Gaya Katulanda - Academia.edu (original) (raw)

Papers by Gaya Katulanda

Journal of medical case reports, Jun 27, 2024

Clinica chimica acta, May 1, 2024

Clinica chimica acta, May 1, 2024

Sri Lanka Journal of Diabetes Endocrinology and Metabolism

BMC Endocrine Disorders

Background Male sexual dysfunction in diabetes is often an unrevealed clinical issue. Though many... more Background Male sexual dysfunction in diabetes is often an unrevealed clinical issue. Though many publications report the prevalence, there is limited data on its associations, impact, and health-seeking behaviour. The objectives were to assess the prevalence of male sexual dysfunction, its associations, impact and treatment-seeking among men with diabetes in a selected tertiary care Diabetes Clinic. Methods A cross-sectional study was conducted at the Diabetes Clinic, National Hospital of Sri Lanka, from January to September 2020. Men with diabetes aged 18 to 70 years undergoing annual assessment were recruited consecutively. Socio-demographic and clinical information were collected using an interviewer-administered questionnaire. Erectile dysfunction (ED), premature ejaculation, mental health and quality of life were assessed using validated self-administered questionnaires. Cardiovascular autonomic reflex tests and total testosterone levels were performed. Penile colour Doppler u...

BMC Cardiovascular Disorders

Background Management of cardiovascular disease (CVD) in patients with haemophilia is extremely c... more Background Management of cardiovascular disease (CVD) in patients with haemophilia is extremely challenging. Therefore, knowing the prevalence of CVD and risk factors in this population is imperative. Methods All consented patients ≥ 18 years of age attending the haemophilia clinic at a tertiary care centre were recruited to the study. Data were collected using a pretested, investigator administered questionnaire. Seated blood pressure, anthropometric measurements and blood samples were obtained using standard techniques. Lipid profile and fasting plasma glucose were estimated. Prevalence of risk factors for CVD was compared with those of age matched males in the general population. P values < 0.05 were considered significant. Results Of the total 109 participants, 92 (84.4%) had haemophilia A. The median age of the study group was 36 years. Three (2.8%) had at least one cardiovascular disease. There were 10 (9.2%), 30 (27.5%), 13 (11.9%) and 4 (3.7%) participants with diabetes, ...

Archives of Diabetes and Endocrine System, 2018

BMC Endocrine Disorders, 2018

BMC Endocrine Disorders, 2019

Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 2019

Sri Lanka Journal of Diabetes Endocrinology and Metabolism

Clinical Biochemist Reviews, 2020

Methods Plasma samples are prepared via protein precipitation with acetonitrile spiked with deute... more Methods Plasma samples are prepared via protein precipitation with acetonitrile spiked with deuterated internal standards. Samples are then injected on to a Sciex Triple Quad 5500+ LC-MS system, under gradient elution, through a Supelco Ascentis Express C18 50 x 2.1 mm, 2.7 μm column. During the validation linearity, sensitivity, precision and accuracy, selectivity/specificity and robustness were assessed as well as recovery, matrix effect, carry over, sample dilution and stability. Results The outcome of all validation criteria was acceptable with the combined method yielding a linear range in mg/L of 0.5-50.0 for fluconazole, 0.08-8.00 for voriconazole and isavuconazole, 0.04-4.00 for posaconazole and 0.03-3.00 for itraconazole. Overall precision varied between 0.7-7.8 % and accuracy 92-107%. Conclusion The implementation of this developed method allows for the continuation of TDM service for azoles using LC-MS/MS and increases the scope of our analysis with the inclusion of isvuconazole. In addition, the combination of all azole assays into one method has simplified the sample preparation process and reduced runtimes of up to 10 minutes to less than 3 minutes. This allows for a reduction in operator time, increased service frequency and a reduction in result turnaround. Moreover, LC-MS/MS provides a greater degree of specificity and selectivity compared to our current employed methods.

Sri Lanka Medical Association-123rd Annual Scientific Sessions 2010_.

