iPURSE 2025

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Morphometric analysis of inferior alveolar canal using cone beam computer tomography in a Sri Lankan population
(University of Peradeniya, Sri Lanka., 2025-08-28) Liyanaarachchi, L.A.I.U.; Laksala, S.D.T.; Lakshan, G.E.T.; Peiris, P.M.; Jayasinghe, R.D.; Angammana, H.M.R.W.
The Inferior Alveolar Canal (IAC) is a single intra-osseous canal present bilaterally in the mandible. Cone Beam Computed Tomography (CBCT) is the best diagnostic image modality which can be used to assess the IAC. Morphometric knowledge of the IAC is important in dental treatments and to prevent complications. A retrospective cross sectional descriptive study was conducted using 87 CBCTs of individuals who attended the dental teaching hospital Peradeniya which included 52 females and 35 males within the age range from 18 - 42 years. We have assessed 130 IACs. On trans-axial view, visibility, shape and distance to IAC from outer buccal and lingual cortical plates, from inferior border of the mandible and root apices were assessed at 2nd mandibular premolar, distal roots of 1st and 2nd molar regions. Also, the horizontal and vertical relationships of the IAC to the tooth roots, course and presence of the bifurcation were evaluated. Statistical analysis was done. The majority of canals were oval in cross section. IAC was closer to buccal cortical plate in 2nd premolar region, to lingual cortical plate in the 2nd molar and 1st molar region. There was a significant difference in the distances to IAC between gender groups with males having thick bony periphery. The horizontal course of the IAC was suggesting an "S" shaped configuration, being buccal to 2nd molar root apex, lingual to 1st molar root apex and apical to the 2nd premolar regions. In the vertical course majority of IACs were closest with the roots of the 2nd molar followed by the 2nd premolar and 1st molar and 57% were progressively descend type while 30% was catenary type and 12% were straight in their course. A 44.6% of the canals showed bifurcation with majority being type IIIa; forward canal without confluence type. This first Sri Lankan CBCT study detailed IAC morphometry, revealing common oval cross sections, 'S' shaped course and 44.6% bifurcation prevalence. Understanding these variations, especially proximity to roots and cortical plates, is Crucial for preventing iatrogenic complications in dental procedures, enhancing patient safety.
Morphometric computed tomography study of the mastoid process and its role in sex differentiation
(University of Peradeniya, Sri Lanka., 2025-08-28) Thasanthan, L.; Uthpala, P.R.H.I.; Uyangoda, U.M.A.P.R.
The mastoid process plays a significant role in forensic science, medicine, and anthropology. This study addresses a gap in the literature regarding the use of computed tomography (CT) for morphometric analysis of the mastoid process in sex determination within a specific population. To examine morphometric differences in the mastoid process between males and females, to evaluate the relationship and prevalence patterns of the measured parameters of the mastoid process and to analyze the differences between the measurements of the right and left mastoid processes in males and females. This retrospective study was conducted using 177 samples of CT brain scans (88 male and 89 female) from the National Hospital Kandy and the Teaching Hospital Peradeniya. Morphometric parameters including true mastoid height, oblique sagittal diameter, oblique coronal diameter, and volume of mastoid process were measured using the RadiAnt DICOM viewer version 2024.1. Statistical analysis of the morphometric differences and correlations with sex was performed using IBM SPSS statistics version 30.0. All recorded parameters were higher in males. The volume of the mastoid process was the most significant parameter for sex determination, showing 70.6% accuracy using CHAID model analysis, with higher accuracy in females (87.6%) than in males (53.4%). Asymmetry between the right and left sides was observed and was significant in males but not in females. CT-based morphometry of the mastoid process has potential for sex estimation. The volume of the mastoid process is the most useful morphometric parameter for sex differentiation. Population-specific data are required and further research using a larger sample and with more advanced modalities is justified for improved accuracy.
Molecular identification of c, e, and f serotypes of streptococcus mutansin a cohort of children with early childhood caries in Sri Lanka
(University of Peradeniya, Sri Lanka., 2025-08-28) Dilshan, P.T.; Amarasiri, D.M.H.B.; Palihakkara, R.S.; Bandara, K.M.S.; Jayarathna, D.P.; Udagedara, S.; Nandasena, B.G.T.L.N.; Premathilake, L.K.N.; Herath, E.M.U.C.K.; Dhanapala, M.P.C.S.; Paranagama, M.P.
Early childhood caries (ECC) is a global public health problem. Despite being a multifactorial disease, Streptococcus mutans is the primary bacterium responsible for ECC. Based on its genetic makeup, S. mutans is classified into four serotypes, namely c, e, f, and k, among which c, e and f are most prevalent and cariogenic, each exhibiting different virulence profiles. Identifying these serotypes may help establish better preventive strategies and targeted treatments for ECC. However, S. mutans serotype diversity in ECC has not yet been reported in Sri Lanka. Therefore, this study aimed to identify c, e, and f serotypes of S. mutans in children with ECC using PCR. Dental biofilm samples were collected from 35 children with ECC, selected based on decayed, missing, filled teeth (dmft) scores, attending the Paedodontic clinic at the Dental (Teaching) Hospital, Peradeniya. Streptococci were isolated on mitis salivarius agar, and their DNA was extracted using an optimized chemical method. First, S. mutans was identified using PCR with species-specific primers. Subsequently, c, e, and f serotypes were identified using serotype-specific primers in multiplex and singleplex PCR. Sanger sequencing of PCR amplicons further confirmed 100% identity of the S. mutans serotypes isolated from Sri Lankan children to reference sequences in the NCBI database. Based on our findings, S. mutans was found in 63% of the children with ECC. Out of S. mutans positive children, 27% had serotype c. Serotypes e and f each were found in 9% of children. Eighteen percent of children co-harboured serotypes c and e. Thus, it can be concluded that serotype c is the predominant S. mutans serotype associated with ECC. Further, children with multiple serotypes had higher dmft scores, suggesting severe decay, reflecting the impact of multiple serotypes on caries severity. Further studies on a larger sample are necessary to consolidate these findings.
