Browsing by Author "Weerasinghe, A."

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Allergic sensitization in children
(The Sri Lanka College of Paediatricians, 2008) Amarasekera, N.D.D.M.; Gunawardena, N.K.; de Silva, N.R.; Weerasinghe, A.
BACKGROUND :Allergic sensitization is considered a significant risk factor for the development of atopic diseases. Appropriate allergen avoidance measures can be taken only when the pattern of sensitization to allergens in a particular population is known. No data is available regarding allergic sensitization among Sri Lankan children. OBJECTIVE: To identify the common allergens causing sensitization in a selected group of schoolchildren. DESIGN, SETTING AND METHOD: A cross-sectional study was carried out in 640 children in grade 5 (age group 9-11 years), from 17 schools in the Western Province. Data regarding atopic diseases was collected using the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. Specific IgE was estimated by ImmunoCAP method for five common aeroallergens (the dust mites Dermatophagoides pteronyssinus and Blomia tropicalis, cockroach, cat epithelium and dander, grass pollen) in a sub-sample of 203. RESULTS: Aeroallergen sensitivity was detected in 163 (80.3%) children. No significant difference for sensitization between boys and girls was noted (P= 0.549). The pattern of allergens in the two groups was similar. Mite allergen sensitivity was the most prevalent (B. tropicalis 84.0%, D. pteronyssinus 69.9%), followed by cockroach (67.5%), cat dander (46.0%) and grass pollen (35.6%). Twenty seven (13.3%) children were sensitized to all allergens tested; 28 (13.8%) children were sensitized to only one allergen; and 68.7% were sensitized to both B. tropicalis and D. pteronyssinus. Children with rhinitis or eczema (but not those with asthma) were significantly more likely to show sensitization to cat dander than asymptomatic controls (P=0.02 and P=0.002 respectively), but not to other allergens. The likelihood of being sensitized to one allergen was well correlated with sensitization to other allergens as evident by the significant correlation coefficients. CONCLUSION: Mites and cockroaches were the most common aeroallergens causing sensitization among schoolchildren in the Western Province.
Assessment of pollution status of Crocodylus porosus and human-crocodile relationship in Bellanwila-Attidiya area
(Department of Zoology and Environmental Management, University of Kelaniya, 2015) Dissanayake, S.; Nawalage, S.K.; Kowshayini, P.; Panagoda, G.; de Silva, A.; Subanky, S.; Nuwan, D.; Weerasinghe, A.; Bellanthuduwa, A.; de Silva, S.
Association between serum total IgE, allergic diseases and geohelminth infections in Sri Lankan children
(BioMed Central, 2007) Amarasekera, N.D.D.M.; Gunawardena, N.K.; de Silva, N.R.; Douglass, J.; O’Hehir, R.E.; Weerasinghe, A.
BACKGROUND: Elevated levels of total IgE (tIgE) in serum are characteristic of allergic diseases. Levels of tIgE are influenced by genetic predisposition, age, sex and helminth infections. However, the association between tIgE and allergic diseases in children living in areas endemic for helminth infections is not clear. The aim of our study was to assess the relationship between tIgE, allergic diseases and geohelminth infections in children. METHODS: A total of 640 schoolchildren 9Y11 years of age was selected by stratified random sampling. Data regarding allergic diseases (asthma, rhinitis and eczema) were collected by a standard questionnaire given to the parent or guardian. Screening for helminth infections was done by examining their fresh stool samples by modified Kato-Katz technique. Serum tIgE was measured by Fluoroenzymeimmunoassay in 67 geohelminth-positive subjects and in a comparable group of geohelminth-negative subjects. RESULTS: The mean age in the study population was 10 years (SDT0.3). The prevalence of geohelminth infection was 15.5%. Trichuris trichiura (14.3%) was the most common followed by Ascaris lumbricoides (4.2%) and hookworm (0.2%). Mixed infection was detected in 20.3% of infected children. Infection intensity was light in 68.9% of infected children while 28.4% and 2.7% showed moderate and heavy infection respectively. The cumulative prevalence of allergic diseases was 33.7%. Prevalence of asthma, rhinitis and eczema was 17%, 21.4% and 5% respectively. Serum tIgE concentrations showed a positively skewed distribution. Geometric mean (GM) for tIgE for the geohelminth infected group (1039.9kU/L) was significantly higher than that of the non-infected group (575.4kU/L) (p = 0.004). It was also higher in the allergic group (933.3kU/L) than in the non-allergic group (639.7kU/L) but the difference was not statistically significant (p = 0.068). The GM for tIgE for non-allergic children in the study population was much higher than that seen in non-allergic children in developed countries. CONCLUSION: Serum tIgE concentration was strongly associated with the presence of geohelminth infections in children. Serum tIgE may not be a useful marker for allergic diseases in children living in areas endemic for geohelminth infections. © 2007 World Allergy Organization
Detection of micrometastases in lymph nodes using reverse transcription polymerase chain reaction (RT-PCR) for cytokeratin 20 (CK-20)--a pilot study
(Sri Lanka Medical Association, 2010) Wijesuriya, S.R.E.; Kuruppuarachchi, K.G.; Weerasinghe, A.; Hewavisenthi, J.; Deen, K.I.
