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Papers by Aindralal Balasuriya

Ischemic Heart Disease (IHD) is classified as one of the world's major cardiovascular dis... more Ischemic Heart Disease (IHD) is classified as one of the world's major cardiovascular diseases and has become the leading cause of deaths in Sri Lanka. Poor treatment adherence plays a significant role in re-hospitalization and death related to IHD. Therefore, a socio-culturally appropriate health counselling intervention was developed for a psychological interventional study to enhance the adherence of prescribed physical activity, diet, and medication among IHD patients attending medical clinics in selected hospitals in Galle district, Sri Lanka. The protocol mainly consisted of two sections (Assessment and Intervention) and six subsections. The intervention method consisted of communication skills, motivational interviewing, goal setting, and problemsolving. An expert panel consisted of a consultant physician, two clinical psychologists, a nurse educator, and a nurse in charge of a health education unit reviewed each subsection on a scale of 0 (total disagreement) to 9 (total agreement) under four aspects in the Delphi review. The ratings in stage one were evaluated and resent for a second round, and the re-ratings were reevaluated for a degree of consensus. Each subsection was revised or removed if 70% or more of the re-ratings were in categories 0-3 and retained if 70% or more of the re-ratings were in categories 4-6 and 7-9. All the subsections were retained, and few modifications were made as per the expert views. This health counselling intervention protocol is expected to be used in the interventional study among patients with IHD in selected hospitals in Galle district, Sri Lanka.

Asian Journal of Medical Sciences

Background: Ischemic heart disease (IHD) has been identified as the foremost cause of morbidity a... more Background: Ischemic heart disease (IHD) has been identified as the foremost cause of morbidity and mortality in Sri Lanka. Aims and Objectives: The main aim of this study was to develop a socio-culturally appropriate health counseling intervention protocol to enhance the adherence of prescribed physical activity, diet, and medication among IHD patients attending medical clinics in Sri Lanka. Materials and Methods: This protocol was designed to be used by health professionals and consisted of two sections – an assessment and an intervention. The intervention section integrated communication skills with motivational interviewing, goal setting, and problem-solving. A panel of five experts reviewed each section of the protocol, in a Delphi process. The ratings received at Delphi stage one that was evaluated for degree of consensus. The protocol was modified according to the comments received and resent for a second Delphi round. Again, the re-ratings were reevaluated for the degree of ...

ABSTRACTIntroductionComplex interventions are widely used in public health practices in other soc... more ABSTRACTIntroductionComplex interventions are widely used in public health practices in other social areas with prominent health consequences which leads to practical and methodological difficulties, which must be overcome successfully. Importantly, the Communication for Behavioural Impact (COMBI) plan is an effective method directed at enacting behaviour change to benefit health and social development which encourage precise behavioural outcomes and is effective in planning a behavioural change for dengue control.ObjectiveThe aim was to develop a COMBI plan to change the behaviour to prevent dengue in a major district of Sri Lanka.MethodsThe plan was developed according to World Health Organization (WHO) COMBI planning 10 steps with the scientific evidence and expert opinion. The situation analysis was conducted using mixed-methodology from January to March 2019 among the adults in a highly dengue-endemic area in Kurunegala District, Sri Lanka. The overall goal of the plan was to c...

Geriatrics, 2022

Undernutrition is a health challenge due to an expanding older population. The aims of the study ... more Undernutrition is a health challenge due to an expanding older population. The aims of the study were to assess the prevalence and determinants of undernutrition and, associated factors of low muscle and high fat mass among older men and women in the Colombo district of Sri Lanka. A cross sectional study was conducted using a multistage cluster sampling technique. Undernutrition was defined based on anthropometry and body composition assessed using bio-electrical impedance. Sex-specific multivariable logistic regression analyses were conducted. Of 800 participants (30.6% men), 35.3% were undernourished. The factors significantly associated with undernutrition among older women were hypertension with an adjusted odds ratio (aOR) (1.97; 1.36–2.88) and musculoskeletal disabilities aOR (2.19; 1.36–3.53). Among women, age ≥ 70 (1.79; 1.18–3.34) and diabetes (1.77; 1.10–2.84) were associated with low muscle mass and age ≥ 70 (2.05; 1.21–3.47), diabetes (2.20; 1.35–3.59) and disability in ...

