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1.
Parasitol Int ; 92: 102686, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36174940

RESUMO

BACKGROUND: Anopheles stephensi was first recorded in the coastal area of Mannar District, Sri Lanka, in December 2016. Since then, this vector has been isolated from other districts in the Northern and Eastern Provinces of Sri Lanka. Chemical control is the main arm of vector control that can be used to reduce the vector densities within a short period. Thus, the present study aimed at evaluating the efficacy of using selected insecticides for the control of An. stephensi larvae. METHOD: The third and fourth instar larval stages of An. stephensi (F2 generation) of field mosquitoes that were caught using cattle baited net trap collections from Columbuthurai, Kurunagar, and Navanthurai areas in Jaffna District, Sri Lanka, were obtained from the laboratory colony established at Jaffna. Batches of 100 larvae were taken for experiments and introduced separately to a concentration series of temephos and novaluron (0.04-400 ppm). A control test was also performed at each setup without introducing insecticides. The mortality rates of An. stephensi larvae exposed to different concentrations of larvicides were recorded at 1, 24 and 48-h intervals. The experiment was replicated five times at individual concentrations for each selected chemical. Data were analyzed using the General Linear Model (GLM) and Probit analysis. RESULTS: The highest mortality rate (100%) at a 1-h exposure period was observed from temephos at >100 ppm. The mortality rates varied significantly for different concentrations and larvicides (p < 0.05). At 24-h of the exposure period, the 100% mortality of An. stephensi larvae were observed from both temephos and novaluron even at 0.04 ppm. CONCLUSION: Both temephos and novaluron reported 100% mortality rates in An. stephensi larvae at 1-h and 24-h exposure periods. Based on the findings, temephos and novaluron can be recommended as effective larvicides for chemical-based control of An. stephensi in Jaffna, Sri Lanka. Further, it is recommended to conduct a field-based study, where habitat types and water quality are highly heterogeneous and may affect the residual activity.


Assuntos
Anopheles , Inseticidas , Animais , Bovinos , Temefós/farmacologia , Inseticidas/farmacologia , Mosquitos Vetores , Sri Lanka , Larva
2.
Acta Trop ; 237: 106719, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36288767

RESUMO

Cutaneous leishmaniasis is prevalent in Sri Lanka since 1992. It remains as a health issue with increasing numbers and spreading from endemic to non-endemic areas in the county. Kegalle district is a new disease focus, which notified the first case in 2016. However, there is no documented evidence of the vector distribution, abundance and potential risk factors in this district. Two Medical Officer of Health (MOH) areas (Rambukkana and Warakapola) that had reported the highest numbers of cases in the Kagalle district was selected and recorded cases (2016-2020) were obtained. The patients were visited and socio-economic, demographic, environmental and awareness-related information was collected using an interviewer-administered questionnaire. Entomological surveys were conducted from July 2019- July 2020 using three standard entomological techniques. Bioclimatic suitability for the disease transmission was evaluated using ecological niche modelling. A total of 107 patients were reported from both MOH areas and 88 were recruited for the study. The study showed that leishmaniasis in the Kegalle district progressed to an outbreak level within 3 years after reporting the first case. School students (n = 22, 25%, P < 0.05) and individuals between 11 and 20 years of age (n = 33, 37.5%, P<0.05) were identified as the main risk groups, while the presence of composting sites (n = 65, 73.9%, P < 0.05), abandoned lands (n = 63, 71.6%, P < 0.05) in the surrounding and suboptimal (dark or normal) lighting conditions (n = 87, 98.8%, P < 0.05) in the house were identified as main risk factors. Areas closer to the adjacent district (Kurunegala), which is a known endemic district for leishmaniasis indicated a high probability (0.3-0.5) for disease transmission. Sergentomyia zeylanica (n = 164, 56.94%), was identified as the predominant sand fly species followed by Phlebotomus argentipes (n = 121, 42.01%), Sergentomyia babu insularis (n = 2, 0.69%) and Sergentomyia punjabensis (n = 1, 0.35%). Phlebotomus argentipes was captured mostly for outdoor resting sites and S. zeylanica was recoded from both indoor and outdoor. The presence of vectors that can transmit leishmaniasis in these areas along with the potential risk factors could increase the transmission risk and disease establishment in new areas that are ecologically favourable for disease transmission. Therefore, vector control entities should undertake immediate measures to stop spreading the disease into new areas.


