Browsing by Author "Beddage, T."

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Alcohol use and alcoholic fatty liver disease: a prospective, communitybased study among adults in an urban community in Sri Lanka
(The Sri Lanka Medical Association, 2022) Niriella, M.A.; Kasturiratne, A.; Beddage, T.; de Silva, S.T.; Dassanayake, A.S.; Pathmeswaran, A.; Wickremasinghe, A.R.; Kato, N.; de Silva, H.J.
Background: Data on alcoholic fatty liver (AFL) is limited. Therefore, we investigated alcohol use and AFL in a cohort of adults in an urban community in Sri Lanka. Methods: The study population (selected by age-stratified random sampling) was screened in 2007 (35-64 years) and re-evaluated in 2014. They were assessed by structured interviews, anthropometric measurements, liver-ultrasound, and biochemical and serological tests. AFL was diagnosed on ultrasound criteria, ‘unsafe’ alcohol consumption (Asian standards: males>14 units, females >7 units per week) and absence of hepatitis B/C markers. Controls were unsafe alcohol consumers who had no fatty liver on ultrasound. Results: 2985/3012 (99%) had complete data for analysis. 272/2985 (9.1%) were unsafe-drinkers in 2007 [males-270; mean-age-51.9, SD-8.0 years]. 86/272 (31.6%) had AFL [males-85; mean-age-50.2, SD-8.6 years]. Male gender [p<0.001], increased waist circumference (WC) [OR 4.9, p<0.01], BMI>23kg/m2 [OR 3.5, p<0.01] and raised alanine aminotransferase (ALT) [OR 2.8, p<0.01] were independently associated with AFL. 173/272 (63.6%) unsafe alcohol consumers from 2007 were re-evaluated in 2014. 134/173 had either had AFL or had changed to ‘safe’ or no alcohol consumption. 21/39 (53.8%) [males-21 (100%), meanage- 57.9, SD-7.9 years] who remained ‘unsafe’ alcohol users who had no fatty liver in 2007 developed AFL after 7-years (annual incidence 7.7%). On bivariate analysis, only male gender was associated with new-onset AFL. Of the 42 who had AFL at baseline but changed their drinking status from unsafe to safe or no alcohol, 6 had resolution of fatty liver in 2014. Conclusion: In this community-based study among adults from an urban community, unsafe alcohol use was found in 9.1%. Among unsafe alcohol users, the prevalence of AFL was 31.6% and the annual incidence of AFL was 7.7%. New-onset AFL was independently associated with male gender.
Incidence and predictors of Diabetes Mellitus: A 7- year community cohort follow-up of urban, adult Sri Lankans
(Sri Lanka Medical Association., 2019) de Silva, S.T.; Ediriweera, D.; Beddage, T.; Kasturiratne, A.; Niriella, M.A.; de Silva, A.P.; Dassanayake, A.S.; Pathmeswaran, A.; Kato, N.; Wickremasinghe, A.R.
INTRODUCTION & OBJECTIVES: There is limited data on incidence of type 2 diabetes mellitus (T2DM) from South Asia. We investigated incidence and predictors ofT2DM in an urban, adult population after seven-years of follow-up. METHODS: The study population (42-71 year-olds in 2014, selected by age-stratified random sampling from the Ragama MOH area) was initially screened in 2007 and re-evaluated in 2014 with informed written consent. On both occasions they were assessed by structured interview, anthropometric measurements, liver ultrasound, biochemical and serological tests. RESULTS: Of the 2986 enrolled in 2007, 737 had established T2DM giving a baseline prevalence of 24.7% (95% CI: 23.1%-26.2%). 2148/2984 (71.6%) of the original cohort attended follow-up [1237 (57.5%) women; median (IQR) 60 (54-66) years]. 1650 participants who did not have T2DM in 2007 presented for follow up; 436 (27.6%) of them had developed new T2DM by 2014, giving an annual incidence of 3.9% (95% CI: 3.0%-4.9%). Of 525 participants with pre-diabetes (HbA1c 5.7-6.4%) in 2007, 364 attended follow up and 201/364 (55.1%) had developed T2DM by 2014, giving an annual conversion rate of pre-diabetes to T2DM of 7.9%. On logistic regression, pre-diabetes (OR:4.4;95%CI:3.3%-6.0%), central obesity (OR: 1.8;95%CI: 1.3%-2.4%), dyslipidemia (OR: l.5;95%CI: 1.1 %-2.1 %) and non-alcoholic fatty liver disease (NAFLD) (OR:1.5;95%CI: 1.1 %-2.1%) showed significant association with incident T2DM. CONCLUSION: In this urban cohort, the annual incidence of T2DM was 3.9% and the annual conversion rate of pre-diabetes to T2DM was 7.9%. Our findings emphasize the need for targeted and intensive lifestyle interventions for individuals with high metabolic risk to prevent T2DM.
