Browsing by Author "de Silva, J."

Now showing 1 - 20 of 30

Acute fatty liver of pregnancy
(Taylor and Francis Group, 2021) de Silva, J.; Padumadasa, S.
No abstract available
Applicability of Google Translate in Sinhalese Diglossic Contexts
(International Postgraduate Research Conference 2019, Faculty of Graduate Studies, University of Kelaniya, Sri Lanka, 2019) de Silva, J.
Diglossia is the co-occurrence of two different varieties of a language, for distinct functions, throughout a speech community. Sinhalese is one of the languages which depict this phenomenon, with standard written Sinhalese and spoken Sinhalese as the two varieties. Nevertheless, the necessity of employing both varieties occur in certain contexts, for example, in the translation of prose work into Sinhalese, in which narrative is generally translated into standard written Sinhalese and dialogues are translated into spoken Sinhalese, unless the necessity of foreignizing or classicizing occurs. The aim of this study has been to examine the response of Google Translate in the translation of prose work from English into Sinhalese, in which the diglossic nature of Sinhalese language should be taken into consideration. Accordingly, the study is based on Sinhalese translations of selected parts of English prose texts, produced by Google Translate. The selected parts of source texts consisted of both narratives and dialogues, and pertained to different social and cultural backgrounds. The Sinhalese translations were compared with relevant source texts and an analysis was conducted in order to determine their appropriateness. The findings of this study indicate that the diglossic nature of Sinhalese language is not given consideration in Google Translate and both written and spoken varieties are employed inconsistently in producing a translation. This inconsistently is identified to occur in both sentence level and paragraph level, with a blend of morphological and syntactic attributes of standard written Sinhalese and spoken Sinhalese. Incompatibility with diglossic languages can be adjudged a significant weakness of Google Translate, which stands parallel to the failure of producing natural output consistently. Developing the option for the user to select the required variety is identified as the measure to solve this issue.
Application of nucleic acid technology (NAT) in the diagnosis of active viral replication in HBV and HCV infections and evidence for HBV surface antigen mutants
(Sri Lanka Association for the Advancement of Science, 2008) Manamperi, A.; Gunawardene, Y.I.N.S.; Hapuarachchi, C.; Bandara, A.; Wellawaththage, C.; Abeyewickreme, W.; de Silva, J.
Introduction: The community prevalence of Hepatitis B (HBV) and hepatitis C (HCV) infections, although considered low (< 1%) in Sri Lanka based on serological markers, pose a significant health threat to patients in high risk groups. The early diagnosis of active viral infection is crucial in such situations to prevent further transmission and to enable the clinicians to initiate successful therapeutic interventions. Objective: This study was carried out to investigate the usefulness of polymerase chain reaction (PCR) in the diagnosis of active viral replication in HBV and HCV infections. Methodology: All specimens from patients with serological evidence of hepatitis B (HBV surface antigen and/or antibodies for HBV core protein) or hepatitis C (antibodies for hepatitis C core protein-Anti-HCV) and referred to the Molecular Medicine Unit from May 2005 to May 2008 were analyzed by PCR and reverse-transcription PCR (RT-PCR) for HBV DNA (n=130) and HCV RNA (n=95) respectively. Results: Of the 130 patients tested, 57 (44%) were positive for HBV DNA. The positive group of patients included 10 renal transplant patients, 4 multiply transfused patients, 4 paediatric patients with lymphoma, and 1 patient with cirrhosis. Six HBV DNA positive patients had negative HBsAg serology profiles indicating the possibility of surface antigen mutant strains. The HBV DNA negative patients with positive serology profiles indicate sero-converted/ patients with resolved infections or false positive serology results. Of the 95 patients tested, 14 (15%) were positive for HCV RNA and included 3 paediatric patients with thalassaemia. HCV RNA negative, anti-HCV positive profiles reflect either false positive serology results (due to less specific antibody assays) or donors who have been exposed to HCV previously and subsequently resolved their infections. Conclusions: A major proportion of patients with serological markers for HBV have active viral infection whereas only relatively a minor proportion of patients with serological markers for HCV have active viral replication. We have also found the first possible evidence of hepatitis B surface antigen mutant strains. This underlines the importance of the nucleic acid based technology in the diagnosis and assessment of infection with or suspected to have hepatitis B or C infections. We also emphasize the importance of introducing NAT for screening donors for HBV DNA and HCV RNA to substantially lower the risk of acquiring HBV/HCV infection from a transfusion.
