Research Symposium, "ENHANCING THE QUALITY OF HEALTHCARE DELIVERY VIA PRECISION MEDICINE IN INDUSTRY 5.0; CONTRIBUTION OF MEDICAL LABORATORY PROFESSIONALS” by CMLS.SL

Annual Scientific Sessions 2020

College of Medical Laboratory Science, Sri Lanka (CMLS.SL)

On February 13, 2020

"ENHANCING THE QUALITY OF HEALTHCARE DELIVERY

VIA PRECISION MEDICINE IN INDUSTRY 5.0;

CONTRIBUTION OF 

MEDICAL LABORATORY PROFESSIONALS”

Ravi Kumudesh
President, CMLS.SL

Medical Laboratory Science has undergone a substantial revolution in recent years, wherein the traditional approach to diagnosing and treating many human diseases has gradually evolved from a generalized conception of health and disease to an individualized approach entailing decisions and interventions tailored to the single patient according to individual responses or risk of disease.

This axiom has evolved from concept to practice, and has been translated into the notion of “precision” or “personalized” medicine. Although personalized or precision medicine will be the core opportunity for effective care in the anticipatable future, many political, economic and cultural challenges need to be overwhelmed, and these include some ongoing healthcare reforms around the globe, cost containment strategies, consolidation of laboratories and in vitro diagnostic testing, as well as the impact of new technologies and tests on the existing laboratory organization.

Annual Scientific Sessions – 2020 of CMLS.SL and Lab Expo 2020 will offer a highly dynamic scientific program stimulating laboratory professionals and offer a great opportunity to discuss emerging issues and cutting-edge techniques coming from the field of Clinical Chemistry and Laboratory Medicine to enhance the laboratory process towards a quality healthcare delivery through precision medicine in industry 5.0.

The aim of this conference is to empower medical laboratory professionals on changes which may ultimately drive or challenge the future of laboratory medicine in the era of precision medicine towards future landscape of medical laboratories.

It is with great pleasure we welcome you to the Annual Scientific Session – 2020 of the College of Medical Laboratory Science Sri Lanka (CMLS.SL) and Lab Expo 2020 at Sri Lanka Exhibition and Convention Centre, Colombo, Sri Lanka.

Session I

Research Symposium

Review Panel  

Prof. S.S. Neluka Fernando

Senior Professor

Faculty of Medical Sciences

University of Sri Jayawardanapura

Prof. Gamini De Alwis

Emeritus Professor in Management

University of Colombo

BA (SriJ) MPA (SriJ) M.Sc.in Psychology (CMB) PhD (UK)

Dr. Lal Panapitiya

Deputy Director General (Medical Services)

Ministry of Health Sri Lanka

MBBS / MSc / MD (Medical Administration and Management

Dr. Rohitha Muthugala

Consultant Clinical Virologist 

In-charge of Regional Clinical Virology Laboratory

Doctoral degree in Medical Virology

Board certification as a specialist in Medical Virology

Mrs. Kamani Mathotaarachchi

Senior Lecturer at University of Colombo

Head, Service Management Program

Institute of Human Resource Advancement

University of Colombo

Ms. Prabhani Pushpamalie

MSc. in Molecular Medicine

MSc in Service Management

BMLS (Hons) / BSc in Biology

Ex. Dip in Service Management

Diploma in Medical Laboratory Technology,

Oral Presentations

1. Effect of quality and quantity of human DNA extracted from forensic hair samples for successful PCR amplification by I.S.S.Dayarathna, B.A.G.A.S.Batugedara, R.J.Illeperuma, K.P.D.Tharaka, and H.M.S.P.Herath (Department of Medical Laboratory Sciences, Faculty of health sciences, Open University of Sri Lanka, GENE TECH molecular diagnostic and school of gene technology)

2. Screening for Thalassaemia traits, blood groups and the prior knowledge about Thalassaemia among students of Haputale Dammananda Maha Vidyalaya by C. P. U . Arachchi, N. Y. R. Fernando, W. T. D. T. Dayani, U. P. N. Perera and H. D. D. Batapola (School of Medical Laboratory Technologists, National Institute of Health Sciences, Kalutara)

3. A study on cost optimization in state sector hospital laboratories of Sri Lanka by Panapiya P.W.C, Kumudesh R., Pushpamalie E.K.P. (Ministry of Health & Indigenous Medicine Sri Lanka, National Hospital of Sri Lanka)

4. Learning Experience of Medical Laboratory Students towards a Self-study E-Learning resource Preliminary Study by C. Jayawardena, R. Thamara, P. Jayasooriya, R. Illeperuma (Faculty of Dental Sciences, University of Peradeniya, Allied Health Sciences University of Peradeniya)

