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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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 Association of GDF15 levels with body mass index and endocrine status in β-Thalassaemia(Blackwell Publishing, 2023) Karusheva, Y.; Petry, C.J.; Yasara, N.; Kottahachchi, D.; Premawardhena, A.; Barker, P.; Burling, K.; Sattar, N.; Welsh, P.; Mettananda, S.; O'Rahilly, S.S.OBJECTIVE: GDF15 has emerged as a stress-induced hormone, acting on the brain to reduce food intake and body weight while affecting neuroendocrine function. Very high GDF15 levels are found in thalassaemia, where growth, energy balance and neuroendocrine function are impaired. We examined the relationships between GDF15 and anthropometric measures and endocrine status in β-thalassaemia. DESIGN: Cross sectional study PATIENTS: All β-thalassaemia patients attending the thalassaemia unit of Colombo North Teaching Hospital for blood transfusions. MEASUREMENTS: Anthropometric data, appetite scores, circulating GDF15, IGF, thyroid and reproductive hormone levels in 103 β-thalassaemia patients were obtained. RESULTS: GDF15 levels were markedly elevated in thalassaemia patients (24.2 fold with β-thalassaemia major compared with healthy controls). Among patients with β-thalassaemia major, the relationship between GDF15 and Body Mass Index (BMI) was curvilinear with all individuals with GDF15 levels above 24,000 pg/ml having a BMI below 20 kg/m2 . After adjustment for BMI, age and Tanner stage, serum IGF1 concentrations correlated negatively with GDF15 in all thalassaemia patients (β=-0.027, p=0.02). We found a significant positive relationship between GDF15 and gonadotropin (in both sexes) and testosterone (in males). CONCLUSIONS: GDF15 levels were markedly elevated in patients with β-thalassaemia and its association with BMI is consistent with the known effect of GDF15 to reduce body weight. The inverse association between GDF15 with IGF1 levels may reflect a neuroendocrine impact of GDF15 or an indirect effect via impaired nutritional state. The positive association with testosterone in males and gonadotropins in both sexes, was surprising and should prompt further GDF15 studies on the hypothalamic pituitary gonadal axis. This article is protected by copyright. All rights reserved.Item Body mass index (BMI) and its relationship with dynamic balance of school children in Colombo educational zone(Sri Lanka Medical Association, 2018) Ramanayake, R. M. C. P.; de Abrew, W. K.INTRODUCTION AND OBJECTIVES: Childhood overweight and obesity are serious epidemic issues that are on the rise in Sri Lanka, especially in the urban community. Excess body mass influences the human anthropometry and causes a direct impact on maintaining dynamic balance; the ability to maintain ones equilibrium when the centre of gravity shifts. Objective of this study was to assess Body Mass Index (BMI) and its relationship with dynamic balance of primary school children in Colombo educational zone METHODS: A cross- sectional study was conducted in randomly selected four National schools in Colombo educational zone among randomly selected 200 (50% boys) primary school children of grade five; 50 from each· school. The height was measured to closest O.Olm, weight was measured to closest O.Olkgand BMI was obtained. To define BMI categories, age and sex specific BMI reference proposed by World Health Organization 2007 was used. Modified Bass Test was used to assess the dynamic balance. RESULTS: Response rate was 100%. In this sample, 8.5% were obese, 13.5% were overweight, 67.5% were normal weight and 10.5%were thin. Effect of the gender on both BMI and dynamic balance of the primary school children was not statistically significant (p>0.05). Obese group had the lowest dynamic balance scores and the increase of BMI was found to be associated with poor dynamic balance in the study group. It was statistically significant (p<0.05). CONCLUSION: Dynamic balance of primary school children was impaired with the increase of BMI in the study group of children.Item Evaluation of Body Mass Index of Sri Lankan Undergraduates(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2016) Kodithuwakku, B.D.E.; Rizla, N.F.; Pieris, A.K.C.V.; Madusanka, P.N.; Amarawickrama, M.K.J.; Madhuranga, V.S.; Jayasinghe, J.A.K.I.; Abeygunawardene, R.A.B.; Hettiarachchi, C.BACKGROUND: Both physical and mental health is very important for the university students for confirmation of higher academic performances. It is obvious that undergraduates can easily obtain a variety of foods and beverages for a lower price inside the university premises. One of the measurements to evaluate the physical health of a person is Body Mass Index (BMI). It depends on person’s height and weight. OBJECTIVE: The main objective of this research is to compare the BMI values of undergraduates in different Sri Lankan universities. METHODS: The target group of this research were undergraduates of University of Colombo, University of Ruhuna and University of Peradeniya. By using proportional allocation, a sample of 700 undergraduates were selected using stratified random sampling method. BMI values were compared with respect to sex, university, place of accommodation, faculty and other important factors. It was found that about 90% of undergraduates have given responses correctly. RESULTS: The mean value of BMI of undergraduates of all three universities was 20.3 kg/m2. Maximum and minimum BMI values were 39.1 kg/m2 and 14.2kg/m2.Majority were in the normal range of BMI whereas, 26.19% were under-weight and 10.32%, over-weight. Maximum BMI values were observed among undergraduates who were residing in their own homes. CONCLUSIONS: There was no significant differences in the minimum BMI values between undergraduates who were residing in their own homes, or hostels and boarding places.Item Body mass index and gestational weight gain in two selected Medical Officer of Health areas in the Gampaha District.