Sri Lanka Journal of Diabetes Endocrinology and Metabolism, 2021

Incidentalomas of endocrine glands are a common problem in endocrine practice. Data on their prev... more Incidentalomas of endocrine glands are a common problem in endocrine practice. Data on their prevalence are limited from South Asian settings. Objective: We aimed to describe incidentalomas and other histopathological abnormalities in an autopsy series of Sri Lankans. Methods: Consecutive autopsies performed at Judicial Medical Office, Colombo from December 2014 to December 2016 were screened and the deceased without a diagnosed endocrinopathy (except diabetes) were included in the study. Pituitary, thyroid, adrenal, pancreas and ovarian specimens were sampled and examined both macroscopically and under light microscopy with Haemotoxylin Eosin stain. Results: Among 441 autopsies (mean age 52.5 years, male 77.8%) examined, pituitary, thyroid, adrenal, pancreatic and ovarian nodules were detected in 0.8%, 37.2%, 1.8%, 1.3% and 18.4% respectively. Thyroid neoplasms were present in 6.4%, of which 87.5% were papillary carcinoma or papillary microcarcinoma and it was associated with background thyroiditis (χ2 = 4.05, p = 0.04) or nodular thyroid enlargement (χ2 = 32.68, p < 0.01). Thyroiditis was commoner in females, but malignancies showed no gender-predilection. No malignant lesions were identified in pituitary, adrenal, pancreatic or ovarian tissues. Conclusions: In this population of Sri Lankan adults, prevalence of thyroid incidentalomas, neoplasms and thyroiditis are comparable to published studies from the West. Papillary carcinoma or microcarcinoma was the commonest type and it showed a predilection to affect thyroid glands with background thyroiditis. Pituitary, pancreatic and adrenal incidentalomas and neoplasms were less prevalent.

Sri Lanka Journal of Diabetes Endocrinology and Metabolism, 2013

Clinical guidelines: The Endocrine Society of Sri Lanka Disclaimer: Clinical Practice Guidelines ... more Clinical guidelines: The Endocrine Society of Sri Lanka Disclaimer: Clinical Practice Guidelines are developed to be of assistance to health care professionals by providing guidance and recommendations for particular areas of practice. The guidelines should not be considered inclusive of all proper approaches or methods, or exclusive of others. The guidelines cannot guarantee any specific outcome, nor do they establish a standard of care. The guidelines are not intended to dictate the treatment of a particular patient. Treatment decisions must be made based on the independent judgment of health care providers and each patient's individual circumstances. The Endocrine Society of Sri Lanka makes no warranty, express or implied, regarding the guidelines and specifically excludes any warranties of merchantability and fitness for a particular use or purpose. The Society shall not be liable for direct, indirect, special, incidental, or consequential damages related to the use of the information contained herein. Endocrine Society of Sri Lanka thanks Novo Nordisk for funding the development of these.

SAGE Open Medical Case Reports, 2022

Neuroleptic malignant syndrome is a rare, fatal antipsychotic-induced idiosyncratic reaction char... more Neuroleptic malignant syndrome is a rare, fatal antipsychotic-induced idiosyncratic reaction characterised by hyperthermia, altered consciousness, autonomic instability and rigidity with elevated creatine kinase levels and leukocytosis. Neuroleptic malignant syndrome and antipsychotics are significant causes for elevated creatine kinase among the extensive list of differential diagnoses. Risperidone is an atypical antipsychotic drug with anti-serotonergic and anti-dopaminergic properties which has a wide range of side effects, including neuroleptic malignant syndrome. Though the rise in creatine kinase in neuroleptic malignant syndrome is commonly around 2000 to 15,000 IU/L due to myonecrosis, ischaemia and heat production, normal creatine kinase levels in neuroleptic malignant syndrome were also reported. Up to now, only two cases have been reported with creatine kinase levels of more than 50,000 IU/L in neuroleptic malignant syndrome, but neither of them was risperidone-induced. W...

