BackgroundIodine deficiency and thyroid dysfunction during pregnancy is associated with number of adverse outcomes that includes mental and physical disabilities creating a huge human and economic burden in later life. Several indicators are used to assess the iodine status of a population: thyroid size by palpation and/or by ultrasonography, urinary iodine excretion and the blood thyroid hormone profile.MethodsThis prospective study was designed to assess the iodine nutrition during the course of pregnancy with reference to urine iodine concentration (UIC) and thyroid determinants among 425 pregnant women from Galle district, Sri Lanka. UIC was estimated in all three trimesters and thyroid functions were assessed in first and third trimesters.ResultsMedian (inter-quartile range IQR) UIC was 170.9 (100.0–261.10) μg/L, 123.80 (73.50–189.50) μg/L and 105.95 (67.00–153.50) μg/L in the first, second and third trimesters respectively (p < 0.001). Median thyroid stimulating hormone (TSH) level in the first trimester was 1.30 (0.80–1.80) µIU/mL. This value significantly increased (p < 0.001) to 1.60 (1.20–2.10) µIU/mL at the 3rd trimester even though it was maintained within the reference range (0.3 – 5.2 µIU/mL). In the assessment of thyroid gland, 67 (16.0 %) women had palpable or visible goitres and 55 (13.1 %) had a goitre that was palpable but not visible. The median thyroid volume of the sample was 5.16 mL (4.30; 6.10 mL) as measured by ultra sound (US) scanning. In multiple regression analysis after controlling for other independent variables (anthropometric, demographic and biochemical parameters); initial body mass index (BMI), goitre size, thyroid volume and parity had significant correlations with the third trimester urinary iodine levels. The thyroid volume accounted for 4.5 % of the urinary iodine variation.ConclusionsEven though iodine status was progressively worsening with the advancement of pregnancy and iodized salt consumption has not met with the increasing demand for iodine, it was not reflected in the serum TSH level. Therefore, it is worthwhile to assess the long term effects of rising TSH levels and inadequate iodine nutrition during pregnancy on the offspring to prevent even mild iodine deficiency.

Background Population aging is a significant social problem in the twenty first century. Recent economic and social changes lead increasing number of elders to spend their lives in elderly homes. Institutionalized elders have to face many physical and psychological problems which negatively impact their quality of life. Geriatric depression (GD), catastrophizing pain (CP) and sleep disorders (SD) are some common problems among them. Methods Present study was designed to assess the prevalence of GD, CP and SD and their correlations in institutionalized elders. A descriptive cross-sectional study was conducted in elderly homes (n = 20) in the Galle district of Sri Lanka enrolling 310 subjects. GD, CP and SD were assessed using validated Sinhala versions of Geriatric Depression Scale (GDS), Pain Catastrophizing Scale (PCS) and Pittsburgh Sleep Quality Index (PSQI) respectively. Data were analyzed using SPSS version 25.0 for windows by using descriptive statistics, the Pearson’s chi-square test and Pearson’s bivariate correlation (p < 0.05). Results Among the participants (response rate: 95.7%), 34.8% (n = 108) and 65.2% (n = 202) were males and females respectively. Age range of the subjects was 60–103 years with the mean age of 74.97 years (SD 8.852). Most of the study subjects (n = 234, 75.5%) had spent five or less than 5 years in elderly homes at the time of the study and 52.8% (n = 164) of them were unmarried. GD was present in 76.5% (95% CI: 71.7–81.2) of subjects and of them 44% had moderate to severe depression. PCS revealed that 29% (95% CI: 24.0–34.1) had CP. SD were identified in 55.5% (95% CI: 49.5–61.0) of elders and according to PSQI, 86% (95% CI: 82.3–90.0) had poor quality sleep. Positive correlations between GD and CP (r = 0.24, p < 0.01), GD and SD (r = 0.13, p = 0.02), CP and SD (r = 0.32, p < 0.01) were statistically significant. Conclusions Prevalence of GD, CP and SD were significantly higher in this sample of institutionalized elders who were apparently healthy. Findings highlighted the importance of early screening of physical and psychological problems in institutionalized elders to assure better quality of life and to reduce the burden to health care system of the country.

Background:Monitoring of the iodization programmes is crucial not only to ensure that the salt contains sufficient amount of iodine but not excessive amounts that lead to adverse health consequences. Countries usually recommend minimum standards for the iodine content of salt at the production level, but less frequently establish standards at the consumer level. Sri Lankan standards recommended salt should have 15.0-30.0 ppm of fortified iodine at the retail level. Objective: To assess the iodide content in crystal and table (powder) salt preparations for the human consumption in Southern Sri Lanka. Methods:Commercially available packets of both crystal and table salt were purchased from randomly selected permanent (57 retail shops and 24 supermarkets) and temporary (8, weekly fairs) shops and analyzed for the iodine content. Information on the storage conditions, the shelf life of the samples was also recorded.Results: There was a total of 89 packets of salt which comprising of crystal (n=30) and powder (n=59) packets belonged to 42 different brands (15 and 27 brands for crystal powder salts respectively). Over 74% of packets had one year and the remainder (26%) had 18 to 24 months of shelf life. The median iodide level of the total sample was 20.40 ppm (range 0.0 to 73.81 ppm) whereas the median iodide level of crystal salt was 18.89 ppm (range 3.70 to 73.81 ppm) and table salt was 21.63 ppm (range 0.0 to 41.24). It was revealed that 21(23.6%) packets of salt (11 crystal and 10 table salts respectively) had iodide levels below 15.0 ppm and 11(12.4%) packets of salt (4 crystal and 7 table) had iodine level above the recommended range of 30.0 ppm. Altogether 22 (52.4%) brands did not have iodine levels within the recommendations and in fact, one powder salt packet did not contain a detectable amount of iodide. Conclusions:Establishing a precise sustainable monitoring system of salt iodization at the production level is important in maintaining iodine nutrition at the optimum level.

Introduction: Chronic kidney disease (CKD) is a risk factor for cardiovascular disease (CVD). It is evident that traditional risk factors as well as uraemia related non-traditional risk factors are responsible for the increased CVD risk in CKD patients. Objective:The objective of this study was to compare the prevalence of selected cardiovascular risk factors among patients with end stage renal disease with controls.Method: Fifty (men=38) consecutive patients with ESRD, awaiting kidney transplant at Teaching Hospitals, Karapitiya and Kandy were included in the study. The control group included 50 age and sex-matched healthy individuals. Data were collected using a questionnaire followed by anthropometric and blood pressure measurements. Fasting plasma glucose (FPG) serum total cholesterol (TCh), triglyceride (TG), high-density lipoprotein cholesterol (HDL-Ch), phosphorous (SPho), corrected calcium (SCCa), creatinine (SCr), albumin (SAl), high-sensitivity C-reactive protein (Hs-CRP), interleukin-6 (IL-6), vitamin D (vit.D) concentrations and blood glycated haemoglobin (HbA1c) were measured. The mean age of the patient group was 44(10) years.Results: Compared to controls, mean TCh (p<0.001), LDL (p<0.001), SCCa (p<0.001) and S.Al (p<0.001) levels were significantly lower among patients. HbA1c (p=0.053), SPho (p=0.001) and SCr (p<0.001) levels were significantly higher among patients with CKD compared to controls. In patients' median serum vit.D (p=0.001) level was significantly lower while serum Hs-CRP (p=0.001) and IL-6 (p=0.003) levels were significantly higher, compared to controls.

No abstract