(College of Community Physicians of Sri Lanka, 2011) Abeysena, C.; Jayawardana, P.OBJECTIVE: To describe gestational weight gain pattern according to the body mass index (BMI) categories. METHODS: This is a descriptive study conducted in two Medical Officer of Health areas of the Gampaha District. Pregnant women were recruited on or before 16 weeks of gestation and followed up until delivery. Maternal weight was measured at the booking visit, during the second trimester and at delivery. Inadequate and excessive weight gain were defined as weight gain below and above the Institute of Medicine (IOM) 2009 recommendations for the BMI categories as well as Ministry of Health (MoH) recommendations. RESULTS: Two hundred and forty seven (30%) of the women were underweight, 432(52%) were normal weight and 131(18%) overweight and obese. According to the Asian BMI classification, 338(41 %) were normal weight and 225(29%) were overweight and obese. Total mean weight gain for the sample was 10.6(SD 3.3) kg and mean rate of gestational weight gain was 0.27(SD 0.08) kg/week. Mean weight gain during second trimester was 6.7(SD 2.7) kg and during third trimester 3.9(SD 2.2) kg. Mean gestational weight gain and rate of weight gain per week was higher among underweight women. Of the 710, 404(57%) women gained less and 62(8.7%) more weight, than recommended by the IOM, whereas 108(15%) gained more weight by MoH standards. CONCLUSIONS: One third of the women were underweight and mean gestational weight gain and rate of weight gain per week were higher amongst them. More than half of the women gained less weight than recommended.Item Nutritional status and productivity of Sri Lankan tea pluckers(Sri Lanka Medical Association, 2003) Selvaratnam, R.R.; de Silva, L.D.R.; Pathmeswaran, A.; de Silva, N.R.OBJECTIVE: To assess the impact of nutritional status on productivity of tea pluckers. DESIGN: Cross-sectional, analytical. SETTING AND PARTICIPANTS OF STUDY: All tea pluckers in five divisions of a tea estate in Hatton. MEASUREMENTS: A dietary survey was conducted using the 24 h dietary recall method. Nutritional status was assessed by measurement of body mass index (BMI) and haemoglobin (Hb) levels, and faeces were examined for helminth ova. The daily weight of tea leaves plucked and the number of days worked by each woman during the preceding month were noted from production records. RESULTS: Three hundred and four women (mean age 37.8 years, SD 8.4) were examined. The majority (59.9%) had evidence of chronic energy deficiency (BMI < 18.5). Almost all (94.4%) were anaemic (Hb < 13.3 g/dl, altitude adjusted cutoff). Mean daily iron intake was 8.7 mg (SD 2.3 mg), 45.9% of the national recommended dietary allowance. Only 10.1% had hookworm infection, all of light intensity. Multivariate regression analysis showed that dietary iron intake, the number of children and the number of children below 5 years, but not hookworm infection, were independently associated with Hb (p < 0.05). There was a strong positive correlation between monthly productivity and Hb, but not with BMI. Variation in Hb levels accounted for 65% of variation in productivity (adjusted R2 = 0.651). CONCLUSIONS: Most of the study population had chronic energy deficiency and anaemia. Dietary inadequacy of iron is a much more important causative factor than hookworm infection. Productivity was strongly associated with the degree of anaemia but not with BMI.Item Evaluation of effectiveness of iron-folate supplementation and anthelmintic therapy against aneamia in pregnancy - a study in the plantation sector of Sri Lanka(American Society of Clinical Nutrition, 1994) Athukorala, T.M.S.; de Silva, L.D.R.; Dechering, W.H.J.C.; Dissanayake, T.S.Intervention measures against anemia available to plantation workers during pregnancy include fortified food supplements (thriposha) and iron-folate supplements containing 60 mg elemental Fe. The effectiveness of these intervention measures was studied in 195 subjects whose iron and nutritional status were assessed at < 24 and > 32 wk of gestation. Taking thriposha conferred no significant benefit on maternal nutritional status, probably because sufficient amounts were not consumed. An increase in the duration of iron-folate supplementation to > 17 wk caused a significant positive change (P < 0.01) in hemoglobin, whereas an increase in the dose frequency had no significant benefit. Anthelminthic therapy in addition to iron-folate supplements caused a significant positive change in hemoglobin (P < 0.001) and serum ferritin (P < 0.005) compared with no supplementation. Thus, anthelminthic therapy significantly increased the beneficial effects of iron supplementation on hemoglobin concentration and iron status.