Approach to study the efficacy and safety of new complementary and alternative medicine formulations: Lesson during COVID-19 from Sri Lanka
(Wolters Kluwer - Medknow, 2023) Pilapitiya, S.; Jayasinghe, S.; Silva, A.; Wickremasinghe, R.; Paranagama, P.; de Silva, J.; Lekamwasam, S.; Kularatne, S.A.M.; Wanigasuriya, K.; Kaluthota, S.; Sumathipala, S.; Rathnnasooriya, C.; Siribaddana, S.
COVID-19 affected Sri Lanka from early 2020, a time of considerable ignorance accompanied by wide media coverage of a devastating epidemic in Italy and Europe. Many were attracted to complementary and alternative medicine (CAM) or traditional medicine (TM) in this desperate situation. Several preparations were claimed to be effective against COVID-19 globally. Dammika Bandara Syrup© was one such preparation promoted for preventing and treating SARS-CoV-2 infection. It was based on bees' honey, pericarp and mace of Myristica fragrans (nutmeg), the seed of Foeniculum vulgare and fresh rhizome of Zingiber officinale, all believed to have anti-viral properties. Following an unpublished clinical study claiming efficacy, Dammika Bandara Syrup© gained wide media publicity and political patronage. The producer claimed of Goddess Kali revealing the formula added an anthropological, cultural, and religious complexity to the issue. The demand for the product increased rapidly as a debate raged both in public and in the parliament on utilizing such products in combating COVID-19. The Department of Ayurveda, which is statutorily responsible for regulating CAM/TM had to respond to the situation. The legislation to regulate such indigenous medicinal products was weak, and the crisis deepened as thousands converged to the production facility, defying mobility restrictions introduced to control COVID-19. This led to the Ministry of Health requesting academics to form a team and conduct a clinical trial to prove its efficacy. This paper outlines the process and issues faced during the regulatory approval for the trial in a polarized political environment. Some health professionals accused the researchers of bowing to political pressure and questioned the scientific justification for the trial. However, the team considered this as an opportunity to streamline a path for research into CAM/TM therapies in situations such as COVID-19. Several processes were identified and addressed, such as the provisional registration of CAM preparations, assessing the potential efficacy of a CAM product, confirmation of authenticity and safety, standardization and supervision of production respecting cultural identities, obtaining approval for human use, choice of comparators, and ethical issues. We believe the study has helped set standards and a benchmark for CAM and TM research in Sri Lanka.
Barriers for cataract treatment among elderly in Sri Lanka
(Hindawi Publication Corporation, 2019) Nishad, N.; Hewage, S.A.; Arulmoly, K.; Amaratunge, M.S.; de Silva, J.; Kasturiratne, K.T.A.A.; Abeysundara, P.K.; Wickremasinghe, A.R.
Cataract is still the leading cause of blindness. Many government institutes and voluntary organizations in Sri Lanka are providing free treatment services to patients with cataract. Still people are not patronizing the available free services; thus they have to live with impaired vision or blindness. This paper describes the barriers for cataract treatment among the population over 60 years of age. Out of 470 elders, 379 were found to have some kind of cataract. This study demonstrated lack of awareness and knowledge, socioeconomic factors, and misconceptions as the main barriers for cataract treatment which has led to a lower cataract surgery rate irrespective of the high cataract prevalence reported. Findings of this study highlight the importance of cataract as a common health problem in elderly and need for removal of the barriers for its treatment which should be given due prominence in the formulation of public health policy in Sri Lanka at the earliest.
