iPURSE 2024

Permanent URI for this collectionhttps://ir.lib.pdn.ac.lk/handle/20.500.14444/5274

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Correlation of inflammatory markers with age and selected clinical symptoms associated with lumbar disc herniation
(University of Peradeniya, Sri Lanka, 2024-08-29) Aravinth, P.; Withanage, N.D.; Pathirage, Sujatha; Athiththan, S.P.; Perera, S.; Athiththan, L.V.
Inflammation plays a major role in exacerbating lumbar disc herniation (LDH) due to irritation of neural elements associated with herniated lumbar discs. This eventually results in increased pain and worsening of symptoms. Elevated level of specific cytokines is reported with different pathology. This study aims to assess the correlation of inflammatory markers with age and selected clinical symptom associated with LDH. A cross-sectional study with subjects diagnosed with LDH and undergoing lumbar microdiscectomy were recruited (n=25) using convenience sampling, where age and clinical details such as presence of radicular pain, results of straight leg raise test (SLRT Positive/ Negative) were recorded. Patients who were diagnosed to have autoimmune disorders, any disease within the past two weeks that could elevate inflammatory marker and pregnant females were excluded. Blood specimens were collected to determine the serum levels of Interleukin- 6 (IL-6) and Tumor necrotic factor-alpha (TNF-α) using an Enzyme-Linked Immunosorbent assay technique. The correlation of cytokines level with the aforementioned variables were assessed. Spearman rank correlation test (Python version 3.10) was used to assess strength (R) and significance (p) for the above. Among the LDH subjects, 44% of patients reported with lumbar radicular pain. The patients with radicular pain had increased mean IL-6 (424.14pg/ml) compared to those without radicular pain (209.86pg/ml). whereas similar mean values were observed for TNF- α in patients with (71.59pg/ml) and without (71.88 pg/ml) radicular pain. Statistically significant positive correlation was obtained between IL-6 and lumbar radicular pain (R = 0.42, (p<0.05), while TNF-α showed a weak positive correlation which was statistically not significant. Further, IL-6 showed a weak positive correlation with age and SLRT, while TNF- α showed a weak negative correlation with SLRT and a weak positive correlation with age and radicular pain which did not show any statistical significance. IL-6 was found to be the predominant cytokine associated with lumbar radicular pain and further studies with a large population are warranted to discover the possible functional role of IL-6 in the pathophysiology of lumbar radicular pain.
Utilizing machine learning algorithms on microcontroller to enhance edge computing for sound regression applications
(University of Peradeniya, Sri Lanka, 2029-08-29) Madhusankha, M.D.K; Thennakoon, T.M.P.; Dissanayake, I.P.C.M.
Internet of Things (IoT) became very popular in the recent decade, due to its simplicity and remote accessibility. Machine learning (ML) plays a major role in developing the IoTs to work without human intervention. These unmanned technologies perform with improved functionality and high efficiency. For human sound recognition systems to achieve higher accuracy, more efficient computing devices with a continuous internet connection are required. This article presents an application of sound regression ML algorithms and the edge computing technique without using the internet. The edge computing technique helps transfer the sound regression machine learning model from the microcontroller to another device. The TensorFlow ML algorithm running in the microcontroller was used to create the noise regression model. This ML model is the framework used to train the dataset. 16000 voice samples were used to train the sound capture ML model. In this sound regression ML model, voice was categorized into four categories: forward, backward, left, and right. This trained sound regression model is run on the MagicBit development board (including the ESP32 microcontroller). Also, the ML model and the human voice were compared and found to be similar. An I2C microphone is used to capture human sounds on the MagicBit development board. With a test set comprising 50 samples, the system successfully recognized 46 samples correctly. This demonstrates an accuracy rate of 92%. The results have proven that the trained data sets were correctly matched with the input voice. The next step was transmitting the sound to another device. The ESP32 supported ESP- NOW communication protocol was used to transmit the detected sound to the Magic Key development board (including the ESP32 microcontroller). Hence, the results prove high efficient functionality of the system, and it underscores the fact that this operation doesn't depend on internet connectivity; only power is needed.
Wind tunnelling effect on different high-density building environments: a computational fluid dynamics approach
(University of Peradeniya, Sri Lanka, 2024-08-29) Edirisinghe, P. M. T. N.; Gunadasa, D. P. N. A. P.; Jayasinghe, J. A. S. C.; Dammika, A. J.
