Browsing by Author "Ranaweera, L."

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An anatomical study of the tarsal tunnel: A cadaveric study
(University of Kelaniya, 2011) Karunanayake, A.; Hasan, R.; Salgado, S.; Salvin, K.A.; Fernando, P.; Ranaweera, L.; de Alwis, R.P.; Herath, S.; Senadipathy, C.; Mahawaththa, T.; Fernado, E.; Ilayperuma, I.
Tarsal tunnel is a passage formed between the flexor retinaculum and the underlying tarsal bones. Tendons of tibialis posterior, flexor digitorum longus, flexor hallucis longus and the neurovascular bundle of the posterior compartment of the leg pass through this tunnel in separate fascial compartments. To relieve symptoms and signs of Tarsal tunnel syndrome, orthopedic surgeries and anesthetic nerve blocks are used. Therefore, knowing the anatomy of the tarsal tunnel is important to understand and manage conditions related to this region. The aim of this study, is to describe the morphology and its possible variations in a Sri Lankan population compared to what is described in standard anatomy text books. A descriptive study was carried out by dissecting 28 human cadavers available in the Department of Anatomy, University of Kelaniya. Typical anatomy was observed in 26 cadavers (92.85%) where tibialis posterior (TP), flexor digitorum longus (FDL),neurovascular bundle and flexor hallucis longus (FHL) were in separate compartments anterior to posterior respectively. In one cadaver (3.57%) FDL and FHL were in a single compartment. In another cadaver (3.57%) bifurcation of the tendon of flexor digitorum longus was observed passing through a separate compartment posterior to neurovascular bundle. Even though the majority of the results were in agreement with the typical description of the anatomy of the tarsal tunnel, a certain degree of variability was observed in this area. This knowledge will be of use to clinicians involved in procedures related to the tarsal tunnel.
Anomalies of the Lumbrical Muscles of the Hand
(University of Kelaniya, 2012) Ranaweera, L.; Hasan, R.; Salgado, S.; Karunanayake, A.; Salvin, K.A.; Fernando, P.; Fernando, E.; Wijesooriya, P.; Vithanage, S.
Introduction:The human hand occupies a unique position in evolution. The lumbrical muscles, one of the major constituents of intrinsic musculature in hand, play significantly greater role in the precision movements of the fingers. There are four cylindrical lumbrical muscles which rise from the four tendons of flexor digitorumprofundus (FDP) in the hand and pass along the radial side of the corresponding metacarpophalangeal joint to insert into the dorsal digital expansion of the medial four fingers. The first and second lumbricals are unipennate while the third and fourth lumbricals are bipennate. Anomalies of the attachments of the lumbricals are not uncommon and have a significant value in the design of surgical procedures. Objectives: To study the possible variations of lumbrical muscles and also document a relevant Sri Lankan study. Methodology:This research was carried out as a descriptive study in19 preserved human hands in the Departments of Anatomy, University of Kelaniya, Ragama. Results: In 9 (47.4%) hands the lumbricals were normal. Regarding the proximal attachments, the third lumbrial was unipennate in 3 (15.7%) whereas same architecture for the fourth lumbrical encountered was 2 (10.5%). Moreover, it was found that 1 (5.3%) of the second lumbricals was bipennate. Regarding the distal attachments, the split insertion of the third lumbrial and fourth lumbrical were observed as 2 (10.5%) and 1 (5.3%), respectively. Interestingly, 1 (5.3%) of the third lumbricals was inserted on the medial side of the middle finger. Conclusion: In our preliminary studyof lumbrical muscles of the hand, it was apparent that majority of the observations are comparable to previous research, while there were a higher percentage of proximal attachment variations than distal attachment variations in the study group.
Anthropometric knee profile measurements on articulator surface of femur among Sri Lankan population.
(Sri Lanka Medical Association, 2023) Fernando, G.K.S.; Ranaweera, L.; Cabral, L.L.E.; Dissanayaka, P.; Bandara, I.D.M.R.N.; Sovis, W.F.U.N.
