Cómo se siente en la ciudad de Tunja?

Department of Biochemistry, Faculty of Medicine, University of Peradeniya

Diabetes mellitus (DM) is one of the five leading causes of death in the world. As estimated in 2008, around 24% of the Sri Lankan population suffer from this deadly disease. Maintenance of normoglycaemia is the key issue in managing these patients, and this is achieved by administering exogenous insulin or other hypoglycaemic agents.

Averrhoa carambola (star fruit) leaves have been a part of traditional medicine used in

Ayurvedic preparations to treat DM in Sri Lanka. Researchers have investigated the hypoglycaemic effects of several insoluble fiber-rich fractions (FRFs) including insoluble dietary fiber, alcohol-insoluble solid and water insoluble solid from the pomace of

A.carambola. The objective of the study was to investigate the effect of A.carambola fruit

pulp on blood glucose level of healthy rats.

Thirty male Sprague Dawley rats weighing between 150-350 g and ten healthy female Sprague Dawley rats of the same age and weight were used in the study. The animals were caged individually at the Animal House, Faculty of Medicine and were provided with 25 g of broiler starter feed per day with ad libitum water. They were allowed to get accustomed to the experimental set up for a period of two weeks and were divided equally into the test groups (male and female), and control groups (male and female). A.

carambola fruit pulp was prepared by homogenising ripe fruit with a little added water in a

warring blender and the resultant pulp was stored at -20oC. The animals in the test groups were then fed with the A. carambola fruit pulp at a rate of 1600 mg/kg body weight for 63 days and the fasting blood glucose levels were measured each week, using an enzymatic assay method using glucose oxidase enzyme. Results were compared between A. carambola fruit pulp treated group (1600 mg/kg BW) and control group which received only the basal diet using analyses of variance and Dunnet’s t-test.

Treatment with A. carambola fruit pulp significantly (p = 0.033) decreased blood glucose levels (mean 131.0 + 10.2 mg/dl) after a treatment period of 8 weeks and elevated body weight in healthy male Sprague Dawley rats compared to that of normal rats (blood glucose levels mean 153.4 + 11.2 mg/dl). However, although there was a decrease in blood glucose level of the test group after three weeks of treatment the difference was not statistically significant up to 7 weeks. Treatment with A. carambola fruit pulp non-significantly decreased the blood glucose levels in healthy female rats after treating for 8 weeks, compared to that of control rats which could be due to hormonal changes in the female animals. This study demonstrates that the A. carambola fruit pulp has a hypoglycaemic effect on mammalian systems, which need to be investigated further.

Proceedings of the Peradeniya University Research Sessions, Sri Lanka, Vol. 16, 24th _{November 2011}

84

A Cross Sectional Study on Nutritional Care Given to In-Ward Medical and Surgical Patients in Teaching Hospital, Perdeniya

M.V.G. Pinto, D.D. Dikowita, S.L.A.D.C.B. Perera, A.T.K. Wijethilaka, D.J.N.M. Kurukulaaratchy and W.S.L De Silva

Department of Anesthesiology, Faculty of Medicine, University of Peradeniya

Ensuring optimum nutritional conditions during an illness is of utmost importance to have a satisfactory patient outcome. Poor nutritional conditions are invariably associated with bad patient outcome resulting in poor wound healing, delayed physical recovery and other complications, finally leading to increased morbidity and mortality. Therefore, the aim of this study was to identify the discrepancies and deficiencies if any in the nutritional intake compared to the individual patient requirement during hospital stay of medical and surgical patients.

The study was carried out in medical, surgical and orthopedic wards in Teaching Hospital Peradeniya, from June to September 2011 and a consecutive sampling method was used. Data was obtained to calculate the calorie requirement using the Harris Benedict equation and protein requirement and both adjusted according to stress factor and sex and compared with what the patient received. Results were expressed as percentages and mean ± (SD), depending on the variable type. Independent sample t test was performed to find out any significant difference between the recommended calorie and protein intake and the amount received.