OBJECTIVES: The aim of the study was to detect micrometastases in lymph nodes in patients with rectal cancer following neoadjuvant therapy, staged node negative by routine histology. PATIENTS AND SETTING: Mesenteric lymph nodes from patients who have undergone neoadjuvant therapy for rectal cancer were harvested during surgery. Nodes were bisected and one half was sent for haematoxylin and eosin (H&E) staining and evaluated by a single pathologist. The other half was examined for CK20 by RT-PCR. The technique was validated by testing mesenteric lymph nodes with known metastases and nodes from patients without cancer. Twenty one lymph nodes from 6 patients (median age 46 years, range 25- 55) which were negative for tumour deposits by H&E stain were assessed for micro-metastases. RESULTS: All 21 nodes which were histologically negative for metastases were positive for micrometastases. Two nodes with known metastases were positive for CK20 and 3 nodes from non cancer patients were negative for CK20.CONCLUSIONS: Detection of CK20 is accurate in identification of rectal cancer micro-metastasing to lymph nodes. Assessment of nodes by H & E histology risks under staging
Detection of micrometastasis in LYMPH nodes using reverse transcription polymerase chain reaction (RT-PCR) for Cytokeratin 20 (CK-20): are we under staging rectal cancer
(The College of Surgeons of Sri Lanka and SAARC Surgical Care Society, 2003) Wijesuriya, S.R.E.; Kuruppuarachchi, K.O.R.; Deen, K.I.; Weerasinghe, A.; Ramesh, R.; Hewavisenthi, J.
INTRODUCTION: Postoperative adjuvant chemotherapy in rectal cancer is determined by the presence of metastases in lymph nodes. Detection of LYMPH node metastases is routinely performed by light microscopy. Conventional histology may not detect all metastases especially following neoadjuvant therapy (NAT). CK-20 is a cytokeratin known to be specific to colonic epithelium which may help detection of rectal cancer metastases in lymph nodes. OBJECTIVE: To detect micro metastases in lymph nodes in patients with rectal cancer. staged node negative by routine histology. METHODS: Mesenteric lymph nodes from patients who have undergone NAT for rectal cancer were harvested during surgery. Nodes were bisected and one half sent for Haernatoxylin and eosin (H&E) staining and evaluated by a single pathologist, while the other half was examined for CK 20 by RT-PCR. The technique was validated by testing lymph nodes with known metastases and nodes from patients without cancer. 21 lymph nodes from 6 patients (median age 46 years, range 25-55) which were negative for tumour deposits by H&E stain were assessed for micro metastases. RESULTS: All 2 l nodes which were histologically negative for metastases were positive for micro metastases (positive predictive value l 00%) whilst 2 nodes with known metastases were positive for CK-20, 3 nodes from non-cancer patients were negative for CK-20. CONCLUSION: Detection of CK-20 is accurate in identification of micro metastases of rectal cancer to lymph nodes. Assessment of nodes by H&E histology risks under staging lymph node micro metastases in rectal cancer.