High-density building environments have become a significant characteristic of modern urban landscapes in response to the requirement of supporting an increasing urban population. The clustering of building structures in these situations presents distinct issues for pedestrian comfort and safety due to the wind interactions with structures such as tunnelling, shielding, and downwash effects. Most past studies on wind effects have focused on a selected arrangement of two or three buildings, without examining wind variations in different building arrangement types. Therefore, through this study, the wind tunnelling effect acting in three main categories of high-density building environments was explored using a block of 25 building units. Computational Fluid Dynamics (CFD) was employed here, utilising the Reynolds-Averaged Navier-Stokes (RANS) method with the Shear Stress Transport turbulence model (2k-ω SST). The mesh size around the building edges was set to 0.9 m, with the element size growth rate as 1.05 in model development. Categories I and II feature a central high-rise building (120 m height), while Category III has a central low-rise building (6 m height). In Category-I, the surrounding buildings have uniform height, with the relative height (λ) being the key parameter. In Categories II and III, the parameter measures the arrangement angle of building heights (θ) to the horizontal plane in negative and positive directions, respectively. The power law wind profile was used with a 5 ms-1 reference wind velocity at a height of 10 m above the ground. The parametric study was conducted by observing wind velocity variations at a height of 2 m above the ground (pedestrian level), and it was observed that Categories I and II demonstrated a gradual reduction of the tunnelling effect, which was followed by a subsequent increase with the increment of their respective parameters λ and θ. This gradual reduction in the tunnelling effect is due to the vortex shedding effect being significant, which dampens the tunnelling effect within the specific parameter range under consideration. Category III illustrated a consistent development in the tunnelling effect with the increment of the relevant parameter θ. This research clarifies how pedestrian comfort levels vary with different building arrangements, aiding city designers in optimizing building layouts to enhance pedestrian comfort.
A Case of mania and psychosis in a patient with Dengue fever
(University of Peradeniya, Sri Lanka, 2024-08-29) Madhusanaka, R.B. D.; Pathirage, L.P.M.M. K.; Perera, S.; Kularatne, S.A.M.; Abeykoon, W.D.S.E.
Dengue is an arboviral infection endemic to the tropical countries. Neurological sequelae like encephalitis is well reported in dengue. There is growing recognition of its psychiatric manifestations like mania, psychosis and post dengue depression specially during convalescence period. We present a middle-aged male who developed mania and visual hallucinations while being managed for dengue during the convalescent phase. A 49-year-old male with 10 days of fever with positive IgM for dengue developed over talkativeness, irritability, visual hallucinations, and disinhibited behaviour during the latter part of the critical phase of the illness. There were no neurological deficits or altered sensorium during the episode. No past history or family history of mental illness. His metabolic screening and non-contrast CT brain were normal. Psychiatry opinion was taken and rapid resolution was noted after starting a small dose of olanzapine and discharged after three days of observation. He had a full recovery within the follow-up period of six weeks. Neuro-psychiatric manifestations of dengue is an emerging entity. These manifestations can be seen during the acute or convalescent phases of dengue due to the direct effect of the virus, capillary leakage or immune mediated derangements. Mood disorders are the most commonly reported psychiatric manifestations without neurological consequences. Our patient has developed psychosis during the leaking phase and it could be cytokine mediated. The pathophysiology behind neuropsychiatric manifestations of dengue remains unsorted. This will be the first reported case of dengue with psychosis in Sri Lanka. Being a dengue endemic country, this case will highlight the necessity of starting large scale studies to identify the pathophysiology of psychiatric manifestations in dengue.
Aflatoxins contamination in commercially available areca nut and commercially prepared areca nut products in Sri Lanka
(University of Peradeniya, Sri Lanka, 2024-08-29) Rajaratnam, R.; Fernando, B.R.; Karunarathne, R.M.S.K.; Senevirathna, K.; Bandara, P.M.P.A.; Jayasinghe, R.D.
The prevalence of aflatoxins is a major concern in various agricultural commodities all over the world due to their harmful health effects including mutagenicity, teratogenicity, and carcinogenicity. Aflatoxins, which are produced by Aspergillus species, have been found in a wide range of food products in Sri Lanka in recent years. Areca nut is an addictive substance and is consumed by individuals either alone or as part of the betel quid. It has many adverse health effects, including the development of oral potentially malignant disorders and oral cancer. This study reports the status of aflatoxins contamination in commercial areca nuts and prepared areca products available in Sri Lankan market: fresh nuts, sun-dried nuts (karunka), fermented nuts (mada-puwak) and the sweetened form of areca nut (pani-puwak). High-Performance Liquid Chromatography with fluorescence detection was used to determine the concentration of aflatoxins B1 (AFB1), B2 (AFB2), G1 (AFG1), and G2 (AFG2) in the areca products. Out of the four areca nut products, pani-puwak had the highest level of total aflatoxins (28.5 μg/kg) and AFB1 contamination (23.47 μg/kg), exceeding the European Union's maximum permissible levels established for total aflatoxins (4 μg/kg) and AFB1 (2 μg/kg) in tree nuts. AFB2 and AFG1 concentrations in pani-puwak were 2.05 μg/kg and 2.9 μg/kg, respectively. The other commercial areca nut products did not contain any type of aflatoxins above the limits of detection (AFB1: 0.03, AFB2: 0.01, AFG1: 0.02 and AFG2: 0.01 μg/kg) of the analytical method. The occurrence of aflatoxins in pani- puwak may have resulted from fungal growth during improper storage and/ or processing. Our results suggest that the pani-puwak may pose an additional health risk in addition to its well-known effects, which calls for further assessment, the establishment of legal restrictions, and raising public awareness on areca nut consumption.