Kidney International Reports, 2020

In long-term follow-up study，there were 60 deaths in 482 CKD patients with the missing rate of 3.... more In long-term follow-up study，there were 60 deaths in 482 CKD patients with the missing rate of 3.98%. Night/day HR ratio, instead of 24 hour, daytime and nighttime mean HR, predicted all-cause mortality in CKD patients. Higher survival probabilities were observed in PTX than non-PTX group with Kaplan-Meier curve (Fig. 2A). The survival probabilities in non-PTX patients were significantly related to the tertiles of night/day HR ratio (Fig. 2B), while there was no significant difference in PTX group (Fig. 2C). Conclusions: In stage 5 CKD patients we provided new information on the prevalence and clinical significance of non-dipping 24 hour ambulatory HR pattern, which predicted higher all-cause mortality. PTX could reverse non-dipping HR ratio and improve survival rate in severe SHPT patients. Circadian rhythm abnormalities of HR are suggested to be treated effectively in order to improve prognosis in CKD. Mechanisms behind the adverse prognostic value of a blunted ambulatory HR rhythm remain to be elucidated.

Annals of Clinical Biochemistry, 2009

Background Apolipoproteins B (apoB) and AI (apoAI) are strong predictors of cardiovascular diseas... more Background Apolipoproteins B (apoB) and AI (apoAI) are strong predictors of cardiovascular disease (CVD). We describe apolipoprotein distributions and their associations with lipids and diabetes subtype in diabetic young adult South Asians. Methods In 995 subjects with diabetes, we measured fasting total cholesterol (TC), high-density lipoprotein cholesterol (HDLC), triglycerides (TG), apoB and apoAI, glycosylated haemoglobin (HbA1c) and glutamic acid decarboxylase antibodies (GADA). Low-density lipoprotein cholesterol (LDLC) and non-HDLC (NHDLC) were calculated. We compared values in subjects aged 15–50 y from the United States National Health and Nutrition Examination Survey (NHANES). Results Median age and duration of diabetes were 38 (range 14–45) and 4 (0–24) y. Men had significantly higher TC, TG, NHDLC, TC/HDLC, apoB/AI and NHDLC/apoB, and lower apoAI than women. Compared with the reference group, patients with type 1 diabetes had lower TG, apoB:apoAI and HDLC:apoAI, and high...

Journal of medical case reports, Jun 27, 2024

Clinica chimica acta, May 1, 2024

Clinica chimica acta, May 1, 2024

Sri Lanka Journal of Diabetes Endocrinology and Metabolism

BMC Endocrine Disorders

Background Male sexual dysfunction in diabetes is often an unrevealed clinical issue. Though many... more Background Male sexual dysfunction in diabetes is often an unrevealed clinical issue. Though many publications report the prevalence, there is limited data on its associations, impact, and health-seeking behaviour. The objectives were to assess the prevalence of male sexual dysfunction, its associations, impact and treatment-seeking among men with diabetes in a selected tertiary care Diabetes Clinic. Methods A cross-sectional study was conducted at the Diabetes Clinic, National Hospital of Sri Lanka, from January to September 2020. Men with diabetes aged 18 to 70 years undergoing annual assessment were recruited consecutively. Socio-demographic and clinical information were collected using an interviewer-administered questionnaire. Erectile dysfunction (ED), premature ejaculation, mental health and quality of life were assessed using validated self-administered questionnaires. Cardiovascular autonomic reflex tests and total testosterone levels were performed. Penile colour Doppler u...

BMC Cardiovascular Disorders

Background Management of cardiovascular disease (CVD) in patients with haemophilia is extremely c... more Background Management of cardiovascular disease (CVD) in patients with haemophilia is extremely challenging. Therefore, knowing the prevalence of CVD and risk factors in this population is imperative. Methods All consented patients ≥ 18 years of age attending the haemophilia clinic at a tertiary care centre were recruited to the study. Data were collected using a pretested, investigator administered questionnaire. Seated blood pressure, anthropometric measurements and blood samples were obtained using standard techniques. Lipid profile and fasting plasma glucose were estimated. Prevalence of risk factors for CVD was compared with those of age matched males in the general population. P values < 0.05 were considered significant. Results Of the total 109 participants, 92 (84.4%) had haemophilia A. The median age of the study group was 36 years. Three (2.8%) had at least one cardiovascular disease. There were 10 (9.2%), 30 (27.5%), 13 (11.9%) and 4 (3.7%) participants with diabetes, ...