Molecular identification of candida albicans genotypes in dental biofilms of children with early childhood caries attending the dental teaching hospital, Peradeniya, Sri Lanka
(University of Peradeniya, Sri Lanka., 2025-08-28) Bandara, K.M.S.; Jayarathne, D.P.; Premadasa, U.D.P.T.D.; Banneheka, B.M.H.S.K.; Udagedara, S.; Herath, E.M.U.C.K.; Senarath, N.H.; Dhanapala, M.P.C.S.; Paranagama, M.P.
Early Childhood Caries (ECC), or tooth decay, is a major health problem in Sri Lanka. Recent studies have revealed that Candida albicans, an opportunistic fungal pathogen in humans, plays a key role in caries progression. Further, C. albicans has multiple genotypes (A, B, and C) and its cariogenicity and antifungal susceptibility are found to vary depending on the genotype. Thus, identifying genotypes associated with ECC is crucial for effective disease control. However, this remains unexplored in Sri Lanka. Therefore, this study aimed to identify genotypes of C. albicans associated with children with ECC in Sri Lanka. Dental biofilm samples were collected from 19 children with ECC attending the Dental Teaching Hospital, Peradeniya and cultured on CHROMagar medium for presumptive identification of the fungus based on its characteristic green-coloured colonies. Five colonies were randomly selected from each of the positive samples. Following subculturing and DNA extraction, PCR was performed for confirmation of the species by targeting its pH-regulated KER1 gene. Genotyping was performed using PCR targeting a group I intron within its 25S rDNA, which yielded a 450 bp amplicon for genotype A, 840 bp amplicon for genotype B, and both amplicons for genotype C. The results were further validated by sequencing the PCR amplicons. Out of the 19 subjects, 10 tested positive for C. albicans. Each C. albicans-positive child harboured only a single genotype, with genotype A being the most frequently observed genotype (70%), followed by genotype C (20%) and genotype B (10%). This data is consistent with studies conducted in other countries reporting that genotype A is predominant among children with ECC. In conclusion, this study provides the first insight into the genotypic diversity of C. albicans among Sri Lankan children with ECC. Further investigations with larger sample sizes are warranted to determine the prevalence of these genotypes.
Molecular identification of porphyromonas gingivalis in the saliva of patients with periodontitis and periodontally healthy individuals attending dental teaching hospital, Peradeniya
(University of Peradeniya, Sri Lanka., 2025-08-28) Branavi, Y.; Somarathna, T.V.M.T.; Jayarathne, D.P.; Udagedara, S.; Gunawardhana, K.S.N.D.; Leuke Bandara, D.; Dhanapala, M.P.C.S.; Paranagama, M.P.
Periodontitis, which affects more than 90% of Sri Lankan adults, can eventually lead to loss of teeth and more serious health complications such as cardiovascular diseases. A keystone pathogen involved in the initiation and progression of periodontitis is Porphyromonas gingivalis. Since P. gingivalis is an anaerobic, slow-growing bacterium, its identification through conventional microbiological techniques is an extremely tedious task. This study aimed to identify salivary P. gingivalis using conventional PCR, compare its detection between individuals with periodontitis and those who are periodontally healthy, and assess the possibility of using salivary P.gingivalis analysis by PCR as a non-invasive screening test for periodontitis risk assessment in Sri Lankan population. For this purpose, unstimulated whole saliva samples were collected from a total of 86 individuals (64 patients with periodontitis and 22 periodontally healthy individuals) aged 18–80 years, attending the Dental Teaching Hospital in Peradeniya. DNA was extracted from samples using a chemical method. PCR amplification was carried out by targeting the 16S rRNA gene of P. gingivalis. The PCR product was visualized using agarose gel electrophoresis. The specificity of the PCR amplicon was verified by Sanger sequencing and comparing it with the reference sequence of P. gingivalis in the NCBI database. P. gingivalis is more frequently detected in periodontitis patients (50.00%; 32/64) compared to periodontally healthy individuals (22.73%; 5/22). The chi-square test demonstrated a significant association between detection of P. gingivalis in saliva and periodontitis, χ2 (5, N=86) = 4.9, p = 0.03. BLAST analysis of the consensus sequence of the PCR product confirmed the specificity of the PCR, showing 100% similarity to the reference P. gingivalis 16S rRNA gene. This study demonstrates the feasibility of non-invasive molecular detection of P. gingivalis in saliva as a potential biomarker for periodontitis in Sri Lankan patients. Further, it lays the foundation for future quantitative analysis of this bacterium using qPCR, for enhancing its application in population-level screening for risk assessment of periodontitis.
Meta-analysis of local tetracycline delivery devices as adjuncts to non-surgical periodontal therapy
(University of Peradeniya, Sri Lanka., 2025-08-28) Soysa, N.S.; Jayakody, S.L.; Alles, C.N.R.A.