5. Comparison of urine dipstick and sulphosalicylic acid (SSA) methods with pyrogallol dye binding methods for detection of urine proteins by P. Vijekanthan, SPDEJ Appuhami, WKTD Weerasekara, RMLP Dahanayake, EMS Bandara, BKTP Dayanath. (Colombo North Teaching Hospital, Ragama, Sri Lanka1, District General Hospital, Negombo, Sri Lanka2, Police Hospital, Narahenpita, Sri Lanka3, Department of Allied Health Sciences, Faculty of Medical Sciences, University of Sri Jayawardenepura, Sri Lanka)

6. The burden of Dengue infection and circulating serotypes in the Western and Southern coastal regions in Sri Lanka by Chathuranga GAL, Withanage WNL, Pathirana GK, Gomes L, Ranadeva ND, Jeewandara C, Malavige GN (Department of Biomedical Science, KIU, Ba􀀻aramulla, Sri Lanka, Centre for Dengue Research, Faculty of Medical Sciences, University of Sri Jayewardenepura)

7. Correlation among Fating Plasma Glucose, Creatinine and Urinary Micro albumin of type 2 Diabetics attending Diabetic Center, Teaching Hospital, Jaffna by Ruwanpathirana, R. P. E, Kandeepan, K. and Arasaratnam, V. (Unit of Allied Health Sciences, Faculty of Medicine, University of Jaffna, Department of Biochemistry, Faculty of Medicine, University of Jaffna)

8. Association between direct LDL, Apo A and Apo B with traditional serum Lipid parameters of people who are attending a tertiary care Hospital by R. R. N. Rajapaksha , W. P. A. Prabhashini, V. S. Sandaruwan, C. J. Kumarapeli, B.K.T.P.Dayanath and E.M.S. Bandara (Open University of Sri Lanka, Department of Bio chemistry, NCTH of Sri Lanka)

9. In vitro An􀀤oxidant and Anti -inflammatory properties of garcinia Cambogia, curcuma longa and sesame oil by Chamikara LHV, Sajitha MLF, Siriwardhene MA (Faculty of Medical Sciences, Department of Allied Health Sciences, University of Sri Jayawardanapura)

10. Detection of Blood Group A1 Using Dolichosbiflorus Antigen A1-Detection Lecithin Extraction, Purified by Ammonium Sulfate Precipitation Method by Basura Gunaratne, Buddini Manulika, Kasun Perera, Darshana Kottahachchi , K.K.S. Kuruppu (Faculty of Allied Health Sciences, General Sir John Kotelawala Defence University; National Blood Transfusion Service, Colombo 05)

11. Serum Interleukin-6, high sensitivity C-Reactive Protein levels and related risk factors in patients undergoing discectomy following cervical / lumbar disc hernia by M.F. Imrana, H.G.R. Priyankara (Faculty of Medical Sciences through the department of Allied Health Sciences at University of Sri Jayewardenepura, Sri Lanka)

12. Correlation of Salivary α- Amylase activity Vs Severity of Stress and Anxiety among Medical Laboratory Technology Trainees during Clinical Laboratory Assessment by T.J.Silva, K.K.U.H.N. Abhayarathne (Department of Medical Laboratory Sciences, Open University of Sri Lanka)

Research Committee

Mr. Dhanushka Lalinda

Mr. Mohomed Shafeek

Mr. Lesantha Chathuranga

Mr. LGT. Dharshana

Mr. EMS. Bandara

Mr. Isuru Namal

Mr. Sanduni Ekenayake

Mr. Manoj Weerathunga

Ms. Dhanushki Gunawardana

Mr. Mohomed Sakoor
Mr. Mohomed Inthusham

Organizing Committee

Mr. Dhanushka Lalinda

Mr. Lesantha Chathuranga

Mr. Asanka Ruwan Sagara

Mr. NM Shafeek 
Mr. Rangika Priyantha

Ms. Sanduni Ekenayake

Mr. Rajith Priyankara Gamage
Mr. Sumil Anupama Lowe 

Mr. Mahesh Epitakumbura
Mr. Sanjeewa Sirimanna

Mr. Gayan Prabhash
Ms. Buddhi Kottahachchi 

CMLS.SL Founder Members

Mr. Ravi Kumudesh
Ms. Prabhani Pushpamali 

Mr. Keerthi Wickramarathne 

Mr. N. M. Shafeek
Mr. Sanjeewa Sirimanna
Mr. Udara Sandakelum
Mr. Asanka Ruwan Sagara
Mr. Mohan Premarathne
Mr. Saman Kodikara
Mr. B. Anandaraja
Mr. B. M. Randika Wimalasiri

Mr. R. A. N. D. Danapala
Mr. Sumil Anupama Lowe
Mr. Udaya Sahabandu
Mr. S. L. A. P. Suraweera
MI. P. Vij ekanthan
Mr. Lesantha Chathuranga
Mr. Keerthi Sapukotana
Mr. H. Weerawama
Mr. Dilanga Marasinghe
Ms. Buddhi Kottahachchi
Mr. Janaka Udara 