Of 96 subjects 38.8% was dependant on the hospital meal service while 57.1% depended on home food. The average daily calorie amount received by male patients was 1214.78 kcal ± 849.93 and for females was 1206.21 kcal ± 519.77. The average daily protein amount received by males and females were 47.82 g ± 36.49 and 49.58 g± 27.20 respectively. Sixty one percent of the study sample did not receive recommended nutritional needs. Further, the average daily calorie and protein amount received by patients was significantly lower than the respective recommended values.

In conclusion, a majority of the study sample did not receive recommended nutritional needs during hospital stay. Therefore, further improvement in adequacy and quality of food intake during hospital stay should be encouraged. Further studies are necessary to find out reasons for underfeeding during hospital stay.

Proceedings of the Peradeniya University Research Sessions, Sri Lanka, Vol. 16, 24th _{November 2011}

85

An Evaluation of Patients’ Attitudes on Hospital Meal Service

M.V.G. Pinto, D.D. Dikowita, S.L.A.D.C.B. Perera, A.T.K. Wijethilaka, D.J.N.M. Kurukulaaratchy and W.S.L. De Silva

Department of Anesthesiology, Faculty of Medicine, University of Peradeniya

The aim of provision of hospital meal service is to provide proper nutrition to inward patients, ensuring their health and quick recovery. Therefore, a proper hospital meal service will improve the nutritional care and also minimize the wastage of food. Since the food is prepared in large quantity, improving the quality of food provision in hospital setting remains a difficult challenge.

The objectives of this study were to identify and describe the problems, if any, associated with diet received during hospital stay among inward patients in Teaching hospital, Peradeniya and to evaluate patients’ attitudes on hospital meal service.

This was a cross sectional study carried out in medical, surgical and orthopedic wards of Teaching Hospital Peradeniya over one month based on a pretested structured questionnaire. The questions were designed to focus on patients’ satisfaction regarding nutritive value of hospital meals, meal preparation, and food presentation and to reflect

their suggestions to improve the quality of hospital diet from patients’ point of view.

Consecutive sampling method was applied and results were expressed as mean ± standard deviation or percentages depending on the variable type.

Out of forty one patients, 51% were medical patients and the rest was surgical. Mean age of study group was 53 ± 16 years and 56% of subjects were males. The mean BMI was 20.5 kg/m2 ± 3.8. Majority of patients (58.5%, n = 24) were satisfied with the nutritive value of the food provided and the way of food presentation (78%, n = 32). However 56% of the respondents did not consume the whole portion provided. The main reasons for not consuming the whole portion or for refusal of certain food items were inadequate taste (24.4%, n = 10) and inadequate cooking (19.5%, n = 8). There was a significant relationship between positive attitude towards the hospital diet and the consumption of whole portion (p<0.01). Proper cooking, providing more choices, increasing the amount were few suggestions made by patients to improve the quality of hospital diet.

In conclusion, the patients’ attitude towards current hospital meal service is satisfactory. However food preparation should be improved in relation to providing more choices, maintaining proper temperature and timing of serving.

Proceedings of the Peradeniya University Research Sessions, Sri Lanka, Vol. 16, 24th _{November 2011}

86

Can the Spread of Spinal Anaesthesia be changed with Serum and Cerebrospinal Fluid Sodium Concentrations?

M.V.G. Pinto1, J.G.S. Ranasinghe2, D.D. Dikowita1, S.L.A.D.C.B. Perera1, A.T.K. Wijethilaka1 and D.J.N.M. Kurukulaaratchy1

1

Department of Anaesthesiology, Faculty of Medicine, University of Peradeniya

2

Department of Biochemistry, Faculty of Medicine, University of Peradeniya

In spinal anaesthesia, the cerebrospinal fluid (CSF) density has a direct relationship with the spread of anaesthetic agent. The CSF density is determined by the CSF sodium (Na+_{) concentration. Therefore, the changes of CSF Na}+ _{may have an effect} on spread of spinal anaesthesia.

