BACKGROUND & AIMS: :We report here, for the first time, a comparison of naturally acquired antibody responses to the 42 and 19 kDa C-terminal processing products of Plasmodium vivax Merozoite Surface Protein-1 assayed by ELISA using p42 and p19 baculovirus-derived recombinant proteins, respectively. Test populations comprised patients with microscopy confirmed acute P. vivax infections from two regions endemic for vivax malaria where low transmission and unstable malaria conditions prevail, and a non-endemic urban area, in Sri Lanka. The antibody prevalence to the two proteins, both at the individual and population levels, tend to respond more to p42 than to p19 in all test areas, where >14% of individuals preferentially recognized p42, compared with <2% for p19. In patients with no previous exposure to malaria, 21% preferentially recognized p42, whereas none exclusively recognized p19. A significantly lower prevalence of anti-p19 IgM, but not anti-p42 IgM, was observed among residents from endemic areas compared with their non-endemic counterparts. Individuals from both endemic areas produced significantly less anti-p19 IgM compared with anti-p42 IgM. IgG1 was the predominant IgG isotype for both antigens in all individuals. With increasing exposure to malaria in both endemic areas, anti-p19 antibody responses were dominated by the functionally important IgG1 and IgG3 isotypes, with a concurrent reduction in IgM that was lacking in the non-endemic residents. This antibody switch was also reflected for PvAMA-1 as we previously reported with the identical battery of sera. In contrast, the antibody switch for p42 was restricted to endemic residents with more extensive exposure. These results suggest that an IgM-dominated antibody response against the p42 polymorphic region in endemic residents may interfere with the development of an IgG-dominated "protective" isotype shift to p19, that may complicate vaccine development.

背景与目标： : 我们在这里首次报告了使用p42和p19杆状病毒衍生的重组蛋白通过ELISA测定的对间日疟原虫裂殖子表面蛋白-1的42和19 kDa C末端加工产物的自然获得抗体反应的比较，分别。测试人群包括经过显微镜检查证实的急性间日疟原发病菌感染的患者，该地区来自间日疟流行的两个地区，该地区流行低传播和不稳定的疟疾状况，以及斯里兰卡的非流行城市地区。在所有测试区域中，在个体和群体水平上，对两种蛋白质的抗体流行率倾向于对p42的响应大于对p19的响应，其中> 14% 的个体优先识别p42，而p19的个体 <2%。在以前没有接触过疟疾的患者中，21% 优先识别p42，而没有人专门识别p19。与非流行地区相比，在流行地区的居民中观察到anti-p19 IgM的患病率显着降低，但anti-p42 IgM的患病率却没有。与anti-p42 IgM相比，来自两个流行地区的个体产生的anti-p19 IgM明显减少。IgG1是所有个体中两种抗原的主要IgG同种型。随着两个流行地区疟疾暴露的增加，anti-p19抗体反应主要由功能上重要的IgG1和IgG3同种型主导，同时IgM降低，而非流行居民缺乏IgM。这种抗体转换也反映了PvAMA-1，正如我们先前用相同的血清电池报道的那样。相反，p42的抗体开关仅限于暴露更广泛的地方居民。这些结果表明，在地方性居民中针对p42多态性区域的IgM主导的抗体反应可能会干扰IgG主导的 “保护性” 同种型向p19转移的发展，这可能会使疫苗开发复杂化。

BACKGROUND & AIMS: :Harmful alcohol drinking can have health and socio-economic consequences. However, consumption is also associated with pleasure and symbolic meanings. Alcohol intake is increasing in Sri Lanka. In-depth explorations of alcohol patterns are needed to inform interventions and policies. Qualitative data were collected over 11 months in 2014 and 2015 in the North Central Province of Sri Lanka. Ten focus group discussions were conducted in gender, age and geographically (rural and semi-urban) segregated groups. Observations were conducted at alcohol selling establishments and social gatherings. Bourdieu's concepts practice, habitus, symbolic capital and distinction were used for the analysis. Three groups of consumers emerged: moderate consumers, abstainers and heavy drinkers. They each exercised distinctions through social codes of conduct within and towards other groups of consumers. Symbolic capital was expressed through choice of alcohol. Norms of 'acceptable consumption' were defined as 'moderate drinking' in covert, social and contained settings. Public, uncontrolled and solitary consumption violated norms of appropriate consumption. Young consumers communicated a 'modern lifestyle' through their consumption. This study found that alcohol practices mirrored social norms in this Sri Lankan setting. Alcohol and drug prevention and intervention efforts should take this into account.

