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Search Results: 1 - 5 of 5 matches for " Anuradhani Kasturiratne "
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Survival of patients with alcoholic and cryptogenic cirrhosis without liver transplantation: a single center retrospective study
Sudul Senanayake, Madunil Niriella, Sanjaya Weerasinghe, Anuradhani Kasturiratne, Jerome de Alwis, Arjuna de Silva, Anuradha Dassanayake, Hithanadura de Silva
BMC Research Notes , 2012, DOI: 10.1186/1756-0500-5-663
Abstract: Complete details were available in 549/651 (84.3%) patients (AC 306, CC 243). Mean follow up duration (SD) (months) was 29.9 (32.6). 82/96 deaths (85.4%) among AC and 80/94 deaths (85.1%) among CC were liver related. Multivariate analysis showed age at diagnosis and Child’s class predicted overall survival among all groups. The median survival in Child’s class B and C were 53.5 and 25.3 months respectively. Survival was similar among AC and CC. Among AC survival was improved by abstinence [HR = 0.63 (95% CI: 0.40-1.00)] and was worse with diabetes [HR=1.59 (95% CI: 1.02- 2.48)] irrespective of alcohol status.The overall survival of AC was similar to CC. Death in both groups were predominantly liver related, and was predicated by age at diagnosis and Child class. Among AC, presence of diabetes and non-abstinence from alcohol were independent predictors for poor survival.The long term survival of cirrhotic patients is an important issue in management, from the initial counseling of the patients at diagnosis to finally planning liver transplantation [1]. This becomes a central issue in settings where liver transplantation is not readily available. Decompensated cirrhosis has a dismal prognosis without transplantation. Although older studies in the pre-transplantation era have used measures such as the Child-Pugh score to predict survival [2,3], new pharmacological and endoscopic therapies have had a significant impact on improving patient survival [4,5]. As liver transplantation has becomes a viable option, even in many developing countries, it has become increasingly difficult to study the natural history of the disease. Although there have been published studies of survival in cirrhosis, these have been on selected populations suitable for transplant or with single aeitology or with relatively short follow up periods [6-8]. Although prospective studies are more valid to assess long term mortality, they would be impossible to perform in the current context as liver tr
The Global Burden of Snakebite: A Literature Analysis and Modelling Based on Regional Estimates of Envenoming and Deaths
Anuradhani Kasturiratne,A. Rajitha Wickremasinghe,Nilanthi de Silva,N. Kithsiri Gunawardena,Arunasalam Pathmeswaran,Ranjan Premaratna,Lorenzo Savioli,David G Lalloo,H. Janaka de Silva
PLOS Medicine , 2008, DOI: 10.1371/journal.pmed.0050218
Abstract: Background Envenoming resulting from snakebites is an important public health problem in many tropical and subtropical countries. Few attempts have been made to quantify the burden, and recent estimates all suffer from the lack of an objective and reproducible methodology. In an attempt to provide an accurate, up-to-date estimate of the scale of the global problem, we developed a new method to estimate the disease burden due to snakebites. Methods and Findings The global estimates were based on regional estimates that were, in turn, derived from data available for countries within a defined region. Three main strategies were used to obtain primary data: electronic searching for publications on snakebite, extraction of relevant country-specific mortality data from databases maintained by United Nations organizations, and identification of grey literature by discussion with key informants. Countries were grouped into 21 distinct geographic regions that are as epidemiologically homogenous as possible, in line with the Global Burden of Disease 2005 study (Global Burden Project of the World Bank). Incidence rates for envenoming were extracted from publications and used to estimate the number of envenomings for individual countries; if no data were available for a particular country, the lowest incidence rate within a neighbouring country was used. Where death registration data were reliable, reported deaths from snakebite were used; in other countries, deaths were estimated on the basis of observed mortality rates and the at-risk population. We estimate that, globally, at least 421,000 envenomings and 20,000 deaths occur each year due to snakebite. These figures may be as high as 1,841,000 envenomings and 94,000 deaths. Based on the fact that envenoming occurs in about one in every four snakebites, between 1.2 million and 5.5 million snakebites could occur annually. Conclusions Snakebites cause considerable morbidity and mortality worldwide. The highest burden exists in South Asia, Southeast Asia, and sub-Saharan Africa.
