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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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 Low prevalence of Hepatitis B and C molecular markers in a cohort of Sri Lankan patients with hepatocellular carcinoma(Sri Lanka Medical Association, 2007) Dassanayake, A.S.; Manamperi, A.; Gunawardena, N.K.; Abeyewickreme, W.; de Silva, A.P.; de Silva, H.J.INTRODUCTION: Hepatitis B (HBV) and C (HCV) infections are leading causes of hepatocellular carcinoma (HCC). Although HCV is the predominant aetiological factor in many parts of the world, HBV remains more important in South Asia. Detection of molecular markers is the most reliable means of diagnosing infection. Molecular studies on HBV and HCV infection in HCC have not been performed in Sri Lanka. OBJECTIVES: To investigate the prevalence of HBV and HCV using molecular markers of infection in a cohort of Sri Lankan patients with HCC. DESIGN, SETTING AND METHODS: 34 consecutive patients with HCC were investigated for evidence of HBV and HCV infection. In addition to serology, serum was tested for HBV DNA and HCV RNA by PCR (sensitivity 500 copies/ml serum) and RT-PCR (sensitivity 200 copies/ml serum ) respectively. A detailed clinical work-up, screening for diabetes mellitus and iron studies were also performed. RESULTS: Of the 34 patients, 32 (94%) -were males; median age was 68 years. All had evidence of background cirrhosis. Five had evidence of past or present HBV infection, four were HBV DNA positive, one was anti-HBc positive but HBV DNA negative, and one was HCV RNA positive. In addition, 23 (67%) had a history of alcohol abuse and 18 (52%) had long standing diabetes. None had evidence of haemochromatosis. CONCLUSIONS: Prevalence of HBV and HCV infection was low in this cohort of Sri Lankan patients with HCC. This is in keeping with the low prevalence of these infections in the community.Item 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.Item Prevalence of enterobiasis among primary school children in Ragama, Sri Lanka(Sri Lanka Medical Association, 2013) Gunawardena, N.K.; Chandrasena, T.G.A.N.; de Silva, N.R.OBJECTIVES: To determine the prevalence of enterobiasis among school children in Ragama Medical Officer of Health (MOH) region and the association between clinical features, potential risk factors and infection status. DESIGN: Cross sectional study. SETTING: School based. Participants 260 school children aged 5-7 years, attending five state schools in the Ragama MOH region. MAIN OUTCOME MEASURES: Prevalence of Enterobius vermicularis infection as diagnosed using adhesive cellophane tapes on the perianal skin on 2 consecutive days. RESULTS: The overall prevalence of enterobiasis was 38%. The risk factors significant on a univariate analysis were male gender, maternal under-education, non-permanency of paternal employment, more household members, more siblings in a family, more persons sleeping with an index child and lack of recent deworming. On a multivariate model more household members, more children in a household, more persons sleeping with the index child, non-permanency of paternal employment and lack of recent deworming were significantly associated with infection. None of the clinical manifestations evaluated (peri-anal itching, insomnia, abdominal pain, and enuresis) showed a significant association with enterobiasis. CONCLUSIONS: Enterobiasis is highly prevalent among primary school children in Ragama.Item Human infection with Wuchereria bancrofti in Matara, Sri Lanka: the use, in parallel, of an ELISA to detect filaria-specific IgG4 in urine and of ICT card tests to detect filarial antigen in whole blood(Academic Press, 2003) Weerasooriya, M.V.; Itoh, M.; Mudalige, M.P.; Qiu, X.G.; Kimura, E.; Gunawardena, N.K.; Fujimaki, Y.The ICT card test to detect circulating filarial antigen and an ELISA that detects filaria-specific urinary IgG(4) were each used to screen 473 subjects from a community in Sri Lanka where Wuchereria bancrofti is endemic. When the ICT test was used as the gold standard, the ELISA was found to have a sensitivity of 91.2%. However, far more of the subjects were found ELISA-positive than ICT-positive (76.5% v. 31.1%). The youngest children studied (aged 1-10 years) were similar to the adult subjects in terms of the prevalence of antigenaemia (33.8%) and the prevalence (72.1%) and concentration of filaria-specific IgG(4) in their urine. Therefore, especially as urine samples are easier, less painful and safer to collect than blood samples, the ELISA may be particularly useful to screen very young and school-age children, to estimate current levels of transmission in a particular area.Item Prevalence and intensity of Wuchereria bancrofti antigenaemia in Sri Lanka by Og4C3 ELISA using filter paper-absorbed whole blood(Oxford University Press, 2002) Weerasooriya, M.V.; Gunawardena, N.K.; Itoh, M.; Qiu, X.G.; Kimura, E.In Sri Lanka 2741 people from Matara, an endemic area for Wuchereria bancrofti, were examined in 1996/97 for microfilariae by 60-microL blood smear and for circulating filarial antigens by Og4C3 ELISA using filter paper-absorbed whole blood. The overall prevalence of microfilaraemia was 3.4%, and that of antigenaemia 14.4%. The prevalence of antigen-positive and microfilaria-negative people was 11.3%. Analysed by age-group,antigenaemia prevalence was similar in all groups, and the average number of antigen units was already very high in the age-group < 10 years, indicating that the infection started in early childhood. Among those who were antigen positive, the microfilaria prevalence was lower in females than in males. Diethylcarbamazine treatment eliminated microfilariae in 78% of the positives. However, 17 months after the treatment, antigenaemia was still positive in 76% of those who were parasitologically cured.Item Wuchereria bancrofti antigenaemia in Sri Lanka.(Blackwell Scientific Publications, 1999) Itoh, M.; Weerasooriya, M.V.; Gunawardena, N.K.; Mudalige, M.P.; Samarawickrema, W.A.; Kimura, E.The prevalence of Wuchereria bancrofti antigenaemia determined in 353 subjects in Matara, Sri Lanka by Og4C3 ELISA was 20.7%. Positive rates obtained with the same subjects by 1 ml Nuclepore filtration and 60 microl thick blood smear were 11.3% and 7.9%, respectively. Antigen levels were positively associated with microfilaria counts. Two-thirds of antigen-positive and microfilaria-negative (Ag+/Mf-) individuals were > 25-year-old, but younger age groups (< or = 25-year-old) tended to have proportionally more Ag+/Mf- cases. Possible origins of the Ag+/Mf- status are discussed