背景与目标： : 有害饮酒会带来健康和社会经济后果。然而，消费也与快乐和象征意义相关联。斯里兰卡的酒精摄入量正在增加。需要深入探索酒精模式，为干预和政策提供信息。定性数据是在斯里兰卡中北部省2014年11个月和2015年收集的。在性别，年龄和地理 (农村和半城市) 隔离的群体中进行了十次重点小组讨论。在酒类销售场所和社交聚会上进行了观察。布迪厄的概念实践，习惯，符号资本和区别用于分析。出现了三类消费者: 中度消费者，戒酒者和重度饮酒者。他们每个人都通过社会行为准则在其他消费者群体内部和对其他消费者群体进行区分。象征性资本是通过选择酒精来表达的。“可接受消费” 的规范被定义为在秘密，社交和封闭环境中的 “适度饮酒”。公共的，不受控制的和单独的消费违反了适当消费的规范。年轻消费者通过消费传达了一种 “现代生活方式”。这项研究发现，酒精习惯反映了斯里兰卡环境中的社会规范。酒精和毒品预防和干预工作应考虑到这一点。

BACKGROUND & AIMS: :Surveys of mosquitos in Sri Lanka have generally been confined to the South. A recent study in Jaffna peninsula in northern Sri Lanka reported on the biology of peridomestic mosquito species. The present survey indicates the predominant species to be Armigeres durhami (Edwaards) and Armigeres subalbatus (Coquillett). Aedes albopictus (Skuse), Ae. aegypti (Linnaeus) and Ae. novalbopictus Barraud were recorded only occasionally during the survey. Sampling of ponds in the Jaffna peninsula recorded the presence of Ae. aegypti, Anopheles sp. and Culex quinquefasciatus (Say).

背景与目标： : 斯里兰卡的蚊子调查通常仅限于南部。最近在斯里兰卡北部贾夫纳半岛进行的一项研究报告了腹膜蚊子的生物学特性。目前的调查表明，主要物种是durhami军械库 (Edwaards) 和subarbatus军械库 (Coquillett)。白纹伊蚊 (Skuse)，埃及伊蚊 (Linnaeus) 和巴罗氏伊蚊 (Ae. novalbopictus Barraud) 仅在调查期间偶尔记录。贾夫纳半岛的池塘采样记录了埃及伊蚊、按蚊和库蚊的存在。

BACKGROUND & AIMS: :KT is the most effective therapeutic option for ESRF. We present our first experiences in a developing country. All children who underwent kidney transplantation since the inception of this program in July 2004 until 30 September 2005 were studied. Their demographic data, operative and peri-operative details, graft and host survival, and drug compliance are described here. Data were collected from patient records and nursing observation records. Eleven children were transplanted during this period (median recipient age 10.75 yr, range: 8-16). The median age of the donors was 41 yr (range: 38-45) and was the mother in eight, father in two and uncle in one. The median (range) follow-up period following transplantation was 12.5 months (7-12). The vascular anastomotic site was aorta and inferior vena cava in nine patients and the cold ischemia time was mean (s.d.) 1.9 h (0.96). All patients received steroids, cyclosporine and MMF for immunosuppression. Hypotension, heart failure and septicemia were common medical complications. Four were treated for acute rejection. Vascular anastomotic leak, burst abdomen, intestinal obstruction, intra-abdominal leak of supra pubic catheter and vesico-ureteric junction obstruction were surgical complications. There were no graft losses or deaths. Despite limited resources good outcomes are possible following renal transplantation in children in developing countries.

