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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty
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Item A Statistical Approach to Define Thresholds for Dengue Epidemic Management in Akurana Medical Officer of Health Area, Kandy District of Sri Lanka(19th Conference on Postgraduate Research, International Postgraduate Research Conference 2018, Faculty of Graduate Studies,University of Kelaniya, Sri Lanka, 2018) Udayanga, N.W.B.A.L.; Gunathilaka, P.A.D.H.N.; Iqbal, M.C.M.; Fernando, M.A.S.T.; Abeyewickreme, W.Stegomyia indices, namely; Premise Index (PI), Breteau Index (BI) and Container Index (CI) are used forvector management approaches in Sri Lanka. Properly defined threshold values for larval indices are of higher importance to provide forecasts on dengue epidemics and also for effective larval management of dengue vectors. However, such critical thresholds are poorly defined for Sri Lanka. The present study aimed to define threshold values forabove larval indices for dengue epidemic management in the Akurana Medical Officer of Health (MOH) in the Kandy District. Larval surveys were conducted on a monthly basis from January, 2016 to June, 2018. Four larval indices, namely BI for Aedesaegypti (BIA) and Aedesalbopictus (BIB), PI and CI were calculated. Further, monthly larval indices of AkuranaMOH area from January, 2012 to December, 2015, were obtained from the MOH office, along with monthly reported dengue cases for the entire study period. Receiver Operating Characteristic (ROC) curves in SPSS (version 23) were used to assess the discriminative power of the larval indices in determiningdengue epidemics and thresholds based on larval indices. As indicated by the area of ROC curve (AUC), the BIA (0.661) and PI (0.637) were having a notable discriminative power to forecast dengue epidemics at a two-month lag period. Both BIB (0.397) and CI (0.526) were non-informative influencers at one and two-month lag periods. The BIA and PI were better predictors of dengue incidence than BIB and CI. Based on the ROC curve, three risk thresholds were defined for BIA as Low Risk (BIA≤2.1), Moderate Risk (3.9≤BIA<4.85), and High Risk (BIA≥4.85), with respect to Ae. aegypti. According to the PI, thresholds were defined as Low Risk (PI≤6.2), Moderate Risk (7.7≤ PI<9.9), and High Risk (PI≥ 9.9). Threshold values defined for BI of Ae. aegypti and PI, could be recommended to be considered in implementing vector control efforts in the above study area for effective dengue epidemic management, through pre planned entomological management of dengue vectors.Item Evaluation of the spatial and temporal trends of dengue outbreaks in Akurana, Central Province, Sri Lanka(Sri Lanka Association for the Advancement of Science, 2015) Udayanga, N.W.B.A.L.; Gunathilaka, P.A.D.H.N.; Iqbal, M.C.M.; Kusumawathie, P.H.D.; Najim, M.M.M.; Amerasinghe, U.S.; Abeyewickreme, W.Renowned as the world's fastest growing vector borne disease, dengue has become one of the major health issues in Sri Lanka leading to an alarming concern due to recent outbreaks throughout the country. Despite the immense efforts taken by the relevant authorities to reduce the rate of mortality, the average number of dengue cases recorded in each year remains around 30,000-35,000 without being changed significantly over time in Sri Lanka. Investigation of the trends in spatial and temporal distribution patterns of dengue is often treasured in the drafting and implementation of management/action plans to ensure effective management of dengue epidemics at regional scale. Thus, a statistical and geo informatics based analysis of the recent trends in dengue distribution was carried out to identify spatial and temporal trends in distribution patterns of Dengue in the Akurana Medical Officer of Health (MOH) area. Monthly records of reported dengue cases from 2010 to 2014 of the Akurana MOH area were obtained and were subjected to a scatter plot analysis in MINITAB (version 14.12.0) to identify the temporal patterns in the recorded dengue cases. Spatial maps of the recorded dengue case distribution in each GND for each month and for the whole study period were prepared by using Arc GIS 10.1. The spatial and temporal variations of dengue outbreak distribution within the Akurana MOH (at GND level) were analyzed to identify the recent trends in dengue incidence. Akurana, Bulugahathenna, Dippitiya, Dunuwila, Konakalagala and Neeralla localities could be identified as areas with relatively high risk to dengue outbreaks throughout the study period, while localities such as Balakanduwa, Delgasgoda, Delgasthenna, Malgamandeniya, Marahela, Palleweliketiya and Udawelikatiya emerged as areas with low risk. As suggested by the results of the paired-Chi square test [>Χ2 (30, 0.95) = 43.773], the emergence of dengue outbreaks indicated a significantly declining trend of recorded dengue cases in most of the GNDs (Aswadduma, Delgasgoda, Kurugoda, Malgamandeniya, Palleweliketiya and Walahena etc.) during the recent years. The evaluation of the trends in temporal and spatial distribution of dengue outbreaks at the localized level, could be recommended as a useful tool in the planning and implementation of action plans to control the rise of dengue, while evaluating the efficacy of already implemented control measures at regional scale.Item Synthesis of Fe2O3 nanoparticles for the development of a rapid diagnostic test kit for dengue detection(Moleclar Medicine Unit, Faculty of Medicine, University of Kelaniya, Sri Lanka, 2015) Jayarathna, I.P.L.; Gunathilaka, P.A.D.H.N.; Athapaththu, A.M.M.H.; Abeyewickreme, W.BACKGROUND: Hybrid nanoparticles have great potential for biotechnological and biomedical applications. It was recently proposed that biopolymer/co-shell nano-materials could be easily obtained by adapting traditional routes used in pharmaceutical science to design drug delivery system. Most of the case, super-paramagnetic nanoparticles of iron oxides, magnetite (Fe3O4) and maghemite (ᵧ -Fe2O3) have been employed and these interesting magnetic properties are due to finite-size effects and high surface/volume ratio. METHOD: Iron oxide was synthesized by using modified co-precipitation method and resulting particles were characterized using X-ray diffraction (XRD), Transmission Electron Microscopy (TEM) and Diffused Reflectance Fourier Transform-Infrared Spectroscopy (DRIFT-IR). RESULTS: The XRD pattern matches well that of ᵧ -Fe2O3. Six characteristic peaks for ᵧ -Fe2O3 (2θ = 31.7°, 36.7°, 41.1°, 53.4°, 57.0° and 62.6°) marked by their Miller indices [(220), (311), (400), (422), (511) and (440)] were observed for sample. The TEM images reveal that the particles are in 5 – 20 nm range, and well fitted with spaniel cubic structure, but when particles are dry it prefer to agglomerate with neighboring particles to reduce their surface charges. The spectrum of ᵧ -Fe2O3 nanoparticles shows a characteristic broad band at 3410 cm-1 is due to the stretching vibration of H2O molecules. The band corresponding to the bending vibrations of H2O molecules is positioned at 1633 cm-1. Two intense IR bands at 627 and 451 cm-1 are typical for ferrihydrite or ᵧ -Fe2O3 nanoparticles. The spectrum of this sample showed the presence of carbonate groups on the basis of IR bands at 1508, 1340 and 1069 cm-1. The presence of carbonate groups is due to the adsorption of atmospheric carbon dioxide by ᵧ -Fe2O3 nanoparticles. The bands of Fe–O stretching vibrations of ᵧ -Fe2O3 appeared at 627 and 451 cm-1 and the bands at 892 and 796 cm-1 can be assigned to Fe-OH···H bending vibrations. CONCLUSION: Magnetic ᵧ -Fe2O3 nanoparticles were synthesized by the co-precipitation method and this work confirmed that magnetic ᵧ -Fe2O3 nanoparticles are in nano-scale and well matches with spaniel cubic structure