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Faculty of Medical Sciences University of Sri Jayewardenepura in collaboration with Sri Jayewardenepura General Hospital Scientific Sessions 2016 7th and 8th April 2016 Golden Rose Hotel, Boralesgamuwa Research Committee Faculty of Medical Sciences University of Sri Jayewardenepura Chairperson Dr. Pradeepa Jayawardane Secretary Dr. Bernadene Fernandopulle Committee Members Prof. S.B Gunatilake Prof. Renu Wickremasinghe Prof. Neluka Fernando Prof. Neelika Malavige Prof. Sugandhika Suresh Dr. Sampatha Goonewardena Dr. Ramani Perera Dr. Guwani Liyanage Dr. Shamini Prathapan Dr. Shalindra Ranasinghe Dr. R.B Marasinghe Dr. Chandima Kulathilake Dr. Manjula Weerasekera Dr. Nithushi Samaranayake Clinical Society Sri Jayewardenepura General Hospital President Dr. Ananda Perera Secretary Dr. Prasanga Palihawadana Assistant Secretary Dr. Dananja Ariyawansa Treasurer Dr. Santhushya Fernando Editor Dr. Jagath Herath Committee Members Dr. Sandamali Amarathunga Dr. Ruchira Perera Dr. Sanithri Samarakoon Dr. Nalin Abeysinghe Dr. Lakmal Alles Dr. Gayani Amarasinghe Organizing Committee Conference Chairperson Dr. Pradeepa Jayawardane Conference Secretary Dr. Chandima Kulathilake Scientific Committee Prof. Saman Gunatilake - Chairperson Prof. Renu Wickremasinghe Prof. Neluka Fernando Prof. Sugandhika Suresh Prof. Neelika Malavige Dr. Pradeepa Jayawardane Dr. Chandima Kulathilake Dr. Bernadene Fernandopulle Dr. Shamini Prathapan Dr. Shalindra Ranasinghe Dr. Guwani Liyanage Dr. Chamil Marasinghe Finance Committee Dr. Shamini Prathapan - Treasurer Prof. Saman Gunatilake Dr. Prasanga Palihawadana Dr. Pradeepa Jayawardane Dr .Guwani Liyanage Dr. R. Marasinghe Social Affairs Committee Dr. Nithushi Samaranayake - Chairperson Dr. Manjula Weerasekera Dr. Sampatha Goonewardena Prof. Neluka Fernando Dr. Chandima Kulathilake Dr. Bernadene Fernandopulle Message from the Vice Chancellor University of Sri Jayewardenepura With the theme “Excellence in Medicine through Innovative Research”, the Scientific Sessions – 2016 of the Faculty of Medical Science of this University will be held on 7th and 8th of April 2016. As a patron of a hallmark event of the university I would like to add these few words to the publication of Programme and Abstracts of the Scientific Sessions- 2016 with humble pleasure. While reiterating the fact that research is the most powerful tool for advancement of almost every field of study, I highly commend the efforts of the Faculty of Medical Sciences in this context. Since it’s inception in 1993 the Faculty of Medical Sciences has always provided an encouraging environment towards the development of research among its academic staff members. Apart from the regular scientific forums and workshops that are organized frequently, the Scientific Sessions held provide a platform for academics of different specialties of medicine to present their research findings. The many oral and poster presentations address national and global health issues and are valuable for decision making to clinicians as well as health care policy makers. Our University always encourages research by way of providing ample grants and other resources to all academics. It is indeed the prestige of any University to have academics with diverse research interests. I am proud to say that all Faculties of the University of Sri Jayewardenepura have a very good research background. Finally, I wish to extend my sincere thanks to the Dean and the staff of the Faculty of Medical Sciences for their unstinted contribution to make this academic event a great success. I heartily congratulate the Chairperson and the Research Committee for their dedication and commitment in organizing this event and I hope the participants will derive maximum benefit of the Sessions. I wish the Scientific Sessions 2016 every success. Prof. Sampath Amaratunge Vice-Chancellor University of Sri Jayewardenepura Message from the Dean Faculty of Medical Sciences University of Sri Jayewardenepura The Scientific Sessions of the Faculty of Medical Sciences held in collaboration with Sri Jayewardenepura General Hospital showcase the wide range of research activities undertaken by faculty members and clinicians. Although the Scientific Sessions of the Faculty of Medical Sciences traditionally have been held once in two years, this year in collaboration with the Clinical Society of Sri Jayewardenepura General Hospital the Scientific Sessions is held just after one year. This event is organized with the aim to promote ethical research among faculty members, clinicians and to promote research collaborations between the two institutes. We consider that creation of research culture among Faculty members and related professionals is our obligation and responsibility. Thus the Scientific Sessions presents a unique opportunity to all those interested in medical research to enhance their skills in conducting, documenting and presenting their findings Research drives better health care. Our faculty members work across academic fields with colleagues at other universities and research institutes within Sri Lanka and around the world. I consider it is essential to nourish these partnerships and seek new ones, so our Faculty will help shape medicine in the 21st century. . I take this opportunity to thank the Chairperson, Dr. Pradeepa Jayawardane and all the members of the Research Committee of the FMS and the President, Dr. Ananda Perera and the members of the Clinical Society of SJGH for organizing the Research Sessions 2016 and I wish the deliberations of the research sessions will prove productive and intellectually stimulating. Professor Surangi G. Yasawardene Dean Faculty of Medical Sciences University of Sri Jayewardenepura Message from the Chairperson Research Committee 2016 Faculty of Medical Sciences It is with great pleasure I welcome you to the Scientific Sessions 2016. In keeping with the Vice Chancellor's vision and the guidance of our Senior Academic members we have made changes in organization of this event. So far the Scientific Sessions have been held once in 2 years, but from this year onwards, it will be an annual event in our calendar. Further, it is held in collaboration with the Sri Jayewardenepura General Hospital and it is my belief that, this partnership would strengthen the bond between the University and the Sri Jayewardenepura General Hospital, and the researchers in both institutions would be the eventual beneficiaries. I thank Dr. Asoka Jayasena, the former President of the Clinical Society of the SJGH for initiating this move. It is vital that the culture of scientific research supports and encourages science that is of high quality, ethical and promotes the well-being of humankind. Inculcation of a research culture of such high standards in a university will nurture and help produce high quality research which, in turn would foster economic growth and ensure the prosperity and the wellbeing of the society at large. In the context of Faculty of Medical Sciences, research conducted by our academics addresses mainly the burning health issues in Sri Lanka such as Dengue, Chronic Kidney Diseases, Cancer, etc. In keeping with the vision of the University, the Research Committee of the Faculty of Medical Sciences conducts a multitude of events to build up a research culture in the faculty and to enhance the quality of research conducted by our academic staff members. The event of Scientific Sessions is one of the most anticipated and an important in the faculty which provides a platform for its researchers as well as the medical academia of the country to meet, present and discuss their findings. I wish to congratulate Prof. Sugandhika Suresh, Professor in Biochemistry for being the recipient of this year’s Faculty Oration to be held for the third time in history of our faculty. This year we have received around 90 abstracts and there will be 12 oral presentations and 53 poster presentations. In keeping with the theme “Excellence in Medicine through Innovative Research” we have a vibrant programme with contributions from many renowned experts and scientists in different fields of medicine from across the country as resource persons. The Plenary Lecture will be delivered by Prof Srinath Chandrasekera, Professor in Surgery of Faculty of Medical Sciences, on “Management of Urolithiasis, the need for further research and innovation”. There will be 4 other symposia on “Excellence in Research”, “Advances in Cardiac Arrhythmias” “Controversies in Medicine” and “Multidisciplinary Approach in Medicine”. I take this opportunity to thank the speakers for their zeal for sharing knowledge and expertise with us and the chairpersons and judges of oral and poster presentations for kindly accepting our invitation. All members of our team have worked tirelessly to make this event a success. Conference secretary Dr Chandima Kulathilake and the Research Committee Secretary Dr Bernadene Fernandopulle, engaged in their duties very enthusiastically attending to all the details. Prof. Saman Gunathilake the Chairperson of the Scientific Committee deserves special thank you for the mentorship and support given at all times. Prof. Renu Wickremasinghe too deserves a special thank you for her generous contribution to make this event a success. I wish to thank Prof. Sampath Amaratunge, Vice Chancellor of the University of Sri Jayewardenepura for his unwavering support and encouragement. I further extend my sincere gratitude to Prof Surangi Yasawardene, the Dean of the Faculty of Medical Sciences for the support given to the Research Committee at all times. Sangeetpati Pradeep Ratnayake is gratefully acknowledged for agreeing to grace the inauguration ceremony with his vibrant melodies. Finally, I hope that all of you would enjoy the programme and would experience a very stimulating conference. Dr Pradeepa Jayawardane Chairperson -Research Committee Faculty of Medical Sciences University of Sri Jayewardenepura Message from the President Clinical Society Sri Jayewardenepura General Hospital It gives me great pleasure and I consider it a privilege to give this message to the Scientific Sessions 2016 of the Faculty of Medical Sciences of the University of Sri Jayewardenepura. Clinical Society of the Sri Jayewardenepura General Hospital collaborates with the Faculty of Medical Sciences in organizing this year’s Scientific Sessions. I must mention that this was originally the idea of Dr. Asoka Jayasene our immediate Past President of the Clinical Society. I am very pleased to mention that I was involved with the teaching for the students from the very first batch of the Faculty of Medical Sciences. I am proud to see some of them are consultants all over Sri Lanka. I consider this a great opportunity for younger clinicians to present their experiences and the research work and I wish them all success in their work. Sri Jayewardenepura Clinical Society always encourages younger clinicians to do research and clinical trials and be up to date with their knowledge and skills. Finally I like to thank my team of the Clinical Society of Sri Jayewardenepura General Hospital and the Organizing Committee of the Faculty of Medical Sciences of the University of Sri Jayewardenepura for giving us this opportunity to participate and make this a joint venture. I wish all the participants a great time in this scientific meeting. Dr. Ananda Perera President, Clinical Society Sri Jayewardenepura General Hospital FACULTY Prof. Srinath Chandrasekera Professor in Surgery Faculty of Medical Sciences University of Sri Jayewardenepura Prof. Chandanie Wanigatunge Professor in Pharmacology Faculty of Medical Sciences University of Sri Jayewardenepura Prof. Priyadarshani Galappatthy Professor in Pharmacology Faculty of Medicine University of Colombo Prof. Hemantha Peiris Professor of Biochemistry Faculty of Medical Sciences University of Sri Jayewardenepura Dr. Suresh Kottegoda Consultant Electro Physiologist Sri Jayewardenepura General Hospital Dr. Rajitha Y de Silva Consultant Cardiothoracic Surgeon Sri Jayewardenepura General Hospital Dr. Shyama Subasinghe Consultant Physician Sri Jayewardenepura General Hospital Prof. Diyanath Samarasinghe Former Professor in Psychiatry Faculty of Medicine University of Colombo Prof. Kamani Wanigasuriya Professor in Medicine Faculty of Medical Sciences University of Sri Jayewardenepura Dr. Uditha Bulugahapitiya Consultant Endocrinologist Colombo South Teaching Hospital Kalubowila Dr. Dilhara Samaraweera Consultant Physician Base Hospital Pimbura Dr. Thushan Beneragama Consultant Plastic Surgeon National Hospital of Sri Lanka Colombo Dr. Udayanganie Ramadasa Consultant Physician General Hospital Ratnapura Scientific Sessions 2016 Programme of the Inauguration Ceremony 7th April 2016 5.00 pm Invitees take their seats 5.15 pm Ceremonial procession 5.20 pm National anthem 5.25 pm Lighting of the ceremonial oil lamp 5.30 pm Welcome address by the Chairperson, Research Committee, Faculty of Medical Sciences, USJP Dr. Pradeepa Jayawardane 5.40 pm Address by the Vice Chancellor, USJP Prof. Sampath Amaratunge 5.50 pm Address by the Dean, Faculty of Medical Sciences, USJP Prof. Surangi Yasawardene 6.00 pm Address by the President, Clinical Society, SJGH Dr. Ananda Perera 6.10 pm Faculty of Medical Sciences Oration “The role of herbal extracts and functional foods in the management of chronic disorders Prof. Sugandhika Suresh Professor in Biochemistry Department of Biochemistry, Faculty of Medical Sciences, USJP 7.00 pm Vote of thanks by the Secretary, Research Committee, Faculty of Medical Sciences, USJP Dr. Bernadene Fernandopulle 7.10 pm “Invocation” by Sangeetpati Pradeep Ratnayake 7.30 pm Procession leaves the hall 7.35 pm Refreshments ‘Excellence in Medicine through Innovative Research’ Faculty of Medical Sciences, University of Sri Jayewardenepura in collaboration with Sri Jayewardenepura General Hospital 8th April 2016 Programme at a glance 8.00 am Registration 8.30 am Inauguration 8.35 am Plenary Lecture “Management of Urolithiasis, the need for further research and innovation” Prof. Srinath Chandrasekera (Citation read by Prof.S.Yasawardene) Symposium 1- Excellence in Research Chairpersons: Prof. Sagarika Ekanayake, Dr. Asoka Jayasena 9.00 am Ethics in research – Prof. Chandanie Wanigatunge Clinical trials – Prof. Priyadarshani Galappatthy Bench to bedside – Prof. Hemantha Peiris 10.10 am Tea and viewing of poster presentations 10.30 am Oral presentations – Session I (OP 1 – OP 6) Chairpersons: Prof. Sharaine Fernando, Dr. Shalindra Ranasinghe Symposium II - Advances in Cardiac Arrhythmias Chairpersons: Prof. J. Indrakumar, Dr. Naomali Amarasena 11.30 am Overview of arrhythmias – Dr. Suresh Kottegoda Non cardiac aetiology of arryhthmias– Dr. Shyama Subasinghe Cardiac surgeons’ perspective of arrhythmias – Dr. Rajitha Y de Silva 12.40 pm Lunch and poster viewing 1.30 pm Oral Presentations – Session II (OP 7 – OP 12) Chairpersons: Dr. Indira Wijesiriwardena, Dr. Ramya Pathiraja Symposium III – Controversies in Medicine Chairpersons: Prof. Saman Gunatilake, Prof. Samudra Kathriarachchi 2.30 pm 3.40 pm Creating disease – Prof. Diyanath Samarasinghe Chronic kidney disease in the North Central Province of Sri Lanka; Have we done enough? – Prof. Kamani Wanigasuriya Controversies in management of diabetes – Dr. Uditha Bulugahapitiya Symposium IV - Multidisciplinary Approach in Medicine Chairpersons: Dr. Aruna Gunapala, Dr. Ananda Perera Teaming up towards better care for the elderly.– Dr. Dilhara Samaraweera Palliative care- a timely need –Dr. Udayaganie Ramadasa Functional reconstruction of the injured hand and upper limb – Dr. Thushan Beneragama 4.50 pm Closing ceremony and awards 5.00 pm Tea Scientific Sessions 2016 Faculty of Medical Sciences, University of Sri Jayewardenepura in collaboration with Sri Jayewardenepura General Hospital 08th April 2016 Detailed Programme 8.00 am Registration 8.30 am Inauguration 8.35 am Plenary Lecture “Management of Urolithiasis, the need for further research and innovation” Prof. Srinath Chandrasekera (Citation read by Prof. S. Yasawardene) 9.00 am Symposium 1- Excellence in Research Chairpersons: Prof. Sagarika Ekanayake, Dr. Asoka Jayasena Ethics in research – Prof. Chandanie Wanigatunge Clinical trials – Prof. Priyadarshani Galappatthy Bench to bedside – Prof. Hemantha Peiris 10.10 am Tea and viewing of poster presentations 10.30 am Oral presentations – Session I (OP 1 – OP 6) Chairpersons: Prof. Sharaine Fernando, Dr. Shalindra Ranasinghe OP 1 Immunohistochemical detection of Claudin low breast cancer; which subcellular level to be assessed? Mudduwa LKB1, Peiris HH2, Gunasekara SN1, Liyanage TG1, Abeysiriwardhana DS1 1 Department of Pathology, Faculty of Medicine, University of Ruhuna ,2Medical Laboratory Sciences, Faculty of Medicine, University of Ruhuna OP 2 Influence of culture medium on in-vitro biofilm formation by Candida species Wijesinghe GK1, Jayarathna PDTA1, Gunasekera TDCP2, Kottegoda N3, Fernando SSN2, Weerasekera MM2 1 Department of Allied Health Sciences, Faculty of Medical Sciences, University of Sri Jayewardenepura., 2Department of Microbiology, Faculty of Medical Sciences, University of Sri Jayewardenepura., 3Department of Chemistry, Faculty of Applied Sciences, University of Sri Jayewardenepura. OP 3 Comparison of psychological wellbeing among undergraduates of University of Sri Jayewardenepura Liyanage G1, Balasooriya A2, Siriwardhane DN1, Jayah FQ1, Seneviratne LSW1 1 Department of Paediatrics, Faculty of Medical Sciences, University of Sri Jayewardenepura, 2Department of Medical Education , Faculty of Medical Sciences, University of Sri Jayewardenepura OP 4 Lung functions and respiratory symptoms among rice millers in Anuradhapura District, Sri Lanka Wickramage SP1, Rajaratne AAJ2, Udupihille M1 1 Department of Physiology, Faculty of Medicine & Allied Sciences, Rajarata University of Sri Lanka, , 2Department of Physiology, Faculty of Medicine, University of Peradeniya OP 5 TiO2 21 nm nanoparticles as photocatalytic antimicrobial agent against Escherichia coli, Candida albicans and Methicillin resistant Staphylococcus aureus; a comparison Senarathna ULNH1, Fernando SSN1, Gunasekara TDCP1, Weerasekera MM1, Wickrama WDSA1,Perera MKR1, Arachchi NDH2, Jayaweera PM2 1 Department of Microbiology, Faculty of Medical Sciences, University of Sri Jayewardenepura, 2Department of Chemistry, University of Sri Jayewardenepura OP 6 A survey on lifestyle restrictions in children with asthma: a comparison with Quality of Life (QoL) Peiris TVM1, Liyanage ML1, Waduge LT1, Sanjaya M1, Wickramathunge CV1, Liyanage G2, Prathapan S3 1 Faculty of Medical Sciences, University of Sri Jayewardenepura, 2Department of Paediatrics, Faculty of Medical Sciences, University of Sri Jayewardenepura 3 Department of Community Medicine, Faculty of Medical Sciences, University of Sri Jayewardenepura 11.30 am Symposium II - Advances in Cardiac Arrhythmias Chairpersons: Prof. J. Indrakumar, Dr. Naomali Amarasena Overview of arrhythmias – Dr. Suresh Kottegoda Non cardiac aetiology of arryhthmias– Dr. Shyama Subasinghe Cardiac surgeons’ perspective of arrhythmias – Dr. Rajitha Y de Silva 12.40 pm Lunch and poster viewing 1.30 pm Oral Presentations – Session II (OP 7 – OP 12) Chairpersons: Dr. Indira Wijesiriwardena, Dr. Ramya Pathiraja OP 7 Assess and compare health related quality of life among elders who live in their own home and elderly care homes Fernando KDS1, Meegoda MKDL1 1 Department of Allied Health Sciences, Faculty of Medical Sciences, University of Sri Jayewardenepura OP 8 Impact of an educational intervention on cancer palliative care among nurses Meegoda MKDL1, Fernando DMS2, Sivayogan S3, Atulomah NOS4, Marasinghe RB5 1 Department of Allied Health Sciences, , Faculty of Medical Sciences, University of Sri Jayewardenepura, 2Department of Physiology, Faculty of Medical Sciences, University of Sri Jayewardenepura, 3Department of Community Medicine, Faculty of Medical Sciences, University of Sri Jayewardenepura, 4Babcock University, Nigeria, 5 Department of Medical Education, Faculty of Medical Sciences, University of Sri Jayewardenepura OP 9 NT-proBNP concentration as a Criterion for the Diagnosis of Heart Failure Patients in Sri Lanka-Preliminary Study Dilshani KWW1, Peiris H1, Ranasinghe G2, Perera PPR1 1 Department of Biochemistry, Faculty of Medical Sciences, University of Sri Jayewardenepura, 2District General Hospital, Kalutara OP 10 Clinico-pathological factors influencing the recurrence free interval of patients with recurrent breast cancer Peiris HH1, Mudduwa LKB2, Thalagala NI3, Jayatilake KAPW4, Ekanayake U5, Horadugoda J5 1 Medical Laboratory Science, Faculty of Medicine, University of Ruhuna, 2Department of Pathology, Faculty of Medicine, University of Ruhuna, 3Family Health Bureau, Ministry of Health, 4Department of Biochemistry, Faculty of Medicine, University of Ruhuna, 5Oncology Unit, Teaching Hospital, Karapitiya OP 11 Is minimally invasive surgery safe to treat significant upper urinary tract obstructive uropathy due to urolithiasis – single entre experience Nandamuni Y1, Manikkage Y1, Hingalagoda C1, Pathirana H1, Seneviratne LN1 1 Sri Jayewardenepura General Hospital OP 12 Supine Percutaneous Nephrolithotomy (s-PCNL) as an alternative to conventional prone approach Pathirana H1, Nandamuni Y1, Manikkage Y1, Hingalagoda C1, Seneviratne LN1 1 Sri Jayewardenepura General Hospital 2.30 pm Symposium III – Controversies in Medicine Chairpersons: Prof. Saman Gunatilake, Prof. Samudra Kathriarachchi Creating disease – Prof. Diyanath Samarasinghe Chronic kidney disease in the North Central Province of Sri Lanka: Have we done enough?– Prof. Kamani Wanigasuriya Controversies in management of diabetes –Dr. Uditha Bulugahapitiya 3.40 pm Symposium IV - Multidisciplinary Approach in Medicine Chairpersons: Dr. Ananda Perera, Dr. Aruna Gunapala Teaming up towards better care for the elderly.