Prevalence of growth hormone receptor gene polymorphisms and their association with milk production and fertility-related traits of cross-bred dairy cows in Sri Lanka

This study investigated the association of selected growth hormone receptor (GHR) gene SNPs with selected fertility and milk production-related phenotypes of cross-bred dairy cows (n = 153) reared on three National Livestock Development Board farms in Sri Lanka. Selected cows were genetically screened for SNPs in the exon 08 (n = 153) and 5' upstream (n = 118) regions of the GHR gene using the target sequencing method. The relationships between different genotypes and fertility traits (average calving interval, average number of services per conception, and age at first calving) and milk production-related traits (average total lactation yield, average lactation length, and average milk yield) were analyzed using the General Linear Model in SPSS. Among the identified Four GHR SNPs, rs1099014416 was significantly associated with average calving interval and age at first calving. Cows with GG genotype exhibited younger age at first calving (918.51 ± 113.42 days) and longer calving intervals (543.41 ± 43.29 days) compared to cows with GT (1275.18 ± 38.31, 515.09 ± 24.49 days) and TT (1212.89 ± 88.22, 364.52 ± 54.01 days) genotypes. Other SNPs did not show associations with the studied traits. SNP rs109014416 has the potential to be used as a genetic marker for fertility-related traits in the selection of cross-bred dairy cows in Sri Lanka which should be validated with a larger population.

Concentration and Distribution of Toxic and Essential Elements in Traditional Rice Varieties of Sri Lanka Grown on an Anuradhapura District Farm

Toxic heavy metals have been the focus of many investigations into chronic kidney disease of unknown aetiology (CKDu) within Sri Lanka. It has been hypothesised that exposure to nephrotoxic arsenic, cadmium and lead could play a role in the development of CKDu, and these metals have previously been found in unsafe concentrations in Sri Lankan rice. Traditional varieties of Sri Lankan rice remain popular due to their perceived health benefits, but their uptake of trace and toxic heavy metals remained unexplored. Here, we report a one-time, cross-sectional dataset on the concentrations of essential and toxic elements present in eleven samples of polished and unpolished traditional rice varieties, all regularly grown and sold in the Anuradhapura district, a CKDu hotspot. All rice was sourced from the same farm, with the exception of one store bought sample grown on another, unidentified farm. Cadmium concentrations varied significantly between varieties, and potentially unsafe concentrations of cadmium were detected in the store-bought sample (Suwadel, 113±13 μg kg-1). Elemental imaging of the grains revealed lead to be stored mainly in the rice bran, which is removed during polishing, while cadmium was distributed in the edible portion of the grain. Essential elements were generally higher in the traditional rice varieties than those reported for non-traditional varieties and are a potential source of trace elements for nutrient-deficient communities. The concentration of selenium, an element that plays a protective role in the kidneys, was too low to provide the minimum recommended intake. The methods developed in this study could be applied to a more comprehensive study of elemental uptake of rice under controlled growing conditions.

A Bite by Shaw's Short Sea Snake (Hydrophis curtus): A Case of Mild Myotoxicity or a Dry Bite?

Although sea snakes (Elapidae) are commonly encountered by fishermen, accurately authenticated envenomings by them are uncommon in clinical literature. We report an authenticated case of Shaw's short, or spine-bellied, sea snake (Hydrophis curtus) bite in a young fisherman from northern Sri Lanka. The patient had clinical and biochemical evidence of mild transient myotoxicity but no evidence of neuromuscular paralysis or significant renal injury. Consideration of the clinical manifestations suggests either a mild envenoming or a dry bite. The patient completely recovered without any antivenom therapy and was discharged on the fourth day. Prolonged observation may be beneficial to exclude complications of sea snake envenoming.

Improving psychological well-being among healthcare workers during the COVID-19 pandemic with an online mindfulness intervention: A randomised waitlist-controlled trial

The high prevalence of psychological problems observed among healthcare workers (HCWs) during the COVID-19 pandemic called for interventions to safeguard their mental health. We assessed the effectiveness of a 6-week online mindfulness-based intervention in improving well-being and reducing stress among HCWs in Sri Lanka. Eighty HCWs were recruited and randomised into two groups: waitlist-control (WLC) and intervention groups. In the intervention, 1-hour online sessions were conducted at weekly intervals and participants were encouraged to do daily home practice. Stress and well-being were measured pre- and post-intervention using the Perceived Stress Scale and WHO-5 Well-being Index, respectively. One-way analysis of covariance was used to evaluate the effectiveness, in both intention-to-treat (ITT) and complete-case (CC) analyses. A significantly greater improvement in well-being occurred in the intervention arm compared to WLC on both ITT (p = .002) and CC analyses (p < .001), with medium-to-large effect sizes (partial η2 = .117-.278). However, the reduction in stress following the intervention was not significant compared to the WLC group on both ITT (p = .636) and CC analyses (p = .262). In the intervention arm, the median number of sessions attended by participants was 3. Low adherence to the intervention may have contributed to the apparent non-significant effect on stress.

The Unified Narcissism Scale-Revised: Expanding Measurement and Understanding of Narcissism Across Cultures

The study of narcissism has been hindered by conceptual, theoretical, and measurement in-consistencies. In this article, we report two studies that tested a novel unified conceptualization and theoretical approach to narcissism using the Unified Narcissism Scale-Revised. Study 1 revised the recently developed Unified Narcissism Scale to construct a preliminary 40-item measure in a sample of 395 American participants (Mage = 41). We confirmed the five-factor first-order model, the two-factor second-order model, and the one-factor third-order model. Study 2 considered the cross-cultural performance of the revised scale in the Chinese language in China (N = 326, Mage = 25.5 years) and in the English language in Sri Lanka (N = 354 Mage = 28.7 years) and constructed a final 35-item measure. In conducting these studies, we have demonstrated the cross-cultural importance of entitlement and self-esteem to the conceptualization of narcissism and suggest that the negative relationship between narcissism and agreeableness may be culture-specific to Western samples (as evidenced by the absence of this relationship in non-Western samples). In this article, we have constructed a measure of narcissism that has refined our understanding of the construct and created a tool to capture this understanding.

Efficacy and Feasibility of Short-Stretch Compression Therapy for Filarial Lymphedema in Sri Lanka

The WHO-recommended essential package of care (EPC) for filarial limb lymphedema consists of daily limb washing, entry lesion management, limb protection, exercises, and elevation. Decongestive therapy (DT) with compression bandaging by trained lymphedema therapists adds additional benefit but is unavailable for most in low- and middle-income countries (LMICs). To determine whether DT using self-adjustable, short-stretch compression garments (SSCG), prefitted using portable, three-dimensional infrared imaging (3DII), would be effective and feasible in LMIC settings, we conducted a pilot 6-week, interventional, single-group, open-label pilot study in Galle, Sri Lanka. Ten participants with Dreyer stage 3 lymphedema used SSCG for 2 weeks after a 4-week lead-in EPC period. Effect of EPC and compression on quality of life was assessed using the 12-item WHO Disability Assessment Schedule 2.0 (WHODAS 2.0). Median participant age was 73 years (range: 32-85 years). Median percent limb volume reduction due to compression was 11.3% (range: 1.1-27.2%). WHODAS 2.0 scores did not change significantly between enrollment and study end. Garment acceptability was high throughout the study. These results provide proof of concept for 3DII-enabled SSCG in LMICs where trained therapists for filarial lymphedema may not be available.

The genetic identity of the Vedda: A language isolate of South Asia

Linguistic data from South Asia identified several language isolates in the subcontinent. The Vedda, an indigenous population of Sri Lanka, are the least studied amongst them. Therefore, to understand the initial peopling of Sri Lanka and the genetic affinity of the Vedda with other populations in Eurasia, we extensively studied the high-resolution autosomal and mitogenomes from the Vedda population of Sri Lanka. Our autosomal analyses suggest a close genetic link of Vedda with the tribal populations of India despite no evidence of close linguistic affinity, thus suggesting a deep genetic link of the Vedda with these populations. The mitogenomic analysis supports this association by pointing to an ancient link with Indian populations. We suggest that the Vedda population is a genetically drifted group with limited gene flow from neighbouring Sinhalese and Sri Lankan Tamil populations. Interestingly, the genetic ancestry sharing of Vedda neglects the isolation-by-distance model. Collectively, the demography of Sri Lanka is unique, where Sinhalese and Sri Lankan Tamil populations excessively admixed, whilst Vedda largely preserved their isolation and deep genetic association with India.

In-classroom physical activity breaks program among school children in Sri Lanka: study protocol for a randomized controlled trial

Background

The problem of sedentary behavior among primary school children is alarming, with numbers gradually increasing worldwide, including Sri Lanka. Physical activity interventions within classroom settings have been acknowledged as a critical strategy to increase students' movement behaviors while enhancing their academic achievement and health. Yet, the busy curriculum and challenging educational demands encourage more sedentary classroom behavior. Hence, this study aims to develop and evaluate an in-classroom physical activity breaks (IcPAB) intervention among fifth graders in Sri Lanka.

Methods

The study will adopt a randomized controlled trial (RCT), comprising an in-classroom physical activity breaks program group and a control group to evaluate the effects of IcPAB on academic achievement, movement behaviors and health outcomes. The intervention design is based on the capability (C), opportunity (O) and motivation (M) behavior (B) (COM-B) model. A least 198 fifth graders will be recruited from two schools in Uva province, Sri Lanka. The recruitment process will start in late 2022. Class teachers of the intervention group will implement 5-min activity breaks at least three times a day after completing a training session. The primary variables include mathematics and reading achievement. The secondary variables include physical activity levels, steps count, sedentary behavior, body mass index, aerobic fitness, and perceived stress. Data collection will be implemented at pre-test and post-test, respectively. Intervention fidelity and the process will also be evaluated.