A GIS-based spatiotemporal analysis of chronic kidney disease/chronic kidney disease of unknown etiology in the North Central Province, Sri Lanka (2010-2020)
(University of Peradeniya, Sri Lanka, 2024-08-29) Dias, W.M.S.S.; Basnayaka, W.B.M.R.S.; Nilani, B.
Chronic Kidney Disease (CKD)/CKD of Unknown Etiology (CKDu), has become a significant public health concern in North Central Province (NCP), Sri Lanka over the last decade. This study aims to analyse the spatiotemporal patterns of CKD/CKDu in the NCP from 2010 to 2020, focusing on hotspots and their correlation with the population over 60 years, the age group with the highest prevalence. The NCP, located in the dry zone, covering 10,472 km2, is the largest province in Sri Lanka that has over 3,000 tanks and a population of 1.3 million, with more than 65% engaged in agriculture-related activities. Data collection relies on the Annual Health Bulletin-2020 for CKD/CKDu cases per 100,000 population, demographic data from the Humanitarian Data Exchange and previous research studies. The analysis focused on 03 time phases; 2010-2013, 2014-2016, and 2017- 2020 employing multi-temporal mapping, hotspot analysis, and correlation analysis using ArcGIS 10.8.2 and Excel. The study revealed that, from 2010-2013, hotspots were concentrated in Padaviya and Kebithigollawa in the northern Anuradhapura district, and during 2014-2016, this concentration shifted to Madavachchiya and Rambewa. From 2017-2020, hotspots moved to Elahera and Tamankaduwa in the west of Polonnaruwa, areas not previously identified as hotspots. Remarkably, the southern of Anuradhapura has consistently been a coldspot over the past decade. In Horowpothana, Kahatagasdigiliya, Maha Vilachchiya, Padaviya, Lankapura, and Elahera, high incidences of CKD/CKDu correlate with a high elderly population. Conversely, areas such as Galnewa, Kekirawa, Ipalogama, Palagala, and Thambuttegama have a high elderly population but fewer reported cases of CKD/CKDu. Access to drinking Reverse Osmosis (RO) water projects, improved health infrastructure, CKD/CKDu screening and awareness programs influenced the CKD/CKDu hotspot dynamics in the NCP. Identifying these spatiotemporal changing patterns and their correlation with demographic factors provides insights for public health interventions and resource allocation to address the CKD/CKDu burden in the region.
A Human right to companionship: addressing the post-pandemic technological isolation
(University of Peradeniya, Sri Lanka, 2024-08-29) Jayasundara, J.M.P.D.; de Silva, H.I.
The COVID-19 pandemic has significantly exacerbated mental health issues worldwide, with a notable increase in the prevalence of conditions such as anxiety and depression. One of the primary contributors to this surge is the heightened isolation stemming from the widespread adoption of modern technology in work and education. The shift to remote work and online education, while necessary for maintaining societal functions during lockdowns, is continued even in the post- pandemic ‘new normalcy’ which has given rise to unprecedented forms of alienation and isolation, especially in the institutional frameworks originally designed and intended to facilitate human interactions. The vitality of companionship has been asserted by many psychological, sociological, and neuroscientific studies. Several human rights bodies including the United Nations Human Rights Council have identified the significance of mental health as a global health priority and has recognized the potential effects of COVID-19 on mental health, and the present study seeks to investigate whether the existing international standards on the right to mental health have adequately addressed the human need for companionship as one of its essential components. A close inspection of relevant international and regional human rights treaties and other universal standards reveals that their major emphasis is on the rights of the mentally disabled and that they offer limited opportunities to meaningfully facilitate a human right to companionship. Therefore, this research aims to establish that companionship is a human right stemming from a fundamental human need and the necessity for its formal recognition in the human rights discourse. Given the interdisciplinary nature of this study, the authors engage in mixed methods research in analyzing the socio- psychological impact of the use of technology on human interactions, and in an in- depth qualitative analysis of primary and secondary legal sources to investigate the human entitlement to companionship and the need for its recognition as a fundamental human right.
A Greek poet and Roman citizenship: Cicero’s Pro Archia Poeta and its reflections on the Roman attitude towards ‘others’
(University of Peradeniya, Sri Lanka, 2024-08-29) Ekanayake, S.W.
Cicero’s Pro Archia Poeta remains as one of the most enduring defenses of the humanities and liberal arts found in classical literature. While defending the poet Archias’ right for Roman citizenship, Cicero eulogizes liberal arts and humanities as essential for the wellbeing of the individual and the society. Consequently, the speech had attracted scholarly attention over time, particularly due to its political, cultural and literary significance. However, the present research examines Cicero’s Pro Archia Poeta and its reflection of the Roman attitude towards ‘others’; an aspect that is critical to the understanding of the work itself, as well as certain modern sensibilities associated with citizenship, migration and identity. Methodologically, the study involves the close reading of Cicero’s speech in the original Latin as the primary source, along with the consideration of modern scholarly views. Upon close analysis, Cicero’s appreciation of Greek literature and admittance of Rome’s debt to Greece is apparent throughout the speech. For him Greece is indeed the center of cultural refinement and intellectual vigour. Yet, it is noteworthy that Cicero celebrates Archias more as a poet than a Greek poet. Thereby, he strips off Archias’ ‘Greekness’ to make him appear more ‘Roman,’ starting with using Archias’ Latin name. The very basis of Cicero’s argument claims, firstly, that Archias has established himself among the Roman elite, winning their patronage. Secondly, Cicero argues that Archias, through his works, has immortalized the greatness of Rome, thus making Archias’ poetic genius a public good conferred on the Romans. Such views appear self-serving for the Roman audience, and possibly used by Cicero due to his undertaking: arguing for a Greek poet’s ‘worthiness’ for Roman Citizenship. Yet, the very fact that Cicero believes such arguments would affect his audience itself is symptomatic of certain racial bias existing in his contemporary Roman society.