Assuntos
Leishmaniose Cutânea , Phlebotomus , Psychodidae , Animais , Sri Lanka/epidemiologia , Insetos Vetores , Ecossistema
3.
Mol Phylogenet Evol ; 178: 107651, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36306995

RESUMO

Uropeltidae is a clade of small fossorial snakes (ca. 64 extant species) endemic to peninsular India and Sri Lanka. Uropeltid taxonomy has been confusing, and the status of some species has not been revised for over a century. Attempts to revise uropeltid systematics and undertake evolutionary studies have been hampered by incompletely sampled and incompletely resolved phylogenies. To address this issue, we take advantage of historical museum collections, including type specimens, and apply genome-wide shotgun (GWS) sequencing, along with recent field sampling (using Sanger sequencing) to establish a near-complete multilocus species-level phylogeny (ca. 87% complete at species level). This results in a phylogeny that supports the monophyly of all genera (if Brachyophidium is considered a junior synonym of Teretrurus), and provides a firm platform for future taxonomic revision. Sri Lankan uropeltids are probably monophyletic, indicating a single colonisation event of this island from Indian ancestors. However, the position of Rhinophis goweri (endemic to Eastern Ghats, southern India) is unclear and warrants further investigation, and evidence that it may nest within the Sri Lankan radiation indicates a possible recolonisation event. DNA sequence data and morphology suggest that currently recognised uropeltid species diversity is substantially underestimated. Our study highlights the benefits of integrating museum collections in molecular genetic analyses and their role in understanding the systematics and evolutionary history of understudied organismal groups.


Assuntos
Museus , Serpentes , Animais , Filogenia , Serpentes/genética , Sequência de Bases , Sri Lanka
4.
Rev. biol. trop ; 70(1)dic. 2022.
Artigo em Inglês | LILACS-Express | LILACS, SaludCR | ID: biblio-1387711

RESUMO

Abstract Introduction: Bibliometric analyses of research in Sri Lanka, a lower-middle income island nation in South Asia, has focused mainly on medical research, concluding that there is a need for increased research productivity and impact, and for local solutions to health concerns. There has been no general bibliometric analysis across scientific disciplines in the nation, or any study that covers a long period of time to identify general time trends. Objective: To measure and analyse Sri Lanka research by focusing on subjects, authors, institutions, journals and citation for half a century. Methods: We used an advanced search method to extract publications with the word "Sri Lanka" in the SCI-EXPANDED, and calculated indicators such as total citations from Web of Science Core Collection since publication year to the end of 2019, citations in 2019, and mean citations per publication. Journal data were taken from 2019 Journal Citation Report. Affiliation re-classification was done to ensure consistency regarding the origin of all publications. Publications were further analysed based on collaboration, and first and corresponding authorship. Results: We retrieved 16 069 publications in 19 document types (77 % articles). Corrections had the highest number of authors per publication (616) followed by articles (116). Four articles had more than 5 000 authors and 593 articles had more than 1 000 authors. The highest citations in this database were for international megaprojects where Sri Lanka authors played minor roles. The UK had the most collaborative articles with Sri Lanka (19 %). The articles were published in 3 051 journals across 177 Web of Science categories. The category of Public, environmental and occupational health, with 193 journals, had 6.7 % of all articles, followed by environmental sciences (6.6 %). Conclusion: Sri Lanka has an unusually strong pattern of participating as small role players in international megaprojects about health and physics. Sri Lanka authors should be encouraged to expand their horizons by researching non-applied fields that are the basis of all innovation; to strengthen their own journals so that they have better visibility and impact, and to improve their positions in international projects that are published in larger journals.


Resumen Introducción: Los análisis bibliométricos de la investigación en Sri Lanka, una nación insular de ingresos mediano-bajos en el sur de Asia, se han centrado principalmente en la investigación médica, concluyendo que existe la necesidad de aumentar la productividad y el impacto de la investigación, y de soluciones locales a los problemas de salud. No ha habido un análisis bibliométrico general de disciplinas científicas o algún estudio que cubra un período largo de tiempo para identificar tendencias generales. Objetivo: Medir y analizar la investigación de Sri Lanka centrándose en temas, autores, instituciones, revistas y citas, durante medio siglo. Métodos: Utilizamos un método de búsqueda avanzada para extraer publicaciones con las palabras "Sri Lanka" en el SCI-EXPANDED, y calculamos indicadores como el total de citas de Web of Science Core Collection desde el año de publicación hasta finales de 2019, citas solo en 2019, y media de citas por publicación. Los datos de revistas son del Journal Citation Report 2019. Revisamos manualmente las afiliaciones para garantizar su coherencia, y, de todos los tipos de publicación, analizamos en detalle los artículos en función de la colaboración y la autoría. Resultados: Hallamos 16 069 publicaciones en 19 tipos de documentos (77 % artículos). Las correcciones tuvieron el mayor número de autores por publicación (616), seguidas de los artículos (116 autores en promedio); cuatro artículos tenían más de 5 000 autores y 593 artículos tenían más de 1 000 autores. Las citas más altas en esta base de datos fueron para megaproyectos internacionales en los que los autores de Sri Lanka desempeñaron papeles menores. El Reino Unido tuvo más artículos colaborativos con Sri Lanka (19 %). Los artículos se publicaron en 3 051 revistas de 177 categorías del Web of Science. La categoría d Salud pública, ambiental y ocupacional, con 193 revistas, tuvo el 6.7 % del total de artículos, seguida de Ciencias ambientales (6.6 %). Conclusión: En Sri Lanka hay una tendencia inusual a participar como pequeños actores en megaproyectos internacionales sobre salud y física. Debería alentarse a quienes hacen ciencia en Sri Lanka a ampliar sus horizontes investigando campos no aplicados, que son la base de la innovación; a fortalecer sus propias revistas para lograr mayor visibilidad e impacto, y a mejorar su ubicación en proyectos internacionales que se publican en revistas más grandes.