Ms. Chandima Mallawa
Mr. Pradeep Jayasinghe 

Mr. Pradeep Madushanka 

Mr. Mahesh Neththikumara 

Mr. R. Janagan
Mr. S. Ravishanker
Mr. J anitha Karunarathne 

Mr. H. S. D. Fernando
Mr. P. H. R. Priyantha
Mr. L. L. Sirisena
Mr. Chamil Gimhan Fernando 

Mr. Mahesh Epitakumbura 

Mr. Damitha Nanayakkara 

Ms. Darshika Premarathne 

Ms. Nalini Kamburapolage 

Ms. Luxmi Rathnamala 

Mr. Y. V. Kandambi
Mr. Gamini Pathirana
Mr. Jagath Kumara
Mr. Piyathilak Kalubowil 

Mr. Thusitha Senaviratne
Mr. Aruna Priyadarshana .
Mr. Sameera Jayawardana.
Mr. Chaminda Karunaratne

Effect of quality and quantity of human DNA extracted from forensic hair samples for successful PCR amplication

I.S.S.Dayarathna¹, B.A.G.A.S.Batugedara¹, R.J.Illeperuma², K.P.D.Tharaka², H.M.S.P.Herath¹¹

(¹Department of Medical Laboratory Sciences, Faculty of health sciences, Open university of Srilanka, ²

GENETECH molecular diagnostic and school of gene technology)

dayarathnamlt22@gmail.com

Introduction:

Introduction of PCR to the Forensic Science has signicantly expanded the ability to analyse DNA from small and degraded biological samples. Forensic hair plays an important role in identifying individuals during criminal investigations. Since the amount of DNA present in hair samples are less, PCR has been frequently unsuccessful.

Objectives:

To identify the causes for failure of PCR amplication of DNA in forensic hair samples and to nd a possible solution to overcome the problem.

Methods:

Study consisted of 443 hair samples which were analyzed as DNA forensic evidence at GENETECH Colombo. Qualitative and quantitative data on the hair samples and the ability to give a positive result in PCR were assessed. A comparative analysis of a set of samples was incorporated in order to suggest a better analysis method.

Results:

The results showed that extracts from hair with root contained 6.44 ng/µL of DNA and they produced a rate of 31.8% of successful PCR amplication while hair without root contained 8.47ng/µL of DNA, but produced only 18.0% rate of successful PCR amplication. There were no signicant associations between the amount of DNA (p=0.433), quality of DNA on the positivity of PCR. An increase in the number of PCR cycles caused an increase in the success rate to get a positive PCR by 16.67%. All together these results concluded that the amount of DNA in hair samples and quality of the extracted samples does not affected for the success rate of PCR amplication.

Conclusions:

The failure rate of PCR amplication of DNA from forensic hair can be overcome by increasing the number of amplication cycles in the PCR procedure.

Key words: Forensic hair, Deoxyribonucleic Acid, Polymerase Chain Reaction.

Screening for Thalassaemia traits, Blood Groups and the prior knowledge about Thalassaemia among students of Haputale Dammananda Maha Vidyalaya

C. P. U . Arachchi^1*, N. Y. R. Fernando¹, W. T. D. T. Dayani¹, U. P. N. Perera¹ and H. D. D. Batapola¹

¹School of Medical Laboratory Technologists, National Institute of Health Sciences, Kalutara

arachchi1974@gmail.com

Introduction:

Thalassaemias are a group of heterogeneous genetic disorders with the reduced or absent synthesis of globin chains in the haemoglobin. Beta thalassaemia major is sympotomatic and patient is transfusion dependent. A marriage of two thalassaemia trait individuals could lead to a birth of thalassaemia major child. In Sri Lanka, the disease is mainly spread out in certain districts such as Kurunagala, Puttalam, Badulla and Hambanthota. Diagnosis of thalassaemia trait patients is important for the prevention of the marriage between thalassaemia trait individuals in order to prevent the birth of a thalassaemia major children.

Objectives:

The study aimed to screen for the thalassaemia traits and blood group among the students of Grade 6 to Grade 13 at Haputhale Dammananda Maha Vidyalaya and to measure their knowledge about thalassaemia.

Methods:

All the students from grade 6 to Grade 13 were screened for the thalassaemia trait using one tube osmotic fragility test and their knowledge about thalassaemia was measured by using a questionnaire. Blood groups of the students were performed using the slide method.

Results:

Among 112 students, 4 (50% male, 50% female) were identied as thalassaemia trait positive (3.6%). Only a minority (9.8%, n=11) had the prior knowledge about thalassaemia while 90.8% (n=101) did not. Majority of students were blood group “O” (41.9%) and 22.3% group A, 29.5 % group B while only 5.4 % had group AB. Rhesus negative blood group (1.8%, all male) while others had Rhesus positive blood group (97.3%). Among thalassaemia traits, 75% was Blood group “B” Positive while 25% was blood group O Positive.

