Pharmacology

Lipid levels of healthy adults in Jaffna district, Northern Province of Sri Lanka: An analysis of secondary data

2024-01-01T00:00:00Z

Lipid levels of healthy adults in Jaffna district, Northern Province of Sri Lanka: An analysis of secondary data Thiyahiny, S.N.; Gajanthan, R.; Janahan, R.; Sujanitha, V.; Sivansuthan, S.; Kesavan, R. Abnormal lipid profile is considered as an important contributor to cardiovascular diseases among South Asians. Sri Lanka is a multiethnic South Asian nation and differences in ethnicity may influence the pattern of lipid profile. The aim of this paper is to analyse the lipid levels of healthy adults of a predominantly Sri Lankan Tamil population in the Northern Sri Lanka and compare it with the lipid levels of different ethnic groups reported in the literature. It was a cross-sectional analysis of secondary data of 500 healthy adults who were the controls of a larger study on the lipid profile of diabetic and non-diabetic patients. Cut-off values for desirable lipid levels used in this study were determined according to national and international guidelines. Chi-squared test, independent t-test/ Mann– Whitney U-test and one-way analysis of variance were used to determine the statistical significance and a p-value <0.05 was considered significant. The majority (61.4%) were women and the mean age was 54.8±12.6 years. Mean lipid levels were within normal range except HDL cholesterol (HDL-C) in women (46.6± ±10.6 mg/dL). Desirable lipid levels were observed in majority of the participants (58%- 80%) except HDL-C among women (32%). Half of the study population had a desirable total cholesterol: HDL-C ratio (50.8%). Significant difference between men and women was observed for HDL-C (p<0.05). The HDL-C levels and total cholesterol: HDL-C ratio of Jaffna population were comparable to those of South Asian populations. Further studies are needed to determine the clinical implication of these observations.

Effectiveness of inhaled therapies in asthma among adults in Northern Sri Lanka, a low-income and middle-income country: a prospective observational study

2025-01-01T00:00:00Z

Effectiveness of inhaled therapies in asthma among adults in Northern Sri Lanka, a low-income and middle-income country: a prospective observational study Guruparan, Y.; Thiyahiny, S.N.; Gowry, S.; Shalini, S.R. Background Inhaled corticosteroids (ICS) alone, or combined with long-acting beta2-agonist (LABA), are recommended for chronic asthma. Limited access to inhaled medications hinders effective control of asthma in low-income and middle-income countries. Objective This study aimed to compare the effectiveness of inhaled therapies in a cohort of adult patients with asthma who were receiving treatment in a tertiary hospital in Northern Sri Lanka. Methods A prospective cohort study was conducted among adult patients with asthma on either ICS alone or ICS/LABA combination for at least 3 months. Participants were followed up for 6 months, with two follow-up interviews conducted 3 months apart. The primary outcome measure was asthma control, assessed by a locally validated asthma control patient-reported outcome measure. Secondary outcome measures included the use of short-acting beta2-agonists (SABA) and the percentage of patients required nebulisations and hospitalisations. McNemar’s test was used to determine the statistical significance. A p value≤0.05 was considered significant. Results Of the 1094 participants, 827 (76%) were on ICS monotherapy and 267 (24%) were on ICS/LABA. Though there were no changes in the treatment, progressive improvement in asthma control was observed from baseline to second follow-up in both ICS (54%–72%) and ICS/LABA (76%–81%) groups. Significant improvement in asthma control (p<0.001) and SABA overuse (p<0.001) at both follow-ups and nebulisation (0.008) at the first follow-up were observed in the ICS group. Conclusion Both ICS monotherapy and ICS/LABA were effective in controlling asthma. Though control was greater with ICS/LABA, the effect of additional monitoring during the follow-up was higher and significant in ICS monotherapy. Considering the low access to ICS/ LABA, a treatment package comprising ICS plus non-pharmacological approaches could be a more realistic and cost-effective treatment strategy in the local context. ICS/ LABA could be reserved for patients who fail to respond. However, this observation needs to be confirmed by interventional studies.

