iPURSE 2025

Permanent URI for this collectionhttps://ir.lib.pdn.ac.lk/handle/20.500.14444/5218

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Identification of coronaviruses in Bat Excreta in a selected semi-urban area in the Kandy district of Sri Lanka
(University of Peradeniya, Sri Lanka., 2025-08-28) Noordeen, F.; Iqbal, B.N.; Fernando, T.; Muthuwaththa, M.G.C.M.; Thilakarathne, G.G.K.T.; Abdeen, A.A.S.
Bats are known asymptomatic reservoirs of many coronaviruses (CoV). Their dense roosting behavior promotes transmission and evolution of these viruses, posing zoonotic risks. Identifying CoV in bat colonies will help recognize emerging CoV, particularly in areas where human-animal interactions are common. This study aims to detect the presence of CoV in bat guano collected from a semi-urban bat colony in a selected site in the Kandy District of Sri Lanka. A total of 50 fresh bat guano were collected from a bat colony from Akurana, Sri Lanka in July 2023. Each guano was mixed separately with 1mL of Phosphate Buffered Saline (PBS). Viral RNA was extracted using Bioflux Biospin Virus DNA/RNA extraction kit, as per manufacturer’s instructions. RNA extracts were subjected to a conventional PanCoV nested RT-PCR, which is designed to target RNA-dependent RNA polymerase gene with a 442 base pair fragment, a conserved segment in the Orthocoronavirinae family. Subsequently, PCR products were visualized using gel electrophoresis using a UV transilluminator. Finally, DNA sequencing was done for the positive samples using Oxford Nanopore Technology. Of the 50 bat guano samples tested, 15 (30%) were confirmed positive for CoV through PanCoV RT-PCR. Of the 15 CoV positive samples, 13 were successfully sequenced; the majority of these samples were classified as beta CoV using the NCBI blast. Identification of beta CoV in 30% of bat guanos in a semi-urban area of the Kandy District, emphasizes the need for enhanced surveillance of bats, especially in underrepresented areas, to understand CoV diversity to mitigate potential zoonotic spillovers that could pose threats to the public.
Immersive ai-driven nursing education: Integrating vr and conversational ai for advanced wound care training
(University of Peradeniya, Sri Lanka., 2025-08-28) Madhushanka, K.G.M.; Bambaragama, H.M.K.D.; Wickramaarachchi, U.I.; Jayasinghe, U.; Ekanayake, E.H.M.R.K.; Dassanayake, H.D.W.T.D.; Vimukthi, R.D.Y.
Nursing education faces significant challenges in delivering effective wound care training due to limited faculty resources, high costs of traditional manikin-based simulations, and ethical constraints surrounding patient consent. These barriers restrict hands on practice, impede skill development, and delay clinical preparedness among nursing students. This study explores the integration of Virtual Reality (VR) simulations and Conversational AI models to revolutionize advanced wound care education, aiming to bridge the gap between theoretical knowledge and practical application. The primary objectives are to enhance critical thinking, clinical competency, knowledge retention, and learner engagement through immersive, interactive technologies tailored to nursing education. A structured literature review was conducted, analyzing 45 peer reviewed studies on VR and AI applications in nursing education, with a specific focus on wound care training. Studies were systematically categorized based on their use of VR, Conversational AI, or combined approaches, revealing a notable gap in research on integrated systems. Findings indicate that VR significantly improves immersion, spatial understanding, and skill acquisition but lacks realistic tactile feedback and robust support for complex decision-making. Conversely, Conversational AI excels in delivering dynamic, personalized feedback and guidance, yet struggles with contextual adaptability and speech recognition accuracy in clinical scenarios. The integration of these technologies remains underexplored, primarily due to hardware limitations, software compatibility issues, and the complexity of replicating domain specific wound care scenarios. Despite these challenges, combining VR’s immersive environments with AI’s adaptive communication offers a promising pathway to create realistic, scalable training platforms. Such systems could simulate diverse clinical cases, provide real time feedback, and foster critical decision-making skills in a safe, controlled setting. This study underscores the transformative potential of integrated VR-AI systems to address current educational limitations, enhance learner outcomes, and better prepare nursing students for real world clinical challenges. Future research should prioritize developing pedagogically sound, interoperable systems that overcome technical barriers, focusing on scalability, accessibility, and alignment with nursing curricula to ensure practical implementation and widespread adoption in educational settings.
In vitro and In silico evaluation of antioxidant potential and phytochemical quantification of Plectranthus amboinicus (Lour.) Spreng roots
(University of Peradeniya, Sri Lanka., 2025-08-28) Ranasinghe, P.A.H.B.; Lorensu Hewage, V.C.; George, G.D.N.; Weerasinghe, W.