Information Seeking Habits and Practices of Freshman Medical Students of University of Kelaniya
(Faculty of Graduate Studies, University of Kelaniya, Sri Lanka, 2016) Abeygunasekera, C.; Solangaarachchi, I.; Beddage, T.; Hewage, S.
Studying information-seeking habits of different groups of students is important as a decision making tool for collection development practices and introducing variety to library services. This study examined the past experiences of information access and usage by freshman medical students prior to their university admission. A survey was conducted on the new batch of MBBS students admitted in 2016 using a self-administered questionnaire distributed at the orientation programme. Of the 155 respondents, majority (65.1%) were female students. They represented eight administrative districts of the country. Highest percentage of students was admitted from the Western Province (52.9%), while 20.6% and 10.3% were from North Western and Central provinces respectively. Students who reportedly visited the library at least on a weekly basis constituted 52.9% of the sample, while the remaining 47.1% did so less frequently. Even though the main information seeking mode was searching the web (99%), a considerable number of students used library books (80%) and personal textbooks (61.9%). Library books were a source of information for 83.7% of females and 75.5% of males, while use of personal text books for this purpose was noted by 62.2% of female and 60.4% of male students. Books lent by colleagues were a source of information for 37.8% of females and 47.2% males. The main purpose of information used by majority of students (84%) was self-study. Seventy-six percent (n=118) of students used information for gaining additional subject knowledge while 68.4% (n=106) used it for entertainment and 50.3% (n=78) for project work. School library is the place for information access for 98.7% of the students, followed by town council libraries (37.4%) and provincial council libraries (16.8%). There was no significant difference between males and females (p = 0.701) or those from the Western Province and other provinces (p = 0.082), when it comes to frequency of library usage. The research finds that even though the main information seeking method of sampled freshman medical students is the internet, a considerable number still rely on libraries and other print based resources.
Non-resolution of non-alcoholic fatty liver disease (NAFLD) among urban, adult Sri Lankans in the general population: A prospective, cohort follow-up study.
(Public Library of Science, 2019) Niriella, M.A.; Kasturiratne, A.; Beddage, T.; Ediriweera, D.S.; de Silva, S.T.; Perera, K.R.; Subasinghe, C.E.; Kodisinghe, S.K.; Piyaratna, T.C.; Rishikesawan, V.; Dassanayake, A.S.; de Silva, A.P.; Pathmeswaran, A.; Wickremasinghe, A.R.; Kato, N.; de Silva, H.J.
BACKGROUND: There are few studies investigating the natural course of non-alcoholic fatty liver disease (NAFLD) in the community. We assessed resolution of NAFLD in a general population cohort of urban Sri Lankans adults. METHODS: Participants were selected by age-stratified random sampling from electoral lists. They were initially screened in 2007 and re-evaluated in 2014. On both occasions structured interview, anthropometric-measurements, liver ultrasonography, and biochemical/serological tests were performed. NAFLD was diagnosed on ultrasound criteria for fatty liver, safe-alcohol consumption (<14-units/week for men, <7-units/week for women) and absence of hepatitis B/C markers. Non-NAFLD was diagnosed on absence of any ultrasound criteria for fatty liver and safe-alcohol consumption. Resolution of NAFLD was defined as absence of ultrasound criteria for fatty liver. Changes in anthropometric indices [Weight, Body-Mass-Index (BMI), waist-circumference (WC), waist-hip ratio (WHR)], clinical [systolic blood pressure (SBP), diastolic blood pressure (DBP)] and biochemical measurements [Triglycerides (TG), High Density Lipoprotein (HDL), Total Cholesterol (TC), HbA1c%] at baseline and follow-up were compared. RESULTS: Of the 2985 original study participants, 2148 (71.9%) attended follow-up after 7 years. This included 705 who had NAFLD in 2007 and 834 who did not have NAFLD in 2007. Out of 705 who had NAFLD in 2007, 11(1.6%) changed their NAFLD status due to excess alcohol consumption. After controlling for baseline values, NAFLD patients showed significant reduction in BMI, weight, WHR, HDL and TC levels and increase in HbA1c levels compared to non-NAFLD people. Despite this, none of them had complete resolution of NAFLD. CONCLUSION: We did not find resolution of NAFLD in this general population cohort. The observed improvements in anthropometric, clinical and biochemical measurements were inadequate for resolution of NAFLD.nal Center for Global Health and Medicine, Toyama, Shinjuku-ku, Tokyo, Japan.