Discussion

The IcPAB is designed to prevent pure educational time loss by introducing curriculum-integrated short bouts of physical active breaks into the classroom routine. If the IcPAB is effective, it can (1) improve the mathematics and reading achievement of fifth-grade girls and boys, which is a significant factor determining the performance at the Grade Five National Scholarship Examination in Sri Lanka; (2) improve movement behaviors as well as physical and mental health outcomes among primary school students. Sequentially, the IcPAB will enrich school-based physical activity intervention approaches which can in turn bring academic and health benefits to primary school children in Sri Lanka.

Trial registration

The first version of the trial was registered with the ISRCTN registry (Ref: ISRCTN52180050) on 20/07/2022.

Development and implementation of a worksite-based intervention to improve mothers' knowledge, attitudes, and skills in sharing information with their adolescent daughters on preventing sexual violence: lessons learned in a developing setting, Sri Lanka

BACKGROUND

Sexual violence among adolescents has become a major public health concern in Sri Lanka. Lack of sexual awareness is a major reason for adverse sexual health outcomes among adolescents in Sri Lanka. This study was intended to explore the effectiveness of a worksite-based parent-targeted intervention to improve mothers' knowledge, and attitudes on preventing sexual violence among their adolescent female offspring and to improve mother-daughter communication of sexual violence prevention with the family.

METHODS

"My mother is my best friend" is an intervention designed based on previous research and behavioral theories, to help parents to improve their sexual communication skills with their adolescent daughters. A quasi-experimental study was conducted from August 2020 to March 2023 in randomly selected two Medical Officer of Health (MOH)areas in Kalutara district, Sri Lanka. Pre and post-assessments were conducted among a sample of 135 mothers of adolescent girls aged 14-19 years in both intervention and control areas.

RESULTS

Out of the 135 mothers who participated in the baseline survey, 127 mothers (94.1%) from the intervention area (IA) physically participated in at least one session of the intervention. The worksite-based intervention was effective in improving mothers' knowledge about adolescent sexual abuse prevention (Difference in percentage difference of pre and post intervention scores in IA and CA = 4.3%, p = 0.004), mother's attitudes in communicating sexual abuse prevention with adolescent girls (Difference in percentage difference of pre and post intervention scores in IA and CA = 5.9%, p = 0.005), and the content of mother-daughter sexual communication (Difference in percentage difference of pre and post intervention scores in IA and CA = 27.1%, p < 0.001).

CONCLUSIONS AND RECOMMENDATIONS

Worksite-based parenting program was effective in improving mothers' knowledge about sexual abuse prevention among adolescent daughters and in improving the content of mother-daughter communication about sexual abuse prevention. Developing appropriate sexual health programs for mothers of different ethnicities, and cultures using different settings is important. Conduction of need assessment programs to identify the different needs of mothers is recommended.

Effects of health educational and participatory consumer group interventions in improving food handling practices in regional director of health services area Kalutara, Sri Lanka: non-randomized controlled community trial

INTRODUCTION

Safe and nutritious food is the key to sustaining life and promoting good health. Unsafe food creates a vicious cycle of disease and malnutrition, particularly affecting infants, young children, the elderly, and the sick.

METHODS

The study consisted of two phases, a descriptive cross-sectional study, and an intervention study. Both studies were conducted in the Regional Director of Health Services area, Kalutara, Sri Lanka. The descriptive cross-sectional study [food handlers (n = 904), food establishments (n = 421)] was conducted with the objective of determining factors associated with food handling practices among food handlers and in food establishments. The interventional study was a three-arm non-randomized controlled community trial (n = 50 per arm) with interventions of a participatory consumer group, educational package group, and control group.

RESULTS

The food establishments assessment tool (FEAT) contained 11 domains including 75 items with more than a hundred assessment points with a guide to conduct an assessment of food handling. The descriptive cross-sectional study found that food handlers' knowledge of food handling practices of storing milk, fish, and meat and fast-food items containing fish and meat was very poor (96.6%). Visibility of the last place of processing inside the food establishments to consumers was inadequate (19.2%) and the absence of the above-mentioned factor was significantly associated with an unsatisfactory level of food handling score in food establishments (p = 0.03). The unsatisfactory level of food handling was significantly higher among food establishments with non-personal ownership (p = 0.005), a low number of notices issued by legal authorities (p = 0.02), dereliction of duty by owners/managers on supervising (p < 0.001) and lack of medical certification to food handlers (p < 0.0001). Participatory consumer group intervention and educational package interventions were effective in improving food handling practices in food establishments and among food handlers (p < 0.0001). Two independent sample analysis using the Mann-Whitney U test showed, the best improvement in food handling practices was by participatory consumer group intervention (p < 0.0001) and the second was educational package intervention (p < 0.0001).

CONCLUSIONS

Knowledge and practices of food handling among participants were poor. A participatory consumer group is more effective than an educational package on improving food handling practices both among food handlers and in food establishments.

Towards the establishment of national diagnostic reference levels for abdomen, KUB, and lumbar spine x-ray examinations in Sri Lanka: a multi-centric study

Diagnostic reference levels (DRLs) and achievable doses (ADs) provide guidance to optimise radiation doses for patients undergoing medical imaging procedures. This multi-centre study aimed to compare institutional DRLs (IDRLs) across hospitals, propose ADs and multi-centric DRLs (MCDRLs) for four common x-ray examinations in Sri Lanka, and assess the potential for dose reduction. A prospective cross-sectional study of 894 adult patients referred for abdomen anteroposterior (AP), kidney-ureter-bladder (KUB) AP, lumbar spine AP, and lumbar spine lateral (LAT) x-ray examinations was conducted. Patient demographic information (age, sex, weight, BMI) and exposure parameters (tube voltage, tube current-exposure time product) were collected. Patient dose indicators were measured in terms of kerma-area product (PKA) using a PKAmeter. IDRLs, ADs, and MCDRLs were calculated following the International Commission on Radiological Protection guidelines, with ADs and MCDRLs defined as the 50th and 75th percentiles of the median PKAdistributions, respectively. IDRL ranges varied considerably across hospitals: 1.42-2.42 Gy cm2for abdomen AP, 1.51-2.86 Gy cm2for KUB AP, 0.83-1.65 Gy cm2for lumbar spine AP, and 1.76-4.10 Gy cm2for lumbar spine LAT. The proposed ADs were 1.82 Gy cm2(abdomen AP), 2.03 Gy cm2(KUB AP), 1.27 Gy cm2(lumbar spine AP), and 2.21 Gy cm2(lumbar spine LAT). MCDRLs were 2.24 Gy cm2(abdomen AP), 2.40 Gy cm2(KUB AP), 1.43 Gy cm2(lumbar spine AP), and 2.38 Gy cm2(lumbar spine LAT). Substantial intra- and inter-hospital variations in PKAwere observed for all four examinations. Although ADs and MCDRLs in Sri Lanka were comparable to those in the existing literature, the identified intra- and inter-hospital variations underscore the need for dose reduction without compromising diagnostic information. Hospitals with high IDRLs are recommended to review and optimise their practices. These MCDRLs serve as preliminary national DRLs, guiding dose optimisation efforts by medical professionals and policymakers.

Caring burden and coping with haemodialysis: a qualitative study with family caregivers in Sri Lanka

OBJECTIVE

The number of patients with end-stage kidney disease (ESKD) requiring renal replacement therapy in Sri Lanka is significantly rising. Most of these patients depend on haemodialysis, carrying a significant burden on their family caregivers. To develop care and support for both the patient and their family caregiver, it is crucial to understand how caregivers experience their caregiving situation. Therefore, this study aimed to explore family caregivers' experiences of burden and coping when caring for a family member receiving haemodialysis in the Sri Lankan context.

DESIGN

Qualitative study with an exploratory design.

SETTING

Family caregivers were recruited at a haemodialysis unit of a main government sector hospital in Sri Lanka between October and November 2021.

PARTICIPANTS

A purposive sampling of 11 family caregivers who cared for a family member receiving haemodialysis in a main government teaching hospital in Sri Lanka for at least 3 consecutive months. Data were collected through individual semistructured telephone interviews and analysed using qualitative content analysis.

RESULTS

The results showed an overarching theme, 'striving to hold on and not let go', with four categories: (1) feeling exhausted by the care burden, (2) feeling burdened as failing the care responsibility, (3) striving to cope and find meaning in caregiving, and (4) coping with caregiving through others' support.

CONCLUSION

The results show that the family caregivers have a multifaceted burden. They continued caring for their family member receiving haemodialysis while making adjustments to the burdensome caregiving situation despite many constraints and suffering. Psychosocial support and financial assistance, including family counselling, are needed by family caregivers, through a community support system, to ensure endurance during their family members' illness trajectory. Advance care planning is vital to alleviate care uncertainty and to meet the care needs of patients with ESKD, particularly in resource-constrained settings.

Reconstitution of oral antibiotic suspensions for paediatric use in households: a cross-sectional study among caregivers of 3-5-year-old children from a selected district, Sri Lanka

INTRODUCTION

Reconstitution of oral pediatric antibiotic suspension by primary caregivers plays an essential role in determining the overall health outcome of the child. Incorrect reconstitution techniques could lead to underdosing, overdosing, or introduction of infection. Underdosing could lead to non-resolving infection and antimicrobial resistance.

OBJECTIVES

To assess the practice and associated factors on reconstitution of oral pediatric antibiotic suspensions (OPAS) among primary caregivers of 3-5-year-old children in a selected district in Sri Lanka.