Plectranthus amboinicus (Lour.) Spreng is a medicinal plant that belongs to the family Lamiacea and is known for its diverse pharmacological properties. Though the various parts of the plant have been extensively studied, roots remain less explored. This research aimed to evaluate phytochemical and antioxidant activities of P. amboinicus roots using in vitro and in silico methods. Different plant extracts of roots were made using sequential cold maceration method with n-Hexane, Chloroform and Methanol. Total Phenolic Content (TPC), Total Flavonoid Content (TFC) and Total Antioxidant Capacity (TAC) were determined while the antioxidant activity was determined using 2,2-diphenyl-1-picrylhydrazyl (DPPH) free radical scavenging method. Gass Chromatography-Mass Spectrophotometry (GC-MS) analysis was performed to identify the phytochemicals present in the root extracts. The identified phytochemicals were subjected to in silico molecular docking study with Superoxide dismutase (SOD) enzyme to simulate binding affinities by using GOLD Suite software. Docking results were compared and analyzed with the standard ligand binding capacity with SOD enzyme. The n-Hexane extract showed the highest TPC (28.22 ± 1.155 mg GAE/g), whereas the Methanol extract showed the highest TFC (21.78 ± 0.254 mg QE/g). The TAC assay indicated n-Hexane extract showed the highest antioxidant capacity (7.3490 ± 0.446 mg AAE/g). Nevertheless, the Methanol extract showed the best scavenging activity with the lowest IC50 of 78 ± 1.194 μg/mL while the standard Ascorbic acid showed IC50 of 148.5 ± 0.333 μg/mL. Palmitic acid (C16H32O2), Aromadendrene (C15H24), and Hexanedioic acid (C6H10O4) were identified as the most abundant compounds present in extracts via GC-MS. Palmitic acid-SOD interaction showed a high binding potential with 3 Hydrogen bonds and 59.1739 of PLP fitness score while the standard Ascorbic acid-SOD showed only 44.496 of PLP fitness score. The study highlights the significant antioxidant potential of P. amboinicus root extracts. The Methanol extract exhibited the highest free radical scavenging activity, while Palmitic acid showed strong binding affinity with the Superoxide dismutase enzyme. These findings indicate that P. amboinicus roots possess considerable potential as a natural source of antioxidant agents. The results can be applied in the development of herbal supplements, functional foods, skincare products, and antioxidant-based therapies.
In vitro anti-inflammatory activity of Guduchyadi taila and its individual ingredients
(University of Peradeniya, Sri Lanka., 2025-08-28) Jayasuriya, W.J.A.B.N.; Herath, H.M.D.R.; Madushan, M.A.H.; Dahanayake, J.M.
Guduchyadi Taila is a traditional formulation used in treating Vatarakta (gouty arthritis). This formulation is prepared by incorporating of Tinospora cordifolia (Rasakinda), cow milk, sesame oil, and water. This study aimed to evaluate the in vitro anti-inflammatory activities of Guduchyadi Taila and its ingredients using egg albumin denaturation assay and heat-induced red blood cell (HRBC) stabilisation assay. T. cordifolia, along with cow milk and sesame oil, was used in the preparation of Guduchyadi taila, according to the standard methods mentioned in Ayurvedic Pharmacopoeia of Sri Lanka. The in vitro anti-inflammatory activity of the Guduchyadi taila and its ingredients (decoction of T. cordifolia stem, cow milk, sesame oil) was evaluated using the egg albumin denaturation assay and the HRBC membrane stabilization assay, with diclofenac sodium as the reference drug. Statistical analysis was performed using one-way ANOVA followed by Tukey's Honestly Significant Difference post hoc test. In egg albumin denaturation assay, T. cordifolia decoction, cow milk, sesame oil, Guduchyadi taila, and diclofenac sodium showed IC50 values of 685.6, 3664, 1694, 565.3 and 780.4 μg/ml, respectively. In the HRBC membrane stabilisation assay, T. cordifolia and Guduchyadi Taila had IC50 values of 683.1 and 658.5 μg/ml, respectively, while sesame oil and cow milk (1414 and 3788 μg/ml, respectively) displayed much weaker activity. The anti-inflammatory activity of T. cordifolia and Guduchyadi Taila was comparable with the standard drug (P > 0.05), while cow milk and sesame oil had significantly weaker activity compared to Guduchyadi Taila and diclofenac sodium (P < 0.05). The present study demonstrated the in vitro anti-inflammatory activity of the traditional formulation Guduchyadi Taila. Decoction of T. cordifolia stem showed in vitro anti- inflammatory activity indicating its potential as a promising source for novel anti- inflammatory agents. A novel topical formulation will be prepared using the ingredients of Guduchyadi Taila.
In vitro antimicrobial activity of Hypochlorous acid (Hocl) on some selected Candida species and oral microflora
(University of Peradeniya, Sri Lanka., 2025-08-28) Gunasena, C.; Wijekoon, W.M.P.S.K.; Jayatilake, J.A.M.S.; Giguruwa, D.N.; Senanayake, M.R.D.M.; Weerasekera, H.S.K.
Hypochlorous acid (HOCl) is used as an antiseptic and a disinfectant. However, antimicrobial activity (AMA) of HOCl on Candida species (CS) and oral microflora (OM) is poorly investigated. This study aimed to evaluate the AMA of HOCl on some selected CS and OM in vitro. AMA of HOCl was tested against standard isolates of Candida; C. albicans (ATCC 90028), C. parapsilosis (ATCC 22019), C. krusei (ATCC 6258), C. glabrata (ATCC 90030) and C. tropicalis (ATCC 13803). Further, the effect of HOCl against OM harvested from healthy individuals was also assessed as follows. HOCl produced by Steripower® unit (Japan) was adjusted to different concentrations (200, 100 and 50 ppm). Phosphate buffered saline (PBS) and 0.2% chlorhexidine were used as negative and positive controls. CS were cultured in Tryptic Soy Broth (TSB) at 37°C for 24 h and were harvested by centrifugation, washed and suspended in PBS (108 cell/ml; 0.5 McFarland). OM was harvested from 5 healthy volunteers after rinsing the mouth with sterile PBS (10 ml) for 30 seconds. Resultant oral rinses were concentrated into 1ml PBS with centrifugation. Afterwards, 0.1 ml of the Candida suspension or concentrated oral rinse was mixed with 0.9 ml of HOCl or control solutions for 1 min. Subsequently, 0.1 ml of the resultant solutions of Candida or OM exposed to HOCl were inoculated on to Sabourauds dextrose agar or blood agar plates respectively. Candida cultures were incubated at 37°C aerobically. OM was incubated at 37°C both aerobic and anaerobic conditions. All cultures were observed up to 48 h for microbial growth. Each experiment was quadruplicated. CS (C. albicans, C. glabrata, C. krusei, C. parapsilosis, and C. tropicalis) and OM of healthy volunteers exposed to HOCl (200, 100, 50 ppm) and 0.2% chlorhexidine for 1min resulted no growth on solid agar after 48 h incubation at 37°C. Exposure to HOCl (200, 100, 50 ppm) and 0.2% chlorhexidine for 1 min completely inhibited all the tested CS (C. albicans, C. glabrata, C. krusei, C. parapsilosis, and C. tropicalis) and the OM of healthy volunteers suggesting a remarkable AMA. This could be attributed to the fact that HOCl dissociates into H+ and OCl– that are capable of denaturing and aggregating microbial proteins resulting in killing a broad spectrum of microorganisms in a brief exposure. HOCl (200, 100, 50 ppm) may be used as an effective antiseptic/disinfectant similar to 0.2% chlorhexidine against C. albicans, C. glabrata, C. krusei, C. parapsilosis, C. tropicalis and OM. Further studies are recommended to assess the in vivo effects of HOCl to explore its application for oral hygiene.