Prevalence of Acanthosis Nigricans in an urban population in Sri Lanka and its utility to detect metabolic syndrome
Anuradha S Dassanayake, Anuradhani Kasturiratne, Madunil A Niriella, Udaya Kalubovila, Shaman Rajindrajith, Arjuna P de Silva, Norihiro Kato, A Rajitha Wickremasinghe, H Janaka de Silva
BMC Research Notes , 2011, DOI: 10.1186/1756-0500-4-25
Abstract: In a community based investigation, 35-64 year adults who were selected using stratified random sampling, underwent interview, clinical examination, liver ultrasound scanning, and biochemical and serological tests. Metabolic syndrome was diagnosed on revised ATP III criteria for Asian populations. AN was identified by the presence of dark, thick, velvety skin in the neck.2957 subjects were included in this analysis. The prevalence of AN, metabolic syndrome and type 2 diabetes mellitus were 17.4%, 34.8% and 19.6%, respectively. There was a strong association between AN and metabolic syndrome. The sensitivity, specificity, positive predictive value and negative predictive value of AN to detect metabolic syndrome were 28.2%, 89.0%, 45.9% and 79.0% for males, and 29.2%, 88.4%, 65.6% and 62.3% for females, respectively.AN was common in our study population, and although it did not have a high enough sensitivity to be utilized as a screening test for metabolic syndrome, the presence of AN strongly predicts metabolic syndrome.Acanthosis nigricans (AN) is an easily identifiable skin lesion characterized by velvety, brownish-black pigmentation of the skin of the neck and intertriginous surfaces. Typical areas of involvement include the posterior aspect of the neck, axillae, elbows and knees; the neck is involved 93% to 99% of the time [1,2]. The common occurrence of AN in the neck is important in a primary care setting because it makes the lesion easily detectable. A quantitative scale of AN has been developed by Burke et al [1]. This scale takes into consideration the severity of AN in neck and axilla, neck texture, and the presence or absence of AN in knuckles, elbows and knees.A number of studies have shown an association between AN and insulin resistance [3,4] and the recent increase in the prevalence of AN [5-7] may well reflect increasing trends in obesity and type 2 diabetes worldwide [1]. The prevalence of AN varies from 7% in unselected populations to 74% in obese p
A Randomized Controlled Trial of a Brief Intervention for Delayed Psychological Effects in Snakebite Victims
Chamara A. Wijesinghe?,Shehan S. Williams?,Anuradhani Kasturiratne,Nishantha Dolawaththa?,Piyal Wimalaratne?,Buddhika Wijewickrema?,Shaluka F. Jayamanne?,Geoffrey K. Isbister?,Andrew H. Dawson?,David G. Lalloo
PLOS Neglected Tropical Diseases , 2015, DOI: 10.1371/journal.pntd.0003989
Abstract: Background Snakebite results in delayed psychological morbidity and negative psycho-social impact. However, psychological support is rarely provided to victims. Aim To assess the effectiveness of a brief intervention which can be provided by non-specialist doctors aimed at reducing psychological morbidity following snakebite envenoming. Method In a single blind, randomized controlled trial, snakebite victims with systemic envenoming [n = 225, 168 males, mean age 42.1 (SD 12.4) years] were randomized into three arms. One arm received no intervention (n = 68, Group A), the second received psychological first aid and psychoeducation (dispelling prevalent cultural beliefs related to snakebite which promote development of a sick role) at discharge from hospital (n = 65, Group B), while the third received psychological first aid and psychoeducation at discharge and a second intervention one month later based on cognitive behavioural principles (n = 69, Group C). All patients were assessed six months after hospital discharge for the presence of psychological symptoms and level of functioning using standardized tools. Results At six months, there was a decreasing trend in the proportion of patients who were positive for psychiatric symptoms of depression and anxiety from Group A through Group B to Group C (Chi square test for trend = 7.901, p = 0.005). This was mainly due to a decreasing trend for symptoms of anxiety (chi-square for trend = 11.256, p = 0.001). There was also decreasing trend in the overall prevalence of disability from Group A through Group B to Group C (chi square for trend = 7.551, p = 0.006), predominantly in relation to disability in family life (p = 0.006) and social life (p = 0.005). However, there was no difference in the proportion of patients diagnosed with depression between the three groups (chi square for trend = 0.391, p = 0.532), and the intervention also had no effect on post-traumatic stress disorder. Conclusions A brief psychological intervention, which included psychological first aid and psychoeducation plus cognitive behavioural therapy that can be provided by non-specialist doctors appeared to reduce psychiatric symptoms and disability after snakebite envenoming, but not depression or post-traumatic stress disorder. Trial Registration Sri Lanka Clinical Trials Registry: SLCTR/2011/003
Systematic Fine-Mapping of Association with BMI and Type 2 Diabetes at the FTO Locus by Integrating Results from Multiple Ethnic Groups
Koichi Akiyama, Fumihiko Takeuchi, Masato Isono, Sureka Chakrawarthy, Quang Ngoc Nguyen, Wanqing Wen, Ken Yamamoto, Tomohiro Katsuya, Anuradhani Kasturiratne, Son Thai Pham, Wei Zheng, Yumi Matsushita, Miyako Kishimoto, Loi Doan Do, Xiao-Ou Shu, Ananda R. Wickremasinghe, Hiroshi Kajio, Norihiro Kato
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0101329
Abstract: Background/Objective The 16q12.2 locus in the first intron of FTO has been robustly associated with body mass index (BMI) and type 2 diabetes in genome-wide association studies (GWAS). To improve the resolution of fine-scale mapping at FTO, we performed a systematic approach consisting of two parts. Methods The first part is to partition the associated variants into linkage disequilibrium (LD) clusters, followed by conditional and haplotype analyses. The second part is to filter the list of potential causal variants through trans-ethnic comparison. Results We first examined the LD relationship between FTO SNPs showing significant association with type 2 diabetes in Japanese GWAS and between those previously reported in European GWAS. We could partition all the assayed or imputed SNPs showing significant association in the target FTO region into 7 LD clusters. Assaying 9 selected SNPs in 4 Asian-descent populations—Japanese, Vietnamese, Sri Lankan and Chinese (n≤26,109 for BMI association and n≤24,079 for type 2 diabetes association), we identified a responsible haplotype tagged by a cluster of SNPs and successfully narrowed the list of potential causal variants to 25 SNPs, which are the smallest in number among the studies conducted to date for FTO. Conclusions Our data support that the power to resolve the causal variants from those in strong LD increases consistently when three distant populations—Europeans, Asians and Africans—are included in the follow-up study. It has to be noted that this fine-mapping approach has the advantage of applicability to the existing GWAS data set in combination with direct genotyping of selected variants.
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