METHODS

A cross-sectional study was carried out among 835 primary caregivers selected using two-stage cluster sampling at field clinics to assess practices for the reconstitution of OPAS. A live demonstration of the reconstitution of the OPAS was assessed by a checklist. Associated factors with caregiver practices on reconstitution were assessed using Chi-square with the statistical significance level set at 0.05.

RESULTS

A total of 820 respondents were recruited and completed the study (response rate = 98.2%). Overall, 56.0% displayed good performance in the demonstration of reconstitution of oral pediatric antibiotic suspension. Poorest performances were observed in shaking the bottle to loosen the powder (Correct: 53.7%), topping up the bottle with water up to the marked line (Correct: 58.0%), and filling the water below the marked line in the bottle (Correct: 59.0%). Caregivers in urban areas compared to rural and estate regions (45.6% vs. 22.7% and 26.5% respectively) and caregivers aged 35 years or above compared to less than 35 years age group (31.5% vs. 22.5%) performed the reconstitution of OPAS poorly. Parental factors, namely age, gender, level of education, and geographical region (urban/rural/estate) were significantly associated with the performance in reconstituting the oral paediatric antibiotic suspension (p = 0.002, p < 0.001, p < 0.001, and p < 0.001 respectively). Factors related to the child, specifically whether they attend preschool and whether they have an older sibling, were found to have a significant association with the correct execution of the reconstitution of OPAS (p = 0.017, and p = 0.030 respectively).

CONCLUSIONS AND RECOMMENDATIONS

A significant number of primary caregivers displayed poor practice in key steps during the reconstitution of OPAS, which could have a negative impact on the health of the child. Targeted place-based behavioural change health programs with the use of infographic leaflets/ posters may correct the practices of caregivers.

Ecological ramifications of marine debris in mangrove ecosystems: Estimation of substrate coverage and physical effects of marine debris on mangrove ecosystem in Negombo Lagoon, Sri Lanka

The adverse environmental impacts on mangrove ecosystems due to anthropogenic marine debris contamination have attracted public attention not only in Sri Lanka but worldwide. Therefore, quantification of marine debris in sensitive ecosystems like mangroves is critical to assess the impacts on ecosystem vitality and services. We conducted this study to assess the abundance and density of marine debris in Negombo lagoon, Western Province, Sri Lanka. We selected two sites (n = 2) using the purposive sampling technique. Marine debris cover and concentration were calculated to explore the extent of pollution from marine debris. The findings revealed that 9.83 ± 1.05 % of the substrate of the mangrove ecosystem is covered by debris. Nine types of marine debris were recorded, and a higher abundance belonged to single-use plastic items. A significantly higher debris cover was found in Kadolkele (18.80 ± 1.74 %, n = 120) than in Molekadolwetiya (0.85 ± 0.03 %, n = 120) (One-way ANOVA, p < 0.05). The study indicated that the mangroves in lagoon are highly polluted with marine debris and act as "litter catchers." Correlation coefficient analysis was used to find the impact of debris cover on physical damage to roots, seedlings, and undergrowth vegetation. Correlation analysis revealed that physical damage to seedlings and branches/barks have a positive correlation with debris cover. To conserve these valuable coastal habitats in Negombo lagoon, it is recommended to take remedial measures to reduce arriving debris loads and to remove the debris present in mangroves.

Physiotherapists' perceptions and barriers to use of telerehabilitation for exercise management of people with knee osteoarthritis in Sri Lanka

PURPOSE

To assess physiotherapists' perceptions and barriers to using telerehabilitation via video and telephone for exercise management for people with knee osteoarthritis (OA) in Sri Lanka.

MATERIALS AND METHODS

Currently registered and practising Sri Lankan physiotherapists who care for knee OA patients were invited to participate in a cross-sectional online survey framed according to a previous study. A logistic regression analysis was used to assess the effect of physiotherapists' characteristics on their interest in telerehabilitation.

RESULTS

A total of 268 physiotherapists completed the survey, which was broadly representative of locations and work settings across Sri Lanka. Only three out of 16 statements received majority agreement; these were that telephone-delivered care would save patients' time (72%), save money (68%) and improve patients' privacy (67%). There was a consensus that video-based care would save money (79%), and many favoured this medium over telephone-delivered care. Lack of experience with telerehabilitation was associated with reduced interest in telephone-delivered care. Increased interest in video-based care was associated with frequent care of knee OA patients. Most physiotherapists perceived technical issues with telerehabilitation as a significant barrier to implementing it.

CONCLUSIONS

Physiotherapists perceived video-based telerehabilitation more positively than care over the telephone. Reduced interest in telerehabilitation was associated with having no prior experience with it. Moreover, technical issues with telerehabilitation were perceived as the main barrier to its use. A training programme for physiotherapists, appropriate guidelines and a framework for better implementing telereahabilitation may yield substantial benefits for knee OA patients.IMPLICATIONS FOR REHABILITATIONPhysiotherapists in Sri Lanka perceive telerehabilitation for exercise management for knee OA patients positively.Telerehabilitation via video or telephone is a viable option for delivering exercise management for knee OA patients in Sri Lanka.The widespread practice of telerehabilitation by physiotherapists in Sri Lanka requires appropriate strategies to mitigate barriers to its implementation.

Surgical Outcome of Pharmaco Refractory Epilepsy in the National Epilepsy Center of Sri Lanka

BACKGROUND

The National Epilepsy Center (NEC) in Sri Lanka was established in 2017. Seizure outcome, effects on quality of life (QOL) and surgical complications among nonpediatric patients who underwent epilepsy surgery from October 2017 to February 2023 are described.

METHODS

Nineteen patients (≥14 years) underwent epilepsy surgery at the NEC. We used Engel classification and Quality of Life in Epilepsy 31 (QOLIE-31) questionnaire to assess seizure outcome and QOL respectively. Surgical complications were categorized into neurological and complications related to surgery.

RESULTS

Nine female and 10 male patients underwent surgery (mean age 27.5 years (range 14-44 years). The mean follow-up duration was 10.5 months (range 6-55 months). Twelve patients underwent temporal lobe resections. At 6-months follow-up, 83.3% (10/12) had favorable seizure outcomes with Engel class I/II. At 1-year follow-up 6/8 patients (75.0%) and at 2-year follow-up, 5/7 patients (71.4%) had a favorable outcome. Seven patients had extra-temporal lobe surgeries and one defaulted. Seizure freedom was observed in 6/6 at 6 months, 3/3 at 1-year, and 2/2 at 2-year follow-up. Five patients (26.3%) experienced minor post-operative surgical site infection. Two (11.1%) had persistent quadrantanopia. Meaningful improvement in QOL (change in QOLIE-31 score ≥11.8) was observed irrespective of seizure outcome or type of surgery (P < 0.001).

CONCLUSIONS

Epilepsy surgery is effective in developing countries. Seizure outcomes in our patients are comparable to those worldwide. Clinically important QOL improvement was observed in our series. This is the first published data on epilepsy surgery outcomes in nonpediatric patients from Sri Lanka.

Parents' Views on Prolonged Maternal Hospital Stay With Sick Newborn Infants in a Tertiary Neonatal Unit in Sri Lanka

BACKGROUND

Mothers of infants in most Sri Lankan neonatal units are required to be "inpatients" during the entirety of their infant's stay. This traditional practice is closely aligned to the relatively newer model of family-integrated care.

PURPOSE

Exploration of parent's views regarding the expectation for mothers to remain in hospital for the entire duration of their infant's neonatal unit stay.

METHODS

Cross-sectional study of parents of infants admitted to the University neonatal unit of Colombo North Teaching Hospital, Ragama, Sri Lanka, using self-administered questionnaires in 2017.

RESULTS

We found that 40% (19/48) of mothers and 43% (16/37) of fathers preferred that mothers traveled from home, rather than being inpatients continuously, in order to care for older children, receive psychological support from family, and also due to other practical inconveniences of living in the hospital. The main barriers to women being able to travel from home were the need to safely provide expressed human milk for their hospitalized infants and current hospital administrative and societal attitudes.

IMPLICATIONS FOR PRACTICE AND RESEARCH

We found that a considerable number of parents with infants in the neonatal intensive care unit in Sri Lanka would like the option of the mother being able travel from home, rather than being confined to hospital. To facilitate this option, changes in hospital protocols and further research into storage and transportation of expressed mother's milk will be required. Improving facilities in hospital and providing more opportunities for families to interact with infants in neonatal intensive care unit will encourage mothers to remain in hospital continuously.

Human health risk attributed to consumption of seafood and recreation swimming in Negombo Lagoon, Sri Lanka: An assessment on lagoon water and inhabitant oysters (Crassostrea cucullata Born, 1778)

The Negombo Lagoon is a coastal lagoon influenced by local communities that introduce waste into its ecosystem. This study examined seven sewage entry points, out of which five sites were chosen for oyster sampling based on availability. Physicochemical and microbiological parameters of water (measured in triplicate at each site, n = 84) and oyster samples (total length, TL > 6 cm, n = 30) were assessed. Variation in regional coliform contamination was analyzed employing a one-way analysis of variance (ANOVA). Results indicated that the northern part of the lagoon exceeded recommended coliform thresholds for swimming (total coliform concentration (TCC) < 126 most probable number (MPN)) and seafood consumption (TCC < 100 MPN/g), indicating the presence of Escherichia coli. Water quality indices affirmed fecal pollution, except in the southern part of the lagoon. Furthermore, the study found high oyster consumption (76.7 %), elucidating that oysters from the northern part of Negombo Lagoon pose health risks.