Scaling and root planning (SRP) is a form of sub-gingival mechanical debridement (often now called “subgingival instrumentation”), and remains the standard non- surgical treatment for periodontitis. Adjunctive tetracycline-based drug delivery may enhance outcomes by controlling subgingival pathogens. This meta-analysis evaluated the short-term (1–3 months) and long-term (6–24 months) efficacy of sustained and controlled-release tetracycline as adjuncts to SRP in chronic periodontitis. A systematic search of PubMed, Cochrane Central, Scopus, and Embase identified randomized controlled trials published until July 2021. Test groups received SRP plus locally delivered tetracyclines, while controls underwent SRP alone or with a placebo. Meta- analysis (R software) calculated weighted mean differences (WMDs) and 95% confidence intervals (CIs) for probing pocket depth (PPD) and clinical attachment level (CAL). Meta-regression analyzed study design, assessment approach, and smoking status. Heterogeneity was assessed via Cochrane’s Q and I2, with publication bias checked using funnel plots and Egger’s test. Fifty-seven studies were included in the analysis. According to the results, adjunctive tetracycline therapy yielded statistically significant improvements over SRP alone. Short-term PPD reductions were significant (WMD = 0.501, 95% CI [0.411; 0.591]), with continued benefits at 6–9 months (WMD = 0.516, 95% CI [0.413; 0.620]) and beyond 12 months (WMD = 0.371, 95% CI [0.181; 0.560]). Similar trends were seen for CAL gains at 1–3 months (WMD = 0.310, 95% CI [0.224; 0.396]), 6–9 months (WMD = 0.336, 95% CI [0.204; 0.467]), and beyond 12 months (WMD = 0.310, 95% CI [0.240; 0.381]). Out of the Tetracycline formulations, Actisite showed the greatest short-term PPD reduction (WMD = 0.705, 95% CI [0.503; 0.907]). Meta-regression indicated study design significantly influenced outcomes, with split-mouth designs showing greater short-term (β = 0.372, 95% CI [0.219; 0.525], p < 0.05) and 6–9-month (β = 0.422, 95% CI [0.231; 0.613], p < 0.05) improvements. Conclusively, localized tetracycline adjuncts to SRP effectively improve periodontal outcomes in both the short and long terms, with effectiveness varying by study design and patient subgroups.
Limited joint mobility syndrome among patients with diabetes and its association with age and gender in a hospital-based population in Kandy district
(University of Peradeniya, Sri Lanka., 2025-08-28) Miruthy, S.; Chamindi, G.G.B.N.; Liyanage, G.L.A.K.; Vishagarabavan, T.; Wijesiri, G.K.G.T.D.; Dissanayake, J.K.
Limited Joint Mobility Syndrome (LJMS) is a musculoskeletal complication commonly seen in diabetic patients, marked by joint stiffness, skin changes, and functional limitations, particularly in the hands. Despite its known association with diabetes- related microvascular complications, LJMS remains understudied in Sri Lanka. This study aimed to evaluate the prevalence of LJMS and its association with age, gender, and duration of diabetes in a hospital-based diabetic population in Kandy District. A descriptive cross-sectional study was conducted at the diabetic clinics of National Hospital Kandy and Teaching Hospital Peradeniya from November 25 to December 8, 2024. A total of 267 diabetic patients aged ≥18 years were recruited using consecutive sampling. Exclusion criteria included congenital hand deformities, arthritis, hand trauma, and certain chronic conditions. Data were collected via an interviewer- administered questionnaire and clinical evaluation using the Prayer Sign and Table Top Sign tests. Statistical analysis involved descriptive methods and association testing via chi-square and Kruskal-Wallis tests. The study population had a mean age of 58.53 years (SD ± 13.47) with 73.4% females. LJMS-related features observed included skin changes (29.96%), painless stiffness (24.34%), and fixed flexion contractures in the proximal interphalangeal joints (12.73% mild, 0.75% significant). Functional impairments such as grip difficulty (16.85%) and impaired fine motor skills (10.49%) were also reported. Prayer Sign was positive in 20% of participants and Table Top Sign in 6%. Painless stiffness and skin changes were significantly associated with positive diagnostic test results (p < 0.05). A longer duration of diabetes showed a statistically significant association with both tests. Though females and those above 60 years showed higher prevalence of LJMS features, sex was not significantly associated with test positivity. This study highlights the prevalence of LJMS among diabetic patients in Kandy and underscores the importance of routine hand assessments. Incorporating simple clinical tests such as the Prayer Sign in diabetic care could enhance early detection, especially in high-risk groups, ultimately improving functional outcomes and quality of life.
Microwave ablation for liver tumours: a retrospective study from Sri Lanka
(University of Peradeniya, Sri Lanka., 2025-08-28) Udupihille, J.; Abeysinghe, N.; Dasanayake, B.; Dharmapala, A.
Hepatocellular carcinoma (HCC) and liver metastases are the most common liver malignancies, with HCC comprising 80–90% of primary liver cancers. Microwave ablation (MWA) offers several advantages over surgical interventions, including shorter hospital stays and quicker recovery. While MWA’s efficacy is well-documented internationally, limited data exist regarding its clinical performance in the Sri Lankan context. This study aimed to evaluate the effectiveness of MWA in treating malignant liver tumours by assessing recurrence rates, residual tumours, and post-procedural complications in a Sri Lankan cohort. A retrospective review was conducted at the Radiology and Hepatobiliary Units of Teaching Hospital Peradeniya, Sri Lanka, including patients who underwent MWA for liver malignancies between 2022 and 2024. Clinical data, procedural outcomes, imaging findings, and complications were extracted from hospital records. Contrast-enhanced computed tomography (CECT) was used at 4 weeks, 6 months, and 1 year post-procedure to assess recurrence and residual disease. A total of 22 tumours were treated with MWA between 2022 and 2024. The median patient age was 68 years (range: 47–83). Indications included HCC in 81.1% (n=18) and metastatic tumours in 18.9% (n=4). Complete ablation was achieved in 81% (n=18), with residual tumour seen in 4.5% (n=1). Tumour recurrence occurred in 9.1% (n=2) on follow-up imaging. No major post-procedural complications were observed. These findings indicate that MWA is both safe and effective, with high success rates and minimal adverse outcomes. The results align with international data and support MWA as a reliable therapeutic option in resource-constrained settings like Sri Lanka.