An Anatomical study on pyramidal lobe and levator glandulae thyroideae of the thyroid gland in Sri Lankan cadavers
(University of Peradeniya, Sri Lanka, 2024-08-29) Ekanayaka, E.M.A.A.; Jayawardhana, H.A.S.Y.; Shehani, N.A.; Angammana, H.M.R.W.; Banneheka, B.M.H.S.K.
The pyramidal lobe (PL) is a developmental variant of thyroid gland, representing a persistent remnant of the thyroglossal duct which is found in 10-30% of the population. During total thyroidectomy, careful examination of the PL is crucial to prevent residual thyroid tissue causing persistent hyperthyroidism and acting as a potential site for thyroid carcinoma. Levator glandulae thyroideae (LGT) is a fibromuscular band or muscle present on the neck, typically connecting the pyramidal lobe to hyoid bone, and is another remnant of thyroglossal duct. In this study, the frequency, location, mode of attachment, and dimensions of the PL in the Sri Lankan cadavers were studied. Ten cadavers from the routine dissection classes were considered in the study, which included six males and four females within the age range of 70-90 years. During careful dissection of the thyroid region, PLs were observed and their length and the widths were measured using a digital vernier calliper. Three PLs were found as two (20%) in males and one in a female (10%) cadaver. All PL were originating from the isthmus at the midline. One (10%) of these male cadavers was associated with the thyroid ima artery. The other male and the female cadavers were having LGT (20%), one being fibrous and the other muscular. Both were connected to the pyramidal lobe inferiorly and were attached to the hyoid bone superiorly. The lengths of the PL were 13.5 mm and 22.95 mm, 4.94mm and the widths were 10.40mm and 5.60mm, 4.36mm respectively. One LGT muscle was associated with an accessory thyroid gland. As the presence of a PL is not rare, detailed knowledge is essential for healthcare professionals further, emphasizing the requirement for preoperative imaging. Furthermore, as the sample size is smaller, further studies are needed regarding the variations of thyroid lobes and vasculature.
Anatomical variations of Ansa Cervicalis: a case series of Sri Lankan cadavers
(University of Peradeniya, Sri Lanka, 2024-08-29) Shehani, N.A.; Ekanayaka, E.M.A.A.; Jayawardhana, H.A.S.Y.; Angammana, H.M.R.W.; Banneheka, B.M.H.S.K.
Ansa cervicalis (AC) is a nerve loop in the neck, containing the ventral rami of cervical spinal nerves, C1-C3. The loop is formed over the carotid sheath by the union of the superior root (C1–2) and the inferior root (C2–C3) and innervates the infrahyoid muscles. It innervates muscles involved in swallowing, vocalization, neck stability and is also used in nerve anastomosis in laryngeal paralysis. As it exhibits numerous anatomical variations, proper understanding of the anatomy is important in reconstructive surgery. However, Sri Lankan studies on the area are very minimal. In this case series, seven bilaterally dissected cadavers of routine dissection classes, including five males and two females in the age range of 70-90 years, were observed. Eleven intact ACs were found, in which eight were bilateral and three unilateral. The position of AC was also observed in relation to the internal jugular vein (IJV) and superior belly of omohyoid muscle (Om). In relation to IJV, it was categorized as medial and lateral, where the superior root being medial and inferior root being lateral to IJV, is considered as lateral type, and when both roots are medial to IJV, it is classed as medial type. There were 27.2 % medial type and 72.7 % lateral type ACs. In bilaterally dissected cadavers, two out of four (50%) were symmetrical. Out of the eleven ACs, three (27.2%) were below Om and one (9.09%) above and seven (63.6%) were at the level of Om. Compared to available literature worldwide and in Sri Lanka our findings in relation to IJV were similar however, in those studies, the majority of AC were reported as being superior to Om. Our findings highlight the diverse anatomical variations in the location of the ansa cervicalis. Therefore, we recommend further studies for Sri Lankan population which will be a good guide for the surgeons.
Anger, anger expression and perceived stress among nursing undergraduates at the University of Peradeniya: a descriptive cross- sectional study
(University of Peradeniya, Sri Lanka, 2024-08-29) Rashani, M.L.; Weerasingha, B.R.G.T.K.