Aromatase (CYP19) gene as a biomarker for detection of naphthalene and phenanthrene in Colombo to Mirissa coastal water in Sri Lanka

Naphthalene (NAP) and phenanthrene (PHE) are prevalent Polycyclic Aromatic Hydrocarbons (PAHs) in the environment. High-Performance Liquid Chromatography (HPLC) analysis was performed on marine water samples (n = 57) collected from 19 locations. Molecular screening of the aromatase (CYP19) gene expression was examined using quantitative Reverse Transcriptase PCR (qRT-PCR). The findings of the study showed a significant range of naphthalene concentrations along the coastline, spanning from 1.70 to 15.05 mg/L, where phenanthrene concentrations varied from undetectable to a maximum of 5.36 mg/L. The relative expression of the CYP19 gene ranged from 0.5 to 13.9 in the sampling sites. The ANOVA analysis showed a significant positive correlation (p < 0.05) between the concentrations of PAHs and CYP19 gene expression. The study concluded that the CYP19 gene could be useful in detecting contaminants such as naphthalene and phenanthrene in water. This study may help develop effective strategies to detect and mitigate PAH pollution in coastal areas.

ornata populations from the western coast of India and Sri Lanka

Advertisement calls in frogs have evolved to be species-specific signals of recognition and are therefore considered an essential component of integrative taxonomic approaches to identify species and delineate their distribution range. The species rich genus Microhyla is a particularly challenging group for species identification, discovery and conservation management due to the small size, conserved morphology and wide distribution of its members, necessitating the need for a thorough description of their vocalization. In this study, we provide quantitative description of the vocal behaviour of Microhyla nilphamariensis, a widely distributed south Asian species, from Delhi, India, based on call recordings of 18 individuals and assessment of 21 call properties. Based on the properties measured acrossed 360 calls, we find that a typical advertisement call of M. nilphamariensis lasts for 393.5 ±  57.5 ms, has 17 pulses on average and produce pulses at rate of 39 pulses/s. The overall call dominant frequency was found to be 2.8 KHz and the call spectrum consisted of two dominant frequency peaks centered at 1.6 KHz and 3.6 KHz, ranging between 1.5-4.1 KHz. Apart from its typical advertisement call, our study also reveals the presence of three 'rare' call types, previously unreported in this species. We describe variability in call properties and discuss their relation to body size and temperature. We found that overall dominant frequency 1 (spectral property) was found to be correlated with body size, while first pulse period (temporal property) was found to be correlated with temperature. Further, we compare the vocal repertoire of M. nilphamariensis with that of the congener Microhyla ornata from the western coast of India and Sri Lanka and also compare the call properties of these two populations of M. ornata to investigate intra-specific call variation. We find statistically significant differentiation in their acoustic repertoire in both cases. Based on 18 call properties (out of 20), individuals of each locality clearly segregate on PCA factor plane forming separate groups. Discriminant function analysis (DFA) using PCA factors shows 100% classification success with individuals of each locality getting classified to a discrete group. This confirms significant acoustic differentiation between these species as well as between geographically distant conspecifics. The data generated in this study will be useful for comparative bioacoustic analysis of Microhyla species and can be utilized to monitor populations and devise conservation management plan for threatened species in this group.

Sign language usage of deaf or hard of hearing Sri Lankans

In Sri Lanka, about 300,000 Sinhala speaking people are either deaf or hard of hearing (DHH) and would benefit from a common Sinhala sign language, technological resources such as captioning, and educational and social support. There is no fully developed common sign language for members of the Sinhalese community, a severe shortage of sign language interpreters, and few resources for teachers. This exploratory study was undertaken in all nine provinces of Sri Lanka into the use of sign language, access to education for people with disabilities, and the availability of trained or qualified educators to work with the DHH people. Data were gathered via interviews and focus groups with Special Education Assistant Directors, Principals and Teachers in Deaf Schools, and Teachers of Special Education Deaf Units in mainstream schools. The DHH members of Sri Lankan society are marginalized, under-supported, and require urgent attention to their educational and social needs. This study provides a basis for much needed attention and reform.

Metabolome evidence of CKDu risks after chronic exposure to simulated Sri Lanka drinking water in zebrafish

It is still a serious public health issue that chronic kidney disease of uncertain etiology (CKDu) in Sri Lanka poses challenges in identification, prevention, and treatment. What environmental factors in drinking water cause kidney damage remains unclear. This study aimed to investigate the risks of various environmental factors that may induce CKDu, including water hardness, fluoride (HF), heavy metals (HM), microcystin-LR (MC-LR), and their combined exposure (HFMM). The research focused on comprehensive metabolome analysis, and correlation with transcriptomic and gut microbiota changes. Results revealed that chronic exposure led to kidney damage and pancreatic toxicity in adult zebrafish. Metabolomics profiling showed significant alterations in biochemical processes, with enriched metabolic pathways of oxidative phosphorylation, folate biosynthesis, arachidonic acid metabolism, FoxO signaling pathway, lysosome, pyruvate metabolism, and purine metabolism. The network analysis revealed significant changes in metabolites associated with renal function and diseases, including 20-Hydroxy-LTE4, PS(18:0/22:2(13Z,16Z)), Neuromedin N, 20-Oxo-Leukotriene E4, and phenol sulfate, which are involved in the fatty acyls and glycerophospholipids class. These metabolites were closely associated with the disrupted gut bacteria of g_ZOR0006, g_Pseudomonas, g_Tsukamurella, g_Cetobacterium, g_Flavobacterium, which belonged to dominant phyla of Firmicutes and Proteobacteria, etc., and differentially expressed genes (DEGs) such as egln3, ca2, jun, slc2a1b, and gls2b in zebrafish. Exploratory omics analyses revealed the shared significantly changed pathways in transcriptome and metabolome like calcium signaling and necroptosis, suggesting potential biomarkers for assessing kidney disease.

Detection of pathogenic Leptospira with rapid extraction followed by recombinase polymerase amplification (RPA) and quantitative polymerase chain reaction (qPCR) assay-A comprehensive study from Sri Lanka

Leptospirosis is the most widespread zoonosis in the world. The disease is more prevalent in tropical regions where the majority of developing countries are located. Leptospirosis is considered a protean manifestation zoonosis with severity of the disease ranging from a mild febrile illness to a severe and life-threatening illness. Clinical symptoms of leptospirosis overlap with other tropical febrile illnesses. Early, rapid, and definitive diagnosis is important for effective patient management. Since Polymerase Chain Reaction (PCR)-based assays are not readily available in most clinical settings, there is a need for an affordable, simple, and rapid diagnostic test. Quantitative PCR (qPCR) and Recombinase Polymerase Amplification (RPA) were implemented at the Faculty of Medicine, University of Kelaniya, and a prospective study to evaluate RPA for diagnosis of acute phase of leptospirosis was conducted. Results indicate that RPA and qPCR were positive in 81% (98/121) of the total positive and acute clinical samples. Of the 81 positive MAT confirmed patients 60 (74%) and 53 (65%) were positive with qPCR and RPA respectively. Retrospective evaluation revealed a high diagnostic accuracy (sensitivity-70% and specificity-87%) of RPA compared to MAT as the reference gold standard. Results further suggest that there is no significant difference between the two assays, qPCR and RPA-SwiftX (P = 0.40). Laboratory procedures for the extraction and detection by qPCR in the laboratory have been optimized to obtain results within 6 hours. However, the RPA-SwiftX method under field conditions took 35 minutes. The RPA-SwiftX method could replace the qPCR which shows similar sensitivity and specificity. Therefore, RPA established under the current study presents a powerful tool for the early and rapid diagnosis of leptospirosis at point-of-care.

Unveiling Sri Lanka's brain drain and labour market pressure: A study of macroeconomic factors on migration

The purpose of this study is to explore the impact of GDP per capita income (GDPPCI), unemployment, higher education (HE), and economic growth (EG) on migration in Sri Lanka. Numerous global and local studies have explored the influence of macroeconomic and socioeconomic factors on migration. In the Sri Lankan context, fewer studies have probed the impact of GDPPCI, unemployment, HE, and EG on migration, particularly concerning brain drain and domestic labour market pressure. An applied research methodology was adopted, utilising annual data from 1986 to 2022. The statistical data were sourced from reports by the Sri Lanka Bureau of Foreign Employment (SLBFE), the Central Bank of Sri Lanka (CBSL), Labor Force Survey Data from the Department of Census and Statistics (LFSDCS), and University Grants Commissions (UGC). This study utilised the Vector Error Correlation model (VECM), Vector Auto-regression (VAR), and Granger Causality test through STATA. The empirical findings of the VAR model highlighted that GDPPCI and EG negatively impact migration, whereas unemployment and HE positively affect migration. The study's implications demonstrated that GDPPCI, unemployment, HE, and EG were the primary factors influencing the country's migration decisions. These findings will hopefully inform and guide the Sri Lankan government and policymakers for more effective decision-making.

Investigating capital flight in South Asian countries: The dual influence of terrorism and corruption

This specific research initiative aims to intricately examine the intricate dynamics connecting terrorism, corruption, and capital flight within the context of South Asian economies, encompassing countries including Bangladesh, India, Pakistan, and Sri Lanka. The principal objectives of this study entail a comprehensive investigation into the synergistic impacts of terrorism and corruption on the prevalence of capital flight. To realize these objectives, the study employs longitudinal data from 1990 to 2019, adopting the portfolio choice framework as its theoretical underpinning. In terms of methodology, the empirical inquiry uses the Generalized Method of Moments (GMM) estimation technique. The empirical findings derived from this analysis distinctly establish a statistically noteworthy and positive correlation between terrorism, corruption, and the occurrence of capital flight across multiple South Asian nations. In light of these discerning outcomes, it is strongly recommended that the governments of South Asian countries prioritize and actively pursue the fortification of their institutional governance mechanisms. This strategic approach is deemed crucial in efficaciously counteracting the escalation of capital flight. Specifically, a targeted focus on augmenting institutional governance practices, fostering transparency, fortifying anti-corruption measures, and intensifying counterterrorism efforts could collectively contribute to reducing capital flight tendencies. By undertaking these recommendations, South Asian governments can foster an environment of enhanced economic stability, attractiveness for investment, and sustainable growth, thereby deterring the adverse impact of capital flight while concurrently combatting the underlying challenges posed by terrorism and corruption.

