Browsing by Author "Undugodage, C."

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    Anaphylaxis: the “killer allergy”
    (Ceylon College of Physicians, 2016) Wijekoon, C.N.; Undugodage, C.; Fernando, D.; Atapattu, P.; Malavige, G.N.; Ranawaka, U.K.
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    Low-dose melatonin for sleep disturbances in early-stage cirrhosis: A randomized, placebo-controlled, cross-over trial
    (John Wiley & Sons Australia Ltd, 2020) de Silva, A.P.; Niriella, M.A.; Ediriweera, D.S.; de Alwis, J.P.N.; Liyanage, I.K.; Ettickan, U.; Liyanapathirana, K.V.; Undugodage, C.; de Silva, H.A.; de Silva, H.J.
    BACKGROUND AND AIM: Melatonin is used to treat sleep disturbances (SDs). The aim of this study was to investigate the safety and efficacy of low-dose melatonin for SDs in early-stage cirrhosis. METHODS: In a single-center, randomized, double-blind, placebo-controlled, cross-over clinical trial, patients with early-stage (Child-Turcotte-Pugh [CTP] class A or B) cirrhosis with SDs, without hepatic encephalopathy, were randomized to placebo or 3 mg of melatonin for 2 weeks. After 2 weeks, the patients were given a washout period of 1 week and crossed over to melatonin or placebo for a further 2 weeks. The Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS) were used to measure sleep quality and daytime sleepiness, respectively. Analysis of results was based on intention to treat, and linear mixed-effect models were used to evaluate the effect of melatonin. Analysis was conducted using R-programming language 3.5.1. RESULTS: Seventy-one patients were recruited (mean age: 61.9 ± 8.7 years, males: 46 [64.8%], and CTP Class A = 52 [73.2%] and Class B = 19 [26.8%]). Sixty patients completed the study (mean age: 61.7 ± 8.8 years, males: 40 [66.6%], and CTP Class A = 45 [75.0%] and Class-B = 15 [25.0%]). Two patients dropped out due to adverse events. Nine patients were lost to follow up. Patients given melatonin had a significantly lower PSQI and ESS compared to both pretreatment (P < 0.001) and postplacebo scores (P < 0.001). Incidence of adverse events was similar (two each of abdominal pain, one each of headache, one each of dizziness) in both groups. CONCLUSION: Melatonin seems safe and effective for use in patients with SDs in early-stage cirrhosis in the short term. However, larger and longer-term studies to assess efficacy and safety are required before its clinical use can be recommended. KEYWORDS: cirrhosis; clinical trial; melatonin; sleep disturbances; treatment.
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    Screening for risk of obstructive sleep apnoea - results of an island wide survey in Sri Lanka
    (Journal of the Ceylon College of Physicians, 2019) Undugodage, C.; Amarasiri, L.; Kamalanathan, M.; Gunasinghe, W.; Sadikeen, A.; Fernando, A.; Wickremasinghe, R.; Gunasekera, K.
    INTRODUCTION: Obstructive sleep apnoea (OSA) is the commonest sleep related breathing disorder worldwide, but there is only limited community level data on the risk of OSA from South Asian countries. AIMS AND OBJECTIVES: This study assessed the community prevalence of persons at high-risk for OSA among Sri Lankan adults. METHODS: A randomly selected sample of adults from 7 (out of 9) provinces of Sri Lanka was screened using the Berlin Questionnaire (BQ). BQ has 3 categories related to snoring severity (category 1), excessive day time somnolence (category 2) and history of hypertension or obesity (category 3). Individuals were classified as high or low risk according to the category score. RESULTS: One thousand six hundred and eight adults (46.2% male) were screened, and 270 were classified as high risk for OSA {16.8%; 95% Cl 14.9 %-18.6% (15.1% in males; 18.3% in females, p >0.05)}. Of the high-risk individuals, 239 (88.5%) were category 1 positive, 142 (52.6%) category 2 positive and 202 (74.8%) category 3 positive. 49/577 (8.5%) among persons = or <40 years and 221/ 1031 (21.4%) among those >40 years were at high risk. 10.3% of the adults had a BMI ≥30 (5.7% of males, 14% of females p<0.001). Snoring was reported by 573 (35.6%) individuals; 120 of them (20.9%) had apneas during sleep. CONCLUSION: The prevalence of high risk for OSA in this Sri Lankan community survey is lower than that reported from Western countries and did not show a gender-related difference.