Perceived stress is an important issue that can have a significant impact on nursing undergraduate’s overall well-being. These issues cause to promote anger. When anger is under-expressed, it leads to negative consequences such as aggression, and physical violence. Therefore, this study aimed to investigate the relationship between anger, anger expression, and perceived stress. A descriptive cross-sectional study was conducted with the participation of 182 nursing undergraduates from the University of Peradeniya. A pre- tested self-administered questionnaire including demographic data, Perceived Stress Scale, Anger Scale, and Anger Expression Scale were used to collect data. Statistical analysis was conducted using SPSS version 27 and the significance level was set as p<0.05. The Pearson correlation coefficient was used to examine the relationships between variables. The results showed a weak positive correlation (r = 0.121, p = 0.128) between moderate stress and moderate anger. A moderate positive statistically significant correlation (r = 0.310, p < 0.001) was found between stress and anger expression among the participants. Moreover, a moderate positive statistically significant correlation (r = 0.346, p < 0.001) was revealed between anger and anger expression. The findings showed when students reported feeling angry, they also tended to express that anger in their behaviors. These findings highlight the importance of supporting students in managing stress and handling their emotions in healthier ways. Offering them strategies to deal with stress and anger could make a real difference in their studies and future careers in nursing. It is crucial to give them tools to handle the pressure they face and find positive ways to express their emotions. This way, we can better support their well-being and their journey in to becoming successful nurses.
An Audit on risk factors, spectrum of the disease and outcome of soft tissue infections
(University of Peradeniya, Sri Lanka, 2024-08-29) Rathnayake, R.M.J.B.S.; Kariyawasam, K.A.M.J.; Seneviratne, T.W.M.C.S.; Agalawatte, A.V.P.M.
Soft tissue infections are a common clinical entity in surgical practice. There are recognized local, regional and systemic risk factors documented in literature with a vast spectrum of presentation. Failure of early treatment could lead to adverse outcomes. There is a minimal number of studies and local data available. This is a descriptive cross-sectional study which was conducted on 53 consecutive patients in Teaching Hospital Peradeniya to describe the risk factors, anatomical site, treatment and the outcome of soft tissue infections. Study population consisted of 30 males and 23 females in the age range of 22 years to 90 years, where 69.8% were above 50 years of age. Cellulitis (54.7%), abscesses (37.7%) and gangrene (13.2%) were the commonest presentations. Surprisingly, the majority had no preceding obvious injury (62.2%), while 30.1% reported a traumatic event. A significant number (80.3%) of the population presented with lower limb soft tissue infections. Diabetes mellitus (41.5%), hypertension (20.8%) and dyslipidaemia (11.3%) were the three main comorbidities identified. 52.8% had scars, 39.6% had an active ulcer and 33.9% had cracked feet which may have contributed. Within the blood investigations 67.9% of patients had increased white cell counts but 77.4% had elevated C-reactive protein levels. Almost all the patients (98.1%) had received antibiotics, mostly in IV route (90.4%). As per surgical management, surgical debridement (28.3%) and incision and drainage (20.75%) were commonly utilized. Out of the study population only 42.5% completely recovered and 51% end up with poor healing ulcers. One patient needed an amputation (2.1%). Therefore, elderly populations with multiple comorbidities are at high risk of developing lower limb soft tissue infections and end up having poor outcomes, despite medical and surgical management.
Antibiotic sensitivity of soil leachates and soil heavy metal status: a case study from Gohagoda municipal solid waste dumpsite, Sri Lanka
(University of Peradeniya, Sri Lanka, 2024-08-29) Amasha, M.A.D.; Jayasuriya, K.M.G.G.; Madawala, H.M.S.P.; Nanayakkara, B.S.
Open dumping is prevalent in developing countries as a primary method of waste disposal without proper environmental safeguards. In Sri Lanka, Gohagoda Municipal Solid Waste Dumpsite is one of the hotbeds for the accumulation of pollutants, which is margined by the River Mahaweli, the main freshwater source for the downstream communities. There is a high chance of contaminating river water with dumpsite leachates, with pollutants like heavy metals, and antibiotic- resistant or less sensitive bacteria. This study aimed to investigate the bacterial abundance, antibiotic sensitivity, and heavy metal status of the Gohagoda dumpsite using soil and leachate samples. Soil samples were collected along four transects, at three distances away from the edge of the dumpsite (0, 10, and 50 m) and at two depths (0-20 and 20-50 cm) at each location. Leachates drawn from soil were used in determining bacterial abundance and antibiotic sensitivity, while soil samples were used for the heavy metal analysis. Bacterial abundance showed a significant difference among transects (p = 0.0012), with the highest abundance in the second nearest transect to the river. Antibiotic sensitivity was investigated using Amikacin (30 μg), Amoxicillin-clavulanate (20/10 μg), Ciprofloxacin (5 μg), Levofloxacin (5 μg), and Gentamicin (10 μg). For Amikacin, significantly reduced sensitivity was observed with an increase in depth (p=0.0185). For Amoxicillin, Ciprofloxacin, and Levofloxacin, sensitivity showed a significant variation among transects (p<0.05), with the least antibiotic sensitivity in the transect nearest to the river. Soil analyses revealed higher Manganese (Mn) levels, based on European Union standards, which may cause health implications like neurological defects upon groundwater contamination. High bacterial abundance and the least antibiotic sensitivity of bacteria in transects closer to the river indicates a major public health risk due to this dumpsite. This highlights the importance of more comprehensive studies to guide authorities in managing solid waste properly.