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Journal of Complementary and Alternative Medical Research, 2021

Aims: Asthma is one of the biggest health burdens on the Sri Lankan population. Achievement of tr... more Aims: Asthma is one of the biggest health burdens on the Sri Lankan population. Achievement of treatment goals isdetermined mainlythrough pharmacological management. The main objective of this study was to evaluate the patient inhaler handling techniques and their awareness regarding their disease condition, as well as to find out how an educational intervention effects patients‘ inhaler handling techniques. Study Design: A Prospective cross sectional study used. Place and Duration of Study: National Hospital for Respiratory Diseases, Welisara and Colombo South Teaching Hospital, Kalubowila between June 2017 to August 2017. Methodology: Clinically diagnosed asthma patients were randomly divided into Control and Test groups. Control comprised 94 patients and the test comprised 93 patients. Their baseline knowledge about asthma and inhaler-using technique were assessed in 1st month by using an interviewer-administered questionnaire and checklist respectively. The test group was given...

Ceylon Medical Journal, 2021

Journal of the College of Community Physicians of Sri Lanka, 2021

Introduction: Clinical evidence suggests that hamstring tightness influences lumbar pelvic rhythm... more Introduction: Clinical evidence suggests that hamstring tightness influences lumbar pelvic rhythm and shortened hamstring increase the risk of injury to the spine. Objectives: To determine the association of hamstring tightness with pelvic tilt in standing position, trunk, and lumbar range of motion during forward bending among sewing machine operators Methods: A descriptive cross-sectional study was conducted among 169 sewing machine operators aged 18-55 years using passive knee extension test, tri-goniometric method, finger to floor test and modified Schober test to measure hamstring tightness, pelvic tilt, trunk flexion and lumbar flexion, respectively. Results: A weak negative correlation between hamstring tightness and lumbar range of motion during forward bending (r=-0.28; p=0.001). A significant association between trunk flexion and hamstring tightness (r=0.47; p=0.001). Conclusions & Recommendations: Hamstring tightness affects the lumbar and trunk range of motion during forward bending.

Journal of the College of Community Physicians of Sri Lanka, 2020

is a state-of-the-art hospital with approximately 704 beds and consists of all specialties includ... more is a state-of-the-art hospital with approximately 704 beds and consists of all specialties including laboratories, cath-lab for complex cardiac interventions, an oncology unit and intensive care units. The UH-KDU is the training hospital of medical and allied health undergraduates of General Sir John Kotelawala Defence University (KDU), Ratmalana. In this narrative report, we describe the public health measures adhered to and taken to manage an institutional outbreak in order to prevent a surge.

Journal of the Postgraduate Institute of Medicine, 2020

Background Ischaemic Heart Disease (IHD) is a major constituent of cardiovascular disease in the ... more Background Ischaemic Heart Disease (IHD) is a major constituent of cardiovascular disease in the world at present and has become the leading cause of death in Sri Lanka. Poor adherence to medication in IHD is related to increased re-hospitalisation and mortality. Therefore, continuous assessment of medication adherence is extremely important among these patients. The Morisky Green Levine Medication Adherence Scale (MGLS) is a widely used instrument to evaluate medication adherence in the clinical setting. The study aimed to translate the MGLS into Sinhala and cross-culturally adapt it to the Sri Lankan setting. Methods A Delphi process was conducted with a panel of experts where content and consensual validity of the scale was assessed after translation, back translation and pre-testing of the original scale. The ratings received from the first round of the Delphi process were noted and the amended translation resent for a second round. The re-ratings were evaluated for the degree of consensus and Items for the MGLS Sinhala version were chosen based on the following criteria: (i) the item was reworded or removed if 70% or more of the re-ratings were in category 0-3. If reworded, the Delphi Process was repeated for that item, (ii) the item was kept with no change if 70% or more of the re-ratings were in categories of 4-6 and 7-9. Results No items were removed from the original scale. Some items were reworded according to the experts' suggestions to retain the conceptual meaning when translated into Sinhala. The Sinhala version of the MGLS exhibited adequate content and consensual validity. Conclusion The Sinhala version of the MGLS can be used in research, medication adherence evaluations and IHD prevention programmes in Sri Lanka.

