International Postgraduate Research Conference (IPRC)

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Author: search.filters.author.de Silva, H.J.

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    Individual risk factors of snakebites in Sri Lankan community
    (Faculty of Graduate Studies, University of Kelaniya, 2015) Ediriweera, E.P.D.S.; Pathmeswaran, A.; Kasturiratne, A.; Gunawardana, N.K.; Jayamanne, S.F.; de Silva, H.J.; Diggle, P.J.
    Sri Lanka has 92 identified snake species, and one of the highest snakebite incidence (SBI) rates in the world. According to hospital statistics about 37,000 patients are admitted to government hospitals annually as a result of snakebite. The aim of the present study is to identify individual risk factors for snakebite in Sri Lanka. Methodology A community-based island-wide study (―National Snakebite Study‖) was conducted in all nine provinces of Sri Lanka, with 5,000 households sampled in each province. All the residents of the selected households were included. One-year recall data for all permanent residents of that particular household was obtained regarding the experience of snakebite. Generalized linear models were used to model SBI. Individual-level gender, age, ethnicity, religion, income, education and employment were included as explanatory variables. Statistical analysis used the R programming language. Statistical significance was assessed at the 0.01 level. Results and conclusions Out of 125,391 participants, 63,604 (50.7%) were males. There was no SBI difference amongst 10-year interval age groups from 30 to 59, hence these three age groups were collapsed. High SBI was observed in the age 30-59 year group compared to age less than 20 (P<0.001), 20 to 29 (P<0.001), 60 to 69 (P<0.003) and over 70 (P<0.007), with lower SBI in the two extreme age groups. Males had higher SBI compared to females (P<0.001). Field workers had higher SBI compared to non-field workers (P<0.001). Ethnicity and income showed a significant interaction. Low income non-Sinhalese had high SBI compared to middle income (Rs. 5000-19,999, P<0.001) and high income (Rs.>20,000, P=0.001) non- Sinhalese, whereas Sinhalese had high SBI irrespective of their income status. In summary, the high risk categories for snakebites are males, field workers, 30 – 60 year individuals, Sinhalese and low income non-Sinhalese.
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    Comparison of gastric emptying of a solid meal with a semi-solid meal using real-time ultrasonography in a cohort of healthy individuals
    (Faculty of Graduate Studies, University of Kelaniya, 2015) Amarasiri1, D.L.; Devanarayana, N.M.; de Silva, M.; Amaratunga, C.; Madushanka, K.B.G.; de Silva, H.J.
    Aims Routine performance of solid gastric emptying (GE) to assess gastroparesis is not feasible due to prolonged test duration and cumbersome preparation of test meals. Substitution of a commercially prepared semisolid meal could increase feasibility. This study compared GE of a solid and semi-solid meal. Methods and materials used Thirty (30) healthy volunteers underwent gastric emptying by real-time ultrasonography after partaking a solid meal (Mung kiribath) and semi-solid meal (‗Nestum mung‘) on two separate days. The calorie content of each meal was 350 Kcal and consisted of approximately 60% carbohydrates, 30% fat and 10% proteins. The pyloric antral area, amplitude and frequency of contractions were measured at 5, 15, 30, 45, 60, 90, 120, 150, 180, 210 and 240 minutes after ingestion. GE parameters were compared and correlated by using Wilcoxon Signed Ranks test and Spearman Rank Correlation. A P<0.05 was considered as statistically significant. Results The subjects were 17 males (mean (SD) age 29.4 (6.0) years, BMI 23.4 (2.94)) and 13 females (mean (SD) age 37.2 3 (11.9) years, BMI 22.9 (4.34)). Mean (SE) fasting antral area, antral areas, gastric emptying rates (GER) and gastric residual ratios at each time point did not differ significantly between the meals. At the end of 4 hours, the mean emptied percentage of the semisolid meal and solid meal was 81.1% and 70.6% respectively. GER of semisolid meal at 90min significantly correlated with GER at 240min. There was no correlation of the solid meal with the 90min and 240min GER. Conclusions A semisolid meal could be substituted in place of a solid test meal. A gastric emptying test can be performed in 90min when utilizing a semisolid meal as opposed to 4 hours when utilizing a solid meal. Ease in preparation of the semisolid meal and reduction in test time increases test feasibility.