Classic polyarteritis nodosa associated with hepatitis C virus infection: a case report
(BioMed Central, 2012) Rodrigo, D.; Perera, R.; de Silva, J.
INTRODUCTION: Hepatitis C virus has been under-recognized as an etiologic factor for polyarteritis nodosa and the presence of hepatitis C antigenemia in patients with polyarteritis nodosa has been reported as insignificant. In the literature hepatitis C virus-associated polyarteritis nodosa is a rare and controversial entity. CASE PRESENTATION: A 34-year-old Sri Lankan Tamil man presented to our facility with a two-week history of slow-resolving pneumonia of the right mid and lower zones. On physical examination he had panniculitic type tender skin nodules with background livedo reticularis. A skin biopsy was suggestive of a small and medium vessel vasculitis compatible with polyarteritis nodosa. He was tested positive for hepatitis C antibodies. A serum cryoglobulin test was negative but perinuclear antineutrophilic cytoplasmic antibody test was positive. Serum complement levels were reduced. He was diagnosed as having classic polyarteritis nodosa associated with hepatitis C infection. He later developed left-sided radiculopathy involving both upper and lower limbs and an ischemic cardiac event. His hepatitis C infection was managed with polyethylene glycol-interferon 2α combined with oral ribavirin. Simultaneously, his classic polyarteritis nodosa was treated with prednisolone and cyclophosphamide. He made a good recovery. CONCLUSIONS: Hepatitis C virus infection is capable of inducing a fulminant form of vasculitis in the form of polyarteritis nodosa. It may be easily confused early in its course with mixed cryoglobulinemia, which is commonly known to be associated with hepatitis C virus. Awareness of hepatitis C virus-related polyarteritis nodosa helps in diagnosing the condition early so combined immunosuppressive and antiviral treatment can be started as soon as possible
Developing a research agenda in a less-than-research-friendly environment: the Ragama story
(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2016) de Silva, J.
Universities should be engines for knowledge generation. Although there are signs of change, a research culture is not widespread in Sri Lankan universities. It was in this environment that the Faculty of Medicine was established at the University of Kelaniya, in 1991. The private North Colombo Medical College, that was its physical forerunner, had virtually no recognized research output. The major strength of the new faculty was the quality of its academic staff. It soon had a critical mass of restless high-achievers with excellent postgraduate training. As with most institutions with a short history, making a mark nationally and internationally depended on drive, commitment, pragmatism and, most importantly, innovation - adapting to research in a resource poor setting. The strategy had to be simple and feasible: not to compete internationally in laboratory-based basic sciences, but to focus on diseases that were relevant locally but rare in the West, and on diseases of affluence that were emerging in the developing world, concentrating on their epidemiology and clinical aspects, and seeking foreign collaboration for their detailed study. Research was undertaken while developing new study programmes, curricula and timetables for the newly established faculty, and servicing one of the busiest teaching hospital in the country. There was a freedom to follow individual research interests, and as each department initially had few staff, inter-departmental, multi-disciplinary research was not just a philosophy, but a necessity. Though there were a few skeptics, research was encouraged at every level, including in the undergraduate curriculum, and achievements publicly acknowledged. International collaborations with leading researchers and institutions followed. Faculty members were recognized for their research and many were soon in influential academic, editorial and administrative positions nationally and internationally. Research infrastructure was built gradually: a molecular medicine unit, a clinical trials unit participating in ground-breaking international trials, a national reference laboratory for thalassaemia, a community cohort for the longitudinal study of non-communicable diseases, and one of the only four WHO-recognized ethics committees in the country, to name a few. At 25 years, and starting from zero, our measureable institutional research output stands at about 1,000 Google Scholar and 500 PubMed publications, with over 10,500 citations and an h-index of 46. Compared to the first five years (1991-1996), publications and citations have increased nearly 10-fold during the last four (2012-2015). Work in some areas has led to implementation or changes in clinical practice and health policy internationally. The output is one of the best in this country, but challenges remain and the impetus needs to be sustained, and the research agenda more ambitious.
