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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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 Asia-Pacific consensus statement on integrated 24-hour activity guidelines for the early years(Elsevier, 2022) Loo, B.K.G.; Okely, A.; Taylor, R.; Novotny, R.; Wickramasinghe, P.; Müller-Riemenschneider, F.; Waqa, G.; Pulungan, A.; Kusuda, S.; Tan, K.H.; Mettananda, Sachith (Asia–Pacific 24-Hour Activity Guidelines for the Early Years Committee)BACKGROUND: Early childhood is a vital period for development and growth. Promoting beneficial lifestyle behaviours in early childhood can help optimise children's health, development and learning, shape their behaviours in adulthood and offer the best protection against future non-communicable diseases (NCDs). In the Asia-Pacific region, NCDs are significant causes of healthcare burden and mortality. Furthermore, there is also a high prevalence of adverse metabolic risk factors and unhealthy lifestyle behaviours among these children. METHOD: Representatives from 19 Asia-Pacific nations and/or jurisdictions developed a consensus statement on integrated 24-hour activity guidelines for the early years using the GRADE-ADOLOPMENT framework. FINDINGS: These guidelines apply to all infants, toddlers and pre-schoolers below 5 years of age. The guidelines aim to provide a holistic and practical approach to lifestyle activities by framing physical activity, sedentary behaviour and sleep within a 24-hour period. Dietary patterns were included as they play an integral role in metabolic health and energy balance. INTERPRETATION: Aligned with the World Health Organization's Global Action Plan for the Prevention and Control of NCDs through health promotion interventions in early life, through cultivating healthy lifestyle behaviours in the children's early years, we aim to provide children with the best start in life and reduce the burden of future NCDs in the Asia-Pacific region. FUNDING: Funded by Integrated platform for research in advancing metabolic health outcomes of women and children.Item Myths and misconceptions about childhood constipation(Springer-Verlag., 2023) Rajindrajith, S.; Devanarayana, N.M.; Thapar, N.; Benninga, M.A.Many widely held beliefs and assumptions concerning childhood constipation continue to interfere with rational management of childhood constipation. Although many still believe that constipation is not a common disease, about 9.5% of the world's children suffer from chronic constipation. Most of these children live in non-Western countries. There are major misconceptions about the etiology of constipation as a significant proportion of clinicians still believe that constipation is caused by some form an organic pathology, whereas in reality, the majority have functional constipation. Contrary to a commonly held belief that children outgrow constipation without long-term problems, there is evidence that constipation leads to significant bowel and psychological consequences and has a major impact on the quality of life which detrimentally affects future health and education. Finally, ineffective management strategies such as increasing fiber and water in the diet, and short duration of treatment owing to the fear that long-term laxative treatment leads to colonic dysfunction, interfere with effective therapeutic strategies. Conclusions: It is apparent that myths and misconception often lead to wrong assumptions regarding the distribution of the disease, its etiology, pathophysiology, and management leading to ordering incorrect investigations and ineffective therapeutic strategies while spending large sums of public funds unnecessarily. Poorly treated constipation leads to deleterious psychological consequences predisposing children to develop significant psychological damage and bowel dysfunctions. This review aims to challenge these myths about various elements of constipation by exploring the existing literature and encouraging clinicians to have a fresh look at old concepts that could interfere with the well-being of children with constipation. What is Known: • Childhood constipation is a growing problem in the world leading to significant suffering and high healthcare expenditure • Myths and misconceptions lead to poor management strategies causing psychological and bowel damage What is New: • Organic, systemic, and bowel disorders leading to constipation are uncommon, and in the majority, it arises due to deliberate fecal withholding and most investigations ordered by clinicians are not very helpful in the management • Most non-pharmacological interventions are not effective in the day-to-day management of childhood constipation. The use of laxatives is considered to be the first-line management strategy.Item Knowledge and practices regarding primary prevention of cardiovascular diseases among adults aged 18-30 years in Colombo District, Sri Lanka(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2021) Senatilleke, N.H.N.; Ramanayaka, R.A.P.D.; Premathilake, K.D.H.D.; Dissanayake, D.M.D.H.U.; Fernando, W.K.M.; Senaratne, B.C.V.; Perera, P.P.R.Introduction: Research on knowledge and practices regarding primary prevention of CVD among adults aged 18-30 years are lacking in Sri Lanka. Objectives: To describe knowledge and practices on diet and lifestyle in preventing cardiovascular diseases and its associated factors among adults aged 18-30 years in the Colombo District. Methods: A descriptive cross-sectional study was conducted recruiting volunteers via a self-administered online Google form. Results: Sample size was 383 participants, ranging from age 18 to 30 years. Majority of the participants (63.2%) had a good overall knowledge (mean score - 73.24% ±SD-18.5). Majority were unaware of the value of fruits and vegetables in the diet (n=203, 53.0%). 