Browsing by Author "Fernando, S."

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Antibiotic sensitivity patterns among ESBL UTIs in Sri Lanka
(Elsevier, 2016) Luke, N.; Wickramasinghe, B.; Sebastiampillai, M.; Miththinda, N.; Fernando, S.; Silva, S.; Premaratna, R.
BACKGROUND: Extended-spectrum β-lactamase (ESBL) producing organisms causing urinary tract infections (UTI) are increasing in incidence and poses a major burden to health care requiring treatment with expensive antimicrobials and prolonged hospital stay. The prevalence of ESBL producing organisms particularly in the Asian region remains unknown. In a study carried out in a tertiary care center in India,70/218(32.1%) clinical isolates of Enterobacteriaceae were confirmed as ESBL. Of them K. pneumonia were the most common ESBL producers(46.4%), followed by E coli (31.7%). Previous studies to evaluate antibiotic susceptibility shows high sensitivity to meropenem (95-100%) with aminoglycoside susceptibility ranging from 45-60%. Objective of this study was to evaluate the antibiotic sensitivity patterns of ESBL UTIs in Sri Lanka. METHODS & MATERIALS: Patients with ESBL-UTI admitted to Professorial Medical Unit, Colombo North Teaching Hospital, Ragama over a period of 6 months from January-July 2015 were recruited to the study. Their Urine culture and ABST reports were analysed after obtaining informed written consent. RESULTS: There were 52 patientswho consented for the study;males30 (57.7%),mean (SD) age 64.11 (12.59)years. The most common organisms causing the ESBL-UTI were E. coli in 44(84.6%),followed by Klebsiella in 8 (15.4%) . The ESBL organisms were mostly sensitive to carbapenems;Meropenem 50 (96.2%) and Imipenem in 38(73.1%). The other sensitivity patterns were Amikacin in 30 (57.7%), Nitrofurantoin in 24 (46.2%) andCeftriaxone in 2 (3.8%). None were sensitive to Ceftazidime. Meropenem resistance was found in 2 (3.8%) and wereE.coli. These two patients had received multiple antibiotics including meropenem in the recent past for recurrant UTI.CONCLUSION: It is evident from the above data that Carbapenems remain as the first line therapy for the majority of UTIs caused by ESBL producing organisms in the local setting. However 3.8% prevalence of meropenem resistance among the study population should draw attention of clinicians and needs implementation of measures to prevent emergence and spread of carbapenum resistant ESBL organisms.
Attitudes toward prenatal diagnosis and termination of pregnancy for genetic disorders among healthcare workers in a selected setting in Sri Lanka
(Wiley, 2008) de Silva, D.C.; Jayawardana, P.; Hapangama, A.; Suraweera, E.G.D.N.; Ranjani, D.; Fernando, S.; Karunasena, C.; Jinadasa, S.
Autoimmune thyroiditis presenting as acute onset pure chorea without encephalopathy
(Sri Lanka College of Paediatricians, 2022) Munasinghe, R.; Razeen, Z.; Suriapperuma, T.; Fernando, S.; Panapitiya, M.
No abstract available
Biocide testing programme for control of lichens on archeological monuments at World Heritage sites in Sri Lanka
(University of Kelaniya, 2008) Fernando, S.; Jayaratne, D.L.
