Determinants of early cessation of exclusive breastfeeding practices among rural mothers from Jaffna District of Sri Lanka.

BACKGROUND: Sri Lanka is an upper-middle-income country with excellent health statistics. However, 2016 Demographic and Health Survey data have shown 82% and 64% of mothers exclusively breastfed infants aged 0-6 months and 4-5 months, respectively. The short duration of exclusive breastfeeding (EBF) has an impact on the growth and development of babies. Since no studies have been reported on EBF practices of the rural mothers in Jaffna District, an administrative district among 25 districts of Sri Lanka, this study aimed to assess the factors influencing the early cessation of EBF. METHODS: For this community-based cross-sectional study, 338 mother-child pairs were selected from 2013-14. EBF was defined as children not receiving any food or drink, including complementary foods, formula milk or milk products except for medicines and vitamins or mineral drops, other than breast milk since birth. Socio-economic and demographic factors, the influence of the mode of delivery, and knowledge on EBF were obtained using an interviewer-administered questionnaire. The details of EBF and reasons for the cessation of breastfeeding before six months were obtained from a subgroup of mothers (n = 208). Multivariate analysis was performed to explore the correlates of breastfeeding. RESULTS: In this study, 71.2% (95% CI 64.5, 77.2) had practiced EBF for six months. Early discontinuation of EBF was practiced by employed mothers (AOR 4.3; 95% CI 1.3, 13.9), mothers of low birth weight babies (AOR 3.6; 95% CI 1.6, 8.2) and those who experienced Cesarean section birth (AOR 2.9; 95% CI 1.2, 6.9). The EBF practiced by mothers of rural Jaffna was not associated with the gender of the babies, type of family, number of children in a family, religion of the household, knowledge on EBF, or family income. CONCLUSION: The prevalence of EBF up to six months was low in rural Jaffna, and it was influenced by employment, birthweight of the babies, and the mode of delivery. To enhance EBF, the Regional Directorate of Health Service, Jaffna, should take necessary action with policymakers to increase maternity leave for at least six months, reduce the Cesarean section rate, and provide nutritional support to pregnant mothers.

Plasma Concentrations of Tranexamic Acid in Postpartum Women After Oral Administration.

OBJECTIVE: To evaluate the pharmacokinetics of tranexamic acid after oral administration to postpartum women. METHODS: We conducted a single-center pharmacokinetic study at Teaching Hospital-Jaffna, Sri Lanka, on 12 healthy postpartum women who delivered vaginally. After oral administration of 2 g of immediate-release tranexamic acid 1 hour after delivery, pharmacokinetic parameters were measured on plasma samples at 0, 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 5, 6, 8, 10, and 12 hours. Plasma tranexamic acid concentrations were determined by high-performance liquid chromatography. The outcome measures were maximum observed plasma concentration, time to maximum plasma concentration, time to reach effective plasma concentration, time period effective serum concentration lasted, area under the curve for drug concentration, and half-life of tranexamic acid. RESULTS: The mean maximum observed plasma concentration was 10.06 micrograms/mL (range 8.56-12.22 micrograms/mL). The mean time to maximum plasma concentration was 2.92 hours (range 2.5-3.5 hours). Mean time taken to reach the effective plasma concentration of 5 micrograms/mL and the mean time this concentration lasted were 0.87 hours and 6.73 hours, respectively. Duration for which plasma tranexamic acid concentration remained greater than 5 micrograms/mL was 5.86 hours. Half-life was 1.65 hours. Area under the curve for drug concentration was 49.16 micrograms.h/mL (range 43.75-52.69 micrograms.h/mL). CONCLUSION: Clinically effective plasma concentrations of tranexamic acid in postpartum women may be achieved within 1 hour of oral administration. Given the promising pharmacokinetic properties, we recommend additional studies with larger sample sizes to investigate the potential of oral tranexamic acid for the treatment or prophylaxis of postpartum hemorrhage.

Prevalence and factors associated with metabolic syndrome among Tamils aged over 18 years in Jaffna district, Sri Lanka.