In Vivo Glycaemic response to selected commonly consumed Sri Lankan rice– based foods prepared using three long-grain rice varieties
(University of Peradeniya, Sri Lanka., 2025-08-28) Somaratne, G.M.; Wijesekara, S.P.; Gunasekara, D.C.S.; Chandrasekara, A.; Bhagya, G.S.K.; Abeysiriwardena, D.S.D.Z.
Sri Lankans heavily rely on rice-based diets. However, the Glycaemic index (GI) values of many local rice-based dishes have been underexplored. This study aimed to investigate the Postprandial Glycaemic Responses (PGRs) elicited by selected rice- based dishes prepared using different cooking methods, from three long grain rice varieties [CIC Savandara Mix, CIC Red Fragrant (Broken) and CIC Super Kernel]. Selected dishes, namely milk rice, Diyabath, rice porridge, fried rice and string hoppers (served as a mixed meal with coconut gravy) were prepared following standard recipes and analysed for proximate composition. In vivo GI values of plain cooked rice and dishes were determined following the ISO 26642:2010 procedure, in a randomized clinical trial, using a healthy human clinical panel of twenty-five volunteers. Each portion of test meals contained 50 g of available carbohydrates. Pure glucose (50 g) dissolved in 250 ml of water was served as the reference. Savandara Mix rice reported a medium GI (58 ± 8.4) whereas milk rice (51±5.0) and Diyabath (40 ± 5.8) prepared from the same rice reported low GI values. Fried rice prepared from Super Kernel rice exhibited a low GI value (40 ± 5.0). Red Fragrant (Broken) rice (67 ± 6.8) and derived dishes; rice porridge (62 ± 10.6) and string hopper mixed meal (59 ± 9.1) were categorized as medium GI food. Additionally, milk rice prepared from Savandara Mix, when served with a minimal sufficient amount (15 g) of a commercially available accompaniment (Katta Sambal) elicited a GI of 50 ± 6.5 indicating no statistically significant difference (p < 0.05) when compared with milk rice served alone. The results indicate that method of preparation and addition of fat, protein and fibre can help optimize the PGR of rice-based dishes. Furthermore, it depicts potential use of commercially available Katta Sambal as a carrier food during GI testing. Moreover, each dish tested can be tailored to specific health needs.
In silico evaluation of the repellent efficacy of selected citrus terpenoids against aedes albopictus OBP 1 protein using molecular docking techniques
(University of Peradeniya, Sri Lanka., 2025-08-28) Alahakoon, S.B.; Fernando, S.S.S.T.; Wijegunawardana, N.D.A.D.; Jayasooriya, R.G.P.T.; Samarakoon, K.W.
Mosquito-borne diseases pose a major global health threat, affecting billions each year. Rising resistance to synthetic pesticides and the lack of antiviral treatments, especially for illnesses like dengue, emphasize the need for alternative prevention methods. Natural plant compounds, particularly citrus-derived terpenoids, have shown promise as eco-friendly mosquito repellents. This study used an in silico approach to assess the binding efficiency of selected citrus-based phytochemicals against Odorant Binding Protein 1 (OBP1) of Aedes albopictus, with the synthetic repellent DEET as a reference. Key compounds analyzed included limonene, α-pinene, β-pinene, linalool, citronellol, myrcene, citral, and neral—chosen for their known repellent activity and abundance in citrus extracts. The OBP1 active site was identified using CASTp, and molecular docking was performed using AutoDock 4.2.6 with standard parameters (Kollman charges and merged non-polar hydrogens). Docking was tested at exhaustiveness levels 8, 30, 50, and 100 to validate results. Additional virtual screening was conducted with Vina, and interactions were visualized using Discovery Studio and ChimeraX. Limonene showed the highest binding affinity at –6.8 kcal/mol, surpassing DEET (–5.0 kcal/mol). Other compounds like α-pinene and β-pinene also exhibited stronger affinities than DEET. The docking interactions included hydrogen bonds, alkyl, and π- alkyl interactions, suggesting favorable structural compatibility with OBP1. While no significant statistical differences were observed across exhaustiveness levels, minor variations in binding affinity were noted. Overall, the findings highlight the potential of citrus-derived terpenoids, particularly limonene, as effective natural alternatives to synthetic mosquito repellents. The study demonstrates the value of computational docking in screening plant-based bioactive compounds for mosquito control strategies.
Genetic and epigenetic alterations in oral and oropharyngeal cancers associated with smoke and smokeless tobacco exposure: a systematic review
(University of Peradeniya, Sri Lanka., 2025-08-28) Batuwanthudawa, B.G.M.I.; Hewa Kodikarage, C.; Senevirathna, K.; Ratnayake, W.M.K.M.; Induijaa, S.; Bandara, R.M.P.A.; Jayasinghe, Y.A.; Siriwardena, S.; Kanmodi, K.K.; Jayasinghe, R.D.
