Exploring the biointerfaces: ab initio investigation of nano-montmorillonite clay, and its interaction with unnatural amino acids.

We investigated the interaction between biomimetic Fe and Mg co-doped montmorillonite nanoclay and eleven unnatural amino acids. Employing three different functionals (PBE-GGA, PBE-GGA + U, and HSE06), we examined the clay's structural, electronic, and magnetic properties. Our results revealed the necessity of using PBE-GGA + U with U ≥ 4 eV to accurately describe key clay properties. We identified amino acids that strongly interacted with the clay surface, with steric orientation playing a crucial role in facilitating binding. Our DFT calculations highlighted significant electrostatic interactions between the amino acids and the clay slab, with the amino group's predominant role in this interaction. These findings hold promise for designing amino acids for clay-amino acid systems, leading to innovative bio-material composites for various applications. Additionally, our ab-initio molecular dynamics simulations confirmed the stability of clay-amino acid systems under ambient conditions, and the introduction of an implicit water solvent enhanced the binding energy of amino acids on the clay surface.

Post treatment quality of life among Sri Lankan women with breast cancer.

BACKGROUND: Breast cancer and its treatment imposes a significant effect in the quality of life (QOL) of women. Being a developing country with contrasting social and cultural norms to the West, Sri Lankan women may have a different experience on QOL following surgical treatment of breast cancer. This study was conducted to evaluate post-treatment QOL in breast cancer patients and to determine its association with the type of surgery. METHODS: A cross sectional study was carried out. Fifty four women with non-metastatic breast cancer who underwent surgery for breast cancer at the Professorial Surgical Unit, Colombo during 2015-2018 and completed a minimum of one year follow up after surgery were invited to participate. Fifty-four women who responded were assessed using the validated EORTC QLQ-C30 and QLQ-BR23 questionnaires. Non-parametric tests were used for statistical analyses. RESULTS: The mean age was 59 years (range 36-81). A majority (61%, n = 35) underwent mastectomy and the rest (n = 19, 45%) breast conservation surgery (BCS). The mean QLQ-C30 score was 68.8 (range 8.3-100) and the mean scores for physical function, role function, emotional function, cognitive function, and social function were 71.4, 81.5, 77.0, 80.2, and 86.4, respectively. The mean scores for body image, sexual functioning, sexual enjoyment, future perspective, systemic therapy, breast symptoms, arm symptoms, and hair loss assessed by the QLQ-BR23 were 76.4, 18.3, 33.3, 73.6, 30.5, 16.2, 23.4 and 32.7, respectively. No significant differences (P > 0.05) were noted in global health status, physical function, role function, emotional function, cognitive function and social function between BCS and mastectomy. QLQ-BR23 body image, sexual functioning, sexual enjoyment and future perspective also did not differ significantly (p > 0.05) between the two groups. CONCLUSIONS: Sexual functioning and enjoyment, breast and arm symptoms and hair loss contributed to poor QOL while the impact on global health status including physical, social and emotional functions were minimal. Type of surgery did not appear to be associated with QOL. Future studies with a larger sample sizes will be helpful to further study these factors.

The incidence and patterns of lung cancers in Sri Lanka from 2001 to 2010: Analysis of national cancer registry data.

OBJECTIVES: Epidemiological studies carried out on lung cancer have shown varying incidence patterns in Asia. We aimed to examine the trends in lung cancer incidence and patterns in Sri Lanka. METHODS: All newly diagnosed lung cancer patients in Sri Lanka during 2001-2010 included in the National Cancer Registry were analysed. Trends in incidence were analysed using the Joinpoint regression software. RESULTS: A total of 8482 lung cancer patients (males = 6831, 80.5%, mean age: 60.2 years) were analysed. The WHO age-standardised incidence rate (ASR) has increased from 3.77 per 100,000 in 2001 (95% confidence interval [95% CI]: 3.47-4.07) to 5.74 per 100,000 in 2010 (95% CI: 5.38-6.09; a 1.52-fold increase (p < 0.05 for trend), with an estimated annual percentage change (EAPC) of 5.4 (95% CI: 3.9-7.0). The proportional increase in incidence was higher for females [ASR: 1.2 to 2.3, EAPC = 6.8(95% CI: 4.0-9.7)] than males [ASR: 6.6 to 9.55, EAPC = 5.2(95% CI: 3.8-6.6)] and with similar patterns. CONCLUSIONS: In Sri Lanka, the incidence of lung cancer has shown as increasing trend with a greater proportional rise in females. Although the observed trends could be partly due to better reporting, the greater increase in females who are generally non-smokers is intriguing. Further studies are required to identify reasons for observed incidence trends in lung cancer in Sri Lanka.