Assuntos
Pesquisa , Sri Lanka , Bibliometria , Indicadores Bibliométricos
5.
PLoS One ; 17(11): e0276647, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36342918

RESUMO

INTRODUCTION: Prevention of cardiovascular disease and diabetes is a priority in low- and middle-income countries, especially in South Asia where these are leading causes of morbidity and mortality. The metabolic syndrome is a tool to identify cardiometabolic risk, but the validity of the metabolic syndrome as a clinical construct is debated. This study tested the existence of the metabolic syndrome, explored alternative cardiometabolic risk characterisations, and examined genetic and environmental factors in a South Asian population sample. METHODS: Data came from the Colombo Twin and Singleton follow-up Study, which recruited twins and singletons in Colombo, Sri Lanka, in 2012-2015 (n = 3476). Latent class analysis tested the clustering of metabolic syndrome indicators (waist circumference, high-density lipoprotein cholesterol, triglycerides, blood pressure, fasting plasma glucose, medications, and diabetes). Regression analyses tested cross-sectional associations between the identified latent cardiometabolic classes and sociodemographic covariates and health behaviours. Structural equation modelling estimated genetic and environmental contributions to cardiometabolic risk profiles. All analyses were stratified by sex (n = 1509 men, n = 1967 women). RESULTS: Three classes were identified in men: 1) "Healthy" (52.3%), 2) "Central obesity, high triglycerides, high fasting plasma glucose" (40.2%), and 3) "Central obesity, high triglycerides, diabetes" (7.6%). Four classes were identified in women: 1) "Healthy" (53.2%), 2) "Very high central obesity, low high-density lipoprotein cholesterol, raised fasting plasma glucose" (32.8%), 3) "Very high central obesity, diabetes" (7.2%) and 4) "Central obesity, hypertension, raised fasting plasma glucose" (6.8%). Older age in men and women, and high socioeconomic status in men, was associated with cardiometabolic risk classes, compared to the "Healthy" classes. In men, individual differences in cardiometabolic class membership were due to environmental effects. In women, genetic differences predicted class membership. CONCLUSION: The findings did not support the metabolic syndrome construct. Instead, distinct clinical profiles were identified for men and women, suggesting different aetiological pathways.


Assuntos
Doenças Cardiovasculares , Diabetes Mellitus , Síndrome Metabólica , Masculino , Feminino , Humanos , Síndrome Metabólica/epidemiologia , Síndrome Metabólica/genética , Síndrome Metabólica/complicações , Sri Lanka/epidemiologia , Estudos Transversais , Obesidade Abdominal/complicações , Glicemia/metabolismo , Seguimentos , Fatores de Risco , HDL-Colesterol , Triglicerídeos , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/genética , Diabetes Mellitus/epidemiologia , Obesidade/epidemiologia
6.
Trials ; 23(1): 940, 2022 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-36380348

RESUMO

BACKGROUND: Chronic neck and shoulder region pain affects many people around the world. This study aims to compare the effectiveness of three 8-week meditation training programmes (each using a different meditation technique: Anapana, Body scan or Metta) on pain and disability in a patient population affected with chronic neck and shoulder region pain, with a usual care control group and with each other. METHODS: This four-arm parallel clinic-level randomised controlled trial will be conducted with male and female patients aged 18-65 years, who are affected with chronic neck and shoulder region pain, and who attend one of four clinics held on four different days of the week in a single medical centre in the Colombo North region, Sri Lanka. Clinics will be considered as clusters and randomly allocated to intervention and control arms. Data will be collected using validated questionnaires, clinical examinations and focus groups. To compare primary (differences in changes in pain (Numeric Pain Rating Scale) at 8 weeks) and secondary (differences in changes in pain, physical disability, range of movement and quality of life (SF-36) at 4 and 12 weeks) outcomes between groups, a two-way ANOVA will be used if data are normally distributed. If data are not normally distributed, a nonparametric equivalent (Kruskal-Wallis) will be used. Focus group transcriptions will be thematically analysed using the Richie and Spencer model of qualitative data analysis. DISCUSSION: This is a four-arm trial which describes how three different 8-week meditation technique (Anapana, Body Scan, Metta) interventions will be implemented with adult patients affected with chronic neck and shoulder region pain. The effectiveness of each meditation intervention on the pain, physical and psychosocial disabilities of patients will be compared between groups and with a usual care control group. The results of this study will contribute to recommendations for future meditation interventions for chronic neck and shoulder pain. TRIAL REGISTRATION: ISRCTN12146140 . Registered on 20 August 2021.