The detection of the expression of Keratin 19 and Keratin 20 genes in the diagnosis of micrometastases of colonic cancers
(Sri Lanka Medical Association, 2003) Weerasinghe, A.; Kuruppuarachchi, G.; Wijesuriya, R.; Hewavisenthi, J.; Deen, K.I.
OBJECTIVE: Keratin 19(K-19) and Keratin 20(K-20) genes are expressed in the epithelial tissues while they are absent in lymphoid-tissues. Therefore the expression of these foreign genes in lymph nodes is used in the diagnosis of micrometastases. We investigated the expression of K19 and K2C in the diagnosis of micrometastases of colonic cancer. DESIGN, SETTING AND METHODS: Regional lymph nodes of patients with colonic cancer (n = 5) were obtained from University Surgical Unit of Ragama. Two corresponding lymph nodes from non-cancer patients and colonic tumor tissue were used as negative and positive control respectively. De-ionized water was used as blank control. Lymph nodes were collected directly to the RNA extracting media (Isogen) during the surgery. Specimens were transported to Medical Research Institute within one hour at 4 C. cDNA was synthesized using reverse transcriptase and K19 and K20 primers were used to detect the expression of these genes. PCR products were identified using agarose gel electrophoresis after amplification using the thermal cycler (Perkin Elmer). (3-actin primer was used for internal quality control. RT/PCR findings were compared with the routine histological findings of the patients. RESULTS: Lymph nodes of all five patients with colonic cancers and the colonic cancer tissues were positive for the expression of K19 and K 20. Both control lymph nodes were negative for the expression of K-19 and K-20. All the patients with colonic cancers were negative on histology of the lymph node biopsies. CONCLUSION: These findings suggest that the detection of the expression of K19 and K20 help to identify the metastases, which are negative on histology.
The Effect of intestinal nematode infections on atopic diseases in children
(Allergy and Immunology Society of Sri Lanka, 2009) Amarasekera, N.D.D.M.; Gunawardena, N.K.; de Silva, N.R.; Douglas, J.; O'Hehir, R.; Weerasinghe, A.
BACKGROUND : The effect of helminth infections on atopic diseases and allergic sensitization is controversial. Little is known about the effect of infection on atopic diseases in children living in areas where both intestinal nematodes and Toxocara infections are prevalent. OBJECTIVE : To examine the association between atopic diseases and helminth infection among children exposed to both intestinal nematodes and Toxocara. METHODS: Children attending grade 5 (age group 9-11 years) in 17 schools in the Western Province of Sri Lanka were recruited. The association of atopic diseases (asthma, rhinitis, eczema) with active intestinal nematode infections (excreting eggs in faeces) and with exposure to Toxocara (specific IgG antibodies in serum) was investigated. A child was deemed sensitized if positive for at least one of the allergens tested (Dermatophagoides pteronyssinus, Blomia tropicalis, cockroach, cat epithelium, grass pollen), based on specific IgE levels in serum. RESULTS: A total of 640 children participated in the study; serum analysis was done in 203. Active intestinal nematode infection appeared to reduce the risk of atopic diseases (OR 0.47, P=0.016) whereas Toxocara exposure did not (OR 0.85 P=0.602). When specific IgE levels against Blomia tropicalis, the most common allergen in the study group (67.5%), were expressed as percentages of the total IgE levels for each child, infected children had significantly lower levels compared to uninfected children (P=0.001). CONCLUSIONS : Intestinal nematode infections seem to protect against atopic diseases in children in Sri Lanka. Polyclonal IgE synthesis may be involved in this protection.
The effect of nutrition on immune response in active pulmonary Tuberculosis
(Sri Lanka College of Microbiologists, 2006) Wijesuriya, M.T.W.; Weerasinghe, A.