INTRODUCTION: In Sri Lankan context there are no published data for articulator surface measurements for knee joints. Forensic, Anatomical, Archaeological, Bio-medical engineering, development of knee S145 prosthesis beneficial with anthropometrics. Digital Vernier Caliper (measuring range 0-140mm, resolution 0.02mm, accuracy ±0.01mm) used to obtain measurements. OBJECTIVES: The aim of this study, was to provide standard anthropometrics for the distal femur in Sri Lankan context. METHODS: Dried adult Femurs (42 male and 28 female) were analysed for the measurements of Medial condyle Antero-Postero Length (MAP), Anteroposterior length of intercondylar area (AP), Medial-Lateral Length (ML), Aspect Ratio (ML/AP) and Epi Condylar breadth (EB). Sex Dimorphism Ratio (SDR) were calculated for dry femurs. RESULTS: The mean values for male; MAP 24.95(±2.22), AP 25.47(±2.27), ML 20.82(±2.56), Aspect Ratio 0.82(±0.11) and EB 7.68(±0.43). The mean values for female; MAP 24.95(±3.08), AP 25.47(±3.16), ML 20.82(±2.28), Aspect Ratio 0.82(±0.18) and EB 7.68(±0.37). SDR values are MAP 107.74, AP 107.12, ML 99.04, and EB 106.55. CONCLUSIONS: The majority of SDR values lie above 100. Therefore, a difference between male and female values can be observed. Findings offer assistance to develop knee joint prostheses with culture-particular values, fitting for the Sri Lankan setting and pave the pathway to the studies on the above-mentioned fields in the local and international context. Sex determination is a crucial element in the creation of a biological profile since it offers information for identities.
A Case Report: the Coastal Vedda Community Trapped in the Civil War in Sri Lanka
(University of Kelaniya, 2015) Ranaweera, L.
Sri Lanka is a small island in the Indian Ocean, located close to the southern tip of the mainland India. Easy accessibility to the island from all the parts might leads to heterogeneous social composition, which is reflected in the different ethnic groups, religious faiths and tongues. Besides the mutually exclusive Vedda people, the Sinhalese and the Sri Lankan Tamils, the other minor ethnic groups include the Indian Tamils, Muslims, Malays, Burghers, Kaffirs, Mukkuvars, Paravars, Kuravans, Kinnaras, Vanni folk, Rodiyas, Colombo Chetties and Vaggei. The country’s original inhabitants are known as Vedda people and there are three Vedda types in Sri Lanka: Stone Vedda (Cave Dwelling Vedda), Village Vedda and Costal Vedda. Unlike the first two groups who are located in the middle of the country with hunting and gathering subsistence pattern, the Coastal Vedda inhibits the Eastern shoreline of the island and practices maritime fishing. The research access to Coastal Vedda was limited by the terrorist problem during the past 30 years. However, after the end of the war against the Liberation Tigers of Tamil Eelam (LTTE) by the Sri Lankan Government, the research doors were opened. The objective of this research was to evaluate the impact of civil war on the Coastal Vedda people. The data was gathered from interviews with different levels of formality, firsthand observations and focus-group discussions. The most important discovery was the fact that the Coastal Vedda people were forced to work under the LTTE as soldiers, which clearly violates the United Nations Declaration on the Rights of Indigenous Peoples. Unfortunately, the Sri Lankan government was not aware of the involvement of the Coastal Vedda people in the battlefield. However, the end result is that the massive damage to the indigenous culture. It was evident that the younger Coastal Vedda generations had only experiences of war and they were not aware of their valuable cultural heritage. Only a few elderly people knew the older Vedda dialect. They are not aware of their unique fishing techniques such as using crushed poisonous plants and special harpoons. Moreover, their fascinating rituals such as worship of cobras and demons, and beliefs such as the presence of dead souls to help them, are becoming obsolete. Therefore, it is really necessary to take measures to preserve these vanishing indigenous inhabitants and assist them in uplifting their intrinsic culture.
Challenges faced in establishing a pediatric liver transplant program in a lower‐middle‐income country with free healthcare service
(Wiley, 2024) Fernando, M.; Tillakaratne, S.; Gunetilleke, B.; Liyanage, C.; Appuhamy, C.; Weerasuriya, A.; Uragoda, B.; Welikala, N.; Ranaweera, L.; Ganewatte, E.; Dissanayake, J.; Mudalige, A.; Siriwardana, R.