– Dr. Dilhara Samaraweera Palliative care- a timely need –Dr. Udayaganie Ramadasa Functional reconstruction of the injured hand and upper limb – Dr. Thushan Beneragama 4.50 pm Closing ceremony and awards 5.00 pm Tea Scientific Sessions 2016 Faculty of Medical Sciences, University of Sri Jayewardenepura in collaboration with Sri Jayewardenepura General Hospital 08th April 2016 Detailed Programme (Poster Presentations) PP 1 Knowledge, attitudes and self-reported practices on post-operative pain management among nurses working in Colombo South Teaching Hospital and Sri Jayewardenepura General Hospital Wijekoon WMPDS1, Seneviratne SMKS1 1 Department of Allied Health Sciences, Faculty of Medical Sciences, University of Sri Jayewardenepura PP 2 Incidence and morphology of the Tubercle of Zuckerkandl and its important relationship in thyroid surgery Ranasinghe KPGN1, Bulathsinhala BKS1, Prasad IHDS1, Fernando R1 1 Professorial Surgical Unit, North Colombo Teaching Hospital, Ragama PP 3 Upper and lower limb fracture patterns in motor vehicle accidents - A single unit experience Pradeep IHDS1, Prasad IHDS1, Prabath IHDS1, Amarasingha AASM1, Perera SAU1, Buddhika UA1, Swarnakumar V1, Jayakumar J1 1 Department of Orthopaedics, North Colombo Teaching Hospital, Ragama PP 4 Crash characteristics and patterns of injury among victims of road traffic crashes admitted to General Hospital, Moneragala, Sri Lanka Tennakoon V1, Gimhani WMC2, Jayasingha-arachchige S3, Wickramasinghe AR4, Yasawardene SG1 1 Department of Anatomy, Faculty of Medical Sciences, University of Sri Jayewardenepura, 2Rehabilitation Hospital, Digana, 3General Hospital, 4 Moneragala, Department of Public Health, Faculty of Medicine, University of Kelaniya PP 5 Laparoscopic Ureterolithotomy for large ureteric stone: Single center experience Hingalagoda C1, Nandamuni Y1, Pathirana H1, Manikkage Y1, Seneviratne LN1 1 Sri Jayewardenepura General Hospital PP 6 Comparison of lipid profiles in a population of Type 2 Diabetes Mellitus patients and normal females in a rural area: A preliminary study Rathnayake RGL1, Perera PPR1, Hettiaratchi UPK1 1 Department of Biochemistry, Faculty of Medical Sciences, University of Sri Jayewardenepura PP 7 Comparison of lipid profile and anthropometric parameters in hypertensive and nonhypertensive females: A case control study Zumara MS1, Riyaza MHF1, Hettiaratchi UPK2, Athiththan LV2 1 Department of Allied Health Science, Faculty of Medical Sciences, University of Sri Jayewardenepura., 2Department of Biochemistry, Faculty of Medical Sciences, University of Sri Jayewardenepura. PP 8 Peak expiratory flow rate of Sri Lankan Tamil adults aged between 20 to 60 years in Jaffna district: A preliminary findings Balasubramaniam M1, Wimalasekera SW2, Sivapalan K1 1 Department of Physiology, Faculty of Medicine, University of Jaffna, 2Department of Physiology, Faculty of Medical Sciences, University of Sri Jayewardenepura PP 9 Study of demographic and socioeconomic characteristics of a cohort of patients with Chronic Kidney Disease (CKD) in North Central Province, Sri Lanka Thilakarathna SNBMIP1, Kiriwandeniya AU2 1 Department of Allied Health Sciences, Faculty of Medical Sciences, University of Sri Jayewardenepura, 2Department of Pathology, Faculty of Medical Sciences, University of Sri Jayewardenepura PP 10 Association between executive functions, quality of life and physical activity in a sample of community dwelling elderly people in Galle Municipality area- preliminary results Gamage MWK1, Hewage DC2, Pathirana KD3 1 Allied Health Sciences, ,Faculty of Medicine, University of Ruhuna, 2Department. of Physiology, Faculty of Medical Sciences, University of Sri Jayewardenepura, 3Department. of Medicine, Faculty of Medicine, University of Ruhuna PP 11 Pharmacists’ perception on providing medication dosing instructions to patients Manchanayake MGCA1, Bandara GRWSK1, Samaranayake NR1 1 Department of Allied Health Sciences, Faculty of Medical Sciences, University of Sri Jayewardenepura PP 12 Personnel, anthropometric and environmental risk factors for domestic falls among persons over 50 years of age Amarasinghe WMSY1, Balasooriya TC1, Eranga RAH , Fernando DTM1,.Fernando PTM 1, Ambawatta A2, Wijesiri WAA3, Prathapan S4 1 Faculty of Medical Sciences, University of Sri Jayewardenepura, 2Colombo South Teaching Hospital, Kalubowila, 3 Department of Community Medicine, 1Faculty of Medical Sciences, University of Sri Jayewardenepura 4 Department of Community Medicine, 1Faculty of Medical Sciences, University of Sri Jayewardenepura PP 13 Attitudes, willingness and factors associated with participation in Pap smear test among women in Ingiriya MOH area Dodangoda TC1, Meegoda MKDL1 1 Department of Allied Health Sciences, 1Faculty of Medical Sciences, University of Sri Jayewardenepura PP 14 Impact of one time in service staff training on newborn care practices at a Teaching Hospital Pathiraja P1, Gunasekera D2 1 Department of Gynaecology and Obstetrics, Faculty of Medical Sciences, University of Sri Jayewardenepura, 2Department of Paediatrics, Faculty of Medical Sciences, University of Sri Jayewardenepura PP 15 Analysis of US Scan findings in neonates with increased risk factors for Developmental Dysplasia of the Hip (DDH) Gamage MAMN1, Rupasinghe D1 1 Department of Paediatrics, Faculty of Medical Sciences, University of Sri Jayewardenepura PP 16 Knowledge, attitudes on neonatal care and associated factors among mothers in antenatal clinics of a tertiary care hospital in Sri Lanka Bandara AMNT1, .Amarasekara AATD1 1 Department of Allied Health Sciences, Faculty of Medical Sciences, University of Sri Jayewardenepura PP 17 Clinical significance of photosensitivity in early childhood epilepsy Wijesekara DS1, Pressler R 2,3,Boyd SG 2,3 ,Cross J.H.2,3,4 1 Faculty of Medical Sciences, University of Sri Jayewardenepura, 2Great Ormond Street Hospital for Children NHS trust, 3UCL-Institute of Child Health, London, UK, 4National Centre for Young people with Epilepsy, Lingfield, Surrey, UK PP 18 Evaluation of turmeric as a surface disinfectant Jayaweera JAAS1, Joseph A1, Kumbukgolla WW2, Croos S1, Weilgama DJ1 1 Department of Microbiology Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, 2Department of Biochemistry, Faculty of Medicine and Allied Sciences Rajarata University of Sri Lanka PP 19 Identification of bacterial aetiologies of dento alveolar abscesses and the antibiotic sensitivity patterns of the aerobic bacteria at selected dental units Jayawardena MN1, Kottahachchi J2, Nalaka ABMJ2, Dissanayaka DMBT2, Athukorala GIADD2, Samaraweera PCU2, Fernando SSN2 1 Postgraduate Institute of Medicine, University of Colombo, 2Department of Microbiology, Faculty of Medical Sciences, University of Sri Jayewardenepura PP 20 Evaluation of a simple and rapid microscopy technique for detection of Leptospira Sumaiha MHF1, Damayanthi MKS1, Weeraseakera MM2, Fernando SSN2, Gunasekara TDCP2 1 Department of Allied Health Science, Faculty of Medical Sciences, University of Sri Jayewardenepura,2Department of Microbiology, Faculty of Medical Sciences, University of Sri Jayewardenepura PP 21 Candida infection in oral leukoplakia: site of infection, etiology and effect of smoking, betel chewing and alcohol consumption Dilhari KAA1, Gunasekara TDCP1, Siriwardhana SJAP1, Maheshika LO1, Karunathilaka AHTS2, Fernando SSN1, Weerasekera MM1 1 Department of Microbiology, Faculty of Medical Sciences, University of Sri Jayewardenepura, 2Oral and Maxillo-Facial clinic, Colombo South Teaching Hospital, Kalubowila PP 22 Do we have clean domestic water sources? A study on microbiological quality of domestic wells in Maharagama and Boralesgamuwa MOH areas Pellawattage M1, Damayanthi N1, Widanagamage RD2, Priyadarshani AMB1, Uluwaduge I1, Wijesekara GUS1 1 Department of Allied Health Sciences, Faculty of Medical Sciences, University of Sri Jayewardenepura 2Department of Medical Laboratory Sciences, Faculty of Allied Health Sciences, General Sir John Kotelawala Defence University PP 23 Species distribution and in-vitro antifungal susceptibility pattern of candida clinical isolates Jayasekera PI1, Sigera LSM1, Shabry ULF1 1 Department of Mycology, Medical Research Institute, Colombo PP 24 Knowledge and practices on infection control among kidney transplant recipients from a selected nephrology unit Sameera AGLA1, Wanigatunge CA2 1 Faculty of Medical Sciences, University of Sri Jayewardenepura, 2Department of Pharmacology, Faculty of Medical Sciences, University of Sri Jayewardenepura PP 25 Are we satisfied with what we know about Human Papilloma virus (HPV) and the HPV vaccine? Karunanayake IU1, Premathilake NR1, Weerasekara MM2, Fernando SSN2, Pathiraja R3, Gunasekara TDCP2 1 Department of Allied Health Sciences, Faculty of Medical Sciences, University of Sri Jayewardenepura, 2Department of Microbiology, Faculty of Medical Sciences, University of Sri Jayewardenepura, 3Department of Obstetrics & Gynecology, University of Sri Jayewardenepura PP 26 How season of birth affects Schizophrenia in Sri Lanka Peramuna PDOSD1, Fernando LH1, Wanigatunga PS1, Kulasiri WGMMT1, Pathirage CL1, Prathapan S2, Gambheera H3 1 Faculty of Medical Sciences, University of Sri Jayewardenepura, 2 Department of Community Medicine, University of Sri Jayewardenepura, 3National Institute of Mental Health, Angoda PP 27 Determining the best discrimination index from Full Blood Count Parameters for screening of Beta thalassemia carriers in Sri Lanka Udawatta LD1, Senarathna PMNK1, Fernandopulle KHBP2, Herath P3 1 Department of Allied Health Sciences, Faculty of Medical Sciences, University of Sri Jayewardenepura,21Department of Pathology, Faculty of Medical Sciences, University of Sri Jayewardenepura, 3Medical Research Institute, Colombo PP 28 What Sri Lankan newspapers publish on sexual health? A content analysis of the articles and advertisements from Sinhalese and English newspapers published in July 2015 Perera PADMP1, Liyanage DLDC1, Pannala WS1, Godakandaarachchi LPP1, Ariyaratne K.A.M.1 1 National STD/AIDS Control Programme, Colombo PP 29 Assessment of nutritional and energy intake and selected anthropometric measurements among a sample of non-academic staff members in University of Sri Jayewardenepura Gunathilaka MDTL1, Hettiaratchi UPK1 1 Department of Biochemistry, Faculty of Medical Sciences, University of Sri Jayewardenepura PP 30 The body fat percentage distribution in a young adult female population of a Sri Lankan University Samarakoon DNAW1, Amarathunga AAMDDN1, Perera PPR2 1 Department of Allied Health Sciences, Faculty of Medical Sciences, University of Sri Jayewardenepura, 2Department of Biochemistry, Faculty of Medical Sciences, University of Sri Jayewardenepura PP 31 Effect of nutritional and psychosocial factors on educational performance of early female adolescents in Galle area-Preliminary study findings Madhushanthi HJH1, Wimalasekera SW2, Goonewardena CSE3, Lenora RSJ4, Amarasekara AATD5 1 Allied Health Sciences, Faculty of Medicine, University of Ruhuna, 2Department of Physiology, Faculty of Medical Sciences, University of Sri Jayewardenepura, 3Department of Community Medicine, Faculty of Medical Sciences, University of Sri Jayewardenepura, 4Department of Physiology, Faculty of Medicine, University of Ruhuna, 5Department of Allied Health Sciences, Faculty of Medical Sciences, University of Sri Jayewardenepura PP 32 Utilization pattern and patient’s accessibility to the Out Patient Department (OPD), District General Hospital, Kalutara Wijegunasekara JLHR1, Ferdinando R2 1 District General Hospital, Kalutara., 2National Institute of Health Sciences, Kalutara PP 33 Prevalence and determinants of musculoskeletal pain (MSP) among teachers in Nugegoda educational division in Sri Lanka Presangika PLS1, Warnakulasuriya SSP1 1 Department of Allied Health Sciences, Faculty of Medical Sciences, University of Sri Jayewardenepura PP 34 Social network addiction among medical students of University of Sri Jayewardenepura Edirisinghe EAST1, Shiyanth S1, Dissanayake MHP1, Dissanayake PH1, Yasewardene SG1 1 Department of Anatomy, Faculty of Medical Sciences, University of Sri Jayewardenepura PP 35 Maternal knowledge on benefits of breastfeeding: A study from a District General Hospital, Sri Lanka Senarathne UD1, De Silva YBP1, Anupama NJS1, Athukorala CL1, Makalandage KK1, Goonetilaka MD1 1 Department of Biochemistry, Faculty of Medical Sciences, University of Sri Jayewardenepura PP 36 Validation and cross cultural adaptation of the Sinhala Version of Quebec Back Pain Disability Scale (QBDS) Warnakulasuriya SSP1, Peiris-John R2, Sathiakumar N3,Wickremasinghe AR4 1 Department of Allied Health Sciences, Faculty of Medical Sciences, University of Sri Jayewardenepura,2 Section of Epidemiology and Biostatistics, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, 3Department of Epidemiology, University of Alabama at Birmingham ,USA, 4Faculty of Medicine, Department of Public Health, University of Kelaniya. PP 37 Work Related Musculoskeletal Disorders (WMSDs) among bus drivers at the central bus stand Colombo, Sri Lanka Udayana WS1, Fernandopulle KHBP2 1 Department of Allied Health Sciences, ,Faculty of Medical Sciences, University of Sri Jayewardenepura, 2 Department of Pathology, Faculty of Medical Sciences, University of Sri Jayewardenepura PP 38 Knowledge, attitudes and practices regarding management of childhood diarrhoea among mothers attending the MOH clinics in Ambalangoda area Jayamali C1, Jayawardane P2 1 Department of Allied Health Sciences, Faculty of Medical Sciences, University of Sri Jayewardenepura, 2Department of Pharmacology, Faculty of Medical Sciences, University of Sri Jayewardenepura PP 39 Knowledge and attitudes of final year nursing students of National School of Nursing, Sri Jayewardenepura and School of Nursing, Colombo on infusion phlebitis Harshani RAT1, Perera PPR2 1 Department of Allied Health Sciences, Faculty of Medical Sciences, University of Sri Jayewardenepura,2Department of Biochemistry, Faculty of Medical Sciences, University of Sri Jayewardenepura PP 40 Knowledge and practices regarding insertion and care of indwelling urinary catheter in female patients at a teaching hospital Rohan JP1, Amarasekara AATD1 1 Department of Allied Health Sciences, Faculty of Medical Sciences, University of Sri Jayewardenepura PP 41 Knowledge attitudes and practices related to hospital ergonomics among nurses working in four selected hospitals in Colombo District Warnakulasuriya SSP1, Peiris-John R2, Sivayogan S3, Sathiakumar N4, Wickremasinghe AR5 1 Department of Allied Health Sciences ,Faculty of Medical Sciences University of Sri Jayewardenepura,2Section of Epidemiology and Biostatistics, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, 3Department of Community Medicine ,Faculty of Medical Sciences ,University of Sri Jayewardenepura, 4Department of Epidemiology, University of Alabama at Birmingham,USA, 5Faculty of Medicine, Department of Public Health, University of Kelaniya PP 42 An intervention to change knowledge attitudes and practices on work ergonomics among nurses in two selected teaching hospitals in Colombo Warnakulasuriya SSP1, Peiris-John R2, Sivayogan S3, Sathiakumar N4, Wickremasinghe AR5 1 Department of Allied Health Sciences, Faculty of Medical Sciences, University of Sri Jayewardenepura, 2Section of Epidemiology and Biostatistics, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, New Zealand, 3Department of Community Medicine, Faculty of Medical Sciences, University of Sri Jayewardenepura, 4Department of Epidemiology, University of Alabama at Birmingham, USA, 5Faculty of Medicine, Department of Public Health, University of Kelaniya PP 43 ICU Nurses’ knowledge regarding ventilator-associated pneumonia and its prevention Muralitharan P1, Seneviratne SMKS1 1 Department of Allied Health Sciences, University of Sri Jayewardenepura PP 44 Constraints and challenges face by the nurses in provision of care at Accident and Orthopedic Service (AOS), National Hospital of Sri Lanka (NHSL) Wijayarathne GHPDS1, Warnakulasuriya SSP2 1 National Hospital Sri Lanka, 2Department of Allied Health Sciences, Faculty of Medical Sciences, University of Sri Jayewardenepura PP 45 A glimpse of International Elective Programme(IFP) at Faculty of Medical Sciences, University of Sri Jayewardenepura Banneheke BMHA1, De Silva D1, Kahatapitiya S1, Dissanayake J1 Adhikari B1, Weeraratne C1 1 Department of Parasitology, Faculty of Medical Sciences, University of Sri Jayewardenepura PP 46 Subcutaneous nodules in a neutropenic patient De Silva SHCK1, Jayasekera PI2, Wanigasooriya S1, Gunasekara SP1 1 National Cancer Institute, Maharagama, 2Department of Mycology, Medical Research Institute, Colombo PP 47 Selfie documentation of hanging: The first ever reported case in Sri Lanka Sanjeewa HKR1, Vidanapathirana M1 1 Department of Forensic Medicine, Faculty of Medical Sciences, University of Sri Jayewardenepura PP 48 A case report of two generations of Incontinentia pigmenti Perera TMR1, Vipulaguna DV2, Suntharesan J2, Wijesekara S1 1 Department of Paediatrics, Faculty of Medical Sciences, University of Sri Jayewardenepura, 2University Paediatric Unit, Colombo South Teaching Hospital, Kalubowila PP 49 A neonatal death with two crucial issues: The identity of the child and whether there was any therapeutic mismanagement Ariyarathne D1, Hulathduwa SR1 1 Department. of Forensic Medicine, Faculty of Medical Sciences, University of Sri Jayewardenepura PP 50 Acrometastasis as the initial presentation of Hepatocellular Carcinoma (HCC) Kiriwandeniya AU1 ,WijerathneT1 , MD Eranthaka2 , AMCP Gunarathna2 1 Faculty of Medical Sciences, University of Sri Jayewardenepura, 2Colombo South Teaching Hospital, Kalubowila PP 51 First patient with Scopulariopsis brevicaulis onychomycosis in Sri Lanka Jayasekera P1, Sigera LSM1, Gamage TM1, Hewage DM2 1 Department of Mycology, Medical Research Institute, Colombo, 2Base Hospital, Mawanella PP 52 First patient with Trichophyton violaceum tinea corporis in Sri Lanka Jayasekera PI.1, Sigera LSM1, Gamage TM.1 1 Department of Mycology, Medical Research Institute, Colombo PP 53 Pyoderma gangrenosum: Surgeons beware…! Perera KAAJ1, Edirisinghe AN1, Gunawardena SA1 1 Sri Jayewardenepura General Hospital FACULTY OF MEDICAL SCIENCES ORATION “The role of herbal extracts and functional foods in the management of chronic disorders” Thusharie Sugandhika Suresh Professor in Biochemistry Faculty of Medical Sciences, University of Sri Jayewardenepura “Let food be thy medicine and medicine be thy food” were great words uttered by the Father of modern medicine. Apart from being used as food, getting healing materials for his ailments was one important benefit obtained by the ancient man from his plant allies. As man gradually developed and evolved into a scientific individual, everything needed to be based on evidence. A trend emerged during the 20th century, where the investigation of safe natural materials as treatment options and the revisiting of traditional medicine expanded globally. Non communicable diseases are becoming an alarming threat to humans at present. With numerous limitations attributed to existing allopathic drugs, more attention is being paid to introduce herbal extracts and functional foods which exert beneficial health effects. Here, I wish to discuss my involvement in proving the scientific rationale for the use of a few herbal extracts and foods mentioned in ancient texts for diabetes mellitus and inflammatory conditions where I was either the principal investigator or the principal supervisor. Ipomoea aquatica (morning glory, kankun / vellaikeerai), Aegle marmelos (beli/vilvam) and the mushrooms Pleurotus austreatus (American oyster) and Pleurotus cystidiosus (abalone), Munronia pinnata (heen binkohomba / sinnavembu) were tested for hypoglycaemic, anti-inflammatory, anti-oxidant, brain ATPase and hepatoprotective effects. Initial studies were carried out in Wistar rats to exclude any toxicity. The first plant to be studied was I. aquatica which is popular green leafy vegetable in the Asian region where it was administered to newly-diagnosed diabetic patients on diet control. This extract resulted in a significant reduction of the fasting and post prandial blood glucose concentrations in these patients. It increased peripheral glucose utilization. The active compound was found to be a flavone glycoside. The 2nd study was on the culinary mushrooms, American oyster and abalone, which were effective in reducing the fasting and post-prandial blood glucose concentrations. A novel hypoglycaemic compound; N10 isopentenyl adenosine was also isolated from the mushrooms. The 3rd study was on the traditional beli mal drink. This proved to be very efficient in reducing the fasting and post prandial blood glucose concentrations and the body weights in diabetic patients with no toxicity. Insulin actions were markedly increased by this drink. The next project was on M. pinnata; a threatened species in Sri Lanka which is hard to be propagated by natural methods. The decoction prepared according to the traditional method proved to have highly significant hypoglycaemic, anti-inflammatory and hepato protective effects. Even though the callus culture extracts had lower potency than the natural plant, callus culture can be introduced as a method of propagating this valuable plant for future use. The study was able to demonstrate for the first time, the hypoglycaemic and anti-inflammatory effects of senecrassidiol. Overall; during my short research carrier, I was able to be involved in the value addition to the Sri Lanka medicinal plants and foods. With wide dissemination of these findings, attempts were made to use the information for the benefit of mankind. Future studies are planned to carry out industry-based value additions at a larger scale. Abstracts of Guest Lectures Plenary Lecture “Management of Urolithiasis, the need for further research and innovation” Prof. Srinath Chandrasekera The history of stone disease runs almost parallel to the history of civilization. Reports of attempts to surgically remove stones date back many thousands of years. Innovative healers conceptualised the possibility of crushing stone to remove them through natural passages as far back as 276 BC. Whilst numerous technical and medical advances made surgery for stone disease feasible from about 400 years ago, it was the development of anaesthesia and later antibiotics that rendered such attempts safe and acceptable. In the recent past, numerous surgical innovations such as fibre-optics, flexible and narrow calibre instruments, illumination, video technology and laser have facilitated the retrieval of urinary stones with minimal or no incisions. Developments in radiology have enabled precise identification and even the prediction of the likely composition of stones in vivo. Miniaturisations of instruments, energy delivery and optics have enabled access to the upper urinary tract with instruments as small as 4.5F. Of note is that several such innovations have originated from South Asia. At present the incision rate for removal of stones is less than 4%, an impressive statistic even some Sri Lankan centres have been able to achieve. Whilst improvements in the technology to treat stones have been dramatic, little light has been shed on the causative and preventive aspects of this largely recurrent disease. Available limited data shows an increasing incidence and trends towards a change in the composition of stones. In the local setting, metabolic screening hardly yields any results, a paradox yet to be resolved. It is timely that all stakeholders concentrate their efforts in seeking answers to many such issues as they are of particular relevance to tropical countries such as Sri Lanka. Symposium I - Excellence in Research Ethics in research Prof. Chandanie Wanigatunge Research is essential for advancement of knowledge and science. Medical research that involves humans, including those that involve identifiable human data or material must be conducted in accordance with the ethical principles laid down in the declaration of Helsinki. Adherence to these principles ensures respect to study participants while helping to protect their rights and wellbeing. Owing to the biological similarities seen between man and animals, animal research has also been an integral aspect of research. Prior data from animal studies are almost always needed before a new product can be tried out in humans. Animal research should also be conducted in a manner that minimizes the impact on animals involved. Human research ethics revolves around four fundamental principles – viz beneficence, nonmaleficence, autonomy and justice. Paying attention to these would ensure protection of research participants, especially those who are vulnerable. The application of these ethical principles when conducting biomedical research will be discussed in the presentation. Clinical trials Prof. Priyadarshani Galappatthy Advances in human health and welfare depend on research in human subjects. Many advances in health care and the impact of these observed today can largely be attributed to the evidence generated from conducting clinical trials. Excellence in any type of research is achieved by ensuring scientific validity and robust methodology. Well-conducted randomised doubled blind controlled clinical trials provide the highest level of evidence on therapeutic interventions. Successful clinical trials conducted through the four phases results in birth of new pharmaceutical products for treatment of humans and contribute to excellence in research. Due to the risk posed to research subjects, clinical trials differ from other non-interventional clinical research in several requirements that need to be fulfilled. These include, the necessity for preclinical trial data, prospective registration in a clinical trial registry, regulatory approval, adherence to Good Manufacturing Practices(GMP) and Good Clinical Practice(GCP) and safety reporting. These ensure minimising the risks and maximising the benefits to trial subjects primarily and humanity at large, achieving excellence in conduct of clinical trials. Despite the robust methodology and adherence to above-mentioned requirements with stringent regulation of clinical trials, there are several challenges that need to be overcome when conducting clinical trials in order to achieve excellence. Eliminating bias and confounders, using valid end points, setting priorities for conducting large clinical trials, employing meta-analyses and systematic reviews to weighing evidence, giving equal weightage to determining safety and efficacy, addressing therapeutic misconception, efficient trial management, incorporating patient reported out comes, managing usual care in trial design, validating biomarkers and surrogate end points include some of these. Communicating results in an accurate and timely manner, including to the public and evaluation of pharmacoeconomic benefits are also equally important to provide maximum benefit of clinical trials to people at large and for achieving excellence in research. Bench to bedside Prof. Hemantha Peiris As we walk through the 21st century, our understanding of the molecular and cellular basis of disease grows ever clearer. Over the next decades, more and more links will be made between genes and diseases which will pave opportunities for better diagnosis and treatment. Timely detection of diseases and conditions will have a profound impact on how clinicians practice in the years to come. Scientists have made landmark discoveries and set down ground work for screening, diagnosis, treatment and monitoring of