Pattern of parenteral antibiotic consumption in in-patient units over five years at Teaching Hospital Jaffna

2024-01-01T00:00:00Z

Pattern of parenteral antibiotic consumption in in-patient units over five years at Teaching Hospital Jaffna Guruparan, Y.; Ajeetha, J.; Praveena Priyadharshini, A.; Thanusika, N.; Nithiyananda, S.; Thiyahiny, S.N. Background and objective: Inappropriate use of antibiotics increases the risk of antimicrobial resistance. Data on antibiotic consumption provides basic information for surveillance. This study describes the pattern of parenteral antibiotic consumption in in-patient units at Teaching Hospital Jaffna (THJ) over a period of five years. Methods: It was a retrospective analysis of parenteral antibiotic consumption from 2018 to 2022. Data were extracted from the pharmacy database of THJ. The consumption volume of antibiotics was expressed in defined daily dose (DDD) which was calculated using the Anatomic Therapeutic Classification (ATC)/DDD system of the World Health Organization Collaborating Centre for Drug Statistics Methodology. Inpatient antibiotic consumption was expressed in DDD/100 admissions/ year. The WHO’s AWaRe classification (Access, Watch, Reserve) for antibiotics was used to describe the pattern of antibiotic consumption. One-way ANOVA was performed to determine the significance of changes over a period of time. A p value ≤ 0.05 was considered statistically significant. Results: Almost all parenteral antibiotics (99.3%) were consumed by in-patient units. Proportion of consumption of oral and parenteral antibiotics in in-patient units was 1:1. Consumption of Access, Watch and Reserve groups of parenteral antibiotics were 60.7%, 38.3% and 0.3% respectively, during the five-year period, consistent with WHO recommendations. Penicillin was the most commonly consumed parenteral antibiotic group and amoxicillin+clavulanic acid was the most frequently consumed single antibiotic. Parenteral antibiotic consumption rate was on the decline except in 2020 and 2021 during COVID-19 pandemic, when an increase was observed. An overall decline in the rate of consumption of parenteral antibiotics was observed (from 180.7 to 125.7 DDD/100 admissions between 2018 and 2022). These changes were not statistically significant. Conclusions: Parenteral antibiotic consumption rate at THJ was in line with World Health Organization’s recommendation based on the AWaRe framework.

Gender-based violence help desk services at Teaching Hospital, Jaffna, Sri Lanka

2023-01-01T00:00:00Z

Gender-based violence help desk services at Teaching Hospital, Jaffna, Sri Lanka Guruparan, K.; Kumar, R.; Guruparan, Y.; Muhunthan, K. Gender-based violence (GBV) is a serious health and social problem in South Asian countries, including Sri Lanka. This study describes the socio-demographic characteristics of clients and their alleged perpetrators, types of violence and outcomes reported, and the services provided by the GBV Help Desk at Teaching Hospital - Jaffna. Data were collected retrospectively from records of all 883 clients who sought help and who were referred to the GBV Help Desk of Teaching Hospital - Jaffna during a 2-year period (January 1, 2019 to December 31, 2020) using a data extraction sheet. The clients of the GBV Help Desk were mostly female (91.3%; n=806). Physical, economic, emotional and sexual violence were experienced by 68.5%, 48.2%, 40% and 29.4% of clients, respectively. In 87.9% (n=776) of cases the husband, lover or partner was the alleged perpetrator. Around two thirds of alleged perpetrators (65%, n=518) had a history of alcohol use. Physical violence was more likely among legally married women (84.3%) compared to legally unmarried women (35.4%) (p<0.001) whereas sexual violence was more likely in legally unmarried women (70.5%) compared to legally married women (10.3%) (p<0.001). Suicidal inclinations were reported by 7.3% (n=64). All clients were befriended; further counselling was arranged for 27.8% (n=245). In conclusion the GBV Help Desk mainly provides services to women following intimate partner violence.