ABSTRACT: BACKGROUND: Liver transplant is the cure for children with liver failure. Sri Lanka is a lower-middle-income country with a predominant free, state health system. Pediatric liver transplant program in Sri Lanka is still in the budding state where the initial experience of the program is yet to be documented. METHODS: A retrospective review was performed including the clinical characteristics of all pediatric liver transplant recipients of Colombo North Centre for Liver Diseases since the inception of the program from June 2020 to May 2023. RESULTS: There were 14 PLT performed in 3 years. The median recipient age and weight were 8 years (6 months–15 years) and 23.3 kg (6.4–49.2), respectively. The majority were boys (64%). All were from low-income backgrounds. Indications for LT were acute liver failure (5/14), decompensated chronic liver disease (5/14), and acute on chronic liver failure (4/14). Underlying liver diseases were Wilson disease (6/14), autoimmune liver disease (3/14), biliary atresia (2/14) and progressive familial intrahepatic cholestasis type 3 (1/14), and unknown etiology (2/14). The majority were living donor liver transplants (86%). Of the living donors, 42% (5/12) were Buddhist priests. There were three immediate deaths and two late deaths. The 3-month survival was 78%, and overall survival was 64%. Living donor transplants carried a higher success rate (92%) compared to diseased donor transplants (0%; 2/2). CONCLUSIONS: Initial experience of pediatric liver transplant program of Sri Lanka is promising despite being established in a free healthcare system amidst the crisis circumstances.
Estimation of sex from the osteometric measurements of the femur in a contemporary Sri Lankan population
(Chilean Society of Anatomy, Argentine Association of Anatomy and Panamerican Association of Anatomy., 2022) Ranaweera, L.; Cabral, E.; Dissanayake, D.M.P.V.; Lakshan, W.S.V.
SUMMARY: Sex estimation from human skeletal remains is of vital importance in the buildup of a biological profile of an individual in medico-legal and bioarchaeological studies. The present study is focused on the estimation of sex from osteometric measurements of the complete femur and its fragmentary parts, and the development of a web based application related to this. Fifteen osteometric measurements were taken from 78 dry cadaveric femurs from the Faculty of Medicine, University of Kelaniya. Using R software, linear discriminant analysis and logistic regression methods were applied to build classification models with the help of the application of a stepwise procedure, to identify the best combination of measurements to estimate the sex of the femur. A cross-validation method was applied to estimate the predictive accuracy of each model. Since the linear discriminant analysis model gave more predictive accuracy than the regression model, we suggest using linear discriminant analysis to estimate the sex using osteometric measurements of the femur. From the whole femur measurements, a formula to determine sex was developed with highest total accuracy of 83 % using four parameters; epicondylar breadth, anteroposterior mid-shaft diameter, bi-trochanter length, and maximum shaft diameter. Similarly, measurements of transverse head diameter and bi-trochanter length with a total accuracy of 76 % for the proximal part of the femur, measurements of anteroposterior mid-shaft diameter with a total accuracy of 77 % for the mid-shaft, and measurements of epicondylar breadth and maximum length of the lateral condyle with a total accuracy of 70 % for the distal part of the femur were identified as significant discriminants to determine sex, and formulae were written accordingly. Average accuracy ranged from 83 % to 70 %, with male accuracy slightly higher than that of females. A web application to estimate the sex of femur using these formulae was developed and this will be of great importance for forensic medicine and bio-archaeological research in Sri Lanka
First Palaeopathological Example of Dental Abscess from Pre-historic Sri Lanka
(Centre for Asian Studies, University of Kelaniya, 2015) Ranaweera, L.; Adikari, G.
Sri Lanka is an island off the tip of southeast of Indian subcontinent and possesses a pre-historic human skeletal record covering 34,000 years, which is inclusive of Meolithic period, Iron age and Historic period. Interestingly, the oldest skeletal remains of anatomically modern Homo sapiens (37 000 BP) reported from the South Asian region were discovered from the cave site, Fahien-lena, The archaeological excavation of Pallemalala shell midden in the southern part of the island was conducted by the Postgraduate Institute of Archaeology, University of Kelaniya in 1997 and yielded six human skeletons, with additional fragments of human and faunal remains, together with stone implements belonging to the Mesolithic culture. Gross morphological analysis indicates abundant and well preserved dental evidences when compared to poor skeletal preservation. Among the collection, there is a left part of a mandible aged around 35-45 years of a male person with the evidence of a large dental abscess cavity associated with the antimortem tooth lost. The reports of palaeopathological conditions on skeletal materials are very rare and this finding highlights the very first dental abscess encountered in Pallemalala population who lived in 4500 BP in Sri Lanka. Since such dental pathology has the potential to provide insights into the composition of the diet, this will open a research path to determine disease progress with evolution.
Human skeletal remains analysis from Pallemalala shell midden in Southern Sri Lanka.
(Chilean Society of Anatomy, Argentine Association of Anatomy and Panamerican Association of Anatomy., 2022) Ranaweera, L.; Adikari, G.