The incidence and patterns of colorectal cancers in Sri Lanka from 2001 to 2010: Analysis of national cancer registry data.

OBJECTIVES: The incidence of colorectal cancer (CRC) has been increasing in many Asian countries. This study aims to analyse trends in CRC incidence and histological patterns in Sri Lanka. METHODS: All newly diagnosed patients with CRC in Sri Lanka during 2001-2010 included in the National Cancer Registry were analysed for trends in incidence using Joinpoint regression software. RESULTS: A total of 7,694 CRC (male:female = 1.02:1, mean age = 58.7 years) were analysed. The incidence of CRC in Sri Lanka has increased from a WHO age-standardised rate of 2.9/100,000 in 2001 (95%-confidence interval [95%-CI]: 2.64-3.16) to 6.08/100,000 in 2010 (95%-CI: 5.71-6.44). This is an estimated annual percentage change (EAPC) of 8.9 (95%-CI: 7.5-10.4). The proportional increase in incidence was observed to be greater for females (2.8 to 5.6, EAPC: 9.4 (95%-CI: 7.7-11.2), p < .05) than males (3.02 to 6.62, EAPC: 8.5 (95%-CI: 6.9-10.2), p < .05). CONCLUSIONS: Similar to other Asian countries, a significant increase in the incidence of CRC was observed in Sri Lanka. Rate of the increase may have been artificially inflated due to better case reporting and diagnostic scrutiny. Future studies focussing on trends in tumour stage and fatality will help shed light on changing patterns in the burden of CRC in Sri Lanka.

The incidence and histological patterns of oesophageal cancer in Sri Lanka from 2001 to 2010: Analysis of national cancer registry data.

OBJECTIVES: An increase in global incidence of oesophageal cancer has been reported in the last few decades. We conducted this study to examine trends in oesophageal cancer in Sri Lanka. METHODS: A retrospective cohort evaluation of newly diagnosed patients with oesophageal cancer during 2001-2010 was performed using population-based data published by the Sri Lanka National Cancer Control Programme. RESULTS: A total of 10,626 (male: female = 1:1.06, mean age: 62 years) oesophageal cancers were analysed. Of those, 1,553(14.6%) were classified as non-specific carcinoma. Of the remaining, 88% (n = 7,986) were squamous cell carcinoma (SCC) and 10.5% (n = 956) were adenocarcinoma. The WHO age-standardised incidence was observed to have increased from 5.78 per 100,000 in 2001 (95% CI = 5.41-6.16) to 6.23 per 100,000 in 2010 (95%CI = 5.86-6.60). WHO age-standardised incidence of SCC has increased from 4.09 to 4.97 per 100,000 from 2001 to 2010 (p < .05 for trend, estimated annual percentage change (EAPC) = 3.6, 95% CI = 0.9-6.3) while incidence of adenocarcinoma showed a greater proportional increase from 0.33 to 0.7 per 100,000 from 2001 to 2010 (p < .05 for trend, EAPC = 7.1, 95% CI = 2.1-12.4). CONCLUSIONS: A statistically significant increase in the incidence of oesophageal cancer in Sri Lanka was noted, with greater proportional increases of adenocarcinomas and cancers in men. Further studies including tumour stage and mortality may help better understand changing patterns of disease burden.

Incidence and histological patterns of thyroid cancer in Sri Lanka 2001-2010: an analysis of national cancer registry data.

