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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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 Challenges faced in establishing a pediatric liver transplant program in a lower‐middle‐income country with free healthcare service(Wiley, 2024) Fernando, M.; Tillakaratne, S.; Gunetilleke, B.; Liyanage, C.; Appuhamy, C.; Weerasuriya, A.; Uragoda, B.; Welikala, N.; Ranaweera, L.; Ganewatte, E.; Dissanayake, J.; Mudalige, A.; Siriwardana, R.ABSTRACT: BACKGROUND: Liver transplant is the cure for children with liver failure. Sri Lanka is a lower-middle-income country with a predominant free, state health system. Pediatric liver transplant program in Sri Lanka is still in the budding state where the initial experience of the program is yet to be documented. METHODS: A retrospective review was performed including the clinical characteristics of all pediatric liver transplant recipients of Colombo North Centre for Liver Diseases since the inception of the program from June 2020 to May 2023. RESULTS: There were 14 PLT performed in 3 years. The median recipient age and weight were 8 years (6 months–15 years) and 23.3 kg (6.4–49.2), respectively. The majority were boys (64%). All were from low-income backgrounds. Indications for LT were acute liver failure (5/14), decompensated chronic liver disease (5/14), and acute on chronic liver failure (4/14). Underlying liver diseases were Wilson disease (6/14), autoimmune liver disease (3/14), biliary atresia (2/14) and progressive familial intrahepatic cholestasis type 3 (1/14), and unknown etiology (2/14). The majority were living donor liver transplants (86%). Of the living donors, 42% (5/12) were Buddhist priests. There were three immediate deaths and two late deaths. The 3-month survival was 78%, and overall survival was 64%. Living donor transplants carried a higher success rate (92%) compared to diseased donor transplants (0%; 2/2). CONCLUSIONS: Initial experience of pediatric liver transplant program of Sri Lanka is promising despite being established in a free healthcare system amidst the crisis circumstances.Item Anthropometric knee profile measurements on articulator surface of femur among Sri Lankan population.(Sri Lanka Medical Association, 2023) Fernando, G.K.S.; Ranaweera, L.; Cabral, L.L.E.; Dissanayaka, P.; Bandara, I.D.M.R.N.; Sovis, W.F.U.N.INTRODUCTION: In Sri Lankan context there are no published data for articulator surface measurements for knee joints. Forensic, Anatomical, Archaeological, Bio-medical engineering, development of knee S145 prosthesis beneficial with anthropometrics. Digital Vernier Caliper (measuring range 0-140mm, resolution 0.02mm, accuracy ±0.01mm) used to obtain measurements. OBJECTIVES: The aim of this study, was to provide standard anthropometrics for the distal femur in Sri Lankan context. METHODS: Dried adult Femurs (42 male and 28 female) were analysed for the measurements of Medial condyle Antero-Postero Length (MAP), Anteroposterior length of intercondylar area (AP), Medial-Lateral Length (ML), Aspect Ratio (ML/AP) and Epi Condylar breadth (EB). Sex Dimorphism Ratio (SDR) were calculated for dry femurs. RESULTS: The mean values for male; MAP 24.95(±2.22), AP 25.47(±2.27), ML 20.82(±2.56), Aspect Ratio 0.82(±0.11) and EB 7.68(±0.43). The mean values for female; MAP 24.95(±3.08), AP 25.47(±3.16), ML 20.82(±2.28), Aspect Ratio 0.82(±0.18) and EB 7.68(±0.37). SDR values are MAP 107.74, AP 107.12, ML 99.04, and EB 106.55. CONCLUSIONS: The majority of SDR values lie above 100. Therefore, a difference between male and female values can be observed. Findings offer assistance to develop knee joint prostheses with culture-particular values, fitting for the Sri Lankan setting and pave the pathway to the studies on the above-mentioned fields in the local and international context. Sex determination is a crucial element in the creation of a biological profile since it offers information for identities.Item A study of morphological and morphometric variations in Sri Lankan diaphyseal nutrient foramina of humerus(WHO Office in Azerbaijan., 2022) Ranaweera, L.; Sulani, W.N.; Uggalla, T.Predominantly, the nutrient artery gives the blood