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Background/AimsAsthmatics have abnormal esophageal motility and increased prevalence of gastroesophageal reflux disease (GERD). The contribution of gastric motility is less studied. We studied gastric myoelectrical activity, gastric emptying (GE) and their association with GERD symptoms and vagal function in adult asthmatics.MethodsThirty mild, stable asthmatics and 30 healthy controls underwent real-time ultrasonography and 1 hour pre- and post-prandial cutaneous electrogastrography, following a test meal (480 kcal, 60% carbohydrate, 20% protein, 20% fat and 200 mL water). The percentage of normal slow waves and arrhythmias, dominant frequency and power, frequency of antral contractions, gastric emptying rate (GER) and antral motility index (MI) was calculated. Twenty-seven asthmatics underwent gastroscopy and in all subjects GERD symptoms were assessed by a validated questionnaire. Vagal function parameters were correlated with gastric motility parameters.ResultsThe asthmatics (37% male; 34.8 ± 8.4 years) and controls (50% male; 30.9 ± 7.7 years) were comparable. None had endoscopic gastric pathological changes. Twenty asthmatics described GERD symptoms. Twenty-two (73.3%) asthmatics showed a hypervagal response. Compared to controls, asthmatics had delayed GER and lower MI, lower percentage of normal gastric slow waves, more gastric dysrythmias and failed to increase the post-prandial dominant power. There was no correlation of GE and cutaneous electrogastrography parameters with presence of GERD symptoms or with vagal function.ConclusionsAsthmatics showed abnormal gastric myoelectrical activity, delayed GE and antral hypomotility in response to a solid meal compared to controls. There was no association with vagal function or GERD symptom status.

ObjectivesTo assess the prevalence of wheeze and factors associated with its severity among 3–6 years old children.MethodologyDesignA population-based, cross-sectional study using the WHO 30 cluster methodology with probability proportionate to size sampling.Setting36 preschools registered at the divisional secretariat offices of Anuradhapura district, Sri Lanka.ParticipantsWe recruited 1060 preschool children from 36 preschools aged 3–6 years.Main outcome measurementsWe used the International Study of Asthma and Allergy in Childhood questionnaire to assess the prevalence, symptomatology and associated factors of wheeze.ResultsThe study sample consisted of 548 (51.70%) male and 512 (48.30%) female children with a mean age of 4.41 (±0.66) years. At least one wheezing episode ever was reported in 323 (30.47%; 95% CI 27.71% to 33.34%) children and 247 (23.30%; 95% CI 20.79% to 25.97%) children had a wheezing attack in the preceding year. Severe episodes of wheezing were reported in 76 (7.17%; 95% CI 5.69% to 8.89%) participants. However, only 27 (35.53%; 95% CI 24.88% to 47.34%) children with severe wheezing had been diagnosed as asthmatics by a clinician. The identified independent risk factors for severe wheeze were allergic rhinitis (OR 6.90; 95% CI 3.84 to 12.40), domestic dog(s) (OR 2.34; 95% CI 1.01 to 5.40), frequent consumption of skipjack tuna (OR 1.94; 95% CI 1.11 to 3.39) and passive smoking (OR 1.70; 95% CI 0.93 to 3.11) while living in a house with a cement floor is a protective factor (OR 0.41; 95% CI 0.21 to 0.80).ConclusionWheezing commonly affects one-fourth of preschool children in rural Sri Lanka. Severe wheezing is often not diagnosed as asthma despite frequent symptoms, probably due to hesitancy in labelling preschool children as asthmatics. Allergic rhinitis, domestic dogs, frequent consumption of Skipjack tuna fish and exposure to passive smoking were independent risk factors for severe wheeze.

Multiple co-morbidities are a common health related issue among the elderly population. The prevalence of heart disease has increased among the older population 2 . The probability of having chronic comorbid diseases such as arthritis, osteoporosis, diabetes and hypertension too has increased in the older population over the past few decades 3 . Comorbidities and physiological changes have compromised the ability of the elderly population to Abstract Objectives: Population ageing is a world phenomenon affecting many sectors including health. High prevalence of multiple co-morbidities, increased healthcare expenditure, psychological disease and social consequences are some major health problems of ageing. Study of physiology and health status among elders is an important component in geriatric care. This is a study protocol to describe overall health status and functional capacity among the elders in residential care facilities in Colombo district.Methods: Eligible elders aged over 65 years, in all residential care facilities in Colombo district, registered under the National Secretariat for elders will be included in this cross-sectional study. Data on basic demography and medical co-morbidities will be collected. Nutritional status will be assessed by 24-hour dietary recall, mini nutritional assessment and anthropometric measurements. Five fried model indicators, Montreal cognitive assessment and geriatric depression scale will be used to assess frailty, depression and cognition respectively. Timed up and go test and five times sit to stand test will be performed to assess the risk of falls and the FRAX index for osteoporotic risk assessment. Spirometry will be used to assess respiratory function. Descriptive and correlation analysis of data will be performed.Discussion: This is a comprehensive health assessment of the elderly population living in residential care facilities for elders in Colombo. The study will contribute to establish better geriatric care in Sri Lanka and will serve as a model to design an island wide study on elderly. Journal of the Ceylon College of PhysiciansAmarasiri W A D L, et al

Background Data on adult asthma is scarce in Sri Lanka. The objective of this study was to estimate the prevalence of asthma and its symptoms in adult Sri Lankans.  Methods A cross-sectional study using a translated version of the European Community Respiratory Health Survey screening questionnaire on subjects $$\ge$$ ≥ 18 years from 7 provinces in Sri Lanka was conducted. The asthma was defined as “wheezing in the past 12 months (current wheeze)”, self-reported asthma attack in the past 12 months or on current asthma medication use. Results Among 1872 subjects (45.1% males, 48.8% between 18–44 years of age), the prevalence of current wheeze was 23.9% (95%CI: 22.0%-25.9%), self-reported asthma was 11.8% (95%CI: 10.3%-13.2%) and current asthma medication use was 11.1% (95% CI: 9.6%-12.5%). The prevalences were higher in adults > 44 years, 31.4% positively responded to any of the above questions (95%CI: 29.3%-33.4%) and 60.9% of current wheezers did not report having asthma whilst 38.2% used asthma medication. Among current wheezers, 80.1% had at least one other symptom, cough being the commonest. Those with no current wheeze, self-reported asthma and on current asthma medication use, 30%, 35.9% and 36.6%, respectively, reported at least one other symptom. Smokers comprises 22% current wheezers, 20.6% of self-reported asthmatics and 18.7% of current asthma medication users. Conclusions The prevalence of asthma in Sri Lankan adults is higher than the other South Asian countries and higher in the older age group. A significant percentage of symptomatic individuals did not report having asthma or being on medication.