Does Sanders-Retzlaff-Kraff (SRK-2) formula suit a Sri Lankan population in phacoemulsification cataract surgery of medium axial length?
(Sri Lanka Medical Association, 2012) Amaratunge, M.S.; de Silva, J.; Wasthuhewaarachchi, I.M.; Uyangoda, S.H.; Mallawaarachchi, M.A.J.I.; Premaratna, R.; Nishad, A.A.N.
INTRODUCTION: After introduction of phacoemulsification with small incision techniques, intraocular lens (IOL) power calculation predictionhas become a crucial step for good refractive outcomes. SRK-2 formula is widely used for that purpose in many locations. AIMS: To evaluate the predictive accuracy of post operative refraction using SRK-2 formula in phacoemulsification of eyes with 22-26mm axial length. METHODS: Patients with senile cataracts undergoing phacoemulsification and IOL during 2011 in Gampaha district by a single surgeon were selected randomly. Single examiner measured simulated manual keratometry preoperatively, seven days postoperatively. Uncorrected visual acuity, slit lamp examination of anterior segment and best spectacle-corrected visual acuity (BSCVA) were measured. The implanted IOL power was used to calculate the predicted postoperative refractive error using time SRK-2 formula. RESULTS: Of 274 patients (56% females, mean (SD) age 65.3(10) years), the right eye was operated in 142(51.8%). On postoperative seventh day, 79% had VA of 6/6 and 14% to 6/9, 4% to 6/12 to 6/36 in the operated eye. Mean (SD) of IOL power used 21.50 (1.90)D. The predicted refractive error with SRK-2 was -0.3(0.145)0 and the achieved refractive error was -0.22(0.732)0. Difference between predicted and achieved refractive error presented a slight hyperopic shift (mean(SD) 0.054(0.397)0}. There was a negative Pearson correlation (-0.126) between the predicted refractive error and achieved refractive error (p=0.04). Predictive error was less than 0.5 in 80.2%, <0.75 in 88.6% and <1.0 in 96.7%. CONCLUSIONS: SRK-2 formula is a good option to predict the refractive error after cataract extraction by phacoemulsification in eyes with medium axial length.
Effect of mebendazole threapy in pregnancy on birth outcome
(Sri Lanka Medical Association, 1998) de Silva, N.; Sirisena, J.; Gunasekera, D.; de Silva, J.
OBJECTIVES : A prospective, unmatched, case-control study was done to assess the safety of mebendazole threapy in pregnancy, a hitherto uninvestigated factor. DESIGN : All women delivering in the University Obstetrics Unit of the Ragama Teaching Hospital between May 1996 and, March 1997 were administered a questionnaire soon after delivery. Details of the birth and the baby were recorded; suspected defects were confirmed by a paediatrician. The incidence of congenital defects in babies of mothers who had taken mebendazole during the pregnancy was compared with the incidence among those who had not taken an anthelmintic (controls). Data analysis was done using Epi Info 6.03. RESULTS : Of 3688 women, 73.5% had taken mebendazole, 24.8% had not taken any any anthelmintic , 1.1% had taken an anthelmintic but could not identify it and 0.6% had taken pyrantel or albedazole. The incidence of birth defects was 2.36% {64/2711) in the mebendazole group compared with 2.3% (21/913) in the controls (odds ratio 1.03, 95% confidence limits 0.61 - 1.75). This difference was not statistically significant even when corrected for other known risk factors by stratified analysis . Data regarding timing of mebendazole threapy was available for 2660 women; 6.9% in the first trimester, 83.8% in the second, and 9.2% in the third. The incidence of birth defects among women who had taken mebendazole in the first trimester was 3.24% (6/185). giving an odds ratio of 1.42 against the controls; this was also not statistically significant.CONCLUSIONS : The use of mebendazole in pregnancy does not lead to a significant increase in the risk of congenital defects.
