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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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 Effect of virgin coconut oil supplementation on cognition of individuals with mild-to-moderate alzheimer's disease in Sri Lanka (VCO-AD study): A randomized placebo-controlled trial(IOS Press, 2023) Fernando, M.G.; Silva, R.; Fernando, W.M.A.D.B.; de Silva, H.A.; Wickremasinghe, A.R.; Dissanayake, A.S.; Sohrabi, H.R.; Martins, R.N.; Williams, S.S.BACKGROUND: Virgin coconut oil (VCO) is a potential therapeutic approach to improve cognition in Alzheimer’s disease (AD) due to its properties as a ketogenic agent and antioxidative characteristics. OBJECTIVE: This study aimed to investigate the effect of VCO on cognition in people with AD and to determine the impact of apolipoprotein E (APOE) ɛ4 genotype on cognitive outcomes. METHODS: Participants of this double-blind placebo-controlled trial (SLCTR/2015/018, 15.09.2015) were 120 Sri Lankan individuals with mild-to-moderate AD (MMSE = 15-25), aged > 65 years, and they were randomly allocated to treatment or control groups. The treatment group was given 30 mL/day of VCO orally and the control group, received similar amount of canola oil, for 24 weeks. The Mini-Mental Sate Examination (MMSE) and Clock drawing test were performed to assess cognition at baseline and at the end of the intervention. Blood samples were collected and analyzed for lipid profile and glycated hemoglobin (HbA1 C) levels.∥ RESULTS: There were no significant difference in cognitive scores, lipid profile, and HbA1 C levels between VCO and control groups post-intervention. The MMSE scores, however, improved among APOE ɛ4 carriers who had VCO, compared to non-carriers (2.37, p = 0.021). APOE ɛ4 status did not influence the cognitive scores in the control group. The attrition rate was 30%.∥ CONCLUSION: Overall, VCO did not improve cognition in individuals with mild-to-moderate AD following a 24-week intervention, compared to canola oil. However, it improved the MMSE scores in APOE ɛ4 carriers. Besides, VCO did not compromise lipid profile and HbA1 C levels and is thus safe to consume.Item Neurocognitive skills in children with congenital hypothyroidism attending the endocrine clinic of the Professorial Unit of the Lady Ridgeway Hospital for Children, Colombo.(Sri Lanka College of Paediatricians, 2017) Sumanasena, S.P.; Gunawardena, N.; Dissanayake, B.; Dilanka, S.; de Silva, S.This is the correspondence to the article appeared in Sri Lanka Journal of Child Health. 2016; 45 (2):95-102. by same authors,Item Neurocognitive skills in children with congenital hypothyroidism attending the endocrine clinic of the Professorial Unit of the Lady Ridgeway Hospital for Children, Colombo(Sri Lanka College of Paediatricians, 2016) Sumanasena, S.P.; Gunawardena, N.; Dissanayake, B.; Dilanka, S.; de Silva, S.BACKGROUND: Early thyroxine replacement prevents intellectual impairment due to congenital hypothyroidism (CHT). There is minimal evidence on neurodevelopmental outcome of children commenced on thyroxine during early infancy from countries not screening for CHT. OBJECTIVE: To assess the neurocognitive skills of children with CHT of age group 6-10 years, attending the endocrine clinic of the Professorial Paediatric Unit, LRH compared to age matched controls and to assess the influence of age at diagnosis, initial thyroid stimulating hormone (TSH) levels, thyroxine commencement dose and number of clinic visits in the first year on neurocognitive skills. METHOD: A retrospective study was carried out from 1st January 2010 to 1stJanuary 2011 on children with CHT of age group 6-10 years, followed up in the endocrine clinic of the Professorial Paediatric Unit, LRH. Age matched healthy children aged 6-10 years were selected from similar socioeconomic backgrounds to compare the neurocognitive attainments. Neurocognitive skills were assessed using an age appropriate battery of instruments. Children older than 10 years were excluded as the assessment tools were designed only for the age range 6-10 years. Children with other co-morbidities adversely affecting their neurocognitive development were also excluded. RESULTS: Twenty three children with CHT of age group 6-10 years were followed up in the endocrine clinic of the Professorial Paediatric Unit, LRH during the study period and 2 were excluded. Forty two age matched controls of age group 6-10 years also participated in the study. The mean age of the children was 2.42±2.59 years. The mean TSH levels at diagnosis was 43.17± 34.25mU/L. Starting dose of thyroxine in the majority was less than 10µg/kg/day. Children with CHT performed less than their peers in all age ranges and in all areas of skills. Statistically significant differences were documented in the total performance percentiles at ages of 8 (p=0.0001) and 9 years (p=0.0002). Similarly, they performed less in literacy at 8 (p=0.015) and 9 years (p=0.004), verbal performance at 8 years (p= 0.0002) and numeracy in 9 years (p=0.035). There was no significant correlation between the neurocognitive scores and age at diagnosis, initial TSH levels, thyroxine commencement dose or the number of clinic visits in the first year. CONCLUSIONS: Children with CHT of age group 6-10 years, attending the endocrine clinic of the Professorial Paediatric Unit, LRH had significantly reduced neurocognitive skills compared to age matched controls. There was no significant correlation between the neurocognitive scores and age at diagnosis, initial TSH levels, thyroxine commencement dose or number of clinic visits in the first year.