diseases. Modern diagnostics have put together enzymes into strips and this technology is popular as the bedside testing known as Point of Care Testing (POCT).Thus, moving diagnostics out of the lab and putting it right at the patient’s bedside or even into the patient’s hands is the goal for improving diagnostic solutions of medical technology. The new Biochip Array technology is the way forward in multi-analyte testing using multiple sample matrices including serum, whole blood, urine and oral fluid which enables rapid evaluation of the complete patient disease profile in a single biological sample within a short time. Unlike other rapid test systems, this can provide a measure of the target biomarker, rather than just a simple” yes” or “no” result. This is particularly useful in monitoring the disease and evaluating the effectiveness of the treatment. When biological samples are applied to the biochip (held in a disposable cartridge), the presence of disease antigen passes at an angle across the chip surface. This electronic signal can then be detected and determined, providing an unequivocal pass/fail result for the particular disease being tested for. Unlike other rapid test systems, this can provide a measure of the target biomarkers as well. Thus, the Biochip Array techniques could be considered as an extremely useful POCT for screening, diagnosis and monitoring of diseases. Symposium II – Advances in Cardiac Arrhythmias Overview of arrhythmias Dr. Suresh Kottegoda Over the last two decades management of cardiac arrhythmias have moved from, merely making an ECG diagnosis and having to take potentially toxic drugs for long periods of time, to curative radiofrequency ablation which is a safe, effective and minimally invasive. There is a timely need to expand cardiac electrophysiology services across the country. Non cardiac aetiology of arrhythmias Dr. Shyama Subasinghe Clinical medicine is challenging at times. Signs and symptoms arising from one particular organ may not necessarily be due to a dysfunction of that organ itself. Actual pathology may be in an anatomically and physiologically totally different organ. As clinicians we have to be careful about these red herrings in clinical medicine. Failure to understand them leads to unnecessary investigations and delays in diagnosis which can threaten the patient’s life or life of an organ. A good example is arrhythmias due to non-cardiac pathologies. Diseases of the respiratory system, brain, eyes, kidneys and endocrine organs can give rise to various cardiac arrhythmias. Diagnosis can be missed unless suspected. Cardiac surgeon’s perspective of arrhythmias Dr.Rajitha Y de Silva Arrhythmia is a common problem encountered by cardiac surgeon during day today practice. It could be following cardiac surgery or it may be a surgery for arrhythmia. Atrial fibrillation is the commonest arrhythmia after cardiac surgery and It could cause significant morbidity. Further there is a new technique been developed for surgical ablation of atrial fibrillation which could be open or minimally invasive. Symposium III – Controversies in Medicine Creating disease Prof. Diyanath Samarasinghe Iatrogenic illness is a well-recognized form of disease generation. And it accounts for a good many deaths. There are other forms of diseases that the medical establishment creates, through a very different mechanism – that of simply adding new disease entities out of thin air. Of the clinical disciplines, psychiatry is the most skilled in performing this illusion. A third way in which we generate disease is through our own knowing and voluntary actions. Diseases that we visit upon ourselves take the form of NCDs, commonly. And finally there are those diseases that are forced upon us by unscrupulous agencies in their relentless pursuit of profit. And they ensure that we are kept in the dark about the scale and range of preventable harm that they inflict upon us. These different forms of morbidity-generation all call for ameliorative action by doctors. We have to learn the specific counter-responses needed for each variety. And our actions have to be as skilful as those we use in clinical practice. Chronic kidney disease in the North Central Province of Sri Lanka: Have we done enough? Prof. Kamani Wanigasuriya The burden of chronic kidney disease has been escalating in the North central dry zone of Sri Lanka over the last two decades. The disease is unrelated to conventional risk factors and hence referred to as the Chronic kidney disease of unknown aetiology (CKDu). Disease burden is most pronounced in the North Central Province (NCP) and extends to the Uva and North Western Provinces. In addition to the associated morbidity and mortality, the disease has caused a huge social and financial impact on the farming communities in the region. Finding the aetiology, early detection, implementing treatment strategies and preventive measures are imperative in order to achieve a sustainable solution. Based on available evidence, etiology of CKDu is multi-factorial, involving environmental toxic agents and possibly genetic predisposition in vulnerable populations. However, the research studies done so far are inadequate to analyze the effects of heavy metals, fluoride, water quality and agrochemicals on the aetiology of CKDu. There is paucity in using novel methods such as biomarkers in the population screening of CKDu enabling identification of the disease in the early stages. In depth knowledge on the disease profile, progression and effective treatment strategies to prevent the progression are lacking among the medical community. Although the treatment facilities have improved in the past, there is a need for more dialysis and transplant facilities within the easy reach of patients. The government of Sri Lanka has taken many initiatives based on the recommendations of the CKDu National Research Study. Supply of safe drinking water, regulation of agrochemical imports, strengthening the tobacco and alcohol control measures are some of the initiatives by the GOL. Some measures such as banning herbicide glyphosate, changing to organic farming etc are currently under debate by the scientific community. Despite the two decades of research and recent strategies implemented by the government, there is a long path ahead to find a sustainable solution to the CKDu burden in NCP of Sri Lanka. Controversies in management of diabetes Dr. Uditha Bulugahapitiya Diabetes mellitus has become a public health challenge worldwide owing to its high prevalence and wide range of associated complications. Many advances in the field of diagnosis and treatment have enabled better control and management of diabetes but several controversies still arise during day to day practice. Prediabetes is a state of intermediate hyperglycemia with glycemic levels below diabetic cut off values but above the normal. This state confers a significant risk of conversion to diabetes mellitus and research had shown the association between prediabetes and cardiovascular disease, emphasizing the importance of early intervention. Lifestyle modifications and pharmacotherapy have shown success in preventing and delaying the onset. Treatment with metformin is advocated in high risk individuals but criteria for such consideration remains unclear. Primary goal of treatment in diabetes mellitus is to achieve a good glycemic control and manage the risk of major complications. Results of multiple randomized control trials have demonstrated the benefit of tight blood sugar control (HbA1C equal or less than 7%) in preventing microvascular disease in diabetic patients. Yet, benefits of treating to specific threshold with a tight glycemic control have been questioned recently, especially amongst patients with advanced age, less life expectancy, having multiple co-morbidities, long standing diabetes and advanced target organ damage. A less tight control is accepted in above subgroup but HbA1C of 6.5 – 7% is targeted early in the disease course in patients who are young, newly diagnosed, with no cardiovascular disease and where major focus is on prevention of complications. Complexity of managing diabetes is partly due to the number of therapeutic approaches available. Metformin is considered the first line therapeutic option in type 2 diabetes mellitus however much debate had been focused on use of metformin in elderly, renal disease and acute illnesses. Thiazolidinediones (TZDs) are another class of anti-diabetic medications which drew much attention over the years. Its use had been limited in certain subgroups of patients due to its side effect profile which includes increased risk of fracture, worsening of heart failure and risk of bladder cancer. More debated is the association between TZDs use and cardiovascular events. Thus the place for TZDs still remains controversial. Insulin remains one of the most effective and flexible treatment modalities for diabetes mellitus. Although the importance of insulin is established, controversies exist on appropriate time of initiation of insulin, how to initiate & intensify insulin treatment, type of insulin to be used and use of insulin in elderly frail population. In addition to glycemic control, multiple risk factor modification is shown to have reduction in risk of microvascular and atherosclerotic cardiovascular outcome. Increased blood pressure is an established risk factor for adverse atherosclerotic cardiovascular events and progression of nephropathy in patients with diabetes. Treating high blood pressure remains a controversy, especially on who should be offered treatment, blood pressure targets to be achieved in patients with and without complications and preferred class of anti-hypertensive medications. Diabetic patients are at high risk of atherosclerotic cardiovascular disease, therefore the question arises when should we treat and how aggressively the prevention with statin and aspirin would be in a diabetic patient. Although statins have shown to be effective in primary prevention of cardiovascular events in diabetic patients, place of aspirin in primary prevention remains controversial. Symposium IV– Multidisciplinary Approach in Medicine Teaming up towards better care for the elderly Dr. Dilhara Samaraweera The elderly patient poses many challenges to the physician. The presentation of diseases in elderly are very non- specific, they have multiple non communicable and degenerative diseases and are on multiple medications. The evolution of medicine has resulted in super specialization with a specialists to deal with different aspects of patient care. It is impossible for a physician to keep abreast with the vastly changing knowledge base of different specialties. However the holistic approach which is vital especially in managing elderly patients can be achieved best by an interdisciplinary/multidisciplinary approach. An interdisciplinary/multidisciplinary approach is an absolute necessity to manage the complex physical, social and psychological problems of the elderly. The delivery of care by an interdisciplinary team consisting essentially of a geriatrician/physician, nurse, physiotherapist, occupational therapist and a social worker is needed to provide a comprehensive package to the elderly. Other members such as dieticians, speech and language therapists, podiatrist, tissue viability nurse would be useful to care for these elderly patients. Comprehensive assessment which is the gold standard for management of the frail elderly cannot be accomplished without the support of an interdisciplinary team. The skills, knowledge and expertise of the different members of the team can be combined to effectively to manage the complexities of the elderly patient and provide better care. Palliative care – a timely need Dr. Udayanganie Ramadasa At present people live longer, and are more likely to die from chronic diseases such as ischemic heart disease, cerebrovascular diseases and cancer. The elderly terminally ill patient dies due to chronic disabling disease and related huge symptom burden. It is the wish of all of us who care for the ill to cure them of their illness, but it is also the inevitable truth that this wish may not come true, and in those whom we cannot cure, the burden of physical, social, psychological and spiritual suffering is significant. Relief of suffering among these patients and their caregivers is a tremendous responsibility in practice of modern day medicine. Miscommunication between physician and patient (and family) may create disputes and may cause our patients die with unresolved symptoms at the later stages of their lives. With new advancement in science and technology the dying phase is prolonged with interventions that are possibly futile. Palliative care over time has searched to strike a balance in improving the quality of life of these patients. The WHO palliative approach clearly recommends that palliative care should come early in the course of an incurable illness, and not just at the end of life. It emphasizes on promoting holistic care to ensure physical, social, psychological and spiritual wellbeing. It is not only the patient but also the family and other caregivers who should be included in the palliative approach. There is an emphasis on impeccable assessment, early identification of palliative issues and implementation of appropriate interventions. Palliative care should be considered as an active process taken to improve the quality of life, and helping patients to live to their fullest in spite of the underlying illness. There is no one ‘’best way’’ to deal with palliation. The professional obligation of the palliative care team is to give patients courage to find meaning in life, whilst grieving for the hopes and dreams that may not be fulfilled for them. Functional reconstruction of the injured hand and upper limb Dr. Thushan Beneragama The hand is an important part of the body as it plays a critical role in the daily functions of all of us. Deformity and disfigurement of the hand can result in functional and emotional impact on the patient. The hand is essential for personal and economic endeavours of every individual regardless of his status. For many manual workers, the hand plays a key role in their daily work although no element of society escapes from the effects of impairment to the function of the hand. Despite accident prevention efforts, about one fourth of all treated injuries involve an injured hand. The actual losses attributable to hand injuries are much larger than records indicate as statistics do not take into account the losses from minor, untreated and unreported cases. To ignore or deny the importance of disfigurement of the hand to one’s socioeconomic well-being is unrealistic and outdated. The aim of surgical reconstruction of hand injuries and deformities is to regain mobility, strength, sensibility as well as to restore a socially acceptable appearance. Early proper surgical management is the key to a good functional outcome. Fractures and injuries to soft tissue, tendons, nerves and vessels should be treated at the time of reconstruction except in certain situations. Nerve reconstruction procedures should be performed early to achieve best surgical outcomes. For patients who present at a later stage, secondary procedures such as tendon or functioning muscle transfers, joint fusion procedures, contracture release and Botulinum toxin injection may be required. Rehabilitation of the injured hand and upper limb should begin as early as possible. Splinting, regular supervised occupational therapy and patient education are also important components in the management of hand injuries. ABSTRACT REVIEWERS Prof. Saman Gunatilake Dr. Chamil Marasinghe Prof. Surangi Yasawardene Dr. R. B. Marasinghe Prof. Sharaine Fernando Dr. Ramya Pathiraja Prof. Renu Wikremasinghe Dr. Shamini Prathapan Prof. Hemantha Peiris Dr. Usha Hettiarachchi Prof. S. D. Jayaratne Dr. Rasika Perera Prof Aloka Pathirana Dr. Shalindra Ranasinghe Prof Deepaka Weerasekera Dr. Ajantha Liyanage Prof. Sagarika Ekanayake Dr. I.S Gunasekera Prof. Srinath Chandrasekara Dr. Muditha Vidanapathirana Prof. Neluka Fernando Dr. Manjula Weerasekera Prof. Dulanie Gunasekera Dr. H Waidyasekera Prof. Neelika Malavige Dr. Prasanga Palihawadana Dr. Indira Wijesiwardena Dr. Jayamal de Silva Dr. D. Ariyarathne Dr. Kushlani Jayatilleke Dr. Hasini Banneheke Dr. Nirmala Wijekoon Dr. Dulani Beneragama Dr. Madura Jayawardane Dr. Bimalka Senevirathne Dr. Chandima Kulathilake Dr. Isha Prematilleke Dr. Thushari Dissanayake Dr. B. Fernandopulle Dr. P Warnakulasuriya Dr. Bawantha Gamage Dr. T Amarasekera Dr. Manori Gamage Dr. Chandimani Undugodage Dr. Sampatha Goonewardena Dr. Ramani Fernando Dr. Chandana Hewage Dr. Saraji Wijesekara Dr. Guwani Liyanage Dr. Ruwanthi Perera Dr. Sanjaya Hulathduwa Ms. Sujatha Seneviratne Dr. Pradeepa Jayawardane Dr. Banuki Jayasuriya Dr. Jananie Kottahachchi Abstracts of Oral Presentations OP 1 Immunohistochemical detection of Claudin low breast cancer; which subcellular level to be assessed? Mudduwa LKB1, Peiris HH2, Gunasekara SN1, Liyanage TG1, Abeysiriwardhana DS1 1 Department of Pathology, Faculty of Medicine, University of Ruhuna, 2Medical Laboratory Science, Faculty of Medicine, University of Ruhuna Objectives: Claudin low breast cancers are often high grade, triple negative tumours with poor prognosis. They are identified at genetic level and are not diagnosed routinely by immunohistochemistry. The objective was to determine the best subcellular level to detect Claudin low breast cancer by immunohistochemistry, in terms of their histopathological prognostic features. Methods: This cross sectional study included all archival breast cancer tissue collected up to December 2015 in our unit. Tissue microarrays (TMA) were constructed using 23 breast cancer cores with a diameter of 2mm, in each TMA. TMAs were immunohistochemically stained for Claudin 3 expression and was scored as; no staining=0, weak staining=1, moderate staining=2 and strong staining=3, separately for membrane, cytoplasmic and nuclear staining. A score <2 was considered Claudin low and analysed against the histopathological prognostic features of the breast cancer. Results: A total of 546 breast cancers were assessed. Claudin low expression was identified at cytoplasmic, membrane and nuclear level in 74.9%, 74.5% and 42% of breast cancers respectively. Low nuclear expression of Claudin 3 was associated with high grade (p=0.028), Nottingham Prognostic Index of >3.4 (p=0.028), ER and PR negative (p<0.001) and HER 2 negative (p=0.013) tumours while low membrane staining was associated with low grade (p=0.038), HER 2 negative (p<0.001) breast cancers. Low cytoplasmic staining was associated with HER 2 negative breast cancer only (p=0.002). Conclusions: Nuclear staining for Claudin should be assessed to identify Claudin low breast cancer by immunohistochemistry as it significantly associates with most of the Claudin low breast cancer characteristics. OP 2 Influence of culture medium on in-vitro biofilm formation by Candida species Wijesighe GK1, Jayarathna PDTA1, Gunasekera TDCP2, Kottegoda N3, Fernando SSN2, Weerasekera MM2 1 Department of Allied Health Sciences, Faculty of Medical Sciences, University of Sri Jayewardenepura ,2Department of Microbiology, Faculty of Medical Sciences, University of Sri Jayewardenepura.,3Department of Chemistry, Faculty of Applied Sciences, University of Sri Jayewardenepura. Objectives: Objective of this study was to establish an in vitro biofilm on the 96 well plates and to determine the efficacy of three different culture media on biofilm formation of Candida albicans and C. tropicalis Methods: A 96 well sterile, polystyrene plate was inoculated using 10^6 cell/ml of C. albicans and C. tropicalis suspensions and the growth rate of planktonic cells was determined by measuring the absorbance (OD492) at 2 hour intervals. Adhesion of Candidial cells to initiate the biofilm formation in the presence of three culture media (Yeast Nitrogen Base (YNB) supplemented with 100 mM glucose, Sabouraud Dextrose Broth (SDB) and RPMI1640) was quantified using MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) and Crystal Violet (CV) assay after 90 minutes. Biofilms of C. albicans, C. tropicalis and 1:1 co-biofilms were developed and the growth rates were quantified at 24 hours’ time intervals. Scanning electron microscope (SEM) was performed to assess the architecture. Results: Planktonic cells of both C. albicans and C. tropicalis showed maximum growth with SDB. C. albicans and co-biofilm adhesion were significantly facilitated with RPMI1640 and the best medium for C. tropicalis adhesion was YNB. Biofilms showed the maximum growth rate in RPMI 1640. C. tropicalis exhibited the minimum growth with all three culture media. Conclusions: The maximum growth rate for planktonic C. albicans and C. tropicalis was achieved with SDB. However RPMI 1640 was the best medium for growth of biofilms. OP 3 Comparison of psychological wellbeing among undergraduates of University of Sri Jayewardenepura Liyanage G1, Siriwardhane DN1, Balasooriya A2, Jayah FQ1, Seneviratne LSW1 1 Department of Paediatrics, Faculty of Medical Sciences, University of Sri Jayewardenepura, 2 Department of Medical Education, Faculty of Medical Sciences, University of Sri Jayewardenepura. Objectives: Psychological distress is an increasingly important public health problem and 12.3% of the population suffers from some form of mental illness. It is experienced as sadness, anxiety, fear and in extreme cases as psychotic symptoms. Psychological distress among university students is more compared to general population. This study was conducted to determine psychological distress and predictive factors in medical undergraduates and to compare them with two other main streams of undergraduate education, in University of Sri Jayewardenepura. Methods: A surveying method was adapted to select 408 final year students from all three faculties using the General Health Questionnaire 30 (GHQ - 30), an internationally accepted, nationally validated to determine psychological distress. Frequency tabulation and Chisquared tests were used for analysis by SPSS (15). GHQ score of six (6) or more indicated distress. Results: Among the undergraduates, 240 (58.8%) had a score more than 6. The prevalence of stress was higher among medical students 95(62.5%), than Applied Sciences 69(60%) and Management students 76(53.5%). Age of students (p=0.015), effect of studies on personal life (p=0.025), responsibilities as a group leader (p=0.05) and transport and meals (p=0.006) were found as independent significant risk factors for distress. Student’s gender (p=0.10), oral presentations (p=0.36) and continuous assessments (p=0.35) were not significantly associated with psychological distress. Specific tasks during clinical appointments were identified as stressful by majority of medical students. Conclusions: High prevalence of psychological distress in undergraduates, especially among medical students is identified. The need for detailed assessment of stressors and coping strategies is highlighted and emphasizes the necessity of early interventions to prevent, long term psychological sequelae. OP 4 Lung functions and respiratory symptoms among rice millers in Anuradhapura district, Sri Lanka Wickramage SP1, Rajaratne AAJ2, Udupihille M1 1 Department of Physiology, Faculty of Medicine & Allied Sciences, Rajarata University of Sri Lanka, 2Department of Physiology, Faculty of Medicine, University of Peradeniya Objectives: Rice is the most important crop cultivated in Sri Lanka and rice milling is the largest agro-based industry in the country. The general objective of this study was to identify and quantify the effects of inhalation of rice husk dust on the respiratory function of the rice millers in Anuradhapura district, Sri Lanka. Methods: Rice millers (male: 84, female: 84) and controls (male: 84, female: 84) were selected and matched for determinants of lung functions, including smoking pack year index. Data were collected via a validated respiratory symptom and occupational history questionnaire, a physical examination and spirometry. Subjects with a known history of respiratory or cardiac diseases were excluded from the study. Results: The rice millers, irrespective of gender, had significantly lower mean forced vital capacity (FVC), forced expiratory volume in the first second (FEV1) and peak expiratory flow rate (PEFR) values (p<0.05) and increased prevalences of respiratory symptoms when compared with controls. Among millers, 42% of males and 38% of females had features of chronic respiratory disease. Further, the mean FEV1/FVC ratio was significantly higher among male millers, while the mean mid expiratory flow rate (FEF25-75%) was significantly