Unveiling reproductive choices: Knowledge and practices of emergency contraceptive pills among the female factory workers in Sri Lanka

BACKGROUND

In Sri Lanka, the Emergency Contraceptive Pill (ECP) is categorized as a Schedule 2A medication, allowing it to be purchased over-the-counter without a prescription, but exclusively from licensed pharmacists. It is estimated that around 3 million ECPs are consumed by Sri Lankan women each year. This study aims to assess the knowledge and practices of Female Factory Workers (FFWs) on ECP and to unearth the association with unintended pregnancy and unsafe abortion.

METHODS

After receiving written informed consent, a structured interview schedule was administered among 585 FFWs attached to eight factories in a selected Export Processing Zone (EPZ). Data analysis was performed using SPSS software.

RESULTS

Only 26 % of FFWs were aware of the effective time period to take an ECP to prevent a pregnancy. Most (67 %) had the impression that a valid prescription is required to purchase ECP from the pharmacies. Around one-tenth of the FFWs (11.3 %, n = 66) had used ECP during their lifetime. Among the 65 respondents who reported having experienced unintended pregnancies, only 26.2 % (n = 17) had utilized ECPs. In contrast, among the 22 respondents who disclosed a history of abortion, only two women had ever employed ECPs.

CONCLUSION

The study highlights the low knowledge and use of ECP among FFWs in Sri Lanka, contributing to unintended pregnancy and unsafe abortion. Results call for targeted interventions to improve knowledge and access to ECP, helping to reduce unintended pregnancy and improve reproductive health outcomes.

Assessment of dosimetric approaches in evaluating radiation exposure for interventional cardiologists in Sri Lanka

Interventional cardiologists face significant radiation exposure during interventional cardiology procedures. Therefore, this study focuses on assessing radiation exposure among interventional cardiologists during their procedures. Specifically, it aims to determine the effectiveness of both single and double dosimeter methods in estimating annual occupational radiation doses. This research holds pioneering significance as it represents the very first study undertaken in Sri Lanka. Thirteen interventional cardiologists performed 486 interventional cardiology procedures over three months in three different healthcare institutes. Active Hp(10) dosimeters were placed to measure radiation exposure. Effective doses were calculated using single and double dosimetric algorithms. Annual occupational doses were assessed on an operator basis. Statistical analyses were conducted to assess algorithmic differences and dose variations using the Kruskal-Wallis test and linear regression. The highest annual occupational dose for each dosimetric algorithm received as 2.00 ± 0.24 mSv, 2.29 ± 0.48 mSv, 3.35 ± 0.71 mSv, and 2.64 ± 0.42 mSv, respectively, and remained below the recommended safety limit of 20 mSv/year. The Kruskal-Wallis test revealed no significant differences in the effective doses among double dosimetric algorithms, as well as between single and double dosimetric algorithms (p > 0.05). Linear regression showed strong correlations among various algorithms, demonstrating consistency. The findings of this study hold significant effects on interventional cardiology practice in Sri Lanka, enhancing radiation safety and monitoring.

Improving Professional Development Based on Evaluation of Nursing Education Programs Through Feedback

A feedback-driven selection process to evaluate professionals strengthens and improves the quality of future education they provide. A university in Sri Lanka invited teaching specialists by incorporating feedback of those teaching educators. The selection of professionals to teach courses improved the quality of education drastically. The findings show that refining education through feedback enhances future education quality and promotes subject matter expert engagement in improving educational programs. [J Contin Educ Nurs. 2024;55(3):110-112.].

Students' perceptions of online education: A session at the FAOBMB-IUBMB-CBSL virtual education symposium 2021

The Federation of Asian and Oceanian Biochemists and Molecular Biologists (FAOBMB) and the College of Biochemists of Sri Lanka (CBSL) organized a virtual education symposium in 2021 funded by the International Union of Biochemistry and Molecular Biology (IUBMB). The parallel session named "Students' Perception" was attended by 188 participants from 11 countries. The main objectives of this session were to aggregate participants' viewpoints on aspects of virtual education, including innovative strategies to enhance motivation and engagement of students, improving teacher-student and student-student interactions, managing stress, and virtual learning platforms. Data were collected via rapporteurs from multiple segments of the session including a mini-introductory talk, poll, role play, and discussions about outstanding student experiences, types of virtual platforms, innovative methods of teaching, student motivation and stress management. The importance of student perception and issues like technological difficulties and the reluctance of students to engage were discussed. In addition to well-established strategies such as using polls, chat box features, and discussions in breakout rooms, participants also proposed exciting learning methods to engage students such as quizzes, competitions and challenges, engagement of multiple sensory modalities, story-based learning, and so forth. This report provides anecdotal evidence on pedagogies described in textbooks and also introduces new ideas based on this existing foundation. Future research should aim to harmonize virtual education with traditional classroom methods and explore innovative virtual tools like avatar-based universities, virtual labs, and user-friendly online assessment platforms. The results apply to all disciplines, and not exclusively to biochemistry and molecular biology (BMB).

Assessing the status of oral health integration in South East Asian Regional Office countries' Universal Health Coverage-A scoping review

BACKGROUND

Oral diseases affect close to 3.5 billion people worldwide and there has been a call by the World Health Organization (WHO) to integrate oral health into the Universal Health Coverage (UHC) agenda.

OBJECTIVES

To collate and synthesise information regarding the status of integration of oral health into the health systems covered by UHC across the 11 countries in the South East Asian Regional Office.

METHODS

Drawing on the framework of the six building blocks of health systems as devised by WHO, we compared the public dental care coverage models, with a focus on outpatient dental care in these countries. We gathered this information from publicly available resources, databases and peer-reviewed publications to populate the template guided by the WHO Health System Building Blocks.

RESULTS

We found a poor access to oral health care, lopsided distribution of manpower, rickety health information systems, and private sector domination and inadequate or absent financing mechanisms for outpatient procedures. The private sector was dominant in all countries except Thailand and Srilanka. Financing was absent in most countries and deficient in Thailand and Indonesia. Dental workforce was deficient in most countries except India, Srilanka, and Thailand. Health information systems were weak with no dental items under price control. Better UHC indicators did not guarantee a lower oral disease burden.

CONCLUSIONS

Our review highlighted the close connection between service quality and human resources, governance, and finance. There is a need to establish standardised dental treatment guidelines that are uniformly adopted across countries, integrate oral health into national health and development programs, push for functional oral health research through collecting robust surveillance, economic, and social impact data and the development of cost-effective strategies tailored to each country's unique needs.

Bruns Garland Syndrome as the first presentation of type 2 diabetes: two case reports and a practical approach to diagnosis

BACKGROUND

Diabetes is a global health problem causing a significant burden on the healthcare systems both due to the disease itself and associated complications. Diabetic radiculoplexus neuropathies or Bruns-Garland syndrome constitutes a rare form of microvascular complications, more commonly affecting the lumbosacral plexus and, very rarely, the cervical plexus. We describe two Sri Lankan males who presented with diabetic lumbosacral radiculoplexus neuropathy and diabetic cervical radiculoplexus neuropathy as the initial manifestation of diabetes.

CASE DESCRIPTION

Case 1: a 49-year-old Sri Lankan hotel chef presented with subacute painful weakness and wasting of the left upper arm for 3 months and weight loss. Left upper limb proximal muscles were wasted with diminished power and reflexes. A nerve conduction study showed comparative amplitude reduction. An electromyogram revealed positive sharp waves, frequent fibrillations, and high amplitude polyphasic motor unit potentials with reduced recruitment in proximal muscles of left upper limb. Case-2: a 47-year-old Sri Lankan carpenter presented with subacute progressive asymmetrical painful weakness and wasting of bilateral thighs for 5 months and weight loss. Lower limb proximal muscles were wasted with reduced power and knee jerks. The nerve conduction study was normal. The electromyogram was similar to case 1 involving both quadratus femoris muscles, which was more prominent on the left side. The work up for an underlying etiology revealed only elevated fasting blood glucose and HbA1c, suggesting a new diagnosis of diabetes associated with neurological symptoms. Patient 1 was diagnosed with diabetic cervical radiculoplexus neuropathy and patient 2 with diabetic lumbosacral radiculoplexus neuropathy. Both showed significant improvement following optimization of glycemic control together with symptomatic treatment and physiotherapy.

CONCLUSION

Diagnosis of diabetic radiculoplexus neuropathy requires a comprehensive workup to rule out other sinister pathologies. This case report has a dual importance; it describes diabetic radiculoplexus neuropathy as the very first manifestation of two previously healthy people, giving rise to a new diagnosis of diabetes and, at the same time, reporting on diabetic cervical radiculoplexus neuropathy, which is extremely rare and has never been previously reported in Sri Lanka.