INTRODUCTION: Studies identifying the active components of immune response against TB should consider the confounding effects of malnutrition and anaemia, which are known to impair cell-mediated immunity. OBJECTIVES: To compare nutritional status (malnutrition and anaemia) and immune status (lymphocyte subpopulations) of patients with Active Pulmonary Tuberculosis (ATB) with healthy controls 2.To describe the effect of nutritional status on immune response to ATB. METHODS: A cross-sectional, comparative study involving 49 smear-positive TB patients (41 males, median age 35 yrs) and 49 controls (25 males, median age 34yrs) was carried out. Persons with immunosuppress!on (HIV infection, diabetes mellitus, corticosteroid or immunosuppressive therapy) or on nutritional supplementation were excluded. Nutritional status was assessed using anthropometry, haemoglobin and red-cell indices. Labeled monoclonal antibodies against lymphocyte surface markers were used in dual parameter flow-cytometry to quantify (cells/mm3) total T(CD5), T-helper(CD4), T-cytotoxic(CDS), B(CD19), B1(CD19+CD5), Natural-killer(CD56), Natural-Killer-T(CD56+CD3)lymphocytes. Student t-test or Kruskal-wallis test for 2 groups was used where appropriate. p<0.05 was considered significant. RESULTS: Whilst nutritional status assessed by weight (43 vs 57 kg, p<0.001), mid-arm circumference (21.1 vs 27.6 cm, p<0.001) and body mass index (16 vs 20.7 kg/m2, p<0.001) was lower in ATB, anaemia was greater (61.2% vs 12.2%, p<0.001). Means of total lymphocytes (2,475 vs 3,211; p<0.0001) and most lymphocyte subsets (T, CD4, CDS, B and Bl cells) were significantly lower in patients with ATB (n-49) compared to controls (n=49). There was no statistically significant difference in the total lymphocytes, T, CD4, CDS, B, Bl, NK and NKT cells in undernourished TB patients (BMI< 18.5) and anaemic TB patients compared to well-nourished and non-anaemic TB patients. CONCLUSIONS: Malnutrition and anaemia observed in ATB does not have an impact on the peripheral depletion of lymphocyte subsets.
Expansion of unconventional T cells with natural killer markers in malaria patients
(Elsevier, 2003) Watanabe, H.; Weerasinghe, A.; Miyaji, C.; Sekikawa, H.; Toyabe, S.; Mannor, M.K.; Morshed, S.R.; Halder, R.C.; Kobayashi, J.; Toma, H.; Sato, Y.; Iwai, K.; Matsuoka, H.; Abo, T.
Immunological states during human malarial infection were examined. In parallel with parasitemia and anemia, granulocytosis was induced in the blood of patients, especially those infected with Plasmodium (P.) falciparum. At that time, the level of lymphocytes remained unchanged or slightly increased in the blood. However, the distribution of lymphocyte subsets was modulated, showing that the proportion of CD56(+)T cells, CD57(+)Tcells, and gammadeltaT cells (i.e. all unconventional T cells) had increased in patients infected with P. falciparum or P. vivax. This phenomenon occurred at the early phase of infection and disappeared in the course of recovery. The data from patients with multiple attacks of P. vivax infection showed that there was no augmentation of these responses. In adult cases, the increase in the proportion of unconventional T cells seemed to closely parallel disease severity. However, all these responses were weak in children, even those infected with P. falciparum. In conjunction with accumulating evidence from mouse malaria experiments, the present results suggest that the immunological state induced by malarial infection might mainly be an event of unconventional T cells and that the immunological memory might not be long-lasting, possibly due to the properties ofunconventional T cells.
Extrathymic T cells in human malaria patients
(Elsevier, 1998) Watanabe, W.; Weerasinghe, A.; Miyaji, C.; Sekikawa, H.; de Silva, N.R.; Gunawardena, S.; Ratnayake, H.; Kobayashi, J.; Thoma, H.; Sato, Y.; Abo, T.
High serum total IgE in children in geohelminthic endemic setting
(Sri Lanka Medical Association, 2008) Amarasekera, N.D.D.M.; Gunawardena, N.K.; de Silva, N.R.; Weerasinghe, A.
