Sampath Gunawardena

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(1) Background: Although Sri Lanka is a developing country and boasts of having a well-established healthcare system along with good healthcare indices, we are still lagging in certain aspects of healthcare. One such aspect is the deficiencies in guidelines and practices related to the handling of pharmaceutical waste. (2) Methods: This was a qualitative study performed using in-depth interviews with the help of a semi-structured questionnaire conducted among staff who are working at a ministry complex in Galle, Sri Lanka. Data analysis was performed using thematic analysis, (3) Results: There were 40 participants which included 29 (72.5%) females. Three main themes were identified, namely, (I) current knowledge, (II) perceptions, and (III) practices towards storage, disposal, and misuse of pharmaceutical waste. The death of the patient, forgetting, relieving symptoms, and adverse effects were some reasons for the accumulation of unused pharmaceuticals at home. Most of the participants did not believe that the reuse of unused medications can cause various health hazards. Moreover, all participants practiced unsafe methods such as flushing down toilets, pouring into a sink, burning, etc. (4) Conclusions: The incorrect practices and poor knowledge in the handling of pharmaceutical waste and less concern for the environment highlight the need for awareness programs to the general public and establishing proper medication waste management such drug take-back systems.

Objectives: Bicipital tendinopathy causes shoulder pain and reduced range of motion (ROM). Analgesics and physiotherapy are used as treatments. The objective is to study the effectiveness of myofascial release for bicipital tendinopathy.Methods: Sixty patients with anterior shoulder pain were randomly allocated to control and experimental groups (n=30/group). Control group received conventional physiotherapy for 10 days, while experimental group received myofascial release. Pain scores and ROM of the shoulder were assessed using a visual analog scale and digital inclinometer respectively, on days 1, 5 and 10. On each day, measurements were obtained before and after intervention.Results: Control group consisted of 8 females and 22 males with a mean age of 35.1± 15.2 years. Interventional group consisted of 9 females and 21 males with a mean age of 34.4± 12.3 years. Rest pain for control group on day 1, day 5 and day 10 (pre and post intervention) were 6.7±0.29,6.03±0.29, 5.63±0.29, 5.17±0.24, 4.90±0.26, 4.43±0.27, respectively. Same parameters for the experimental group were 6.60±0.35, 5.00±0.39, 4.30±0.30, 3.60±0.26, 3.10±0.26, 2.56±0.25, respectively. Both interventions significantly reduced pain scores compared to the baseline. Notably, experimental group demonstrated a greater reduction in pain score from day 1 to day 10 compared to the control group (p<0.0001). In the control group, change in ROM from the baseline for each session was 2.960±0.97, 3.660±1.22, 4.560±1.27, 4.430±1.07, and 5.200±1.17. In the experimental group, the corresponding values were 15.100±5.37, 16.430±5.51, 20.870±6.66, 22.670±7.41, and 23.330±7.71. The experimental group showed significantly greater improvement in ROM compared to the control group at each session (p<0.001).Conclusions: Myofascial release works better than conventional physiotherapy for bicipital tendinopathy as it results in greater improvement of pain and ROM. Further research warrants to explore what could be the exact mechanism by which those improvements were happened.

Objectives: The iliotibial band (ITB) is a thick fascial band formed near the hip by merging the fascia of the gluteus maximus, gluteus medius, and tensor fasciae latae muscles. Iliotibial band syndrome (ITBS) is a common overuse injury, manifests as pain on the outer side of the knee and hip due to ITB friction with the femur. Athletes may experience reduced hip and knee mobility, potentially impacting performance. This study aims to compare the efficacy of two ITBS treatments: Thera-Band Exercise Program (TBEP) as the experimental group and Electro-Physiotherapy (EPT) as the control group.Methods: A randomized controlled trial carried out at the Teaching Hospital Karapitiya, with thirty athletes in each group. The control group received EPT, and medications, for two weeks, the experimental group received TBEP and medications for the same duration. Abductor Muscle strength assessment was conducted on Day 01 and Day 28 using handheld dynamometer (HHD)Results: The mean ages in the control and experimental groups were 24.33±6.40 years and 24.97±6.87 years, respectively. Muscle strength (N) for the control group on Day 1 and Day 28 were 99.77± 24.81 and 108.83±22.36, respectively. In the experimental group, the corresponding values were 102.50±26.71 and 147.00±29.92, respectively. The mean differences for muscle strength of two groups in D1 and D28 were 2.733(P>0.683) and 38.167(P<0.001) (RM-ANOVA). TBEP had a statistically significant effect (p=0.000), and it explained 16.8% of the variance in muscle strength. The Partial Eta Squared was 0.168.Conclusions: The Thera band program works better in improving abductor muscle strength of the athletes with ITBS compared to electro- physiotherapy.