Cultural monuments in the world heritage sites in Sri Lanka have suffered many disfigurements over the centuries due to a variety of threats. The main threats are the biological agents such as higher plants, bryophytes, algae, fungi and lichens. Lichen is a symbiotic association of a fungus with an alga that appears to be a single plant. These lichens attached firmly to the surfaces of monuments and as they grow and spread progressively weaken the surface making disfigurement of monuments. This study focused on finding the safe and best effective treatment which can remove and control all the different types of lichens growing on stone monuments at Sigiriya and Anuradapura. The two acceptable methods for the removal of lichens from the archeological monuments are the physical removal and the chemical treatment for eradication. The application of biocide chemicals for the complete eradication of lichens have been considered as the most effective method than physical removal which allows remaining microscopic propagules eventually colonize monument surface making more denser cover than the previous colonization. Therefore, seven commercially available biocides; "Captan, Mancozeb, F olicur, Hadonal D, Paraquat, Mergal S 89 and No More Mould" were tested on the stone monuments in three different locations at Sigiriya and one location at "Abayagiriya Monastry", Anuradapura. To begin treatments, the lichen inhabiting surface areas of 1 00cm2 quadrates were marked on the stone monuments. Then randomly selected five quadrates in each location were assigned to each of the biocide treatment. The manufacturers recommended concentrations of the biocides were spayed at the rate of 0.03ml/cm2 onto the lichens inhabiting surface area of the assigned quadrates using hand operated sprayers. The observations were recorded every three months intervals during the 18 months period. Data were analyzed statistically using two-way ANOVA. The treatments showed highly significant effects on lichen control (p< 0.001). Further the Tukey's multiple comparison tests concluded that the product "No more mould" has highly significant positive control effect on the eradication of lichens in the treated areas. This product is an effective biocide recommended for the eradication of both partners (the fungi and algae) of the symbiotic association of lichens. Also, the treatment showed some kind of sealer effect to retard recolonization of lichens and other growth forms for a minimum of one year period on the treated quadrates of the stone monuments.
Can we improve physiology tutorials? An assessment of targeted vs. non-targeted tutorials
(University of Kelaniya, Sri Lanka, 2003) Fernando, N.; Devanarayana, N.; Ferdinandis, H.; Jinadasa, S.; Karunasena, C.; Fernando, S.; de Silva, D.C.
Abstract available
Cardiovascular autonomic functions of gas station attendants in Sri Lanka
(Springer Nature., 2021) Warnakulasuriya, T.; Medagoda, K.; Kottahachchi, D.; Luke, D.; Wadasinghe, D.; de Silva, D.; Ariyawansha, J.; Rathnayaka, P.; Dissanayaka, T.; Fernando, S.; Devanarayana, N.M.
Introduction: Sri Lanka, a middle-income country in South Asia, has seen a rapid expansion in motor vehicles and, associated with this, an increase in demand for fuel. The dispensing of fuel at fuel stations is performed manually by male fuel handlers, who have long working hours. Such workers are exposed to hydrocarbon fuels which are associated with multiple health effects. This study was performed to determine cardiovascular autonomic functions among fuel handlers in a densely populated district of Sri Lanka. Methods: Fuel handlers (n = 50) from the Gampaha district of Sri Lanka, aged between 19 and 65 years, were identified for the study from seven selected fuel stations. Age and gender-matched controls (n = 46) without occupational exposure to fuel were used as controls. All participants were male (females were not employed as fuel handlers). After obtaining written informed consent, demographic data were collected, and general physical examination performed before autonomic function assessment. Non-parametric methods were used for data analysis. Ethical approval was granted by the ethics review committee of the Faculty of Medicine, University of Kelaniya, Sri Lanka. Results: There were no significant differences in weight, height or BMI among the study and the control populations (p[0.05). Both the systolic (SBP) and diastolic (DBP) blood pressures were significantly higher among the fuel handlers compared to controls (SBP, Mann Whitney U = 743.5, p = 0.003) and (DBP, Mann Whitney U = 686.5, p = 0.001). Valsalva ratio was significantly higher among the fuel handlers (Mann Whitney U—874.00, p = 0.043). The rise in DBP during sustained handgrip, a sympathetic parameter, was significantly higher among the controls (Mann Whitney U = 863.00, p = 0.049). Conclusions: Altered sympathetic:parasympathetic balance was observed among the fuel handlers. Monitoring of the health, using personal protective equipment, and curtailing hours of employment per week is recommended for those employed at fuel stations.
A case of multiple sulfatase deficiency
(Sri Lanka College of Paediatricians, 2022) Razeen, Z.; Suriapperuma, T.; Fernando, S.; Munasinghe, R.; Jasinge, E.; Panapitiya, M.
No abstract available
A Comprehensive Part of Speech (POS) Tag Set for Sinhala Language.