Envenoming Snakebite Risk Map for Sri Lanka
(Faculty of Graduate Studies, University of Kelaniya, Sri Lanka, 2016) Ediriweera, D.; Kasturiratne, A.; Pathmeswaran, A.; Pathmeswaran, A.; Gunawardena, N.; Jayamanne, S.; Wijayawickrama, B.; Isbister, G.; Giorgi, A.D.E.; Diggle, P.; Lalloo, D.; de Silva, J.
Snakebite is a neglected tropical disease. Hospital based statistics often underestimate snakebite incidence because a significant proportion of victims seek traditional treatments. Since geospatial risk assessments of snakebite envenoming are rare, health care resources are distributed based on administrative boundaries rather than on a need analysis. The aim of the study was to develop a snakebite envenoming risk map for Sri Lanka. Epidemiological data was obtained from a community-based island-wide survey. The sample was distributed equally among the nine provinces. 165,665 participants living in 1118 Grama Niladhari divisions were surveyed. Model-based geostatistics was used to determine the geographical distribution of envenoming bite incidence. The Monte Carlo maximum likelihood method was used to obtain parameter estimates and plug-in spatial predictions of risk. A predictive model was developed with natural and social environmental variables to construct an estimated envenoming bite incidence map and a probability contour map (PCM) to demonstrate the spatial variation in the predictive probability that local incidence does or does not exceed national envenoming snakebite incidence (i.e. 151 per 100,000). Envenoming bite incidence had a positive association with elevation up to 195 meters above sea level, with incidence dropping at higher elevations. The incidence of envenoming was higher in the dry zone compared to intermediate and wet climatic zones and decreased with increasing population density. Developed risk maps showed substantial within-country spatial variation in envenoming bites. Conclusion: The risk maps provide useful information for healthcare decision makers to allocate resources to manage snakebite envenoming in Sri Lanka. We used replicable methods which can be adapted to other geographic regions after re-estimating spatial covariance parameters for each region of interest.
Evaluating Spatiotemporal Dynamics of Snakebite in Sri Lanka
(International Postgraduate Research Conference 2019, Faculty of Graduate Studies, University of Kelaniya, Sri Lanka, 2019) Ediriweera, D.; Diggle, P.; Kasturiratne, A.; Pathmeswaran, A.; Gunawardena, N.; Jayamanne, S.; Lalloo, D.; de Silva, J.
Snakebite data has shown spatial and temporal variations in many countries and regions. Yet, no study has evaluated spatiotemporal patterns of snakebites across a country in detail. We used data from the National Snakebite Survey (NSS), which sampled 0.8% of the national population (165665 people) living in 1118 clusters representing all the provinces. Explanatory variables of previously published spatial and temporal models for the NSS data were considered as candidate explanatory variables for our spatiotemporal models. Spatial prediction models for snakebite incidence was a geostatistical binomial logistic model and the temporal prediction model was a Poisson log-linear model, which predicted snakebite incidence at the national level. These spatial and temporal models could not explain locally varying temporal patterns in the country. Therefore, we constructed spatiotemporal models at the provincial levels. The NSS was conducted for 11 consecutive months, and different clusters were surveyed in each month. Therefore, the NSS can be considered as a set of 11 repeated cross-sectional surveys at different locations. NSS captured bite events that occurred in the survey month and in the 12 preceding months. Hence, each individual provided information regarding the number of bites experienced in each of 13 months. In the NSS data, the location of each sampled individual was fixed at the cluster centroid and the data contain the month of each recorded bite, if any, over a 13 month period covering the survey month and each of the preceding 12 months. We modelled the data from each cluster as an inhomogenous Poisson process with