Conclusions:

Noteworthy amount of thalassaemia trait students were identied by the present study and extensive screening of the population is needed in the area for further clarication. The knowledge about thalassaemia among the school children needs to be improved using the health education systems.

Key words: Thalassaemia trait, Blood Groups, health education

Comparison of urine dipstick and sulphosalicylic acid (SSA) methods with pyrogallol dye binding methods for detection of urine proteins

P. Vijekanthan ¹, SPDEJ Appuhami ², WKTD Weerasekara ¹, RMLP Dahanayake ³, EMS Bandara ⁴, BKTP Dayanath ¹

(¹Colombo North Teaching Hospital, Ragama, Sri Lanka, ²District General Hospital, Negombo, Sri Lanka, ³Police Hospital, Narahenpita, Sri Lanka, ⁴Department of Allied Health Sciences, Faculty of Medical Sciences, University of Sri Jayawardenepura, Sri Lanka)

pvijekanthan@yahoo.com

Introduction:

The presence of trace amount of protein in urine is an early sign of renal damage. Kidney diseases often have no early symptoms hence detection of proteinuria helps to detect kidney diseases. Moreover it is a screening test for assessment of kidney status.

Objectives:

To evaluate the accuracy of ve brands of dipstick methods and Sulphosalilic Turbidometric method compared to dye binding method in urine protein measurement.

Methods:

Cross sectional study using 164 urine samples of Patients referred to OPD lab, CNTH, Ragama . Analysis was done by using Dipstick, 3 % SSA method and Pyrogallol method. The results were compared..

Results:

Out of 164 samples, 89 samples gave same results when they were tested by each dipstick brand - 54 %. Specicity of ve brands of dipstick gave 89 – 100%. Trace results showed low performance 22% - 55% by ve brands of dipstick. Dipsticks showed ≥ 3+ protein levels which is less sensitive - 50%. Best sensitivity range was 2+ in dipstick method.

Conclusions:

Urine dipstick method is not reliable in detecting of trace amounts of urinary proteins. Measuring ≥ 3+ protein level and trace level by dipsticks, is less sensitive. The sensitivity of urine dipstick was varying in each brand. SSA method had a moderate sensitivity compared to the urine dipstick method in majority of urine protein levels, except +2 which had a high sensitivity.

Key words: Urine proteins, dipstick, sulphosalicylic acid, pyrogallol dye

Learning Experience of Medical Laboratory Students towards a Self-study e-Learning resource -Preliminary Study

C. Jayawardena¹, R. Thamara², P. Jayasooriya¹, R. Illeperuma²

(Faculty of Dental Sciences, University of Peradeniya. Allied Health Sciences University of Peradeniya.)

ruvinitd@gmail.com

Introduction:

E-learning resources have been popularized as a self-learning tool. Acceptances of E-learning resources by students are inuenced by several factors such as students learning approaches, and quality of the learning resource.

Objectives:

To investigate the learning approaches and perception towards E-learning resources among Medical Laboratory Science (MLS) students

Methods:

Revised two Factor Study Process with pre-test and post-test questionnaires were used for investigation

of learning approaches using fty-one MLS students.

Results:

Mean scores for surface approach (SA) and deep approach (DA) were 31.26±6.2 and 23.41±5.9 respectively. The DA score is higher than their SA score in majority of students (n=78.4%). A signicant difference (p=0.00) in the mean scores of pretest and post tests were observed. Students who showed a greater DA score than their SA score received a higher posttest score ( 73.1±13.0 ) than that of the students who showed a greater SA score than their DA score (68.9±12.8) although the difference was not statistically signicant. The majority of students (98%) agreed the statement that “the E-learning resource was interesting and it motivated them to study the subject”. Many students (67%) disagreed with the statements that “the subject matter was boring and that they could get more knowledge and better understanding by reading a book on the same subject”. Video components were the most interesting part for many students; while the most boring part was the reading text material.

Conclusions:

Results indicated that E-learning resource used within a limited time signicantly improved the knowledge of preparation of microscopic slides among students irrespective of the type of learning approaches.

Key words: e-Learning, Surface approach, Deep approach

A study on cost optimization in state sector hospital laboratories of sri lanka

Panapitiya P.W.C.¹, Kumudesh R.², Pushpamalie E.K.P. ²

1	2	,
Ministry of Health & Indigenous Medicine Sri Lanka	, National Hospital of Sri Lanka
kumudeshr@gmail.com

Introduction:

It is observed that there's a vast discrepancy in the cost per test of the biochemistry analytics of the same test parameters, in the In-vitro diagnostic (IVD) market of Sri Lanka. Hence, the most commonly tested ve parameters (Glucose, Cholesterol, Creatinine, ALT, and AST) were considered in the study to evaluate the cost variance. In order to bring in a validation for budget optimization in the industry and achieve a sustainable nancial resource performance, with the focus on large institutions and high through put analyzers (throughput over 400 tests per hour) which will reect the effect on a large portion of budget utilization (teaching hospitals, provincial general hospitals & district general hospitals) were studied.