Oral and oropharyngeal squamous cell carcinomas are influenced by several variables, such as alcohol use, tobacco use and human papillomavirus (HPV) infections. Among them, tobacco usage is closely linked to squamous cell carcinomas of the oropharynx and oral cavity. Tobacco-induced genetic and epigenetic alterations are crucial contributors to carcinogenesis and their exact processes are still unknown. The aim of this systematic review was to compile the most recent information regarding the genetic and epigenetic changes caused by tobacco use that lead to the initiation and progression of oral and oropharyngeal cancers. Databases such as PubMed, Scopus, and Web of Science, Dentistry & Oral Sciences Source and AMED – The Allied and Complementary Medicine Database were used in a methodical search. Altogether 28 studies on tobacco-related oral/oropharyngeal malignancies that were published between 2014 and 2024 were included and focused only on in-vitro experiments. PRISMA guidelines were used to screen the articles. Key findings, tobacco usage, cell culture conditions, study type, and important molecular changes were considered during extraction and data analysis. Both smoke and smokeless tobacco products were analyzed collectively. SYRCLE’s risk of bias tool was used for the risk of bias assessment since most of the studies were used both animal models and cell lines. We found that frequent mutation of TP53, CDKN2A, and NOTCH1 genes in tobacco users. Hypermethylation of tumor suppressor gene promoters and changes in the expression of regulatory microRNAs like miR-21 and miR-155 were examples of epigenetic changes. Additionally, tobacco smoke has been connected to chromatin remodeling and histone de-acetylation, both leading to uncontrolled cell growth and invasion. The development of oral and oropharyngeal cancer was driven by certain genetic alterations and epigenetic dysregulation as a result of tobacco usage. These results provide promising insights into novel treatment approaches such as molecular biomarkers for early detection of tobacco-associated head and neck malignancies.
Geochemical characterization and health risk assessment of groundwater in Sri Lanka
(University of Peradeniya, Sri Lanka., 2025-08-28) Munasinghe, D.T.R.; Chandrajith, R.
This study evaluates the hydro-geochemical properties of water samples from various domains across climatic zones and geological complexes to determine water quality and potential health risks. Groundwater quality data are presented from a total of 1508 groundwater samples. Key parameters such as temperature, pH, total alkalinity (TA), total hardness (TH), electrical conductivity (EC), bicarbonate (HCO3−), sulfate (SO42−), phosphate (PO43−), nitrate (NO3−), chloride (Cl−), fluoride (F−), sodium (Na+), potassium (K+), magnesium (Mg2+), and calcium (Ca2+) were analyzed. The county's greatest median EC and TH values (1350.29 μS cm−1 and 494.97 mg L−1) might be sedimentary terrain. The greatest geographical changes in EC and TH values, which are probably influenced by climate, were found on the metamorphic terrain that makes up more than 90% of the island. The Water Quality Index (WQI) and Health Index (HI) were calculated to assess water usability and associated health implications. The results show significant variability in water quality across different zones. The dry zone exhibits higher mineral content and poor water quality, with domains like A having the highest WQI of 93.00 (Very Poor). The wet zone, particularly domain H, demonstrates the best water quality with a WQI of 9.00 (Excellent). Parameters like electrical conductivity, hardness, and chloride levels are elevated in the Sedimentary and Wanni complexes, indicating salinity and mineralization issues. The average pH (6.73) is within permissible limits, but acidity is noted in the wet zone Highlands (pH 4.73). Health risk assessments reveal that the dry zone poses the greatest health concerns, with a maximum HI of 5.36. The findings highlight the need for targeted water management strategies, including salinity control in the dry zone, enhanced mineral content monitoring, and water quality maintenance in the wet zone. This study underscores the importance of region-specific interventions to ensure safe and sustainable water resources.
Gray level co-occurrence matrix (GLCM) texture features analysis for brain tumor classification using MRI
(University of Peradeniya, Sri Lanka., 2025-08-28) De Silva, W.M.K.; Basnayaka, D.T.; Hewavithana, B.; Jayathilake, M.L.; Vijithananda, S.M.; Hareendra Upul, P.D.S.
Medical imaging Physics is rapidly developing area of research in the world. The Gray- Level Co-occurrence Matrix (GLCM) is a method for extracting texture information from the medical images. Magnetic Resonance Image (MRI) is a non-invasive modality commonly used in cancer diagnosis. Tumors are classified as benign or malignant based on their biological behavior, histological characteristics, and potential for metastasis. This study applies GLCM texture feature analysis to classify brain MR images into benign tumors, malignant tumors, and normal brains. The aim is to differentiate between benign and malignant tumors and normal brains using GLCM features and to identify the most suitable machine learning model for classification. The features Contrast, Correlation, Energy, Homogeneity, Dissimilarity, Angular Second Moment (ASM), Entropy, Auto-correlation, Variance, Inverse Difference Momentum (IDM), Sum Average, Sum Entropy, Sum Variance, Different Entropy, and Different Variance in GLCM are used in this study. DICOM format images were used to select tumor ROIs (Region of Interests) in the MR images. ROIs were manually selected using MATLAB, and corresponding texture feature values were extracted. Statistical analysis was used to compare the feature values to identify the discriminant tumors and normal brains. ANOVA F-test was used to select the best feature performance. These features were then used to identify the most effective machine learning model. Among the features, correlation yielded the lowest ANOVA F-score (2.409331) and was excluded from further analysis. The Support Vector Machine (SVM) model demonstrated the highest classification accuracy of 86.67%. Therefore, SVM can be used to differentiate between malignant tumors, benign tumors, and normal brains with high accuracy. The study concludes that GLCM features excluding correlation can effectively differentiate malignant tumors, benign tumors, and normal brains. The SVM model enables the development of a high-performance ML model that can assist in the decision-making steps of the brain tumor diagnosis process in MRI.
