Medicine

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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty

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Author: search.filters.author.Chandrasena, L.G.

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    Composite carotid intima-media thickness as a risk predictor of coronary heart disease in a selected population in Sri Lanka
    (Public Library of Science,, 2022) Abeysuriya, V.; Wijesinha, N.A.I.; Priyadharshan, P.P.; Chandrasena, L.G.; Wickremasinghe, A.R.
    Background: Segment-specific variations of carotid intima-media thickness (CIMT) have not been assessed in South Asian populations. The purpose of this study was to determine if segment-specific CIMTs or a composite-CIMT score is a better risk predictor of coronary heart disease in South Asian populations. Methods: A comparative prospective study was conducted from November 2019 to October 2020 in a hospital in Colombo, Sri Lanka. Based on pre-defined inclusion and exclusion criteria, cases (having a diagnosis of Coronary Heart Disease (CHD), n = 338) and controls (non-CHD group, n = 356) were recruited. Ultrasound examination of the common carotid (CCA), the carotid bulb (CB) and the internal carotid segments (ICA) of the carotid vessels was conducted by a radiologist, and CIMTs were measured. A composite-CIMT score defined as the average value of all six segments of the left and right sides was derived. Results: 694 participants were enrolled (male n = 399, 57.5%). The mean (±SD) age of the study sample was 60.2 (±9.86) years. There were variations in segment-specific values between the left and right vessels. The mean composite-CIMT value of the CHD group was significantly higher than that of the non-CHD group. A composite-CIMT score of 0.758 had a sensitivity of 98.4% and a specificity of 64.6% in distinguishing CHD from non-CHD groups (Area under the curve (AUC): 0.926). Conclusions: Carotid artery segment-specific CIMT variations were present in this population. The composite CIMT score is better than segment-specific CIMTs in predicting CHD and may be used to predict CHD in this population.
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    Serum cystatin C as a marker to identify patients with moderately impaired renal function
    (Association of Clinical Biochemists of India,, 2008) Peiris, H.; Chandrasena, L.G.; Lanerolle, R.D.
    ABSTRACT: The low molecular weight protein cystatin C produced by all nucleated cells and eliminated by glomerular filtration is of special benefit as a marker of renal function. A study was therefore undertaken to investigate whether serum cystatin C could be used as a marker to identify patients with moderately impaired renal function. A cross-sectional descriptive hospital based study was carried out and serum cystatin C was measured in fifty subjects aged 12 to 74 years with a 24 hr creatinine clearance estimation done at the same time. The gold standard creatinine clearance was used to compare the predicted glomerular filtration rate measured using serum cystatin C. Predicted glomerular filtration rate gave a sensitivity of 82% and specificity of 68% with a diagnostic cut-off value of 1.25mg/L cystatin C for identification of patients with moderately impaired renal function with a single random blood sample. AUTHOR KEYWORDS: Creatinine; Cystatin C; Glomerular filtration rate; Moderately impaired renal function
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    The socio-demographic and economic profile of patients attending emergency services in a private hospital
    (Sri Lanka Medical Association, 2018) Abeysuriya, V.; Chandrasena, L.G.; Wickremasinghe, A.R.
    INTRODUCTION AND OBJECTIVES: Studies have highlighted that the private sector contributes a major share in outpatient healthcare and a small proportion in inpatient care in Sri Lanka. There is little or no information on the contribution of the private health sector in emergency care. METHODS: A descriptive cross sectional study was carried out on patients admitted to an emergencytreatment unit of a private hospital in Colombo from October 15th to December 15th 2016. Data were abstracted from medical records, verbal interviews, and the computerized database maintained by the hospital. Data were analyzed using the SPSS 16. RESULTS: 2395 patients (1426 men; 59.2%) were admitted during the study period. The majority of patients were 61 to 70 years (30.4%) and 80.3% were employed. 61.6% of patients had a health insurance policy; 67.3% of these were private insurance policies. 38.4% of insurance policies were self-financed. The monthly income ranged between Rs.15, 000 and Rs.150, 000 (mean Rs.41, 800±26,180). Persons less than 60 years were more likely to have insurance cover (1.58 times in state policies and 1.34 times in private insurance) as compared to patients 60 years and over. Persons with an education less than A-Levels were more likely (OR=l.78) to have private insurance cover as compared to a person with a higher education.CONCLUSION: Persons with varying economic backgrounds seek emergency health care in private hospitals. A large percentage of patients seeking emergency health care in private hospitals have to bear out-of-pocket expenditure. The older the person, the less likely that (s)he has health insurance cover.