Assuntos
Dor Crônica , Meditação , Adulto , Humanos , Masculino , Feminino , Dor de Ombro/terapia , Cervicalgia/terapia , Cervicalgia/psicologia , Qualidade de Vida , Medição da Dor , Sri Lanka , Ombro , Resultado do Tratamento , Dor Crônica/diagnóstico , Dor Crônica/terapia , Dor Crônica/psicologia , Ensaios Clínicos Controlados Aleatórios como Assunto
7.
Molecules ; 27(21)2022 Oct 24.
Artigo em Inglês | MEDLINE | ID: mdl-36364010

RESUMO

Syzygium cumini, also called Jamun, or black plum, is an excellent source of bioactive components such as flavonoids, polyphenols, antioxidants, iron, and vitamin C. The Jamun tree is a tropical evergreen blooming plant and is an important medicinal plant from the Myrtaceae family that has been used for a long time in Indian and other traditional medicines across the world. Jamun is mainly cultivated in Asian countries such as Pakistan, India, Sri Lanka, and Bangladesh. Since ancient medicine, it has been utilized to treat a variety of diseases and physiological conditions. Currently, it is mostly used as a medication to treat various metabolic issues, including diabetes, hyperlipidemia, hypertension, obesity, etc. Therefore, Jamun could serve a beneficial role against metabolic syndrome (MS). In this work, the latest available scientific literature on Jamun was collected and the clinical trials investigating its effect on diabetes, hypertension, obesity, and hyperlipidemia were analyzed to find out how Jamun could improve the symptoms and biomarkers of MS. Overall, the results of this study found a significant association of Jamun with the prevention and treatment of these biomarkers of MS. In many studies, Jamun showed pharmacological modifications not only in MS but in many other diseases as well. Currently, its utilization as a folk medicine for the treatment of patients with MS is widely acknowledged. Hence, the findings of a large number of clinical studies confirmed the ameliorating effects of Jamun against MS due to its antioxidation, antidiabetic, anti-inflammation anticarcinogenic, and hyperlipidemic effects. More research is still needed to determine and identify the Jamun compounds and to elucidate their mechanisms of action that are responsible for these astounding bioactive properties and health benefits.


Assuntos
Diabetes Mellitus , Hipertensão , Síndrome Metabólica , Syzygium , Humanos , Síndrome Metabólica/tratamento farmacológico , Antioxidantes/farmacologia , Antioxidantes/uso terapêutico , Diabetes Mellitus/tratamento farmacológico , Obesidade/tratamento farmacológico , Hipertensão/tratamento farmacológico , Sri Lanka , Extratos Vegetais/farmacologia , Extratos Vegetais/uso terapêutico
8.
PLoS One ; 17(11): e0277108, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36413533

RESUMO

Pet ownership is an integral part of a modern-day family. It provides a wide range of benefits to humans. However, data on pet ownership are relatively limited from rural regions, Southern Asia and low-middle-income countries. We aim to report the prevalence and associated factors for pet ownership and veterinary visits in Anuradhapura, Sri Lanka. A community-based, cross-sectional study was conducted. An interviewer-administered questionnaire was used. Binary logistic regression was performed to determine significant associations between variables of interest and pet ownership (p < 0.05). Out of the 532 households, 57% currently owned a pet. The most common pet was the dog owned by 41% of the households and the cat was the second most owned by 17%. Security (69% - 152/220) was the most common role for dogs at home while it was companionship for cats (31% - 27/88) and hobby for both birds (64% - 18/28) and fish (54% - 14/26). Most dogs (54% - 118/220) had one veterinary visit within the last year. Households with >1 adult female [p = 0.02; OR = 1.61 (95% CI 1.09 to 2.36)], participants living alone [p = 0.03; OR = 0.24 (95% CI 0.07 to 0.86)] and Buddhists [p = 0.02; OR = 2.56 (95% CI 1.16 to 5.63)] were significantly associated with pet ownership. Pet ownership is common among people in Anuradhapura, Sri Lanka, with a few demographic factors having a significant association with pet ownership. Dogs are the most common type of pet and highlight the opportunity for research related to canine companionship and human health. Future research on such topics should consider the above-mentioned socio-demographic predictors as potential confounders.