lower among female millers, than their respective controls. Exposure to the dust over a few hours caused significant reductions in FVC and FEV1 in female millers. Conclusions: The observed deficiencies in lung functions of rice millers were probably caused by the occupational exposure to rice husk dust. Wearing face masks, worker education and adequate ventilation in mills are recommended. OP 5 TiO2 21 nm nanoparticles as a photocatalytic antimicrobial agent against Escherichia coli, Candida albicans and Methicillin resistant Staphylococcus aureus: A comparison Senarathna ULNH1, Fernando SSN1, Gunasekara TDCP1, Weerasekera MM1, Wickrama WDSA1, Perera MKR1, Arachchi NDH2, Jayaweera PM2 1 Department of Microbiology, Faculty of Medical Sciences, University of Sri Jayewardenepura, 2Department of Chemistry, University of Sri Jayewardenepura Objectives: To determine and compare the antimicrobial activity of 21 nm TiO2 nanoparticles against Escherichia colii, Candida albicans and Methicillin resistant Staphylococcus aureus (MRSA). Methods: Titanium dioxide (TiO2) 21 nm anatase nanoparticles (13.9 g/l) were suspended in miliQ (MQ) water, sonicated (35 MHz for 1 hour) and autoclaved. Sterile glass petriplates were treated with TiO2 suspension or sterile MQ(control). Overnight cultures of E.coli MRSA and C. albicans were added to TiO2 coated plates and control plates and kept at room temperature. Viable counts were obtained by spread plate method at 0 hours and 24 hours; before and after sunlight exposure for 30 minutes. Colony forming units (CFU) / ml was calculated to determine percentage reduction of CFU in presence of TiO2. Experiments were done in triplicates. Results: TiO2 nanoparticles demonstrated antimicrobial activity against E.coli, MRSA and C. albicans. Estimated percentage CFU reduction in E.coli (138.4), MRSA (126.6) and C. albicans (364.9) was observed at 0 hours of contact in the supernatant. The bactericidal effect was enhanced on exposure of the plates to sunlight. Estimated percentage CFU reductions are E. coli (467.9), MRSA (990.2) and C. albicans (990.4). The results for 24 hours were (951), (352.1) and (834) reduction for E. coli, MRSA and C. albicans respectively. When the 24 hour plates were exposed to sunlight (990.6), (990.6) and (990.2) reduction was seen for E.coli, MRSA and C. albicans respectively. Conclusion: Anatase 21 nm TiO2 nanoparticles show enhanced antimicrobial activity against the tested microbial strains following photoactivation by sunlight. Antimicrobial activity against three different types of microbial strains has varying effects. OP 6 A survey on lifestyle restrictions in children with asthma: A comparison with Quality of Life (QoL) Peiris TVM1, Liyanage ML1, Waduge LT1, Sanjaya M1, Wickramathunge CV1, Liyanage G2, Prathapan S3 1 Faculty of Medical Sciences, University of Sri Jayewardenepura, 2 Department of Paediatrics, Faculty of Medical Sciences, University of Sri Jayewardenepura, 3 Department of Community Medicine, Faculty of Medical Sciences, University of Sri Jayewardenepura Objectives: To describe the Quality of Life and the restrictions imposed by parents and caregivers of asthmatic children aged 7-15 years. Methods: This comparative cross sectional study was conducted at outpatient clinics of two hospitals in Colombo. Children with physician diagnosed bronchial asthma, aged 7-15 years were recruited by systematic random sampling. The QoL was assessed using Mini Paediatric Asthma Quality of Life Questionnaire (MPAQoLQ). QoL was categorized as good (score=1.00-3.00) moderate (3.01-5.00) and poor (5.01-7.00). Results: A total of 254 completed questionnaires were returned. The mean MPAQoLQ score was 4.9. Six (2.4%) had poor, 116(45.7%) had moderate and 132(52%) had good scores. There were significant restrictions to food items, such as cold/chilled food (n=202; 79.5%), eggs (n=159; 62.6%), fresh milk (n=159; 62.6%) and soya bean products (n=127; 50.0%). Furthermore physical activity (n=23; 9.1%) and playing with pets (n=197; 77.6%) were restricted. There was a statistically significant association between MPAQoLQ score and restrictions on cold/chilled food (p=0.000), soya bean products (p=0.001), physical activity (p=0.000) and bathing (p=0.001). Conclusions: Quality of life of children with asthma is affected and it is in par with statistics of developed countries. However, dietary restrictions were highly prevalent (93.3%). These restrictions may be related to myths and beliefs in our society. Caregiver education on diet and lifestyle should be an integral part of out-patient management. OP 7 Assess and compare health related quality of life among elders who live in their own home and elderly care homes Fernando KDS1, Meegoda MKDL1 1 Department of Allied Health Sciences, University of Sri Jayewardenepura Objectives: Health Related Quality of Life (HRQOL) of elderly population is emphasized with the medical and public health advances. This study was conducted to assess the HRQOL of elders who live in their own home and elderly care homes. Methods: Descriptive cross sectional study was carried out in Elderly Care Homes (ECH) and Own Homes (OH) of elderly people in Minuwangoda Pradeshiya Sabha. Data were collected from elderly (> 60 years of age) people using interviewer administered Short Form health survey questionnaire (SF 36) and a form designed for recording demographic data. Informed consent was obtained. Ethical approval was obtained from the ethical review committee of the Faculty of Medical Sciences, University of Sri Jayewardenepura. Data were analyzed using Statistical Package for Social Sciences (SPSS) version 21. Results: Out of eight domains of SF 36, mean score of physical health of elders who live in their OH was 59.38±16.37, while that of elders who live in ECH was 46.04±16.00. Total mental health of elders who live in their OH and ECH scored 51.64±8.62 and 46.08±8.06 respectively. The elders live in ECH showed lowest mean score (23.10±40.99) for the domain of role limitation due to emotional problems while the mean score of elders who live in their OH were relatively high (48.02±41.79). Mean score of total quality of life of elders who live in their OH and ECH were 57.87±14.54 and 46.85±13.79 respectively. Conclusions: Health related quality of life of elderly people who live in their OH was higher than that of elderly people who live in ECHs. OP 8 Impact of an educational intervention on cancer palliative care among nurses Meegoda MKDL1, Fernando DMS2, Sivayogan S3, Atulomah NOS4, Marasinghe RB5 1 Department of Allied Health Sciences, Faculty of Medical Sciences, University of Sri Jayewardenepura, 2Department of Physiology, Faculty of Medical Sciences, University of Sri Jayewardenepura , 3Department of Community Medicine, Faculty of Medical Sciences, University of Sri Jayewardenepura, 4Babcock University, Nigeria,5Department of Medical Education, Faculty of Medical Sciences, University of Sri Jayewardenepura Objectives: To evaluate the impact of an educational intervention on the knowledge of nurses providing palliative care (PC) Methods: Nurses were selected from the medical and surgical oncology units of National Institute of Cancer Maharagama (NICM) (n=38) and Teaching Hospital Karapitiya (THK) (n=37) using convenient sampling technique as the intervention and control groups respectively. An educational intervention was prepared including printed material and DVD on cancer PC. The duration of the intervention was eight weeks. Pre and post intervention assessment of knowledge was done on intervention and control group. Ethical approval was obtained from the ethical review committee of the Faculty of Medical Sciences. Independent t-test and ANOVA were applied to determine significant differences (p>0.05). Results: The age, educational qualifications and the professional experience was similar in the two groups. Pre intervention knowledge was similar in the intervention (28.61±6.66) and the control (28.73± 5.31) groups. However, the knowledge of intervention group improved significantly immediately after the intervention (47.00±3.93). Further when assessing knowledge of nurses 12 weeks after the intervention, there was a significant improvement in knowledge of intervention group (50.36±3.97) when compared to control group (28.23±4.88). When comparing the pre-intervention knowledge of intervention group (28.61±6.66) the post intervention (12th week) knowledge was significantly higher (50.36±3.97). Conclusions: The educational intervention for nurses on cancer palliative care was effective in improving knowledge. OP 9 NT-proBNP concentration as a criterion for the diagnosis of heart failure Patients in Sri Lanka: A Preliminary study Dilshani KWW1, Peiris H1, Ranasinghe G2, Perera PPR1 1 Department of Biochemistry, University of Sri Jayewardenepura, 2District General Hospital, Kalutara Objective: To compare N-terminal pro-brain natriuretic peptide (NT-proBNP) level between chronic heart failure patients and individuals without heart failure. Methods: Blood samples were collected from echocardiographycally confirmed 46 chronic heart failure patients and 46 non heart failure individuals at cardiology unit District General Hospital, Kalutara. Serum samples were analyzed for serum creatinine level to exclude renal influence and NT Pro BNP level was measured using a minividas® auto analyzer. Bilateral comparisons were made using Mann-Whitney U test. P values lower than 0.05 were considered as statistically significant. The data were analyzed using SPSS version 16. Results: Patients with chronic heart failure were shown to have higher NT-proBNP values with a mean of 1553.17±1555.07pg/ml (range124-6167) than control subjects with a mean of 39.61±20.23pg/ml (range 15-90) (P 0.001). A statistically significant difference was observed in plasma NT-proBNP values between heart failure patients and healthy individuals (p < 0.001). When the data were evaluated, minimum value of NT-pro BNP was found to be 124pg/ml for chronic heart failure patients. Based on the results of healthy individuals, 82.7pg/ml was established as the 95th percentile. Conclusions: NT-proBNP is an important biomarker in evaluating CHF patients. The presented data suggest a population cut-off level of 82.7pg/ml to exclude heart failure in individuals with symptoms suggestive of heart failure or to risk stratify individuals at risk of heart failure. OP10 Clinico-pathological factors influencing the recurrence free interval of patients with recurrent breast cancer Peiris HH1, Mudduwa LKB2, Thalagala NI3, Jayatilake KAPW4, Ekanayake U5, Horadugoda J5 1 Medical Laboratory Science, Faculty of Medicine, University of Ruhuna, 2Department of Pathology, Faculty of Medicine, University of Ruhuna, 3Family Health Bureau, Ministry of Health, 4Department of Biochemistry, Faculty of Medicine, University of Ruhuna, 5Oncology Unit, Teaching Hospital Karapitiya Objectives: Clinico-pathological factors affect the prognosis of breast cancer (BC) reflecting the heterogeneity of the disease. Following initial treatment, there is an ongoing risk of recurrence. The influence of these prognostic factors on the time taken to develop recurrence is not well established. This study was designed to determine the effect of clinic-pathological factors on the recurrence free interval (RFI) of BC patients with recurrent disease. Methods: This retrospective study included BC patients who had sought the immunohistochemistry laboratory services of our unit from May 2006 to December 2012. Mean follow up time was 45±23 months. All BC patients who had recurrences (loco-regional and distant metastasis) during the follow up period were enrolled. RFI was measured from the date of first therapeutic intervention to the date of confirmation of recurrence. Chi-square test was used for analysis. Results: Out of 944 BC patients, 188(mean age 50±11 years), had recurrences (loco-regional =35, distant metastasis =153). More than 50% of them had recurrence within 24 months of initial treatment (local=18/35 and distant=81/153). Mean RFI was 33±21 months for oestrogen receptor (ER)/progesterone receptor (PR) positive BC and 22±16 months for ER/PR negative BC. ER/PR positive BCs had a significant upward trend in developing recurrences over time (χ2 trend<0.001) while the rest had a downward trend. Other clinicopathological factors were not associated with RFI. Majority (49/53) of the ER/PR positive BC patients had received hormone therapy and 179/188 BC patients had received chemotherapy. Conclusions: ER/PR positive BC patients develop late recurrences while hormone receptor negative patients develop early recurrences depicting late and early treatment failure in respective groups. OP 11 Is minimally invasive surgery safe, to treat significant upper urinary tract obstructive uropathy due to urolithiasis: Single centre experience Nandamuni Y1, Manikkage Y1, Hingalagoda C1, Pathirana H1, Seneviratne LN1 1 Sri Jayewardenepura General Hospital Objectives: Upper urinary tract obstruction (UTO) is a urological emergency. Failure in timely intervention results in nephron loss, urosepsis and death. The objective was to assess the safety and efficacy of minimally invasive surgery in UTO. Methods: Prospective Descriptive Study was carried out at professorial surgical unit of Sri Jayewardenepura Hospital. All patients presenting with upper tract urolithiais from January 2014 to January 2015, with significant upper tract obstruction (moderate to severe hydronephrosis) were included. CT KUB±Urogram confirmed the obstructing calculus and the degree of hydronephrosis. Patients with significant UTO were analyzed by presentation, interventions, complications and outcome. Results: Out of 224 patients, 25% (n=57) had significant UTO. Of them 41%, and 14% had Diabetes mellitus and chronic kidney disease respectively. Eighteen patients (32%) had UTO complicated with urosepsis and/or acute kidney injury, out of them each underwent PCN insertion (n=7) and retrograde stenting (n=7) followed by secondary ureteroscopic lasertripsy (URSL) while 4 patients underwent Primary URSL in 4±2 days. Uncomplicated UTO patients (n=39) underwent Percutaneous nephrolithotomy (n=6), primary URSL (n=23), laparoscopic ureterolithotomy (n=8) and open surgery (n=2) as definitive treatment in 32±11 days. Two patients with complicated UTO underwent nephrectomy. There were no intervention related major complications including renal loss or deaths. 95% had fovourable renal recovery by 6 month of follow up Conclusions: One in four patients who present with UTO has significant obstruction. Timely management of complicated UTO by immediate urinary diversion or decompression saves lives and kidneys. Significant UTO can be effectively managed with minimally invasive surgical techniques by careful patient selection and prioritization. OP 12 Supine percutaneous nephrolithotomy (s-PCNL) as an alternative to conventional prone approach Pathirana H1, Nandamuni Y1, Manikkage Y1, Hingalagoda C1, Seneviratne LN1 1 Sri Jayewardenepura General Hospital Objectives: Percutaneous Nephrolithotomy (PCNL) is conventionally performed in the prone position. However supine PCNL(s-PCNL) may be more advantageous in terms of facilitating simultaneous flexible ureterorenoscopy and negating the need for a second percutaneous renal access for complex stones. It may reduce the cardio-respiratory compromise seen in the prone position. We reviewed our experience of performing supine percutaneous nephrolithotomy (s-PCNL) in the management of large or complicated renal calculi. Methods: Data was prospectively collected on 103 consecutive cases of s-PCNL performed at our institution from September 2014 to December 2015. Stone fragmentation was done using Lithoclast Master and inaccessible stones were manipulated simultaneously using a flexible ureterorenoscopy. Stone clearance was assessed with CT-KUB. Results: The mean age and BMI were 53.2 years (range 27 – 81) and 29kg/m2(range 20 – 34), respectively. Calculi size ranged from 16-41 mm (mean 23 mm) which included staghorn, calyceal, diverticular, pelvis and upper ureteric calculi. Lower pole calyx was utilized as the most frequent form of access (63%), followed by upper pole(7%) and interpolar(30%) access. Simultaneous flexible ureterorenoscopy was used in 15% of patients. Median operative time and hospital stay were 80 min (range 40 – 240 min) and 3 days(range 3 – 15 days) respectively. Complications noted were pyrexia, renal derangement and pulmonary embolism (0.97% each). Interval CT KUBs confirmed complete stone clearance in 91% of patients. Conclusions: s-PCNL is safe and effective in treating renal calculi. Patient benefits include a comfortable position, lack of major complications (in our series) and favourable stone clearance rates. We would advocate the supine, extended lithotomy position in centers performing PCNL. Abstracts of Poster Presentations PP 1 Knowledge, attitudes and self-reported practices on post-operative pain management among nurses working in Colombo South Teaching Hospital and Sri Jayewardenepura General Hospital Wijekoon WMPDS1, Seneviratne SMKS1 1 Department of Allied Health Sciences, Faculty of Medical Sciences, University of Sri Jayewardenepura Objectives: This study was aimed at describing knowledge, attitudes and self- reported practices on post- operative pain management (POPM) among nurses. Methods: A descriptive cross sectional study was conducted using a sample of 132 nurses from surgical wards of two teaching hospitals using a pre-tested self-administered questionnaire. Data were analyzed using SPSS (version-16). Results: The mean overall knowledge score was 64.89±1.39. Most nurses were knowledgeable on the need for pain assessment (80.3%), pain assessment tools (79.5%), need for administering analgesia around the clock (68.2%) and the risk of respiratory depression due to opioids (87.1%). Only 44.7% were aware of intravenous opioids being the best method to treat sudden onset of severe pain. The mean overall attitude score was 3.76±0.37. Almost all (98%) felt that they have responsibility for POPM while 93.1% believed that the patient had a right to request analgesia. Most nurses (75.8%) believed that opioids administration should be minimized due to addiction. The mean overall practice score was 54.97±1.56. Administration of opioids was minimized ‘Always’ (50.8%) and ‘Sometimes’ (42.4%) considering the possibility of a risk of addiction. Although most nurses (84.1%) felt the importance of a standard method to assess pain, 48.5% had never used pain assessment scales. Some have reported giving a placebo to confirm whether the pain is real (34.1%). Conclusions: Nurses’ overall knowledge on POPM and self–reported practices were satisfactory and overall attitudes were positive. There were deficiencies in attitudes and practices related to administration of opioids that should be minimized through training on POPM to improve patient outcomes. PP 2 Incidence and morphology of the Tubercle of Zuckerkandl and its important relationship in thyroid surgery Ranasinghe KPGN1, Bulathsinhala BKS1, Prasad IHDS1, Fernando R1 1 Professorial Surgical Unit, North Colombo Teaching Hospital, Ragama Objectives: The Zuckerkandl tubercle (ZT) is an embryological remnant of thyroid gland seen as a distinguishable thickening or nodule at posterolateral aspect of the gland. Our objectives were to find out the incidence and morphology of the ZT 2, to describe Its relationship to the recurrent laryngeal nerve (RLN) and to describe the relationship of ZT with pressure symptoms Methods: In this observational study, the presence of the ZT and size was assessed during all total thyroidectomies done at CNTH, professorial surgical unit from 01/01/2013 in 102 patients. Relationship of the ZT to the RLN was assessed and the closest distance between RLN and ZT was measured. Preoperative pressure symptoms were compared with the presence of grade III tubercle. Results: The ZT was present in 94(92.2%) patients, in 84(89.4%) at right side, in 66(70.2%) at left side and 61.7% (58) in both sides. In right side 52% had Grade I(1-5mm), 30% had grade II(6-10mm) and 18% had grade III (>10mm) tubercles. In left side 60% had grade I and II and 40% had grade III tubercles. The RLN lies always within 3mm from the tubercle and lies either posteriorly or posteromedially. Pressure symptoms were present in 26% patients and it was not related with grade III tubercle. Conclusions: Identification of ZT is a helpful landmark in thyroid surgery as it is present in 92.2% and closely related to the RLN. It’s more common in right lobe but larger (grade III – 40%) in left lobe. There is no significant association between pressure symptoms and grade III tubercle. PP 3 Upper and lower limb fracture patterns in motor vehicle accidents - A single unit experience Pradeep IHDS1, Prasad IHDS1, Prabath IHDS1, Amarasingha AASM1, Perera SAU1, Buddhika UA1, Swarnakumar V1, Jayakumar J1 1 Department of Orthopaedics, North Colombo Teaching Hospital, Ragama Objectives: To evaluate the limb fracture patterns in different mechanisms of motor vehicle accidents in Sri Lankan context. Methods: All the motor vehicle accident (MVA) victims with limb fractures admitted to Colombo North Teaching Hospital from 2014/11/01 to 2015/03/31were included. Patients who have been transferred for specialized care to National Hospital Sri Lanka before completion of the orthopedic management were excluded. Results: During 5 months period, 214 patients admitted after MVA and 81.3% (174) were males while 18.7% (40) females. Most were motorcycle (MC) accidents (63.5%) followed by Three Wheelers (TW) - 14.5%, push cycles (PC) - 9.8%, Light vehicles(LV) - 6.5% and Heavy vehicles(HV) - 5.6%. Fractures of the forearm bones were the commonest limb fracture seen in MC (26.6%), TW (32.4%), PC (60%) and LV (33.3%) groups. In contrast ankle and foot fractures were the commonest in HV (36.3%) group. Conclusions: MC leads MVAs and sustains mainly forearm, hand, leg and foot fractures. TW accidents are the 2nd cause and mainly caused forearm, shoulder, leg and ankle fractures. Preventive measures should be implemented at national level to reduce morbidity of MVA. PP 4 Crash characteristics and patterns of injury among victims of road traffic crashes admitted to General Hospital, Moneragala, Sri Lanka Tennakoon V1, Gimhani WMC2, Jayasingha-arachchige S3, Wickramasinghe AR4, Yasawardene SG1 1 Department of Anatomy, Faculty of Medical Sciences, University of Sri Jayewardenepura, 2Rehabilitation Hospital, Digana, 3General Hospital, 4 Moneragala, Department of Public Health, Faculty of Medicine, University of Kelaniya Objectives: To identify crash characteristics and patterns of injury among victims of road traffic crashes (RTC) admitted to General Hospital, Moneragala. Methods: A descriptive study was conducted among hospitalized victims of RTC to identify crash details, injury patterns and contributory factors for crash over a period of four months. A pre-tested questionnaire was filled interviewing the victim or bystander. Needed injury descriptions were adopted from the bed-head-tickets. Results: Out of 274 victims, 203(74%) were males and 71(26%) were females. Victims’ age ranged from one year to 78 years. The youth; 20-39 years comprised 54% of the sample. Motorcyclists and pillion riders were involved in majority (50%) of RTC. Skidding (34%) and head-on collision (30%) were the most common types of RTC. The commonest cause for RTC was high speed (36%). Nearly 2/3rd of the crashes occurred during the day (6am-6pm). Majority of the victims (51%) were brought to hospital by three-wheeler. Only 7% had received first-aid on site. The limbs (68%) and head, face and neck (48%) were the commonest body regions injured. Apart from the superficial injuries (76%), crush and fractures accounted for 30% and 26% of the injuries respectively. Minimal to maximal days of stay at hospital varied from one to 36 with a mean of 3. Restricted activities were experienced by many. 16% of victims were recommended physiotherapy for more than three months. Conclusions: Male youth riding on motorcycles were highly susceptible for RTC. Extremities were injured in majority of the victims causing long/short term limitations in domestic and social activities. PP 5 Laparoscopic Ureterolithotomy for large ureteric stone: Single center experience Hingalagoda C1, Nandamuni Y1, Pathirana H1, Manikkage Y1, Seneviratne LN1 1 Sri Jayewardenepura General Hospital Objectives: Laparoscopic ureterolithotomy (LU) is a minimally invasive treatment option for large impacted ureteric calculi not amenable to pneumatic ureteroscopic treatment or shock wave lithotripsy. The objective of the study was to evaluate the efficacy and safety of LU for management of ureteric stones. Methods: Prospective study was carried out from September 2013 to August 2014. All patients with large ureteric stones >1.5 cm in size with density >1000 HU with upper tract dilatation were included. Stone extraction was done using a lap-bag using 3 or 4 port technique. Double-J stent was inserted with intracorporeal suture repair of the ureterotomy. Patients’ characteristics, stone characteristics, peri and post-operative complications (minimum follow-up of one year) were analyzed. Results: Fifteen (15) patients with mean age of 43±12 years, with median BMI of 27.7 kgm2 were included. 