Browsing by Author "Fernando, J."

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    Effects of probiotics combined with dietary and lifestyle modification on clinical, biochemical, and radiological parameters in obese children with nonalcoholic fatty liver disease/nonalcoholic steatohepatitis: a randomized clinical trial
    (Korean Pediatric Society, 2022) Rodrigo, T.; Samaranayake, D.; Seneviratne, S.N.; de Silva, A.P.; Fernando, J.; de Silva, H.J.; Jayasekera; Wickramasinghe, V.P.
    Background: Childhood obesity is a global problem associated with metabolic abnormalities. The gut-liver axis is thought to play a major role in its pathogenesis. Probiotics are known to alter the gut microbiota and, therefore, could be a therapeutic option in the management of childhood obesity-related complications. Purpose: This double-blind randomized placebo-controlled trial evaluated the effects of probiotics on metabolic derangement in obese children with nonalcoholic fatty liver disease/nonalcoholic steatohepatitis (NAFLD/NASH). Methods: Obese children with NAFLD/NASH treated at the nutrition clinic of the University Paediatric Unit at Lady Ridgeway Hospital, Colombo, were recruited. Anthropometry, body fat, metabolic derangement, and liver ultrasound scan (USS) results were evaluated at baseline and after 6 months. Transient elastography (FibroScan®) was performed on a subsample of these patients. Eighty-four patients were recruited and randomized into the probiotics (n = 43) and placebo (n = 41) groups. The mean age was 11.3±1.9 versus 12.1±1.5 years in the probiotic and placebo groups, respectively. Baseline parameters including liver disease stage on USS, body fat percentage, fasting blood sugar, lipid profile, liver function, and C-reactive protein showed no significant intergroup differences. Results: In the probiotic group, a statistically significant reduction in body mass index was noted from the baseline value. However, the reduction was not significant compared with the placebo group. There was a significant reduction in triglycerides, aspartate transaminase (AST), alanine aminotransferase (ALT), AST/ALT ratio, and alkaline phosphatase in the placebo group over the treatment period. Although the liver disease stage on USS improved from stage II-III to stage I in a small number of patients in the probiotic-treated group, transient elastography performed in a subsample did not demonstrate significant improvement in either group. Conclusion: Our results indicate that probiotics have no advantage over lifestyle modification for improving obesity-associated metabolic derangement in children.
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    Student perceptions of an online post graduate course in family medicine in Sri Lanka
    (Health Informatics Society of Sri Lanka, 2010) de Silva, R.E.E.; Fernando, J.; Sumanasekera, R.D.N.; Liyanagama, S.D.; de Silva, D.P.
    BACKGROUND: The online Diploma course in Family Medicine (DFM) of the Post Graduate Institute of Medicine (PGIM) of the University of Colombo is one of the pioneering online post graduate medical courses in Sri Lanka.OBJECTIVES : To describe student perceptions on the online DFM course.METHODS : The study population comprised of all the students (19) of the first batch of the course. Pre- tested self administered questionnaires were administered to all students. A Likert scale was used to assess the domains of teaching, learning, levels of understanding, and technical problems. The scale ranged from 1= ["poor / not useful/did not understand"] to 5= ["excellent/ very useful/ understood very well"]. A focus group discussion was carried out to strengthen the student perceptions, based on the themes which emerged.RESULTS : Response rate was 98.4%. Levels of understanding the lessons were perceived to be high with an average of 4.8. Students were of the opinion that discussions and assignments helped them to engage in active learning. Online discussions were found to be the most useful form of learning. 88% commented that they are able to link clinical work to their online course work.CONCLUSIONS : This online course has been useful in improving student knowledge and the levels of understanding of individual lessons are satisfactory. The most useful form of learning appeared to be online discussions