Sri Lanka, an island off the tip of the Southeast of the Indian subcontinent processes the earliest skeletal evidence of anatomically modern Homo sapiens (37,000 B.P.) and the best human skeletal record sequence in the South Asian region. Adding another to the list, the skeletal remains, which belong to Mesolithic culture were found at Pallemalala shell midden in Southern Sri Lanka during scientific archaeological exploration by Postgraduate Institute of Archaeology, University of Kelaniya. Sri Lanka. The aim of the study was to determine the minimum number of human individuals, age, sex, and pathological conditions related to the ancient Pallemalala commiunity. For the primary analysis, 426 bone fragments were available. Out of those, 233 bones were identified as human bones which represent 7 minimum number of individuals. The rest of the collection comprises some animal bones and shell species. The community was predominated by the female population. The identified age categories were around 20 years, between 35-45 years, and over 45 years. The encountered pathological lesions were bone thickening, alveolar resorption, dental abscesses, dental caries, antemorterm tooth loss, calculus deposits and brown colour stains on teeth. Regarding the dietary pattern, it was evident that their diet may have consisted of coarse foodstuffs with an extremely basic dietary chemistry.
Identification of patients with type 2 diabetes with non-alcoholic fatty liver disease who are at increased risk of progressing to advanced fibrosis: a cross-sectional study
(BMJ Publishing Group Ltd, 2023) Mettananda, C.; Egodage, T.; Dantanarayana, C.; Fernando, R.; Ranaweera, L.; Luke, N.; Ranawaka, C.; Kottahachchi, D.; Pathmeswaran, A.; de Silva, H.J.; Dassanayake, A.S.
INTRODUCTION: Identification of advanced hepatic fibrosis in non-alcoholic fatty liver disease (NAFLD) is important as this may progress to cirrhosis and hepatocellular carcinoma. The risk of hepatic fibrosis is especially high among patients with diabetes with NAFLD. Annual screening of patients with diabetes for fatty liver and calculation of Fibrosis-4 (FIB-4) score and exclusion of significant fibrosis with vibration-controlled transient elastography (VCTE) have been recommended. However, VCTE is expensive and may not be freely available in resource-limited settings. We aim to identify predictors of significant liver fibrosis who are at increased risk of progression to advanced liver fibrosis and to develop a prediction model to prioritise referral of patients with diabetes and NAFLD for VCTE. METHODS AND ANALYSIS: This cross-sectional study is conducted among all consenting adults with type 2 diabetes mellitus with NAFLD at the Colombo North Teaching Hospital, Ragama, Sri Lanka. All patients get the FIB-4 score calculated. Those with FIB-4 ≥1.3 undergo VCTE (with FibroScan by Echosens). Risk associations for progression to advanced liver fibrosis/cirrhosis will be identified by comparing patients with significant fibrosis (liver stiffness measure (LSM) ≥8 kPa) and without significant fibrosis (LSM <8 kPa). A model to predict significant liver fibrosis will be developed using logistic regression. ETHICS AND DISSEMINATION: Ethical approval has been obtained from the Ethics Committee of the Faculty of Medicine, University of Kelaniya (P/66/07/2021). Results of the study will be disseminated as scientific publications in reputable journals.
Identification of type 2 diabetes patients with non-alcoholic fatty liver disease who are at increased risk of significant hepatic fibrosis: a cross-sectional study
(Sri Lanka Medical Association, 2023) Mettananda, K.C.D.; Egodage, T.; Dantanarayana, C.; Solangarachchi, M.B.; Fernando, R.; Ranaweera, L.; Siriwardhena, S.; Ranawaka, C.K.; Kottahachchi, D.; Pathmeswaran, A.; Dassanayake, A.S.; de Silva, H.J.