Anti-Candida effect of leaf extract of Diospyrus atrata
(University of Peradeniya, Sri Lanka, 2024-08-29) Wickramasinghe, W.R.M.R.L.K.; Kularathne, N.K.; Bhaddrathilake, H.G.W.M.; Senanayake, M.R.D.M.; Jayatilake, J.A.M.S.
The genus Candida belongs to the kingdom fungi that causes superficial and systemic infections in humans as well as animals including pigs, cattle and chicken. Candidiasis is treated with antifungals while antifungal resistance has been documented. Diospyrus atrata belongs to the family Ebenaceae which has many floral species with medicinal values. However, studies on anti-Candida effect of D. atrata are lacking. Objective of this study was to investigate the effect of the leaf extract of D. atrata against three medically important Candida species; Candida albicans, Candida parapsilosis, and Candida tropicalis. The extract of D. atrata leaves was prepared with 99% ethanol using the ground tender leaves followed by rotary evaporation. Then 0.1g of the rotary evaporated product was dissolved in 10ml of 99% ethanol for testing the anti-candida effect. Further, 99% ethanol was used as a negative control. Agar well diffusion assay was performed using Muller Hinton Agar plates in triplicate. The readings were taken by subtracting the diameter of the zone of inhibition given by the control from the diameter of the inhibition zone of the plant extract. The mean zone of inhibition against C. albicans was 10.67±0.58mm, C. parapsilosis was 4.33±1.53mm and C. tropicalis was 9.33 ±1.15mm. Above results indicate that the anti-candida activity of D. atrata leaf extract was higher against C. albicans and C. tropicalis compared to C. parapsilosis. As the conclusion, ethanolic extract of D. atrata leaves demonstrated anti-Candida effect against C. albicans, C. tropicalis and C. parapsilosis, indicating the potential of ethanolic extracts of D. atrata leaves to be developed as an anticandidal agent.
Antimicrobial activity of Apis cerana bee honey and Beeswax from dry and wet zones of Sri Lanka
(University of Peradeniya, Sri Lanka, 2024-08-29) Pathirage, C.J.P.; Abayasekara, C.L.; Jayasuriya, K.M.G.G.; Wijesinghe, M.B.; Nanayakkara, B.S.
Antimicrobial resistance is a current global health crisis, urging the need for novel antimicrobials. Apis cerana bee honey and beeswax are natural substances rich in bioactive compounds. The objectives of the current study were to investigate the antibacterial and anti-candidal activity of A. cerana bee honey and beeswax. Twelve samples of honeybee colonies were collected; six from dry zone and six from wet zone. Honey and wax were separated and tested against 11 clinically important microorganisms; three Gram-positive bacteria, three Gram-negative bacteria and five Candida species (standard cultures). Dilutions of bee honey from 5% to 30% (v/v) were tested in Mueller Hinton Agar using the agar dilution method, to determine the Minimum Inhibitory Concentrations (MICs). The sugar content, density, pH, colour intensity and odour of honey were measured and correlated with the MIC (%). Antimicrobial activity of ethanolic extracts of beeswax was investigated using the well diffusion bioassay. Honey samples from the dry zone exhibited higher antibacterial activity against Escherichia coli, and higher anti- candidal activity against Candida albicans, C. parapsilosis and C. tropicalis compared to the wet zone samples. Lower activity was observed against the other test organisms. The sugar content and density of honey showed a weak correlation, pH and odour a positive and colour intensity a negative correlation with MIC (%). There was no significant difference (p>0.05) between inhibition zone diameters obtained for wax samples from dry and wet zones. The highest diameter (25 mm) was produced by beeswax against Methicillin resistant Staphylococcus aureus (MRSA) and lower diameters for Candida species. High sugar content and acidic pH may be responsible for the antimicrobial activity, particularly in bee honey. Detailed investigations are needed to identify the chemical compounds responsible for the activity. Apis cerana bee honey is a promising antimicrobial while the ethanolic extract of A. cerana beeswax is a promising antibacterial agent, particularly against MRSA.
Assessing flood prediction models for the Kalu Ganga Basin using Hec- Hms
(University of Peradeniya, Sri Lanka, 2024-08-29) Kamburugamuwa, S.W.; Netthikumara, N.K.Y.; Nandalal, H.K.