BACKGROUND: Elevated levels of total IgE (tlgE) in serum are characteristic of atopic diseases. However, the usefulness of tlgE in diagnosing atopic diseases in children living in areas endemic for helminth infections is not well established. OBJECTIVE: To assess the effect of geohelminth infections on serum tlgE levels in children with atopic diseases. DESIGN, SETTING AND METHODS: A total of 640 children in grade 5 were recruited from 17 schools in the Western Province. Data regarding atopic diseases were collected by a standard questionnaire. Screening for helminth infections was done by examining their stool samples by modified Kato-Katz technique. Serum tlgE was measured by fluoroenzymeimmunoassay. RESULTS: The mean age in the study population was 10 years (SD±0.3). The prevalence of geohelminth infection was 15.5%. Trichuris trichiura (14.3%) was the most common, followed by Ascaris lumbricoides (4.2%) and hookworm (0.2%). Mixed infection was detected in 20.3% of infected children. The cumulative prevalence of atopic diseases was 33.7%. Prevalence of asthma, rhinitis and eczema was 17%, 21.4% and 5% respectively. Geometric mean (GM) for tlgE for the geohelminth infected group (1039.9kU/L) was significantly higher than that of the non-infected group (575.4kU/L) (p=0.004). It was also higher in the allergic group (933.3kU/L) than in the non-allergic group (639.7kU/L) but the difference was not statistically significant (p=0.068). CONCLUSION: In the presence of geohelminth infections, raised IgE may be due to geohelminth infection or atopic diseases or both. Therefore, serum tlgE may not be a useful marker for allergic diseases in children living in areas endemic for geohelminth infections.
Impact of helminth infection on childhood allergic diseases in an area in transition from high to low infection burden
(Asia Pacific Association of Allergy, Asthma and Clinical Immunology, 2012) Amarasekera, M.; Gunawardena, N.K.; de Silva, N.R.; Douglass, J.A.; O Hehir, R.E.; Weerasinghe, A.
BCKGROUND: The effect of helminth infections on allergic diseases is still inconclusive. Furthermore, the effect of helminth infections on childhood allergic diseases in a tropical area where prevalence of helminth infections has undergone dramatic changes is not well documented. OBJECTIVE: To investigate the relationship between allergic diseases and helminth infection in a cohort of schoolchildren in an area that has undergone dramatic changes in intensity of helminth infections. METHODS: Children attending grade 5 were recruited from 17 schools in Western Province of Sri Lanka. They were assessed for allergic diseases using the International Study of Asthma and Allergies in Childhood questionnaire. Their serum total IgE (tIgE) and allergen-specific IgE (sIgE) for five common aeroallergens were measured by ImmunoCAP® method and stools were examined for the presence of helminth infections. RESULTS: A total of 640 children (mean age 10 years) were recruited to the study. Of them, 33.7% had evidence of allergic disease and 15.5% had helminth infections. Majority of infections (68.9%) were of low intensity. A significant relationship between allergic disease and helminth infections was not observed, however, a trend toward protective role of helminth infections against allergic diseases was noted. Multivariate analysis showed helminth infections to be an independent predictor of high tIgE levels whereas allergic disease was not. Allergic sensitization (atopy) was a significant risk factor for allergic disease only among non-infected children (odds ratio 3.025, p = 0.022) but not in infected children. The ratio of sIgE to tIgE was higher in non-infected children. CONCLUSION: Though not significant, a reduced risk of allergy in helminth-infected children was observed in this population. A Decrease in intensity of helminth infections may have contributed to the reduced capacity of immune-modulation by helminths in this paediatric population.
Management of urticaria
(State Pharmaceuticals Corporation, 2006) Weerasinghe, A.
No Abstract Available
Presenting symptoms/conditions and selected aspects of health care quality at the Outpatient Department (OPD) of the Wickramarachchi Ayurvedic Hospital, yakkala
(College of the Community Physicians of Sri Lanka, 2007) Wanigasekara, C.; Weerasinghe, P.; Weerasinghe, A.; Weerasooriya, S.; Wellagiriya, S.; Wickramarathne, S.; Wijerathne, B.; Abeysena, C.