Monitoring of rainwater quality in Kandy and Peradeniya, Sri Lanka

The composition of atmospheric deposition is a measure of air quality, an important aspect of the health of the ecosystem. Consequently, continuous monitoring of atmospheric deposition is crucial to obtain remedial measures to avoid undesirable aspects that would affect living things. In this context, the objective of this study was to determine the rainwater quality at selected locations in Kandy and Peradeniya area of Sri Lanka, namely, Kandy, Polgolla, and University of Peradeniya (UOP), and to identify possible correlations between quality parameters through statistical means. Forty (40) rainwater samples from the UOP site and seven (07) samples each from the Kandy and Polgolla sites were collected from 18 May 2020 to 28 April 2021. The volume-weighted average (VWA) pH values of UOP, Kandy, and Polgolla sites were determined to be 7.44, 7.19, and 7.19, respectively, and moreover, acid rain (pH < 5.6) occurrences were not detected during the sampling period. The VWA values of rainfall, conductivity, salinity, TDS, and hardness at the UOP site were 40.12 mm, 51.93 μS cm-1, 0.0300 ppt, 26.59 mg L-1, and 13.55 mg L-1, respectively. The corresponding values of the Kandy site were 16.52 mm, 64.04 μS cm-1, 0.0361 ppt, 30.80 mg L-1, and 19.49 mg L-1, respectively; and those of the Polgolla site were 33.10 mm, 53.90 μS cm-1, 0.0310 ppt, 25.76 mg L-1, and 19.31 mg L-1, respectively. The VWA values of conductivity, salinity, and TDS were the highest at the Kandy site. Further, the VWA values of hardness at Kandy and Polgolla sites were approximately equal, probably due to the spring of Ca2+ and Mg2+ particulates from the dolomite quarry located in Digana area. The most prominent anion was identified as Cl- in bulk deposition at all three sites, while NO3- showed the lowest concentration of all sites. Moreover, very strong significant positive correlations were identified between conductivity-TDS, conductivity-salinity, conductivity-hardness, TDS-hardness, TDS-salinity, salinity-hardness, SO42--Cl-, and NO3--Cl- according to the relevant Pearson correlation coefficients. It is thus concluded that the pollutants come from the same sources, either natural or anthropogenic.

Variation of floristic diversity, community composition, endemism, and conservation status of tree species in tropical rainforests of Sri Lanka across a wide altitudinal gradient

Tropical rainforests in Sri Lanka are biodiversity hotspots, which are sensitive to anthropogenic disturbance and long-term climate change. We assessed the diversity, endemism and conservation status of these rainforests across a wide altitudinal range (100-2200 m above sea level) via a complete census of all trees having ≥ 10 cm diameter at breast height in ten one-hectare permanent sampling plots. The numbers of tree families, genera and species and community-scale tree diversity decreased with increasing altitude. Tree diversity, species richness and total basal area per ha across the altitudinal range were positively associated with long-term means of maximum temperature, annual rainfall and solar irradiance. Percentage of endangered species increased with increasing altitude and was positively associated with cumulative maximum soil water deficit, day-night temperature difference and high anthropogenic disturbance. Percentage of endemic species was greater in the lowland rainforests than in high-altitude montane forests. Nearly 85% of the species were recorded in three or less plots, which indicated substantial altitudinal differentiation in their distributions. Less than 10 individuals were recorded in 41% of the endemic species and 45% of the native species, which underlined the need for urgent conservation efforts across the whole altitudinal range.

Clinical characteristics and outcome of cardiac resynchronization therapy for heart failure in National Hospital of Sri Lanka from year 2005 to 2020 - a retrospective observational study

BACKGROUND

Cardiac resynchronization therapy (CRT) has been a well-established treatment modality for moderate to severe left ventricular systolic dysfunction with left ventricular desynchrony. This is the pioneering study that analyses the cohort who underwent CRT implantation at the National Hospital of Sri Lanka (NHSL) in Colombo from 2005 to 2020.

OBJECTIVES

This study was carried out to describe socio-demographic factors, improvements in clinical outcome (symptoms, electrocardiographic, and echocardiographic features), and post-CRT complications in the study population, as well as to determine the efficacy of CRT in heart failure.

METHOD

A retrospective observational study was conducted on all the living patients who had undergone CRT implantation from 2005 to 2020. The data was gathered from all the consented patients who visited the device programming clinic using a physician-administered questionnaire and clinical records. Data was analyzed using SPSS 25, and significant statistics were assessed with the McNemer test, the Student T test, and the Chi-Squared test.

RESULTS

The study included 50 patients with a mean age of 52.82+/- 11.66 years and female predominance (56%, n = 28). Idiopathic dilated cardiomyopathy (50%, n = 25) was the leading etiological factor, followed by ischemic cardiomyopathy (28%, n = 14). Clinical symptoms have improved significantly with CRT implantation (p < 0.001). A significant improvement was found in NYHA functional class (p < 0.001, 95% CI = 0.072 to 0.284), QRS width (p < 0.001, 95% CI = 0.229 to 0.534), ejection fraction (p < 0.001, 95% CI = - 16.437 to - 8.504), and LV EDD (p < 0.001, 95% CI = 2.89 to 9.24). Post-CRT complications included lead malfunction (6%, n = 3) and chronic (14%, n = 7), bleeding or hematoma (2%, n = 1), pocket erosion or infection (6%, n = 3), and infective endocarditis (2%, n = 1).

CONCLUSION

According to the study, CRT significantly improves both clinical and functional outcomes in patients with moderate to severe heart failure.

Factors impacting sustained coverage in the context of donor transitions: experience from Sri Lanka

Although not reliant on donor funding for health, the external assistance that Sri Lanka receives contributes to the improvement of the health system and health outcomes. In this study, we evaluated transition experiences of the expanded programme on immunization (EPI) that received Gavi funding to expand the vaccine portfolio and the Anti-Malaria Campaign (AMC) that received funding from the Global Fund for AIDS, Tuberculosis and Malaria to scale-up interventions to target and achieve malaria elimination. We assessed if EPI and AMC programmes were able to sustain coverage of previously donor-funded interventions post-transition and explain the facilitators and barriers that contribute to this. We used a mixed methods approach using quantitative data to assess coverage indicators and the financing mix of the health programmes and qualitative analysis guided by a framework informed by the Walt and Gilson policy triangle that brought together document review and in-depth interviews to identify facilitators and barriers to transition success. The EPI programme showed sustained coverage of Gavi-funded vaccines post-transition and the funding gap was bridged by mobilizing domestic financing facilitated by the Gavi co-financing mechanism, full integration within existing service delivery structures, well-established and favourable pharmaceutical procurement processes for the public sector and stewardship and financial advocacy by technically competent managers. Although the absence of indigenous cases of malaria since 2012 suggests overall programme success, the AMC showed mixed transition success in relation to its different programme components. Donor-supported programme components requiring mobilization of operational expenses, facilitated by early financial planning, were successfully transitioned (e.g. entomological and parasitological surveillance) given COVID-19-related constraints. Other key programme components, such as research, training, education and awareness that are dependent on non-operational expenses are lagging behind. Additionally, concerns of AMC's future financial sustainability within the current structure remain in the context of low malaria burden.

Fine-scale monitoring of insecticide resistance in Aedes aegypti (Diptera: Culicidae) from Sri Lanka and modeling the phenotypic resistance using rational approximation

BACKGROUND

The unplanned and intensified use of insecticides to control mosquito-borne diseases has led to an upsurge of resistance to commonly used insecticides. Aedes aegypti, the main vector of dengue, chikungunya, and Zika virus, is primarily controlled through the application of adulticides (pyrethroid insecticides) and larvicides (temephos). Fine spatial-scale analysis of resistance may reveal important resistance-related patterns, and the application of mathematical models to determine the phenotypic resistance status lessens the cost and usage of resources, thus resulting in an enhanced and successful control program.

METHODS

The phenotypic resistance for permethrin, deltamethrin, and malathion was monitored in the Ae. aegypti populations using the World Health Organization (WHO) adult bioassay method. Mosquitoes' resistance to permethrin and deltamethrin was evaluated for the commonly occurring base substitutions in the voltage-gated sodium channel (vgsc) gene. Rational functions were used to determine the relationship between the kdr alleles and the phenotypic resistant percentage of Ae. aegypti in Sri Lanka.

RESULTS

The results of the bioassays revealed highly resistant Ae. aegypti populations for the two pyrethroid insecticides (permethrin and deltamethrin) tested. All populations were susceptible to 5% malathion insecticide. The study also revealed high frequencies of C1534 and G1016 in all the populations studied. The highest haplotype frequency was detected for the haplotype CC/VV, followed by FC/VV and CC/VG. Of the seven models obtained, this study suggests the prediction models using rational approximation considering the C allele frequencies and the total of C, G, and P allele frequencies and phenotypic resistance as the best fits for the area concerned.

CONCLUSIONS

This is the first study to our knowledge to provide a model to predict phenotypic resistance using rational functions considering kdr alleles. The flexible nature of the rational functions has revealed the most suitable association among them. Thus, a general evaluation of kdr alleles prior to insecticide applications would unveil the phenotypic resistance percentage of the wild mosquito population. A site-specific strategy is recommended for monitoring resistance with a mathematical approach and management of insecticide applications for the vector population.

Title-molecular diagnostics of dystrophinopathies in Sri Lanka towards phenotype predictions: an insight from a South Asian resource limited setting

BACKGROUND

The phenotype of Duchenne muscular dystrophy (DMD) and Becker muscular dystrophy (BMD) patients is determined by the type of DMD gene variation, its location, effect on reading frame, and its size. The primary objective of this investigation was to determine the frequency and distribution of DMD gene variants (deletions/duplications) in Sri Lanka through the utilization of a combined approach involving multiplex polymerase chain reaction (mPCR) followed by Multiplex Ligation Dependent Probe Amplification (MLPA) and compare to the international literature. The current consensus is that MLPA is a labor efficient yet expensive technique for identifying deletions and duplications in the DMD gene.

