Patient Satisfaction on Telehealth Services Used in Urban Sri Lankan Settings, During the COVID-19 Pandemic.

This research intended to assess satisfaction of urban patients on the use of telehealth over the last two years; mainly across the Covid-19 pandemic in Sri Lanka. Most of the telehealth users were the younger patients, and they were generally satisfied with the technical quality, serviced delivery as well as the overall experience. However, telehealth was utilized mainly for delivery of a limited range of services. In the future, Telehealth seems to have great potential to exist as a supplement to conventional appointments.

Using Facebook™ as a Platform for Remote Patient Care to Address Rehabilitation Needs in a Resource-Limited Environment During a Crisis.

The Covid 19 Pandemic affected Physiotherapy Clinics as much as it did all Clinical Services Provisions all over the world. This paper discusses a model where Facebook social media platform was successfully used as an emergency platform to deliver clinical services to the clients of a Physiotherapy Clinic in a Developing Country, during the Covid 19 pandemic.

Feeding behavior of feedlot lambs fed diets with different energy and protein sources.

This study aimed to evaluate the effect of the replacement of ground corn by crude glycerin and soybean meal by cottonseed cake, in association or not, on feedlot lambs' feeding behavior. Thirty-two non-castrated crossbred ½ Dorper ½ Santa Inês lambs, with an average body weight of 18.52 ± 3.24 kg (mean ± standard deviation), were distributed in a completely randomized design, into four treatments and eight replicates per treatment, in a 2 × 2 factorial scheme. Four experimental diets were tested with different sources or combinations of energy and protein ingredients in the concentrate, respectively: (1) ground corn + soybean meal; (2) ground corn and cottonseed cake; (3) crude glycerin and soybean meal; and (4) crude glycerin and cottonseed cake. The glycerin decreased dry matter (DM) and neutral detergent fiber (NDF) (P < 0.001) intakes, whereas it increased times spent in feeding (P = 0.009; from 21.8 to 28.6), rumination (P = 0.006; from 56.2 to 67.2), and chewing (P < 0.001; from 79.4 to 97.2), in minutes/100 g of DM. Feeding efficiencies of DM (P = 0.003) and NDF (P = 0.008) were decreased by the diets. Protein sources increased (P = 0.018) the times spent in chewing and per period in rumination (P = 0.014). Cottonseed cake, as a protein source, up to a 112 g/kg DM level, can totally replace soybean meal in diets for feedlot lambs without effects on the intake, behavioral activities, and feeding efficiencies. In contrast, the crude glycerin energy source is not adequate to replace ground corn in lambs' diets.

Use of Nursing Interventions as an Indicator to Assess the Workload of Nurses in a Tertiary Care Surgical Ward Setting in Sri Lanka.

This research looked into the possibility of using the number of Nursing Interventions as a measure of Nurses workload in a Surgical ward setting. The quantification of the number of interventions was done using the Nursing Interventions Classification (NIC). This strategy could generate the average number of interventions required per patient and per shift as well as could assess the variation of the number of interventions under different factors.

Syzygium cumini (L.) Skeels improves metabolic and ovarian parameters in female obese rats with malfunctioning hypothalamus-pituitary-gonadal axis.

BACKGROUND: Obesity is a chronic and multifactorial disease characterized by increased adipose tissue. In females, obesity leads to reduced ovulation and lower chances of conception in diseases like polycystic ovary syndrome, making it important to characterize complementary medicine to attenuate such deleterious effects. Therefore, the aim of this study was to assess the effects of a hydroethanolic extract from Syzigium cumini leaves in female reproductive impairments present in the obesity model of neonatal L-monosodium glutamate injection. METHODS: Newborn Wistar rats received saline (CTRL) or L-monosodium glutamate 4 mg/g BW (MSG). At 90 days of age, CTRL and some MSG rats received saline, while others received hydroethanolic extract of S. cumini leaves (HESc 500 mg/kg/day, MSG-Syz group) for 30 consecutive days. Estrous cycle was determined by daily vaginal washes. On days 26 and 28 of treatment, oral glucose tolerance test and blood collection were performed for biochemical assessment. At the end, animals were euthanized during estrous phase; blood was collected to measure sex hormones and organs collected for weighing and histological evaluation. RESULTS: MSG-Syz showed reduced Lee Index, retroperitoneal fat pads and restored gluco-insulin axis. Moreover, HESc treatment reduced serum cholesterol levels when compared to MSG. Treatment with HESc did not restore the oligociclicity observed in obese animals, though MSG-Syz reestablished ovarian follicle health back to CTRL levels, with proliferating primordial follicles - these effects were followed by a decrease on periovarian adipocyte area. CONCLUSIONS: This is the first report to show the reversibility of the reproductive dysfunctions seen in MSG female rats through ethnopharmacological treatment. Moreover, it expands the use of HESc as a prominent tool to treat metabolic and reproductive disorders. Finally, we provide novel evidence that, without a functioning hypothalamus-pituitary-gonads axis, metabolic improvement is ineffective for estrous cyclicity, but critical for ovarian follicle health.