INTRODUCTION: Annual screening of patients with diabetes for fatty liver, and identifying those with significant hepatic fibrosis using the FIB-4 score and vibration-controlled transient elastography (VCTE) has been recommended to detect patients who may progress to advanced hepatic fibrosis/cirrhosis. However, VCTE is not freely available in resource-limited settings. OBJECTIVES: To identify clinical and biochemical predictors of significant liver fibrosis in diabetics with fatty liver. METHODS: We conducted a cross-sectional study among all consenting adults with T2DM and non-alcoholic fatty liver disease (NAFLD) attending the Colombo North Teaching Hospital, Ragama, Sri Lanka from November 2021 to November 2022. FIB-4 scores were calculated and patients with a score ≥1.3 underwent VCTE. Risk associations for liver fibrosis were identified by comparing patients with significant fibrosis (LSM ≥8 kPa) with those without significant fibrosis (FIB-4<1.3). RESULTS: A total of 363 persons were investigated. Of these, 243 had a score of FIB-4 <1.3. Of the 120 with a FIB-4 ≥1.3, 76 had LSM ≥8 kPa. Significant fibrosis was individually associated with age (OR 1.01, p<0.0001), duration of diabetes (OR 1.02, p=0.006), family history of liver disease (OR 1.42, p=0.035), waist (OR 1.04, p=0.035), and FIB-4 (OR 2.08, p<0.0001). However, on adjusted analysis, significant fibrosis was only associated with a family history of liver disease (OR 2.69, p=0.044) and FIB-4 (OR 1.43, p<0.001). CONCLUSION: In patients with T2DM and fatty liver, advancing age, increased duration of diabetes, a family history of liver disease, waist circumference and a high FIB-4 score increase the risk of significant hepatic fibrosis. Targeted interventions in this group may help prevent progression to advanced hepatic fibrosis/cirrhosis.
Immediate outcome of microwave ablation for liver tumours in a single cohort of patients in Sri Lanka.
(The College of Surgeons of Sri Lanka, 2022) Appuhamy, C.; Ganewatte, E.; Ranaweera, L.; Dassanayake, A.S.; Gunetilleke, M.B.; Tillakaratne, S.; Gunawardena,H.P.; Niriella,M.A.; Siriwardana,R.C.
Introduction and Objectives Microwave ablation (MWA) is an emerging treatment modality for hepatocellular carcinoma (HCC) and other liver tumours. We aimed to assess the immediate success and complications of MWA in a cohort of patients. Method Patients were assessed retrospectively, using an intervieweradministered questionnaire and a follow-up CECT/MRI at, 6-week.Result 55 patients underwent MWA from October 2021-May 2022, at Colombo-North Teaching Hospital, Ragama, Sri Lanka, and selected private hospitals( Durdans Hospital, Colombo, Nawaloka Hospital, Colombo, Lanka Hospital, Colombo).The median age was 64 (40-82) years, with a male preponderance (n=45, 81.1%). The indication was HCC in 54 (98.1%) and metastatic tumour in one (1.8%). The median tumour size was 28 (10-80) mm. Segment VII was the commonest site to be involved (n=18, 34.6%). The majority (n=40, 72.7%) was a single lesion. No participant underwent the procedure twice. The mean post-procedural hospital stay was 12 hours (95%CI=11.4-12.5, SD=2.0).In the 6-week follow-up, 2 recurrences (3.6%) and single death (1.8%) with no relation to the procedure, were reported. Another 2 (3.6%) denied the follow-up. Complete ablation was reported in 46 patients (83.7%), comparable to the rates in literature (95-97%), with only 7 patients (12.7%) having residual tumours. No major complications were reported. 9 patients (16.4%) developed 'Post ablation syndrome', not as common as in literature (34%). They presented with abdominal pain (7.3%), vomiting (7.3%), and fever (3.6%).Conclusion MWA is a successful and safe treatment option for primary liver tumours in Sri Lanka, with ablation rates comparable to the western world.
Injuries at the National Sport Festival Taekwondo Championship in Sri Lanka [Lesioni al National Sport Festival Taekwondo Championship in Sri Lanka]
(Edizioni Minerva Medica, 2020) Ranaweera, L.; Kumari, M.I.; Samaraweerachchi, U.I.
BACKGROUND: Taekwondo is a Korean martial art that had been growing in popularity in Sri Lanka and internationally. Although studies have examined injuries in other non-contact sports, to date, no published medical study has examined injuries in taekwondo competitions in Sri Lanka. The purpose of this study was to identify the injury profile in the “National Sport Festival Taekwondo Championship” in Sri Lanka. METHODS: This is a descriptive cross-sectional study. In the competition, 193 athletes were observed prospectively to detect the injury type, site of injury, severity of injury and the rate of injury. Injury data were recorded using an interviewer administered questionnaire with the help of the attending physician. The software program “SPSS 16.0’ was used to analyze the data. RESULTS: Importantly, 78 injuries were recorded. The most prevalent injury type was contusions (67.9%) followed by lacerations (12.8%), sprain (5.1%), concussion (5.1%) and fractures (3.8%). The lower limbs were determined as the most prevalent anatomical region of the body to sustain an injury during a competition followed by the head and neck. The most frequent injuries were mild injures (71.8%) which is followed by moderate injuries (17.9%) and the equal frequency of 5.1% for both severe and critical injuries. The injury rate was found to be 220.3 injuries per 1000 athlete-exposures. CONCLUSIONS: The most common injury location and type were found to be the lower limb and contusion, respectively. The majority of injuries appeared to be of mild in nature. Most importantly, the injury rate in Sri Lankan taekwondo athletes is very much higher than the rates reported from the other parts in the world. There is an urgent need of launching programs related to injury prevention among the players and the referees in order to decrease the rate of taekwondo injuries in Sri Lanka. KEY WORDS: Martial arts; Sports; Athletic injuries; Contusions
Mitochondrial DNA history of Sri Lankan ethnic people: their relations within the island and with the Indian subcontinental populations
(Nature Publishing Group, 2014) Ranaweera, L.; Kaewsutthi, S.; Win Tun, A.; Boonyarit, H.; Poolsuwan, S.; Lertrit, P.
