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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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 Knowledge and adherence to National Institute of Clinical Excellence 2020, dyslipidaemia management guidelines and its associations among medical officers in Gampaha district, Sri Lanka: a descriptive study(Sri Lanka College of Internal Medicine, 2023) Ansy, A.; Angunawala, A.; Anushika, E.; Ariyasena, S.; Aryachandra, S.; Fernando, K.; Mettananda, C.INTRODUCTION: Dyslipidaemia is an important risk factor for cardiovascular diseases(CVD) and optimal management helps prevent CVD burden in a country. Knowledge of medical officers(MOs) on dyslipidaemia management is critical in this regard. We assessed knowledge and adherence of MOs of Gampaha district to the National Institute of Clinical Excellence (NICE) guideline 2020 on management of dyslipidaemia. METHODS: We conducted a cross-sectional study at five secondary/tertiary-care hospitals in Gampaha District in January 2022. Knowledge and adherence were studied using a self-administered questionnaire consisting of 25 multiple-choice questions. Each question was scored "1" and the cumulative score was converted to 100. A score >80 was considered "good knowledge and adherence" and its associations were studied using logistic regression. RESULTS: A total of 413 MOs (63.4% females, mean age 45±7.6 years) participated in the study. Of them, 73.1% had worked in a medical ward previously. The mean knowledge and adherence score was 77±9.3. Only 30% had a score >80. Good knowledge and adherence was significantly associated with being <45 years (p .004) in age, having work experience in a medical ward (p<.001), having post-graduate training (p<.001), working in a tertiary care hospital(p=.007), and involved in private practice(p=.002). There was no significant association with attendance at continuing medical education programmes (p=.320) or the duration of service(p=.120). CONCLUSIONS: Only a third of MOs of Gampaha district had good Knowledge and adherence to NICE-2020 dyslipidaemia guidelines. Knowledge and adherence to the guideline was better in MOs who are young, in postgraduate training, with previous experience in medical wards, working in tertiary care hospitals or engaged in private practice.Item Cardiovascular risk stratification in primary prevention of non-communicable diseases(Ceylon College of Physicians, 2022) Mettananda, C.No abstract availableItem Coconut consumption and cardiovascular disease incidence, is there an association? a case control study in Sri Lankan population(Royal Society of Chemistry, 2015) Athauda, L.; Kasturiratne, A.; Wickremasinghe, A.R.INTRODUCTION & OBJECTIVES: Consumption of coconut and its products is reported to be associated with an increased risk of cardiovascular disease (CVD). This study was conducted to determine if there is an association between coconut consumption (oil and coconuts) and CVD incidence among Sri Lankans who are known to consume a large amount of coconut-based products. METHODS: A hospital based case control study was conducted at the Colombo North Teaching Hospital, Ragama, Sri Lanka comprising 176 cases and 148 controls. Previously healthy patients admitted with a first incident Acute Coronary Syndrome (ACS) or a Cerebrovascular Event (stroke) were recruited as cases and patients with no previous history of CVD or diabetes mellitus were recruited from surgical wards as controls. There were 136 ACS and 40 Stroke patients as cases. An interviewer-administered questionnaire was used to estimate the average consumption of coconut (nuts and oil) and to obtain information on risk factors of CVD. Descriptive analysis and multiple logistic regression analysis were conducted using SPSS. RESULTS: The mean (+SD) age of cases and controls were 57.68 +8.91 and 56.05 +10.02, respectively (p=0.192). Mean (+SD) coconut nut consumption per person per week was 1.97 +0.81 in cases and 2.11 +1.01 nuts in controls (P=0.66). Coconut oil use for cooking was 88.44 +61.6 ml/person/week in cases and 81.4 +51.52 ml/person/week in controls (p=0.175). 91.5% cases and 98% controls used coconut oil for cooking. Coconut oil use was protective for cases (OR:0.197, 95% CI:0.052-0.744) while number of sedentary hours per day (OR:1.11, 95% CI: 1.044-1.188) and family history of IHD (OR:2.293, 95%CI:1.318-3.991) and stroke (OR:2.275, 95%CI:1.268-4.082) were significant risk factors after adjusting for each other and for the amount of oil used per person per week, number of coconuts used per person per week, family history of NCD, being current smokers and consumers of alcohol. CONCLUSION: There was no evidence of an association between coconut consumption and incidence of cardiovascular disease or stroke. Use of coconut oil had a protective effect on the incidence of cardiovascular disease.