Objective:

The study aimed to evaluate that the cost per test of the test parameters and relationship with the quality and the end user satisfaction.

Method: The quality of the analyzers were evaluated through six months EQAS reports as secondary data and analyzed using descriptive statistics using parameters of percentage deviations and coefcients of variation. Obtained results were compared with quality specications derived from biological variation and the user satisfaction derived through the standard questionnaire. SPSS version 16.0 was used to analyze the questionnaire.

Results:

It was evident that the result quality of each analyzer in the target population were within the satisfactory criteria. The correlation of the quality and the user satisfaction against the cost per test was -0.014 and - 0.007 respectively.

Conclusion:

The cost per test has no relationship with the quality and the end user satisfaction. In order to prevent the vast discrepancies of costs involved in the IVD sector, a price cap regulation is recommended to ensure, that the prices do not exceed the Maximum Retail Price (MRP) and the oor price efciently utilize the limited budget while shielding the service providers from losses.

Key Words: EQAS, Quality, IVD Market in Sri Lanka, Cost per Test

The burden of Dengue infection and circulating serotypes in the Western and Southern coastal regions in Sri Lanka

Chathuranga GAL¹, Withanage WNL¹, Pathirana GK¹, Gomes L², Ranadeva ND¹, Jeewandara C², Malavige GN²

1

(Department of Biomedical Science, KIU, Battaramulla, Sri Lanka ,

2

Centre for Dengue Research, Faculty of Medical Sciences, University of Sri Jayewardenepura ,)

lesanthacvaw@gmail.com

Introduction:

Sri Lanka has been affected by regular dengue epidemics with a yearly increase in the number of cases and geographical expansion. Although the dengue epidemiology has been extensively studied in the Colombo district, there is scarcity of data from other regions.

Objectives:

To investigate the burden of dengue and circulating serotypes in Western and Southern regions to implement better control programs and for possible implementation of future dengue vaccines.

Methods:

The study consisted of 555 patients presenting with a febrile illness to the outpatient departments of four hospitals in the Western and Southern regions from November 2018 to June 2019,. Dengue NS1 antigen test and dengue IgM and IgG ELISA were carried out and a quantitative real-time PCR was done to determine the infecting dengue virus (DENV) serotypes.

Results:

In this study 151/555 (27.2%) patients showed evidence of acute dengue infection by either a positive NS1

antigen test, PCR or by the presence of dengue specic IgM antibodies. Of these infections, 43/146

(29.4%) were reported from rural areas while 108/409 (26.4%) were reported from the urban/semi-urban

areas. Patients with dengue infection were signicantly more likely to have myalgia (p=0.0002),

arthralgia (p<0.0001), lethargy (p<0.0001), vomiting (p=0.01) and less likely to have upper respiratory

tract symptoms such as a cough (p<0.0001), cold (p<0.0001) and a sore throat (p=0.0004). From 82/151

samples were positive for PCR for dengue and the predominant serotype identied was DENV2 (52.4%),

followed by DENV3 (28.05%) and DENV1 (19.5%). DENV4 was not identied in any patient. Although

DENV2 was the predominant serotype until March 2019, DENV3 emerged from March 2019, coinciding

with the large dengue outbreak that was reported from the Western and Southern regions in Sri Lanka.

Interestingly, the 54/151 (35.8%) dengue infections were due to a primary infection whereas 41/151

(27.1%) of infections were due to secondary dengue infection. The serostatus was inconclusive in 56/151

(37.1%) of infections.

Conclusions:

Infection with the DENV accounted for 27.2% of febrile episodes presented to the outpatient departments in this region in Sri Lanka. Monitoring of the change in DENV serotypes is important to take rapid measures to prevent the escalation of outbreaks.

Key words: Dengue, Stereotypes, Burden of infection

In vitro antioxidant and anti-inammatory properties of Garcinia

cambogia, Curcuma longa and Sesame oil

Chamikara LHV, Sajitha MLF, Siriwardhene MA

(Faculty of Medical Sciences, Department of Allied Health Sciences, University of Sri Jayawardenepura

visalchamikara1@gmail.com

Introduction:

Garcinia cambogia, Curcuma longa and sesame oil are commonly used as food commodities in Sri Lanka.

Objectives:

To evaluate the in vitro antioxidant and anti-inammatory activity of the aqueous extracts of G. cambogia and C. longa and sesame oil.

Methods:

In vitro antioxidant activity was determined by 2,2-diphenyl-1-picrylhydrazyl (DPPH) free radical scavenging assay and anti-inammatory activity by the inhibition of albumin denaturation and the heat induced human red blood cell (hRBC) membrane stabilization assay. Linear regression analysis was used to calculate the IC50 value.