(The Third International Conference on Linguistics in Sri Lanka, ICLSL 2017. Department of Linguistics, University of Kelaniya, Sri Lanka., 2017) Dilshani, N.; Fernando, S.; Ranathunga, S.; Jayasena, S.; Dias, G.
Sinhala, which belongs to Indo-Aryan language family, is a morphologically complex language. Most of the features of the words are postpositionally affixed to the root word. Thus, well-developed Part of Speech (POS) tag sets for languages such as English cannot be easily adopted to create a POS tag set for Sinhala. Moreover, currently available Sinhala POS tag sets have many limitations such as the unavailability of tags for certain words. The objective of the research is to overcome and to identify ambiguities and limitations of the present POS tag sets for Sinhala language, and to develop a comprehensive multi-level tag set for Sinhala language. The new tag set was designed after a thorough evaluation of different types of corpora such as news articles and official government letters, and as well as an analysis of the existing POS tag set for Sinhala. This new tag set consists of 148 tags and is organized into 3 levels. Thus, it covers most of the word classes and inflection based grammatical variations of the Sinhala language. The ultimate purpose of developing this tag set is to implement an automatic POS tagger, which is an essential tool in implementing Natural Language Processing Applications. To train the automatic POS tagger, a corpus of 300000 words has been POS annotated manually using this tag set. This tag set produced an overall accuracy of 84.68% and it bypasses the other Sinhala POS taggers. However, this annotation is done only up to level 2 in the tag set. Annotating at level 3 has the potential to introduce many ambiguities to the manual annotation process, due to the large number of POS tags. Thus this opens up new research avenues to investigate on the use of inflectional morphological features of Sinhala language, in order to determine the POS tag of a word at the third level.
Conflicting effects of market volatility on the power of two-pass OLS test on the CAPM: A simulation analysis
(University of Kelaniya, 2013) Fernando, S.; Nimal, P.D.
Cost Effective High Availability Transparent Web Caching with Content Filtering for University of Kelaniya, Sri Lanka
(Faculty of Computing and Technology, University of Kelaniya, Sri Lanka, 2016) Pathirana, T.; Fernando, S.; Gunasekara, H.
The rapid growth of Internet usage at University of Kelaniya with the concept of “Bring Your Own Device” have increased issues with traditional proxy systems. The key problem is to introduce a suitable web caching system with content filtering which will enable end users to access internet without setting up proxy server details on their devices. On this study it is intended to analyse the network flow of University of Kelaniya and introduce a transparent system which will cache and filter the content according to university’s existing policies. The implementation should be a cost effective and a high availability caching mechanism which will allow users to browse internet without changing their browser settings. This will introduce a free and open source proxy system “Squid” and a content filtering system, “DansGuardian” on two dual NIC Linux boxes based on Ubuntu operating system and will be placed between Local Area Network and the firewall. Squid is a FOSS proxy widely used in the community as a traditional proxy provider. In this scenario squid will be configured as a transparent proxy which will listen on port 3128, using Linux IP tables all http traffic coming to LAN side interface will be redirected to port 8080. Default gateway for the servers will be the firewall while all internal subnets will be routed to LAN L3 devices by the servers. Between L3 device and servers, load balancing will be done based on port grouping. Before forwarding cached traffic according to squid rules, they will be checked against the content filtering policies of DansGuardian which listens on port 8080. Once content filtering is done it will be sent to the requester. End users are configured with DHCP and with No-Proxy browser settings and therefore they may not notice any traditional proxy as all caching and filtering will be transparent to the users. After testing and fine tuning wireless users for 2 months, the system was integrated for the whole network. As an influencer for BYOD, removing existing proxy settings enabled any authorized user to access the Internet through the local network. Number of detected end computers were drastically rising and therefore high bandwidth necessity was also going up. Analysing loading times and bandwidth peaks, it was confirmed that the system was stable. This made the subscribed Internet use rise up to 100% on peak times and more than 50% on off peak compared to 80% and 10% record for the traditional proxy. User comments were also positive than for the previous system as now they can bring their devices and do the browsing without consulting IT helpdesk for the proxy settings. Implementation of the transparent proxy in University of Kelaniya was the first long term transparent proxy installations in a Sri Lankan University which influenced other institutes to adopt the concept. Only downfall was this implemented system cannot detect or cache https traffic which were encrypted. Web caching and content filtering is crucial when it comes to network bandwidth considerations. In a university it has to be done with saving advantages for Education. The implemented system is a cost effective and reliable solution to address the problem on government and educational background. This will allow any authorized user to access network with their own device without any major changes.