BACKGROUND: The aim was to determine the prevalence and factors associated with Metabolic Syndrome (MS) among adults aged over 18 years in Jaffna district, Sri Lanka. METHODS: This study was carried out as a community based cross sectional descriptive study in Jaffna district, Sri Lanka. Multistage stratified cluster sampling technique was employed. Total sample size was 544. An interviewer administrated questionnaire was used to gather data. Waist circumference (WC) and blood pressure (BP) measurements were recorded in standard method. Overnight fasting blood samples were obtained from all subjects. Fasting plasma glucose (FPG), high density lipoprotein (HDL), and triacylglycerols were analyzed by the enzymatic colorimetric assay (Semi Automated analyser Teco Diagnostics TC 3300). Modified National Cholesterol Education Program's Adult Treatment Panel III (NCEP ATP III) criterion was used to define the MS. RESULTS: Sample response rate was 95.3 %. Of them, 43.8 % (n = 224) was male. Prevalence of central obesity (WC for male ≥102 cm, female ≥88 cm) was 16.2 %. Prevalence of raised FPG (≥100 mg/dL), hypertriacylglycerolaemia (≥150 mg/dl), low level of HDL cholesterol (<40 mg/dL in males, <50 mg/dL in females) and raised BP (systolic BP ≥130 or diastolic BP ≥85 mmHg) were 23.9, 25, 79.3 and 36.6 % respectively. Prevalence of MS was 24.1 % (n = 123, 95 % CI: 20.4-28) and it was 26.8 and 21.9 % among males and females respectively. Participants living in urban area had higher prevalence of MS when compared with participants living in rural area (P = 0.015). Older age (P < 0.001) and smoking (P = 0.005) were risk factor for development of MS. Prevalence of MS among the participants with sedentary and active lifestyle was 29.9 and 23.7 % respectively. CONCLUSION: One out of four had MS. Old age, urban living and smoking carried higher risk for developing MS in Jaffna community.

Osmo-, thermo- and ethanol- tolerances of Saccharomyces cerevisiae S1

Saccharomyces cerevisiae S1, which is a locally isolated and improved strain showed viability at 40, 45 and 50ºC and produced ethanol at 40, 43 and 45ºC. When the cells were given heat shock at 45ºC for 30min and grown at 40ºC, 100% viability was observed for 60h, and addition of 200gl-1 ethanol has led to complete cell death at 30h. Heat shock given at 45ºC (for 30min) has improved the tolerance to temperature induced ethanol shock leading to 37% viability at 30h. when the cells were subjected to ethanol (200gl-1 for 30 min) and osmotic shock (sorbitol 300gl-1), trehalose contents in the cells were increased. The heat shocked cells showed better viability in presence of added ethanol. Soy flour supplementation has improved the viability of S. cerevisiae S1 to 80% in presence of 100gl-1 added ethanol and to 60% in presence of 300gl-1 sorbitol. In presence of sorbitol (200gl-1) and ethanol (50gl-1) at 40ºC, 46% viability was retained by S. cerevisiae S1 at 48h and it was improved to 80% by soy flour supplementation.

Osmo-, Thermo- and Ethanol- Tolerances of Saccharomyces cerevisiae S1.

Saccharomyces cerevisiae S1, which is a locally isolated and improved strain showed viability at 40, 45 and 50°C and produced ethanol at 40, 43 and 45°C. When the cells were given heat shock at 45°C for 30min and grown at 40°C, 100% viability was observed for 60h, and addition of 200gL(-1) ethanol has led to complete cell death at 30h. Heat shock given at 45°C (for 30min) has improved the tolerance to temperature induced ethanol shock leading to 37% viability at 30h. When the cells were subjected to ethanol (200gL(-1) for 30 min) and osmotic shock (sorbitol 300gL(-1)), trehalose contents in the cells were increased. The heat shocked cells showed better viability in presence of added ethanol. Soy flour supplementation has improved the viability of S. cerevisiae S1 to 80% in presence of 100gL(-1) added ethanol and to 60% in presence of 300gL(-1)sorbitol. In presence of sorbitol (200gL(-1)) and ethanol (50gL(-1)) at 40°C, 46% viability was retained by S. cerevisiae S1 at 48h and it was improved to 80% by soy flour supplementation.