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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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 Can a composite index predict ischaemic heart disease risk?(Sri Lanka Medical Association, 2012) Ediriweera, E.P.D.S.; Samita, S.INTRODUCTION: Ischaemic heart diseases (IHD) are the leading cause of death worldwide and it accounts for 12.2% of the total deaths globally. Although the individual risk factors of IHD are well understood, the possibility of predicting the risk of IHD of an individual at a given time is less understood. Aims: To develop an index to predict the risk of IHD based on individual biological parameters. Methods: Secondary data of 217 individuals were analysed. Multivariate and logistic regression techniques were used to construct a composite index (CI) based on standardised measurements of lipid profile, fasting blood sugar, systolic and diastolic blood pressure. Two sample ttest and 95% confidence interval based on composite index scores were used to compare the two groups and define a cutoff point. Results: Mean [±SE] of the CI scores for undiagnosed and diagnosed IHD individuals were 0.013 [+0.014] and -0.1 [±0.041] respectively. The mean scores of the two groups were significantly different (p=0.008) and the confidence intervals for undiagnosed and diagnosed groups were -0.181 to -0.019 &-0.016 to 0.042 respectively. Accordingly, cut off point was estimated as - 0.018. CONCLUSIONS: The CI score can be used to distinguish those who are at risk from those who are risk free. Since the CI is based on several variables, the tests are more powerful compared to those based on individual variables. The CI approach has to be evaluated in several other study settings for verification. With some detailed studies, working cut off point can be established.Item Glutathione peroxidase and severity of ischaemic heart disease in a cohort of Sri Lankan patients(Sri Lanka Medical Association, 2010) Perera, P.P.R.; Chandrasena, L.G.; Indrakumar, J.; Peiris, H.OBJECTIVES: To study the association between glutathione peroxidase (GPx) levels in relation to severity and extent of cardiac ischemia and age in a cohort of Sri Lankans. METHODS: Seventy nine patients with ischaemic heart disease (IHD) awaiting coronary artery bypass grafting (CABG) were recruited to the study. GPx was measured before CABG. The severity and extent of myocardial ischemia were measured by the vessel, stenosis and extent scores by perusing the coronary angiograms. RESULTS: The mean GPx concentration of the study sample was 120.44 units GPx/mg Hb which is below the normal value of 275 units GPx/mg Hb. The mean vessel, stenosis and extent scores of the study sample were 2.04 (out of a possible 3) 9.86 (out of a maximum of 32) and 46.42% respectively. The GPx levels showed a significant inverse correlation with the vessel, stenosis and extent scores (p < 0.01), No significant correlation was observed between the GPx levels and age in the study population. CONCLUSIONS: GPx may be a predictor of severity and extent of ischaemia in ischemic heart disease patients. GPx levels did not change with the age.Item Association between homocysteine, vitamin B12, folate, MTHFR polymorphisms and ischaemic heart disease(Sri Lanka Medical Association, 2010) Perera, P.P.R.; Chandrasena, L.G.; Indrakumar, J.; Peiris, H.OBJECTIVES: The present study investigated the association between homocysteine and ischaemic heart disease (IHD) and the factors influencing homocysteine levels. METHODS: A case control study involving 221 patients with IHD and 221 age and sex matched controls admitted to Colombo South Teaching Hospital and an analytical study involving 79 patients awaiting coronary artery bypass grafting at Nawaloka Hospitals PLC were done. RESULTS: Hyperhomocysteinaemia was a significant predictor of IHD after controlling for hypertension and hypercholesteroleamia (adjusted odds ratio 2.38). Hyperhomocysteinaemia was a significant predictor of IHD in the young but not in the elderly. Among persons below 50 years, persons with hyperhomocysteinaemia were 4.5 times more likely to develop IHD as compared to those with normohomocysteinaemia. Vitamin B^ and folate levels showed a negative correlation with serum homocysteine concentrations. The homocysteine concentration did not differ significantly with the genotypes of Methylenetetrahydrofolate reductase (MTHFR) C677T and A1298C polymorphisms. CONCLUSIONS: People with hyperhomocysteinaemia have a 2-3 fold increase in risk of developing IHD. Hyperhomocysteinaemia is a predictor of IHD in the young but not in the elderly. A decrease in either vitamin B12 or folate concentrations in serum is associated with higher homocysteine concentrations whereas MTHFR A1298C and C677T gene mutations do not have an effect on the homocysteine concentrations.