背景与目标： : KT是ESRF最有效的治疗选择。我们介绍了我们在发展中国家的第一次经历。研究了自2004年7月该计划启动以来直到2005年9月30日所有接受肾脏移植的儿童。此处描述了他们的人口统计数据，手术和围手术期详细信息，移植物和宿主存活率以及药物依从性。数据来自患者记录和护理观察记录。在此期间移植了11名儿童 (中位接受者年龄10.75岁，范围: 8-16岁)。捐赠者的平均年龄为41岁 (范围: 38-45岁)，母亲为8岁，父亲为2岁，叔叔为1岁。移植后的中位 (范围) 随访期为12.5个月 (7-12)。9例患者的血管吻合部位为主动脉和下腔静脉，平均冷缺血时间 (s.d.)1.9 h (0.96)。所有患者均接受类固醇，环孢素和MMF进行免疫抑制。低血压、心力衰竭和败血症是常见的内科并发症。四例因急性排斥反应而接受治疗。血管吻合口漏，腹部爆裂，肠梗阻，耻骨上导管腹腔内漏和膀胱-输尿管交界处梗阻是手术并发症。没有移植损失或死亡。尽管资源有限，但在发展中国家的儿童进行肾移植后，仍有可能取得良好的结果。

BACKGROUND & AIMS: :A pilot feasibility study utilizing primary health care workers (PHCW) in the early detection of oral cancer and precancer was reported in 1984. The present study was to assess the reproducibility of this model in a different geographic area using existing Government Health Services. In order to improve the compliance of individual referrals following detection (54% in the previous study) a simultaneous health education program was mounted. Of 72,867 villagers aged 20 years and over who were allocated for screening, 57,124 (78%) were examined during 1 year by 36 PHCWs. Oral lesions were detected in 3559 (6.2%). Of these, 2193 (62%) complied by presenting for a reexamination at the hospital. Twenty new cancers and 1716 subjects with oral precancerous lesions were confirmed. While the population screening coverage achieved was higher than in the feasibility study, compliance was marginally improved. Noteworthy, however, was the detection of 20 new cancers as compared to 4 in the feasibility study. This primary health care model for cancer detection appears to be organizationally feasible for a developing country.

背景与目标： : 1984年报道了一项利用初级卫生保健工作者 (PHCW) 早期检测口腔癌和癌前病变的试点可行性研究。本研究旨在使用现有的政府卫生服务评估该模型在不同地理区域的可重复性。为了提高检测后个人转诊的依从性 (在先前的研究中54%)，同时启动了健康教育计划。在分配给筛查的72,867名20岁及以上的村民中，57,124名 (78% 名) 在1年内由36名phcw进行了检查。在3559中检测到口腔病变 (6.2%)。其中，2193 (62%) 在医院提出复查。确认了20例新的癌症和1716例口腔癌前病变。虽然实现的人口筛查覆盖率高于可行性研究，但合规性略有改善。然而，值得注意的是，在可行性研究中发现了20种新癌症，而在可行性研究中发现了4种。对于发展中国家来说，这种用于癌症检测的初级卫生保健模式在组织上似乎是可行的。

BACKGROUND & AIMS: Background & objectives:Attempts have been made to estimate appendicular skeletal muscle mass (ASMM) using anthropometric indices and most of these are country specific. This study was designed to develop and cross-validate simple predictive models to estimate the ASMM based on anthropometry in a group of healthy middle-aged women in Sri Lanka. Methods:The study was conducted on a randomly selected group of community-dwelling women aged 30-60 years. ASMM (kg) quantified with dual-energy X-ray absorptiometry (DXA) (ASMMDXA) was used as the reference standard. Anthropometric measurements such as body weight (kg), height (m), limb circumferences (cm) and skinfold thickness (mm) which showed significant correlations with ASMMDXA, were used to develop the models. The models were developed using a group of 165 women (aged 30-60 yr) and were cross-validated using a separate sample of women (n=167) (mean age: 48.9±8.56 yr), selected randomly. Results:Nine anthropometry-based models were developed using weight, height, skinfold thicknesses, circumferences, body mass index, menopausal status (MS) and age as independent variables. Four models which were based on height, weight, triceps skinfold thickness (TSFT), age and MS met all the validation criteria with high correlations (ranged 0.89-0.92) and high predictive values explaining high variance (80-84%) with low standard error of estimate (1.10-1.24 kg). Interpretation & conclusions:The four models (ASMM 1-ASMM 4) developed based on height, weight, TSFT, age and MS showed a high accuracy in estimating the ASMM in middle-aged women.

