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Concept: Lanka

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Hemoprotozoan parasites are responsible for significant economic losses in cattle. We screened Sri Lankan cattle populations for the presence of Babesia bovis, Babesia bigemina, Theileria annulata, and Theileria orientalis, using species-specific PCR assays. Out of 316 samples collected from animals in four different districts of Sri Lanka (Nuwara Eliya, Polonnaruwa, Ampara, and Jaffna), 231 (73.1%) were positive for at least one parasite species. All four parasite species were detected among the study groups from all of the districts surveyed. The first and second commonest hemoprotozoan parasites identified were T. orientalis (53.5%) and B. bigemina (30.1%), respectively. We found that the dry zones (Polonnaruwa, Ampara, and Jaffna) had more Babesia-positive animals than the hill country wet zone (Nuwara Eliya). In contrast, T. orientalis was the predominant species detected in Nuwara Eliya, while infection with T. annulata was more common in the dry zones. In addition, 81 (35.1%) of the 231 positive samples were infected with more than one parasite species. The presence of multiple parasite species among the different cattle populations is of clinical and economic significance. Therefore, island-wide control and prevention programs against bovine babesiosis and theileriosis are needed to minimize the financial burden caused by these parasites.

Concepts: Sri Lanka, Babesiosis, Tamil language, Tamil people, Babesia, Lanka, Northern Province, Sri Lanka, Jaffna

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INTRODUCTION: Immunoturbidimetry studies the phenomenon of immunoprecipitation of antigens and antibodies in solution, where there is the formation of large, polymeric insoluble immunocomplexes that increases the turbidity of the solution. We used immunoturbidimetry to investigate the interaction between commercial snake antivenoms and snake venoms, as well as cross-reactivity between different snake venoms. METHODS: Serial dilutions of commercial snake antivenoms(100μl) in water were placed in the wells of a microtitre plate and 100μl of a venom solution (50μg/ml in water) was added. Absorbance readings were taken at 340nm every minute on a BioTek ELx808 plate reader at 37°C. Limits imposed were a 30minute cut-off and 0.004 as the lowest significant maximum increase. Reactions with rabbit antibodies were carried out similarly, except that antibody dilutions were in PBS. RESULTS: Mixing venom and antivenom/antibodies resulted in an immediate increase in turbidity, which either reached a maximum or continued to increase until a 30minute cut-off. There was a peak in absorbance readings for most Australian snake venoms mixed with the corresponding commercial antivenom, except for P. textilis venom and brown snake antivenom. There was cross-reactivity between Naja naja venom from Sri Lanka and tiger snake antivenom indicated by turbidity when they were mixed. Mixing rabbit anti-snake antibodies with snake venoms resulted in increasing turbidity, but there was not a peak suggesting the antibodies were not sufficiently concentrated. The absorbance reading at pre-determined concentrations of rabbit antibodies mixed with different venoms was able to quantify the cross-reactivity between venoms. Indian antivenoms from two manufacturers were tested against four Sri Lankan snake venoms (D. russelli, N. naja, E. carinatus and B. caeruleus) and showed limited formation of immunocomplexes with antivenom from one manufacturer. DISCUSSION: The turbidity test provides an easy and rapid way to compare and characterise interactions between antivenoms and snake venoms.

Concepts: Antibody, Concentration, Sri Lanka, Venom, Antivenom, Lanka, Elapidae, Indian Cobra

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Physical inactivity is a modifiable risk factor of many non-communicable diseases. The aim of this study was to assess the pattern of physical activity among Sri Lankan adults in the district of Colombo, Sri Lanka. The study was carried out among a sample of 1320 adults aged 20 to 59 years, selected using stratified, cluster sampling method. Physical activity was assessed using the long form of the International Physical Activity Questionnaire validated for Sri Lanka. The prevalence of sufficient physical activity was 82.0% (CI = 78.5-85.0) for males and 79.7% (CI = 76.5-82.6) for females. The odds of having sufficient activity were lower with increase in the level of urbanisation. Activity was achieved mainly through domestic and transport related activity. Only 21.7% carried out at least some activity for leisure. As Sri Lanka continues to urbanize, it is important to find strategies to increase the level of activity especially at leisure.

Concepts: Sample, Sampling, Sri Lanka, Cluster sampling, Colombo, Lanka, Sinhala language, Sri Lankan Moors

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Sri Lankan Agricultural Nephropathy (SAN), a new form of chronic kidney disease among paddy farmers was first reported in 1994. It has now become the most debilitating public health issue in the dry zone of Sri Lanka. Previous studies showed SAN is a tubulo-interstitial type nephropathy and exposure to arsenic and cadmium may play a role in pathogenesis of the disease.