Using a Simulation Modelling Approach to Manage Outpatient Department Waiting Time at the National Hospital of Sri Lanka.

A simulation modeling approach was used to determine the optimal human resource solutions for the main functions of the OPD by observing 384 conveniently selected patients at the National Hospital of Sri Lanka. This work seems to be optimized by increasing the morning shift doctors, causing minimal disturbance and inconvenience to the administration and the workers.

Use of Social Media in Facilitating Health Care Research Among Nursing and Allied Health Undergraduates in Sri Lanka.

A mentoring program was designed to promote conduction, completion and dissemination of undergraduate research among Nursing and Allied Health students in Sri Lanka. Several social media platforms were used; mainly the Facebook, YouTube and Google Hangouts. Knowledge sharing, interaction and collaboration were promoted. Student motivation was also done. Research presentation skills and applying for conferences was also facilitated. Over 90% of the participated 262 students completed a research project and close to 50% presented them both locally and internationally.

Attitude Towards Health Information Privacy and Electronic Health Records Among Urban Sri Lankan Adults.

Sri Lanka is planning to move towards an Electronic Health Record (EHR) system. This research argues that the public preparedness should be considered in order to implement a functioning and an effective EHR system in a country. When asked about how concerned the participants were about the security of their health records, 40.5% stated they were concerned and 38.8% were very concerned. They were asked to rate the 'level of trust' they have on health institutes in Sri Lanka on a scale from 1 to 10 (1 lowest level of trust and 10 highest), 66.1% rated at level 5 or less.

Cephalometric analysis of modifications of the pharynx due to maxillo-mandibular advancement surgery in patients with obstructive sleep apnea.

Cephalometry has been used to measure hard and soft facial tissues, as well as the pharyngeal air space for the diagnosis of obstructive sleep apnea (OSA). The changes occurring in the pharynx due to maxillo-mandibular advancement (MMA) have not been established or quantified. The objective of this study was to identify the anatomical changes of the pharynx and of hard tissues that occur in patients with OSA after MMA. 19 patients with a polysomnographic diagnosis of OSA were submitted to cephalometric analysis before and 6 months after surgery in order to evaluate the changes produced by MMA in the pharynx and soft tissues. Cephalometry was standardized in order to obtain descriptive measurements of the dimensions of the airways, the position of the hyoid bone, and maxilla-mandibular relations. The modifications of the pharynx due to MMA showed a significant relation obtained by cephalometry. For each millimeter of maxillary and mandibular bone advancement there was a 0.76mm increase in the retropalatal region and a 1.2mm increase in the pharynx in the retrolingual region. In addition, MMA promoted a significant repositioning of the hyoid bone in the cranial direction.

Glycerol as substrate for the production of biosurfactant by Pseudomonas aeruginosa UCP0992.