Determination of air way pressure generated by positive expiratory pressure device (blow bottle) using computational fluid dynamic analysis
(Research Symposium on Pure and Applied Sciences, 2018 Faculty of Science, University of Kelaniya, Sri Lanka, 2018) Silva, M. D. C.; Wijesinghe, W. L. P. K.; Atapattu, P. M.; Fernando, S.; Wijesinghe, R. A. N. K.; Santos, M. D.
Positive expiratory pressure (PEP) therapy is used by respiratory physiotherapists to prevent post-operative pulmonary complications such as atelectasis and pneumonia. PEP therapy involves breathing out against a resistor which generates a positive pressure in the airways which prevents airway closure. The blow bottle is a device easily assembled using a bottle with water and tubing. PEP is generated by the resistance caused when exhaling into the water via the tubing, In order to have airflow through the blow bottle, the patient has to establish a higher airway pressure than pressure at the bottom of the bottle during expiration. Studies on blow bottle PEP suggest that 10 cm H2O pressure has to maintain at the bottom of the bottle. The aim of this study was: 1) to determine the airway pressure generated by a blow bottle constructed with commercially available tubes of 40 cm length with 10 mm and 11mm inner diameter and 10 cm water column in the bottle, at 5, 10, 15, 20 and 25 L/min flows, and 2) to determine if the blow bottle is a threshold resistor device when constructed this way. The boundary element method in Analysis System (ANSYS) was used for the analysis of pressure variation along the tube from the bottom of the bottle to airway opening. The airway pressure tested for above mentioned flow rates varied between 9.5 cm H2O-10.8 cm H2O for a tube with 10 mm inner diameter and 9.8 cm H2O -11.2 cm H2O for a tube with 11mm inner diameter. The results are within recommended pressure range for PEP. Hence tubes with 10 mm - 11mm inner diameter, 40 cm length and 10 cm water height maintained in the tube are suitable for a PEP device generating approximately 10 cm H2O pressure at the water seal.
Development of a Job Control System to Optimize Web Traffics
(2007) Fernando, S.; Dalugama, J.; Jayasekera, R.; Dassanayake, G.; Patu, V.; Minato, A.; Ozawa, S.
Developments and Trends in Qualitative Research in Agricultural Science
(Faculty of Science, University of Kelaniya Sri Lanka, 2024) Fernando, S.; Lankapura, A. I. Y.; Udagedara, G.; Jayaneththi, H. U.; Kumara, S. N.