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    The role of antioxidants in filarial infection
    (Royal Society of tropical medicine and Higiene (RSTMH), American Society of tropical medicine and Higiene(ASTMH), British Society for Parasitology, 2000) Premaratna, R.; Chandrasena, T.G.A.N.; Senarath, S.; Chandrasena, L.G.; de Silva, N.R.; de Silva, H.J.
    Abstract Available
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    Clearance of microfilaraemia and red blood cell glutathione peroxidase(GPX) levels in asymptomatic microfilaraemics after single dose and 14 days’ treatment with diethyl carbamazine citrate(DEC) 
    (Sri Lanka Medical Association, 2001) Premaratna, R.; Chandrasena, T.G.A.N.; Abeyewickreme, W.; de Silva, N.R.; Chandrasena, L.G.; de Silva, H.J.
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    Clearance of microfilaraemia and red blood cell glutathione peroxidase(GPX) levels in asymptomatic microfilaraemics after single dose and 14 days’ treatment with diethyl carbamazine citrate(DEC)
    (Wiley, 2001) Premaratna, R.; Chandrasena, T.G.A.N.; Abeyewickreme, W.; de Silva, N.R.; Chandrasena, L.G.; de Silva, H.J.
    Abstract Available
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    Red blood cell antioxidant levels after treatment with diethyl carbamazine
    (Wiley, 2001) Premaratna, R.; Chandrasena, T.G.A.N.; Abeyewickreme, W.; de Silva, N.R.; Chandrasena, L.G.; de Silva, H.J.
    Abstract Available
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    Characteristics of patients admitted to an emergency treatment unit of a private sector hospital
    (Faculty of Medicine, University of Kelaniya, Sri Lanka, 2016) Abeysuriya, V.; Chandrasena, L.G.; Kasturiratne, A.; Senanayake, M.G.B.; Wickremasinghe, A.R.
    BACKGROUND: Studies have highlighted that the private sector contributes a major share in outpatient healthcare and a small proportion in in-patient care in Sri Lanka. There is little or no information on private health sector emergency care. OBJECTIVES: To determine the socio-economic characteristics of patients admitted to an emergency treatment unit (ETU) in a private hospital in Colombo. METHODS: A descriptive cross sectional study was carried out on patients admitted to the ETU of a private hospital in Colombo from October 16th to December 15th 2015. Data were abstracted from medical records, verbal interviews, and the computerized data base maintained by the hospital. RESULTS: 2395 patients (1426 men; 59.2%) were admitted during the study period. The majority of patients were 61 to 70 years (30.4%). 80.3% were employed. 61.6% of patients had an insurance policy of which, 41.5% were private insurance policies. The monthly income ranged between Rs.15, 000 and Rs.150, 000 (mean Rs.43, 700±19,020). The commonest admissions were due to diseases of the digestive system (27.4%). Persons with an educational level of
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    Red blood cell antioxidant levels after treatment with diethyl carbamazine citrate in persons with asymptomatic microfilaraemia
    (Sri Lanka Medical Association, 2001) Premaratna, R.; Chandrasena, T.G.A.N.; Abeyewickreme, W.; de Silva, N.R.; Chandrasena, L.G.; de Silva, H.J.
    Abstract Available
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    Clostridium difficile infection in inflammatory bowel disease patients in Sri Lanka
    (Sri Lanka Medical Association, 2012) Waraketiya, P.R.; de Silva, A.P.; Wijesinghe, N.T.; Waraketiya, P.R.; Wijewantha, H.S.; Chandrasena, L.G.; Pathmeswaran, A.; de Silva, H.J.
    INTRODUCTION: Over the last decade an increase in Clostridium difficile associated diarrhoea (CDAD) has been observed among Caucasians (1%). The frequency of CDAD is very high in Caucasian IBD patients; 8.7% in one study of IBD patients in remission. This has led to guidelines recommending routine screening for CDAD in IBD. Clinical impressions are that CDAD is rare among Sri Lankans. AIMS: This study was conducted to determine the frequency of CDAD in a cohort of Sri Lankan IBD patients and healthy controls. METHODS: Cases [n=154] were histologically confirmed IBD patients, in clinical remission. The controls [n=100) were non-IBD patients who presented to medical clinics without diarrhoea and with no exposure to antibiotics for up to 8 weeks prior to recruitment. Immunoassays for Clostridium difficile toxins A and B were performed on stool samples obtained from both groups. RESULTS: The frequency of CDAD was 0.7% (n=l) and 0% (n=0) in IBD patients and controls respectively. CONCLUSIONS: Compared to Caucasians, CDAD was very rare in this cohort of Sri Lankans, including those with IBD. Routine screening for CDAD does not seem necessary in our setting.
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