53.3% had an average level of overall practices in diet and lifestyle. Inadequate physical activity levels were observed in 60.1% of participants. There was a significant association between good level of practices with male gender (p=0.016) and being undergraduate (p=0.025). The tendency to engage in physical activity was significantly associated with age (p=0.02), being male (p=0.004), and being an undergraduate (p=0.022). Smoking was significantly associated with male gender (p<0.01), age (p=0.046) and lower monthly income (p=0.047). Consuming alcohol had a significant association with male gender (p<0.01) and highest educational qualification (p<0.01). There was a significant association between good level of knowledge and good level of practice (p=0.042). Conclusions: Even though majority of the participants had a good level of knowledge majority had an average level of practice in diet and lifestyle in preventing CVD.Item Effect of larval nutritional regimes on morphometry and vectorial capacity of Aedes aegypti for Dengue transmission(BioMed Research International, 2019) Gunathilaka, N.; Upulika, H.; Udayanga, L.; Amarasinghe, D.BACKGROUND: Nutritional level in larval diet of mosquito vectors influence on life history traits and vectorial capacity (VC). Therefore, the present study was carried out to assess the effect of larval diet concentration on vector bionomic and VC of Aedes aegypti in Sri Lanka. Method. Three batches of 400 Ae. aegypti larvae (first instar) were reared under different concentrations of larval diet (6%, 8%, and 10%; Volume/Volume), which was prepared by mixing 12.5 g of tuna meal, 9.0 g of bovine liver powder, and 3.5 g of Brewer’s yeast, in 100 ml of distilled water. The effect of larval diet concentration on different morphometric and functional parameters of larvae (length and width of head, abdomen, survival rate, and pupation success), pupae (length and width of cephalothorax, survival rate, and adult emersion), adult (length and width of thorax, abdomen, survival rate, longevity, biting frequency and fecundity of adults) were examined. In addition, VC of Ae. aegypti was evaluated. The General Linear Model (GLM) was used for the statistical analysis. Results. Larval head length, head width, thoracic width, abdominal length, abdominal width, total length, and survival rate significantly increased with higher doses of larval diet (P<0.05). In case of pupae, length, and width of cephalothorax, survival rate and adult emergence rate denoted an increasing trend with the elevated larval diets. However, the variations of survival rate and adult emergence rate were statistically significant (P<0.05). In adults, all morphometric parameters (thoracic length, abdominal length, abdominal width, and wing length) significantly increased with elevating larval diets levels (except for thoracic width) along with the biting frequency, fecundity, and survival rate (P<0.05) of adult females. The VC also denoted significant variations (F4,14 = 24.048; ) with the larval diet concentration, whereby the highest VC of 196.37 was observed at 10% treatment. Conclusion. Larval food availability has a significant influence on the adult fitness and thus may affect the incidence of dengue due to variations in the VC of Ae. aegypti. Hence, this investigation highlights the requirement in accounting the environmental variation at the larval stages in order to understand transmission dynamics and control of dengue in Sri Lanka.Item Determination of the efficiency of diets for larval development in mass rearing Aedes aegypti (Diptera: Culicidae)(CABI Publishing, 2018) Gunathilaka, P.A.D.H.N.; Uduwawala, U.M.H.U.; Udayanga, N.W.B.A.L.; Ranathunge, R.M.T.B.; Amarasinghe, L.D.; Abeyewickreme, W.Larval diet quality and rearing conditions have a direct and irreversible effect on adult traits. Therefore, the current study was carried out to optimize the larval diet for mass rearing of Aedes aegypti, for Sterile Insect Technique (SIT)-based applications in Sri Lanka. Five batches of 750 first instar larvae (L 1) of Ae. aegypti were exposed to five different concentrations (2-10%) of International Atomic Energy Agency (IAEA) recommended the larval diet. Morphological development parameters of larva, pupa, and adult were detected at 24 h intervals along with selected growth parameters. Each experiment was replicated five times. General Linear Modeling along with Pearson's correlation analysis were used for statistical treatments. Significant differences (P < 0.05) among the larvae treated with different concentrations were found using General Linear Modeling in all the stages namely: total body length and the thoracic length of larvae; cephalothoracic length and width of pupae; thoracic length, thoracic width, abdominal length and the wing length of adults; along with pupation rate and success, sex ratio, adult success, fecundity and hatching rate of Ae. aegypti. The best quality adults can be produced at larval diet concentration of 10%. However, the 8% larval diet concentration was most suitable for adult male survival.