Medicine
Permanent URI for this communityhttp://repository.kln.ac.lk/handle/123456789/12
This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty
Browse
5 results
Search Results
Item “What’s in a name?”–The implications of change in nomenclature for fatty liver disease from NAFLD to MAFLD to MASLD(The Sri Lanka Medical Association, 2024) Niriella, M.A.No abstract availableItem Alcohol use and alcoholic fatty liver disease: a prospective, communitybased study among adults in an urban community in Sri Lanka(The Sri Lanka Medical Association, 2022) Niriella, M.A.; Kasturiratne, A.; Beddage, T.; de Silva, S.T.; Dassanayake, A.S.; Pathmeswaran, A.; Wickremasinghe, A.R.; Kato, N.; de Silva, H.J.Background: Data on alcoholic fatty liver (AFL) is limited. Therefore, we investigated alcohol use and AFL in a cohort of adults in an urban community in Sri Lanka. Methods: The study population (selected by age-stratified random sampling) was screened in 2007 (35-64 years) and re-evaluated in 2014. They were assessed by structured interviews, anthropometric measurements, liver-ultrasound, and biochemical and serological tests. AFL was diagnosed on ultrasound criteria, ‘unsafe’ alcohol consumption (Asian standards: males>14 units, females >7 units per week) and absence of hepatitis B/C markers. Controls were unsafe alcohol consumers who had no fatty liver on ultrasound. Results: 2985/3012 (99%) had complete data for analysis. 272/2985 (9.1%) were unsafe-drinkers in 2007 [males-270; mean-age-51.9, SD-8.0 years]. 86/272 (31.6%) had AFL [males-85; mean-age-50.2, SD-8.6 years]. Male gender [p<0.001], increased waist circumference (WC) [OR 4.9, p<0.01], BMI>23kg/m2 [OR 3.5, p<0.01] and raised alanine aminotransferase (ALT) [OR 2.8, p<0.01] were independently associated with AFL. 173/272 (63.6%) unsafe alcohol consumers from 2007 were re-evaluated in 2014. 134/173 had either had AFL or had changed to ‘safe’ or no alcohol consumption. 21/39 (53.8%) [males-21 (100%), meanage- 57.9, SD-7.9 years] who remained ‘unsafe’ alcohol users who had no fatty liver in 2007 developed AFL after 7-years (annual incidence 7.7%). On bivariate analysis, only male gender was associated with new-onset AFL. Of the 42 who had AFL at baseline but changed their drinking status from unsafe to safe or no alcohol, 6 had resolution of fatty liver in 2014. Conclusion: In this community-based study among adults from an urban community, unsafe alcohol use was found in 9.1%. Among unsafe alcohol users, the prevalence of AFL was 31.6% and the annual incidence of AFL was 7.7%. New-onset AFL was independently associated with male gender.Item Non-alcoholic fatty liver disease: a Sri Lankan perspective(The Sri Lanka Medical Association, 2022) Niriella, M.; Dassanayake, A.; de Silva, J.No Abstract availableItem From NAFLD to MAFLD: characterising fatty liver disease in Sri Lanka(Ceylon College of Physicians, 2022) Niriella, M.A.No abstract availableItem Medico legal and ethical aspects of surrogacy; A case report of a tragic maternal death from Sri Lanka(Elsevier Ltd, 2022) Kitulwatte, I.D.G.; Gangahawatte, S.; Perera, U.L.M.S.; Edirisinghe, P.A.S.A case report from Sri Lanka on surrogacy leading to a tragic maternal death; medico-legal and ethical aspects. Surrogacy, with multiple ethical and legal issues associated with it, is practised worldwide. Although regulations are not available in Sri Lanka, we report a woman who had a tragic death as a complication of surrogate pregnancy. The body of a young mother with four living children was brought for autopsy examination. According to the documents provided, there was a controversy about the deceased’s identity. A woman volunteered to show a pillow trapped in her abdomen, simulating a pregnancy. By surrogacy, her husband’s sperm were inseminated in this woman’s uterus artificially according to a contract. She was diagnosed and managed for pregnancy-induced hypertension in the second trimester. At 36 weeks of gestation, she was admitted to the hospital in labour. On admission, she was icteric with elevated blood pressure. A cesarean section delivered a baby, and it was noted that she had an abruption of the placenta. She developed a postpartum haemorrhage following delivery, and resuscitation failed, resulting in her death. She had elevated liver enzymes and low serum proteins before death. Autopsy findings included intense icterus, congested lungs, global ischemic changes in the myocardium, pale kidneys and fatty soft yellow liver. This case discusses many unanticipated legal and ethical issues related to surrogate pregnancy, especially in a lack of regulations regarding the practice and relatively cheap medical expenses.