Modified corn starch as a fat replacer in low-calorie mayonnaise
(University of Peradeniya, Sri Lanka., 2025-08-28) Samarakoon, E.R.J.; Madhuwanthi, A.T.T.M.
The growing demand for healthier food options has spurred interest in reducing fat content in popular products like mayonnaise. This study investigates the potential of using modified corn starches as fat replacers to develop low-calorie mayonnaise emulsions with desirable physicochemical and sensory characteristics. Corn starch was subjected to four distinct modification techniques: annealing (ANN), citric acid hydrolysis (CA), acetylation (ACT), and heat-moisture treatment (HMT). The resulting modified starches were incorporated into mayonnaise formulations at 30% and 50% fat replacement levels, with a full-fat (FF) mayonnaise serving as a control. Comprehensive physicochemical analyses, including color, pH, viscosity, and emulsion stability (including freeze-thaw stability), were conducted. Furthermore, sensory evaluation was performed to assess the acceptability of the reduced-fat mayonnaise samples. Physicochemical analyses revealed significant variations in the properties of the modified starches due to the different treatments. Notably, mayonnaise samples formulated with ACT, CA, and HMT starches at a 30% fat replacement level exhibited high viscosities, comparable to the FF control. In contrast, ANN starch failed to provide adequate viscosity at both replacement levels. Interestingly, all fat-reduced mayonnaise samples demonstrated improved freeze-thaw stability compared to the FF control and exhibited high overall emulsion stability. Sensory evaluation (9 point hedonic test) indicated that mayonnaise prepared with ACT 30%, CA 30%, HMT 30%, and the FF control achieved comparable scores across all sensory attributes (appearance, color, aroma, texture, and taste), leading to high overall acceptability. Conversely, the ANN 50% sample received lower scores in all sensory aspects, consistent with its observed lower viscosity. This study highlights the promising potential of acetylated (ACT), citric acid hydrolyzed (CA), and heat-moisture treated (HMT) modified corn starches as effective fat replacers in mayonnaise, particularly at a 30% replacement level. These modifications enable the development of low-calorie mayonnaise alternatives that maintain crucial textural and sensory attributes comparable to their full-fat counterpart. Annealing, however, proved less effective in achieving desirable viscosity and sensory properties in reduced-fat mayonnaise. These findings offer valuable insights for the food industry in formulating healthier mayonnaise options.
Livedoid vasculopathy in the Sri Lankan context – a case series
(University of Peradeniya, Sri Lanka., 2025-08-28) Abeysinghe, A.A.G.H.; Dandeniya, C.L.
Livedoid vasculopathy is a rare thrombo-occlusive vasculopathy marked by painful ulceration, livedoid changes, and skin atrophy with healing lesions, primarily affecting lower extremities. Diagnosis is often delayed due to variable presentation and overlapping features with autoimmune conditions. We present three histopathologically confirmed cases to illustrate the disease spectrum and different treatment options. This case series aims to identify the clinical features, serological profiles, different treatment options, and response in patients with livedoid vasculopathy. Three patients presenting to the rheumatology clinic at Teaching Hospital Peradeniya were evaluated for chronic recurrent ulceration in the ankle region. Clinical features, serology, and characteristic histopathology- luminal fibrinoid deposition, vessel-wall segmental hyalinization, and minimal perivascular inflammation were used to confirm the diagnosis of livedoid vasculopathy. Treatment was tailored based on patient-specific findings and included combinations of antiplatelets, immunosuppressants, corticosteroids, and vasodilators. Clinical response was monitored over time. One female and two male patients had chronic, recurrent painful leg ulcers healed with scarring (atrophie blanche). The female had recurrent leg ulcers for 6 years, positive antinuclear-antibodies (1:640 nuclear- homogeneous), non-scarring alopecia, inflammatory arthralgia; was diagnosed with Undifferentiated Connective Tissue Disease (lupus spectrum) and treated with tapering- steroids, aspirin, azathioprine, and hydroxychloroquine. One male had weakly positive lupus anticoagulant (confirmed on repeat testing), no autoimmune features and leg venous stasis risk factors; treated with tapering low-dose of steroids, aspirin, and compression stockings. The third had negative autoimmune markers and extensive ulceration; treated with tapering low-dose steroids, aspirin, bosentan. All responded with active ulcer healing and no recurrences. Livedoid vasculopathy is a rare and challenging disease with minimal evidence-based treatment options. The diagnosis should be considered in patients with recurrent, chronic ulcers. Bosentan is a newly attempted successful treatment option. Early diagnosis with histopathology and individualized management improves the outcome significantly.
Maternal nocturnal caregiving to infants and parenting satisfaction: a qualitative inquiry
(University of Peradeniya, Sri Lanka., 2025-08-28) Senadheera, B.M.K.S.; Pathiranage, A.M.S.D.
