iPURSE 2019

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https://ir.lib.pdn.ac.lk/handle/20.500.14444/37

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Browsing iPURSE 2019 by Author "Alahakoon, A. R. T. V."

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    Association between visceral adiposity index, hirsutism and cardiometabolic risk factors in women with polycystic ovarian syndrome
    (University of Peradeniya, 2019-09-12) Fonseka, S.; Subhani, B,; Alahakoon, A. R. T. V.; Gunawardana, J. N.; Dassanayake, S. N. B.; Herath, H. M. S. S.; Wijeyaratne, C. N.; Gawarammana, I. B.; Kalupahana, N. S.; Rosairo, S.; Kumarasiri, P. V. R.
    Visceral adiposity index (VAI) is a mathematical index derived from the body mass index (BMI), waist circumference (WC), serum fasting triglyceride (TG) and high-density lipoprotein cholesterol (HDL-C). It reflects visceral adipocyte dysfunction (VAD) and is associated with cardiometabolic risk. Women with polycystic ovarian disease (PCOD) have adipocyte dysfunction, which is associated with metabolic disorders. Hirsutism in PCOD is considered to be due to high insulin levels which enhances androgen activity at the pilosebaceous unit. Objectives were to determine the association between VAI, hirsutism and cardiometabolic risk factors in patients with PCOD. A cross-sectional study of 99 patients aged 18-40 years with PCOD diagnosed by the Rotterdam consensus criteria-2003 and a hirsutism score of 8 or more according to the Ferriman-Gallway Score (FGS) was carried out. BMI, WC, fasting lipid profile, serum leptin, insulin, sex hormone binding globulin (SHBG), free-androgen index (FAI), fasting blood glucose (FBG) and oral glucose tolerance test (OGTT) were determined. Homeostasis model assessment (HOMA)-beta, HOMA-insulin resistance (IR) and VAI were calculated. Diameter and rate of hair growth at sideburns and chin and density of hair at sideburns were measured. Data were analyzed by SPSS-22.0. There was no significant association between parameters of hirsutism and VAI [Correlation between natural logarithms of VAI and hirsutism parameters were: rate of hair growth on the left : r=-0.047 (p=0.646), right : r=-0.012 (p=0.904), chin: r = -0.044 (p=0.664); density of hair growth: r = 0.099 (p=0.33); diameter of hair on the left : r=0.015 (p=0.886), right : r = 0.079 (p=0.438) and chin: r = 0.145 (0.152)]. There was a significant association between VAI and OGTT, FAI, systolic and diastolic blood pressure, but not between VAI and other metabolic parameters. Visceral adipocyte dysfunction is closely linked to glucose intolerance and blood pressure in women with PCOD. However, hirsutism is unlikely to be due to adipocyte dysfunction
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    Effectiveness of ethinyl estradiol /cyproterone acetate and ethinyl estradiol/ desogestrel with or without low-dose metformin on perceived quality of life in hirsute women with polycystic ovary syndrome: a randomized, double-blind study
    (University of Peradeniya, 2019-09-12) Fonsek, S.; Alahakoon, A. R. T. V.; Subhani, B.; Athauda, A. M. I. R. K.; Dassanyake, S. N. B.; Wijeyaratne, C. N.; Gawarammana, I. B.; Kalupahana, N. S.; Rosairo, S.; Ratnatunga, N.; Kumarasiri, P. V. R.
    Polycystic Ovary Syndrome (PCOS) is an endocrine disorder with various endocrine and metabolic abnormalities. It is often associated with menstrual irregularity, infertility, obesity and dermatological manifestations such as hirsutism and acne. Because of these reasons, women with PCOS suffer from psychological problems such as anxiety, eating disorders, dissatisfaction with body shape, depression, sexual dysfunction and impaired health-related quality of life. This study was carried out to evaluate the change of perceived of quality of life in PCOS patients treated with Ethinyl estradiol (35 μg) / cyproterone acetate (2 mg) (EE/CPA) and Ethinyl estradiol (20 μg)/ Desogestrel (0.15mg) (EE/DES) alone and combination with low-dose metformin (500 mg daily). A total of 107 patients with PCOS diagnosed according to Rotterdam Consensus Criteria 2003 with a hirsutism score of 8 or more according to modified Ferryman- Gallwey Score (mFGS) were randomized to receive one of four drug combinations (arm A – EE/CPA plus two placebos, arm B- EE/DES plus two placebos, arm C- EE/CPA plus metformin and a placebo, arm D- EE/DES plus metformin and a placebo). The outcomes assessed were body mass index (BMI), hirsutism (using mFGS) and quality of life (using polycystic Ovary Syndrome Health- Related Quality of Life Questionnaire (PCOSQ) and Visual Analog Scale (VAS) score) at the beginning and after 12 months of treatment. PCOSQ score related to the hirsutism, emotions, menstruation, obesity and infertility and VAS score related to hirsutism and obesity showed a statically significant improvement at the end of 12 months (p< 0.001) in all treatment arms. Statistically significant improvements were seen in BMI arm A and mFGS in arms A and B at the end 12 months. However, there was no significant difference between treatment arms in all measured outcomes at baseline and the end of 12 months.