背景与目标：

BACKGROUND & AIMS: :Invasive alien plants (IAPs) are a significant cause of socio-ecological change in Sri Lanka. Many studies have focused on the ecological dimensions of this problem, but few have addressed sociological factors such as the knowledge and perceptions of individuals and groups tasked with addressing IAPs. This study investigates how IAP issues are understood and perceived by professional forest and wildlife officers in Sri Lanka. The data analyzed were gathered using a questionnaire that covered three themes: the respondents' ability to identify IAPs, the impacts of IAPs and the threats they pose, and knowledge regarding control and mitigation. The questionnaire was completed by 186 field officers, and the resulting descriptive statistics and a probit regression analysis were used to analyze the data. The results show that almost all of the participating forest and wildlife officers were aware of the problems associated with IAPs but more than 75% of them lacked an accurate understanding of scientific means for controlling them and control policies established by the government of Sri Lanka. Generally, wildlife officers had a better understanding than forest officers. In addition, the analysis shows that officers' knowledge and perceptions of IAPs were positively correlated with their level of education and position within the organization. The analysis points to several recommendations for Sri Lankan officials when designing and implementing comprehensive policies and professional programs, particularly for lower-level field officers.

背景与目标： : 外来入侵植物 (iap) 是斯里兰卡社会生态变化的重要原因。许多研究都集中在这个问题的生态层面上，但很少有研究涉及社会学因素，例如负责解决iap的个人和群体的知识和看法。这项研究调查了斯里兰卡的专业森林和野生动植物官员如何理解和感知IAP问题。分析的数据是使用问卷收集的，问卷涵盖了三个主题: 受访者识别iap的能力，iap的影响及其构成的威胁以及有关控制和缓解的知识。问卷由186名现场官员完成，并使用结果的描述性统计和概率回归分析来分析数据。结果表明，几乎所有参与的森林和野生动物官员都知道与iap有关的问题，但其中75% 多名官员缺乏对控制它们的科学手段和斯里兰卡政府制定的控制政策的准确理解。一般来说，野生动物官员比森林官员有更好的理解。此外，分析表明，军官对iap的了解和看法与他们的教育水平和在组织中的地位呈正相关。分析指出，在设计和实施综合政策和专业方案时，特别是针对较低级别的外勤干事，对斯里兰卡官员提出了几项建议。

BACKGROUND & AIMS: BACKGROUND:Sri Lanka has reduced its overall suicide rate by 70% over the last two decades through means restriction, through a series of government regulations and bans removing highly hazardous pesticides from agriculture. We aimed to identify the key pesticide(s) now responsible for suicides in rural Sri Lanka to provide data for further pesticide regulation. METHODS:We performed a secondary analysis of data collected prospectively during a cluster randomized controlled trial in the Anuradhapura district of Sri Lanka from 2011 to 16. The identity of pesticides responsible for suicides were sought from medical or judicial medical notes, coroners' records, and the person's family. Trend analysis was done using a regression analysis with curve estimation to identify relative importance of key pesticides. RESULTS:We identified 337 suicidal deaths. Among them, the majority 193 (57.3%) were due to ingestion of pesticides while 82 (24.3%) were due to hanging. A specific pesticide was identified in 105 (54.4%) of the pesticide suicides. Ingestion of carbosulfan or profenofos was responsible for 59 (56.2%) of the suicides with a known pesticide and 17.5% of all suicides. The increasing trend of suicides due to carbosulfan and profenofos over time was statistically significant (R square 0.846, F 16.541, p 0.027). CONCLUSION:Ingestion of pesticides remains the most important means of suicides in rural Sri Lanka. The pesticides that were once responsible for most pesticide suicides have now been replaced by carbosulfan and profenofos. Their regulation and replacement in agriculture with less hazardous pesticides will further reduce the incidence of both pesticide and overall suicides in rural Sri Lanka.

