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Concept: Sri Lanka


The current chronic kidney disease epidemic, the major health issue in the rice paddy farming areas in Sri Lanka has been the subject of many scientific and political debates over the last decade. Although there is no agreement among scientists about the etiology of the disease, a majority of them has concluded that this is a toxic nephropathy. None of the hypotheses put forward so far could explain coherently the totality of clinical, biochemical, histopathological findings, and the unique geographical distribution of the disease and its appearance in the mid-1990s. A strong association between the consumption of hard water and the occurrence of this special kidney disease has been observed, but the relationship has not been explained consistently. Here, we have hypothesized the association of using glyphosate, the most widely used herbicide in the disease endemic area and its unique metal chelating properties. The possible role played by glyphosate-metal complexes in this epidemic has not been given any serious consideration by investigators for the last two decades. Furthermore, it may explain similar kidney disease epidemics observed in Andra Pradesh (India) and Central America. Although glyphosate alone does not cause an epidemic of chronic kidney disease, it seems to have acquired the ability to destroy the renal tissues of thousands of farmers when it forms complexes with a localized geo environmental factor (hardness) and nephrotoxic metals.

Concepts: Scientific method, Chronic kidney disease, Kidney, Epidemiology, Infectious disease, Theory, Sri Lanka, Epidemic


BACKGROUND: Although an initial IFA-IgG titer greater or equal to 1/64 or 1/128 is considered positive in presumptive diagnosis, in clinical practice in an endemic setting for rickettsioses in Sri Lanka, some patients with IFA-IgG titer of 1/128 for either spotted fever group (SFG) or scrub typhus (ST) did not respond to treatment. FINDINGS: To determine a clinically helpful diagnostic algorithm, IFA-IgG results of serologically confirmed treatment responders were analyzed in relation to duration of illness at sampling.Of 146 suspected SFG, 3 responders of 25 patients had titers <=1/128 with < 7 days of illness while all 9 with titers >=1/256 responded (false negative with 1/256 cutoff was 12%, false positive was 0%). For illness > 7 days, the false negative and positive rates were 4.3% (3/59) and 11.3% (6/53). Of 115 suspected ST, false negative and positive rates with >=1/256 cutoff at <7 days of illness were (2/15) and 0% (0/8) respectively while > 7 days, false negative and positive rates were 2% (1/51) and 0% (0/42). CONCLUSIONS: For clinical decision making, duration of illness at sampling is important in interpreting serology results in an endemic setting. If sample is obtained <=7 day of illness, an IgG titer of <=1/128 requires a follow up sample in the diagnosis and > 7 days of illness, a single >=1/256 titer is diagnostic for all ST and 90% of SFG.

Concepts: Epidemiology, Infectious disease, Rickettsia, Rocky Mountain spotted fever, Sri Lanka, Inequality, Typhus, Equality


BACKGROUND: Dental caries among young children are a global problem. Scant attention is paid towards primary teeth, leading to high prevalence of dental caries. There are only few studies done in Sri Lanka, addressing oral hygiene among preschool children. Scientific evidence is in need to persuade authorities to establish a programme promoting oral hygiene among preschool children. METHODS: A descriptive cross sectional study was conducted in Ragama Medical officer of Health area. Consecutive children between 2 – 5 years of age, attending child welfare clinics were recruited for the study. Practices related to dental hygiene and socio-economic characteristics were obtained using an interviewer administered questionnaire. Mouth was examined for evidence of dental caries. Data collection and examination were done by two doctors who were trained for this purpose. The data were analysed using SSPS version 16. RESULTS: Total of 410 children were included. None had a routine visits to a dentist. Practices related to tooth brushing were satisfactory. Prevalence of dental caries gradually increased with age to reach 68.8% by 5 years. Mean total decayed-extracted-filled (deft) score for the whole sample was 1.41 and Significant caries index (SIC) was 4.09. Decayed tooth were the main contributor for the deft score and Care index was only 1.55. Girls had a significantly higher prevalence of caries than boys. CONCLUSIONS: Dental care provided for Sri Lankan preschool children appears to be unsatisfactory as prevalence of dental caries among this cohort of preschool children was very high. There is an urgent need to improve dental care facilities for Sri Lankan preschool children.

Concepts: Teeth, Dental caries, Sri Lanka, Dental plaque, Oral hygiene, Dental floss, Halitosis, Toothbrush


The purpose of this study was to evaluate gender-wise diversity of digital dermatoglyphic traits in a sample of Sinhalese people in Sri Lanka.

Concepts: Sri Lanka, Tamil language, Colombo, Sinhalese people


Early or timely initiation of breastfeeding is crucial in preventing newborn deaths and influences childhood nutrition however remains low in South Asia and the factors and barriers warrant greater consideration for improved action. This review synthesises the evidence on factors and barriers to initiation of breastfeeding within 1 h of birth in South Asia encompassing Afghanistan, Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan and Sri Lanka.

