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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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 Awareness on alternative medical systems among diabetes mellitus patients in Uva and North Central provinces; Mullaithivu, Mannar and Killinochchi districts in the Northern Province(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2016) Nuwansiri, L.S.B.; Abeysooriya, S.R.; Thilakarathne, M.G.T.C.; Pathirana, G.K.M.; Peiris, L.D.C.; Mirfaha, M.A.F.BACKGROUND: Diabetes Mellitus is a metabolic disorder due to deficiency of insulin. According to Ayurveda concepts this is part of urinary disorders characterized by profuse urination with several abnormal qualities due to Dhosic imbalances. According to the Siddha concept Alaldhosha increase first, then Walidhosha increase, afterwards Wali and Aryamdhoshas is increased. Concurrently disturbance of seven Dhathus function occur and eliminate body energy through urine. The concept of Unani that mentioned Zinbatusshukkari (Diabetes Mellitus) develops due to weakness of the kidney as a result of strong exposures power, weakness of the retentive power and causative factors. Prevention is the best method to control this disease. Awareness among people should be increased to prevent this disease. All medical systems should combine efforts. Other than allopathic system Ayurveda, Siddha, and Unani are other alternative medical systems that can provide awareness. OBJECTIVE: To find out awareness of people about other alternative medical systems that can control Diabetes Mellitus and to find out method of continuing treatment at diabetes clinics in these medical systems. METHODS: An interviewer administered questionnaire was used to collect data visiting Sidda, Unani, Ayurveda District Hospitals, Central Dispensaries and free Ayurveda Dispensaries in Uva province, North central province, Killinochhi, Mannar,and Mullaithivu districts. RESULTS: There were few hospitals that provide Diabetic clinics (Uva-20%, North central -11%, Killinochchi, Mannar and Mullaithivu districts -25%). Of 40 patients identified from clinics only 50% of patients were aware of Ayurveda, Siddha, Unani treatments for Diabetes. CONCLUSIONS: Availability of alternative medical facilities for management of Diabetes Mellitus is limited in these districts. The awareness of people about these systems is not satisfactory.Item How important is blood glucose control in diabetes?(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2016) Patel, A.Diabetes is now a common condition, with rapidly increasing prevalence globally. Individuals with diabetes have a two to three-fold increased risk of developing macrovascular complications such myocardial infarction and stroke, compared with those without diabetes. Premature morbidity and mortality in people with diabetes is also associated with microvascular complications, including retinopathy and kidney disease. In 2008, the results of three large-scale randomised trials of intensive blood glucose control failed to provide evidence in the reduction of macrovascular disease in people with type 2 diabetes; indeed in one trial, intensive glucose control was associated with poorer outcomes. These findings were unexpected, in light of the epidemiological associations between blood glucose levels and both microvascular and macrovascular disease. Some proposed that the absence of benefits (or presence of harm) from intensive blood glucose lowering might reflect adverse effects of excess severe hypoglycaemia, or the concept of “metabolic memory”, whereby any beneficial effects may be observed only several years after the onset of tight blood glucose control. In this presentation I will provide an overview of the trial evidence relating to blood glucose control in people with type 2 diabetes, including recently reported data on long-term follow-up in the pivotal trials, ostensibly addressing the issue of “metabolic memory”.Item Prevalence of diabetes mellitus and hypertension among three populations with cataract in Vavuniya and Gampaha districts in the post conflict era(Sri Lanka Medical Assosiation, 2012) Amaratunge, M.S.; de Silva, J.; Wasthuhewaarachchi, I.M.; Uyangoda, S.H.; Mallawaarachchi, M.A.J.; Premaratna, R.; Nishad, A.A.N.INTRODUCTION: Identification of socio economic factors and non communicable disease profiles of patients with cataract is important to plan vision related health services. AIMS: To compare prevalence of diabetes mellitus [DM] and hypertension (HT) among three groups of cataract patients. METHODS: Prevalence of diabetes-and hypertension was compared in groups of patients with cataracts during second quarter of 2011. Group A: a rural population in Vavuniya, B: semi-urban low socioeconomic group and C: semi-urban higher socioeconomic group in Gampaha. Standard criteria used to detect diabetes and hypertension. RESULTS: Population in A 167(36% males), B 207(62% males) and C 407(40% males). Mean (SD) age was 65(10) years. Male diabetes prevalence (95% CI) were A 20% (9.3-28), B 30%(22.6-38.4) and C 37.9%(30.8-45.6) (p=0.009). Prevalence (95%CI) of diabetes in females were A 17.8% (11.7-26), B 19% (11.9-29) and C 33.7% (28.1-39.9) (p=0.002). Hypertension prevalence in males (95%CI) A 23.3% (15- 35.4), B 35.4% (27.6-44) and C 36-6% (29.6-44.3) (>=0.16) a"d in females A 26.2% (18.8-35.2), B 15.2% (9-24.7) and C 45.1% (39-51.4) (p=0.001). Prevalence of either diabetes or hypertension among males A 31.7% (21-44), B 54.3% (45.7-62.7) and C 56% (48.2-63.3) (p=0.001) and among females A 34.6% (26- 44), B 26.6% (18-37.2) and C 57.8% (51,5-63.7) (p=0.001). Conclusions: Females in higher socioeconomic group of Gampaha district had higher diabetes and hypertension prevalence than in lower socioeconomic populations. Male groups showed same pattern for diabetes but not for hypertension. Overall prevalence of hypertension and diabetes mellitus were higher than for general population in Sri Lanka.Item Knowledge, attitudes and practices regarding type 2 diabetes mellitus, nutrition and lifestyle in urban Sri Lankan women(Sri Lanka Medical Association, 2013) Waidyatilaka, P.H.I.U.; de Silva, A.; Atukorala, S.; Somasundaram, N.; Lanerolle, P.; Wickramasinghe, R.AIMS: Data on population specific patterns of knowledge, attitudes and practices (KAP) is essential for the design of effective intervention strategies. The aim of this study was to assess KAP regarding type 2 diabetes mellitus (T2DM), nutrition and lifestyle in Sri Lankan urban women who were unaware of their glycaemic status. Methods: 2800 apparently healthy urban women (30 - 45 years) were screened for dysglycaemia and 345 normoglcaemics and 272 dysglycaemics were selected from Coiombo Municipal Council area by random cluster sampling for a cross sectional study. An interviewer administered questionnaire was used to obtain KAP, demographic information and family history. Chi square test and Student's t- tests were used for categorical variables and for group comparison respectively. RESULTS: KAP on T2DM, nutrition and healthy lifestyle were poor. Knowledge on pre-diabetes and prevention of T2DM was also poor. However majority wanted to improve their knowledge. Women with a family history had better knowledge (p< 0.001) and attitudes (p< 0.05), but lower practice scores (p< 0.05) compared to women without a family history of T2DM. A significant (p< 0.001) proportion of women with a family history of T2DM found it difficult to resist eating foods high in fat and sugar. CONCLUSIONS: Overall KAP was poor, especially about pre-diabetes and prevention. Willingness to learn can be used positively to direct future interventions. Poor practices despite better knowledge and attitudes among women with a family history of T2DM indicate a need for targeted intervention.