BACKGROUND: An increasing incidence of thyroid cancer is observed in many developed countries. Increasing incidence may also reflect better reporting or increased diagnostic scrutiny. We conducted this study to examine trends in thyroid cancer incidence and histological patterns in Sri Lanka. METHODS: A retrospective cohort evaluation of patients with thyroid cancer during 2001-2010 was performed using population based data published from the Sri Lanka National Cancer Registry. Trends in incidence and histological patterns were analysed by age and gender. RESULTS: The age-standardized incidence of thyroid cancer increased from 2.44 per 100,000 in 2001 (95% confidence interval [95% CI]: 2.21-2.67) to 5.16 per 100,000 in 2010 (95% CI: 4.85-5.47); a 2.1-fold increase (p < 0.05 for trend). A greater part of this increase is attributable to increase in incidence of papillary thyroid cancer, which increased from 1.64 to 3.61 per 100,000; a 2.2-fold increase (p < 0.05 for trend). Follicular cancer showed lesser, yet a significant increase from 0.56 to 0.95 per 100,000 (p < 0.05). Other varieties of thyroid cancer showed no significant increases in incidence. Trends in the increases in incidence of papillary cancer in females showed a much greater increase compared with males (from 2.45 to 5.60 per 100,000, a 2.28-fold increase in females compared with from 0.82 to 1.55; a 1.89-fold increase in males, p < 0.001). Highest incidence of papillary cancer was observed in 30-39-year age group, which has increased from 5.56 to 12.9 per 100,000; a 2.32-fold increase (p < 0.001). CONCLUSIONS: The increasing incidence of thyroid cancer in Sri Lanka is predominantly due to the increasing incidence of papillary cancers. These trends may reflect increased detection and better reporting, although an inherent increase in the incidence is the likely main contributor. Further studies including tumour stage and mortality may help answer these questions.

Incidence trends and patterns of breast cancer in Sri Lanka: an analysis of the national cancer database.

BACKGROUND: A gradual decline in the incidence of breast cancer is documented in developed countries especially over last two decades, while in developing countries the incidence continues to rise. We conducted this study to examine trends in incidence of breast cancer in a developing country, Sri Lanka. METHODS: A retrospective cohort evaluation of patients with breast cancer during 2001-2010 was performed using population based data from the Sri Lanka National Cancer Registry. Trends in incidence were analysed using Joinpoint regression analysis. RESULTS: The age standardized incidence of female breast cancer in Sri Lanka appears to have increased from 17.3 per 100,000 in 2001 (95% confidence interval [95% CI] 16.5-18.2) to 24.7 per 100,000 in 2010 (95% CI 23.7-25.7); a 1.4-fold increase (p < 0.05) with an estimated annual percentage change (EAPC) of 4.4 (95% CI 3.3-5.5). Highest incidence of breast cancer was seen among women of 60 to 64-year age group which has increased from 68.1 to 100.2 per 100,000 over this period (EAPC 4.6%, 95% CI 3.9-5.2, p < 0.001 for trend). A substantially greater increase was observed among women older than 50 years (from 50.4 to 76.9 per 100,000; EAPC 5.5, 95% CI 4.1-7.0, p < 0.05) compared with women younger than 50 years (from 32.0 to 39.6 per 100,000; EAPC 2.3, 95% CI 1.1-3.5, p < 0.05). CONCLUSIONS: A gradual but a significant increase in the incidence of female breast cancer is observed in Sri Lanka. A rapid rise in the breast cancer incidence among post-menopausal women appears to be the major contributor towards this increase. Improving cancer data collection appears to have been a contributor to the observed increase. However, an inherent increase is also likely as differential rates of increase were observed by age groups. Further research is needed to identify the reasons for the observed increase which may help with future cancer control efforts in Sri Lanka.

Bilateral Dorsal Nail Curvature of the Thumb Distal Phalanx - A Case Report.

Congenital dorsal curvature of the distal phalanx has been previously described as 'reverse Kirner' or 'ski-jump' deformity. This report describes bilateral occurrence in the thumbs. A 13-year-old male presented with difficulty caring for his thumbnails and in picking up small objects. Examination showed dorsal curvature of the distal phalanges of both thumbs, with greater curvature of the right side. Radiographs showed wedge-shaped epiphyses and dorsal curvature without coronal plane deviation of the distal phalanges. There was objective and subjective decrease in function associated with lateral pinch and tripod grasp. The reported aetiopathogenesis for Kirner deformity cannot explain the observed dorsal curvature. The bilateral nature makes a secondary physeal cause unlikely and suggests an embryologic basis. Due to the noticeable deficits in function, operative intervention may be warranted. Level of Evidence: Level V (Therapeutic).