OBJECTIVE: To describe the presenting symptoms/conditions and selected aspects of health care quality of the Outpatient Department (OPD) of the Wickramarachchi Ayurvedic Hospital. METHODOLOGY: A descriptive cross sectional study was conducted on patients seeking treatment from the CPD oi the Wickramarachchi Ayurvedic Hospital. Yakkala between February to April 2007. A pre-tested interviewer administered questionnaire was used to gather information from 250 patients. RESULTS: Fever, cold and respiratory symptoms (44.2%; n=46), musculoskeletal complaints (28.8%; n=30) and dermatological conditions (14.4%; n=15) were the commonest presentations among persons up to 40 years old. Musculoskeletal complaints (26.8%; n=38). lever, cold and respiratory symptoms (24.6%; n=35) diabetes and hypertension (20.4%; n=29) and eye problems (9.8%; n=14) were the commonest presentations among persons above 40 years. Out of 250 patients, 56(22.4%) had visited the Ayurvedic Hospital as the first preference for the current illness and the balance 194(77.6%) patients had taken treatment from other health care institutions. The majority (86%: =168) sought ayurvedic medicine after taking western medicine. The most common reason for giving up previous treatment methods was treatment failure (69%; n=135). The distance between home and the hospital was <10 km for 52.4%(n=137) patients and >20 km for 11.6%(n=54) patients. Median total expenditure for one visit to the Ayurvedic hospital was Rs.200 (Range Rs. 00500 to 3000.00) and 57.6%(n=144) had spent Rs.100-500 for one visit. Median waiting time for consultation was 90 minutes (Range 5 — 300min). Consultation time was <5 minutes in 52%(n=131) and >10minutes in 24%(n=60) of patients. Two hundred and seven (83%) patients were satisfied with treatment given and 224 (69.6%) on facilities provided by the Ayurvedic hospital. Statistically significant associations were observed between high satisfaction and low educational level (p<0.001) and previous treatment failure from other systems (p<0.001). CONCLUSION: Patients seek ayurvedic treatment for various symptoms/diseases irrespective of their severity. patient's age and the distance to the hospital. The commonest reason for seeking ayurveda treatment was treatment failure at other methods. A majority were satisfied with the treatment provided and facilities available.
Prevalence of atopic diseases among school children in Western Province
(University of Kelaniya, 2007) Amarasekera, N.D.D.M.; Gunawardena, N.K.; de Silva, N.R.; Weerasinghe, A.
Background : Atopic diseases such as asthma, rhinitis and eczema in children are major public health problems in developed, industrialized countries as well as in some developing countries. Our objective was to assess the prevalence of atopic diseases in schoolchildren in grade 5 in the Western Province of Sri Lanka. Method : Schoolchildren in grade 5 were selected by stratified - random sampling frbm 17 schools in the Western Province. Internationally validated ISAAC (International Study of Asthma and Allergies in Childhood) questionnaire, filled by the parent or guardian was used to collect details regarding atopic diseases. Results : A total of 640 schoolchildren were recruited. Five hundred ~nd eleven (79.8%) returned the completed questionnaire. The mean age was I 0 years (SD ± 0.3) and 55.9% of the study population was boys. Prevalence of asthma, rhinitis and eczema was 17%, 21.4% and 5% respectively, while 33.7% had one or more diseases, Thirty three (21.4%) of the children with an atopic disease was on long term treatment. Only the prevalence of allergic rhinitis showed a statistically significant difference between the two sexes, being more common in boys. Less than 30% of affected children's parents recognized that their child had either asthma or rhinitis, whereas a higher number of parents (54.2%) recognized that their child had eczema. Among children with asthma, 44.4% had rhinitis and wheezing was severe enough to disturb their sleep in 52.4% of children. Conclusion: One in 3 children in grade 5 had either asthma or rhinitis or eczema, but parental recognition of these conditions was poor. Atopic diseases are a significant health problem among schoolchildren in the Western Province.
Prevalence of childhood atopic diseases in the Western Province of Sri Lanka
(Sri Lanka Medical Association, 2010) Amarasekera, N.D.D.M.; Gunawardena, N.K.; de Silva, N.R.; Weerasinghe, A.
