Browsing by Author "Senanayake, H."

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Association between heavy metals and endometriosis; results of a preliminary study
(Sri Lanka College of Obstetricians and Gynaecologists, 2010) Senanayake, H.; Peiris-John, R.; Wickremasinghe, A.R.; Wadugtf, V.
OBJECTIVE: To determine the association between heavy metal concentrations in whole blood and ectopic endometrial tissue in endometriosis. DESIGN, SETTING, METHODS: A case-control study was conducted in a tertiary care setting to compare heavy metal concentrations in whole blood among those with and without endometriosis. Endometriosis was confirmed by laparoscopy or laparotomy (n=14). There were 11 age matched controls who had no evidence of the disease. Informed written consent was obtained pre-operatively. Blood samples were collected from all participants. Ectopic endometrial tissue samples were obtained from 10 cases by a single surgeon. After measuring the wet weight, whole blood samples and ectopic endometrial tissues were digested with supra pure 65% HNO3 and analyzed for heavy metals by the Total Reflection X-ray Fluorescence (TXRF) technique. Means of the log transformed metal levels were compared using t-tests. RESULTS: Mean (+SD) blood levels of nickel in the cases (2.19±0.45 PPB) was significantly higher than in the controls (0.65±0.14 PPB, p=0.029). The mean (+SD) lead levels in the cases (21.85±1.99 PPB) and controls (17.85 ±1.5 PPB) were similar (p=0.378). Tissue samples had higher mean (+SD) levels of nickel (9.3±15.31 PPB) and lead (18.16 ±1.58 PPB) as compared to blood levels of nickel (0.502±0.406 PPB) and lead (66.60+10.37 PPB), respectively, which were statistically significant {p<0.05 for both nickel and lead). CONCLUSIONS: Nickel is known to exert oestrogenic effects. Patients with endometriosis had higher levels of nickel; there is evidence that nickel accumulates in endometrial tissues. Further studies with a larger sample size are needed to determine if nickel is an aetiological factor of the disease in our population.
Cadmium a metalloestrogen: are we convinced?
(Wiley, 2012) Silva, N.; Peiris-John, R.; Wickremasinghe, R.; Senanayake, H.; Sathiakumar, N.
Metalloestrogens are inorganic metal ions that bind to and activate oestrogen receptors. They are implicated in the aetiology of oestrogen-dependent diseases such as cancers of the breast and endometrium as well as endometriosis. Cadmium is one of the most studied metalloestrogens. In this review, scientific evidence for the oestrogenic effects of cadmium is critically evaluated to determine if there is sufficient evidence to support cadmium as an aetiological factor of oestrogen-dependent disease in humans. Results of the review indicated that, although the in vitro and in vivo evidence of the oestrogenic properties of cadmium was persuasive, evidence from population-based human studies remains conflicting. Considerable knowledge gaps exist on the potential oestrogenic effect of cadmium in humans. Research that focuses on bridging these knowledge gaps would be useful in preventing and managing oestrogen-dependent disease in humans
Difficult caesarean delivery
(Taylor and Francis Group, 2021) Padumadasa, S.; Senanayake, H.
No abstract available
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.
Intra-uterine fetal blood transfusion
(Sri Lanka Medical Association, 2012) Dias, T.; Senanayake, H.; Ruwanpura, L.; Pathirana, P.; Dissanayake, P.
No aAbstract Available
Maternal mortality and morbidity: epidemiology of intensive care admissions in pregnancy
(Elsevier, 2013) Senanayake, H.; Dias, T.; Jayawardena, A.
Maternal mortality reviews are used globally to assess the quality of health-care services. With the decline in the number of maternal deaths, it has become difficult to derive meaningful conclusions that could have an impact on quality of care using maternal mortality data. The emphasis has recently shifted to severe acute maternal morbidity (SAMM), as an adjunct to maternal mortality reviews. Due to its heterogeneity, there are difficulties in recognising SAMM. The problem of identifying SAMM accurately is the main issue in investigating them. However, admission to an intensive care unit (ICU) provides an unambiguous, management-based inclusion criterion for a SAMM. ICU data are available across health-care settings prospectively and retrospectively, making them a tool that could be studied readily. However, admission to the ICU depends on many factors, such as accessibility and the availability of high-dependency units, which will reduce the need for ICU admission. Thresholds for admission vary widely and are generally higher in facilities that handle a heavier workload. In addition, not all women with SAMM receive intensive care. However, women at the severe end of the spectrum of severe morbidity will almost invariably receive intensive care. Notwithstanding these limitations, the epidemiology of intensive care admissions in pregnancy will provide valuable data about women with severe morbidity. The overall rate of obstetric ICU admission varies from 0.04% to 4.54%