The incidence and trends of laryngeal malignancies in Sri Lanka from 2001 to 2019: a Joinpoint analysis of the national cancer database.

INTRODUCTION: Laryngeal cancer is the ninth commonest cancer among Asian males. Global and regional epidemiological analyses have shown varying patterns in the incidence and risk factors for laryngeal cancer. Therefore, we aimed to analyse the trends in the incidence and histological patterns of laryngeal cancers for the first time in Sri Lanka. METHODS: We used the population-based Sri Lanka cancer registry data and pooled all newly diagnosed patients with laryngeal malignancies from 2001 to 2019 (a 19-year study period). The WHO age-standardised incidence rates (ASR) were calculated using the WHO standard pollution. We used the Joinpoint regression software to calculate the estimated annual percentage change (EAPC) and analysed the trends in the incidence by different age categories and sex. RESULTS: From 2001 to 2019, 9808 new cases of laryngeal cancers (males = 8927, 91%, mean age = 62 years) were registered. The incidence of laryngeal cancers was greatest in the 70-74-year followed by 65-69-year age groups. Around 7.9% were reported as carcinoma not otherwise specified (NOS). Squamous cell carcinoma (90.1%) was the commonest documented histology type. A rise in the WHO-ASR was noted from 1.91 per 100,000 in 2001 [95% confidence interval (95% CI): 1.69-2.12] to 3.59 per 100,000 in 2017 [(95% CI: 3.34-3.84); EAPC: 4.4 (95% CI: 3.7-5.2), p < 0.05 for trend] followed by a decrease in the incidence [2.97 per 100,000 in 2019 (95% CI: 2.74-3.2), EAPC: - 7.2 (95% CI: - 21.1-9.1, p > 0.05)]. From 2001 to 2017, the proportional increase in incidence was greater in males than females [EAPC: 4.9 (95% CI: 4.1-5.7 vs. 3.7 (95% CI: 1.7-5.6)]. CONCLUSIONS: We identified an increasing incidence of laryngeal cancer in Sri Lanka from 2001 to 2017 followed by a slight decrease. Further studies are essential to identify the aetiological factors. Development of laryngeal cancer prevention and screening programmes for high-risk populations may be considered.

Incidence and Patterns of Liver Cancers in Sri Lanka from 2001 to 2010: Analysis of National Cancer Registry Data.

Sanjeewa SeneviratneObjectives Varying trends in the incidence of liver cancer have been observed in many Asian countries. We conducted this study to examine trends in liver cancer incidence and histological patterns in Sri Lanka. Materials and Methods All newly diagnosed patients with liver cancer included in Sri Lanka National Cancer Registry during 2001 to 2010 were analyzed. Statistical Analysis Joinpoint regression analysis was performed. A p -value of less than 0.05 was considered statistically significant. Results Overall, 1,482 (male:female = 2.7:1; mean age = 57.5 years) liver cancers were analyzed. Majority were hepatocellular carcinomas ( n = 1,169; 78.9%), followed by intrahepatic cholangiocarcinomas ( n = 100; 6.75%). Highest incidence of liver cancer was observed in 70-74-year age group (5.1/100,000). Overall, the World Health Organization age-standardized rate (ASR) has increased during 2001 to 2004, from 0.6/100,000 (95% confidence interval [CI] = 0.48-0.72) to 1.0/100,000 (95% CI = 0.85-1.15), with an estimated annual percentage change (EAPC) of 17.8 (95% CI = 5.0-46.2); p > 0.05. From 2004 to 2010, a gradual decline in the incidence was observed. ASR in 2010 was 0.96 (95% CI = 0.81-1.1), with an EAPC of -0.9 (95% CI = -6.7 to 5.4); p > 0.05. Similar patterns of incidence change were observed in both genders. Conclusions Overall, the incidence of liver cancer appears to be steadily declining in Sri Lanka. Similar patterns of incidence change were observed in both genders. The actual decline is likely to be greater as it is likely that diagnostic scrutiny and reporting would have improved during the study period.