BACKGROUND: Atopic diseases in children are major public health problems around the world and the prevalence is increasing. Our objective was to assess the prevalence of atopic diseases in schoolchildren in the Western Province of Sri Lanka. METHODS: Children attending grade 5 in 17 schools in the Western Province of Sri Lanka were recruited to the study. Data were collected using the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire, which was filled by the parent/guardian of the selected children. RESULTS: A total of 640 schoolchildren were recruited. Their mean age was 10 years (SD +/- 0.5) and 55.9% of the study population was boys. Prevalence (95% CI) of asthma, rhinitis and eczema was 17% (13.7-20.3), 21.4% (17.8-25.1) and 5% (3.1-7.0) respectively, while 33.7% (29.6-37.9) had one or more diseases. Only the prevalence of allergic rhinitis showed a statistically significant difference between the two sexes, being more common in boys. Less than 30% of affected children's parents recognised that their child had either asthma or rhinitis, whereas a higher number of parents (54.2%) recognised that their child had eczema. Among children with asthma, 44.4% had rhinitis. CONCLUSIONS: The prevalence of atopic diseases in schoolchildren in grade 5 in the Western Province of Sri Lanka is as common as in other countries in the south Asian region. Parental recognition of these conditions was not satisfactory
Reduced risk of atopic diseases among schoolchildren infected with intestinal Nematodes
(Federation of Immunology Societies of Asia-Oceania, 2008) Amarasekera, N.D.D.M.; Gunawardena, N.K.; de Silva, N.R.; Pathmeswaran, A.; Douglass, J.; O’Hehir, R.; Weerasinghe, A.
BACKGROUND: The effect of helminth infections on atopic diseases and allergic sensitization is controversial. Little is known about the effect of infection on atopic diseases in children living in areas where both intestinal nematodes and Toxocara infections are prevalent. OBJECTIVE : To examine the association between atopic diseases and helminth infection among children exposed to both intestinal nematodes and Toxocara. METHODS: Children attending grade 5 (age group 9-11 years) in 17 schools in the Western Province of Sri Lanka were recruited. The association of atopic diseases (asthma, rhinitis, eczema) with active intestinal nematode infections (excreting eggs in faeces) and with exposure to Toxocara (specific IgG antibodies in serum) was investigate. A child was deemed sensitized if positive for at least one of the allergens tested (Dermatophagoides pteronyssinus, Blomia tropicalis, cockroach, cat epithelium, grass pollen), based on specific IgE levels in serum. RESULTS : A total of 640 children participated in the study; serum analysis was done in 203. Active intestinal nematode infection appeared to reduce the risk of atopic diseases (OR 0.47, P=0.0I6) whereas Toxocara exposure did not (OR 0.85, P=0.602). When specific IgE levels against Blomia tropicalis, the most common allergen in the study group (67.5%), were expressed as percentages of the total IgE levels for each child, infected children had significantly lower levels compared to uninfected children (P=0.001). CONCLUSIONS : Intestinal nematode infections seem to protect against atopic diseases in children in the tropics. Polyclonal IgE synthesis may be involved in this protection.
Sensitization pattern of allergens among adolescent school children with asthma in a district of Sri LankaSensitization pattern of allergens among adolescent school children with asthma in a district of Sri Lanka
(Sri Lanka Medical Association, 2009) Danansuriya, M.N.; Rajapakse., L.C.; Weerasinghe, A.; Katelaris, C.
INTRODUCTION: Asthma is one of the common diseases among adolescents in Sri Lanka. Identification of sensitisation pattern to common allergens is helpful in planning rational control measures, minimising restrictions and in adopting immunotherapy. OBJECTIVE: To assess the sensitisation pattern among school going adolescent asthmatic children in Gampaha district. MATERIALS AND METHODS: A cross sectional study was carried out in 42 randomly selected schools in the Gampaha district. Within each school, one class from grade 8, 9 and 10 was randomly chosen. Students with physician diagnosed asthma and reporting symptoms in the previous 12 months were tested together with a healthy sibling. Sensitisation to house dust mite (Dermatophagoides pteronyssinus), cockroach (Blattella germanica), and storage mite (Blomia) were assessed using standardised allergen extracts. A skin wheal diameter, 3mm or greater than the negative control, was considered positive. RESULTS: Of 94 students selected, 61 responded (64%). The mean age was 13.8 years (SD=0.94) in asthmatics and 13.0 years (SD=3.7) in controls. Among asthmatics majority (60.7%) were males, compared to 47.5% among controls. Forty eight (78.7%) asthmatics had positive skin reaction to at least one allergen; the prevalence in the control group was 16.4%. The commonest allergen among asthmatics was cockroach (60.7%) followed by house dust mite (49.2%) and blomia (45.9%) The prevalence among the controls was 15.3%, 5.1% and 8.5% respectively. The differences were statistically significant. CONCLUSION: A significantly higher prevalence of sensitisation to cockroaches, house dust mites and storage mite was seen among asthmatic adolescents compared to their healthy siblings.