supply to the long bones through the nutrient foramen. The present study analyzed the morphometric and morphological variations of Sri Lankan diaphyseal nutrient foramen of the humerus concerning the number, size, location, and direction along the shaft. A sample of 50 dry adult humeri was analyzed. The mean length of the bones was 29.53cm. The mean foramen index was 55.59. The current study encountered single, double, and triple nutrient foramina as well as the absence of such foramina. Five main locations of nutrient foramina were observed along the shaft of the humerus: anteromedial surface, medial border, lateral border, anterior border, and posterior surface. The nutrient foramen directions were towards the distal end or proximal end of the humerus. Most Sri Lankan humeri had single nutrient foramen. Most humeri had nutrient foramina on the anteromedial surface on the middle third of the shaft which is directed distally. The information regarding the nutrient foramina is important for the procedures such as bone graft, bone repair, and microsurgical bone transplantation.Item Virtual anatomy learning through the eye of ayurveda medical students in Sri Lanka during COVID 19 pandemic.(WHO Office in Azerbaijan., 2022) Ranaweera, L.; Samaranayake, G.V.P.; Cabral, E.Anatomy is the foundation stone of medical education. The COVID 19 pandemic imposed unexpected disruption to Anatomy education with most universities moving regular onsite classes to the online session. The purpose of this study was to identify the perceptions of Ayurveda medical students regarding virtual or online Anatomy learning. The study was conducted on 69 second-year Ayurveda medical students using a self-administrated questionnaire. The majority of the students (92.8%) did not have prior experience in online learning (OL) before the COVID 19 pandemic. Regarding the learning activities preferred by students prior to the COVID 19, 73.9% of students preferred the live lectures from the academic staff. It was evident that 92.8% of students believed that zoom cloud meeting is the most effective method of Anatomy in the OL platform. In order to improve their Anatomy dissection knowledge, 50.7% of students were suggested to show live Gross Anatomy dissection. The OL is more successful than onsite learning for the theory of Anatomy. Access to online materials (86.9%), learning from their own places (92.7%), the ability to stay at home (95.6%), interactivity of the class (56.5%), and the ability to record a meeting (88.4%) are the key advantages of OL. Reduced Interaction with the teacher (78.2%), technical issues (92.7%), lack of interactions with their colleagues (82.6%), poor learning conditions at home (71%), and social isolation (81.1%) are the main disadvantages that they must face in their online learning process. In the era of smartphones and the internet, it was indicated that the Ayurveda medical students prefer to be engaged in the hybrid system which includes online Anatomy lectures with onsite Anatomy practicals.Item A Study of morphological and morphometric variations in Sri Lankan femoral diaphysial nutrient foramina [Estudio de las variaciones morfológicas y morfométricas de los forámenes nutricios diafisarios de fémur en Sri Lanka](Universidad de la Frontera, 2020) Ranaweera, L.; Perera, P.I.; Pathiraja, P.P.M.C.K.; Sulani, W.N.; Wijesooriya, W.A.P.S.ABSTRACT: Blood supply to the diaphysis of long bones is majorly through nutrient artery, which enters the bone via nutrient foramen. The present study aims to identify morphological and morphometric variations of nutrient foramina of the femur, which is the largest long bone of the body extending from the pelvis to knee. A sample of 81 Sri Lankan adult femur were analyzed. The mean length of the femur analyzed was 436.93 mm and mean foramen index was 43.52. The majority of the bones had a single nutrient foramen. The predominant location of the nutrient foramen was on the posterior aspect of the bone in the middle third of the shaft according to the study. Majority of foramina were directed distally. The indices on nutrient foramen are important for procedures such as bone grafts and tumor resections, in managing trauma, orthopedic