The postpartum period is challenging for new mothers, as they must provide continuous care for their newborns. Nocturnal caregiving responsibilities often lead to stress and fatigue. These demands can significantly affect parenting satisfaction and influence their overall perception of the early maternal experience. The research aims to explore maternal involvement, challenges and coping strategies related to nocturnal caregiving to infants and its influence on parenting satisfaction during the initial postpartum period among primiparous mothers. A qualitative phenomenological study was conducted in Gangawatakorale and Gangaihala MOH areas of the Kandy district among ten primiparous mothers within the first eight weeks of the postpartum period. Purposive sampling was employed, and individual, in-depth interviews were conducted using a pre-tested, interviewer-administered, semi-structured guideline. Data collection continued until saturation was reached; no new themes emerged after the 10th interview. Ethical approval was obtained, informed consent was secured, and confidentiality was strictly maintained. The data were analysed thematically using the Braun and Clarke method. A total of nine major themes and eighteen subthemes were identified. 1) Maternal nocturnal caregiving responsibilities are dynamic in nature and involve both infant centered caregiving activities and supportive roles toward their husbands, 2) Factors influencing maternal involvement is categorized into positive and negative factors, 3) Maternal perceptions of nocturnal caregiving included emotional experiences and maternal attitudes, 4) Nocturnal care giving has been shown to adversely affect physical and psychological wellbeing of mothers , 5) Balancing nocturnal caregiving with other life demands(strained social and family relationships, and daytime caregiving), 6) Adaptive self- management (practical strategies, emotional coping) 7) Collaborative strategies (support from spouse and extended family). 8) Fostering strong parent infant bond (attentiveness and responsiveness to infant needs, joy in observing baby's development), 9) Strengthening spousal bond (mutual appreciation and understanding, strengthened team work). For many, despite the physical and mental demands, nocturnal caregiving positively influences parenting satisfaction by fostering a strong bond with the infant and strengthening the spousal bond. It addresses a key gap in literature by offering culturally specific insights into postpartum care urging healthcare professionals to incorporate this understanding into antenatal and postnatal period education programs.
Maternal risk factors for macrosomia: findings from a tertiary care setting in the Kandy district
(University of Peradeniya, Sri Lanka., 2025-08-28) Ambagaspitiya, A.W.D.T.; Abewardhana, M.G.D.K.; Tennakoon, S.; Ratnayake, R.M.C.J.; Alles, C.N.R.A.
Macrosomia, defined as birth weight (BW)>3.5 kg in term babies, is an emerging concern due to the associated delivery-related complications. While maternal body mass index (BMI), gestational weight gain (GWG) and macronutrient intake during pregnancy influence BW, there is limited local evidence on their role in development of macrosomia. This study aimed to evaluate the impact of maternal BMI, GWG, and energy and macronutrient intake during first half of the pregnancy on risk of delivering macrosomic babies, in a cohort of pregnant mothers attending Teaching Hospital, Peradeniya. A prospective cohort study was conducted recruiting singleton pregnant mothers aged 19-35 years. Data on BMI and GWG were categorized based on national guidelines. Energy and macronutrient intake over a month during first half of pregnancy was assessed by a validated questionnaire - “Food Frequency Questionnaire”, and analyzed via nutrient analysis software. Data from 35 mothers who delivered macrosomic babies and 309 mothers who delivered normal BW babies (2.5 kg < BW > 3.5 kg) were analyzed. Relative risks (RR) of delivering macrosomic babies by overweight and obese BMI and excess GWG were assessed. Mean energy and macronutrient intakes were compared using Independent-t-test, and p<0.05 considered significant. The risk of delivering macrosomic babies was 5.5 times higher with overweight BMI (RR: 5.46, 95% CI: 2.73-10.89) and 5.9 times higher with obese BMI (RR: 5.86, 95% CI: 1.93-17.75), compared to normal BMI. The risk of delivering macrosomic babies was 6.3 times higher with excess GWG than adequate GWG (RR: 6.29, 95% CI: 2.95-13.39). The mean energy, carbohydrate and protein intake were higher among mothers who delivered macrosomic babies (2639.4 ± 464.5 kCal/day, 635.4 ± 131.6 g/day, 94.9 ± 24.0 g/day) than mothers who delivered normal BW babies (2466.7 ± 561.3 kCal/day, 612.5 ± 106.9 g/day, 91.8 ± 23.8 g/day), but not statistically significant. Maternal overweight or obese BMI, and excess GWG significantly increase the risk of delivering macrosomic babies. Weight monitoring and nutritional counselling of mother with such risk factors may mitigate the risk. Further studies are necessary to evaluate the impact of maternal energy and macronutrient intakes on birth weight.
Measurements of pharmaceuticals and personal care products in hospital wastewater
(University of Peradeniya, Sri Lanka., 2025-08-28) Ranasinghe, U.G.P.K.; Premarathne, K.V.T.K.; Herath, G.B.B.; Weerakoon, G.M.P.R.