Results:

The aqueous extracts of G. cambogia , C. longa and sesame oil showed the antioxidant activity against the DPPH free radical scavenging assay. The IC50 values of the aqueous extracts of G. cambogia and C. longa were reported as 5.2481mg/ml and 7.0795μl/ml, respectively. Ascorbic acid was used as standard with the IC50 value of 0.0447mg/ml. Likewise, aqueous extracts of G. cambogia and C. longa showed the anti-inammatory activity against inhibition of albumin denaturation assay with the IC50 of 0.3548mg/ml and 0.3981mg/ml, respectively. Here we used ketoprofen as standard with the IC50 value of 0.4169mg/ml. In the investigation of anti-inammatory activity against the membrane stabilization assay, the results were obtained in negative values. It might be indicated that the anti-inammatory mechanism of the aqueous extract either was not by the membrane stabilization activity or might be an error in the method used.

Conclusions:

The anti-inammatory mechanisms of aqueous extracts are gained through the oxidative stress path way and by the inhibition of protein denaturation. The anti-inammatory mechanisms of the sesame oil is gained by the oxidative stress pathway.

Key words: in vitro antioxidant and anti-inammatory activity

Association between direct LDL, apo A₁ and apo B with traditional serum lipid parameters of people who are attending a tertiary care hospital.

R. R. N. Rajapaksha^1*, W. P. A. Prabhashini¹ , V. S. Sandaruwan¹, C. J. Kumarapeli¹, B. K. T. P. Dayanath² and E. M. S. Bandara¹

(Open University of Sri Lanka¹, Department of Bio chemistry, NCTH of Sri Lanka²)

renukanilrajapaksha@gmail.com

Introduction:

The Low Density Lipoprotein - cholesterol (LDL) is the main target for the diagnosis and treatment for hyperlipidemia. According to the clinical guidelines throughout the world, accurate reporting of LDL cholesterol is very important. LDL is estimated by Friedewald formula in the routine clinical practice. Recently apolipoprotein B 100 (apo B) and apolipoprotein A1 (apo A1) are considered as better measurements for monitoring patients at risk for cardiovascular diseases (CVD) compared to LDL and High Density Lipoprotein cholesterol (HDL) respectively.

Objectives:

This study was carried out to determine the correlation between calculated LDL (CLDL) by Friedewald formula and direct LDL (DLDL) as well as to determine correlation between measured apo A1 and apo B l00 levels with traditional lipid prole parameters of patients attending the Biochemistry Laboratory of Colombo North Teaching Hospital (CNTH), Sri Lanka.

Methods:

A cross sectional correlation study was conducted among 294 subjects. LDL level was calculated by Friedewald formula . Direct LDL, Apo A and Apo B level were measured by immuno-turbidimetric method.

Results:

Among the study subjects,there was a statistically good positive correlation with DLDL and CLDL (r =0.958, p≤0.05) for the total population. Triglyceride levels grouped in to lt;150 mg/dl, 151-200 mg/dl, and ≥201 mg/dl and compared with LDL and DLDL. Among these correlations best statistically signicant correlation was seen in the 151mg/dl -200mg/dl group (r =0.96, p≤0.05). However, c-LDL underestimates d-LDL by 6.5%. The proportion of underestimation was increased gradually with high triglyceride concentration. Apo B was better correlated with DLDL (r =0.939, p≤0.05) than CLDL (r =0.914≤0.05). Further statistically signicant correlation was seen with the Apo A with HDL.

Conclusions:

Even though c-LDL underestimate the d-LDL level by 6.5% , the calculation of LDL by Friedewalds formula can be used to determine LDL in routine lipid prole with reference to national cholesterol education program. Underestimation proportion of LDL by Friedewald formula was increased with high triglyceride levels. Apo B was signicantly associated with LDL and apo A was signicantly associated with HDL.

Key words: Direct LDL, Apo A1, Apo B

Detection of Blood Group A₁ using dolichosbiorus Antigen A₁ - detection lectin extraction, puried by Ammonium sulfate precipitation method

Basura Gunaratne¹, Buddini Manulika¹, Kasun Perera¹, Darshana Kottahachchi¹, K.K.S. Kuruppu²

(Faculty of Allied Health Sciences, Genera Sir John Kotelawala Defence University¹,

National Blood Transfusion Service, Colombo 05²)

neranjanakasun@gmail.com

Aims

Isolation and purication of antigen A1 detection lectin from Dolichosbiorusseed extract.

Methods

Coarsely grounded dryDolichosbiorusseeds were used for the study. Acetone was used for the defatting of the seed powder. A 0.15M NaCl diffusion method was used for the crude extraction of antigen A1 detection lectin. Ammonium Sulphate precipitation was used for the purication of the crude extracts. Protein (lectin) was precipitated at 00 to 100% Ammonium Sulphate saturations. The protein (lectin) precipitate was subjected to two fold serial dilution series and its hemagglutination activity was analyzed using A1 and A2 cells. From the data collected optimum working reagent was prepared from the protein (lectin) precipitate.