背景与目标：

BACKGROUND & AIMS: :The saw-scaled viper (Echis carinatus carinatus) is a major venomous snake in Sri Lanka (SL) responsible for massive numbers of snakebites on the island; nevertheless, its venom proteome composition has never been explored. The proteome composition of SL E. c. carinatus venom (SL ECV), revealed by tandem mass spectrometry analysis, showed that it is composed of 42 enzymatic and nonenzymatic proteins belonging to 12 snake venom protein families. Snake venom metalloproteases (SVMP) and snaclec comprised the most abundant enzymatic and nonenzymatic proteins, respectively. When the composition of SL ECV was compared to the previously determined venom composition of Southern India ECV (SI ECV), 16 proteins were found in common. The SL ECV proteome composition was correlated with the clinical manifestations and pathophysiology of E. c. carinatus envenomation in SL. Polyvalent antivenom (PAV) raised in equine against the "Big Four" venomous snakes of India is typically exported to SL for snakebite treatment; however, the poor immunological cross-reactivity, partial in vitro neutralization of enzymatic activities, and some pharmacological properties, mostly shown by low molecular mass toxins (25 kDa) of SL ECV by Indian PAVs are major concerns for the effective treatment of ECV envenomation in SL.

背景与目标： : 锯鳞毒蛇 (Echis carinatus carinatus) 是斯里兰卡 (SL) 的一种主要毒蛇，负责岛上大量蛇咬; 尽管如此，它的毒液蛋白质组组成从未被探索过。通过串联质谱分析揭示了SL E. c. carinatus venom (SL ECV) 的蛋白质组组成，表明它由属于12个蛇毒蛋白家族的42种酶促和非酶促蛋白组成。蛇毒金属蛋白酶 (SVMP) 和snaclec分别包含最丰富的酶促和非酶促蛋白。将SL ECV的组成与先前确定的印度南部ECV (SI ECV) 的毒液组成进行比较时，发现共有16种蛋白质。SL ECV蛋白质组组成与SL中E. c. carinatus毒化的临床表现和病理生理相关。马中针对印度 “四大” 毒蛇饲养的多价抗蛇毒血清 (PAV) 通常出口到SL进行蛇咬治疗; 但是，较差的免疫交叉反应性，部分体外中和酶活性以及某些药理特性，印度PAVs的SL ECV的低分子量毒素 (25 kDa) 主要显示出有效治疗SL中ECV毒化的主要问题。

BACKGROUND & AIMS: :The mortality and morbidity of road traffic accidents (RTA) is increasing in the South Asian region, including Sri Lanka. Therefore, the demographic factors, types of vehicles involved, and the severity of injuries sustained in RTA was studied. Age, gender, and details of the incident of all patients admitted to hospital following a RTA, between January 2007 and August 2012, were obtained by interview. Following a medico-legal examination, the type and severity of injuries was categorized as, non-grievous, grievous, endangering life or fatal in the ordinary course of nature. Of the 579 RTA casualties examined, 72% were males, 28% females, and 26% were in the 20-29 year age group. There were 44% passengers, 32% drivers, and 20% pedestrians. Of the 440 vehicle occupants, 37% were on motor cycles, 28% in three wheelers, 13% in dual purpose vehicles and 11% in buses. Of the 114 pedestrians, 33% had been struck by motor cycles, 19% by three-wheelers and 17% by dual purpose vehicles. There was at least one soft tissue injury in 84%, whilst 45% had one or more fractures. In 85% of bicycle riders, the injuries were grievous, endangering life or fatal in the ordinary course of nature. A high proportion of young adults sustained grievous injuries due to RTA. Almost two thirds of the casualties resulted from motorcycle or three wheeler accidents. Laws limiting the number of passengers carried, installation of side doors, mandatory use of seat belts in three wheelers, and protective garments for motorcyclists are recommended.

背景与目标： : 在包括斯里兰卡在内的南亚地区，道路交通事故的死亡率和发病率正在上升。因此，研究了人口统计学因素，涉及的车辆类型以及RTA中受伤的严重程度。通过访谈获得了2007年1月和2012年8月之间的RTA后入院的所有患者的年龄，性别和事件的详细信息。经过医学法律检查后，伤害的类型和严重程度被归类为，非严重，严重，危及生命或在正常自然过程中致命。在所检查的579名RTA伤亡中，72% 名是男性，28% 名是女性，26% 名是20-29岁年龄组。有44% 名乘客、32% 名司机和20% 名行人。在440名车辆乘员中，有37% 人在摩托车上，28% 在三轮汽车上，13% 在两用车辆上，11% 在公共汽车上。在114名行人中，33% 人被摩托车击中，19% 人被三轮车击中，17% 人被两用车辆击中。84% 年至少有一个软组织损伤，而45% 有一个或多个骨折。在自行车骑手85%，伤害是严重的，危及生命或致命的自然过程。由于RTA，很大比例的年轻人遭受了严重伤害。几乎3分之2的人员伤亡是摩托车或三轮车事故造成的。建议限制载客人数的法律，安装侧门，在三轮汽车中强制使用安全带以及为摩托车手提供的防护服。