Agricultural science is a broad, multidisciplinary field combining elements of natural and social sciences and informs the applicability of quantitative and qualitative methods to solve its issues. Despite the application of quantitative methods predominate, there remains an ambiguity in the application of qualitative methods to solve issues in agricultural science due to quality, validity and reliability concerns. Moreover, agricultural science researchers face the challenge of selecting among interviews, focus group discussions (FGDs), observations, case studies, and textual analysis, or a combination of these methods to enhance validity and reliability. This study reviews the application of qualitative methods in agricultural science to identify common methods used, their purpose, and their contributions to investigating agricultural phenomena to provide agricultural science researchers with a guideline to enhance research quality and clear misconceptions. The study uses PRISMA reporting guidelines and has developed a protocol with search terms, and inclusion criteria. Scopus is used as the main database and initial search on qualitative data collection methods from 1981 to 2024 resulted in 1,368 articles which were reduced to 628 after applying selection criteria. The research utilized both manual and automatic reviews to ensure unbiased selections. At the final stage, articles were included for bibliometric analysis using R. The results revealed that the production of qualitative studies has increased notably since 2000. As a country, Indonesia ranked first in the application of qualitative data collection methods, followed by the USA, UK, Canada, and Australia in agricultural science research. Among the qualitative data collection methods, interviews are the most used method in agricultural science research, followed by observations, focus group discussions, narratives, and open-ended surveys. The application of qualitative data collection methods has increased significantly in agricultural science research from 2011 to the present. Early application of qualitative methods remained to about a few themes, including environment, forestry and local knowledge. From 2021 to 2024, the thematic areas of qualitative enquiry have expanded significantly, indicating their ability to apply to a broad range of subjects in agricultural science consisting of climate change, livelihood, organic farming, smallholder farming, extension, food security, conservation agriculture, agroforestry, aquaculture, food safety, and sustainability. Broadly speaking, there has been a gradual increase in applying more than one qualitative method since 2009. The increasing use of multiple methods to study phenomena highlights the importance of data triangulation in qualitative research. Additionally, investigator and data source triangulation have increased the quality and validity. Among 60% of the ten topmost cited papers used more than one data collection method, implying that multiple methods enhance the validity and reliability of the studies. Of them, 40% used a single qualitative method and 60% used interviews. The use of multiple methods could be a reason for the higher impact of these studies. The swift increase in the use of qualitative data collection methods and the combination of multiple methods shows their broader relevance for examining the phenomena in agricultural science and their ability to produce quality and valid work.
Does Sri Lanka English (SLE) have dialects, and can one be identified as standard SLE?
(University of Kelaniya, 2008) Fernando, S.
Establishment of human endometriai stromal cell cultures as in-vitro models to test the effects of metalloestrogens in women with or without endometriosis
(Sri Lanka Medical Association, 2012) Silva, N.; Tennekoon, K.; Senanayake, H.; Samarakoon, S.; Fernando, S.; Wickremasinghe, A.R.; John, R.P.
INTRODUCTION: Effects of metalloestrogens like cadmium (Cd), lead (PbJ and nickel (Ni) are difficult to demonstrate in-vivo due to toxicity and therefore requires suitable in-vitro models. AIMS: To establish endometriai stromal cell (ESC) cultures as in-vitro models to demonstrate the effects of metalloestrogens in women with and without endometriosis. METHODS: Stromal cells were isolated from eutopic endometriai samples from five women with endometriosis (patients) and five women without endometriosis (controlsj. ESC cultures were established and maintained in RPMI medium. Cultures were treated with Cd, Pb and Ni at concentrations of 10-6M, 10-9M and 10-9M respectively. At 24 h and 48 h, cell number was counted using the Neubauer haemocytometer. Sulphorhodamine(SRB) cytotoxicity assay was used to test the effect of different concentrations of metals on ESC cultures. After 24 h of treatment, caspase levels in ESC cultures were evaluated with a commercially available ELISA kit Relative cell proliferation, SRB assay results and caspase levels were analyzed with ANOVA. RESULTS: ESC cultures were maintained up to 30 days. In both patients and controls Cd, but not Pb or Ni increased the relative proliferation in ESC cultures (p<0.05). At 48 h, Cd induced ESC proliferation was higher in patients than in controls (p=0.02). SRB assay results and caspase levels were similar in the two groups. CONCLUSIONS: Established ESC cultures served as stable in-vitro models. Cd induced the proliferation of ESC from women with endometriosis which appears to be independent of reduced apoptosis. Similar effects of Pb and Ni could not be demonstrated in this in vitro model.
Factors associated with urinary tract infections caused by extended spectrum beta-lactamase (ESBL) producing organisms in Sri Lanka
(Elsevier, 2016) Fernando, S.; Luke, N.; Wickramasinghe, S.; Sebastiampillai, B.; Gunathilake, M.; Miththinda, N.; Silva, S.; Premaratna, R.