The existence of Pharmaceuticals and Personal Care Products (PPCPs) in the water environment is considered a global water quality issue. PPCPs may originate from industrial sources, hospitals, long-term care facilities, landfill leachate and may enter the water environment by improper wastewater discharges posing threats to ecosystems and human health. Some implications include abnormal physiological processes and reproductive impairment, increased cancer incidence, development of antibiotic- resistant bacteria, and the potential for increased toxicity of chemical mixtures. Generally, PPCPs in wastewater are not removed by conventional wastewater treatment processes. Therefore, this study aimed to identify the presence, seasonal variation and removal efficiency of five commonly used PPCPs; amoxicillin, carbamazepine, sulfamethoxazole, ibuprofen and diclofenac in hospital wastewater around Kandy. The research also assessed the potential environmental risks associated with the presence of these compounds. Composite wastewater samples were collected between 6:00 - 7:00 a.m. from five hospital influents to the sewer, and from the influent and effluent of the Kandy city wastewater treatment plant, resulting in a total of seven samples per sampling event. There were two sampling events in the rainy season and one in the dry season, providing comprehensive coverage of seasonal variations. All the samples were analyzed utilizing Solid-Phase Extraction (SPE) and High-Performance Liquid Chromatography (HPLC) methods to quantify the concentrations of selected PPCPs. Then, Hazard Quotient (HQ) values were estimated to assess environmental risk. Results showed that the presence of selected PPCPs varied significantly between hospitals and the season with the highest values of 2888 μg/L amoxicillin, 23.6 μg/L ibuprofen, 6.9 μg/L diclofenac, 41 μg/L carbamazepine and 10.1 μg/L sulfamethoxazole at wet season, while average removal efficiencies of these PPCPs at the treatment plant was 94%, 71%, 78%, 60% and 99% respectively. The HQ values for amoxicillin (19.7) and carbamazepine (152.7) indicate significant environmental risks due to their persistence and resistance to treatment, particularly during the wet season, while other parameters remained within safe limits (HQ < 1.0). This research provides valuable insights into the concentration of PPCPs in hospital effluents and their persistence in the environment, contributing to improvements in wastewater treatment practices to mitigate environmental risks posed by PPCPs.
Knowledge, attitudes and practices on antibiotic use among older adults in Sri Lanka: a cross-sectional study
(University of Peradeniya, Sri Lanka., 2025-08-28) Priyanjana, T.P.H.C.; Liyanapathirana, V.C.; Sakeena, M.H.F.
Antibiotics save millions of lives but their misuse leads to antimicrobial resistance (AMR). Appropriate antibiotics use among geriatric patients is essential to prevent resistance and ensure effective treatment outcomes. In Sri Lanka, evidence regarding knowledge, attitudes and practice of older adults on antibiotic use remains limited. This study aimed to assess the knowledge, attitudes, and practices regarding antibiotic use among geriatric patients at a tertiary hospital in Sri Lanka. A cross-sectional, interviewer-administered survey was conducted at the Outpatient Department of Teaching Hospital, Peradeniya. Using convenience sampling method, 200 geriatric patients aged above 60 years were recruited. A brief introduction about antibiotics was provided before data collection. Patients who had no idea of antibiotics even after the introduction were excluded. Descriptive and comparative data analyses were performed. The fisher’s exact test was applied to identify significant associations. Knowledge and practice scores were calculated on scales of 20 and 7 respectively. Majority of participants (61.1%) learned about antibiotics through doctors. 60.5% were educated only up to ordinary level. Out of 200 participants, 194 (97%) scored between 0-14 for the knowledge section indicating poor knowledge about antibiotics [mean:5.4 (SD 3.725); median:5 (IQR 7-3)]. Only 34% respondents correctly identified amoxicillin as an antibiotic while 13.5% and 14.5% misidentified that aspirin and paracetamol were antibiotics respectively. Only 21% respondents had heard the term “antibiotic resistance” and 24% thought resistance develops in human body rather than in bacteria. Out of 200 participants, 170(85%) scored between 0- 4 for practices indicating poor practice level of antibiotics [mean: 4.45 (SD 0.966); median:4 (IQR 5- 4)]. Attitudes toward antibiotic use reflected mixed awareness. 32% respondents mistakenly expected antibiotics for colds. 97% of respondents reported using antibiotics as labeled by the pharmacist, indicating high adherence. A significant association was found between poor knowledge level and stopping antibiotics once symptoms improve. (n = 65% p ≤ 0.05, Fisher's exact test). This study reveals poor knowledge and unsafe antibiotic practices among older adults, potentially contributing to AMR. Tailored interventions, including awareness programs using visual or digital aids to address literacy barriers, may improve understanding and practices. Future follow-up studies are recommended to evaluate the effectiveness of such interventions.
Knowledge, attitudes and practices on dietary salt intake among opd and hypertension clinic attendees at teaching hospital, Peradeniya, Sri Lanka
(University of Peradeniya, Sri Lanka., 2025-08-28) Hansika, H.D.B.; Aththanayake, A.M.W.T.B.; Lakshan, G.M.D.; Waduge, W.W.S.S.; Marambe, K.N.
A cross-sectional descriptive study was conducted at Teaching Hospital Peradeniya to assess knowledge, attitudes, and practices (KAP) regarding dietary salt intake among adult attendees of the Outpatient Department (OPD) and Hypertension Clinic. The sample included 403 randomly selected participants (OPD: 103; Clinic: 300). Data were collected via a pre-tested, self-administered bilingual questionnaire. Of the participants, 62.8% were female, 59.8% were over 40 years, and 65.5% had education level A/L or above. Analysis using Jamovi and Excel included chi-square tests to assess associations between demographic variables and KAP indicators. Clinic attendees demonstrated higher levels of satisfactory knowledge (77.7%) and practices (60.3%) compared to OPD attendees (59.0% and 47.6% respectively). Female participants (81.0%) and those aged ≥ 40 years (77.0%) showed significantly better knowledge (p < 0.001). Practices were significantly better among older adults (61.0%) and individuals with higher education (78.4%, p = 0.025). Residence (urban vs. rural) showed no significant association with either knowledge or practices (p > 0.05). The average estimated salt intake was 9.15 g/day, nearly double the WHO-recommended limit. Television was the most cited health information source (62.0%), especially among clinic attendees, while social media use was higher among younger OPD participants. The study highlights a discrepancy between knowledge and behavioural practices across both groups and suggests that greater emphasis is needed on behaviour-focused interventions. Rather than suggesting conclusive causality, these findings support integration of targeted dietary counselling in outpatient settings and the strategic use of media platforms for public health messaging.
