iPURSE 2016
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Browsing iPURSE 2016 by Author "Adikari, S.B."
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- ItemBurden of tobacco smoking and its awareness(University of Peradeniya, 2016-11-05) Hewageegana, V.P.; Hemamala, K.S.V.L.; Herath, H.M.B.G.R.P.; Herath, H.M.S.S.K.; Herath, M.G.B.U.G.W.; Herath, R.H.S.M.; Herath, W.A.K.M.D.; Hettiarachchi, H.D.M.; Hewauluwatte, S.P.; Jayakody, J.A.A.C.; Jayalath, J.M.C.C.; Jayamaha, J.H.S.K.; Adikari, S.B.Tobacco smoking is one of the leading causes of cardiovascular and respiratory diseases burdening the society. Smoking adversely affects individuals who smoke (first hand smoking), those who inhale smoke by being near smokers (second hand smoking) and those who are exposed to nicotine and other toxic residues left on indoor surfaces due to tobacco smoke (third hand smoking). The present study aims to describe the pattern of exposure of individuals to smoking, the socio- economic factors associated with smoking and the awareness on the health effects of being exposed to tobacco smoke in Gangawata Korale Medical Officer of Health (MOH) area in Sri Lanka. A cross sectional descriptive study was done with 648 randomly selected subjects using a self-administered questionnaire. Their awareness regarding the health effects of first hand, second hand and third hand smoking was assessed in three categories. Half or more correct answers in each category were considered as “Satisfactory Awareness” for that category. A separate section assessed smoking habits. The data was analysed using SPSS (Version 20). Of the sample, 48% were males. The ages ranged from 18 to 44 years (mean=30). Ninety (14%) of the sample were smokers and almost all (98.9%) of them were males. There was a significant correlation between the level of education and smoking, the better educated were more likely to be non-smokers (P< 0.001). The awareness on the health effects was found to be satisfactory in 499 (77%) regarding first hand smoking, 418 (64.5%) regarding second hand smoking and 305 (47.1%) regarding third hand smoking. There was a significant correlation between the level of education and the satisfactory awareness on the health effects of smoking (P=0.035). Public awareness campaigns mostly address first and second hand smoking. The novelty of the concept of third hand smoking is reflected in the limited awareness shown by the participants. Although the study population is aware about the health effects of first hand smoking and second hand smoking, the awareness regarding third hand smoking is lacking. Educated people tend to be non-smokers with better awareness about the effects of tobacco smoke on health. Interventions should target uneducated males. The issue of third hand smoking need to be highlighted in awareness programmes.
- ItemOligoclonal band positive and negative multiple sclerosis: do they represent clinically distinct subgroups of multiple sclerosis?(University of Peradeniya, 2016-11-05) Nasim, F.N.; Gamage, S.M.K.; Wickramarathna, A.A.D.; Wijenayake, W.M.W.C.; Wijeweera, I.; Adikari, S.B.; Sominanda, H.M.A.The oligoclonal band test is an important investigation which aids diagnosis of Multiple Sclerosis (MS). Isoelectric Focusing (IEF) and immunoblotting is the gold standard method for OCB detection according to current consensus. In a typical western MS population, 95-98% of patients are positive for OCB, reflecting an intrathecal antibody response parallel to the central nervous system inflammatory pathology. A genetic basis for this discrepancy has been reported in a number of studies. OCB positive patients are associated with HLA-DRB1*15 and negative with HLA-DRB1*04, suggesting the possibility of immunogenetically different subgroups that may have a different disease course, and outcome status with varied drug response and possibly prognosis. Therefore, the relationship of OCB status has been studied in relation to clinical presentation and outcome in patients with MS, but still the relationship remains unclear. Thus, the objective of this study was to compare between OCB positive and negative MS populations in terms of clinical, demographic and investigation findings. Thirty one definite MS patients diagnosed using McDonalds criteria were included in the study. Clinical and MRI features were documented and analyzed to compare between OCB positive and negative groups. All were tested for OCB in both serum and CSF samples. Of the 31 MS patients, 14 (45.2%) were positive for OCB whereas 17 (54.8%) were negative. Comparison of demographic features (i.e. gender, nationality), clinical subtype frequency (i.e. relapsing- remitting, secondary progressive or primary progressive MS), disease course and disability (EDSS) revealed no significant difference between OCB positive and negative groups. Similarly, comparison of clinical features (i.e. cerebral sensory, cerebral motor, cerebellar, etc.) revealed no significant difference. However, on comparison of MRI features, the presence of cervical cord lesions were significantly higher among the OCB positive group (p<0.01). The rest of the imaging features were not different between groups. In conclusion, there are no major differences in presentation and clinical course of OCB positive and negative subgroups of MS. Yet, there are some differences seen in MRI findings reflecting an association between MS immunopathology and radiological manifestations of Sri Lankan MS. This might facilitate defining MS subtypes on OCB status with further studies on larger samples.