Fungal agents associated with toe web infections in patients with diabetes mellitus: a single-centre study in Sri Lanka
(University of Peradeniya, Sri Lanka., 2025-08-28) Thilakarathna, W.D.S.P.; Jayarathne, K.G.S.H.; Weerasooriya, B.W.M.S.B.; Dheerasekara, W.K.H.; Rathnayake, B.M.C.; Dalugama, C.; Mendis, B.C.G.
Infected toe webs are more common among diabetes cases but less studied condition. Therefor early identification is crucial for preventing complications and improving outcomes. This study aims to investigate the prevalence and the microbial pattern of the fungal infections in the toe webs with diabetes mellitus, documenting specific fungal agents and identifiable risk factors. For this purpose, a descriptive cross-sectional study was conducted between 20th October 2024 and 20th November 2024 at the Teaching Hospital Peradeniya and total of 50 samples were collected. Sterile swabs with 70% alcohol cleansing were used to collect samples. Each sample were cultured on Sabouraud dextrose agar (SDA) containing gentamicin, at room temperature and at 35°C. Identification of fungal species was based on microscopic and macroscopic features. The obtained data were analyzed by applying an independent samples t-test and chi-square test to assess correlations among variables, using Jamovi 2.3.28. Out of the total samples, 30% showed as clinically significant microbial growth. Among the identified fungal species, Candida albicans was the most prevalent (27.3%), followed by Candida auris (22.7%), Candida tropicalis (22.7%), Candida glabrata (9.1%), Candida famata (9.1%), Trichophyton rubrum (4.5%), and Microsporum species (4.5%). A statistically significant association was observed between the presence of respiratory symptoms (such as cough and cold) and positive fungal culture results (p = 0.023). Therefore, further investigation into the association between fungal positivity and respiratory symptoms is necessary. Additionally, the use of less sensitive sample collection method, such as swabbing, may influence results and should be considered when comparing finding with previous literature.
Formulation of economically viable, energy-dense, low-glycaemic, blenderized tube feeding formula for malnourished adults requiring nutritional support in Sri lankan hospitals
(University of Peradeniya, Sri Lanka., 2025-08-28) Bogahawatta, L.B.G.S.; Somaratne, G.M.; Udagedara, M.; De Silva, C.; Abeykoon, E.; Rathnayake, M.P.S.
The high cost of commercially available enteral nutrition formulas has driven the increased use of blenderized tube feeding (BTF) in Sri Lankan hospitals, particularly for managing adult malnutrition. This study aimed to develop cost-effective, energy- dense, and macronutrient-balanced BTF formulas suitable for clinical use. The target was to achieve approximately 1 kcal/ml energy density while aligning with the World Health Organization (WHO) guidelines for macronutrient distribution: carbohydrates (55– 75%), fats (15–30%), and proteins (10–15%). Following preliminary trials with different rice forms (cooked raw rice, overnight cooked rice, and cooked roasted rice) to minimize viscosity, roasted white Nadu rice was selected as the carbohydrate base. Three natural, soup-based BTF formulations (F1, F2, F3) were developed using locally available ingredients, including roasted white Nadu rice, dhal, peanuts, milk powder, dates, coconut milk, and cow's milk, guided by the Sri Lanka Food Composition Tables. To assess the suitability of one selected formulation for patients with diabetes glycaemic index (GI) was measured. All formulas were evaluated for physicochemical, microbiological, rheological, and osmolar properties to assess clinical safety and suitability. Energy density values of the three formulations were 0.82 (F1), 0.71 (F2), and 0.68 (F3) kcal/ml, which were lower than the required value of the standard formula (1 kcal/ml). All three formulations adhered to the recommended macronutrient distribution (carbohydrate: fat: protein), 51:30:19, 50:36:14, 52:30:18 for F1, F2. F3 formulations, respectively. F1 was chosen for the GI study, and the GI of the formulation was measured to be 37 ± 8.6 (low GI), which can be recommended for patients with diabetes. The findings highlight the feasibility of using locally sourced ingredients to meet hospital nutrition needs in resource-constrained settings. However, further clinical trials are recommended to validate their effectiveness in patient care.
Fuel use, kitchen environment, and smoke exposure in Sri Lankan pregnant women: cross-sectional insights for public health interventions; an interim analysis of RESPIRE 2 SL indoor air quality study
(University of Peradeniya, Sri Lanka., 2025-08-28) Paranagama, L.; Yasaratne, D.; Wimalasekara, S.; Madageradara, D.; Bowatte, G.; Goonawardena, S.; Amarasekara, T.; Dissanayake, P.; Kaththriarachchi, L.; Waidyasekara, H.; Jayasinghe, D.; Karunarathna, C.; Kariyawasam, A.; Nissanka, D.; Thilakaratne, R.; Ariyawansha, N.; Dhadhujan, J.; Wijesinghe, S.; Lin, C.; Schwarze, J.