Located only a short distance off the southernmost shore of the Greater Indian subcontinent, the island of Sri Lanka has long been inhabited by various ethnic populations. Mainly comprising the Vedda, Sinhalese (Up- and Low-country) and Tamil (Sri Lankan and Indian); their history of settlements on the island and the biological relationships among them have remained obscure. It has been hypothesized that the Vedda was probably the earliest inhabitants of the area, followed by Sinhalese and Tamil from the Indian mainland. This study, in which 271 individuals, representing the Sri Lankan ethnic populations mentioned, were typed for their mitochondrial DNA (mtDNA) hypervariable segment 1 (HVS-1) and part of hypervariable segment 2 (HVS-2), provides implications for their settlement history on the island. From the phylogenetic, principal coordinate and analysis of molecular variance results, the Vedda occupied a position separated from all other ethnic people of the island, who formed relatively close affiliations among themselves, suggesting a separate origin of the former. The haplotypes and analysis of molecular variance revealed that Vedda people's mitochondrial sequences are more related to the Sinhalese and Sri Lankan Tamils' than the IndianTamils' sequences. MtDNA haplogroup analysis revealed that several West Eurasian haplogroups as well as Indian-specific mtDNA clades were found amongst the Sri Lankan populations. Through a comparison with the mtDNA HVS-1 and part of HVS-2 of Indian database, both Tamils and Sinhalese clusters were affiliated with Indian subcontinent populations than Vedda people who are believed to be the native population of the island of Sri Lanka.
Morphological variations of human pulmonary fissures: An anatomical cadaveric study in Sri Lanka
(Firenze University Press, 2022) Ranaweera, L.; Sulani, W.N.; Nanayakkara, W.L.R.L.
The aim of this study was to identify morphological and morphometric variations of pulmonary fissures. A sample of 50 adult formalin fixed Sri Lankan cadaveric lungs (24 left and 26 right lungs) were observed with the help of magnifying glass and length measurements of the lung fissures were taken using a measuring tape. Complete oblique fissure was seen in 16 (66.67%) left lungs and 11 (42.3%) right lungs. Incomplete oblique fissure was seen in 8 (33.33%) left lungs and 15 (57.69%) right lungs. There was complete absent of horizontal fissure in 4 (15.38%) right lungs whereas rest of the 22 right lungs indicated incomplete horizontal fissure (84.61%). The mean lengths of the left oblique fissure, right oblique fissure and horizontal fissure were 26.88±5.88cm, 27.31±6.04 cm and 8.31±3.61 cm, respectively. Incomplete fissure was the most common variant of the fissures in the analyzed sample. There was a high prevalence of incomplete horizontal fissure of right lung followed by incomplete right and left oblique fissures. Absence of oblique fissure was not found in either left or right lungs. The mean length of right oblique fissure was slightly greater than the mean length of left oblique fissure. The knowledge lung fissures, indeed help clinicians and radiologists to identify alterations of the disease distribution and to reduce the misinterpretation of radiological modalities as well as to arrive at an accurate diagnosis with plan of management of a patient.
Morphological variations of lumbrical muscles in Sri Lankan cadavers
(IMED Research Publications, 2022) Ranaweera, L.; Wijesooriya, P.; Vithanage, S.; Cabral, E.