Concepts: Chronic kidney disease, Kidney, Toxicology, Lead, Sri Lanka, Heavy metal music, Lanka, Sri

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In a recent study published by the National Project Team on chronic kidney diseases of unknown origin in Sri Lanka, identified cadmium as a major risk factor but strong conclusions were not made as the identified environmental toxins were within the permissible levels.Sri Lankan food consumption pattern is different so that approach of total exposure of cadmium by food and water been calculated. Such calculation point out that total exposure of cadmium exceed the provisional tolerable weekly intake determined by international agencies.

Concepts: Chronic kidney disease, Kidney, Nephrology, Medicine, Epidemiology, Infectious disease, Sri Lanka, Lanka

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Standard economic theory suggests that one-time business grants can have at most temporary effects, and accordingly, policies to increase incomes of the self-employed in developing countries typically rely on sustained engagement. In contrast, we found long-lasting impacts from one-time grants given in a randomized experiment to subsistence firms. Five years after we gave $100 or $200 to 115 of 197 male and 100 of 190 female Sri Lankan microenterprise owners, we found 10-percentage-point-higher enterprise survival rates, and $8-to-$12-per-month-higher profits for male-owned businesses that received the grants. Female-owned businesses showed no long-term (or short-term) impacts. Our follow-up investigation interviewed 94% of the original sample and collected survivorship data from the remaining 6%, demonstrating that tracking long-term outcomes is both feasible and worthwhile. The results suggest that one-off grants may have lasting impacts on some types of subsistence firms, challenging the view that sustained engagement is always required.

Concepts: Economics, India, Sri Lanka, Maldives, Buddhism, Lanka, Sri

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Acute respiratory tract infections (ARTIs) are a common reason for antibiotic overuse worldwide. We previously showed that over 80% of outpatients presenting to a tertiary care hospital in Sri Lanka with influenza-like illness received antibiotic prescriptions, although almost half were later confirmed to have influenza. The purpose of this qualitative study was to assess Sri Lankan patients' and physicians' attitudes towards ARTI diagnosis and treatment.

Concepts: Medicine, Patient, Physician, Sri Lanka, Lanka, Sri

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Companionship during labor is known to have both physical and psychosocial benefits to mother and baby. Sri Lanka made a policy decision to allow a labour companion in 2011. However, implementation has been unsatisfactory. Given the leading role Obstetricians play in the implementation of policy, a study was undertaken to assess the knowledge, attitudes and practices among them.

Concepts: Pregnancy, Learning, India, Sri Lanka, Lanka, Sri

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Suicide prevention efforts in Asia have increasingly turned to ‘quick win’ means restriction, while more complicated cognitive restriction and psychosocial programmes are limited. This paper argues the development of cognitive restriction programmes requires greater consideration of suicide methods as social practices, and of how suicide cognitive schemata form. To illustrate this, the paper contributes an ethnographically grounded study of how self-poisoning becomes cognitively available in Sri Lanka. I argue the overwhelming preference for poison as a method of self-harm in the country is not simply reflective of its widespread availability, but rather how cognitive schemata of poison - a ‘poison complex’ - develops from early childhood and is a precondition for suicide schemata. Limiting cognitive availability thus requires an entirely novel approach to suicide prevention that draws back from its immediate object (methods and causes of self-harm) to engage the wider poison complex of which suicide is just one aspect.

Concepts: Childhood, Poison, Sri Lanka, Tamil people, Suicide methods, Lanka, Sri, Provinces of Sri Lanka

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BACKGROUND: The migration of health-care workers contributes to the shortage of health-care workers in many developing countries. This paper aims to describe the migration of medical specialists from Sri Lanka and to discuss the successes and failures of strategies to retain them. METHODS: This paper presents data on all trainees who have left Sri Lanka for postgraduate training through the Post Graduate Institute of Medicine, University of Colombo, from April 1980 to June 2009. In addition, confidential interviews were conducted with 30 specialists who returned following foreign training within the last 5 years and 5 specialists who opted to migrate to foreign countries. RESULTS: From a total of 1,915 specialists who left Sri Lanka for training, 215 (11%) have not returned or have left the country without completing the specified bond period. The majority (53%) migrated to Australia. Of the specialists who left before completion of the bond period, 148 (68.8%) have settled or have started settling the bond. All participants identified foreign training as beneficial for their career. The top reasons for staying in Sri Lanka were: job security, income from private practice, proximity to family and a culturally appropriate environment. The top reasons for migration were: better quality of life, having to work in rural parts of Sri Lanka, career development and social security. CONCLUSIONS: This paper attempts to discuss the reasons for the low rates of emigration of specialists from Sri Lanka. Determining the reasons for retaining these specialists may be useful in designing health systems and postgraduate programs in developing countries with high rates of emigration of specialists.

Concepts: Medicine, Human migration, India, Sri Lanka, Colombo, Lanka, University of Colombo, Sri Lankan Civil War