Exposure to household air pollution from traditional cooking practices is a significant public health concern, particularly for pregnant women in low- and middle-income countries. In-utero exposure to smoke from biomass fuels has been associated with adverse maternal and fetal outcomes. This interim analysis aims to assess cooking practices, fuel usage, kitchen structure, and ventilation conditions among pregnant women under 24 weeks of Period of Amenorrhea (POA) to inform targeted interventions. A cross-sectional survey was conducted among 173 pregnant women with POA ≤24 weeks attending antenatal clinics. Structured questionnaires were used to collect data on stove type, fuel use, kitchen characteristics, ventilation, and exposure to biomass smoke. Descriptive statistics were used to summarize cooking behaviors, structural features of the kitchen, and smoke exposure patterns. The vast majority of participants (96.4%) cook, while only a small minority (3.6%) do not. Nearly 29% of respondents still relied on firewood for cooking. More than half (56.3%) reported using an additional stove, primarily traditional (44.6%) or gas (33.7%). Additionally, 55.9% of respondents reported exposure to biomass smoke. A majority of households (82.7%) kept their doors or windows open while cooking. However, only 57.2% had chimneys, and just 41.2% cleaned them regularly. More than half of the kitchens had asbestos roofs (51.6%), and covered cement floors (64.9%). On average, cooking began at the age of 18.6 years, with approximately 2.4 hours spent on cooking per day. Despite the widespread adoption of LPG, many pregnant women continue to be exposed to biomass smoke due to the use of supplementary stoves and inadequate ventilation. Structural kitchen issues worsen exposure risks. Promoting exclusive clean fuel use, enhancing ventilation, and educating on safe cooking practices are vital to safeguarding maternal and fetal health during pregnancy.
Factors associated with pain and quality of life among breast cancer patients undergoing chemotherapy in a national tertiary care hospital in Sri Lanka
(University of Peradeniya, Sri Lanka., 2025-08-28) Keerthirathna, U.G.S.H.; Athukorala, A.Y.R.
Breast cancer remains the most common cancer among woman globally and it significantly contributes to the cancer morbidity and mortality in women worldwide. Chemotherapy as an effective treatment modality improves survival rates, however, it leads to detrimental effects such as pain which significantly impact on patients' quality of life (QoL). This study aimed to assess pain severity and QoL among breast cancer patients undergoing chemotherapy in a national tertiary care hospital in Sri Lanka and to identify factors associated with pain and QoL. A descriptive cross-sectional study was conducted in a consecutive convenience sample of 199 female breast cancer patients who underwent at least one cycle of chemotherapy at female oncology ward in National Hospital, Kandy, Sri Lanka. Participants’ QoL was assessed using Validated Sinhala and Tamil versions of European Organization for Research and Treatment of Cancer Core 30 (EORTC QLQ-C30) and QoL Questionnaire specific to Breast Cancer (QLQ-BR23) and their self-reported pain intensity was measured using Visual Analogue Scale (VAS). Demographic and clinical characteristics were also documented. Chi-squared and Fisher’s Exact tests were used to assess associations of socio-demographic and clinical factors with pain severity and QoL (p < 0.05). Most participants (84.9%) experienced mild pain, while 11.6% had moderate pain and 3.5% had severe pain. Pain severity was significantly associated with age (p = 0.027), cancer stage (p = 0.000), time since diagnosis (p = 0.003), and prior treatments (p = 0.020). Poor QoL was reported by 78.4% of participants. QoL was significantly associated with educational level (p = 0.000), occupation (p = 0.008), residential area (p = 0.000), and number of chemotherapy sessions (p = 0.015). Majority of participants experienced mild pain, and pain associated with age, cancer stage, time since diagnosis and prior treatments. Poor QoL was reported among majority of participants and QoL associated with educational level, occupation, residential area and number of chemotherapy sessions. Future research should adopt longitudinal designs to capture the evolution of pain and QoL over time, along with qualitative approaches to explore patient experiences.
Feasibility and efficacy of a group telerehabilitation program for people with knee osteoarthritis in Sri Lanka – a pilot study
(University of Peradeniya, Sri Lanka., 2025-08-28) Sarjana, M.S.F.; Dissanayake, T.; Kariyawasam, A.P.
Knee osteoarthritis (OA) causes pain and disability in older adults. The Physiotherapy Exercise and Physical Activity for Knee OA (PEAK) program provides evidence-based exercise therapy through education, strengthening, and physical activity, tailored to individual needs. Telerehabilitation supports adherence with home-based care and is as effective as in-person sessions, but its effectiveness remains unstudied in Sri Lanka. This study aimed to evaluate the feasibility and efficacy of telerehabilitation group consultation using PEAK program for people with knee OA in Sri Lanka. This single- arm pre-post pilot study involved knee OA patients attending 1-hour Zoom-based telerehabilitation sessions, three times weekly for eight weeks. Primary outcomes including feasibility, acceptance, and adherence were assessed through attrition rates, a 5-point Likert scale for satisfaction, and adverse event reports. Secondary outcomes, such as knee pain, stiffness, physical function, lower extremity strength, and dynamic balance, were measured using the Visual Analogue Scale (VAS), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the 30-Second Chair Stand Test at baseline and post-intervention. 21 individuals screened, 14 (66.7%) enrolled and 12 (85.7%) completed the 8-week telerehabilitation. Most were female (75%) with a median age of 54.2 years (SD±6.5). Mean class attendance was 93.4% (SD±6.3), satisfaction was 100%, and no adverse events were reported. Significant improvements were seen in knee pain (VAS: Z = -3.115, P = 0.002; WOMAC pain MD = 3.67, 95% CI: 2.89–4.45, P < 0.001), stiffness (MD = 1.33, 95% CI: 1.02–1.65, P < 0.001), and function (MD = 12.58, 95% CI: 10.17–14.99, P < 0.001). Strength and balance also improved (30S CST MD = −3.17, P < 0.01). The telerehabilitation group consultation using the PEAK program may feasible, safe, and effective in improving knee pain, stiffness, physical function, lower extremity strength, and dynamic balance in a pilot cohort of knee OA patients. Its efficacy should be confirmed through a randomized controlled trial before being implemented in clinical practice.