Results

Results indicated a clear increase in protein (lectin) precipitation from 40%-50% to 60%-70% Ammonium Sulphate saturation. All the protein (lectin) precipitates shows both A1 and A2 hemagglutination activity at lower dilutions, however only A1 hemagglutination activity is observed at higher dilution levels. Furthermore from 60%-70% ammonium sulphate saturation onwards, a clear increase in blood group A1 hemagglutination activity was visible.

Discussion

ABO blood group is considered as one of the most immunogenic blood group in humans. ABO blood group is comprised of A, B, AB and O blood groups. From these blood groups, blood group A has two major sub groups; subgroup A1 and sub group A2. Accurate identication of A1 and A2 blood groups are important in blood transfusion as incorrect identication of A1 and A2 blood groups and can lead to sever transfusion reactions.Dolichosbiorusseed extracts have the ability to specically hemagglutinate A1 blood cells due to a special lectin.

Conclusions

The methods employed for the extraction and purication of Dolichosbiorusantigen A1 detection lectin shows promising results. Acetone defatting, 0.15M NaCl diffusion and Ammonium Sulphate precipitation methods were able to increase the total activity of the Dolichosbiorus antigen A1 detection lectin.

Correlation among Fasting Plasma Glucose, Creatinine and Urinary microalbumin of type 2 Diabetics attending Diabetic centre, Teaching Hospital, Jaffna

Ruwanpathirana, R. P. E.¹, Kandeepan, K.² and Arasaratnam, V.²

(Unit of Allied Health Sciences, Faculty of Medicine, University of Jaffna¹,

Department of Biochemistry, Faculty of Medicine, University of Jaffna².)

erandika.r4@gmail.com

Introduction:

Diabetes mellitus can lead to renal failure ,cardiovascular, neurological and retinal complications.

Objectives:

To evaluate the correlation among fasting plasma glucose (FPG), serum creatinine and urinary microalbumin in type 2 diabetic patients attending Diabetic Centre, Teaching Hospital, Jaffna.

Methods:

In this study 98 patients diagnosed as type 2 diabetics, without chronic kidney diseases, between 40-85 years were selected. FPG (Glucose Oxidase method), serum and urine creatinine (Jaffe Alkaline Picric Acid method) and random urine albumin (Immuno-turbidimetry method) were estimated. The strength of correlation was determined by Pearson correlation.

Results:

The mean FPG, serum creatinine, urine albumin, urine creatinine and urine albumin to creatinine ratio

were 136.17 (±53.92) mg/dL, 1.25 (±0.64) mg/dL, 18.9 (±16.2) mg/L, 1.21 (±0.80) g/L and 17.11

(±14.16) mg/g creatinine respectively. Urine albumin level was increased with increased FPG (r = 0.424,

p= 0.001). However, the FPG level did not correlate with serum creatinine (r= 0.107, p= 0.293), and urine

creatinine (r = 0.002 and p= 0.982). In contrast, FPG signicantly correlated with urine creatinine ratio (r =

0.422, p= 0.001). Serum creatinine level showed non- signicant correlations with urine albumin (r=

0.109, p= 0.283), urine creatinine (r= 0.138, p= 0.176) and urine albumin to urine creatinine ratio (r=

0.062, p= 0.546). This study showed that urine creatinine level was not correlated with urine albumin (r= -

0.051, p= 0.615) while urine albumin to urine creatinine ratio signicantly correlated with urine creatinine (r= -0.307, p= 0.002) and urine albumin (r= 0.847, p= 0.001).

Conclusions:

This study revealed that, the FPG could be used to predict the excretion of albumin and therefore early renal diseases in diabetic patients. In contrast the measurement of serum creatinine had not correlated with albumin and creatinine excretions in urine and urine albumin to creatinine ratio.

Key words: Albumin, Creatinine, Fasting plasma glucose, Type 2 diabetes

Serum interleukin-6, high sensitivity C-Reactive Protein levels and related risk factors in patients undergoing discectomy following cervical / lumbar disc herniation

M.F. Imrana, H.G.R. Priyankara

(Faculty of Medical Sciences through the department of Allied Health Sciences at University of Sri Jayewardenepura, Sri Lanka.)

rajithrpg@gmail.com

Introduction:

Intervertebral disc herniation is dislocation of the disc materials beyond the normal margin of intervertebral space. Lumbar disc herniation (LDH) and cervical disc herniation (CDH) are commonly seen. It results inammatory reaction and sever pain related to nerve root irritation around the herniated disc area and elevates inammatory and pain related bio markers in blood. Interleukin 6 (IL-6) is one of the main inammatory and pain related bio marker. IL-6 act as a gene expression regulator for high sensitivity C-Reactive Protein (hs-CRP). Several risk factors are associated with LDH and CDH.