This study was designed to detect the relationship between CSF Na+ and the spread of spinal anaesthesia, and to detect any relationship between serum Na+ and CSF Na+.

In this cross sectional study, women (n = 60) with a singleton pregnancy of at least 36 weeks gestation who were scheduled to undergo elective Caesarean delivery under spinal anaesthesia were randomly selected. When spinal anaesthesia was performed, CSF and venous blood were collected to determine the Na+ levels using atomic absorption spectrophotometry. The time taken to achieve the maximum sensory level, the quality motor block, and the changes of blood pressure and heart rate were recorded. Results were expressed as mean ± standard deviation depending on the variable type. Pearson correlation coefficient was used for statistical analyses (alpha = 0.05).

There was a weak positive correlation between serum Na+ _{concentration and} CSF Na+ concentration (r = 0.308; p = 0.028). Further, there was a weak negative correlation between CSF Na+ _{concentration and time taken to achieve maximum sensory} level (r = -0.305; p = 0.03). There were weak negative correlations between CSF Na+ concentration and time taken to achieve a maximum systolic blood pressure drop (r = - 0.327 p = 0.037) and diastolic blood pressure drop (r = -0.376. p = 0.014).

In conclusion the findings indicate that there is a significant relationship between serum Na+ _{and CSF Na}+ _{concentration. Further, the increase in CSF Na}+ _{concentration} will facilitate in achieving a quick sensory block.

Proceedings of the Peradeniya University Research Sessions, Sri Lanka, Vol. 16, 24th _{November 2011}

87

A Preliminary Study of Distribution of Somatotypes among Sri Lankan Male Elite Runners

A.M. Weerasinghe1, B.H.W.M.G.T. Wijethilake1, A. Ratnayake2, H.J. Suraweera2 and J.K. Dissanayake1

1

Department of Anatomy, Faculty of Medicine, University of Peradeniya

2

Sports Medicine Unit, Teaching Hospital, Peradeniya

Physical performance is correlated with the body shape and is also associated with the success in sports performance. The genetic makeup dictates our unique body shape and physiological tendencies. Most successful athlete should have a physical structure best suited for it. Studies of high level performances have clearly indicated the association between somatotype and performance.

An individual’s somatotype can be defined by three components namely endomorphy, mesomorphy and ectomorphy. The Heath - Carter method of somatotyping is the most commonly used method to assess somatotype at present. The purpose of this study was to describe the body somatotypes of elite male Sri Lankan short distance runners (SD), middle distance runners (MD), long distance runners (LD) and to compare the three event groups in terms of somatotypes.

The subjects included 16 male athletes who attended the Sports Medicine clinic at Teaching hospital Peradeniya during the period from July 2011 to September 2011. Ten morphological body measurements were taken on a sample of 02 SD (100 m and 200 m), 07 MD (800 m, 1500 m and 3000 m) and 07 LD (5000 m, 10000 m and Marathon) with a mean age of 23.5 years. Somatotypes were calculated according to the standard Carter and Heath (2002) method.

Mean somatotypes were 2-3.6-3, 1.8-3-3.6, and 1.8-3-3.4 in SD, MD and LD respectively. Mesomorphic-ectomorph body type (50.0%) was found to be dominant among all runners followed by Balanced-mesomorphic body type (18.75%), whereas the endomorphic component was the least marked. Commonest somatotype among LD was mesomorphic-ectomorph (71.43%) body type. Distribution of somatotype among MD runners showed a mixed pattern with Mesomorphic-ectomorph, Balanced-mesomorph and Balanced-ectomorph body types (28.57% each). Adequate sample size is necessary to comment on the distribution of somatotype among SD.

Proceedings of the Peradeniya University Research Sessions, Sri Lanka, Vol. 16, 24th _{November 2011}

88

Comparision of Diagnostic Efficacy of Rapid Diagnostic Assays Used for the Detection of Hepatitis B Virus Surface Antigen