Rainfall-runoff modeling is a crucial tool for authorities managing flood-prone rivers. In Sri Lanka, flooding ranks among the costliest disasters in terms of property loss and human casualties. The country has 103 significant river basins. 17 associated with flooding issues. Among these, the Kalu Ganga is particularly prone to frequent flooding. The HEC-HMS (Hydrologic Engineering Center’s Hydrologic Modelling system) has been successfully used to assess the behavior of rivers in numerous river basins worldwide, including those in Sri Lanka. Therefore, developing an HEC HMS model for the Kalu Ganga basin is an efficient strategy to predict floods and mitigate their damage. The HEC-HMS (Version 4.10) proves invaluable for simulating and analyzing rainfall-runoff dynamics. Event-based hydrological modeling reveals how a basin responds to individual rainfall events, which is crucial for flood prediction. This study evaluates six combinations of rainfall-runoff models using various hydrological approaches to determine the most effective model for catchment up to Ellagawa. The study considers criteria such as rainfall type (Event based), spatial process (Semi-lumped), model type (Empirical), and relevant parameters (Fitted parameters) based on acquired data to select model combinations. Event-based rainfall data from four gauging stations in the Rathnapura district and discharge data from the Ellagawa gauging station for the period of 2018-2021 are for Calibration and Validation. The initial parameters are optimized revealing that each model combination performs differently for each event. Among the selected combinations, the Initial Constant method paired with the Clark Unit hydrograph, the Recession base flow method with Lag, and the Muskingum method exhibit excellent performance. The model evaluation shows a Nash Sutcliff efficiency value of 0.98, RMSE of 0.1, and a Percent bias of 0.16. Visual assessments and statistical indicators demonstrate that the developed model reasonably predicts floods in the basin. Consequently, as we got in the evaluation part, it can serve as a valuable tool for flood prediction, providing forecasts for flood peaks and their timing with a reasonable degree of accuracy.
Assessment of satisfaction with laboratory services among patients attending the out-patient department at teaching hospital, Peradeniya, Sri Lanka
(University of Peradeniya, Sri Lanka, 2024-08-29) Shifna, M.S.F.; Rathnayake, S.
Assessing the patients’ satisfaction is an essential strategy for improving the quality of laboratory services. This study aimed to assess patients’ satisfaction with laboratory services, who attended the out-patient department at Teaching Hospital, Peradeniya, Sri Lanka in August 2022. A cross-sectional survey was conducted using an interviewer-administered questionnaire among a consecutive sample of 232 patients where laboratory investigations were requested. A 5-point Likert scale with 1 (lowest satisfaction) and 5 (Highest satisfaction), was used to assess the patient’s satisfaction. The overall rate of satisfaction for the specific laboratory service was calculated as (the number of very satisfied ratings x 5) + (the number of satisfied ratings x 4) + (the number of neutral ratings x 3) + (the number of dissatisfied ratings x 2) + (the number of very dissatisfied rating x 1) divided by the total number of rating (1-5). Fisher’s Exact Test was performed to assess the association between dependent and independent variables using SPSS version 25. P value less than 0.05 was accepted. The majority were female (70.7%) and belonged to the age group of 58 years and above (29.3%). The mean satisfaction score was 3.82 ± 0.386. The mean scores of satisfactions for different laboratory services ranged from 3.17(±.856) to 4.13(± .654). Patients were highly satisfied with the location of the laboratory (82.6%), phlebotomy services (81%), measures taken to assure privacy during specimen collection (80.8%) and the ability of sample collectors (80.4%) while least satisfied with waiting time (63.4%), queue process (68.8%) and cleanliness of the latrines (69.2%). Age (P=0.035), and occupation (P=0.008) had a significant association with overall patient satisfaction. The patients’ overall satisfaction was high. However, least satisfied areas were waiting time, cleanliness of latrines, and queue process. Improving these areas will advance the quality of laboratory services in Teaching Hospital, Peradeniya, Sri Lanka.
Assessment of BRAFV600E mutation by PCR in background thyroid tissue with chronic lymphocytic thyroiditis associated papillary thyroid carcinomas of patients
(University of Peradeniya, Sri Lanka, 2024-08-29) Uduwela, V.R.; Ratnayake, P.; de Silva, W.A.P.P.
Papillary Thyroid Carcinoma (PTC) is the commonest type of endocrine malignancy in Sri Lanka, and it’s characteristic BRAFV600E mutation increases cancer risk and aggressiveness. Chronic Lymphocytic Thyroiditis (CLT) is an autoimmune disease studied for its association with PTC globally and in Sri Lanka. In this study, we hypothesized that CLT may serve as an etiological factor of PTC by facilitating an environment conducive to mutation occurrence; hence, the characteristic BRAFV600E mutation may also be present in non-neoplastic CLT areas. The aim of this study was to determine any significant association of BRAFV600E with CLT tissues. Hematoxylin and Eosin-stained slides of 62 PTC cases at National Hospital Kandy from January 2022 to July 2023 were retrieved and screened. Slides containing non-tumor backgrounds were categorized based on the presence and absence of CLT. FFPE tissue blocks of CLT-positive (n=15), and CLT-negative (n=17) cases were sectioned, followed by DNA isolation using an FFPE-specified gSYNCTM DNA Extraction kit. PCR amplification of a <150bp target sequence of BRAF exon 15 containing nucleotide 1799, and real-time mutation detection was performed using a Human BRAF gene mutation detection kit. Fischer’s exact test with a significance level α=0.05, and an Odds Ratio (OR) was calculated considering BRAFV600E status as outcome and CLT presence as cause. The RT-PCR found BRAFV600E in 1/15 CLT-positive samples and 0/17 CLT-negative samples. Fischer’s exact test revealed no statistically significant difference between the two groups (P=0.46875). Odds ratio of 3.62 (0.136, 95.6) suggests that odds of BRAFV600E occurring in CLT-positive group is 3.62 times higher than CLT-negative group. Although odds ratio indicated a higher likelihood of BRAFV600E in CLT-positive cases, results were not statistically significant. Thus, no significant association between BRAFV600E and CLT in non-neoplastic tissue of PTC patients was established. Further research with larger sample sizes is needed to validate these findings.