60% were males. Mean stone diameter was 19mm (1.5-2.9mm) and density was 1215HU. Two (02) stones were at pelvi-ureteric junction, nine (09) at upper and four (04) at mid ureter. Thirteen patients had single stone disease, and rest had two each. Mean operative time was 107±50 minutes. There were two conversions to open ureterolithotomy. All patients had complete stone clearance (100%). Mean hospital stay was 4days and duration of double-J stenting was 8 weeks. None of the patients developed long-term post-operative complications during the mean follow up of 18 months. Conclusions: LU is a safe and effective approach for selected patients with large and dense ureteric stones where there is no LASER facility. This should replace open surgery as reduced postoperative complications and short hospital stay, and should be considered as a treatment option for such stones. PP 6 Comparison of lipid profiles in a population of Type 2 Diabetes Mellitus patients and normal females in a rural area- A preliminary study Rathnayake RGL1, Perera PPR1, Hettiaratchi UPK1 1 Department of Biochemistry, Faculty of Medical Sciences, University of Sri Jayewardenepura Objectives: The aim of this study was to compare the lipid profiles of a population of type 2 Diabetes Mellitus (T2DM) patients and non-diabetic females in a rural area. Methods: Diabetic and non-diabetic (each n=24) females living in Elehera regional secretary area were selected using convenient sampling method. Ten and twelve hour fasting blood samples were collected for determination of fasting blood sugar (FBS) and lipid profile assays [total cholesterol (TC) serum triglyceride (TG), high density lipoprotein (HDL), low density lipoprotein (LDL)]. Results: The mean age of the T2DM group was 43 years and the controls were 40 years. FBS level of T2DM group and control group were 129.0±49.1 mg/dl and 83.5±9.3 mg/dl respectively and were significantly different (p<0.05). TG levels of diabetic and non-diabetic groups were 150.8±84.1 mg/dl and 103.5±71.8 mg/dl respectively and significantly higher in T2DM cases (p<0.05). However, other lipid parameters were not significantly different among the two groups. Hypertriglyceridemia were seen in 33.3% tests and 8.3% controls, while lower HDL levels were observed in 50% tests and 29.2% controls. Interestingly, 50% of the controls were having hypercholesterolemia (test-37.5%), and elevated LDL levels (test-33.3%). Conclusions: Hypertriglyceridemia is associated with the T2DM population in this study and interventions need to be carried out as one third of the test population is having elevated levels of other lipid profile parameters although the values were not significantly higher compared to the controls. As considerable percentage of controls also had elevated lipid profile parameters, regular screenings should be advised. PP 7 Comparison of lipid profile and anthropometric parameters in hypertensive and nonhypertensive females: A case control study Zumara MS1, Riyaza MHF1, Hettiaratchi UPK2, Athiththan LV2 1 Department of Allied Health Science, Faculty of Medical Sciences, University of Sri Jayewardenepura., 2Department of Biochemistry, Faculty of Medical Sciences, University of Sri Jayewardenepura Objectives: To compare the correlation of hypertension with lipid profile and anthropometric parameters among hypertensive and non- hypertensive females Methods: Age sex matched case control study was conducted among 50 (hypertensive 25 and non-hypertensive 25) females from a suburban area aged 35-55 years. Blood pressure, waist circumference (WC), height and weight were measured. Body Mass Index (BMI) was calculated. After a twelve hour fast blood sample was collected for total cholesterol (TC), high density lipoprotein cholesterol (HDL), and triglycerides (TG) assays. Total cholesterol / HDL ratio and low density lipoprotein cholesterol (LDL) (Friedwald formula) were calculated. Data was analyzed using SPSS version 16. Results: Mean ages of hypertensive and non-hypertensive females were 51 ± 4 and 45 ± 7 years respectively. About 96% of the hypertensive subjects were above 45 years whereas only 46% of the subjects were above 45 years in the controls. All the lipid profile parameters were within the normal reference range except LDL which was elevated in both the hypertensive and non-hypertensive subjects. Triglycerides showed a positive correlation with hypertension. Mean WC and BMI were higher in both hypertensive (90.61±7.05cm, 26.04±3.45kg/m2) and non-hypertensive (87.51±9.81cm, 26.21±4.52kg/m2) subjects respectively. Conclusions: There were no significant difference in both the lipid profile and anthropometric parameters in hypertensive and non- hypertensive subjects. But elevated levels of WC, BMI and LDL in both hypertensive and non- hypertensive subjects suggest that the study subjects are at risk of developing metabolic syndrome. PP 8 Peak expiratory flow rate of Sri Lankan Tamil adults aged between 20 to 60 years in Jaffna district- A preliminary finding Balasubramaniam M1, Wimalasekera SW2, Sivapalan K1 1 Department of Physiology, Faculty of Medicine, University of Jaffna, 2Department of Physiology, Faculty of Medical Sciences, University of Sri Jayewardenepura Objectives: As variations in PEFR amongst ethnic groups have been observed in many studies and a lack of normal values amongst the Tamil adult population hampers clinical use of the PEFR as an indicator of respiratory dysfunction, objective of this study was to measure the normal peak expiratory flow rate (PEFR) of Sri Lankan Tamil adults. Methods: Healthy adults (n=267) aged between 20-60 years from regions of Jaffna district were studied. Standing height, sitting height and weight were measured. Age, BMI, sitting height to standing height ratio were calculated. PEFR was measured with (mini - Wright compatible) Asthma Plan peak flow meter. Independent t test and Pearson correlation were used in SPSS for analysis. A p value of <0.05 was set as significant. Results: There were125 males and 142 females. The mean age was 41± 10 years, and 37± 10 years in males and females respectively. The mean PEFR were 458 ±70 l/min in males and 316 ± 46 l/min in females. The mean PEFR differed significantly between both sexes. Reduction in PEFR after fifth decade (37 males, 26 females) was significant in males. There was a significant negative correlation (r = - 0.281) between PEFR and age amongst the males. Significant correlations of PEFR were observed with standing height (0.428), weight (0.327) and sitting height (0.374) in males. In females standing height (0.211) and sitting height (0.264) had significant correlation with PEFR. Conclusions: Normal values of PEFR in Sri Lankan Tamil adults were studied. A reduction in the PEFR was observed after the fifth decade of life in this population. PP 9 Study of demographic and socioeconomic characteristics of a cohort of patients with Chronic Kidney Disease (CKD) in North Central Province, Sri Lanka Thilakarathna SNBMIP1, Kiriwandeniya AU2 1 Department of Allied Health Sciences, Faculty of Medical Sciences, University of Sri Jayewardenepura, 2Department of Pathology, Faculty of Medical Sciences, University of Sri Jayewardenepura Objectives: To describe demographic and socioeconomic characteristics of a cohort of patients with CKD in North Central Province Methods: This is a descriptive cross sectional study of the patients who attended the renal clinic in Teaching Hospital, Anuradhapura. Study sample (n=384) was selected using systematic sampling technique. Data was collected using a pre-tested structured interviewer administered questionnaire. Results: Prevalence of chronic kidney disease with uncertain aetiology (CKDu) in the total population with CKD was 70.8%. Among the 29.2% of patients with CKD with known etiology (CKDd), commonest underlying diseases were hypertension (49.1%) and Diabetes (19.6%). Of the CKDu patients, 48.5% had a positive family history. Prevalence among males was higher (1.45:1). Mean age was 57.3 years (SD 9.8).Cultivating using agrochemicals and consuming such food (97.1%), being local residents for over 40 years (96.7%) and usage of well water (62.1%), were common. Spending on bottled water for day today purposes was a problem in 73.2%. Alcoholism, smoking and betel chewing were also common issues. Conclusions: Nearly three fourths of this study sample has CKDu. It appears to affect people in their sixth decade, residing locally for over four decades, drinking water from own wells, cultivating and consuming food using agrochemicals. These may be pointers towards aetiology of CKDu. Significant burden of expenditure for water for day today purposes on this low income group has to be addressed immediately. PP 10 Association between executive functions, quality of life and physical activity in a sample of community dwelling elderly people in Galle Municipality area- Preliminary results Gamage MWK1, Hewage DC2, Pathirana KD3 1 Allied Health Sciences, Faculty of Medicine, University of Ruhuna, 2Department of Physiology, Faculty of Medical Sciences, University of Sri Jayewardenepura, 3Department. of Medicine, Faculty of Medicine, University of Ruhuna Objectives: Cognitive function is becoming more important for independent living of the elderly with weakening extended family support system. The executive functions (EFs) such as working memory and inhibition are thus important. This study was conducted to assess the association between EFs, level of physical activity and quality of life (QOL) in a sample of elderly people. Methods: Study was conducted with 30 community dwelling elderly people in Galle Municipality area in Galle District. The EFs were assessed via computerized verbal working memory (VWM) and stop signal (SS) inhibitory tasks. The IPAQ (International physical activity questionnaire) was used to assess level of physical activity while QOL was assessed via WHOQOL-BREF (WHO quality of life-BREF). Correlation was assessed through spearmen correlation coefficient (r) and significant level was kept at p<0.05. Results: The sample comprised of 80% females and 20% males with mean age of 66.23 years (+5.99). Mean scores of WHOQOL-BREF and IPAQ were 66.99 (+12.34) and 5400.43 MET-minutes/week (+1917.95) respectively. Mean scores of VWM span level and SS task commission errors were 14.19 (+7.62) and 1.47 (+0.89) respectively. Both VWM and SS tasks were significantly correlated with physical activity level (r =0.37,p=0.044 and r=0.39,p=0.030) and with environmental (r=0.40, p=0.027) and physical health domains (r=0.38, p=0.035) of QOL respectively. Conclusions: EFs of elderly were significantly correlated with their level of physical activities and physical and environmental health domains of QOL while social relationships, psychological health, general health and overall QOL were not correlated. This may be due to the small sample size. PP 11 Pharmacists’ perception on providing medication dosing instructions to patients Manchanayake MGCA1, Bandara GRWSK1, Samaranayake NR1 1 Department of Allied Health Sciences, Faculty of Medical Sciences, University of Sri Jayewardenepura Objectives: We assessed the perception of pharmacists on providing medication dosing instructions to patients. Methods: This is a sub-study of a larger study on completeness and comprehensibility of written dosing instructions provided by pharmacists. Pharmacists in a selected hospital and community pharmacy were interviewed using a self-administered questionnaire on demographics, current practices on providing medication dosing instructions, barriers and suggestions to improve. Results: All pharmacists responded (N=32). Most were aged 30–50 years (75.0%) and were women (71.9%). Most pharmacists agreed that medicine name (75.0%), dosage form (68.8%), strength (71.9%), units per day (90.6%), frequency (93.8%), route of administration (90.6%), and relationship with meals (96.9%) needs to be communicated to patients irrespective of the type of medicine dispensed. However, only some pharmacists claimed to communicate both written and verbal instructions on medicine name (21.9%), dosage form (18.8%), strength (9.4%), units per day (34.4%), frequency (43.8%), duration (25.0%), route of administration (28.1%), relationship with meals (46.9%), special instructions (15.6%), common side effects (9.4%) and storage conditions (12.5%). Illegibility of prescriptions (100%), shortage of pharmacy staff (96.8%), and difficulty in contacting prescriber for prescription doubts (96.8%) were commonly agreed barriers. Improving patient awareness on importance of dosing instructions (100%), having workshops/training (96.9%), and improving available resources (96.9%) and pharmacy staff (96.9%) were suggested as improvements. Conclusions: Pharmacists agree that key medication dosing instructions should be communicated to patients. However, their current practices on providing dosing instructions varied. A standard procedure on providing written dosing instructions needs to be defined to guide pharmacists. PP 12 Personnel, anthropometric and environmental risk factors for domestic falls among persons over 50 years of age Amarasinghe WMSY1, Balasooriya TC1, Eranga RAH , Fernando DTM1,.Fernando PTM 1, Ambawatta A2, Wijesiri WAA3, Prathapan S4 1 Faculty of Medical Sciences, University of Sri Jayewardenepura, 2Colombo South Teaching Hospital, Kalubowila, 3 Department of Community Medicine, 1Faculty of Medical Sciences, University of Sri Jayewardenepura 4 Department of Community Medicine, 1Faculty of Medical Sciences, University of Sri Jayewardenepura Objectives: This research was undertaken to determine the personnel, anthropometric and environmental risk factors for domestic falls above age of 50 years. Methods: It was a case control study involving 100 cases and 100 controls carried out in accident Service Unit and Orthopedic wards of Colombo South Teaching Hospital. Controls were matched with cases according to the age and sex selected from the same hospital. Interviewer administrate questionnaire was used to collect data after gaining verbal consent. Collected data was analyzed by Statistical Package for the Social Sciences and significance was set at 95%. Results: Identified statistically significant risk factors were cataract (OR=3.62; 95%CI=2.006.58), difficulty in walking (OR=2.20; 95%CI=1.09-4.44), previous history of falls after age of 50 years (OR=2.36; 95%CI=1.27-4.39), wearing foot wear inside the house (OR=4.24; 95%CI=2.28-7.90) Other risk factors were epilepsy (OR=2.02; 95%CI=0.18-22.64), diabetes mellitus (OR=1.08; 95%CI=0.62-1.89), hypertension (OR=1.56; 95%CI=0.89-2.74), osteoporosis (OR=2.59; 95%CI=0.88-7.65), malignancy (OR=2.09; 95%CI=0.61-7.17), some drugs such as insulin (OR=2.04; 95%CI=0.37-11.41), antihypertensive (OR=1.50; 95%CI=0.86-2.62), consuming alcohol (OR=1.31; 95%CI=0.47-3.68) which were not statistically significant. Among anthropometric factors height less than 150cm (OR=0.71; 95%CI=0.39-1.31), weight less than 50Kg (OR=0.64; 95%CI=0.34-1.19), BMI less than 23 Kgm2 (OR=0.92; 95%CI=0.52-1.62) also had protective value according to our results. Among environmental factors tile floor (OR=1.50; 95%CI=0.86-2.64), and incomplete house (OR=2.03; 95%CI=0.82-5.03) had increase risk of domestic falls. Wearing footwear inside the house (OR=4.24; 95%CI=2.28-7.90) had increased risk for domestic falls and it was statistically significant. Wearing spectacles (OR=0.44; 95%CI=0.25-0.78), cement floor (OR=0.76; 95%CI=0.43-1.32), dry floor (OR=0.29; 95%CI= 0.14-0.58) and concrete floor (OR=0.55; 95%CI 0.16’ 1.95) were protective factors. Conclusions: Medical co-morbid factors need to be advised on persons over 50years in preventing of domestic falls. To reduce the risk factors for domestic falls, a policy decision with the architecture in designing homes and proper care is helpful. PP 13 Attitudes, willingness and factors associated with participation in Pap smear test among women in Ingiriya MOH area Dodangoda TC1, Meegoda MKDL1 1 Department of Allied Health Sciences, 1Faculty of Medical Sciences, University of Sri Jayewardenepura Objectives: To describe attitudes, willingness and factors associated with participation in Pap smear test (PST) among 35-60 year old married women in Ingiriya MOH area. Methods: A cross-sectional descriptive survey was conducted to collect data using interviewer-administered questionnaire. Cluster sampling technique was used to select participants from the gramasewa divisions of the selected MOH area. Ethical approval from the ethical review committee of Faculty of Medical Sciences and informed consent from the participants were obtained. Frequency distribution with percentages and chi square statistics were calculated using SPSS version 21. Results: Of the sample (n=456) only 41.3% has had a PST done at least once. Most (73.1%) of the participants believed that cervical cancer is preventable if it is detected early through a PST. Findings of the attitudinal dispositions for PST revealed that negligence (58.7%) shyness (63%) and fear (52.7%) were the obstacles for participating PST. More than 93% participants were willing to participate in a PST. Having at least one PST was significantly related to age, OR=1.7 (95% CI: 1.2-2.4); education level, OR=1.2 (95% CI: 1.0-1.4) and current employment status, OR=1.2 (95% CI: 1.0-1.4). Willingness to participate in a PST was associated with age, OR=5.9 (95% CI: 2.3-15.2); marital status, OR=4.6 (95% CI: 1.811.6) and level of education OR=2.1 (95% CI: 1.0-4.1). Conclusions: Though most of the women were willing, negligence, shyness and fear were the main obstacles for participating in PST. Having at least one PST and willingness to participate in a screening program were significantly associated with age and education level of the participants. PP 14 Impact of one time in service staff training on newborn care practices at a Teaching Hospital Pathiraja P1, Gunasekera D2 1 Department of Gynaecology and Obstetrics, Faculty of Medical Sciences, University of Sri Jayewardenepura, 2Department of Paediatrics, Faculty of Medical Sciences, University of Sri Jayewardenepura Objectives: To evaluate outcome and sustained improvement in labour room (LR) and breast feeding (BF) practices (over six months) after one Essential Newborn Care Workshop for staff Methods: 60% of nurses and midwives involved in newborn care, were assessed on certain LR and BF practices, before, one and six months after the above workshop. Certain essential newborn care practices were assessed during the routine labour room shift. BF practices were assessed by observing BF mothers for correct positioning and attachment. Assessments were done by trained Senior House officers. Results: LR practices which improved significantly were hand washing before delivery, delivering the baby onto the abdomen, changing gloves before cord care, skin to skin contact at birth, initiating breast feeding within one hour and cleaning around the bed after delivery. Counting the baby's respiration improved only after six months. Using APGAR scores, changing suction tubes after delivery were not done even after the workshop. In BF mothers, positioning was correct even before the workshop while attachment improved only at one month and deteriorated thereafter. Conclusions: Impact on staff practices following this ENBC workshop was variable and not sustained over the next six months. In order to gain maximum benefit, continuous monitoring and refresher workshops are essential. PP 15 Analysis of US Scan findings in neonates with increased risk factors for Developmental Dysplasia of the Hip (DDH) Gamage MAMN1, Rupasinghe D1 1 Department of Paediatrics, Faculty of Medical Sciences, University of Sri Jayewardenepura Objectives: To analyse US Scan abnormalities detected in neonates with increased risk factors for DDH Methods: Descriptive analysis of the US Scan reports and Bed Head tickets were done using a Per forma in 100 neonates detected to have increased risk factors for DDH. Results: There were 52 female babies in our study and all were born at term. The indications for hip US Scans were breech presentation in 56% and detection of a unilateral ‘hip click’ in 42%. Out of all requested, only 96 attended for Us Scan assessment. Thirty one babies were detected to have shallow acetabulum during the initial assessment while repeat scan done after 6 weeks showed that only 4 babies needed an orthopaedic referral. Twenty four babies found to have shallow acetabulum and all babies who needed orthopaedic referral were screened ultrasonically due to a Hip ‘Click’ detected during neonatal check. Conclusions: Careful Clinical hip screening is very important and can use as a guide to decide need for Hip Scan. PP 16 Knowledge and attitudes on neonatal care and associated factors among mothers in antenatal clinics of a tertiary care hospital in Sri Lanka Bandara AMNT1, .Amarasekara AATD1 1 Department of Allied Health Sciences, Faculty of Medical Sciences, University of Sri Jayewardenepura Objectives: Neonatal mortality is one of the most neglected health problems in the developing world. The proper and adequate knowledge and attitudes regarding neonatal care among mothers needed to control the neonatal mortality. There is a paucity of data regarding the level of knowledge, attitudes and associated factors on neonatal care among antenatal mothers in Sri Lanka. Objectives were to describe level of knowledge, attitudes on neonatal care and associated factors among mothers in antenatal clinics at Colombo South Teaching Hospital. Methods: The study was a descriptive cross-sectional using a pre-tested interviewer administered questionnaire among systematic randomly selected antenatal mothers (n=377). This study was approved by the Ethics Review Committee, Faculty of Medical Sciences, University of Sri Jayewardenepura. Results: The study found that more than half of the participants (55.2%) had inadequate knowledge level on neonatal care. Majority of them (95%) had favorable attitudes level on neonatal care. The age of antenatal mothers (P = 0.032), average monthly-income (P = 0.022), number of living children in family (P = 0.000) and main source of information on neonatal care (P = 0.001) were significantly associated with poor knowledge level regarding neonatal care. Similarly, living area (P = 0.010) and main source of information (P = 0.021) were significantly associated with moderate attitudes level on neonatal care. Conclusions: Nearly half of the antenatal mothers had inadequate level of knowledge regarding neonatal care. This point to an urgent need of health education programs on neonatal care for antenatal mothers. PP 17 Clinical significance of photosensitivity in early childhood epilepsy Wijesekara DS1, Pressler R 2,3,Boyd SG 2,3 ,Cross J.H.2,3,4 1 Faculty of Medical Sciences, University of Sri Jayewardenepura, 2Great Ormond Street Hospital for Children NHS trust, 3UCL-Institute of Child Health, London, UK, 4National Centre for Young people with Epilepsy, Lingfield, Surrey, UK Objectives: In classification of photoparoxysmal response (PPR), type 4 (generalized spikes and wave or polyspike wave) is of clinical significance. More specifically, a PPR type 4 in very young has reported as pathognomonic of certain aetiologies. The objective was to evaluate the clinical significance of PPR in children <5 years of age. Method: Case notes and EEG characteristics of patients < 5 years with a history of seizures who demonstrated type 4 PPR’s following intermittent photic stimulation during routine EEG performed between 2003-2010 were retrospectively studied. Results: Type 4 PPR was demonstrated in 41/6627 (0.6%) children (19 girls) < 5 years. Age at the onset of epilepsy (0.3 to 56 months; mean: 22.6) was categorized into two distinct groups: (A) 0-24 months and (B) 25-60 months. In Group A (n=25, mean age onset 9.4) 6 (24%) had a definitive syndrome diagnosis (SMEI/ Dravet’s syndrome). Others had no syndrome diagnosis, majority had generalized seizures. In group B (n=16, mean age onset 44), 10(62.5%) had a distinct epilepsy syndrome diagnosis 5 (50%) had childhood absence epilepsy, 3 myoclonic absence, 1 myoclonic atonic and 1 Lennox Gastaut Syndrome. History of status epilepticus