cluster-level explanatory variables and estimated the model parameters by maximising the pooled log-likelihood over all. The fitted cluster-level spatiotemporal models were aggregated so as to predict the province-level monthly bite incidence rates in Sri Lanka. Snakebite incidence showed complex spatiotemporal patterns in Sri Lanka. Models fitted for Southern, North Central, Uva and Sabaragamuwa provinces showed both spatial and temporal variation in snakebites. The geographical extent of the high-risk areas (i.e. hotspots) in these provinces dynamically changed over a period of a year. The remaining five models (i.e. Western, Central, North Western, Northern and Eastern) did not show any spatio-temporal interaction, in risk, i.e. the geographical extent of the hotspots persisted throughout the year. Southern, Sabaragamuwa and North Central provinces showed triannual seasonal trends. High snakebite incidences in Southern and Sabaragamuwa provinces were noticed in April followed by December and August to September. Peak incidences in North Central province were seen in November and another two smaller peaks were observed in April and July. Uva province showed a biannual trend with highest incidences in June followed by December. These findings can inform healthcare decision-making at local level, taking account of the seasonal variations in order to prevent and manage snakebites in Sri Lanka
Fetal effects of environmental exposure of pregnant women to organophosphorus compounds in a rural farming community in Sri Lanka
(Informa Healthcare, 2008) Samarawickrema, N.; Pathmeswaran, A.; Wickremasinghe, R.; Peiris-John, R.; Karunaratna, M.; Buckley, N.A.; Dawson, A.; de Silva, J.
BACKGROUND: The possible deleterious effects of low-grade, chronic environmental and occupational exposure to organophosphorus compounds (OPCs) are not well documented. OBJECTIVE: To investigate the possible effects of low-level, chronic exposure of pregnant mothers to OPCs on the fetus by measuring OPC levels, and using markers of OPC exposure, oxidative stress and oxidative tissue damage. METHODS: Toxicity was assessed by measuring (i) OPC levels in breast milk and plasma from maternal and cord blood using gas chromatography, (ii) maternal and fetal butyrylcholinesterase (BChE) activity using inhibition assays, (iii) antioxidant status of the fetus using superoxide dismutase activity assays, (iv) oxidative stress in the fetus by determining malondialdehyde (MDA) concentrations, and (v) examining for fetal DNA fragmentation using electrophoresis. Samples were obtained from consenting mothers living in a farming community in southern Sri Lanka at the end of the pesticide spray season (study group) and just before the commencement of the spray season (in-between spray season; control group). RESULTS: Organophosphate residues were detected in only two subjects (chlorpyrifos in maternal and cord blood of one during the spray season and dimethoate in breast milk of another during the in between spray season), but the test employed was capable of only detecting concentrations above 0.05 mg/l. However, cord blood obtained during the spray season showed significant inhibition of BChE activity, increased oxidative stress and more DNA fragmentation when compared with cord blood obtained during the in-between spray season. CONCLUSIONS: Inhibition of cord blood BChE activity indicates fetal exposure to organophosphorus compounds during times when there is a high probability of environmental drift. This provides a plausible explanation for the increased oxidative stress and high DNA fragmentation in the fetus. Long-term outcomes of such exposures are unknown.
Fifty liver transplants: a single centre experience of haemodynamic management in liver transplantation for cirrhosis [part 1]
(College of Surgeons of Sri Lanka, 2021) Gunetilleke, B.; Ranamuni, R.; Jayaweera, D.; Welikala, N.; Kerner, V.; Munasinghe, N.; Withanage, R.; Wickremasinghe, N.; Hewage, S.; Wijesuriya, N.; Rodrigo, U.; Mudalige, A.; Fernando, M.; Hettiarachchi, D.; Dissanayake, J.; Niriella, M.; Dassanayake, A.; Thilakaratne, S.; de Silva, J.; Siriwardana, R.; WIjesuriya, R.; Liyanage, C.