Objective:

To determine the association of serum interleukin-6 (IL-6) levels, high-sensitivity C-reactive protein (hs-CRP) and related risk factors in patients undergoing discectomy following cervical disc herniation (CDH) or lumbar disc herniation (LDH).

Method:

Present study was carried out among 77 patients undergoing discectomy following lumbar disc herniation (LDH) and cervical disc herniation (CDH). Socio demographic, behavioral and occupational data were obtained through an interviewer administered questionnaire. Serum interleukin-6 (IL-6), and serum high-sensitivity C-reactive protein (hs-CRP) were analyzed in each individual. IL-6 was analyzed by Enzyme Linked Immunosorbent assay method,Hs-CRP was determined by using Konelab 20xt analyzer. Results were analyzed by using SPSS version 25.0.

Results:

There was no signicant correlation (r=0.02) between interleukin-6 ( IL-6 )(pg/ml) and serum high-sensitivity C-reactive protein (hs-CRP) (mg/L) concentration in serum with cervical disc herniation (CDH) or lumbar disc herniation (LDH) (p value> 0.05) And there wasn't signicant association between age category (p=3.759), sex (p=0.542), Body mass index (BMI) category (p=0.965), family history (0.650), physically demanding nature of occupation (p=0.542), duration of occupation (p=0.446), smoking (0.629), alcohol consumption (p=0.608), type of exercise (p=0.371), type of sports (p=0.339) with CDH and LDH. The mean value of IL-6 was x signicantly high in chronic back pain and neck pain patients with LDH and CDH patients (p=0.043), the mean value of hs-CRP was signicantly high in acute back pain neck pain with LDH and CDH patients (p=0.048).

Conclusion:

There was no correlation between interleukin-6 (IL-6) and high-sensitivity C-reactive protein hs-CRP levels in serum with cervical disc herniation (CDH) or lumbar disc herniation (LDH). No signicant association between selected known risk factors (behavioral, occupational, anthropometrical). The IL-6 mean was higher in chronic back pain and neck pain patients with LDH and CDH. And hs-CRP mean was higher in acute back pain /neck pain patients with LDH and CDH.

Key words: C-Reactive Protein, Herniation.

Correlation of Salivary α- Amylase activity vs Severity of Stress and Anxiety among Medical Laboratory Technology Trainees during Clinical Laboratory Assessment

T.J.Silva, K.K.U.H.N.Abhayarathne

(Department of Medical Laboratory Sciences, The Open University of Sri Lanka)

harshananath84@gmil.com

Background

Stress produces denable mental and physiological reaction in body. Various methods are being proposed to identify the level of stress.Salivary α- amylase (SAA) activity measurement is one of the least complicated repeatable bio marker available to detect the level of stress and anxiety disorders.

Objective

To investigate the correlation of endocrine bio marker, Salivary α amylase activity and conventional severity labels of psychological effect (stress, anxiety, and depression)on MLT students, who are sitting for laboratory practical assessment.

Method

Final year eighty (80)students were included in the study. The level of stress,anxiety and depression was determined using DASS 21 tool. The Saliva samples were collected by unstipulated passive drool techniques. The SAA activity was determined by ELISA kit available for research purposes.

Results

Majority of the students 65% (52/80)showed moderate level of stress while 12.5% (10/80) and 1.3% (01/80) showed mild and severe stress respectively. The normal stress level was shown only by 21.3%(17/80) students. Most of the students 63.7% (51/80) showed normal level anxiety while 16.3% (13/80) and 13.8%1/80) showed mild and moderate level severity of anxiety. The severe anxiety level was seen in 6.3% (5/80) of the selected population.None of the students were identied with any level of depression. The highest level of SAA activity was detected in students with severe anxiety. There was a strong positive correlation between SAA activity and severity of anxiety while a positive but weak correlation was observed between SAA activity and severity stress. Multiple Regression was tted assuming normal distribution of data (scores) and homogenous variance considering SAA as the response variable. R2 value of the tted model was 0.9423 with an adjusted R2 value of 0.9408. Both effects, the stress (b=26.84,p=<.0001) and the anxiety (b=137.67, p=<.0001) were signicant in the model and model coefcient was positive, indicating a positive relationship between SAA activity and levels of stress and anxiety. Group of fourteen (17.5%, 14/80) students obtained below average results which included all ve students (5/14, 37.5%) with severe anxiety. There was a signicant correlation (P< 0.0001) between the poor performance and the severe anxiety while probability of parameter estimates of stress remained non-signicant (P=0.0423).

Conclusion

Salivary alpha amylase is signicantly high in MLT trainees who showed severe anxiety. The lowest level of SAA activity was seen in MLT trainees with normal stress and anxiety levels.

Key words: Salivary alpha amylase, Stress, Anxiety.

Proceedings of the Scientic Sessions 2020, CMLS.SL