Knowledge, attitudes and practices regarding psychological stress management among first-year students of the faculty of allied health sciences, university of Peradeniya
(University of Peradeniya, Sri Lanka., 2025-08-28) Upeksha, E.P.A.; Paranagama, M.P.
Psychological stress is one of the major problems faced by university students. Proper stress management plays a vital role in making university life a success. However, there is limited information and no validated tool to assess knowledge, attitudes, and practices (KAP) related to stress management among Sri Lankan university students. This study aims to develop a questionnaire and assess the KAP regarding stress management among first-year students of the Faculty of Allied Health Sciences, University of Peradeniya. A descriptive cross-sectional study was conducted among 143 students selected by stratified proportional sampling method. Data was collected using a self- administered questionnaire developed by the investigator. Its content validity and test- retest reliability were assessed. Data was analyzed using SPSS (version 26). The questionnaire showed an acceptable level of reliability (Cronbach’s alpha – 0.768). Out of 143 participants, 102 (71.3%) were females and 41 (28.7%) were males. Their mean age was 22.85 ± 0.93 years. The mean knowledge score was 67.20 ± 20.74, with females scoring significantly higher than males (p = 0.035). The mean attitude score was 79.08 ± 10.50, with no significant gender difference (p = 0.267). Regarding stress management practices, the participants most frequently sought support from family and friends (80.5%) compared to professional support systems (19.4%) and used avoidance- based coping strategies (55.4%) compared to problem-solving strategies (45.05%). The majority of students demonstrated good knowledge and attitudes towards stress management. The most frequently used stress management strategies were seeking support from family and friends, and avoidance-based practices. These findings highlight the need to enhance their awareness of professional support systems and the importance of problem-solving strategies to manage their psychological stress.
Knowledge and exposure to occupational hazards in nursing profession among nursing undergraduates in three state universities, the university of Peradeniya, the university of Sri Jayawardhanapura and the university of Ruhuna in Sri Lanka
(University of Peradeniya, Sri Lanka., 2025-08-28) Srimali, K.H.N.; Liyanage, E.
Nurses are an integral component of the healthcare system and, they are prone to various hazards. Most of the research on occupational hazards (OH) in the nursing profession (NP) involves nurses, and a very small number of research have been conducted among nursing students in countries such as: Ethiopia, Turkey, China, and Egypt. There is no research published in Sri Lanka on this area. The objective of the study is to determine the knowledge of an exposure to OH in the NP among nursing undergraduates (NU) in three state universities. This was a descriptive cross-sectional online study, conducted among 308 NU from University of Peradeniya (UoP), University of Sri Jayawardhanapura (UoJ), and the University of Ruhuna (UoR). A proportionate random sampling method was utilized, such that a proportionate number of participants was recruited from each batch of nursing degree programme from each University. The questionnaire was sent out to all students via WhatsApp groups and emails. After two weeks, reminders were sent requesting to fill out the questionnaires. Upon receiving responses, proportionate numbers of responses were selected using random number generator on Excel. Data was collected using a self-administered questionnaire. Permission was obtained from the developers of the questionnaire in Ethiopia. The questionnaire was pre-tested among 30 NU. It comprised six parts: socio demographic data, knowledge about OH, and exposure to biological, physical, mechanical & psychological factors. The knowledge part comprised 5 questions. Biological, physical, mechanical, psychological factors; each comprised 6, 6, 6, and 8 questions respectively. The overall percentages reported in the findings were calculated similar to the study done in Ethiopia. The majority of participants were females 81.2%. 59.9% represented UoR. 20.1%, and 19.7%, were from the UoJ and the UoP respectively. In the study, 29.6%, 28.5%, 26.5% and 15.2% of participants were from the first, second, third, and final year respectively. The majority, (90%) of the students had learned about OH at the university. The majority, 95.5% of participants had knowledge that needle prick, blood flush, and skin cuts can cause OH while only 94.8% knew that mechanical injuries and chemical & biological factors can cause OH. The prevalence of exposure to biological, mechanical, physical and physiological factors was 66.85%, 50.42%, 58.32% and 63.10% respectively. The NU had a high prevalence of exposure to OH. Although, majority of the NU had learnt about OH at the university and had knowledge about OH, the exposure to OH was high. Ongoing training on OH, safety and infection prevention and control for NU is strongly recommended based on the study results.
Knowledge, attitude, and practice on first aid and safety measures regarding sports-related injuries among sportsmen and women in university of Peradeniya, Sri Lanka
(University of Peradeniya, Sri Lanka., 2025-08-28) Srirama, S.M.C.N; Nandadeva, D.