In this work the influence of the carbon source concentration, of the type and concentration of the nitrogen source and of the cultivation conditions (temperature, aeration and agitation speed) in mineral medium formulated with glycerol was studied for biosurfactant production by Pseudomonas aeruginosa UCP0992. The kinetics of microorganism growth and biosurfactant production have been described for the medium supplemented with 3% glycerol and 0.6% NaNO(3), at 28 degrees C during 120 h under 200 rpm, showing a growth-associated production. The isolated biosurfactant corresponded to a concentration of 8.0 g/l after 96 h. The medium surface tension was reduced to 27.4 mN/m and the emulsification index of hexadecane reached 75-80% after 72 h. A CMC of 700 mg/l and an interfacial tension against hexadecane of 2 mN/m were obtained. The biosurfactant showed stability when submitted at 90 degrees C during 2 h, and thermal (4-120 degrees C) and pH (4-12) stability regarding the surface tension reduction and the emulsification capacity of vegetable oils and hydrocarbons, and tolerance under high salt concentrations (2-10%). The biosurfactant was characterized as a group of rhamnolipids with anionic nature. The crude biosurfactant did not show toxicity against the microcrustacean Artemia salina and the cabbage (Brassica oleracea), while the isolated biosurfactant showed toxicity against the microcrustacean at the CMC. The application of the biosurfactant in diesel recovery from sand was demonstrated by removal percentiles above 85%. The results obtained in this work are noteworthy for possible biosurfactant production from glycerol with potential of application in the environment.

Transfusion-transmitted infectious diseases.

A spectrum of blood-borne infectious agents is transmitted through transfusion of infected blood donated by apparently healthy and asymptomatic blood donors. The diversity of infectious agents includes hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency viruses (HIV-1/2), human T-cell lymphotropic viruses (HTLV-I/II), Cytomegalovirus (CMV), Parvovirus B19, West Nile Virus (WNV), Dengue virus, trypanosomiasis, malaria, and variant CJD. Several strategies are implemented to reduce the risk of transmitting these infectious agents by donor exclusion for clinical history of risk factors, screening for the serological markers of infections, and nucleic acid testing (NAT) by viral gene amplification for direct and sensitive detection of the known infectious agents. Consequently, transfusions are safer now than ever before and we have learnt how to mitigate risks of emerging infectious diseases such as West Nile, Chikungunya, and Dengue viruses.

Effect of biphasic calcium phosphate on human macrophage functions in vitro.

Bioceramics may initiate several and complex biological reactions in host tissues. The cell-biomaterial interaction can determine macrophage activation that may elicit and sustain inflammatory response at the implant site. The current study describes some of the in vitro phenomena regarding the effect of surface reactivity of biphasic calcium phosphate (BCP) granules on human macrophages locomotion and secretion. X-ray diffraction analysis indicated that the synthesized ceramic presented 80% hydroxyapatite and 20% tricalcium phosphate. When BCP was put in contact with human macrophage cells, we observed that cells and BCP granules attached to each other. Cells attached to BCP presented a higher intracellular free Ca(2+) concentration compared with nonattached neighbors and secreted calcium phosphate particles into the medium. Energy dispersive X-ray analysis showed that the secreted particles presented a calcium/phosphorus ratio of 1.64 +/- 0.05, similar to hydroxyapatite. We propose that the secreted particles create a transition zone that allows further macrophage adhesion.

Excess maternal transmission and familial aggregation of Type 2 diabetes in Sri Lanka.

INTRODUCTION: An excess of maternal transmission of Type 2 diabetes mellitus has been reported in Europid populations, but not in South India. METHOD: A questionnaire-based survey was carried out in 1000 (502 male) people with Type 2 diabetes to establish whether there is an excess of maternal transmission and familial aggregation in a Sri Lankan population. RESULTS: Mean age of onset was 47+/-12 (+/-S.D.) years and duration of diabetes was 9+/-7 years. Thirty-seven percent reported parents with diabetes, 46.9% had no parents with diabetes, 16.1% did not know the diabetes status of at least one parent and there was no diabetes in the other. Of the probands, 59.4% had at least one affected relative. When both parents' diabetes status was known and only one was affected, diabetes was more common among mothers (n = 156) than fathers (n = 125) of probands (P < 0.001). A further 54 probands had both parents with diabetes. Mean age of onset and duration of the disease among probands with parental diabetes was 43.1+/-(11.1) and 9.6+/-(6.8). In the previous generation, 21.2% of maternal grandmothers and 17.3% of maternal grandfathers in the maternal diabetes group and 4.8% of maternal grandmothers and 17% of maternal grandfathers in the paternal diabetes group had diabetes. Diabetes in siblings and children was more common in those with mothers who had diabetes (53.8% and 4.5%) when compared with those in whom fathers had diabetes (42.4% and 1.6%) (P < 0.0001 and P < 0.01). CONCLUSION: Familial aggregation and excess maternal transmission were observed in people with Type 2 diabetes in Sri Lanka.