was found only in Group A. There was an associated clinical correlate with PPR in 33/41 (80%). Conclusions: In children presenting with epilepsy < 24m, early PPR is suggested as a feature of SMEI. However, there is a strong association with status epilepticus. In Group B, a recognized syndrome diagnosis is more suggestive. The significance of PPR<24m requires further evaluation. However, there is a strong association with status epilepticus. In Group B, a recognized syndrome diagnosis is more likely. The significance of PPR<24m requires further evaluation. PP 18 Evaluation of turmeric as a surface disinfectant Jayaweera JAAS1, Joseph A1, Kumbukgolla WW2, Croos S1, Weilgama DJ1 1 Department of Microbiology Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, 2 1Department of Biochemistry, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka Objectives: To test the usefulness of turmeric as a surface disinfectant and calculate the effective concentration and the frequency of application of aqueous turmeric solution. Methods: Rhizome was cut into small pieces and drying done at 45°C.The antibacterial effect of turmeric on 30 Methicillin Resistant S. aureus (MRSA) and 30 S. aureus (SA) strains on Mueller-Hinton agar was evaluated using agar plate dilution method. The minimum inhibitory concentration (MIC) was determined using serial dilution as 0, 3, 6,9,12, and 15 % (w/v) of turmeric powder in sterilized deionized water and found to be 9% (w/v) against all the strains assayed. Kinetics of turmeric was tested with 9% using agar pour plate method. The effect of turmeric on microbes residing on cement and tiled floors were tested. Here 0.5 McFarland of MRSA and SA were applied on 7.5x7.5 cm areas on floors. Initial swabbing was done and turmeric 9% solution was added to each area and swabbing was done at 30 minute intervals as stated above and cultured on both NA and blood agar; incubated for 24 hours at 37C. Results: MIC of turmeric was 9 % (w/v) against MRSA and SA and the antibacterial effect lasted for a maximum of about 4 hours in nutrient agar plate and for 3.5 hours on tile and cement surfaces. Conclusions: Application of 9 % (w/v) turmeric solution will be an effective disinfectant against potentially pathogenic MRSA and SA. However, to achieve a maximum timely protection, it is necessary to apply once in every 3.5 hours on ground surfaces. PP 19 Identification of bacterial aetiologies of dento alveolar abscesses and the antibiotic sensitivity patterns of the aerobic bacteria at selected dental units Jayawardena MN1, Kottahachchi J2, Nalaka ABMJ2, Dissanayaka DMBT2, Athukorala GIADD2, Samaraweera PCU2, Fernando SSN2 1 Postgraduate Institute of Medicine, University of Colombo, 2Department of Microbiology, Faculty of Medical Sciences, University of Sri Jayewardenepura Objectives: To identify the bacterial aetiologies and the antibiotic sensitivity patterns of the aerobic bacteria at selected dental units. Methods: A descriptive cross sectional study was performed among patients presenting to the dental units at National Hospital and Colombo South Teaching Hospital, with acute dentoalveolar abscesses. An aspirated sample was processed in the microbiology laboratory to isolate the aerobic and anaerobic bacteria. Antimicrobial susceptibility was performed for the aerobes. Results: In thirty patients, aerobic cultures isolated mainly viridians streptococci, Staphylococcus aureus and coagulase negative staphylococci. Erythromycin resistance was shown by five isolates and clarithromycin resistance shown by four, in the viridans group streptococci and two of the Staphylococcus aureus isolates showed macrolide resistance. Penicillin resistance was shown by only two viridians streptococci. Ampicillin/amoxicillin resistance was shown by only one of them. Among the strict anaerobes, the Porphyromonas species was the most commonly identified isolate, followed by the Peptostreptococci, Bacteroides and Fusobacterium species. Other isolates included Clostridium hastiforme, Actinomyces odontolyticus, Proprionibacter and Veillonella species. Conclusions: Acute dentoalveolar abscesses have polymicrobial etiology, with the majority being anaerobes. The aerobes are mostly sensitive to the commonly used antibiotics, such as amoxicillin. It must be noted that, though the prevalence of β-lactamase production is increasing among the anaerobes, most of them remain susceptible to metronidazole. However, further studies are needed to determine the susceptibility patterns of the anaerobic bacteria. PP 20 Evaluation of a simple and rapid microscopy technique for detection of Leptospira Sumaiha MHF1, Damayanthi MKS1, Weeraseakera MM2, Fernando SSN2, Gunasekara TDCP2 1 Department of Allied Health Science, Faculty of Medical Sciences, University of Sri Jayewardenepura,2Department of Microbiology, Faculty of Medical Sciences, University of Sri Jayewardenepura Objectives: Determine the usefulness of Fontana staining method and dark field microscopy to detect Leptospira species in spiked urine and serum. Methods: Leptospira interrogans serovar icterohaemorrhagiae and canicola were cultured in EMJH (Ellinghausen-McCullough-Johnson-Harris) medium to obtain 6×108 organisms/ml (McFarland =2). Organisms were spiked to PBS, alkalinized human urine and serum in triplicates, and serial dilutions were made (6×106to 6×101organisms/ml). Smears were prepared using 10 µl of each dilution. Further centrifuged sediments of urine were used to prepare smears. Slides were stained by modified Fontana method as reported by Gangadhar etal. and examined. Number of Leptospires per field was recorded. Motility of Leptospira were observed using light microscope modified with an in-house dark field stop Results: Characteristic morphology of Leptospires was observed in PBS, uncentrifuged urine and in urine sediment using modified Fontana silver staining. Leptospires could not be clearly observed in serum. Leptospires could be detected in Fontana stained smears made from cultures of 6x103 – 6x106 organisms/ml. At a concentration of 6x103 organisms/ml at least 1-3 organisms/smear could be detected in PBS and urine (centrifuged and uncentrifuged), while an average of 5 organisms/field could be detetcted in a smear made from cultures of 6x105 organisms/ml. In-house darkfield microscopy was only able to detect motile Leptospires in the urine sediment spiked with 6×106 organisms/ml and not in uncentrifuged urine or PBS. Conclusions: Modified Fontana staining was found to be a simple and rapid test for detection of Leptospira in urine with a detection limit of 6000 organisms/ml. PP 21 Candida infection in oral leukoplakia: site of infection, etiology and effect of smoking, betel chewing and alcohol consumption Dilhari KAA1, Gunasekara TDCP1, Siriwardhana SJAP1, Maheshika LO1, Karunathilaka AHTS2, Fernando SSN1, Weerasekera MM1 1 Department of Microbiology, Faculty of Medical Sciences, University of Sri Jayewardenepura, , 2Oral and Maxillo-Facial clinic, Colombo South Teaching Hospital, Kalubowila Objectives: The study aimed to determine the etiology of oral leukoplakia and the site of infection among patients attending Oral and Maxillo-Facial clinic at Colombo South Teaching Hospital. Further risk of smoking, betel chewing and consumption of alcohol among Candida associated leukoplakia was determined. Methods: Clinically suspected 80 oral leukoplakia patients were included. Data was collected using a questionnaire. An oral swab was collected from the lesion while the control swab was collected from an unaffected area. Germ tube, sugar assimilation, chlamydospores and CHROMagar tests were used for yeast speciation. Results: Candida associated leukoplakia was seen in 47% (38/80) of patients. C.albicans (94.7%) was the commonest pathogen. Majority of Candida associated leukoplakia lesions were seen in the buccal mucosa. Alteration of taste (p=0.021), having lesions in the oral cavity (p=0.008), angular cheilitis (p=0.024) and periodontitis (p=0.041) showed a significant association. Smoking (p=0.026) and betel chewing (p=0.006) were significant risk factors for Candida associated leukoplakia. Among the patients (n=35) claiming to have all three habits of smoking, betel chewing and alcohol consumption 23 were positive for Candida. Cigarettes smokers were more prone to have candidal infection (16/23). Majority had chewed >2 betelquid/day (18/23). Fifteen had chewed betel quid for >20 years. Thirteen out of 23 had consumed alcohol 1-8 times /week. Conclusions: The patients who had all three habits of smoking, betel quid chewing and alcohol consumption together were significantly at a higher risk of developing Candida associated leukoplakia. C.albicans was the most common pathogen. PP 22 Do we have clean domestic water sources? A study on microbiological quality of domestic wells in Maharagama and Boralesgamuwa MOH areas Pellawattage M1, Damayanthi N1, Widanagamage RD2, Priyadarshani AMB1, Uluwaduge I1, Wijesekara GUS1 1 Department of Allied Health Sciences, Faculty of Medical Sciences, University of Sri Jayewardenepura 2Department of Medical Laboratory Sciences, Faculty of Allied Health Sciences, General Sir John Kotelawala Defence University Objectives: To investigate the microbiological quality of well water samples collected from Maharagama and Boralesgamuwa MOH areas. Methods: Water samples were collected from a total of twenty five domestic wells from Maharagama and Boralesgamuwa MOH areas. The coliforms and E. coli counts were enumerated using multiple tube method as per “Sri Lanka standard specification for potable water Part 2 - 1983: Bacteriological requirements (SLS 614: Part 2: 1983”. The results were interpreted according to the “Sri Lanka Standard 614: 2013 - Specification for potable water”. The interviewer administered questionnaire was used to collect the data regarding factors that could attribute to microbial contamination. Results: Results revealed that twenty of the wells were unsuitable for consumption as coliforms and E. coli were found to be above the Sri Lankan Standards ie.,more than 10 coliform bacteria/100 mL and detection of E. coli/100 mL, respectively. Twenty of the wells were positive for total coliform count where as five of them were positive for E. coli, indicating a recent faecal pollution. However, the results highlighted the fact that the occurrence of coliforms is predisposed with the distance between the wells and the toilet pit was less than 10 m. Conclusions: Twenty of the wells analyzed were not secure microbiologically for drinking without additional treatments such as boiling or disinfection. The appropriate environmental and personal hygiene must be maintained by the users to avoid contamination with microorganisms otherwise this could lead to outbreak of water borne diseases. PP 23 Species distribution and in-vitro antifungal susceptibility pattern of candida clinical isolates Jayasekera,PI1, Sigera LSM1, Shabry ULF1 1 Department of Mycology, Medical Research Institute, Colombo Objectives: To determine the Candida species, isolated from various clinical specimens received at the Department of Mycology, MRI from 08/08/14 - 25/10/14 and to determine their antifungal susceptibility pattern for commonly used antifungals in Sri Lanka. Methods: Identification of 90 clinical isolates was done by using conventional methods of Candida identification and API kits. In-vitro antifungal susceptibility pattern of isolates to fluconazole, amphotericine B, ketoconazole, itraconazole, miconazole, nystatin, clotrimazole and voriconazole were determined according to CLSI M44A. Results: Candida tropicalis (37.7%) was the most frequently isolated species, followed by C.albicans (36.6%), C.parapsilosis (24.4%) and C.krusei (1.1%). C.tropicalis was the predominant isolate from blood, sterile fluids and urine specimens. Majority of the isolates from scraping specimens were C.parapsilosis while C.albicans was the commonest in respiratory specimens. Variations in resistance were seen depending on the species and the respective type of specimen. All Candida isolates were sensitive to amphotericin B. Twentythree (24.44%) fluconazole resistant isolates were isolated from blood, urine, pus, sterile fluids, respiratory specimens, & scraping specimens. Variable sensitivity pattern was observed for voriconazole, miconazole, itraconazole, ketoconazole, nystatin and clotrimazole. Conclusions: All clinical yeast isolates should be identified up to species level and antifungal susceptibility testing should be performed to prevent therapeutic failures. Resistance to fluconazole, is an alarming sign for emerging antifungal resistance in Sri Lanka. PP 24 Knowledge and practices on infection control among kidney transplant recipients from a selected nephrology unit Sameera AGLA1, Wanigatunge CA2 1 Faculty of Medical Sciences, University of Sri Jayewardenepura, 2Department of Pharmacology, Faculty of Medical Sciences, University of Sri Jayewardenepura Objectives: To assess knowledge and practices on infection control among kidney transplant recipients from a selected nephrology unit in Sri Lanka. Methods: A descriptive cross sectional study was carried out. All post renal transplant patients registered at the selected clinic were included in the study. An interviewer administered pretested questionnaire was used for data collection. Data were analyzed using SPSS – 20 statistical package. Results: Of the 152 participants majority (67.1%) were males. The ages ranged from 16 -75 years (44.7, SD: ±13.25) and 48.7% were between 46 – 60 years. Hypertension (35.5%) was the commonest cause for chronic renal disease while it was idiopathic in 25%. Majority (n=66, 77.3%) use a face mask only when they go outside of their homes while only 68.4% participants use soap and water for hand washing. Signs of urinary infections were correctly named by 52.6% and 79.6 % of participants were aware that fever is a sign of infection while and 59.2% mentioned severe pain at the transplant site as a sign of rejection. Masks were used by only 43.4%. Level of education (p<0.05/0.043) and sex (p<0.05/0.016) were associated with practices of infection control. Knowledge of infection control (52.6%) was at a satisfactory level though practices of infection control was less (29.6%). Conclusions: The knowledge and practices of post renal transplant recipients on infection control and life style changes that need to be instituted should be improved. Continued health education could be a tool to improve outcome after renal transplant. PP 25 Are we satisfied with what we know about Human Papilloma virus (HPV) and the HPV vaccine? Karunanayake IU1, Premathilake NR1, Weerasekara MM2, Fernando SSN2, Pathiraja R3, Gunasekara TDCP2 1 Department of Allied Health Sciences, Faculty of Medical Sciences, University of Sri Jayewardenepura, 2Department of Microbiology, Faculty of Medical Sciences, University of Sri Jayewardenepura, 3Department of Obstetrics & Gynecology, University of Sri Jayewardenepura Objectives: To investigate the knowledge regarding Human papilloma virus infections and HPV vaccine among patients attending the Gynecology clinic and the antenatal clinic at the Colombo South Teaching Hospital. Methods: A cross-sectional survey of 400 women was conducted between September 2015 and December 2015. A pre tested self-administered questionnaire was used to collect data. Knowledge was assessed using 34 questions. An average score of ≥75% was considered good, 74%-50% as moderate and <50% poor. Results: Out of 400 women who participated in this study, the percentage of respondents who had heard of HPV, cervical cancer and genital warts was 23% , 80% and 41% respectively. However only 16% knew that there is an association between HPV and CC. Although 48% believed that CC is common in Sri Lanka, only 6.8% considered themselves at risk. Overall knowledge of risk factors, symptoms, transmission and diagnosis was 44% (CC)and 14% (HPV infection) respectively. Only 14.3% were aware of the availability of HPV vaccine in Sri Lanka. In our study having multiple partners (43.8%), unprotected sexual practices (36%) were risk factors quoted by majority. Only 34.8% knew that HPV infection is curable if detected early and that screening is done using the Pap smear test (32.3%). TV and Radio programs were the most quoted sources of knowledge in this population. Conclusions: The overall knowledge on HPV in this population was poor (29%). The overall knowledge on HPV vaccine was 10%. Substantial effort should be made to educate the society regarding HPV infection, complications and preventive measures. PP 26 How season of birth affects Schizophrenia in Sri Lanka Peramuna PDOSD1, Fernando LH1, Wanigatunga PS1, Kulasiri WGMMT1, Pathirage CL1, Prathapan S2, Gambheera H3 1 Faculty of Medical Sciences, University of Sri Jayewardenepura, 2 Department of Community Medicine, University of Sri Jayewardenepura, 3National Institute of Mental Health, Angoda Objectives: To study any association between the development of schizophrenia and the season in which the birth took place. Methods: A descriptive cross sectional study was done on a sample of 684 discharged patients from the National Institute of Mental Health, who were treated for schizophrenia. Socio-demographic factors and other details were extracted from records. Each patient was contacted over the telephone to obtain his/her date and place of birth. The date and place of birth were available for the study in only 393. The data was analysed by routine statistical methods and compared with that of the general population and the weather parameters, obtained from the Department of Meteorology. Results: The distribution of births showed two peaks in March and August, where no such pattern was present in the general population. Considering the monthly rainfall, March and August are comparatively dry but the highest rainfall is observed in May and October. The rainfall peaks are exactly two months following birth peaks. The distribution of sociodemographic factors was a reflection of that of the general population, except for sex showing male:female ratio of 3:2 when the general population ratio is 1:1. 46.6% patients have abused substances and 42.3% had a positive family history of mental illness. Conclusions: Conclusions: When compared to general population, the study sample showed a variation in the monthly birth pattern, with peaks in March and August and emphasized that seasonal changes following birth, is a possible risk to the later development of schizophrenia in Sri Lanka. PP 27 Determining the best discrimination index from Full Blood Count Parameters for screening of Beta thalassemia carriers in Sri Lanka Udawatta LD1, Senarathna PMNK1, Fernandopulle KHBP2, Herath P3 1 Department of Allied Health Sciences, Faculty of Medical Sciences, University of Sri Jayewardenepura,21Department of Pathology, Faculty of Medical Sciences, University of Sri Jayewardenepura, 3Medical Research Institute, Colombo Objectives: To determine the hematological indices suitable for screening of Beta Thalassemia Trait (BTT) in Sri Lanka and to derive a suitable discrimination index. Methods: BTT confirmed with HPLC (HbA2>3.5%) at MRI were selected and FBC reports, serum iron studies were analyzed. Patients with iron deficiency (serum ferritin level<15 µg/L), patients< 10 years and pregnant women were excluded. Hb, RBC Count, MCV, MCH, MCHC, and RDW were tabulated for each patient. These details were then analyzed using the Mentzer , Srivastava , England and Fraser , Shine and Lal , Green and King and Thal Index .The sensitivity of each index for detecting Beta Thalassemia trait was calculated. Data was analyzed by SPSS. Results: 157 BTT cases (without concurrent iron deficiency) and 206 BTT without ferritin results were analyzed. Ranges and mean for each of the RBC parameters were as follows in the BTT group where iron studies were available and were not iron deficient. Hb 6.5 – 14 g/dl; mean 9.7 g/dl. RBC count 2.6 – 6.8; mean 4.9. MCV 48 -79 fl; mean 64 fl. MCH 15.6 29.7 pg ;mean 19.9 pg. MCHC 26.7 – 39.2 g/dl ; mean 31 g/dl . RDW 11.8 – 44.5 %; mean 17.6%. Sensitivity for each indexes , in the BTT group without iron deficiency were , England and Fraser Index - 25.3% ; Srivastava Index - 44.2% ; Green and King Index 61.5% Thal Index - 73.3% ; Shine and Lal Index – 98.7% . The Sensitivity for Shine and Lal Index when applied to the group of BTT without S. ferritin reports is 99.1%. Conclusions: Shine and Lal Index (MCV2×MCH/100) with a Sensitivity Index of 98.7% is the most reliable index to identify Beta Thalassemia Trait cases in Sri Lanka , when iron deficiency has been ruled out. All RBC parameters except MCHC were outside the normal ranges, however a mean MCV of 64 fl with SD of 4.5 and MCH of 19.9 with a SD of 2 best denote a BTT on FBC. PP 28 What Sri Lankan newspapers publish on sexual health? A content analysis of the articles and advertisements from Sinhalese and English newspapers published in July 2015 Perera PADMP1, Liyanage DLDC1, Pannala WS1, Godakandaarachchi LPP1, Ariyaratne K.A.M.1 1 National STD/AIDS Control Programme, Colombo Objectives: To analyze the quantity and the content of sexual health related articles and advertisements published in Sri Lankan newspapers. Methods: This was a descriptive cross sectional study and the sample consisted of Sinhalese and English weekly newspapers and a random sample of daily newspapers published in July 2015, that were available at the Public library- Colombo, which were scrutinized to identify sexual health related articles and advertisements. Data was collected using pre-tested checklists, independently by two researches. Data was analyzed using SPSS. Results: Among a total of 236 newspaper issues, 210 articles and advertisements were on sexual health. Majority (60%, n=125) were advertisements which appeared more on weekly Sinhala newspapers. Majority (71%, n=89) of advertisements were for sexual health services and from them 61% (n=54) were for sexual dysfunctions and 39% (n=35) on STI treatments. Advertisements on services for sexual health significantly appeared more in Sinhalese newspapers. (p=0.035) Almost 90% (n=78) of service advertisements did not indicate a service provider. None were on condoms. Nearly 50% (n=42) of 85 detailed articles were related to risk populations, out of that, 69% (n=29) mentioned stigma/discrimination. Only 1/3 (n=28) of articles directly mentioned STI, HIV or both. 2 articles mentioned condoms as a preventive method and another 4 had details on linked to care. Conclusions: There were many advertisements related to sexual health and most of them were advertising treatment services for sexual dysfunctions. Significant percentage of advertisements lacked details of the service provider. Very few articles addressed STD/HIV in-depth and they also markedly lacked information on condoms, link to care services including NSACP. The bulk of the analyzed articles were on risk populations with mentioning of stigma/ discrimination. PP 29 Assessment of nutritional and energy intake and selected anthropometric measurements among a sample of non-academic staff members in University of Sri Jayewardenepura Gunathilaka MDTL1, Hettiaratchi UPK1 1 Department of Biochemistry, Faculty of Medical Sciences, University of Sri Jayewardenepura Objectives: The aim was to assess a nutritional and energy intake and selected anthropometric measurements among a sample of non-academic staff members in University of Sri Jayewardenepura. Methods: The study was carried out with statistically analysed sample number (n=130) of non academic staff members. Study design was descriptive cross sectional. Anthropometric measurements [weight, height, waist circumference (WC), hip circumference (HC)] were taken and Body Mass Index (BMI), waist to hip ratio (WHR) were calculated using WHO methods. The energy requirement was calculated using the basal energy expenditure by Harris Benedict equation. A self administered seven day dietary recall was carried out. Results: Most of the participants were males (53.9%) and >40 years (54.6%). BMI of females and males were 22.9±3.8 kg/m2 and 23.1±4.2 kg/m2 respectively. Higher number of males (16.9%) were overweight than females (15.4%), and a lower number of males (4.6%) were obese than females (6.2%). WC of males and females were 85.9±8.6cm and 82.4±9.3cm respectively. Most of the participants were at high risk of development of metabolic complications based on WC (53.8%) and WHR (63.9%). Carbohydrate, fat and protein constituted 66%, 22.4% and 17.6% of total energy respectively and energy from protein was higher than the recommended levels. Mean energy intakes were less than the estimated energy requirements in females (1630.2±287.6 vs. 1695.0±148.5 kcal/day) and males (2078.0±326.8 vs. 