Assuntos
Características da Família , Propriedade , Adulto , Cães , Humanos , Animais , Feminino , Estudos Transversais , Sri Lanka , Inquéritos e Questionários
9.
BMC Psychiatry ; 22(1): 716, 2022 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-36397028

RESUMO

INTRODUCTIONS: This study assessed the prevalence of cognitive impairment, the degree of impairment in individual cognitive domains and sociodemographic and clinical correlates among patients attending to psychiatry clinics at Teaching Hospital, Karapitiya, Sri Lanka. METHODS: A cross-sectional study was carried out at the psychiatry outpatient clinics of Teaching Hospital, Karapitiya, Sri Lanka. Their cognitive functions were assessed using the culturally validated Sinhala version of Addenbrooke's Cognitive Examination - III (ACE-III-S). ACE-III-S score below 85.5 was considered as significant cognitive impairment. Linear regression analysis was used to assess the factors associated with cognitive impairment. A P value of 0.05 is considered significant. RESULTS: One hundred forty patients with schizophrenia were assessed. Of this, 125 patients had significant cognitive impairment with a prevalence of 89.3% (95% CI:84.1-94.5). Impairment in each cognitive domain was as follows: 60% in attention, 65.7% in memory, 55% in fluency, 61.4% in language, and 63.6% in visuospatial skills. Impairment was not different between cognitive domains. Advancing age (P < 0.001), shorter duration of formal education (P = < 0.001), longer duration of illness (P = < 0.001) and not having a full-time employment (P = 0.020) showed a positive association with cognitive impairment. CONCLUSIONS: Nine out of ten patients with schizophrenia experienced significant cognitive impairment. Patients showed more than 50% impairment in all cognitive domains. The cognitive domains did not show disproportionate impairment. This study highlights the importance of introducing routine cognitive assessment protocols in patients with schizophrenia.


Assuntos
Disfunção Cognitiva , Esquizofrenia , Humanos , Esquizofrenia/complicações , Esquizofrenia/epidemiologia , Estudos Transversais , Testes Neuropsicológicos , Prevalência , Sri Lanka/epidemiologia , Disfunção Cognitiva/etiologia , Disfunção Cognitiva/complicações , Hospitais de Ensino
10.
BMJ Open ; 12(11): e056480, 2022 11 23.
Artigo em Inglês | MEDLINE | ID: mdl-36418134

RESUMO

INTRODUCTION: Atrial fibrillation (AF) is the most common arrhythmia globally. It is associated with a fivefold risk in stroke, but early diagnosis and effective treatment can reduce this risk. AF is often underdiagnosed, particularly in low-income and middle-income countries (LMICs) where screening for AF is not always feasible or considered common practice in primary care settings. Epidemiological data on AF in LMICs is often incomplete particularly in vulnerable populations. This LMIC research collaborative aims to identify the prevalence of AF in the Northern Sri Lankan community. METHODS AND ANALYSIS: A cross-sectional household survey piloted and codesigned through a series of community engagement events will be administered in all five districts in Northern Province, Sri Lanka. A multistage cluster sampling approach will be used starting at district level, then the Divisional Secretariats followed by Grama Niladhari divisions. Twenty households will be selected from each cluster. The study aims to recruit 10 000 participants aged 50 years or older, 1 participant per household. Demographic and socioeconomic characteristics, well-being and lifestyle and anthropometric measurements will be collected using a digital data platform (REDCap, Research Electronic Data Capture) by trained data collectors. Participants will be screened for AF using a fingertip single-lead ECG via a smartphone application (AliveCor) with rhythm strips reviewed by a consultant cardiologist. Prevalence of AF and risk factors will be established at province and district-levels. Adjusted ORs and population attributable fractions for AF risk factors will be determined. ETHICS AND DISSEMINATION: This study was approved by the Ethics Review Committee of Faculty of Medicine at University of Jaffna. Written informed consent will be obtained from all participants. Findings will be disseminated through publication in a peer-reviewed journal and presentations at conferences. The findings will enable early treatment for new AF diagnoses and inform interventions to improve community-based management of AF in LMICs.


