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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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 6503 Using anthropometric data to investigate the nutritional status of children included on the Sri Lankan cerebral palsy register.(BMJ Publishing Group Ltd, 2024) Sumanasena, S.; Fernando, R.; Kurukulaarachchi, S.; Heiyanthuduwage, T.M.; Sheedy, H.S.; Wijesekara, S.; Jagoda, J.; Muttiah, N.OBJECTIVES The nutritional data from children with cerebral palsy (CP) in low and middle income countries (LMIC) is sparse. In high income countries (HICs) well established nutritional care plans, commercial products and good psycho-social support are available.1 A multitude of complications arise due to malnutrition leading to poor quality of life.2 Here we investigated the nutritional status of children included in the Sri Lankan Cerebral Palsy Register (SLCPR).METHODS The study included 768 children aged 0–18 years with CP, attending three teaching hospitals in the Western Province, from September 2018 to November 2021. Data included clinical profile and anthropometry [weight (Kg), height (cm), BMI, mid upper arm circumference (MUAC) (cm), and OFC (cm)] based on WHO. Average was calculated using three repeated measurements. Children who could not stand independently (GMFCS level 4/5) underwent height estimations with the knee height equation: height = (2.69 X Knee height) + 24.2.Indicators used to measure the nutritional status were: weight for age Z score (WAZ), height for age Z score (HAZ), weight for height Z score (WHZ), BMI for age Z score (BAZ), and MUAC for age Z score (MUACZ). WHO Anthro and WHO AnthroPlus software calculated all Z scores.4 HAZ and BAZ were calculated for children aged <18 years, WAZ was calculated for children aged <10.1 years, and WHZ and MUACZ were calculated for children aged <5.1 years. The z scores < -2.0 SD were categorized as underweight (WAZ), stunted (HAZ), wasted (WHZ or MUAC), thin (BAZ).RESULTS Total of 768 children (mean age 59.6 months, SD 44.9, 62.5% males) participated. There were (n=431) children under 61 months and (n=520) from 0–10 years. Of them, 51.3% (n = 267/520) were underweight, 59.8% (n = 258/431) were stunted and 27.3% (n = 210/768) were thin. Among children aged < 5 years, 26.7% (n = 115/431) had severe wasting and severe acute malnutrition (SAM) according to MUACZ < -3SD. Both underweight and stunting were significantly higher among children with spastic CP compared with others (p<0.05). In the 5–19 year group 16.9% (n= 57/337) were obese (BAZ > + 2SD).CONCLUSION Predominant stunting and underweight in this population calls for urgent action to minimize chronic malnutrition. It is imperative to further explore nutritional intake and feeding difficulties in this group and offer structured nutritional care plans. The trend observed in older children towards obesity possibly indicates the need for coordinated nutrition and exercise programmes. It is recommended to regularly monitor growth and nutritional status of all children with CP as there may be serious implications for their activity levels.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.