Browsing by Author "Samita, S."

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Can a composite index predict ischaemic heart disease risk?
(Sri Lanka Medical Association, 2012) Ediriweera, E.P.D.S.; Samita, S.
INTRODUCTION: Ischaemic heart diseases (IHD) are the leading cause of death worldwide and it accounts for 12.2% of the total deaths globally. Although the individual risk factors of IHD are well understood, the possibility of predicting the risk of IHD of an individual at a given time is less understood. Aims: To develop an index to predict the risk of IHD based on individual biological parameters. Methods: Secondary data of 217 individuals were analysed. Multivariate and logistic regression techniques were used to construct a composite index (CI) based on standardised measurements of lipid profile, fasting blood sugar, systolic and diastolic blood pressure. Two sample ttest and 95% confidence interval based on composite index scores were used to compare the two groups and define a cutoff point. Results: Mean [±SE] of the CI scores for undiagnosed and diagnosed IHD individuals were 0.013 [+0.014] and -0.1 [±0.041] respectively. The mean scores of the two groups were significantly different (p=0.008) and the confidence intervals for undiagnosed and diagnosed groups were -0.181 to -0.019 &-0.016 to 0.042 respectively. Accordingly, cut off point was estimated as - 0.018. CONCLUSIONS: The CI score can be used to distinguish those who are at risk from those who are risk free. Since the CI is based on several variables, the tests are more powerful compared to those based on individual variables. The CI approach has to be evaluated in several other study settings for verification. With some detailed studies, working cut off point can be established.
Local recurrence of rectal cancer in patients not receiving neoadjuvant therapy - the importance of resection margins
(Sri Lanka Medical Association, 2011) Dassanayake, B.K.; Samita, S.; Deen, R.Y.I.; Wickramasinghe, N.S.A.; Hewavisenthi, J.; Deen, K.I.
OBJECTIVES : Local recurrence of rectal cancer reduces quality of life and survival. A multi-factorial linear logistic model was used to analyse risk factors for local recurrence in rectal cancer in patients not receiving preoperative chemo-radiation. METHODS : A case-control study of patients with rectal cancer having surgery with curative intent, between 1996 and 2008. Eighteen putative risk factors for local recurrence were subjected to uni-variate analysis. Significant factors were selected for multi-factorial analysis. RESULTS : Twenty-one patients with local recurrence (cases) and 78 controls were selected. Uni-variate analysis showed significant associations with recurrence for nodal stage (N) (p=0.027), metastasis (M) (p=0.009), adjuvant chemotherapy (p=0.039), positive resection margin (R) (p=0.018) and American Joint Committee for Cancer (AJCC) tumours above stage II (p=0.043). Significant uni-variate odds ratios (OR) were obtained for the same factors. Two linear logistic models were fitted as (1) N, M, R1 status and adjuvant chemotherapy and (2) AJCC stage, R1 status and adjuvant chemotherapy. From both models, the only factor significantly associated (p≤0.01) with local recurrence was found to be a positive resection margin (OR 4.81 and 5.51 respectively). CONCLUSIONS: A positive resection margin is the single factor affecting local recurrence of rectal cancer in patients not receiving neo-adjuvant therapy.
Risk of low birth weight on adulthood hypertension - evidence from a tertiary care hospital in a South Asian country, Sri Lanka: a retrospective cohort study
(BioMed Central, 2017) Ediriweera, D.S.; Dilina, N.; Perera, U.; Flores, F.; Samita, S.
BACKGROUND: Although low birth weight (LBW) is common in South Asian region there are not many studies being done to evaluate LBW and adulthood hypertension association in this region, including in Sri Lanka. Although this association has been studied in other regions, most studies have not evaluated this association in the presence of socioeconomic and lifestyle factors. This study was conducted to investigate whether low birth weight (LBW) is associated with adulthood hypertension after adjusting for other potential risk factors of hypertension. METHODS: Nearly 15,000 individuals born during 1950 to 1965 were selected and invitations were sent to their original addresses. Out of them 217 individuals responded and among them birth weight was recovered for 122 individuals. Separate linear logistic models were fitted to model high systolic blood pressure (SBP: systolic blood pressure > 140 mmHg), high diastolic blood pressure (DBP: diastolic blood pressure > 90 mmHg) and hypertension (either SBP > 140 mmHg or DBP > 90 mmHg). RESULTS: Separate linear logistic model fitting revealed LBW having a significant association with high SBP (OR = 2.89; 95% CI: 1.01 to 8.25; P = 0.04), and hypertension (OR = 3.15; 95% CI: 1.17 to 9.35; P = 0.03), but not with high DBP (OR = 0.75; 95% CI: 0.22 to 2.16; P = 0.62), when effect of LBW was studied after adjusting for all other potential risk factors. CONCLUSIONS: LBW has a tendency to cause high adult blood pressure in South Asian region, and the findings are consistent with previous work on LBW and adulthood hypertension association in other regions of the world.
Young patients with colorectal cancer have poor survival in the first twenty months after operation and predictable survival in the medium and long-term: analysis of survival and prognostic markers
(BioMed Central, 2010) Chan, K.K.; Dassanayake, B.; Deen, R.; Wickramarachchi, R.E.; Kumarage, S.K.; Samita, S.; Deen, K.I.
OBJECTIVES: This study compares clinico-pathological features in young (<40 years) and older patients (>50 years) with colorectal cancer, survival in the young and the influence of pre-operative clinical and histological factors on survival. MATERIALS AND METHODS: A twelve-year prospective database of colorectal cancer was analysed. Fifty-three young patients were compared with forty-seven consecutive older patients over fifty years old. An analysis of survival was undertaken in young patients using Kaplan Meier graphs, non-parametric methods, Cox's Proportional Hazard Ratios and Weibull Hazard models. RESULTS: Young patients comprised 13.4 percent of 397 with colorectal cancer. Duration of symptoms and presentation in the young was similar to older patients (median, range; young patients; 6 months, 2 weeks to 2 years, older patients; 4 months, 4 weeks to 3 years, p > 0.05). In both groups, the majority presented without bowel obstruction (young--81%, older--94%). Cancer proximal to the splenic flexure was present more in young than in older patients. Synchronous cancers were found exclusively in the young. Mucinous tumours were seen in 16% of young and 4% of older patients (p < 0.05). Ninety-four percent of young cancer deaths were within 20 months of operation. At median follow up of 50 months in the young, overall survival was 70% and disease free survival 66%. American Joint Committee on Cancer (AJCC) stage 4 and use of pre-operative chemoradiation in rectal cancer was associated with poor survival in the young. CONCLUSION: If patients, who are less than 40 years old with colorectal cancer, survive twenty months after operation, the prognosis improves and their survival becomes predictable.