Assuntos
Fibrilação Atrial , Humanos , Fibrilação Atrial/diagnóstico , Fibrilação Atrial/epidemiologia , Fibrilação Atrial/terapia , Estudos Transversais , Sri Lanka/epidemiologia , Prevalência , Eletrocardiografia
11.
Trials ; 23(1): 955, 2022 Nov 22.
Artigo em Inglês | MEDLINE | ID: mdl-36415006

RESUMO

BACKGROUND: Knee osteoarthritis (KOA) is the most common form of arthritis, causing disability and impaired quality of life especially in the elderly. Sri Lankan traditional medicine (STM) is widely used to treat OA, but no clinical trial evaluated on STM regimens for KOA to discuss their safety and efficacy in the treatment. The aim of this study is to compare the efficacy and safety of STM regimen for KOA in comparison to recommended conventional pain management therapy over a period of 8 weeks on relieving the condition. STUDY DESIGN: This is a clinical trial following a protocol-driven open-labeled randomized controlled study enrolling patients with KOA that will be conducted as a single-center trial in the National Ayurveda Teaching Hospital, Sri Lanka. Rasnadvigunabhagasaya herbal decoction (RDBD) and an herbal pill Yoaraja Guggulu were selected as the rescue medication for treating joint disorders. The two Ayurvedic dosage forms will be tested against the non-steroidal anti-inflammatory drugs tab paracetamol and tab ibuprofen as the rescue medication for their safety and efficacy. As test products for external application, oil with an herbal fomentation-Kumburuetaperumkayam Pottani (KAP)-and paste-Sandivadam Lepaya (SVL)-were selected. External applications will be tested against the diclofenac sodium gel and hot water fomentation. KOA patients will be allocated randomly into two arms, and the medications will be given orally for 60 days and externally for 30 days. The primary endpoint is the change in the score on the WOMAC after 08 weeks. WOMAC and KOOS will be recorded and compared between the two arms prior to visiting 1, at the end of 15 days and end of 30 days, and end of the 45 days and end of the second month and 3 months of follow-up. KOOS and WOMAC subscales, a pain disability index, a visual analog scale for pain and sleep quality, and a quality-of-life index are used as secondary outcome measurements. DISCUSSION: This clinical trial will be able to provide evidence-based scientific data on Sri Lankan traditional medicine regimens in the management of KOA. This trial is expected to develop capacity to scientifically evaluate various STM that are claimed to have efficacy in treatment of various disease conditions. TRIAL REGISTRATION: ISRCTN58050062 .


Assuntos
Osteoartrite do Joelho , Humanos , Idoso , Osteoartrite do Joelho/diagnóstico , Osteoartrite do Joelho/tratamento farmacológico , Sri Lanka , Qualidade de Vida , Ayurveda , Dor , Ensaios Clínicos Controlados Aleatórios como Assunto
12.
Pharmacogenomics ; 23(17): 917-923, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-36285665

RESUMO

Aims: To describe the diversity of pharmacogenomic variants affecting warfarin metabolism in Sri Lankans. Materials & methods: Genotype data were filtered out from an anonymized database of 400 Sri Lankans, and minor allele frequencies (MAF) were calculated. Variants of CYP2C9, VKORC1 and CYP4F2 genes were studied. Results: Overall, CYP2C9*2 and CYP2C9*3 alleles had MAFs of 2.25% (95% CI: 0.80-3.70) and 10.38% (95% CI: 7.50-13.50), respectively. CYP2C9*11 and CYP2C9*14 alleles had MAFs of 0.13% (95% CI: 0-0.74) and 2.50% (95% CI: 0.97-4.03), respectively. MAFs of VKORC1 variants rs7294, rs9934438, rs8050894 and rs2884737 were 47.25% (95% CI: 42.36-52.14), 10.13% (95% CI: 7.28-13.22), 9.88% (95% CI: 7.06-12.94) and 4.88% (95% CI: 2.86-7.14), respectively. MAF of CYP4F2 variant rs2108622 was 45.63% (95% CI: 40.87-50.63). Conclusion: Compared with other populations, the frequencies of some studied variants were significantly different in Sri Lankans, and these are likely to account for variability in warfarin dosage requirements.


Assuntos
Variantes Farmacogenômicos , Varfarina , Humanos , Vitamina K Epóxido Redutases/genética , Citocromo P-450 CYP2C9/genética , Família 4 do Citocromo P450/genética , Sri Lanka , Anticoagulantes , Genótipo , Relação Dose-Resposta a Droga
13.
PLoS One ; 17(10): e0274642, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36201463