Introduction: Lumbricals are the small, worm-like, intrinsic muscles responsible for performing the precision pinch movements of the hand. These are quite unique in their position owing to movable proximal and distal tendon attachments. Purpose of the study: The aim of the study was to identify anomalies of lumbrical muscle present in the Sri Lankan people. Materials and Methods: A sample of 39 formalin preserved cadaveric human hands were subjected to the gross morphological study. Results: It was encountered that 59% of the lumbricals were normal in proximal and distal attachments whereas the rest of the lumbicals (41%) indicated the morphological variations. Among the hands, unipennate third lumbrical was seen in 7.7% (Left-15.7%: Right 0%) and unipennate fourth lumbrical was seen in 5.1% (Left-10.5%: Right 0%). The bipennate second lumbrical was seen in 5.1% (Left 5.3%: Right 5.1%). The 10.3% of split insertion was encountered in third lumbricals (Left 10.5%: Right 10%) as well as in fourth lumbricals (Left 5.3%: Right 15%). The third lumbrical insertion on the medial side of the middle finger was seen in 2.5% (Left 5.3%: Right 0%). Conclusion: The left hand is having more lumbrical variations than the right hand of the subjected human cadavers. The most common variation site is the insertion site. The variants are numerous in third and fourth lumbricals. The most common type of variation is the split insertion.
Morphology of the Thyroid Gland and its common variations
(12th Annual Research Symposium, University of Kelaniya, 2011) Hasan; Rizvi; de Alwis, R.P.; Herath, S.; Senadipathy, C.; Mahawaththa, T.; Karunanayake, A.; Salvin, K.A.; Fernando, P.; Ranaweera, L.; Fernado, E.; Ilayperuma, I.; Salgado, S.
The thyroid gland is an endocrine gland located in the anterior triangle of the neck across the midline. Many pathological conditions such as tumours and inflammatory diseases are associated with the thyroid gland. The incidence of thyroid diseases, with or without an indication for surgical intervention is a common occurrence in clinical practice. Hence an in-depth knowledge of the morphology of the thyroid gland and its variation is of paramount importance to clinicians. Literature surveys carried out do not reveal adequate studies relevant to the morphology of the thyroid gland and its variations in a Sri Lankan population. The aim of the study is to identify the morphology of the thyroid gland and its possible variations in the Sri Lankan population. A descriptive study was carried out by dissecting 31 human cadavers (12 female and 19 male) aged between 35-80 years in the Department of Anatomy, University of Kelaniya. Measurements were taken with Vernier Caliper. The results show thirty one thyroid glands (62 sides) were observed and measurements were taken. Average length, width and thickness of the right lateral lobes were 4.11cm, 1.25cm and 1.95 respectively. Average length, width and thickness of the left lateral lobes were 4.02cm, 1.13cm and 2.05cm respectively. Pyramidal lobe was found in 12 thyroid glands (38.7%), of which 4 were in females and 8 in males. Of these 12, in 9 glands pyramidal lobe was arising from the left lobe (75%) and the rest from the isthmus(25%). Only 83.33% of pyramidal lobes were associated with levator glandulae thyroidae and the rest were independent. Levator glandulae thyroidae was observed in 10 glands (32.25%). In three glands (9.67%) isthmus was found to be absent. Significant gender difference was not identified in the dimensions of the gland. No significant difference in dimensions was observed when compared to western figures. Presence of the pyramidal lobe is not an uncommon finding. Therefore, having a sound knowledge in morphology of the thyroid may reduce the unwarranted outcomes in thyroid surgeries in Sri Lanka.
A study of morphological and morphometric variations in Sri Lankan diaphyseal nutrient foramina of humerus
(WHO Office in Azerbaijan., 2022) Ranaweera, L.; Sulani, W.N.; Uggalla, T.
Predominantly, the nutrient artery gives the blood supply to the long bones through the nutrient foramen. The present study analyzed the morphometric and morphological variations of Sri Lankan diaphyseal nutrient foramen of the humerus concerning the number, size, location, and direction along the shaft. A sample of 50 dry adult humeri was analyzed. The mean length of the bones was 29.53cm. The mean foramen index was 55.59. The current study encountered single, double, and triple nutrient foramina as well as the absence of such foramina. Five main locations of nutrient foramina were observed along the shaft of the humerus: anteromedial surface, medial border, lateral border, anterior border, and posterior surface. The nutrient foramen directions were towards the distal end or proximal end of the humerus. Most Sri Lankan humeri had single nutrient foramen. Most humeri had nutrient foramina on the anteromedial surface on the middle third of the shaft which is directed distally. The information regarding the nutrient foramina is important for the procedures such as bone graft, bone repair, and microsurgical bone transplantation.