Archives of Diabetes and Endocrine System, 2018

BMC Endocrine Disorders, 2018

BMC Endocrine Disorders, 2019

Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 2019

Sri Lanka Journal of Diabetes Endocrinology and Metabolism

Clinical Biochemist Reviews, 2020

Methods Plasma samples are prepared via protein precipitation with acetonitrile spiked with deute... more Methods Plasma samples are prepared via protein precipitation with acetonitrile spiked with deuterated internal standards. Samples are then injected on to a Sciex Triple Quad 5500+ LC-MS system, under gradient elution, through a Supelco Ascentis Express C18 50 x 2.1 mm, 2.7 μm column. During the validation linearity, sensitivity, precision and accuracy, selectivity/specificity and robustness were assessed as well as recovery, matrix effect, carry over, sample dilution and stability. Results The outcome of all validation criteria was acceptable with the combined method yielding a linear range in mg/L of 0.5-50.0 for fluconazole, 0.08-8.00 for voriconazole and isavuconazole, 0.04-4.00 for posaconazole and 0.03-3.00 for itraconazole. Overall precision varied between 0.7-7.8 % and accuracy 92-107%. Conclusion The implementation of this developed method allows for the continuation of TDM service for azoles using LC-MS/MS and increases the scope of our analysis with the inclusion of isvuconazole. In addition, the combination of all azole assays into one method has simplified the sample preparation process and reduced runtimes of up to 10 minutes to less than 3 minutes. This allows for a reduction in operator time, increased service frequency and a reduction in result turnaround. Moreover, LC-MS/MS provides a greater degree of specificity and selectivity compared to our current employed methods.

Sri Lanka Medical Association-123rd Annual Scientific Sessions 2010_.

Sri Lanka Journal of Diabetes Endocrinology and Metabolism, 2021

Incidentalomas of endocrine glands are a common problem in endocrine practice. Data on their prev... more Incidentalomas of endocrine glands are a common problem in endocrine practice. Data on their prevalence are limited from South Asian settings. Objective: We aimed to describe incidentalomas and other histopathological abnormalities in an autopsy series of Sri Lankans. Methods: Consecutive autopsies performed at Judicial Medical Office, Colombo from December 2014 to December 2016 were screened and the deceased without a diagnosed endocrinopathy (except diabetes) were included in the study. Pituitary, thyroid, adrenal, pancreas and ovarian specimens were sampled and examined both macroscopically and under light microscopy with Haemotoxylin Eosin stain. Results: Among 441 autopsies (mean age 52.5 years, male 77.8%) examined, pituitary, thyroid, adrenal, pancreatic and ovarian nodules were detected in 0.8%, 37.2%, 1.8%, 1.3% and 18.4% respectively. Thyroid neoplasms were present in 6.4%, of which 87.5% were papillary carcinoma or papillary microcarcinoma and it was associated with background thyroiditis (χ2 = 4.05, p = 0.04) or nodular thyroid enlargement (χ2 = 32.68, p < 0.01). Thyroiditis was commoner in females, but malignancies showed no gender-predilection. No malignant lesions were identified in pituitary, adrenal, pancreatic or ovarian tissues. Conclusions: In this population of Sri Lankan adults, prevalence of thyroid incidentalomas, neoplasms and thyroiditis are comparable to published studies from the West. Papillary carcinoma or microcarcinoma was the commonest type and it showed a predilection to affect thyroid glands with background thyroiditis. Pituitary, pancreatic and adrenal incidentalomas and neoplasms were less prevalent.