METHODOLOGY

Genetic analysis was performed in a cohort of 236 clinically suspected pediatric and adult myopathy patients in Sri Lanka, using mPCR and MLPA. A comparative analysis was conducted between our findings and literature data.

RESULTS

In the entire patient cohort (n = 236), mPCR solely was able to identify deletions in the DMD gene in 131/236 patients (DMD-120, BMD-11). In the same cohort, MLPA confirmed deletions in 149/236 patients [DMD-138, BMD -11]. These findings suggest that mPCR has a detection rate of 95% (131/138) among all patients who received a diagnosis. The distal and proximal deletion hotspots for DMD were exons 45-55 and 6-15. Exon 45-60 identified as a novel in-frame variation hotspot. Exon 45-59 was a hotspot for BMD deletions. Comparisons with the international literature show significant variations observed in deletion and duplication frequencies in DMD gene across different populations.

CONCLUSION

DMD gene deletions and duplications are concentrated in exons 45-55 and 2-20 respectively, which match global variation hotspots. Disparities in deletion and duplication frequencies were observed when comparing our data to other Asian and Western populations. Identified a 95% deletion detection rate for mPCR, making it a viable initial molecular diagnostic approach for low-resource countries where MLPA could be used to evaluate negative mPCR cases and cases with ambiguous mutation borders. Our findings may have important implications in the early identification of DMD with limited resources in Sri Lanka and to develop tailored molecular diagnostic algorithms that are regional and population specific and easily implemented in resource limited settings.

Screening for antibacterial and cytotoxic activities of Sri Lankan marine sponges through microfractionation: Isolation of bromopyrrole alkaloids from Stylissa massa

Sri Lanka is a biodiversity hotspot and one of the richest geographical locations of marine sponges in the Indian ocean. However, the most extensive taxonomical study on Sri Lankan sponge biodiversity dates back ~100 years and only a limited number of studies have been conducted on sponge natural products. In the current study, 35 marine sponge specimens (collected from 16 sponge habitats around Sri Lanka) were identified, microfractionated and evaluated for antibacterial and anticancer assays. In total, 30 species were characterized, of which 19 species gave extracts with antibacterial and/or cytotoxic activities. Microfractionated organic extract of Aciculites orientalis gave the most potent antibacterial activity against Staphylococcus aureus and strongest lymphoma cell toxicity was exhibited by the organic extract of Acanthella sp. Guided by the molecular ion peaks in the bioactive fractions, large-scale extraction of Stylissa massa led to the isolation of three bromopyrrole alkaloids, sceptrin, hymenin and manzacidin A/C. Of these, sceptrin exhibited broad spectrum antibacterial activity against both Escherichia coli and S. aureus (MIC of 62.5 μM against both species). Based on natural product literature, seven promising species were identified as understudied. Their further exploration may lead to the discovery of structurally novel compounds.

The mechanical failure of locally manufactured prosthetic feet from the Jaffna Jaipur Centre for Disability Rehabilitation (JJCDR), Sri Lanka

BACKGROUND

The International Organization for Standardization (ISO) 10328 standards are used to verify the safety of lower limb prosthetic devices. However, the ISO 10328 tests are performed in sterile laboratory settings and do not account for environmental or sociocultural factors associated with prosthetic use. Most locally manufactured prosthetic feet from low-income and middle-income countries, which are safely used for years, do not meet these standards. In this study, we investigate the modes of wear patterns of naturally worn prosthetic feet from Sri Lanka.

OBJECTIVE

To characterize wear patterns of locally manufactured prosthetic feet from low-income and middle-income countries.

METHODS

Sixty-six replaced prosthetic feet from the Jaffna Jaipur Center of Disability and Rehabilitation were analyzed. Delamination between the keel and rest of the foot could not be detected with ultrasound. Sole wear pattern was quantified by photographing soles and dividing them into 200 rectangles and scoring the rectangle's wear from 1 to 9 (no to extreme wear). Homologous scores were averaged to create a contour map of prosthetic foot wear.

RESULTS

The highest levels of wear occurred at the heel, end of the keel, and the perimeter of the prosthetic foot. All regions of the prosthetic feet had significantly different wear scores ( p < 0.005).

CONCLUSIONS

Locally manufactured solid ankle cushion heel feet display high levels of wear in localized areas of the sole of prosthetic feet, which can limit their life span. High levels of wear occur at the end of the keel, which would not be detectable in the ISO 10328 tests.

Healthy lifestyle practices: Evidence from clinic attending mothers in the northern province, Sri Lanka

Healthy lifestyles are known to reduce noncommunicable disease-related mortalities and morbidities. Public health initiatives should encourage healthier lifestyles to prevent the risk of noncommunicable diseases. This study aimed to determine healthy lifestyle practices and their associated factors among clinic-attending mothers (mothers attending antenatal clinics, postnatal clinics, well-baby clinics, family planning clinics, well-women clinics, and polyclinics) in the Chavakachcheri Medical Officer of Health (MOH) area. We conducted a clinic-based cross-sectional study in 19 centers covering 28 Public Health Midwives (PHM) areas. Healthy lifestyle practices, such as regular exercise, consumption of recommended servings of fruits and vegetables, measuring their own BMI, and average salt consumption, were poor. In the multivariate analysis, we found only three factors that had higher odds of affecting healthy lifestyle practices that were statistically significant: attributes of higher level of perceptions about healthy lifestyle practices (AOR = 4.36, 1.32-14.39), participating in Mothers' Support Groups (AOR = 7.97, 2.17-29.27) and BMI value of < 23 kg/m2 (AOR = 4.47, 1.35-14.73). Effective targeted healthy lifestyle-related educational programs instead of regular training during clinic visits and promoting participation in peer groups at the community level may benefit clinic-attending mothers.

A short report on a preliminary interventional study to evaluate play-mediated interaction skills in caregivers of children with autism spectrum disorder from Sri Lanka

LAY ABSTRACT

Most children with autism spectrum disorder live in low- and middle-income countries. Most of them do not have access to timely and culturally acceptable interventions. Research from high-income countries and low- and middle-income countries, such as Sri Lanka, show that parent-mediated intervention programmes improve functional outcomes, highlighting the importance of parents as partners. We undertook a preliminary study to evaluate how play-based parent coaching will enhance the parent interaction skills to promote social-emotional, cognitive and language skills in children with autism spectrum disorder aged 2-4 years. We evaluated how parents acquire interaction skills to engage with children using a caregiver skills assessment checklist adapted from freely accessible resources. Before and after training, all parent-child dyads participated in a 10-min video-recorded play session with a set of toys of their choice. Over the course of 2 weeks, all parents spent 2 h/day playing and interacting with the child to harness the desired skills. The results showed that the parental training had a positive effect on all 30 caregivers in gaining skills, with a significant improvement in all three domains with the highest impact on skills for social-emotional development. Overall, parents reported high levels of satisfaction on the training. The significant improvement in parent interaction skills was promising. However, further studies to look at the sustainability of the skills and the impact on children's overall development need to be looked into using larger and more generalised studies.

Fiscal policies and regulations for healthy diets in Sri Lanka: an analysis of the political economy of taxation and traffic light labelling for sugar-sweetened beverages

BACKGROUND

Unhealthy dietary patterns significantly contribute to rising non-communicable diseases (NCDs) in Sri Lanka. The government has implemented policy measures to promote healthy dietary patterns, including the traffic light labelling (TLL) system for sugar-sweetened beverages (SSBs) in 2016 and taxation on SSBs in 2017.

OBJECTIVES

To analyse how ideas, institutions, and power dynamics influence the formulation and implementation of these two interventions, and to identify strategies for public health actors to advocate for more effective food environment policies in Sri Lanka.

METHODS

This study drew on Kingdon's theory of agenda-setting and Campbell's institutionalist approach to develop the theoretical framework. We examined the political economy at the policy development and implementation stages, adopting a deductive framework approach for data collection and analysis. Data were collected from documents and key informants.

RESULTS

NCDs and nutrition are recognised and framed as important policy issues in health-sector policy documents, and the SSB tax and TLL system are seen as means of improving diets and health. Sri Lanka's commitment to addressing NCDs and nutrition-related issues is evident through these policies. The Ministry of Health led policy development, and key stakeholders were involved. However, there are opportunities to learn and strengthen policy in Sri Lanka and elsewhere. Limited involvement and commitment of some stakeholders in developing national policies, industry interferences, and other gaps resulted in weaker policy design. Gender considerations were also given minimal attention in policy formulation and implementation.

CONCLUSIONS

To enhance the effectiveness of the policies and regulations to promote healthy diets in Sri Lanka, comprehensive policy coverage, multistakeholder involvement and commitment to national policies, balanced power dynamics, technical feasibility, government commitment backed with high-level political support, awareness, and knowledge creation, managing industry interferences, integrating gender considerations are crucial factors.

Genetic diversity and phylogeography of Phlebotomus argentipes (Diptera: Psychodidae, Phlebotominae), using COI and ND4 mitochondrial gene sequences

BACKGROUND

Phlebotomus argentipes complex is the primary vector for cutaneous leishmaniasis, a burgeoning health concern in contemporary Sri Lanka, where effective vector control is important for proper disease management. Understanding the genetic diversity of the P. argentipes population in Sri Lanka is vital before implementing a successful vector control program. Various studies have indicated that genetic divergence, caused by genetic drift or selection, can significantly influence the vector capacity of arthropod species. To devise innovative control strategies for P. argentipes, exploring genetic diversity and phylogeography can offer valuable insights into vector competence, key genetic trait transfer, and impact on disease epidemiology. The primary objective is to analyze the genetic diversity and phylogeography of the P. argentipes complex in Sri Lanka, based on two mitochondrial genomic regions in modern representatives of P. argentipes populations.