A Study of morphological and morphometric variations in Sri Lankan femoral diaphysial nutrient foramina [Estudio de las variaciones morfológicas y morfométricas de los forámenes nutricios diafisarios de fémur en Sri Lanka]
(Universidad de la Frontera, 2020) Ranaweera, L.; Perera, P.I.; Pathiraja, P.P.M.C.K.; Sulani, W.N.; Wijesooriya, W.A.P.S.
ABSTRACT: Blood supply to the diaphysis of long bones is majorly through nutrient artery, which enters the bone via nutrient foramen. The present study aims to identify morphological and morphometric variations of nutrient foramina of the femur, which is the largest long bone of the body extending from the pelvis to knee. A sample of 81 Sri Lankan adult femur were analyzed. The mean length of the femur analyzed was 436.93 mm and mean foramen index was 43.52. The majority of the bones had a single nutrient foramen. The predominant location of the nutrient foramen was on the posterior aspect of the bone in the middle third of the shaft according to the study. Majority of foramina were directed distally. The indices on nutrient foramen are important for procedures such as bone grafts and tumor resections, in managing trauma, orthopedic procedures and radiological interpretations. © 2020, Universidad de la Frontera. All rights reserved.
Variations in the Termination of the Human Thoracic Duct
(University of Kelaniya, 2012) Hasan, R.; Salgado, S.; Karunanayake, A.; Salvin, K.A.; Fernando, P.; Ranaweera, L.; Vithanage, S.; Wijesooriya, P.; Ilayperuma, I.; Fernando, E.
Introduction: The mammalian thoracic duct is the main lymphatic channel which drains lymph from the distal extremities of the trunk, lower limbs and the left half of the proximal trunk. In humans, it runs a typical course commencing over the twelfth thoracic vertebra and ascends through the aortic orifice of the diaphragm. It inclines to the left at the level of the Sternal angle and terminates by draining into the left jugulosubclavian junction. Objectives: Variations from this typical course are not uncommon and have been the subject of extensive research. Knowledge of the possible variations in the thoracic duct would enable accurate thoraco- cervical surgery, thus preventing inadvertent damage to the thoracic duct and consequent leakage of chyle.This research is carried out with the aim ofenhancing the existing knowledge of the possible variations of termination of the human thoracic duct while also documenting a relevant Sri Lankan study. Methodology: This research was carried out as a descriptive study in36 preserved human cadavers in the Departments of Anatomy, the University of Kelaniya and the University of Ruhuna. Results: In 22 (61.11%) cadavers the thoracic duct drained into the left jugulosubclavian junction whereas in 11 (30.56%) cadavers it drained into the left subclavian vein. Moreover, in 2(5.56%) cadavers it drained into the left internal jugular vein. Interestingly, in 1 (2.77%) cadaver thoracic duct drained into both left subclavian vein and jugulosubclavian junction through the presence of a bifurcation. Conclusion: It was apparent that majority of the findings are comparable to previous research, while there were variations in the percentage incidence of the findings.
Virtual anatomy learning through the eye of ayurveda medical students in Sri Lanka during COVID 19 pandemic.
(WHO Office in Azerbaijan., 2022) Ranaweera, L.; Samaranayake, G.V.P.; Cabral, E.
Anatomy is the foundation stone of medical education. The COVID 19 pandemic imposed unexpected disruption to Anatomy education with most universities moving regular onsite classes to the online session. The purpose of this study was to identify the perceptions of Ayurveda medical students regarding virtual or online Anatomy learning. The study was conducted on 69 second-year Ayurveda medical students using a self-administrated questionnaire. The majority of the students (92.8%) did not have prior experience in online learning (OL) before the COVID 19 pandemic. Regarding the learning activities preferred by students prior to the COVID 19, 73.9% of students preferred the live lectures from the academic staff. It was evident that 92.8% of students believed that zoom cloud meeting is the most effective method of Anatomy in the OL platform. In order to improve their Anatomy dissection knowledge, 50.7% of students were suggested to show live Gross Anatomy dissection. The OL is more successful than onsite learning for the theory of Anatomy. Access to online materials (86.9%), learning from their own places (92.7%), the ability to stay at home (95.6%), interactivity of the class (56.5%), and the ability to record a meeting (88.4%) are the key advantages of OL. Reduced Interaction with the teacher (78.2%), technical issues (92.7%), lack of interactions with their colleagues (82.6%), poor learning conditions at home (71%), and social isolation (81.1%) are the main disadvantages that they must face in their online learning process. In the era of smartphones and the internet, it was indicated that the Ayurveda medical students prefer to be engaged in the hybrid system which includes online Anatomy lectures with onsite Anatomy practicals.