2732.9±250.7kcal/day). Protein intake was higher in 83.8% of the participants than their requirement. Conclusions: About 40% of the total population is either overweight or obese and further, more than 50% of the population is at risk of development of metabolic complications. Therefore, the interventions and educational programmes need to be set up to control the overweight and obesity and promote the quality PP 30 The body fat percentage distribution in a young adult female population of a Sri Lankan University Samarakoon DNAW1, Amarathunga AAMDDN1, Perera PPR2 1 Department of Allied Health Sciences, Faculty of Medical Sciences, University of Sri Jayewardenepura, 2Department of Biochemistry, Faculty of Medical Sciences, University of Sri Jayewardenepura Objectives: To determine the body fat percentage (BF%) distribution in female undergraduates (age group 20-26years) residing in hostels of University of Sri Jayewardenepura (USJP). Methods: A cross sectional study was performed among 367 females, randomly selected using hostel registries (Obesity prevalence of Sri Lankan females =36.5%). Height was measured using stretch‐resistant measuring tape to the nearest 0·1cm according to National Health and Nutrition Examination Survey (NHANES) guidelines. BF% values were taken using Karada Scan®, Body fat analyzer (Bioelectrical Impedance Analysis). Data analysis was performed using SPSS16. Ethical Clearance was obtained from Ethics Review Committee, Faculty of Medical Sciences, University of Sri Jayewardenepura. The cut-off marks were taken according to the manufacturer’s specifications. Results: In study population 4.1% were with low BF% (5%-19.9%), 59.1% were with normal BF% (20.0%-29.9%), 28.9% were with high BF% (30.0%-34.9%) and 7.9% were with very high BF% (35.0%-50.0%). When considering BF% distribution in different areas of the body, the highest fat% was seen in arms with a mean of 40.57% (SD±5.5). The lowest fat% was seen in the trunk with a mean of 19.41% (SD±4.5). Mean fat% in the legs was 35.39% (SD±6.2). High proportion of females (98.4%) had normal visceral fat levels (level of 1-9) and only 1.7% was in the risk level (level ≥10). Conclusions: Approximately one third of the study population (36.8%), was with a high BF%. Since high body fat content can lead to many disease conditions, they have to be advised on the importance of proper diet schedule and regular exercise. PP 31 Effect of nutritional and psychosocial factors on educational performance of early female adolescents in Galle area-Preliminary study findings Madhushanthi HJH1, Wimalasekera SW2, Goonewardena CSE3, Lenora RSJ4, Amarasekara AATD5 1 Allied Health Sciences, Faculty of Medicine, University of Ruhuna, 2Department of Physiology, Faculty of Medical Sciences, University of Sri Jayewardenepura, 3Department of Community Medicine, Faculty of Medical Sciences, University of Sri Jayewardenepura, 4Department of Physiology, Faculty of Medicine, University of Ruhuna, 5Department of Allied Health Sciences, Faculty of Medical Sciences, University of Sri Jayewardenepura Objectives: To describe the nutritional status of early female adolescent and its effects on educational performance Methods: A school based descriptive cross sectional study was conducted on randomly selected 100 female adolescents (age 11 to 14 years) from Galle educational zone. Weight, height, waist and hip circumference were measured to assess protein energy nutritional status. Centers for Disease Control, 2000 values for BMI were used to categorize nutritional status. Socio-demographic questionnaire and psychosocial adversity scale were administered to investigate confounders affecting nutritional status. The scores for mathematics, Sinhala and Science subjects were used to assess educational performance. Results: The mean BMI was 18.08 (±4.35 SD). The prevalence of thinness (BMI<5th percentile) was 33% (n=32) and 13.4% (n=13) were overweight (BMI>85th percentile). Stunting, an indicator of previous or long standing malnutrition, affected 25.8% (n=25) while 28.9% (n=28) were wasted. Only 8.2% (n=8) were obese. 68% (N= 5) of obese children and 46.6% (N= 6) overweight children belonged to high income category. There is a significant association of mother’s educational state (p = 0.021) and father’s occupational state (p=0.027) with educational performance. There is no significant association between BMI and average score for subject mark (p=0.153). Conclusions: High rate of growth deficiency and under nutrition in adolescence require urgent nutritional intervention strategies. Nutritional status did not play a major role in educational performance of school going adolescents. Mother’s educational state and father’s occupational state are important factors affecting educational achievement of child. PP 32 Utilization pattern and patient’s accessibility to the Out Patient Department (OPD), District General Hospital, Kalutara Wijegunasekara JLHR1, Ferdinando R2 1 District General Hospital, Kalutara., 2National Institute of Health Sciences, Kalutara Objectives: This paper outlines the demography of patients, their accessibility, time distribution of patients and the waiting time in the Out Patient Department, District General Hospital, Kalutara. Methods: Descriptive cross sectional study of three months in a sample of 423 patients of 18-70 years were collected using Systematic sampling by two trained assistants with an interviewer administered questionnaire. Results: Average daily attendance was 1154 patients; 53% attended before 10 am; 35% belonged to the age group 31-45 years; two thirds were females; majority had education in the range “Grade 6-10”; one third had come within “1-5 kilometer”; this was the closest OPD for 77% of patients; majority had spent less than ½ hour for arrival; bus is the main mode of transport. Majority were registered and seen by a doctor within 30 minutes; consultation time was limited to less than 5 minutes in 78%; 35% had spent 1-3 hours in the dispensary; 50% had taken more than 30 minutes for the investigations and finally 56% % had spent 1-3 hours and 22% had spent more than 3 hours in the OPD. Conclusions: Measures need to be taken to redistribute the staff according to the patient load. Capacity building and drug availability should be targeted to the majority groups. Measures need to be taken to improve waiting time. PP 33 Prevalence and determinants of musculoskeletal pain (MSP) among teachers in Nugegoda educational division in Sri Lanka Presangika PLS1, Warnakulasuriya SSP1 1 Department of Allied Health Sciences, Faculty of Medical Sciences, University of Sri Jayewardenepura Objectives: To demine the prevalence of musculoskeletal problems, associated factors and preventive measures practiced by teachers in Nugegoda education division. Methods: A descriptive cross sectional study was conducted among 247 teachers working in Nugegoda education division. A pretested self-administered questionnaire was used to ascertain the data related to work characteristics and musculoskeletal symptoms and preventive measures of teachers. Data analysis was carried out using the SPSS statistical package (version 16). Descriptive statistics and chi-square test were used to determine the proportions of MSP and their associations with work related variables. Results: Response rate was 63.1% and majority (95.5%) of respondents were females. Prevalence of knee pain was 51.2% followed by pain in ankles (42.1%) and neck (34.7%) during the past twelve months. Age was significantly associated with shoulder pain (OR=1.93, 95%CI; 1.02-3.67) and knee pain (OR=1.91, 95% CI; 1.08-3.38). Number of students in the class was significantly associated with knee pain (OR=2.04, 95% CI; 1.133.67) and ankles pain (OR=2.38, 95%CI; 1.33-4.26) respectively. Further, work experience was significantly associated with knee pain (OR= 2.07, 95% CI; 1.21-3.53). Being a parent with three or more children was significantly associated with knee pain (OR=2.28, 95%CI; 1.01-5.13). Less than half (44.2%) of the respondents had sought medical advices for their pain symptoms. About 40.1% of teachers had managed their pains with home remedies. Conclusions: Knee pain was the predominant pain symptom among teacher. Years of experience, having three or more children, number of students in the class room, were other determinants of pain symptoms. PP 34 Social network addiction among medical students of University of Sri Jayewardenepura Edirisinghe EAST1, Shiyanth S1, Dissanayake MHP1, Dissanayake PH1, Yasawardene SG1 1 Department of Anatomy, Faculty of Medical Sciences, University of Sri Jayewardenepura Objectives: To determine the impact of Social Networking Sites (SNS) addiction among medical students of University of Sri Jayewardenepura (USJP) Methods: One Hundred forty three (143) students of FMS, USJP of 2013/2014 A/L intake completed a simple self-administered questionnaire containing Bergen Facebook Addiction Scale to measure usage of Facebook and YouTube. Two sets of criteria were used to calculate addiction rates {a score of 3 on at least four from all 6 survey items (moderate) and a score of 3 on all six items- (severe) }. Results: Out of 156 students 143 have completed the survey with the response rate of 91.6%. Out of this 94 were female with a general ratio of 2:1. Facebook was most commonly used (89.5%), followed YouTube by (84.6%) Addiction rates varied significantly across the two SNSs and varied according to the criteria used. Severe Facebook addiction was noted on 2.09% (3/143) and all were female. Moderate Facebook addiction was noted 15.3% (22/143) and 9.7%(14/143) in females’ and males’ respectively. Percentage 2.79(4/143) of students were severely addicted to YouTube and ¾ were male. Moderate YouTube addiction was noted among 9.09% in female and 6.99% in male students. Precentage 74.8 (107/143) students stated less than 20% usage of Facebook for their academic related activities while majority of 33.5% of students have highlighted of using You Tube for academic related activities was between 40-60%. Conclusions: Rates of SNS addiction among this batch of medical students is moderate and somewhat academic related. Addiction rates decreased when work-related activity was taken into consideration which indicates that rates may adjust according to purpose of use. PP 35 Maternal knowledge on benefits of breastfeeding: A study from a District General Hospital, Sri Lanka Senarathne UD1, De Silva YBP1, Anupama NJS1, Athukorala CL1, Makalandage KK1, Goonetilaka MD1 1 Department of Biochemistry, Faculty of Medical Sciences, University of Sri Jayewardenepura Objectives: The aim was to determine the level of knowledge on breastfeeding, factors that contribute to the knowledge and to identify any gaps in knowledge among antenatal mothers. Methods: Following ethical approval, a descriptive study was carried out among mothers admitted for confinement in December 2015 to District General Hospital Negombo. Data was collected using an interviewer administered questionnaire and analysed using SPSS. Results: Out of 227 mothers included in the analysis, 32% were primiparae. Majority were Sinhalese (85.5%) and 95% belonged to the age group of 20-39y. Monthly income of half the population (49%) was <Rs.25000 while 68% of the mothers had studied up to G.C.E. Ordinary Level or above. More than half (58%) had participated in at least 2 ‘antenatal lactation sessions’ while 82% mentioned television/ radio as their other sources of information. Seventy percent of the mothers agreed that breastfeeding on demand as the best method of infant feeding. When considering the knowledge score on benefits of breastfeeding, 77% scored >50% which was significantly associated with maternal education (p=0.001) and participation in antenatal lactation sessions (p<0.000). Although the majority (87%) agreed with exclusive breastfeeding for 6 months, only 50% were aware of the beneficial properties of colostrum while 23% stated that colostrum needed to be supplemented. Conclusions: Maternal education contributes to a better level of knowledge on benefits of breastfeeding while antenatal sessions attribute to it. Since a significant percentage has gaps in the knowledge on benefits of colostrum, this needs to be addressed at the clinic or postnatal settings. PP 36 Validation and cross cultural adaptation of the Sinhala Version of Quebec Back Pain Disability Scale (QBDS) Warnakulasuriya SSP1, Peiris-John R2, Sathiakumar N3,Wickremasinghe AR4 1 Department of Allied Health Sciences, Faculty of Medical Sciences, University of Sri Jayewardenepura,2 Section of Epidemiology and Biostatistics, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, 3Department of Epidemiology, University of Alabama at Birmingham ,USA, 4Faculty of Medicine, Department of Public Health, University of Kelaniya Objectives: To translate Quebec Back Pain Disability Scale (QBDS) to Sinhala language, and to validate the Sinhala version of QBDS among Sinhala speaking people. Methods: We translated QBDS in to Sinhala language then back translated it to English. All the steps of cross cultural adaptation process were followed and the translated pre-final Sinhala version was pre-tested among 20 participants to prepare the final Sinhala version. The final Sinhala version QBDS was tested among 138 patients with diagnosed back disorders at the time of the study and 124 people without back disorder (comparison group). Content validity was assured by a multidisciplinary team. In addition, correlation between Sinhala version of QBDS and Sinhala version of SF-36 was assessed by determining Pearson correlation coefficients. The Student’s t-test and Cronbatch alpha coefficient were used to check the score difference of both tools and internal consistency reliability of Sinhala version of QBDS Results: Final Sinhala version of QBDS significantly correlated with Sinhala version SF -36 quality of life questionnaire [r=-0.75 (r2=0.57), p<0.05] indicating very good construct validity. Internal consistency reliability for the Sinhala version reached a Cronbach’s alpha coefficient of 0.91 indicating very good internal consistency reliability. Conclusions: The Sinhala translation of the QBDS provides an easy to understand; reliable and valid condition specific outcome measure of disability related to Low Back Pain among Sinhala speaking population and is recommended for use in Sri Lanka. PP 37 Work Related Musculoskeletal Disorders (WMSDs) among bus drivers at the central bus stand Colombo, Sri Lanka Udayana WS1, Fernandopulle KHBP2 1 Department of Allied Health Sciences, ,Faculty of Medical Sciences, University of Sri Jayewardenepura, 2 Department of Pathology, Faculty of Medical Sciences, University of Sri Jayewardenepura Objectives: WMSDs are common among Bus Drivers since bus driving requires repetitive movements of the limbs/ head and long-term sitting in the same posture. Objectives of this study were to determine the prevalence of WMSDs among bus-drivers at the Central Bus Stand in Colombo and identify associated risk factors. Methods: A descriptive cross-sectional study was conducted using interviewer-administered pre-tested questionnaire among bus drivers at the Central Bus Stand. Results: 119 Government and 131 Private Sector drivers were questioned. Most of the participants (78.4%) suffered from different kinds of musculoskeletal pains. Of these 49.6% of the participants suffered lower back pain, 38.1% from knee pain, 35.2% from shoulder pain, 29.2% upper back pain, 25.2% neck pain, 25.2% ankle pain, 12.8% wrist pain, and 8% from elbow pain. Only 22.8% of bus-drivers have sought medical help. 20% were visiting Western medicine doctors and 7.2% were taking Ayurveda treatment. 16.4% of bus drivers took over the counter medicines without doctor’s prescription and 12.8% were taking alcohol for pain relief. The presence of pain was significantly related to driving in traffic (p=0.008) , type of seat (p= 0.009) and bus company (Govt /Pvt) (p=0.011) There was no correlation between occurrence of pain and BMI of bus-drivers(p= 0.87) ,total distance travelled per month(p=0.64),size of the bus (p=0.25), age(p=0.325). 25.6% of drivers were not satisfied with the driving-seat, 16 % with the clutch, 4.8 % with gears, 4.4% with steering wheel. There is no access to medical care at the Bus Stand. Conclusions: Majority (78.4%) complained of pain affecting one or more areas. The most prevalent areas were lower back, knee, shoulder, upper back, ankle and neck. Majority do not take treatment. The only correlations with pain were travelling in traffic, type of the seat and bus company. Government policies to improve work conditions to reduce WMSDs need to be in place as well as making available medical help onsite to bus drivers. PP 38 Knowledge, attitudes and practices regarding management of childhood diarrhoea among mothers attending the MOH clinics in Ambalangoda area Jayamali C1, Jayawardane P2 1 Department of Allied Health Sciences, Faculty of Medical Sciences, University of Sri Jayewardenepura, 2Department of Pharmacology, Faculty of Medical Sciences, University of Sri Jayewardenepura Objectives: The aim of this study was to assess the maternal knowledge, attitude and practices regarding management of childhood diarrhoea in Ambalangoda MOH area, Southern Province, Sri Lanka. Methods: This study was conducted as a descriptive cross-sectional study in Ambalangoda MOH area between October 2015 and December 2015.Three hundred eighty four mothers who had five years or less than five years old children were recruited for the study. Data was collected using an interviewer administered questionnaire. Data are presented as descriptive summary statistics. Results: Three hundred and eighty four mothers were recruited for the study. The mean age of the mothers was 26.17 (SD+/- 4.59) and 41.1% (n=158) mothers had an education up to advanced level. Of the study sample 48.69% (n=187) had a moderate level of knowledge and 43.75 (n=168) had a good level of knowledge regarding management of diarrhea. Only 42.91 % (n=165) mothers stated that they use Jeewani as an oral rehydration therapy commonly. Information of ORS was well disseminated however only (52.6%) of the mothers had an adequate knowledge on preparation of oral rehydration salts. Majority of mothers (92.18%) had a good knowledge regarding preventive practices of diarrhoea. Conclusions: Majority of the mothers knew proper management of diarrhea however only 43% used Jeewani in the management of diarrhea of their children. Only 53% followed proper instructions when preparing Jeewani. Knowledge on proper use of ORS needs to be strengthened. Though knowledge on diarrhea management among the study sample was satisfactory and knowledge on proper use of ORS needs to be strengthened. PP 39 Knowledge and attitudes of final year nursing students of National School of Nursing, Sri Jayewardenepura and School of Nursing, Colombo on infusion phlebitis Harshani RAT1, Perera PPR2 1 Department of Allied Health Sciences, Faculty of Medical Sciences, University of Sri Jayewardenepura,2Department of Biochemistry, Faculty of Medical Sciences, University of Sri Jayewardenepura Objectives: Knowledge on peripheral venous catheter related infection is important to help healthcare professionals to minimise the risk of infection. However nurses/students knowledge regarding this aspect has not been studied previously. Thus this study was carried out to evaluate the knowledge and attitudes of final year nursing students on infusion phlebitis. Methods: This descriptive cross sectional survey was carried out at National School of Nursing Sri Jayewardenepura and School of Nursing Colombo. A validated selfadministrated questionnaire was applied. The questionnaire included 3 sections. Section “A” consisted of 3 questions about their educational background and gender. Section “B” consisted of 12 questions regarding knowledge on Phlebitis. Section “C” consisted of the attitudes scale regarding safe practice of cannulation which included 19 statements. Results: Final year students in both nurses training schools participated in the study and 216 questionnaires were collected. Most of the students were female (95.8%). Most of the students had fair knowledge (60.6%) and mean knowledge score was 48.8. They had favourable attitudes towards safe practice of cannulation except hand hygiene technique (3.2%), type of gloves used during the procedure (3.7%), best place for documentation of cannulation (38%) and selection of cannula (29.6%). Conclusions: The sample of student nurses’ knowledge to some areas on infusion phlebitis is inadequate. This could be a potential risk for patient safety. Thus the subject should be more emphasized in training of student nurse PP 40 Knowledge and practices regarding insertion and care of indwelling urinary catheter in female patients at a teaching hospital Rohan JP1, Amarasekara AATD1 1 Department of Allied Health Sciences, Faculty of Medical Sciences, University of Sri Jayewardenepura Objectives: Catheter Associated Urinary Tract Infection (CAUTI) is the most common hospital acquired infection in world wide. Adhering evidence based practice guidelines and correct practice regarding insertion and care of indwelling catheter minimize CAUTI. The objectives of this study were to determine knowledge and practices of nurses regarding insertion and care of indwelling urinary catheter in female patients at Colombo South Teaching Hospital. Methods: The study was a descriptive cross-sectional study using pre-tested semi-structured questionnaire to collect information about knowledge and practices of nurses regarding insertion and care of indwelling urinary catheter in female patients at Colombo South Teaching Hospital, Sri Lanka. There were 122 participants from selected wards/units. The study was conducted at Colombo South Teaching Hospital Sri Lanka. This study was approved by Ethics Review Committee, Faculty of Medical Sciences, University of Sri Jayewardenepura. Results: The response rate was 66.6%. Based on the scoring system, knowledge level on indwelling urinary catheter insertion was 36.1% and it was at fair category level. Most participants (79.5%) had satisfactory level of practices regarding indwelling urinary catheter insertion. Eighty-two present of the participants had unsatisfactory level of knowledge regarding indwelling urinary catheter care. Majority of the participants (78.7%) had satisfactory level of practices regarding indwelling urinary catheter care Conclusions: The findings highlighted that most nurses in this study showed satisfactory level of practices regarding indwelling catheter care. However significant level of knowledge deficit found on indwelling urinary catheter insertion and care. This points to an urgent need of education and training on catheterization and catheter care for nurses in Sri Lanka. PP 41 Knowledge attitudes and practices related to hospital ergonomics among nurses working in four selected hospitals in Colombo District Warnakulasuriya SSP1, Peiris-John R2, Sivayogan S3, Sathiakumar N4, Wickremasinghe AR5 1 Department of Allied Health Sciences, Faculty of Medical Sciences University of Sri Jayewardenepura ,2Section of Epidemiology and Biostatistics, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, 3Department of Community Medicine ,Faculty of Medical Sciences ,University of Sri Jayewardenepura, 4Department of Epidemiology, University of Alabama at Birmingham,USA, 5Faculty of Medicine, Department of Public Health, University of Kelaniya Objectives: To assess the levels of knowledge, favorable attitudes and desirable practices related to work ergonomics among nurses in four selected hospitals in Colombo district. Methods: A cross sectional survey was conducted in four selected hospitals in Colombo district using pretested, self-administered questionnaire among 862 female nurses to ascertain data related to work ergonomics. Sample was randomly selected according to nurses’ ratio in each hospital. Data were analyzed with descriptive statistics using SPSS statistical software (version 16). Knowledge levels were calculated using standard criteria. Favorable attitudes and desirable practices were determined based on the mean scores. Results: Response rate was 70% (n=603) and mean age of the nurses was 34.6(+SD=8.3). Only 4.4% had university degrees. The overall knowledge of the nurses (46.6%) on work related ergonomic was moderate, and the proportion of nurses who had good knowledge on work ergonomics was 0 (0%). The majority of the nurses had unfavourable attitudes towards work ergonomics. Among fourteen statements that reflect attitudes, only four statements were marked in favour of work ergonomics. Nurses marked their practices in frequencies. Of the 12 statements related to nursing activities attributed to work