procedures and radiological interpretations. © 2020, Universidad de la Frontera. All rights reserved.Item Injuries at the National Sport Festival Taekwondo Championship in Sri Lanka [Lesioni al National Sport Festival Taekwondo Championship in Sri Lanka](Edizioni Minerva Medica, 2020) Ranaweera, L.; Kumari, M.I.; Samaraweerachchi, U.I.BACKGROUND: Taekwondo is a Korean martial art that had been growing in popularity in Sri Lanka and internationally. Although studies have examined injuries in other non-contact sports, to date, no published medical study has examined injuries in taekwondo competitions in Sri Lanka. The purpose of this study was to identify the injury profile in the “National Sport Festival Taekwondo Championship” in Sri Lanka. METHODS: This is a descriptive cross-sectional study. In the competition, 193 athletes were observed prospectively to detect the injury type, site of injury, severity of injury and the rate of injury. Injury data were recorded using an interviewer administered questionnaire with the help of the attending physician. The software program “SPSS 16.0’ was used to analyze the data. RESULTS: Importantly, 78 injuries were recorded. The most prevalent injury type was contusions (67.9%) followed by lacerations (12.8%), sprain (5.1%), concussion (5.1%) and fractures (3.8%). The lower limbs were determined as the most prevalent anatomical region of the body to sustain an injury during a competition followed by the head and neck. The most frequent injuries were mild injures (71.8%) which is followed by moderate injuries (17.9%) and the equal frequency of 5.1% for both severe and critical injuries. The injury rate was found to be 220.3 injuries per 1000 athlete-exposures. CONCLUSIONS: The most common injury location and type were found to be the lower limb and contusion, respectively. The majority of injuries appeared to be of mild in nature. Most importantly, the injury rate in Sri Lankan taekwondo athletes is very much higher than the rates reported from the other parts in the world. There is an urgent need of launching programs related to injury prevention among the players and the referees in order to decrease the rate of taekwondo injuries in Sri Lanka. KEY WORDS: Martial arts; Sports; Athletic injuries; ContusionsItem Mitochondrial DNA history of Sri Lankan ethnic people: their relations within the island and with the Indian subcontinental populations(Nature Publishing Group, 2014) Ranaweera, L.; Kaewsutthi, S.; Win Tun, A.; Boonyarit, H.; Poolsuwan, S.; Lertrit, P.Located only a short distance off the southernmost shore of the Greater Indian subcontinent, the island of Sri Lanka has long been inhabited by various ethnic populations. Mainly comprising the Vedda, Sinhalese (Up- and Low-country) and Tamil (Sri Lankan and Indian); their history of settlements on the island and the biological relationships among them have remained obscure. It has been hypothesized that the Vedda was probably the earliest inhabitants of the area, followed by Sinhalese and Tamil from the Indian mainland. This study, in which 271 individuals, representing the Sri Lankan ethnic populations mentioned, were typed for their mitochondrial DNA (mtDNA) hypervariable segment 1 (HVS-1) and part of hypervariable segment 2 (HVS-2), provides implications for their settlement history on the island. From the phylogenetic, principal coordinate and analysis of molecular variance results, the Vedda occupied a position separated from all other ethnic people of the island, who formed relatively close affiliations among themselves, suggesting a separate origin of the former. The haplotypes and analysis of molecular variance revealed that Vedda people's mitochondrial sequences are more related to the Sinhalese and Sri Lankan Tamils' than the IndianTamils' sequences. MtDNA haplogroup analysis revealed that several West Eurasian haplogroups as well as Indian-specific mtDNA clades were found amongst the Sri Lankan populations. Through a comparison with the mtDNA HVS-1 and part of HVS-2 of Indian database, both Tamils and Sinhalese clusters were affiliated with Indian subcontinent populations than Vedda people who are believed to be the native population of the island of Sri Lanka.