Assessment of the level of physical activity and its awareness among hypertensive patients attending teaching hospital, Peradeniya
(University of Peradeniya, Sri Lanka, 2024-08-29) de Silva, A.M.A.M.; Neelawathura, N.W.T.S.K.; Nimashi, U.D.P.; Vithana, R.L.; Ariyasinghe, A.S.; Kariyawasam, A.
Hypertension is a significant global public health concern and approximately 1.28 billion adults aged 30-79 years are hypertensive. Sedentary lifestyles contribute significantly to hypertension, alongside unhealthy diets, tobacco, alcohol, and obesity. WHO recommends 150 minutes/week of moderate-intensity or 75 minutes/week of vigorous aerobic activity for those aged 18 years and above who are healthy or with chronic conditions including hypertension. The aim of this study was to determine the physical activity level in hypertensive patients and assess the awareness about the association between physical activity and hypertension. This cross-sectional study included 349 hypertensive patients above 20 years of age attending the hypertension clinic at Teaching Hospital, Peradeniya. The International Physical Activity Questionnaire validated for Sri Lanka was used to gather data on awareness, physical activity, demographics, disease characteristics, and risk factors. Blood pressure and anthropometrics were measured following standard protocols. Physical activity levels were measured using the metabolic equivalent of task (MET) scores. Analysis was conducted with SPSS version 20. Ethical approval was obtained from the Ethics Review Committee, Faculty of Medicine, University of Peradeniya. The mean age was 63 years and consisted of 70.2% females and 29.8% males. The majority (64.75%) had education beyond ordinary levels; 10.6% had education below grade five. Of the sample, 53% were never employed, 24.9% had retired and 22.06% were currently employed. Only 33% identified physical activity as a modifiable risk factor while 54% engaged in low, 37% moderate, and 9% high physical activities. Factors contributing to low levels of physical activity included time constraints (35%), social stigma (7.5%), body aches/discomfort (21%), lack of suitable exercise facilities (5.8%) and other unspecified factors (5.7%). This study concluded that the physical activity level among hypertensive patients attending the Peradeniya hypertensive clinic was low and awareness about physical activity for prevention of hypertension was poor.
A Study on comparison of inter-arm difference in blood pressure between patients with cardiovascular diseases and non-cardiac conditions in a tertiary care hospital
(University of Peradeniya, Sri Lanka, 2024-08-29) Bandara, D.M.O.T.K.; Samarasingha, K.A.P.P.; Rathnayake, B.M.C.; Ralapanawa, D.M.P.U.K.
An "Inter-Arm Difference" (IAD) in blood pressure (BP) is the difference between right and left-arm BP values which can deviate by more than 10 points, indicating a higher risk for cardiovascular diseases (CVD). Therefore, this study was aimed to compare IAD of BP in between CVD patients and non-cardiac patients (NCP) in a selected tertiary care hospital in Kandy. A descriptive study was conducted, including 124 patients with CVDs and 124 with non-cardiac conditions, selected from the medical wards and hypertension clinics at Teaching Hospital Peradeniya. In each participant, BP was measured simultaneously in both arms, three times in 5 minutes apart using a digital BP monitor while participants were in sitting position. The average of the second and third readings was calculated for each participant. Data were analysed by SPSS version 26. Average right arm systolic BP (SBP) among CVD patients and NCPs were 133±24 mmHg and 117±16 mmHg (p<0.001). Average left arm SBP among CVD patients and NCPs were 131±24 mmHg and 116±16 mmHg (p<0.001). The mean absolute systolic inter-arm difference of BP (SIAD) was 10±8 mmHg in CVD group as compared to 4±3 mmHg in NCP group (p<0.001) and the mean absolute diastolic inter-arm difference of BP (DIAD) was 5±5 mmHg in CVD patients whereas it was 3±3 mmHg in NCP group (p<0.001). In the CVD group, 38.7% had clinically significant SIAD of ≥10 mmHg and 12.9% had DIAD of ≥10 mmHg. A statistically significant association was found between the presence of CVDs with SIAD >10 mmHg (p< 0.001). Finally, binary logistic regression suggested that SIAD of BP is an independent predictor of CVDs with an odds ratio of 1.25 (95% CI; 1.15 - 1.36). An IAD of BP is associated with the presence of cardiovascular diseases. While the findings lead to the recommendation of measuring BP in both arms at the first instance to prevent the misdiagnosis of hypertension, this local study also emphasizes the significance of SIAD in BP for predicting the CVD risks.

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