Ceylon Journal of Medical Science, 2020

Background: Hamstring is a key component of flexibility in the human body and it is more prone to... more Background: Hamstring is a key component of flexibility in the human body and it is more prone to get tightened. Inability to achieve greater than 160 degrees of knee extension when the hip is flexed to 90 degrees is considered as hamstring tightness. Objectives: This study aims to find the prevalence of hamstring tightness among sewing machine operators and to assess the association of hamstring tightness with prolonged sitting, body mass index, physical activity level and gender. Method: A descriptive cross sectional study was carried out among 169 sewing machine operators aged between 18-60 years of a selected garment factory. Passive knee extension (PKE) test was used to measure the hamstring tightness among sewing machine operators. A validated interviewer administered questionnaire was used to determine the physical activity level among the participants. Results: Prevalence of hamstring tightness among sewing machine operators is 83.4% (n=141) and it is higher in males (91.8%) than females (78.7%). There was a significant association between prolonged sitting and hamstring tightness in the dominant limb (p=0.02, chi square = 7.79). Significant associations were not found between hamstring tightness with the BMI level (p=0.46, r=-0.05) and physical activity (p=0.41, r=-0.06). Conclusion: Majority of the sewing machine operators have hamstring tightness. Prolonged sitting is a contributory factor in hamstring muscle tightness.

Journal of Allergy and Clinical Immunology, 2007

Background: The literature regarding the association between breast-feeding and atopic diseases h... more Background: The literature regarding the association between breast-feeding and atopic diseases has been contradictory. Objective: We have assessed the relationship between breastfeeding and atopic disorders in a cohort followed into middle age. Methods: The Tasmanian Asthma Study is a population-based prospective cohort study that has followed participants from the age of 7 to 44 years. Exclusive breast-feeding in the first 3 months of life was examined as a risk factor for atopic diseases by using multiple logistic regression and generalized estimating equation analyses. Results: At age 7 years, exclusively breast-fed children with a maternal history of atopy had a marginally lesser risk of current asthma than those not exclusively breast-fed (odds ratio [OR], 0.8; 95% CI, 0.6-1.0). However, after age 7 years, the risk reversed, and exclusively breast-fed children had an increased risk of current asthma at 14 (OR, 1.46; 95% CI, 1.02-2.07), 32 (OR, 1.84; 95% CI, 1.06-3.3), and 44 (OR, 1.57; 95% CI, 1.15-2.14) years. Exclusively breast-fed children also had a reduced risk of food allergy at age 7 years but an increased risk of food allergy (OR, 1.26; 95% CI, 1.1-1.5) and allergic rhinitis (OR, 1.2; 95% CI, 1.0-1.3) at 44 years. Conclusion: Exclusively breast-fed babies with a maternal history of atopy were less likely to develop asthma before the age of 7 years, but more likely to develop asthma after the age of 7 years. Clinical implications: The current recommendation to breastfeed high-risk infants for protection against early wheezing illness can be confirmed. However, the recommendation should be reconsidered for protection against allergic asthma and atopy in the longer term.

Conference Presentations by Aindralal Balasuriya

Ischemic Heart Disease (IHD) is classified as one of the world's major cardiovascular diseases an... more Ischemic Heart Disease (IHD) is classified as one of the world's major cardiovascular diseases and has become the leading cause of deaths in Sri Lanka. Poor treatment adherence plays a significant role in re-hospitalization and death related to IHD. Therefore, a socio-culturally appropriate health counselling intervention was developed for a psychological interventional study to enhance the adherence of prescribed physical activity, diet, and medication among IHD patients attending medical clinics in selected hospitals in Galle district, Sri Lanka. The protocol mainly consisted of two sections (Assessment and Intervention) and six subsections. The intervention method consisted of communication skills, motivational interviewing, goal setting, and problemsolving. An expert panel consisted of a consultant physician, two clinical psychologists, a nurse educator, and a nurse in charge of a health education unit reviewed each subsection on a scale of 0 (total disagreement) to 9 (total agreement) under four aspects in the Delphi review. The ratings in stage one were evaluated and resent for a second round, and the re-ratings were reevaluated for a degree of consensus. Each subsection was revised or removed if 70% or more of the re-ratings were in categories 0-3 and retained if 70% or more of the re-ratings were in categories 4-6 and 7-9. All the subsections were retained, and few modifications were made as per the expert views. This health counselling intervention protocol is expected to be used in the interventional study among patients with IHD in selected hospitals in Galle district, Sri Lanka.