Sports injuries can occur unexpectedly and negatively affect an athlete’s performance and overall health. Awareness of proper first-aid techniques and safety measures is crucial for minimizing the severity of injuries and avoiding complications. This study aimed to assess the knowledge, attitude, and practice on first aid and safety measures regarding sports-related injuries, and to identify demographic factors determining knowledge, attitude, and practice on first aid and safety measures regarding sports- related injuries among sportsmen and women at the University of Peradeniya. A quantitative cross-sectional study was conducted among athletes of the sports teams at the University of Peradeniya using a pre-tested, self-administered questionnaire. Based on previous literature, the knowledge and practice total score was converted into percentages and categorized as “≤ 49% = Poor”, “50% - 70% = Adequate/Satisfactory”, and “≥ 71 = Good”. Each statement in the attitude section was scored on the Likert scale, and the total score was converted into percentages and categorized as “0- 49%=Negative attitude” and “50%-100%=Positive attitude”. Data are presented as mean score±standard deviation, frequencies, and percentages. Out of 442 participants, 63.8% were males. Sports injuries were reported by 65.6%, and 62% had no first-aid training. Overall knowledge and practice were poor in 52.5% and 69% of athletes, respectively, However, 98.87% showed a positive attitude toward first aid and safety. Athletes from medicine-related faculties had better knowledge (60.00 ± 21.32%, p ˂ 0.001) compared to other science-based faculties, (46.90 ± 18.96%), and non-science- based faculties, (43.64 ± 20.45%). Additionally, receiving first-aid training and both knowledge and practice in first-aid and safety measures showed significant positive associations (p ˂ 0.05). No significant associations were observed between gender and knowledge, attitude, or practices (p ˃ 0.05). These findings indicate that overall knowledge and practice in first aid and safety measures were poor, while attitude was positive among sportsmen and women at the University of Peradeniya. Therefore, awareness and skill enhancement programs on first aid and safety measures regarding sports-related injuries for university athletes are needed.
Knowledge, attitude and prevalence of cervical cancer and pap smear screening tests at well-women clinics conducted by the medical officer of health (MOH) offices in Matara district
(University of Peradeniya, Sri Lanka., 2025-08-28) Thasanthan, L.; Chethana, H.H.
Cervical cancer is the fourth most common cancer in women and a leading cause of death, especially in resource-limited settings. It’s preventable with early detection, like the Pap smear test. Factors like gender, socio-economic status, culture, and education influence knowledge and practices regarding cervical cancer prevention. The study aimed to identify the participants’ attitudes in the cervical cancer screening test, to examine the basic knowledge regarding cervical cancer and pap smear tests, to investigate the prevalence of cervical cancers among women in well-women clinics and to assess preventive measures for cervical cancer. This retrospective descriptive cross- sectional study was conducted among 403 participants on Well-women clinics attendees in 17 MOH offices from January to December 2023. Prevalence was estimated as a retrospective study and data was collected as a prospective study. The questionnaire was pretested on 10 women who attended the pap smear screening test. Data was collected using a pre-tested, Computer Assisted Telephone Interview (CATI) questionnaire. The collected data was entered into a Microsoft Excel spreadsheet and SPSS statistical software version 25 was used to analyze the data. The results indicated that most of the participants, 147 (36.5%), had low knowledge of cervical cancer. Meanwhile, 133 participants (33%) demonstrated a moderate level of expertise, and 123 participants (30.5%) displayed a high level of knowledge regarding cervical cancer. The final results of the knowledge of cervical cancer screening reflected the majority; 187 (46.4%) of study participants had poor expertise in cervical cancer screening. While 130 (32.3%) had a moderate knowledge level, 86 (21.3%) participants had good expertise towards cervical cancer screening. The prevalence of cervical cancers among women in well- women clinics in Matara district 2023 is 0.01%. Although, the knowledge level of both cervical cancer and screening tests was poor. Therefore, there is a need to conduct awareness programs about cervical cancer and screening to improve their awareness.
Green synthesis and characterization of hydroxyapatite nanoparticles using chicken egg shells for cefazoline delivery
(University of Peradeniya, Sri Lanka., 2025-08-28) Gamagedara, T.P.; Pathirana, R.P.P.S.
Hydroxyapatite ( Ca10(PO4)6(OH)2 ) is a naturally occurring inorganic mineral. It is used for biomedical applications due to biocompatibility, biodegradability, and osteoconductivity of their nanostructures. In this study, HAP NPs were synthesized using green and facile methods. This study was done to develop a facile synthesis method for producing hydroxyapatite nanoparticles using chicken egg shells for cefazolin delivery and to evaluate the effect of the method for the characteristics of the NPs. The research was a laboratory based experimental study that used wet chemical precipitation methods for the synthesis. In method 1, Ca(CO)3 was transformed via Al(OH)3 under controlled pH (10) and temperature (60 0C). Method 2 was done under thermal decomposition and HAP was obtained at 60 0C without external pH control. After that characterization was done using SEM, FT-IR and XRD analysis. According to the SEM analysis, spherical shape NPs were observed in average size of 10 nm with nanosize porosity and needle shapes were obtained with 15 nm x 100 nm. FTIR spectra were obtained for the both CFZ loaded and pure HAP NPs to identify the functional groups. Peak analysis of the both shapes revealed that their functional groups were perfectly indexed with the standard spectra of HAP NPs. CFZ- loaded HAP NPs illustrated the significance bonds of CFZ while making some changes of the pure HAP NPs spectra. XRD was done to identify the crystallinity. According to that, XRD patterns were matched with standard peaks of the HAP NPs. When calculating the crystallinity size, Spherical shape was given 30 nm and needle shape was given 12 nm of average sizes. Finally, HAP NPs were synthesized using green methods, and size and morphology was tuned using different structure- directing agents like Al(OH)3. CFZ was loaded successfully for both morphologies and spherical shapes show higher CFZ loading capacity than needle- shapes due to the high surface area/volume ratio and strengths of the bonds in FTIR analysis.

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