Sri Lanka Journal of Diabetes Endocrinology and Metabolism, 2013

Clinical guidelines: The Endocrine Society of Sri Lanka Disclaimer: Clinical Practice Guidelines ... more Clinical guidelines: The Endocrine Society of Sri Lanka Disclaimer: Clinical Practice Guidelines are developed to be of assistance to health care professionals by providing guidance and recommendations for particular areas of practice. The guidelines should not be considered inclusive of all proper approaches or methods, or exclusive of others. The guidelines cannot guarantee any specific outcome, nor do they establish a standard of care. The guidelines are not intended to dictate the treatment of a particular patient. Treatment decisions must be made based on the independent judgment of health care providers and each patient's individual circumstances. The Endocrine Society of Sri Lanka makes no warranty, express or implied, regarding the guidelines and specifically excludes any warranties of merchantability and fitness for a particular use or purpose. The Society shall not be liable for direct, indirect, special, incidental, or consequential damages related to the use of the information contained herein. Endocrine Society of Sri Lanka thanks Novo Nordisk for funding the development of these.

SAGE Open Medical Case Reports, 2022

Neuroleptic malignant syndrome is a rare, fatal antipsychotic-induced idiosyncratic reaction char... more Neuroleptic malignant syndrome is a rare, fatal antipsychotic-induced idiosyncratic reaction characterised by hyperthermia, altered consciousness, autonomic instability and rigidity with elevated creatine kinase levels and leukocytosis. Neuroleptic malignant syndrome and antipsychotics are significant causes for elevated creatine kinase among the extensive list of differential diagnoses. Risperidone is an atypical antipsychotic drug with anti-serotonergic and anti-dopaminergic properties which has a wide range of side effects, including neuroleptic malignant syndrome. Though the rise in creatine kinase in neuroleptic malignant syndrome is commonly around 2000 to 15,000 IU/L due to myonecrosis, ischaemia and heat production, normal creatine kinase levels in neuroleptic malignant syndrome were also reported. Up to now, only two cases have been reported with creatine kinase levels of more than 50,000 IU/L in neuroleptic malignant syndrome, but neither of them was risperidone-induced. W...

Kidney International Reports, 2020

In long-term follow-up study，there were 60 deaths in 482 CKD patients with the missing rate of 3.... more In long-term follow-up study，there were 60 deaths in 482 CKD patients with the missing rate of 3.98%. Night/day HR ratio, instead of 24 hour, daytime and nighttime mean HR, predicted all-cause mortality in CKD patients. Higher survival probabilities were observed in PTX than non-PTX group with Kaplan-Meier curve (Fig. 2A). The survival probabilities in non-PTX patients were significantly related to the tertiles of night/day HR ratio (Fig. 2B), while there was no significant difference in PTX group (Fig. 2C). Conclusions: In stage 5 CKD patients we provided new information on the prevalence and clinical significance of non-dipping 24 hour ambulatory HR pattern, which predicted higher all-cause mortality. PTX could reverse non-dipping HR ratio and improve survival rate in severe SHPT patients. Circadian rhythm abnormalities of HR are suggested to be treated effectively in order to improve prognosis in CKD. Mechanisms behind the adverse prognostic value of a blunted ambulatory HR rhythm remain to be elucidated.

Annals of Clinical Biochemistry, 2009

Background Apolipoproteins B (apoB) and AI (apoAI) are strong predictors of cardiovascular diseas... more Background Apolipoproteins B (apoB) and AI (apoAI) are strong predictors of cardiovascular disease (CVD). We describe apolipoprotein distributions and their associations with lipids and diabetes subtype in diabetic young adult South Asians. Methods In 995 subjects with diabetes, we measured fasting total cholesterol (TC), high-density lipoprotein cholesterol (HDLC), triglycerides (TG), apoB and apoAI, glycosylated haemoglobin (HbA1c) and glutamic acid decarboxylase antibodies (GADA). Low-density lipoprotein cholesterol (LDLC) and non-HDLC (NHDLC) were calculated. We compared values in subjects aged 15–50 y from the United States National Health and Nutrition Examination Survey (NHANES). Results Median age and duration of diabetes were 38 (range 14–45) and 4 (0–24) y. Men had significantly higher TC, TG, NHDLC, TC/HDLC, apoB/AI and NHDLC/apoB, and lower apoAI than women. Compared with the reference group, patients with type 1 diabetes had lower TG, apoB:apoAI and HDLC:apoAI, and high...