BACKGROUND & AIMS: :Colletotrichum is an important fungal genus with great diversity, which causes anthracnose of a variety of crop plants including rubber trees. Colletotrichum acutatum and Colletotrichum gloeosporioides have been identified as the major causative agents of Colletotrichum leaf disease of rubber trees in Sri Lanka based on morphology, pathogenicity, and the analysis of internally transcribed spacer sequences of the nuclear ribosomal DNA. This study has been conducted to investigate the members of the C. acutatum species complex causing rubber leaf disease using a morphological and multi gene approach. For the first time in Sri Lanka, Colletotrichum simmondsii, Colletotrichum laticiphilum, Colletotrichum nymphaeae, and Colletotrichum citri have been identified as causative agents of Colletotrichum leaf disease in addition to C. acutatum s. str. Among them, C. simmondsii has been recognized as the major causative agent.

背景与目标： : 炭疽菌是一种重要的真菌属，具有很大的多样性，会引起包括橡胶树在内的多种农作物的炭疽病。根据形态，致病性和核糖核糖体DNA内部转录的间隔区序列分析，已确定acutatum炭疽菌和gloeosporioides炭疽菌是斯里兰卡橡胶树炭疽菌叶病的主要病原体。进行了这项研究，以使用形态学和多基因方法研究引起橡胶叶病的C. acutatum物种复合体的成员。除C. acutatum.str外，在斯里兰卡，simmondsii炭疽菌，laticiphilum炭疽菌，nymphaeae炭疽菌和citri炭疽菌首次被确定为炭疽菌叶病的病原体。其中，C. simmondsii被认为是主要的病原体。

BACKGROUND & AIMS: BACKGROUND:Breast cancer (BC) is known to be the most common malignancy in females whereas colorectal cancer (CRC) incidence also higher in both genders in Sri Lanka. TP53 is an important tumour suppressor gene and its somatic mutations are reported in approximately 27% of BC and 43% of CRC cases. Analysis of TP53 gene variants not only provides clues for the aetiology of the tumour formation, but also has an impact on treatment efficacy. The current study was conducted to investigate the pattern of TP53 variants in patients with BC and CRC from Sri Lanka. METHODS:30 patients with BC, 21 patients with CRC and an equal number of healthy controls were screened for mutational status of TP53 by polymerase chain reaction (PCR) followed by direct sequencing. In addition, a subset of these samples were analysed for the protein expression of p53 and comparison made with the mutational status of TP53. We also analysed the protein expression of p21 and MDM2 as potential indicators of p53 functional status and compared it with the protein expression of p53. Additionally, hotspot codons of the KRAS, BRAF and PIK3CA genes were also analysed in a subset of CRC patients. RESULTS:Twenty seven sequence variants, including several novel variants in the TP53 gene were found. Nine BC and seven CRC tumour samples carried pathogenic TP53 variants. Pathogenic point missense variants were associated with strong and diffuse positive staining for p53 by immunohistochemistry (IHC), whereas, wild type TP53 showed complete absence of positive IHC staining or rare positive cells, regardless of the type of cancer. There was no direct correlation between p21 or MDM2 expression and p53 expression in either BCs or CRCs. Four of the CRC patients had pathogenic hotspot variants in KRAS; three of them were on codon 12 and one was on codon 61. CONCLUSION:The prevalence of pathogenic somatic TP53 variants was 31 and 33.33% in the studied BC and CRC cohorts respectively. All of them were located in exons 5-8 and the pathogenic missense variants were associated with strong immuno-positive staining for p53.

