion syndrome. Here, we describe a 28-year-old Sri Lankan male with Langer-Giedion syndrome and high-functioning autism. The karyotype found a microdeletion of the long arm of chromosome 8 with mosaicism [46,XY/46,XY,del(8)(q24.1q24.3)]. This is probably the first report of Langer-Giedion Syndrome with autism and the first report of the genetic syndrome from Sri Lanka. Furthermore, we could only access one previous report of the same microdeletion, which was from an autopsy of a 36-week-old infant.
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    Psychological morbidity and illness perception among patients receiving treatment for tuberculosis in a tertiary care centre in Sri Lanka
    (Sri Lanka Medical Association, 2016) Galhenage, J.S.; Rupasinghe, J.P.; de Silva, A.P.; Williams, S.; Gunasena, B.
    INTRODUCTION AND OBJECTIVES: To describe the disease perception and prevalence of depression and anxiety among TB patients at National Hospital for Respiratory Diseases, Welisara, Sri Lanka. METHOD: A descriptive cross sectional study involving TB patients from both inward and outpatient clinic settings was conducted. All consecutive patients who gave informed consent were assessed using the self-administered validated Sinhala and Tamil translations of the Hospital Anxiety and Depression Scale (HADS) and the Brief Illness Perception Questionnaire (BIPQ). RESULTS: A total of 254 inward patients and 176 clinic patients participated. Of the clinic patients, 17.6% screened positive for anxiety and 8.5% screened positive for depression. Of the inward patients 25.2% had depression and 12.6% had anxiety. Mean BIPQ score was 27.44 for the whole population and for clinic and inward patients the mean scores were 23.84 and 29.91, respectively. Prevalence of depression was significantly higher among inward patients (p<0.0001), elderly age groups (p=0.007) and in patients with low education levels (p= 0.012). Previously treated TB patients and those on Category 2 treatment regime had a higher proportion of persons with depression (p=0.004 and p=0.002). Among the Inward patients, previously treated patients, patients with low education level, those with depression and anxiety had a higher BIPQ score (p=0.002, p=0.005, P<0.0001, p=0.001 and P<0.0001, respectively). CONCLUSIONS: Psychological morbidity is present among patients undergoing treatment for TB. Addressing this issue will improve treatment outcome and overall wellbeing of the patients.
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