RESUMO

Globally, more than a third of pregnant women are anemic, and progress in its prevention and control is slow. Sri Lanka is a lower-middle-income country with a unique public health infrastructure that provides multiple interventions across the lifecycle for anemia prevention, despite which anemia in pregnancy remains a challenge. Studying the factors associated with maternal anemia in this context would provide unique information on challenges and opportunities encountered as low-and-middle-income countries attempt to control anemia by improving health care coverage. All first-trimester pregnant women registered for antenatal care in the Anuradhapura district between July 2019 to September 2019 were invited to participate in the baseline of a cohort study. Interviewer-administered and self-completed questionnaires were used. Anemia was defined using a full blood count. A hierarchical logistic regression model was built to identify factors associated with anemia. Out of 3127 participants, 451 (14.4%) were anemic. According to the regression model (Chi-square = 139.3, p<0.001, n = 2692), the odds of being anemic increased with the Period of gestation (PoG) (OR = 1.07, 95% CI = 1.01-1.13). While controlling for PoG, age and parity, history of anemia (OR = 3.22, 95%CI = 2.51-4.13), being underweight (OR = 1.64, 95%CI = 1.24-2.18), having the last pregnancy five or more years back (OR = 1.57,95%CI = 1.15-2.15) and having used intrauterine devices for one year or more (OR = 1.63, 95%CI = 1.16-2.30) increased the odds of anemia. Breast feeding during the last year (OR = 0.66, 95%CI = 0.49-0.90) and having used contraceptive injections for one year or more (OR = 0.61,95%CI = 0.45-0.83) reduced the risk of anemia. Proxy indicators of being in frequent contact with the national family health program have a protective effect over the socioeconomic disparities in preventing early pregnancy anemia. Maintaining the continuum of care through the lifecycle, especially through optimizing pre and inter-pregnancy care provision should be the way forward for anemia control.


Assuntos
Anemia , Deficiências de Ferro , Transtornos Puerperais , Anemia/complicações , Estudos de Coortes , Anticoncepcionais , Feminino , Humanos , Paridade , Gravidez , Fatores de Risco , Fatores Socioeconômicos , Sri Lanka/epidemiologia
16.
PLoS One ; 17(10): e0274901, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36315507

RESUMO

BACKGROUND: Patient's knowledge on the medicines prescribed is vital in reducing medication errors and improving adherence and patient satisfaction. This study assessed the patients' knowledge on medicines prescribed and compared improvement following verbal or written information given in patients own language. METHODS: Seventy-five trainee pharmacists randomised to verbal or written groups, provided information to consecutive consenting patients attending medical and surgical clinics in the outpatient department of National Hospital of Sri Lanka. Baseline knowledge and immediate recall knowledge was scored on 5 categories (name, indication, dose, frequency of administration, and additional relevant details) for each drug prescribed. Scores <5/10, 5-7/10 and > 7/10 were considered as poor, moderate, and good knowledge. Sample of 384 in each group had 80% power to detect a 10% difference in knowledge level. Data was analysed using SPSS v26. RESULTS: Of the 747 patients, 429(57%) were females, mean age was 54.3 years(SD±12), 450(60%) were on 5 or more drugs and 149(20%) were elderly (>65 years). At baseline, knowledge scores were comparable in both groups with 47% (352/747) patients having poor knowledge, 34% (254/747) moderate knowledge and only 19% (141/747) good knowledge. Patients knew the name only on 1653(42%) drugs prescribed, indication on 1603(41%), dose on 860(22%), administration details on 2255(58%) and additional details (adverse effects/storage) only on 267(7%) medicines prescribed. After the intervention, 276(74%) patients had good knowledge (score>7), in written group vs 217(58%) in verbal group (p<0.05). In all 5 aspects knowledge improved significantly more in written group compared to the verbal group. Binomial logistic regression analysis indicated that ordinary level (OR:2.32), advanced level(OR:2.13) and university education(OR:3.72), and lower number of medicines prescribed(OR:0.83) significantly increased the odds of having a "Good Knowledge on Medicines". CONCLUSION: Patient's knowledge on medicines prescribed was poor and providing the medication plan in writing in patients' own language would improve the knowledge significantly compared to providing verbal information.


Assuntos
Idioma , Satisfação do Paciente , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Farmacêuticos , Sri Lanka , Redação
18.
BMJ Glob Health ; 7(10)2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-36220306