ergonomics, majority of participants carried out undesirable practices in seven and desirable practices in five. Conclusions: Knowledge, attitudes and practices were not favourable to hospital work ergonomics in the study population. Since hospital work ergonomics is one of the major determinant of work related health problems and occupational health, steps should be taken to improve knowledge, attitudes and practices related to work ergonomics among nurses. PP 42 An intervention to change knowledge attitudes and practices on work ergonomics among nurses in two selected teaching hospitals in Colombo Warnakulasuriya SSP1, Peiris-John R2, Sivayogan S3, Sathiakumar N4, Wickremasinghe AR5 1 Department of Allied Health Sciences, Faculty of Medical Sciences, University of Sri Jayewardenepura, 2Section of Epidemiology and Biostatistics, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, New Zealand, 3Department of Community Medicine, Faculty of Medical Sciences ,University of Sri Jayewardenepura, 4Department of Epidemiology, University of Alabama at Birmingham,USA, 5Faculty of Medicine, Department of Public Health, University of Kelaniya Objectives: To test the effectiveness of and educational intervention to improve knowledge, attitudes and practices among nurses on work ergonomics. Methods: Two groups of nurses from two selected teaching hospitals in Colombo (study group 30 and control group 30) were selected for an experimental study following an eligibility test. . Only study group received comprehensive study pregame for two days’ which was conducted by a multi-disciplinary expert team. Both groups were pretested with self-administered questionnaire on work ergonomics. Post-test was carried out using the same questionnaire after three months of the educational intervention. Independent sample t-test and paired T-test were used to check the differences within and between the groups Results: Drop rate was 30% in the study group and 16.6% in the control group at the post test. There was a significant difference of knowledge (p<0.001) and attitudes (p<0.001) in the study group compared to the control group. However, there was no significant difference in practices between study and control groups (p=0,416).There was a significant difference in mean scores of knowledge, attitude and practices (p<0.001) within the study group at the post test. Contrastingly, there were no significant changes in mean scores of knowledge (p=0.097), attitudes (p=0.683) and practices (p=0.169) within the control group. Conclusions: Knowledge and attitudes of the nurses on work ergonomics can be significantly improved through predesigned educational programs. However, further investigation would be necessary to identify strategies to changes in practices related to work ergonomics PP 43 ICU Nurses’ knowledge regarding ventilator-associated pneumonia and its prevention Muralitharan P1, Seneviratne SMKS1 1 Department of Allied Health Sciences, University of Sri Jayewardenepura Objectives: To assess knowledge regarding Ventilator-Associated Pneumonia (VAP) and its preventive measures among ICU Nurses. Methods: A descriptive cross-sectional study was conducted using a sample of 127 nurses from adult ICUs at Colombo South Teaching Hospital and Sri Jayewardenepura General Hospital. A self-administered pre-tested questionnaire was used. Data were analysed using SPSS version 20.0. Knowledge levels were categorized as “Good”= above 75%, “Average” = 50-75% and “Poor” = below 50%. Results: Overall results showed that a majority of participants 79(62.2%) had “Average” level of knowledge, 42(33.1%) had “Good” level of knowledge and 6(4.7%) had “Poor” knowledge. Mean knowledge score was 70.15±10.5. Most of the participants had “good” knowledge on what is VAP [87(68.5%)], functions of upper respiratory tract [107(84.3%)], causative microorganisms [72(56.7%)] and mode of transmission [100(78.7%)]. A majority had “average” knowledge on standard precautions [62(48.8%)] and “poor” knowledge on signs of VAP [66(52%)]. With regard to prevention of VAP, most participants had “good” knowledge on natural preventive mechanisms [117(92.1%)], measures such as use of suction catheters [123(96.9%)] and reducing microbial colonization in oropharynx [119(93.7%)]. In contrast “poor” knowledge was evident on minimum Endotracheal (ET) suction pressure [88(69.3%)], minimum ET cuff pressure [82(64.6%)], early weaning from ventilator [92(72.4%)] and disinfection of ventilator parts [68(53.5%)]. Conclusions: Overall knowledge of ICU nurses on VAP and its preventive measures were at “average” level. Knowledge deficiencies were identified on preventive strategies in maintaining airways and disinfection of ventilator parts. Continuous training on preventing VAP is important to address the deficiencies for better patient outcomes. PP 44 Constraints and challenges face by the nurses in provision of care at Accident and Orthopedic Service (AOS), National Hospital of Sri Lanka (NHSL) Wijayarathne GHPDS1, Warnakulasuriya SSP2 1 National Hospital Sri Lanka, 2Department of Allied Health Sciences, Faculty of Medical Sciences, University of Sri Jayewardenepura Objectives: To describe the constraints and challenges face by the nurses in provision of care at Accident and Orthopedic Service (AOS), National Hospital of Sri Lanka (NHSL). Methods: Nurses currently working in AOS included for the sample (n=223). Pre-tested selfadministered questionnaire was used to collect data related to personal characteristics and perceived challenges of nurses. Data analysis was done using SPSS statistical software and descriptive statistics were used to analyze data Results: The response rate was 77.2% (n= 163), majority (90%) was female. High percentage (70%) of the nurses experience work related stress and majority (80%) has job satisfaction and positive level of autonomy (60%) in their nursing practice. However, majority (85%) of nurses experienced time pressure to complete tasks and high percentage (80%) of nurses felt that dealing with patients with substance abused, aggressive behavior, patients and family members with unrealistic expectations as challenges during their practice. Almost half (50%) of the nurses felt increased number of patients and dealing with patients with critical conditions as challenging conditions in their working area. And also most of them (75%) felt increased number of working hours, excessive number of night shifts and work over load as challenges during their clinical practice. Conclusions: Nurses at AOS perceived many challenges during their practice .Most common factors that contributed were dealing with substance abused or aggressive patients and family members, unrealistic expectations of clients and their family members, increased number of work hours, excessive number of night duties and heavy work overload at the ASOS. PP 45 A glimpse of International Elective Programme(IFP) at Faculty of Medical Sciences, University of Sri Jayewardenepura Banneheke BMHA1, De Silva D1, Kahatapitiya S1, Dissanayake J1 Adhikari B1, Weeraratne C1 1 Department of Parasitology, Faculty of Medical Sciences, University of Sri Jayewardenepura Objectives: To survey the pattern of international students enrolling into and determine the positive and negative aspects of IEP, FMS Methods: All students registered during 2012 to 2015 were included. A form containing questions with regard to academic, interpersonal, life experience was used to get feedback. Results: There were 222 students with 58.1% females. Registered students consisted of 29, 65, 39 and 89 respectively in 2012, 2013, 2014 and 2015. Majority (128, 57.6%) were from UK followed by Australia (28, 12.6%). Majority were solely interested in clinical subjects (190, 85.6%). Popular subjects were medicine (114, 51.4%), surgery (74, 33.3%), gynaecology & obstetrics (69, 31.1%) and paediatrics (59, 26.6%). Most (120, 54%) stayed 4 weeks. July to September (81, 36.5%) had the highest enrolments. Feedback forms were returned by 27. Majority stayed 4 weeks (40.7%). Half (50%) found IEP through a web search. The excellent or satisfactory scores for achievement of learning objectives, clinical exposure, supervisor’s cooperation, coordinator’s assistance and local students’ support were 100%, 100%, 92.6%, 95.8% and 88% respectively. Majority (95.8%) would recommend to others. The students enjoyed the great exposure to tropical diseases, friendly people, food and the beautiful country. Language barrier, crowded ward round and long waiting times were the problems encountered. Students suggested a hospital tour on first day and partnering up with a local student to improve the programme. Conclusions: Popularity of IEP, FMS has risen gradually yet there are ways to improve. PP 46 Subcutaneous nodules in a neutropenic patient De Silva SHCK1, Jayasekera PI2, Wanigasooriya S1, Gunasekara SP1 1 National Cancer Institute, Maharagama, 2Department of Mycology, Medical Research Institute, Colombo Introduction: Fusarium spp. is the second most-common mold infection in immunocompromised patients. Disseminated fusariosis is life-threatening and the outcome is influenced by the host’s immune status. Mortality ranges from 50-80%. Prolonged and profound neutropenia is a major risk factor. We report the first case of disseminated fusariosis with Fusarium aquaeductuum in Sri Lanka. Case Report: 5 1/2 year old boy with ALL after completing chemotherapy, admitted with a relapse after 6 months. On admission he was asymptomatic. But the absolute neutrophil count was 650/L. He was started with IV vancomycin and IV ciprofloxacin empirically. While on those two antibiotics for 11 days, fever spikes appeared and merepenem and IV fluconazole were added on top of that. Fever did not subside and after 2 days he developed multiple painful subcutaneous nodules about 2cm in radius, mainly on limbs. Blood culture was positive for branching fungal filaments and it was later identified as Fusarium aquaeductuum. IV amphotericin B (conventional) was started empirically with fever and subcutaneous nodules. Oral voriconazole was added after 2 days and both were continued for total of 2 weeks after negative repeat blood culture. Discussion: Our patient was started on amphotericin B, with high clinical suspicion. Voriconazole was added due to initial poor response and positive repeat blood cultures. Although the mortality rate following disseminated fusariosis ranges 50% to 80%, with timely management our patient fully recovered. PP 47 Selfie documentation of hanging: The first ever reported case in Sri Lanka Sanjeewa HKR1, Vidanapathirana M1 1 Department of Forensic Medicine, Faculty of Medical Sciences, University of Sri Jayewardenepura Introduction: Electronic data are now admissible in court of law in Sri Lanka under Evidence Special Provisions Act No 14 of 1995. Video recording or obtaining photographs is not a common finding among suicidal acts and they may perform such practices for multiple reasons. The case under discussion is the first ever reported case of a Selfie documentation of his act of hanging. Case report: A 19 year old male was found in complete hanging inside a closed room. The rope used to hang him-self was firmly tied to a rafter and the suspension point was accessible. A mobile phone and a ‘suicide’ note were found at the scene. The scene was undisturbed. The post mortem examination revealed a ligature around the upper most part of the neck with a sliding knot in the back. There were no petechial haemorrhages in conjunctivae or face. The hyoid bone and the thyroid cartilage were intact. There were no evidences of incapacitation, intoxication or defense injuries. Toxicological reports were unremarkable. The mobile phone contained one bust photograph and three live photographs of the hanging incident. Discussion: There were no evidences suggestive of homicidal hanging but it could be a suicidal hanging. However, there is a remote chance of being an accidental death while doing an experimental hanging in order to win the sympathy of his girlfriend. This is the first ever reported Selfie documentation of a case of hanging. PP 48 A case report of two generations of Incontinentia pigmenti Perera TMR1, Vipulaguna DV2, Suntharesan J2, Wijesekara S1 1 Department of Paediatrics, Faculty of Medical Sciences, University Jayewardenepura, 2 University Paediatric Unit, Colombo South Teaching Hospital, Kalubowila of Sri Introduction: Incontinentia pigmenti (IP) or Bloch- Sulzberger syndrome is a rare X linked dominant genodermatosis with multiorgan involvement due to a mutation in NEMO gene. It mostly affects females as it could be lethal in males. Ectodermal in origin, this disorder gives rise to ocular, dental, skin and neurological manifestations. Landy and Donnai have introduced criteria for diagnosis of IP in 1993. Case Report: We report a 2-year-old girl (index case) and her mother who fulfil the above criteria for IP. The child has had all four stages of cutaneous manifestations since birth while the mother had three. The girl also had characteristic dental and hair manifestations. She is developmentally and neurologically normal. The mother has ophthalmological, nail and hair changes of IP and suffers from seizures. Her dentition is normal. Maternal family history is insignificant. Index case is the only child and there were no miscarriages in the mother. Discussion: Integrated multi-disciplinary management including genetic counseling arranged for both patients. This is the first Sri Lankan publication on IP in two generations with classic clinical features. PP 49 A neonatal death with two crucial issues: the identity of the child and whether there was any therapeutic mismanagement Ariyarathne D1, Hulathduwa SR1 1 Department. of Forensic Medicine, Faculty of Medical Sciences, University of Sri Jayewardenepura Introduction: Every neonatal death causes much distress to parents making the ward-staff vulnerable to accusations of medical mismanagement. JMO was confronted with two main issues: the possibility of malicious exchange and whether the life would have been saved with early intervention. Case Report: A 17 year old primi with a 36 week POA was admitted with dribbling on the same day. She was managed conservatively for three days. On the third day she developed a mild fever and a lower abdominal pain and went into spontaneous labour to deliver a severely asphyxiated baby girl of 2.5 kg. who died 7 hrs 30 mts after delivery. The parents were preoccupied with the gender of their unborn child preparing blue clothing anticipating a baby boy. The labour-room staff has clad the child with pink clothing for genuine reasons creating a grave suspicion in the bereaved mother of malicious exchange of her healthy boy for a sick girl. The medico-legal investigation concluded the cause of death as birth asphyxia (peripartum hypoxia) with intra-cerebral haemorrhages. Discussion: Simple measures of effective communication such as showing the gender of the newborn to the mother at the time of delivery would certainly have prevented issues regarding wrongful identity. Birth asphyxia has numerous causes most of which cannot be established at a routine autopsy. Whether there was an element of chorio-amnionitis is a clinical decision beyond the purview of JMO. Serious consideration should be given to the fact whether the outcome could have been better if the baby had been delivered early through Caesarian section in the context of marginal prematurity, teenage pregnancy and possibility of uterine infection. PP 50 Acrometastasis as the initial presentation of Hepatocellular Carcinoma (HCC) Kiriwandeniya AU1,Wijerathne T1, MD Eranthaka2 , AMCP Gunarathna2 1 Faculty of Medical Sciences, University of Sri Jayewardenepura, 2Colombo South Teaching Hospital, Kalubowila Introduction: Acrometastasis occur infrequently, accounting for approximately 0.1% of all metastatic osseous involvement. Its presentation mimics infectious or inflammatory disease. Primary presentation of HCC as bone metastasis is rare. When present, they are mostly vertebral, rib or skull deposits. Primary manifestation of HCC as acrometastasis is extremely rare. Case Report: A 59 year old alcoholic male was admitted with sudden onset profuse bleeding from an ulcer involving middle and proximal phalanx of left middle finger. This was a chronic wound following a road traffic accident. Patient underwent amputation of this finger for the clinical diagnosis of chronic osteomyelitis. Macroscopy of amputated finger showed a continuous lesion from skin to bone with evidence of bone destruction. Microscopy together with immunohistochemistry (HepPa 1 antibody) confirmed a deposit of a HCC with skin and bone infiltration. Follow up radiological investigations revealed two foci of hepatocellular carcinoma with background cirrhosis. Discussion: HCC show a haematogenous spread usually via pulmonary circulation and vertebral circulation. Hence the mechanism of spread into bones other than the bones of the axial skeleton, bypassing the lung is not explained. Amputation, radiation, excision, and systemic therapy are the available treatment options. Radiotherapy is an effective and noninvasive treatment that improves patient’s quality of life. When patients present with lytic lesions of the bone considering a deposit of a HCC despite the site will be helpful to complete the preoperative work up with a USS of abdomen. The presence of acrometastasis in patients with cancer helps staging the disease and usually indicates a very poor prognosis. PP 51 First patient with Scopulariopsis brevicaulis onychomycosis in Sri Lanka Jayasekera P1, Sigera LSM1, Gamage TM1, Hewage DM2 1 Department of Mycology, Medical Research Institute, Colombo, 2Base Hospital, Mawanella Introduction: Scopulariopsis brevicaulis represents 1∼10% of the non-dermatophyte onychomycoses. We report the first patient with onychomycosis due to Scopulariopsis brevicaulis in Sri Lanka. Case Report: A 35 year old patient was referred by a Dermatology Clinic to Department of Mycology at MRI with a typical distal and lateral subungual onychomycosis. He is a nondiabetic patient with no other identifiable precipitating factors. Nail scrapings were collected for fungal studies. Direct microscopic examination with potassium hydroxide revealed brown coloured septate fungal filaments. The sample was cultured on Sabouraud dextrose agar supplemented with chloramphenicol +/- cyclohexamide and incubated at specific temperatures for 2 weeks. On day 10, culture was positive for a mould. The isolate was initially white, expanding with a powdery surface and then turned into brown color. Reverse was brown in colour. Slide culture test revealed chains of rough walled, lemon-shaped conidia on numerous branched conidiophores. Antifungal sensitivity was not done. Discussion: S. brevicaulis is a common saprophytic fungus. The genus Scopulariopsis consists of more than 30 species, where eight specs have been reported to cause infections in humans. Of these, S. brevicaulis the most common. Scopulariopsis often reported in proximal onychomycosis result in yellow-striated nails .The toe nails get affected mostly and it is common in adults. Skin and soft tissue infection, endocarditis and endophthalmitis have been reported among immnunocompromised patients. Many publications have showed multiresistance in S. brevicaulis with high in vitro MICs against amphotericin B, itraconazole, posaconazole, voriconazole, caspofungin and terbinafine. This makes the treatment much more difficult. PP 52 First patient with Trichophyton violaceum tinea corporis in Sri Lanka Jayasekera PI.1, Sigera LSM1, Gamage TM.1 1 Department of Mycology, Medical Research Institute, Colombo Introduction: Trichophyton violaceum (formerly T. soudanense) is an anthropophilic fungus which is frequently isolated in patients with tinea capitis in certain regions of Africa. Infection of the skin and nail is less common. We report the first case of tinea corporis due to Trichophyton violaceum in Sri Lanka. Case Report: A 5 year old child developed a pruritic, scaly lesion in popliteal areas of both lower limbs. The area was lightly pigmented and size of both lesions was increasing gradually. No evidence of active inflammation. No other body areas were involved. None of the family members or her play mates had similar type of condition. She was referred to the Department of Mycology for further investigations and skin scales were collected for mycological studies. The direct microscopic examination revealed no fungal filaments, spores or arthrospores. The sample was cultured on Sabouraud dextrose agar supplemented with chloramphenicol +/- cyclohexamide and incubated at specific temperatures for two weeks. Cultures were observed frequently for any growth. There was a fungal growth on day 13 and the macroscopic appearance of colony was slow-growing, glabrous, leathery, wrinkled and yellow in colour. Highly distorted fungal hyphae had reflexive or right-angle branching with septae in the slide culture. Pyriform microconidia were present and numerous chlamydoconidia was observed in older culture. Discussion: These nail infections are extremely difficult to eradicate and resemble those caused by other endothrix organisms. If any case of skin or nail infection identified, a familial source of infection should be sought, as in all cases of anthropophilic fungal infection PP 53 Pyoderma gangrenosum: Surgeons beware…! Perera KAAJ1, Edirisinghe AN1, Gunawardena SA1 1 Sri Jayewardenepura General Hospital Introduction: Pyoderma gangrenosum (PG) is an uncommon, ulcerative cutaneous condition of uncertain aetiology. In up to 50% of patients it’s associated with an underlying systemic disease, ie, inflammatory bowel disease, arthritis or a haematological disease. This neutrophilic dermatosis most frequently affects the lower extremities of adults aged 25–54 years. PG is a diagnosis of exclusion, other causes of similar cutaneous ulcerations need to be excluded. PG ulcers demonstrate pathergy, ie, worsening in response to minor trauma or surgical debridement. Case Report: A 62 year old male, diagnosed with myelodysplastic syndrome (MDS) 3 years ago, presented with a non-healing leg ulcer for more than a year. He had developed a small wound over the area following minor trauma which had progressively worsened over the past year, leading to an almost circumferential leg ulcer. He had undergone several aggressive surgical wound debridements which had not improved the condition but rather worsened it. The ulcer had undermined, overhanging, dusky purple edges with surrounding induration and erythema. The base of the ulcer contained necrotic tissue with a purulent exudate. A diagnosis of PG was made using the criteria described by Su et al, and the patient was started on systemic and topical steroids. The ulcer responded dramatically to this treatment and is reducing in size and healing well at present. Discussion: It is important to be aware of PG and to suspect it in the relevant patient. Surgical intervention, may sometimes appear tempting, but will simply make the condition worse. Acknowledgements The Research Committee of the Faculty of Medical Sciences wish to thank the following for their help and support in organizing the Scientific Sessions 2016 The Vice Chancellor, University of Sri Jayewardenepura for his encouragement and continued support Dean, Faculty of Medical Sciences for her unwavering support, encouragement and guidance President and the members of the Clinical Society, Sri Jayewardenepura General Hospital All the eminent invited guest speakers Sangeetpati Pradeep Rathnayake for gracing the inauguration ceremony Prof. Hemanthi Ranasinghe, Dean of the Faculty of Graduate Studies for permission to use the poster stands for display of posters Those who submitted abstracts for free papers All academic staff members who reviewed the abstracts Academic staff members who chaired the sessions Academic staff members who evaluated the oral and poster presentations University of Sri Jayewardenepura for financial support Management and staff of Golden Rose Hotel, Boralesgamuwa AV Productions for sounds and backdrop Lassana Flora for floral arrangements Ananda Press for printing the Book of Proceedings Drs Madhu Sundaran Rajkumar and Kavinda Samarakoon, Thilini Premasiri and Maduri Wijegunathilake (Demonstrators) for their support Mr Chamil Munasinghe for designing the web content relevant to the Scientific Sessions 2016 and for designing the tool for abstract submission Non-academic staff for all the support List of Sponsors State Pharmaceuticals Corporation of Sri Lanka Fonterra Brands Lanka (Pvt) Ltd Genix Pharma (Pvt) Ltd Renata Ltd A J Medichem Medisolve GlaxoSmithKline Pharmaceuticals Seven Seas Aristopharma Ltd IPCA Laboratories Darley Butler and Co Ltd