BACKGROUND: Urinary tract infections (UTI) caused by extendedspectrum beta-lactamase (ESBL)-producing organisms are a major burden in clinical practice. Hospitalization in the past 3 months, antibiotic treatment in the past 3 months, age over 60 years, diabetes mellitus, Klebsiella pneumoniae infection, previous use of second or third-generation cephalosporins, quinolones or penicillins are known associations and risk factors for ESBL-UTI. METHODS & MATERIALS: A descriptive study was conducted over a period of 6 months from January - July 2015 recruiting patients with UTI caused by ESBL producing organisms, who were admitted to the Professorial Medical unit, Colombo North Teaching Hospital, Ragama Sri Lanka in order to identify risk factors and associations. Data were obtained using a pre-tested interviewer administered questionnaire and from relevant medical records after obtaining informed written consent. RESULTS: 52 patients were recruited; males 30 (57.7%), mean (SD) age 64.1(.12.6)years. Of them, 46 (88.5%) had diabetes mellitus, 32 (61.5%) had hypertension and 10 (19.2%) had chronic liver disease as comorbidities.20 (38.5%) had ultrasonographic evidence of acute pyelonephritis. At presentation16 (30.8%)had biochemical and/or ultrasonographic evidence of chronic or acute on chronic kidney disease. History of constipation was observed in 18 (34.6%), hospitalization during the past 3 months was seen in 24(46.2%)and history of urinary catheterization in 16(30.8%). Features of obstructive uropathy such as hydronephrosis, hydroureter and prostatomegaly were seen in 4 (7.7%) patients each. Antibiotic treatment within the past 3 months was observed in 32(61.5%);penicillins in 18(34.6%), 3rd generation cephalosporins in 16(30.8%),quinolones in 14(26.9%) and 2nd generation cehalosporins in 12 (23.1%). 18 (34.6%) had received more than one antibiotic within the past 3 months. 8(15.4%)patients studied were on prophylactic antibiotics for recurrant UTIs. None of them had recent Klebsiella pneumonia. CONCLUSION: Similar to other studies,diabetes mellitus, recent antibiotic treatment, hospitalization and catheterization were observed in our patients with ESBL-UTI. The fact that only 53.8% patients had received antibiotics at community level and 38.5% patients had never received antibiotics prior to developing ESBLUTI suggest high prevalence of ESBL producing organisms at community level.
Factors associated with Urinary tract infections caused by extended spectrum β-lactamase (ESBL) producing organisms in Sri Lanka
(Elsevier, 2016) Fernando, S.; Luke, N.; Wickramasinghe, S.; Sebastiampillai, B.; Gunathilake, M.; Miththinda, N.; Silva, S.; Premaratna, R.
BACKGROUND: Urinary tract infections (UTI) caused by extended-spectrum β-lactamase (ESBL)-producing organisms are a major burden in clinical practice. Hospitalization in the past 3 months, antibiotic treatment in the past 3 months, age over 60 years, diabetes mellitus, Klebsiella pneumoniae infection, previous use of second or third-generation cephalosporins, quinolones or penicillins are known associations and risk factors for ESBL-UTI. METHODS & MATERIALS: A descriptive study was conducted over a period of 6 months from January - July 2015 recruiting patients with UTI caused by ESBL producing organisms, who were admitted to the Professorial Medical unit, Colombo North Teaching Hospital, Ragama Sri Lanka in order to identify risk factors and associations. Data were obtained using a pre-tested interviewer administered questionnaire and from relevant medical records after obtaining informed written consent. RESULTS: 52 patients were recruited; males 30 (57.7%), mean (SD) age 64.1(.12.6)years. Of them, 46 (88.5%) had diabetes mellitus, 32 (61.5%) had hypertension and 10 (19.2%) had chronic liver disease as comorbidities.20 (38.5%) had ultrasonographic evidence of acute pyelonephritis. At presentation16 (30.8%)had biochemical and/or ultrasonographic evidence of chronic or acute on chronic kidney disease. History of constipation was observed in 18 (34.6%), hospitalization during the past 3 months was seen in 24(46.2%)and history of urinary catheterization in 16(30.8%). Features of obstructive uropathy such as hydronephrosis, hydroureter and prostatomegaly were seen in 4 (7.7%) patients each. Antibiotic treatment within the past 3 months was observed in 32(61.5%);penicillins in 18(34.6%), 3rd generation cephalosporins in 16(30.8%),quinolones in 14(26.9%) and 2nd generation cehalosporins in 12 (23.1%). 18 (34.6%) had received more than one antibiotic within the past 3 months. 8(15.4%)patients studied were on prophylactic antibiotics for recurrant UTIs. None of them had recent Klebsiella pneumonia. CONCLUSION: Similar to other studies,diabetes mellitus, recent antibiotic treatment, hospitalization and catheterization were observed in our patients with ESBL-UTI. The fact thatonly 53.8% patients had received antibiotics at community level and 38.5% patients had never received antibiotics prior to developing ESBL-UTIsuggest high prevalence of ESBL producing organisms at community level.