Concepts: India, Sri Lanka, Buddhism, South Asia, Pakistan, South Asian Association for Regional Cooperation


The Malay people are an important ethnic composition in Southeast Asia, but their genetic make-up and population structure remain poorly studied. Here we conducted a genome-wide study of four geographical Malay populations: Peninsular Malaysian Malay (PMM), Singaporean Malay (SGM), Indonesian Malay (IDM) and Sri Lankan Malay (SLM). All the four Malay populations showed substantial admixture with multiple ancestries. We identified four major ancestral components in Malay populations: Austronesian (17%-62%), Proto-Malay (15%-31%), East Asian (4%-16%) and South Asian (3%-34%). Approximately 34% of the genetic makeup of SLM is of South Asian ancestry, resulting in its distinct genetic pattern compared with the other three Malay populations. Besides, substantial differentiation was observed between the Malay populations from the north and the south, and between those from the west and the east. In summary, this study revealed that the genetic identity of the Malays comprises a mixed entity of multiple ancestries represented by Austronesian, Proto-Malay, East Asian and South Asian, with most of the admixture events estimated to have occurred 175 to 1,500 years ago, which in turn suggests that geographical isolation and independent admixture have significantly shaped the genetic architectures and the diversity of the Malay populations.

Concepts: Southeast Asia, Asia, Sri Lanka, Singapore, Malaysia, Indonesian language, Malaysian Malay, Malay language


The chronic kidney disease of unknown etiology (CKDu) among paddy farmers in was first reported in 1994 and has now become most important public health issue in dry zone of Sri Lanka. The objective was to identify risk factors associated with the epidemic in an area with high prevalence.

Concepts: Chronic kidney disease, Medicine, Public health, Epidemiology, Toxicology, Sri Lanka, Debut albums, Sri


India is a patchwork of tribal and non-tribal populations that speak many different languages from various language families. Indo-European, spoken across northern and central India, and also in Pakistan and Bangladesh, has been frequently connected to the so-called “Indo-Aryan invasions” from Central Asia ~3.5 ka and the establishment of the caste system, but the extent of immigration at this time remains extremely controversial. South India, on the other hand, is dominated by Dravidian languages. India displays a high level of endogamy due to its strict social boundaries, and high genetic drift as a result of long-term isolation which, together with a very complex history, makes the genetic study of Indian populations challenging.

Concepts: India, Sri Lanka, South Asia, Urdu, Sanskrit, Language family, Indo-European languages, Dravidian languages


Socioeconomic challenges continue to mount for half a billion residents of central India because of a decline in the total rainfall and a concurrent rise in the magnitude and frequency of extreme rainfall events. Alongside a weakening monsoon circulation, the locally available moisture and the frequency of moisture-laden depressions from the Bay of Bengal have also declined. Here we show that despite these negative trends, there is a threefold increase in widespread extreme rain events over central India during 1950-2015. The rise in these events is due to an increasing variability of the low-level monsoon westerlies over the Arabian Sea, driving surges of moisture supply, leading to extreme rainfall episodes across the entire central subcontinent. The homogeneity of these severe weather events and their association with the ocean temperatures underscores the potential predictability of these events by two-to-three weeks, which offers hope in mitigating their catastrophic impact on life, agriculture and property.Against the backdrop of a declining monsoon, the number of extreme rain events is on the rise over central India. Here the authors identify a threefold increase in widespread extreme rains over the region during 1950-2015, driven by an increasing variability of the low-level westerlies over the Arabian Sea.

Concepts: Weather, India, Indian Ocean, Sri Lanka, Ocean, Cyclone, Rain, Bay of Bengal


The South Asian Monson (SAM) is one of the most intense climatic elements yet its initiation and variations are not well established. Dating the deposits of SAM wind-driven currents in IODP cores from the Maldives yields an age of 12. 9 Ma indicating an abrupt SAM onset, over a short period of 300 kyrs. This coincided with the Indian Ocean Oxygen Minimum Zone expansion as revealed by geochemical tracers and the onset of upwelling reflected by the sediment’s content of particulate organic matter. A weaker ‘proto-monsoon’ existed between 12.9 and 25 Ma, as mirrored by the sedimentary signature of dust influx. Abrupt SAM initiation favors a strong influence of climate in addition to the tectonic control, and we propose that the post Miocene Climate Optimum cooling, together with increased continentalization and establishment of the bipolar ocean circulation, i.e. the beginning of the modern world, shifted the monsoon over a threshold towards the modern system.

Concepts: Climate, Weather, India, Indian subcontinent, Indian Ocean, Sri Lanka, Ocean, Monsoon