背景与目标：

BACKGROUND & AIMS: BACKGROUND:Gastroesophageal reflux disease (GORD) is a chronic and a common condition worldwide which causes mild to severe symptoms. Private tuition attendees are a group which could have potential risk factors for GORD. Therefore, we aimed to determine the prevalence, associated factors and medication for symptoms related to GORD among advanced level private-tuition attendees of Anuradhapura, Sri Lanka. METHODS:A descriptive cross-sectional study was conducted among students aged ≥18 years. A self-administered questionnaire was used to collect data. Students scoring ≥ eight on the Frequency Scale for Symptoms of GORD were categorised to have symptoms related to GORD. Logistic regression was performed to determine the significant association between the variables of interest and the presence of symptoms related to GORD (P < 0.05). RESULTS:Data of 1114 students were included for the analysis. A high prevalence of symptoms related to GORD (52% - 580/1114) was noted. Heartburn received the highest score among GORD symptoms. Biology students had the highest prevalence of GORD symptoms (63% - 127/201). Also, Biology students had the highest percentage for the utilisation of overall (17% - 35/201) and prescribed (13% - 27/201) medication for GORD symptoms. Presence of symptoms related to GORD was significantly associated with female sex [OR - 0.436 (95% CI 0.342-0.555)], being boarded [OR - 2.021 (95% CI 1.325-3.083)], chronic illness [OR - 2.632 (95% CI 1.439-4.813)], midnight snack [OR - 1.776 (95% CI 1.379-2.287)], frequent lack of breakfast [OR - 2.145 (95% CI 1.688, 2.725)], quick eating [OR - 1.394 (95% CI 1.091-1.780)] and inadequate sleep [OR - 2.077 (95% CI 1.624-2.655)]. CONCLUSION:A high prevalence of symptoms related to GORD in comparison to previous literature was found among private tuition attendees. Possible reasons for the above findings were discussed.

背景与目标：

BACKGROUND & AIMS: BACKGROUND AND PURPOSE:Speckle Reduction Imaging is a new algorithm that improves the image quality of B-mode scanning by reducing the reverberation artifacts. In the present study the value of this method for the characterization of atherosclerotic plaques in the internal carotid artery was investigated. METHODS:Two hundred and twenty two patients (161 men, 61 women; mean age 73 years) referred for carotid ultrasound evaluation were included in the study. Patients with plaques of the internal carotid artery as identified by conventional B-mode scanning were investigated also with the addition of Speckle Reduction Imaging (SRI) with the use of a 4-11-MHz wide band linear transducer. Plaque morphology was rated according to a standardized protocol by two independent observers. RESULTS:For the determination of plaque echogenicity, the reproducibility of SRI (kappa=0.83) was higher than that of conventional B-mode ultrasound (kappa=0.68). The interobserver agreement for plaque surface characterization was also higher for SRI (kappa=0.8) than for conventional B-mode (kappa=0.61). At the evaluation of the image quality through a semiquantitative analysis, SRI was rated superior in the plaque texture resolution, plaque borders determination, vessel wall demarcation and fibrous cap depiction. In addition, the level of "speckle" was reduced with the use of SRI. CONCLUSIONS:SRI is a technique that shows good general agreement with high-resolution B-mode and can be used for the characterization of atherosclerotic plaques in the carotid artery. Furthermore, because this advanced technique allows reduction of ultrasound artifacts, it improves the image quality allowing more precise visualization of plaque morphological details.

背景与目标：

BACKGROUND & AIMS: BACKGROUND:Gitelman syndrome (GS) is a rare autosomal recessively inherited salt-wasting tubulopathy associated with mutations in the SLC12A3 gene, which encodes for NaCl cotransporter (NCC) in the kidney. CASE PRESENTATION:In this report, we describe two siblings from a Sri Lankan non-consanguineous family presenting with hypokalaemia associated with renal potassium wasting, hypomagnesemia, hypocalciuria and hypereninemic hyperaldosteronism with normal blood pressure. Genetic testing showed that both were homozygotes for a novel missense mutation in exon 10 of the SLC12A3 gene [NM_000339.2, c.1276A > T; p.N426Y], which has not previously been reported in the literature in association with GS. Their mother was a heterozygous carrier for the same mutation. The father was not alive at the time of testing. This novel mutation extends the spectrum of known SLC12A3 gene mutations and further supports the allelic heterogeneity of GS. Interestingly both siblings had young onset Diabetes with strong family history. CONCLUSION:These findings have implications in providing appropriate genetic counseling to the family with regard to the risk associated with inbreeding, the detection of carrier/presymptomatic relatives. It further expands the known spectrum of genotypic and phenotypic characteristics of Gitelman syndrome.

背景与目标：