Focal seizures as first presentation of Pepper syndrome in a six-week-old girl
(Sri Lanka College of Paediatricians, 2022) Sandakelum, U.; Balasubramaniam, R.; Fernando, M.; Gunasekera, S.; Ganewatte, E.; Fernando, S.; Dissanayake, D.
No abstract available
Heart rate variability among gas station attendants exposed to benzene, toluene, and xylenes (BTX) in Sri Lanka
(Springer Nature., 2021) Warnakulasuriya, T.; Medagoda, K.; Kottahachchi, D.; Luke, D.; Wadasinghe, D.; de Silva, D.; Ariyawansha, J.; Rathnayaka, P.; Dissanayaka, T.; Fernando, S.; Devanarayana, N.M.; Scheepers, P.T.J.
Introduction: Benzene, toluene, and xylenes (BTX) exposure among gas station attendants in Sri Lanka is high. Cardiovascular morbidity and mortality are reported to be higher among those exposed to BTX. A hypothesis is based on alterations in the autonomic nervous system, especially disruption of autonomic regulation of the heart. Autonomic regulation of cardiac functions can be assessed by short-term heart rate variability (HRV), which measures the fluctuations in the interval between sequential sinus heartbeats. Objective: To determine whether BTX exposure affects the heart rate variability (HRV) among gas station attendants. Methods: Forty-nine gas station attendants from the Gampaha district of Sri Lanka, aged between 19 and 65 years, were recruited for the study. Age and gender-matched controls (n = 46) without occupational exposure to fuel were used as controls. Ethical approval for the study was granted by the Ethics Review Committee of the Faculty of Medicine, University of Kelaniya, Sri Lanka. Informed written consent was obtained from each participant. Demographic data were collected, and a physical examination was performed before the HRV assessment. We measured SDNN, RMSSD, pNN50, HF, LF, and LF: HF ratio as HRV indices. Pre- and post-shift samples of end-exhaled air were collected and analyzed for BTX using a thermal desorption gas chromatography–mass spectrometry system (TD-GC-MS) among 24 gas station attendants and 14 controls. As a proxy of shift exposure, we calculated the increase from pre-shift (as a baseline) to postshift and reported this as ‘delta’. Results and discussion: For gas station attendants (n = 24) median pre-/post-shift exhaled air concentrations (ng/L) were: benzene 10.47/ 19.00; toluene 10.41/21.86; m/p-xylene 1.63/2.14; o-xylene 0.93/1.42. For controls (n = 14) these values were 9.40/11.05, 3.19/3.91, 1.23/ 1.43 and 0.47/0.47. The heart rate variability (HRV) analysis showed significantly higher SDNN and SD2 among the gas station attendants (n = 49) than controls (n = 46) (Mann Whitney U = 842.00, p = 0.034 and Mann Whitney U = 843.50, p = 0.035, respectively). RMSSD, pNN50, Total power, HF, and SD1 among gas station attendants negatively correlated at a significant level with the mean increment in exposure to BTX (p\0.05).Conclusions: Exposure to BTX alters the HRV indices, indicating an effect on autonomic cardiac regulation. Funding: University of Kelaniya research grant: RP/03/04/03/01/ 2017, Foreign Award 2017 of the Dutch Occupational Hygiene Society (NVvA).
Hysterectomy-need of a paradigm shift
(Sri Lanka College of Obstetricians and Gynaecologists, 2012) Fernando, S.
No Abstract Available