The incidence and patterns of gastric cancers in Sri Lanka from 2001 to 2012: Analysis of National Cancer Registry Data.

OBJECTIVES: Varying patterns in incidence of gastric cancer (GC) have been reported globally. We aimed to examine the trends of GC incidence in Sri Lanka. METHODS: All newly diagnosed patients with GC in Sri Lanka during 2001-2012 included in the National Cancer Registry were analyzed. Joinpoint regression analysis was used to determine the trends in incidence by age and gender. The minimum number of joinpoints were added to the model and statistical significance was checked using the Monte-Carlo permutation method. RESULTS: Overall, 3353 (male : female = 2.7:1, mean age: 59.5 years) GCs were included in the analysis. Histology findings were available in 2835 patients. Of those, 14.3% (n = 404) were classified as nonspecified neoplasm/carcinoma. Of the remaining 2431 patients, majority (84.1%, n = 2044) were adenocarcinoma/its variants and 9.4% (n = 228) were squamous cell carcinoma. The WHO age-standardized incidence of GC was found to have significantly increased from 1.06 in 2001 (95% CI = 0.9-1.21) to 2.41/100 000 population in 2012 (95% CI = 2.2-2.61); with an estimated annual percentage change (EAPC) of 7.7 (95% CI = 6.1-9.4). Highest incidence of GC was seen in 65-69 year age group (8.2/100 000). The proportional rise in incidence was higher for females (from 0.5 to 1.36, EAPC: 9.0 [95% CI = 6.4-11.8], P < .05 for trend) compared with males (from 1.71 to 3.66, EAPC: 7.5 [95% CI = 5.5-9.6], P < .05 for trend). CONCLUSIONS: A rise in the incidence of GC was noted in Sri Lanka during the period 2001-2012, which was predominately observed in females. A combination of true increase in incidence and improved reporting may have contributed to this increase. Future studies analyzing tumor characteristics and mortality would enable better understand the burden of GC and potential underlying reasons.

Incidence and age-standardized rates of pancreatic cancer in Sri Lanka from 2001 to 2010: An analysis of national cancer registry data.

BACKGROUND: Varying trends in the incidence of pancreatic cancer (PC) are observed in many Asian countries. This study aimed at describing the incidence and age-standardized rates of PC in Sri Lanka from 2001-2010. METHODS: A retrospective cohort evaluation of patients with PC from 2001 to 2010 was performed using the population-based data published by the Sri Lanka National Cancer Registry. The trends in the incidence of PC was analyzed by age and sex using joinpoint regression analysis. RESULTS: A total of 808 PC patients studied from 2001-2010, of which males were 438 (54.2%). The mean (±standard deviation) age of the total population was 55.7 (±13.8) years [males = 56.5 (±13.3) vs. females = 54.8 (±14.3), P=0.07]. The World Health Organization (WHO) age-standardized incidence of PC in Sri Lanka increased marginally from 0.44 per 100,000 in 2001 (95% confidence interval (CI) = 0.34-0.54) to 0.58 per 100,000 in 2010 (95% CI = 0.46-0.69) which is a 1.3-fold increase (P < 0.05 for trend) with an estimated annual percentage change (EAPC) of 3.5 (95% CI = 0.5-6.6). The proportional increase in incidence was more significant in females compared to males. The analysis of the overall cohort rates of PC in Srilanka between 2001-2010 showed the highest rates in the 60-70-year category with an EAPC of 5.06 (95% CI = 1.3-9.0). CONCLUSION: In our study, we found that there was a marginal rise in the incidence of PC in Sri Lanka with a higher proportional increase in females compared to males.

Constipation with megacolon in a 36-year-old man: a rare presentation of MEN2B from Sri Lanka.

Diffuse intestinal ganglioneuromatosis is a rare condition associated with MEN2B. It is also seen in conditions like neurofibromatosis type 1 and Cowden syndrome. This is a report of a patient who underwent total colectomy with end ileostomy creation for a megacolon. He was diagnosed to have diffuse ganglioneuromatosis on histological examination of the resected segment of colon. The definitive management of diffuse ganglioneuromatosis is to resect and anastomose.