Cardiac arrest is a sudden loss of heart function with serious consequences. In developing countries, healthcare professionals use clinical documentation to track patient information. These data are used to predict the development of cardiac arrest. We published a dataset through open access to advance the research domain. While using this dataset, our work revolved around generating and utilizing synthetic data by harnessing the potential of synthetic data vaults. We conducted a series of experiments by employing state-of-the-art machine-learning techniques. These experiments aimed to assess the performance of our developed predictive model in identifying the likelihood of developing cardiac arrest. This approach was effective in identifying the risk of cardiac arrest in in-patients, even in the absence of electronic medical recording systems. The study evaluated 112 patients who had been transferred from the emergency treatment unit to the cardiac medical ward. The developed model achieved 96% accuracy in predicting the risk of developing cardiac arrest. In conclusion, our study showcased the potential of leveraging clinical documentation and synthetic data to create robust predictive models for cardiac arrest. The outcome of this effort could provide valuable insights and tools for healthcare professionals to preemptively address this critical medical condition.

Cardiac arrest is a sudden loss of heart function with serious consequences. In developing countries, healthcare professionals use clinical documentation to track patient information. These data can be used to predict developing cardiac arrests. We are publishing the data set through open access to advance the research domain. Based on this data set, our work revolves around generating and utilizing synthetic data by harnessing the potential of synthetic data vaults. We conducted a series of experiments by employing state-of-the-art machine learning techniques. These experiments were aimed to assess the performance of our developed predictive model in identifying the likelihood of developing cardiac arrests. This approach is effective in identifying the risk of cardiac arrest in inpatients, even in the absence of electronic medical recording systems. The study evaluated 112 patients who were transferred from the Emergency Treatment Unit to the Cardiac Medical Ward. The developed model achieved 96\% accuracy in predicting the risk of developing cardiac arrest. In conclusion, our study showcases the potential of leveraging clinical documentation and synthetic data to create robust predictive models for cardiac arrest. The outcome of this effort will provide valuable insights and tools for healthcare professionals to preemptively address this critical medical condition.

Background: Core stability training (CST) is used to enhance sports performance. The relationship between core endurance and physical performance in rugby players had not been evaluated before in Asia. Aims and Objectives: This study aims to determine the effects of a 6-week specific CST program on the core endurance and physical performances (speed, upper body power, lower body power, and agility) following a CST intervention in male rugby players. Materials and Methods: Professional rugby players (n=8, intervention and n=8, control) were randomly selected. Mean (SD) age, height and weight of intervention group were 25.25 (2.4) years, 1.64 (0.03) m, and 69.6 (14.9) kg, respectively. In the control group, corresponding values were 29.75 (4) years, 1.66 (0.04) m, and 72.3 (19.1) kg, respectively. Intervention group was trained CST sessions complementary to the usual physical training, 3 times/week for 6 weeks. The control group followed the usual physical training. Subjects were tested for four physical performances (using 40 m sprint, vertical jump, 3 kg medicine ball put, and agility T tests) and four core endurance tests (back extension, abdominal fatigue [AF], and left and right bridges). Results: AF, left bridge, right bridge, and total core endurance were significantly increased in the intervention group (P=0.028, P=0.006, P= 0.008, and P=0.001, respectively). Agility and AF were increased significantly in the control group (P=0.048, P=0.027). The right side bridge endurance (P=0.024) was significantly increased in the intervention group compared to the control group. Conclusion: The results suggest that the CST improves core endurance without improving physical performances in rugby players.

In Sri Lanka, four athletic deaths were reported in 2013. All four deaths took place while participating in school marathon competitions and the victims were teenaged school children. The Ministry of Health and Ministry of Education took steps to temporarily remove marathon events from school athletic competitions in 2014. Three more athletic deaths were reported after the marathon events were resumed in 2015, which led to the development of guidelines in conducting Pre-Participation Physical Examination (PPE) for school athletes. There were no further deaths reported since the implementation of these guidelines.

Anatomic variation and susceptibility for injuries depending on gender were described for the ulnar nerve. The aim of this study was to investigate the association between gender and ulnar never motor conductance and the influence of sidedness for this association. Study was conducted as a retrospective study using nerve conduction study data of ulnar nerve of 2,526 patients. Influences of age, gender, and sidedness on ulnar never motor conduction velocity (UMV) were investigated. Regression analysis was conducted to compare the relationship between UMV and age. Regression was significantly higher in males (-0.253 vs. -0.113), suggesting higher influence of age on UMV in males than in females. When analyzing right and left sides separately, influence of age on UMV is higher in males (-0.286 vs. -0.109) only in right side. Multiple regression analysis was done comparing the influence of age, gender, and sidedness on UMV, and it found that the order of influence is gender, age, and sidedness (Beta values 0.153, -0.140, and 0.029). Ulnar nerve motor conductance depends on gender, age, and sidedness. Males are having lower UMV than females. Age-dependant change of UMV is more prominent in males than in females and is more prominent in right hand than in left hand in males.