Sensitization patterns of allergens among asthmatics in Sri Lanka
(Lippincott Williams & Wilkins, 2007) Weerasinghe, A.; Weerasinghe, S.; Amarasena, M.; Medagoda, K.; Katelaris, C.H.
Introduction: The sensitization pattern among asthmatics in Sri Lanka is unknown. Objectives: To determine the sensitization pattern among asthmatics in Sri Lanka. Methodology: The study was carried out in forty physician-diagnosed asthmatic patients. Twenty two non-asthmatics were recruited as controls. Sensitization to 12 allergens was assessed by skin prick test using standardized allergen extracts. A skin wheal diameter, 3mm greater than the negative control was considered a positive reaction. Results: The mean age of asthmatics was 32.4 years (range 9Y59) and 57.5% were males. The mean age of controls was 32.2 years (range 14Y58) and 59.1% were males. The analysis of the data showed that 97.5% asthmatics had positive skin reaction to at least one allergen compared to 72.7% prevalence in the control group. The common allergens among asthmatics were Dermatophagoides pteronyssinus (77.5%), blomia (65.5%), cockroach (55%), storage mite (35%), latex (20%)), cat fur (17.5%), aspergillus (12.5%), grass pollen (12.5%), cow’s milk (12.5%) egg white (10%) cereals (7.5%) and dog hair (5.%). The pattern of sensitization among non-asthmatics was Dermatophagoides pteronyssinus (54.5%), cockroach (50%), blomia (36.4%), aspergillus (36.4%), grass pollen (27.3%), storage mite (22.7%), cow`s milk (18.2%), latex (13.6%), egg white (13.6%), cereals (13.6%), dog hair (9.1%) and cat fur (9.1%). Sixty two percent (n = 25) of the asthmatics had at least one other allergic manifestation while non-asthmatics with other allergic manifestation were 36.4% (n = 8). Other allergic manifestations in the asthmatic group were rhinitis alone 22 (55%), eczema alone 1(2.5%) and both rhinitis & eczema 2(5%) whereas in the non-asthmatic group it was rhinitis alone 7 (31%), eczema alone 0% and both rhinitis and eczema 1(4.5%). The pattern of sensitization for mites alone, cockroaches alone and mites and cockroaches in the asthmatic group with rhinitis (n = 24) was 23 (57%), 11(27%) and 11(27%) and in the non-asthmatic group with rhinitis (n = 7) was 3 (13%), 4 (18%) and 3 (13%) respectively. Conclusion: The results show that mites, and cockroaches are the most common sensitizing allergens in asthmatics and the commonest association of asthma was rhinitis in Sri Lanka.
Twin pregnancy chorionicity determination in a tertiary care setting
(Sri Lanka Medical Association, 2013) Dias, T.; Weerasinghe, A.; Amarathunga, P.; de Silva, C.; Thilaganathan, B.
Ultrasound determination of chorionicity is most reliable before 14 weeks and subsequently reduces in accuracy with advancing gestation. The aim of this study was to evaluate the accuracy of chorionicity determination in a birth cohort of twin pregnancies. Antenatal ultrasound determination of chorionicity in twin pregnancy was undertaken at sub optimal period of gestation in over two thirds of twin pregnancies. Even in the first trimester of pregnancy, the accuracy of chorionicity determination was lower than previously reported.