ABSTRACT: Cirrhosis with end stage liver disease (ESLD) is a leading cause of non-communicable disease related deaths in Sri Lanka. Liver transplantation is the only curative treatment for patients with ESLD. The complex multisystem involvement and unique cardiovascular profile characteristic of ESLD present formidable challenges during liver transplantation. Management of the rapid and varied hemodynamic changes during surgery requires an in depth understanding of the physiological effects of each intervention. Based on the current literature and the experience gained at our center during the management of 50 liver transplants, we present optimization strategies and perioperative hemodynamic interventions which we use to ‘Fast track’ recovery following liver transplantation. KEYWORDS: Liver transplantation, cirrhosis, non-alcoholic fatty liver disease, alcohol related liver disease
Fifty liver transplants: a single centre experience of haemodynamic management in liver transplantation for cirrhosis [part 2]
(The College of Surgeons of Sri Lanka, 2021) Gunetilleke, B.; Ranamuni, R.; Jayaweera, D.; Welikala, N.; Kerner, V.; Hettiarachchi, D.; Munasinghe, N.; Withanage, R.; Wickremasinghe, N.; Hewage, S.; Fernando, M.; Hettiarachchi, D.; Niriella, M.; Dassanayake, A.; Thilakaratne, S.; Wijesuriya, R.; Liyanage, C.; Siriwardana, R.; Dissanayake, J.; Wijesuriya, N.; Rodrigo, U.; Rodrigo, U.; Mudalige, A.; de Silva, J.
Globally, an estimated one million deaths occur annually due to complications of cirrhosis. Cirrhosis with end stage liver disease [ESLD] is a leading cause death due to non- communicable diseases in Sri Lanka. Non-alcoholic fatty liver disease [NAFLD] and alcohol related liver disease [ARLD] are the principal causes of ESLD due to cirrhosis in Sri Lanka. Liver transplantation remains the only curative treatment for such patients. Multiorgan dysfunction and hemodynamic instability characteristic of ESLD adds to the complexity of perioperative care in liver transplantation. Maintenance of stable hemodynamics including optimal hemostasis forms the core of the anaesthetic strategy in liver transplantation.
Liquid chromatography-tandem mass spectrometry method for the simultaneous quantitative determination of the organophosphorus pesticides dimethoate, fenthion, diazinon and chlorpyrifos in human blood
(Elsevier, 2009) Salm, P.; Taylor, P. J.; Roberts, D.; de Silva, J.
Simultaneous determination of the organophosphorus pesticides dimethoate, fenthion, diazinon and chlorpyrifos in human blood by HPLC–tandem mass spectrometry was developed and validated. The pesticides were extracted by a simple one-step protein precipitation procedure. Chromatography was performed on a Luna C18 (30 mm × 2.0 mm, 3 μm) column, using a step-gradient at a flow rate of 0.4 ml/min. The assay was linear from 0.5 to 100 ng/ml (r2 > 0.992, n = 24) for all pesticides. The inter- and intra-day accuracy and precision for the method was 96.6–106.1% and <10%, respectively. The lower limit of quantification was 0.5 ng/ml. In conclusion, the method described displays analytical performance characteristics that are suitable for the quantification of these pesticides in cases of acute poisoning.
Metabolic syndrome and risk of endometrial carcinoma among asymptomatic, postmenopausal, urban Sri Lankan females: a community cohort follow-up study
(Wiley Publishing, 2017) Dias, T.; Niriella, M.; de Silva, S.; Motha, C.; Palihawadana, T.S.; Ediriweera, D.; de Silva, J.