METHODOLOGY

A total of 159 P. argentipes specimens were collected from five endemic areas of cutaneous leishmaniasis and identified morphologically. Two mitochondrial regions (Cytochrome c oxidase subunit I (COI) and NADH dehydrogenase subunit 4 (ND4) were amplified using the total DNA and subsequently sequenced. Partial sequences of those mitochondrial genes were utilized to analyze genetic diversity indices and to explore phylogenetic and phylogeographic relationships.

PRINCIPAL FINDINGS

Among five sampling locations, the highest genetic diversity for COI and ND4 was observed in Hambantota (Hd-0.749, π-0.00417) and Medirigiriya (Hd-0.977, π-0.01055), respectively. Phylogeographic analyses conducted using COI sequences and GenBank retrieved sequences demonstrated a significant divergence of P. argentipes haplotypes found in Sri Lanka. Results revealed that they have evolved from the Indian ancestral haplotype due to historical- geographical connections of the Indian subcontinent with Sri Lanka.

CONCLUSIONS

Utilizing high-mutation-rate mitochondrial genes, such as ND4, can enhance the accuracy of genetic variability analysis in P. argentipes populations in Sri Lanka. The phylogeographical analysis of COI gene markers in this study provides insights into the historical geographical relationship between India and P. argentipes in Sri Lanka. Both COI and ND4 genes exhibited consistent genetic homogeneity in P. argentipes in Sri Lanka, suggesting minimal impact on gene flow. This homogeneity also implies the potential for horizontal gene transfer across populations, facilitating the transmission of genes associated with traits like insecticide resistance. This dynamic undermines disease control efforts reliant on vector control strategies.

Effect of Temperature Humidity Index (THI) on resting pattern of dairy cows in different regions of Sri Lanka

The ability to spend time resting is extremely important for dairy cattle welfare. Through this study, lying behaviour of dairy cows in to Up-Country (UP), Mid-Country (MC), Coconut-Triangle (CT) and Western-Province (WP) of Sri Lanka was studied to get an insight into their resting pattern. Resting pattern was assessed in 170 Holstein-Friesian/ Jersey crossed, tie-stalled lactating cows (UP = 49, MC = 49, CT = 48 and WP = 24) using electronic data loggers. Appropriate resting behaviours were attained in UP and MC regions, with longer lying time (11.7, 11.3 h/day) and lying bout durations (78.0, 84.9 min) respectively, where lower THI ranges were observed compared to other regions. WP and CT resulted with lower lying times (9.00, 9.26 h/day) and lying bout durations (48.3, 64.3 min) respectively with higher THI. There is a slight variation of the environmental temperature of each region with the time period of experiment. Cows in all regions prefer to lie on their left side (UP-6.1, MC-6.1, CT-4.4, WP-4.7 h/d) and with significant differences (P<0.05) between MC-WP, MC-CT, UP-CT and UP-WP. A negative significant (P<0.05) correlation was observed between THI and lying behaviours. There were significant effects of time (hour) and time × region interaction (P<0.05) on the lying down pattern. More lying down was observed in late night and early morning with a peak rest around the hours of 21:00-05:00. Overall, according to the results of the current study, the existing environmental conditions of four regions affected the resting pattern of dairy cows and, identification of possible mechanisms to modify the environment to enhance cow comfort is vital.

Factors affecting job performance of Sri Lankan IT professionals working from home

This study investigated the influence of the physical work environment, work life balance, work flexibility, and effective communication on the job performance of IT professionals in Sri Lanka's IT industry who work from home (WFH). A standard questionnaire was used to collect data from 293 IT specialists in 50 different IT organizations in Sri Lanka, and a stepwise probit model was employed for data analysis. According to the findings, both the physical work environment and work life balance had a significantly positive effect on job performance. A one-unit increase in the physical work environment and work life balance increased the likelihood of high job performance by 0.21% and 0.19%, respectively. In contrast, work flexibility had a negative effect on job performance, with an increase of one unit resulting in a 0.18% decrease in the likelihood of high job performance. The positive impact of effective communication on job performance was less significant. The study emphasises the significance of providing a conducive work environment and promoting work life balance to enhance the job performance of IT professionals in Sri Lanka's IT industry who WFH.

Plasmodium ovale infection in Sri Lanka: distant exposure and incidental detection of hyperparasitemia: a case report

BACKGROUND

Plasmodium ovale malaria, which was previously endemic to tropical Africa and the Southwest Pacific islands is now being reported from parts of Asia. In Sri Lanka, the indigenous transmission of malaria has not been documented since October 2012. Since then, there have been several imported cases of malaria, including P. ovale, which have been detected sporadically. The reporting case of P. ovale was imported and detected incidentally in 2021, with several atypical presentations.

CASE PRESENTATION

A 40-year-old Sri Lankan medical doctor developed continuous fever with chills, rigors, and dysuria a day following removal of a large lipoma at the root of the neck under general anaesthesia. When the fever has been responding to antibiotics, on the 4th postoperative day a mild thrombocytopenia on complete blood count was detected. A blood smear which was done on the 5th postoperative day incidentally found a malaria parasite and confirmed as Plasmodium ovale with a density of 6535 parasites/microliter on the same day. He never had malaria in the past, but he had worked in South Sudan 1 year ago and visited India six months ago. On the 6th postoperative day, he was treated with chloroquine, and hyperparasitemia reduced rapidly by the next day. As the fever recurred with clinical deterioration, he was treated with different antibiotics. During the course of the illness, he did not develop pallor, or icterus except for a palpable soft spleen. The parasite count was zero on the 9th postoperative day and his fever subsided on the next day. Further, he was treated with primaquine to prevent future relapse and transmission.

CONCLUSION

A long incubation period, incidental detection of P ovale in a blood smear, and hyperparasitaemia are the atypical presentations of this case. Postoperative bacterial infection and stress may have reactivated the dormant malaria (hyponozoites) in this patient with an unusual picture. Coinfection of malaria with bacterial sepsis is a challenge in the management of the patient. As the Anopheles mosquito vector exists in Sri Lanka, the risk of indigenous transmission is high from such imported cases of P. ovale.

Knowledge and practice of infection control during radiology procedures among radiography undergraduates in Sri Lanka

INTRODUCTION

Sufficient knowledge and adherence to infection control measures are essential for healthcare workers to effectively combat healthcare-associated infections (HCAIs). Radiography undergraduates should stay updated and proficient in their infection control practice. This study aimed to assess knowledge and practice of infection control measures during radiological procedures among radiography undergraduates in Sri Lanka.

METHOD

A web-based, descriptive, self-administered, cross-sectional study was conducted. The questionnaire collected data on demographic, knowledge and practice related to infection control measures from radiography undergraduates.

RESULTS

A total of 167 radiography undergraduates returned the completed questionnaire. The majority (88%) have never participated in infection control programs. The mean knowledge and practice scores were 58% and 41.1%, indicating moderate and poor levels, respectively. A significant difference was observed in the overall knowledge of infection control when considering the academic year (p = 0.001) and the duration of clinical exposure (p = 0.01). There was no significant difference between practice and gender, age, ethnicity, academic year and duration of clinical exposure (p > 0.05).

CONCLUSIONS

The results of this study indicate that knowledge of nosocomial infection was moderate and practice was inadequate among most of the radiography students surveyed. This highlights the need to reassess the educational components of radiography programs to incorporate practical and comprehensive teaching, learning and monitoring of infection control measures.

Polyphyly of the Dinurinae Looss, 1907 (Digenea: Hemiuridae) and resurrection of the Mecoderinae Skrjabin & Guschanskaja, 1954 based on novel collection of Tubulovesicula laticaudi Parukhin, 1969 from marine elapid snakes in Sri Lanka

With one exception, the only known hemiurid trematodes that do not use teleost fishes as definitive hosts instead occur in marine elapid snakes. These comprise six species across four genera and three subfamilies, and so presumably indicate at least three independent invasions of marine snakes from teleost fishes. Here, one of these taxa, Tubulovesicula laticaudi Parukhin, 1969 (= T. orientalis Chattopadhyaya, 1970 n. syn.) is reported from Sri Lanka, collected from Shaw's sea snake Hydrophis curtus (Shaw) (Elapidae: Hydrophiinae: Hydrophinii), the annulated sea snake H. cyanocinctus Daudin and the yellow sea snake H. spiralis (Shaw) off Nayaru in the Bay of Bengal, and from H. spiralis in Portugal Bay, Gulf of Mannar. Novel molecular data, for COI mtDNA and ITS2 and 28S rDNA, are the first for a species of Tubulovesicula Yamaguti, 1934. Nominally, Tubulovesicula belongs in the Dinurinae Looss, 1907, but in phylogenetic analyses based on 28S rDNA, our sequences for T. laticaudi resolved relatively distant from that for representatives of Dinurus Looss, 1907, the type-genus, rendering the subfamily polyphyletic. Tubulovesicula laticaudi resolved closest to data for the type-species of the Plerurinae Gibson & Bray, 1979, but that subfamily is also polyphyletic. These findings lead us to re-evaluate an alternative classification considered by Gibson & Bray (1979). We propose restricting the Dinurinae for forms with a permanent sinus-organ (Dinurus, Ectenurus Looss, 1907; Erilepturus Woolcock, 1935; Paradinurus Vigueras, 1958; Qadriana Bilqees, 1971) and resurrect the Mecoderinae Skrjabin & Guschanskaja, 1954 for forms with a temporary sinus-organ (Mecoderus Manter, 1940, Allostomachicola Yamaguti, 1958, Stomachicola Yamaguti, 1934 and Tubulovesicula).