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    English language proficiency has a significant impact on medical school examination performance
    (University of Peradeniya, 2019-09-12) Seneviratne, H. M. T. W.; Somaratne, K. M. K; Alahakoon, A. R. T. V.; Bandara, G. D. D. J.; Bandara, Y. M. D. M.
    Medical education in Sri Lanka is done exclusively in English Language. An overwhelming majority of students who enter the medical school have had their secondary school education in Sinhala medium, which is their mother tongue. This change of medium of instruction on entry to medical school and the level of English language proficiency of students, achieved during school education might affect the academic performance of medical students. The purpose of this study is to assess how the English language proficiency of students and the medium of instruction in school affect medical school examination performance. The study was conducted from June to July 2018. All students who had completed at least the second year medical examination of the Faculty of Medicine, University of Peradeniya, whose mother tongue is Sinhala were included in the study. Medium of instruction at GCE (O/L), Grades obtained for English language at GCE (O/L) (as an indicator of English language proficiency) and the medical school examination results of second year and fourth year (Grade Point Average values- GPA) were collected. Students' T test was used for statistical analysis and significance was set at p= <0.05. Total of 416 students were included in the study. Eighty eight percent of students had achieved an “A” grade for English language at the GCE (O/L) Examination while 91.8% had done their school education in Sinhala medium. There was a statistically significant difference between mean GPA values for second year exam between students who had achieved A grades for English language in GCE (O/L) and who had not (3.02 vs 2.57 p=0.001). The same was true for fourth year exam results (3.21 vs 2.77 p=0.003). With reference to medium of instructions in school, there was no significant difference in medical college examination results between the Sinhala medium and English medium students (p=0.3). In conclusion, our study shows that the English language proficiency has significant impact on medical school examination results but not the medium of instructions in school.
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    High fidelity simulation to teach therapeutics of anaphylaxis to medical undergraduates
    (University of Peradeniya, 2019-09-12) Seneviratne, T.; Somaratne, K. M. K.; Bandara, G. D. D. J.; Alahakoon, A. R. T. V.; Bandara, Y. M. D. M.
    Therapeutic management of anaphylaxis is an important learning outcome in clinical medicine. Gaining pharmacotherapeutic knowledge in relation to the situation where it will be applied, benefits the speed and quality of recall. High fidelity simulations (HFS) provide safe and controlled real life learning environment in which students can gain hands on experience. Hence, we introduced HFS to teach therapeutics of anaphylaxis. This paper describes the perception of the students and the knowledge gain. A group of final year medical students (n=46) during their professorial paediatric appointment were included in the study. Students who volunteered were included in the study. Scenario of anaphylaxis using HFS was given to groups of 5 to 6 students at a time. Initial briefing was given for 05 minutes and then the simulation conducted for 20 minutes followed by debriefing for 10 minutes. Perception about the simulated session was assessed using a self-administered questionnaire in five-point Likert scale. Acquisition of knowledge was assessed using a pre and post-test. Data were analysed using SPSS version 23. Percentage of the responses in Likert scale for the perception of the simulated session was calculated. The total pre and post- test marks were compared using the Wilcoxon signed rank test. Students scored significantly higher marks for the post-assessment of knowledge compared to the pre-assessment p=<0.001. All the students opined that simulation contributed to their understanding of drug therapy in anaphylaxis. 91.3% of students mentioned that the session was appropriate to their knowledge and experience and 89.1 % agreed that the training session resembled a real-life situation. All of them agreed that it encouraged their active participation. 95.6% of the students believed simulated sessions are better than small group discussions and 95.7% mentioned that HFS is an effective tool to teach clinical drug therapy of anaphylaxis. All the students mentioned that it is a valuable use of their time and they want to have further sessions. In conclusion, the use of High-fidelity simulations to teach therapeutics of anaphylaxis is well received by the students.