Browsing by Author "Pushpakumara, K."

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A nationwide survey of hospital-based thalassemia patients and standards of care and a preliminary assessment of the national prevention program in Sri Lanka
(Public Library of Science, 2019) Premawardhena, A.P.; Mudiyanse, R.; de Silva, S.T.; Jiffry, N.; Nelumdeniya, U.; de Silva, U.; Lamabadusuriya, S.P.; Pushpakumara, K.; Dissanayaka, R.; Jansz, M.; Rifaya, I.; Navarathne, U.; Thirukumaran, V.; Arambepola, M.; Bandara, W.D.; Vaidyanatha, U.; Mendis, D.; Weerasekara, K.; de Silva, N**.; Kumara, D.K.S.; Amarasena, S.D.; Hemantha, K. K.; Refai, M.A.C.M.; Silva, I.; Hameed, N.; Rajiyah, F.; Mettananda, S.; Allen, A.; Weatherall, D. J.; Oliveri, N. F.
OBJECTIVES:Our aim was to describe the numbers and distribution of patients with different types of thalassemia and to assess the standards of care in all thalassemia treatment centers throughout Sri Lanka and the success of the ongoing prevention programme.METHODS:This cross-sectional island-wide survey was conducted by two trained medical graduates, who visited each thalassemia center to collect data from every patient, using a standardized form. Data was collected through review of patient registers and clinical records.RESULTS: We collected data on 1774 patients from 23 centers. 1219 patients (68.7%) had homozygous β-thalassemia, 360 patients (20.3%) had hemoglobin E β-thalassemia, and 50 patients (2%) had sickle β-thalassemia. There were unacceptably high serum ferritin levels in almost all centers. The annual number of births of patients with β-thalassaemia varied between 45-55, with little evidence of reduction over 19 years. CONCLUSIONS:Central coordination of the treatment and ultimately prevention of thalassemia is urgently needed in Sri Lanka. Development of expert centers with designated staff with sufficient resources will improve the quality of care and is preferred to managing patients in multiple small units.
Sickle cell disease in Sri Lanka: clinical and molecular basis and the unanswered questions about disease severity
(BioMed Central., 2020) Darshana, T.; Bandara, D.; Nawarathne, U.; de Silva, U.; Costa, Y.; Pushpakumara, K.; Pathirage, S.; Basnayake, S.; Epa, C.; Dilrukshi, P.; Wijayawardena, M.; Anthony, A. A.; Rodrigo, R.; Manamperi, A.; Smith, F.; Allen, A.; Menzel, S.; Rees, D.; Premawardhena, A.
BACKGROUND: Though case reports and limited case series of Sickle cell disease in Sri Lanka have been reported previously, no attempt has been made hitherto to undertake a comprehensive genotypic-phenotypic analysis of this "rare" group of patients. RESULTS: All accessible Sickle cell disease patients, totaling 60, including, 51 Sickle β-thalassaemia and 9 homozygous sickle patients were enrolled from seven thalassaemia treatment centres between December 2016-March 2019. The majority of patients were of Sinhalese ethnicity (n = 52, 86.67%). Geographically, two prominent clusters were identified and the distribution of Sickle haemoglobin in the island contrasted markedly with the other haemoglobinopathies. 3/ 9 homozygous sickle patients and 3/ 51 Sickle β-thalassaemia patients were receiving regular transfusion. Joint pain was the commonest clinical symptom among all sickle cell disease patients (n = 39, 65.0%). Dactylitis was significantly more common in homozygous sickle patients compared with the Sickle β-thalassaemia groups (p 0.027). Two genetic backgrounds sickle mutation were identified namely, Arab Indian and Benin. Among the regulators of Foetal hemoglobin in Sickle patients of the present study rs1427407 G > T seemed to be the most prominent modifier, with a significant association with Foetal haemoglobin levels (p 0.04). CONCLUSIONS: Overall, the clinical course of the Asian version of Sickle cell disease in Sri Lanka appears to be milder than that described in India. KEYWORDS: Clinical; Genetic; Severity; Sickle cell; Sri Lanka.
Traditional Knowledge Illustrated in the Palm Leaf Manuscripts of Anuradhapura District, Sri Lanka
(Department of Library and Information Science, Faculty of Social Sciences, University of Kelaniya, Sri Lanka, 2016) Pushpakumara, K.; Dehigama, K.
Palm leaves played a major role in recording, and preserving information on various aspects of Sri Lankan culture in place of books and paper until the advent of printing in the 19th century. A search through of palm leaf collections in Sri Lanka reveals that they took part significantly in carry forwarding a tradition that considerably influenced to preserve Sri Lankan indigenous traditional knowledge that has been passed orally from generation to generation. Sri Lanka is in the custody of massive repository of manuscript wealth preserved in cultural institutions. However, an overview of literature reflects, studiesare mainly confined to the preservation, historical information andto widely address the documentation aspects of the palm leaf manuscripts of Sri Lanka. This indicates that there is no research focusing on the theme that encompasses the study of paintings that depict the various aspect of traditional knowledge embedded in palm-leaf manuscripts.Theretofore, the present study is undertaken to explore the paintings in the palm leaf manuscripts in Sri Lanka. Anuradhapura district has been selected for the study. A survey has been carried out with a view to find paintings in the undocumented hither to unknown palm leaf manuscripts. Accordingly on the basis of previous pilot surveys, five Gram Sava Divisions were selected from the five different AGA Divisions of Anuradhapura District. In addition to the document analysis, focus group discussions and observations were used to collect data. While the survey produced paintings of various traditional knowledge related to Arts, the Indigenous Medicine, Magic and charms, Astrology and Agriculture, work of artappeared in palm leaf manuscripts related to ancient Sri Lankan agricultural activities are only presented in this paper. Surveying and studying hither to unknown collections at Anuradhapura District of Sri Lanka will be of momentous achievement for the benefit of research and learning. Due to the utmost value of the manuscriptsit is recommended to take over the collections from theheritors with a view to preserve palm leaf manuscripts for the future generations.