RESUMO

BACKGROUND: Snakebite envenoming is a neglected tropical disease. Data from the worst affected countries are limited because conducting epidemiological surveys is challenging. We assessed the utility of inhibitory geostatistical design with close pairs (ICP) to estimate snakebite envenoming incidence. METHODS: The National Snakebite Survey (NSS) in Sri Lanka adopted a multistage cluster sampling design, based on population distribution, targeting 1% of the country's population. Using a simulation-based study, we assessed predictive efficiency of ICP against a classical survey design at different fractions of the original sample size of the NSS. We also assessed travel distance, time taken to complete the survey, and sensitivity and specificity for detecting high-risk areas for snake envenoming, when using these methods. RESULTS: A classical survey design with 33% of the original NSS sample size was able to yield a similar predictive efficiency. ICP yielded the same at 25% of the NSS sample size, a 25% reduction in sample size compared with a classical survey design. ICP showed >80% sensitivity and specificity for detecting high-risk areas of envenoming when the sampling fraction was >20%. When ICP was adopted with 25% of the original NSS sample size, travel distance was reduced by >40% and time to conduct the survey was reduced by >75%. CONCLUSIONS: This study showed that snakebite envenoming incidence can be estimated by adopting an ICP design with similar precision at a lower sample size than a classical design. This would substantially save resources and time taken to conduct epidemiological surveys and may be suited for low-resource settings.


Assuntos
Mordeduras de Serpentes , Antivenenos/uso terapêutico , Humanos , Incidência , Doenças Negligenciadas , Tamanho da Amostra , Mordeduras de Serpentes/epidemiologia , Venenos de Serpentes , Sri Lanka/epidemiologia
19.
PLoS Negl Trop Dis ; 16(10): e0010821, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-36228029

RESUMO

Cutaneous leishmaniasis (CL) is a notifiable disease in Sri Lanka with increasing case numbers reported from every part of the country. In addition to disease treatment and vector control measures, knowledge and perceptions in a community are key contributors to a successful intervention program. An island-wide survey was carried out to assess the knowledge and perceptions regarding CL across the island, with 252 confirmed CL cases and 2,608 controls. Data was collected by trained personnel, using a pre-tested Case Reporting Form (CRF). Although the percentage who referred to CL by its correct name was low (1.4%), majority stated that it is a fly induced skin disease (79.1%). Knowledge on the symptoms, curability and the name of the vector was high in these communities, but specific knowledge on vector breeding places, biting times and preventive methods were poor. The patients were more knowledgeable when compared to the controls. Differences in the level of knowledge could be identified according to the level of education of the participants as well as across the different areas of the country. The main source of information was through the healthcare system, but the involvement of media in educating the communities on the disease was minimal. While this study population was unaccustomed to the use of repellants or sprays, the use of bed nets was high (77.7% of the participants) in this study population. Although misconceptions and incorrect practices are rare in Sri Lankan communities, promoting health education programs which may improve disease awareness and knowledge on vector and its control will further strengthen the control and prevention strategies.


Assuntos
Leishmaniose Cutânea , Animais , Vetores de Doenças , Humanos , Conhecimento , Leishmaniose Cutânea/diagnóstico , Leishmaniose Cutânea/epidemiologia , Leishmaniose Cutânea/prevenção & controle , Sri Lanka/epidemiologia , Inquéritos e Questionários
20.
Artigo em Inglês | MEDLINE | ID: mdl-36231148

RESUMO

As in many other parts of the world, the urban areas of the South Asian region are increasingly expanding. While cities today are the heart of commercial, technological and social development, they are also vulnerable to a variety of natural and anthropogenic threats. The complex urban infrastructure, and the ever-expanding population in cities, exacerbate the impacts of climate change and increase the risk of natural hazards. Throughout history, various hydrological disasters including floods, tidal surges, and droughts, and non-hydrological disasters such as earthquakes, landslides, and storms have led to catastrophic social, economic and environmental impacts in numerous South Asian cities. Disaster risk reduction is therefore central to ensure sustainability in urban areas. Although Nature-based Solutions (NbS) are identified as a promising strategy to reduce risk and increase resilience, there appears to be a lack of evidence-based approaches. NbS are measures that can be practiced to obtain benefits of nature for the environmental and community development through conserving, managing, and restoring ecosystems. Against this backdrop, the South Asian cities provide opportunities to evaluate capacities for achieving Nature-based Resilience (NbR) through NbS. This study documents insights from five cities of five different countries of the South Asian region which are subjected to a wide array of disasters: Barishal (Bangladesh), Phuentsholing (Bhutan), Gurugram (India), Kathmandu (Nepal), and Colombo (Sri Lanka). The primary objective of this study is to provide evidence on how NbS are being practiced. Thus, some success stories in cities under consideration are highlighted: restoration of natural canals through integrated development plans and community participation (Barishal), concepts of Gross National Happiness (GNH) and minimal nature interventions (Phuentsholing), "Greening cities'' including eco-corridors, vegetation belts, biodiversity parks (Gurugram), proper land use planning aims at different disasters (Kathmandu), and wetland restoration and management with multiple benefits (Colombo). These cases could therefore, act as a "proxy" for learning from each other to prepare for and recover from future disasters while building NbR.


Assuntos
Desastres , Ecossistema , Cidades , Mudança Climática , Inundações , Sri Lanka
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