Factors affecting the knowledge, attitudes and practices on hypertensive disorders of pregnancy among pregnant women with risk factors: a cross-sectional study in a tertiary care centre
(University of Peradeniya, Sri Lanka., 2025-08-28) Jayawardana, W.J.B.S.M.S.; Gihan, M.C.; Ratnayake, R.M.C.J.; Dissanayake, K.; Rosairo, S.; Pathirage, L.P.M.M.K.; Nandadeva, D.
Hypertensive disorders of pregnancy (HDP), including preeclampsia are among the top five causes of maternal deaths worldwide. Women with risk factors for preeclampsia are more likely to experience more severe complications of HDP. Having better awareness on HDP could result in improved outcomes in these women. Therefore, the objectives of this study were to assess the knowledge, attitudes, and practices (KAP) on HDP among pregnant women with high or moderate risk factors for preeclampsia and to identify demographic factors that may affect KAP scores. A descriptive cross- sectional study was conducted among 229 pregnant women with at least one high or moderate risk factor for preeclampsia from obstetric clinics, Teaching Hospital Peradeniya. Convenience sampling method was used. A pretested, interviewer- administered questionnaire was used to collect data. Knowledge score >80% was considered as good. Scores of > 50% in attitudes and practices were considered as positive and good, respectively. Data are presented as mean ± standard deviation (SD), median (interquartile range, IQR) and percentages. Associations between demographic variables and the domains of knowledge, attitude and practice were assessed using the Chi-squared test. Mean age of the participants was 30 ± 5 years and the median period of amenorrhea was 24 (14-32) weeks. Majority (77%) were primi mothers and 11% had at least one high risk factor. Good knowledge was seen among 74%, all had positive attitudes but only 21% engaged in good practices. Knowledge score was higher in women educated at least up to A/Ls (77%vs60%; p=0.020), monthly income > Rs. 60,000/= (78%vs64%; p = 0.026) and those who participated in antenatal counselling sessions (79%vs61%; p = 0.004). Only 42% were aware regarding all 5 red flag symptoms of preeclampsia with a greater percentage of multiparous women having awareness compared to primi mothers (57%vs32%; p = 0.001). No associations were identified with attitudes or practices. These findings suggest that there is a considerable gap between knowledge and practices despite positive attitudes among pregnant women regarding HDP. Developing targeted health education programs to improve knowledge and addressing factors for not adhering to good practices could improve the outcome of HDP.
Expression of human papillomavirus in dysplastic and non-dysplastic oral lichen planus - an immunohistochemical study
(University of Peradeniya, Sri Lanka., 2025-08-28) Karunarathne, N.G.S.D.; Rajapakse, S.; Jayasinghe, R.D.; Siriwardena, B.S.M.S.
Oral lichen planus (OLP) is a persistent, autoimmune-mediated disease with a potential risk of oncogenic transformation within the oral cavity. Despite other etiologic factors, human papillomavirus (HPV) is predicted to be a causative agent in oral cancers; however, investigations have been inconclusive regarding its role in epithelial dysplastic subtypes associated with OLP. This study aimed to determine the expression of HPV in dysplastic OLP and its association between dysplastic and non-dysplastic variants of OLP. A case-control study was performed retrospectively by obtaining thirty archived samples from the middle-aged, Sri Lankan female population. Hematoxylin and Eosin staining was performed for the reviewing and categorization of OLP followed by an immunohistochemical recognition of HPV to determine the expression of HPV in mild-grade dysplastic and non-dysplastic OLP. The primary antibody utilized was the Monoclonal Mouse Anti-Human Papillomavirus Clone K1H8, Dakocytomation (dilution 1:50), capable of identifying the expression of both high-risk and low-risk type HPV. As for the outcomes, HPV expression was detected in 33.3% (5/15) of mild-grade dysplastic and 13.3% (2/15) of non-dysplastic OLP. A statistically significant association of HPV between mild-grade dysplastic and non-dysplastic OLP was not revealed through the analysis (p > 0.05). The outcome of this study indicated a relatively higher expression of HPV in mild-grade dysplastic OLP compared to non-dysplastic OLP. Therefore, it is vital to discern the association of HPV in different degrees of epithelial dysplasia in OLP in the future to elucidate the role of viral infection in disease progression.
Extended effects of allopurinol on disease progression in chronic kidney disease of unknown aetiology (CKDu) patients: two-year follow-up of a randomized controlled trial
(University of Peradeniya, Sri Lanka., 2025-08-28) Sonnadara, T.; Hettiarachchi, T.; Herath, D.; Pushpakumara, W.R.A.M.D.R.N.; Erandika, H.G.N.; Medagedara, A.; Elladeniya, N.; Abeysundara, H. T. K.; Ranasinghe, J.G.S.; Alles, N.; Nanayakkara, N.