OBJECTIVES: Metabolic syndrome (MetS) has been recognised as a risk factor for malignancies. The aim of this study was to evaluate the association of MetS and risk of endometrial carcinoma (EC), by measuring endometrial thickness (ET). METHODS: The Ragama Health Study (RHS) recruited 35-64-year-old female cohort by age-stratified random sampling in 2007 and re-evaluated them in 2014, using a structured interview, anthropometric measurements and biochemical tests. Liver ultrasound to detect fatty liver was performed in 2007. Pelvic ultrasound to detect ET was performed in 2014 among consenting participants. MetS was diagnosed on established International Diabetes Federation (IDF 2012) criteria. Increased ET was defined as >5mm. Simple logistic regression was used to screen variables and multiple logistic regression was used to obtain adjusted effects of risk factors for increased ET. RESULTS: 813/1636(49.7%) of the original female cohort attended follow-up; ET was measured in 567(69.7%). Median (IQR) age of females was 61 (56-66) years. 323 fulfilled criteria for MetS (prevalence 57.1%) in 2007. 57(10.1%) had increased ET in 2014. Increasing plasma triglycerides [OR=1.004 per mg/dl, 95%CI:1.001-1.007, p<0.05] and being hypertensive [OR=2.16, 95%CI:1.11–4.08, p<0.05] were associated with increased ET, while advancing age [OR=0.93 per year, 95%CI:0.89–0.98, p<0.01] and being diabetic [OR= 0.34, 95%CI:0.10–0.89, p<0.05] were protective. CONCLUSIONS: Hypertension and increased plasma triglyceride levels, in the pre-menopausal period, were risk factors for future asymptomatic increased ET.
Non-alcoholic fatty liver disease: a Sri Lankan perspective
(The Sri Lanka Medical Association, 2022) Niriella, M.; Dassanayake, A.; de Silva, J.
No Abstract available
Notes towards a history of the faculty of Medicine, University of Kelaniya
(University of Kelaniya, 2009) Fonseka, C.; de Silva, J.
Perceived impact of the COVID-19 pandemic on psychiatric training among final-year medical undergraduates in Sri Lanka: an online survey of students from eight universities
(American Psychiatric Press, 2022) Baminiwatta, A.; Dayabandara, M.; de Silva, J.; Gadambanathan, T.; Ginige, P.; Premarathne, I.; Rajapaksha, H.; Wickramasinghe, A.; Sivayokan, S.; Wijesinghe, C.
Objective: This study aimed to assess the perceived impact of the COVID-19 pandemic on undergraduate psychiatry training in Sri Lanka and to explore several potentially associated factors. Methods: An online survey was distributed among students from eight medical schools who recently faced their final exam. Their perceptions on the impact of the pandemic on the psychiatry training and exam performance were rated on a 10-point scale. Resilience was assessed using a two-item scale. Results: A total of 644 students responded (69.5% female, mean age=27.5 years). Among them, 164 (25.5%) reported being quarantined; 25 (4%) reported becoming infected with COVID-19; and 170 (28.6%) reported ward closure for over a week during the clerkship. Greater impact was reported for patient availability (mean=7.08), mental status assessments (mean=6.3), developing rapport (mean=6.2), and diagnostic skills (mean=5.9), whereas the impact on peer-learning (mean=5.5) and self-study (mean=3.6) was relatively lower. Impact on clinical components of the final exam (mean=6) was rated higher than on theory components (mean=4.5). The majority (70.3%) reported that COVID-19-related stress affected their exam preparations. Higher resilience predicted lower perceived impact on all aspects of training/exam performance. Female gender and ward closure predicted greater impact on diagnostic skills, overall training, and clinical exam performance, whereas being quarantined predicted greater impact on peer-learning and self-study. Conclusion: The pandemic has significantly affected the undergraduate psychiatry training in Sri Lanka, particularly its clinical components. Increasing clinical exposure to patients, managing students' stress, and building their resilience should be key concerns for medical educators during the pandemic.
Pernicious anaemia--a case report
(Sri Lanka Medical Association, 1983) Wijesiriwardena, B.C.; de Silva, J.; Jayasinghe, K.S.; Sheriff, M.H.; Dharmadasa, K.