Pre-University Web Usage Behavior among New Medical Entrants
(Faculty of Graduate Studies, University of Kelaniya, Sri Lanka, 2016) Solangaarachchi, I.; Abeygunasekera, C.; Beddage, T.; Hewage, S.
With the development and wide accessibility of Information and Communication Technology (ICT) students would be expected to move away from traditional sources of information, such as books, towards the internet. With the objective of studying information seeking behaviour and the use of internet prior to university entrance, a survey was carried out on first year MBBS undergraduates at the Faculty of Medicine, University of Kelaniya in 2016. Data were collected using a self-administered questionnaire distributed at the orientation programme for students. Of the 155 students that responded to the questionnaire, 65% were females and 52.9% were from the Western Province. The most frequent method of finding required information prior to entering the university, as noted by the responders, was searching the internet (98.7%). Referring library books (80.0%) and their own textbooks (61.9%) were the next most common methods. This is also reflected by 87.1% of the students stating that they accessed the internet at least several days per week. Finding information was mentioned by most (94.2%) as the reason for going online. But, a considerable number also used the internet for entertainment (85.8%) and accessing social media websites (78.1%). The main devices used when accessing the web were smart phones (87%) and personal desktops/laptops (79.4%). When it comes to frequency of internet usage, comparative analyses failed to show significant differences between the two genders (χ2 = 2.242, p = 0.134) or those residing in and outside the Western Province (χ2 = 1.534, p = 0.215). Even with the inclination towards the internet as a major source of information, the reliance on text books (either their own or of colleagues or from the libraries) seem to have still maintained its relevance (with 94.2% as compared to the 98.7% that referred to the web). Wide availability of devices and methods of accessing the internet, along with the ever increasing influence of ICT in education as well as day-to-day life is reflected in these findings.
Predictors of mortality in a cohort of adult Sri Lankans
(Sri Lanka Medical Association., 2019) Kasturiratne, A.; Beddage, T.; de Silva, S.T.; Niriella, M.A.; Pathmeswaran, A.; Kato, N.; Wickremasinghe, A.R.; de Silva, H.J.
INTRODUCTION & OBJECTIVES: There is limited knowledge on early predictors of mortality among Sri Lankans. We investigated predictors of mortality in the Ragama Health Study cohort 10 years after recruitment. METHODS: The study population (35-64-year-olds selected by age-stratified random sampling from the Ragama Medical Officer of Health area) was initially screened in 2007 for socio-demographic, lifestyle, anthropometric and clinical risk factors with informed written consent. Their vital status was assessed in 2017 and the causes of death of the deceased were retrieved from death certificates available with the next-of-kin or declaration of death records from the hospital where the death occurred. RESULTS: Of the 2986 enrolled in 2007, 169 [Males: 107 (63.3%)] had died over the 10-year period, giving an overall mortality rate of 5.7% (95% CI: 5.0 % - 6.4%). The number of deaths due to cardiovascular and cancer related causes were 73/169 and 31/169, respectively. On multivariate analysis using Cox's proportional hazards model, advancing age, male sex, lower educational level, unsafe alcohol consumption and the presence of metabolic syndrome at baseline were independent predictors of all-cause mortality. Advancing age, male sex, unsafe alcohol consumption and the presence of metabolic syndrome at baseline were independent predictors of cardiovascular mortality, while advancing age and unsafe alcohol consumption were the only independent predictors of cancer-related mortality. CONCLUSION: Unsafe alcohol consumption and the presence of metabolic syndrome were important modifiable risks for mortality in this population. Addressing these risks in early adulthood will help to improve longevity.