CKDu is a significant emerging health challenge in Sri Lanka. Lack of a clear pathogenesis has become a clinical challenge and has prevented development of effective treatment strategies. Among possible interventions, long-term efficacy of urate-lowering therapies like Allopurinol in slowing disease progression remains uncertain. This study aimed to assess whether the extended, two-year urate lowering therapy, following an initial one-year trial, can significantly delay CKDu progression, reduce morbidity and mortality, prevent cardiovascular events (CVE), and improve clinical outcomes. In this open-label, single-centre randomized controlled trial, 335 CKDu patients from the Girandurukotte renal clinic were assigned to either a treatment group (n=165; Allopurinol targeting SUA < 6 mg/dL in males, <5 mg/dL in females) or a control group (n=162; standard care). Patients were followed for two additional years. Primary endpoints were renal progression, assessed via eGFR decline, CVE, and survival. Secondary endpoints included changes in blood pressure, lipid profiles, electrolytes, inflammatory markers (hs-CRP), hematological parameters, and urinary biomarkers. Data were analyzed using linear mixed models (LMM), Kaplan–Meier (KM) survival curves, and Cox regression. At the beginning of the extended follow-up, mean SUA was significantly lower in the treatment compared to controls (5.74 ± 1.42, 6.94 ± 1.36 mg/dL, p < 0.001), reflecting the effect of one-year trial. LMM showed significant differences in SUA trends (p < 0.001). However, there were no significant differences in eGFR decline over time between groups (p = 0.943), and in the rate of decline between groups (p = 0.461). Renal event-free survival was higher in the treatment group (98.2% vs. 93.8%; log-rank p = 0.049), with a renoprotective trend in Cox analysis (HR = 0.279, p = 0.053). Occurrence of CVE was rare (p = 1.000) and no significant differences were observed in secondary endpoints (all p > 0.05). Although extended allopurinol therapy did not significantly alter CKDu progression or cardiovascular outcomes, it showed sustained changes in SUA and improved renal event-free survival. This study represents a meaningful step forward in CKDu research, highlighting the feasibility and potential benefit of long-term urate-lowering strategies.
Exploring the antioxidant activity of ocimum tenuiflorum from different geographical regions
(University of Peradeniya, Sri Lanka., 2025-08-28) Naleef, M.C.F.S.; Athapaththu, A.M.A.S.; Ushara, N.B.M.; Heenpalla, H.D.M.K.; Perera, P.N.D.; Samarakoon, N.; Kodithuwakku, N.D.
Ocimum tenuiflorum, also known as Krishna Tulsi, is known for its diverse medicinal and spiritual attributes, many of which have been investigated. The antioxidant activity of medicinal plants is widely studied for their potential health benefits. However, these antioxidant properties may differ with geographical regions. This study aims to assess the antioxidant activity of Ocimum tenuiflorum collected at the same time from dry zone, wet zone, and intermediate zone which are three different geographical regions in Sri Lanka. To evaluate the invitro antioxidant activity of Ocimum tenuiflorum from the dry zone, wet zone, and intermediate zone. Whole plant samples of Ocimum tenuiflorum were collected at the same time from three different geographical areas. Plant samples were authenticated by the Botany Division, Bandaranayake Memorial Ayurvedic Research Institute, Nawinna, Maharagama. Methanolic Plant extracts were prepared from the whole plant of Ocimum tenuiflorum using the maceration method. Antioxidant activity was assessed using 2,2-Diphenyl-1-picrylhydrazyl (DPPH) and ferric-reducing antioxidant power (FRAP - Oyaizu method) assays. Absorbance readings were obtained from the spectrophotometer. Statistical analysis was performed using one-way ANOVA in GraphPad Prism based on triplicate % inhibition values at 50 μg/mL (for DPPH) and triplicate absorbance readings at 50 μg/mL (for FRAP) to assess significance across geographical regions. Both DPPH and FRAP assays revealed a notable geographical variation in antioxidant activity. The wet zone extract showed the highest antioxidant activity (DPPH: IC50 19.90 μg/mL) followed by the intermediate zone (DPPH: IC50 30.06 μg/mL) and the dry zone extract showed the lowest activity (DPPH: IC50 470.3 μg/mL). Ascorbic acid showed the highest antioxidant activity (DPPH: IC50 2.228 μg/mL). Statistical analysis indicated that there is a significant difference in antioxidant activity between the regions for DPPH (p=0.0004). For the FRAP assay, while differences in reducing power were observed, they were not statistically significant (p=0.1796). This study indicates a significant variation in the antioxidant activity of Ocimum tenuiflorum based on geographical origin with the wet zone extracts showing the highest antioxidant activity. The results indicate environmental factors may influence the therapeutic potential of Ocimum tenuiflorum.
Exploring the experience of medication adherence among older people with hypertension: a qualitative study from a tertiary care hospital, Sri Lanka
(University of Peradeniya, Sri Lanka., 2025-08-28) Devindi, N.D.A.; Sakeena, M.H.F.; Rathnayake, S.
Hypertension is one of the leading risk factors for cardiovascular diseases, contributing significantly to global mortality rates. The older population is particularly vulnerable to hypertension and its complications. Medication adherence is essential for minimizing these risks, reducing adverse reactions and improving health outcomes, thereby reducing the burden on the healthcare system. This study aimed to explore experiences on medication adherence among older people with hypertension at a tertiary care hospital in Sri Lanka. An exploratory qualitative study was conducted among 15 individuals who had a history of uncontrolled blood pressure for more than a year and attending the hypertension clinic at Teaching Hospital Peradeniya, Sri Lanka. In-depth interviews were conducted using a semi-structured interview guide. Participants were selected using purposive sampling until data saturation was achieved. Interviews were audio recorded, transcribed verbatim, and analyzed using inductive thematic analysis. The consolidated criteria for reporting qualitative research (COREQ) guidelines were followed when presenting the results. Three main themes emerged: (a) Knowledge and awareness, (b) Barriers to medication adherence and (c) Support systems in medication adherence. Under Knowledge and awareness, Sub-themes included early detection awareness, knowledge of disease and therapeutic approaches, self-medication management and monitoring. The theme barriers to medication adherence included side effects, polypharmacy, psychological impacts, lifestyle and behavioral factors, forgetfulness, motivational drivers, and personal affairs. Finally, support systems in medication adherence included peer influence, family support, accessibility to medical care, perceived quality of care and health education by the institution. This study highlights the importance of knowledge and awareness in promoting medication adherence. It emphasizes that the gaps in disease understanding contribute to poor health outcomes. Key barriers and weak support systems further hindered medication adherence. Patient-centered interventions and enhanced support mechanisms are crucial for improving medication adherence in the elderly population.

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