Abstracts of oral and poster presentations

Jithangi Wanigasinghe
2019 Ceylon Journal of Medical Science  
In today's world, an intellectual property (IP) asset is treated as a tool to foster innovation of any successful entity in the technology-driven world and the effective use of one or more types of (IP) is necessary to gain and maintain a substantial competitive edge in the marketplace. This is certainly true for medical and healthcare sectors. The concept of IP refers to any product of the human intellect that the law protects from unauthorized use. Objectives: To broaden the understanding of
more » ... P system among healthcare professionals in Sri Lanka in order to effectively utilize the incentive system based on IP rights to promote medical innovation for sustainable development of the healthcare ecosystem in the country Methods: This research is carried out primarily as a critical review of literature. Comparative research and analysis are deployed to glean the experience of selected jurisdictions. Results: Even though advanced and emerging economies have effectively used the IP system to promote innovation in the healthcare sector, Sri Lanka has made inadequate use of the same, viewed through the lens of IP statistics. When compared with the experience of advanced countries, the IP system has been and is effectively used to protect, promote, commercialize healthcare innovation. Moreover, use of complementary IP strategy is necessary to extract value and commercialize inventions in the healthcare sector. Conclusions: It is imperative for the healthcare sector of the country to effectively utilize the IP system to promote innovation and investment. This research suggests that policymakers need to pay urgent attention to this perceived deficiency in the healthcare ecosystem. Introduction: Endothelial dysfunction (ED) has been recognized as a precursor of cardiovascular diseases, thus enable the possibility of early detection. However, noninvasive measurement of ED is only possible with peripheral vasodilatory regulation stimulated by artificially induced reactive hyperemia. These measurements include physiological parameters such as flow-mediated dilation (gold standard) and Doppler flow rate, temperature, arterial pressure and oxygen saturation. Objectives: To develop a device to assess vasodilatory endothelial dysfunction Methods: A device was developed to simultaneously measure above mentioned parameters at the distal end of the arm to assess vasodilatory endothelial dysfunction. This device includes a new parameter; bioimpedance which reflects electrical characteristics due to reactive hyperemia. Initially, the temperature and arterial pressure was measured on 11 diabetes subjects and 10 healthy subjects. As the final step, patients with pre-diabetes and healthy subjects with cardiovascular risk factors will be tested to investigate the presence of endothelial dysfunction during reactive hyperemia with the intention of establishing an early detection method to assess the risk of developing cardiovascular diseases. Results: The findings reflected a significant difference between the two groups (p<0.05) indicating the validity of the device. In addition, the newly introduced bioimpedance parameter indicated consistent variations on 10 healthy subjects during the reactive hyperemia with respect to the resting period procedure. Conclusions: A demonstration of the device will be available at the Congress for further descriptions. Introduction: Amputation of the lower limbs due to diabetic foot is a major cause of debility in Sri Lanka. The etiology includes ischemia, neuropathy and susceptibility to infections. Detecting the presence of early neuropathy and ischemia would help prevent further deterioration and development of ulcers and later amputations. Thermal imaging corresponds to surface blood flow of the plantar areas and pressure distribution on standing is an index of mechanical pressure on the different areas of the foot. Areas of low blood flow and /or high mechanical pressure are therefore likely to be at risk of ulcer formation. Near-infrared thermography has proven to be a convenient and accurate temperature profiling technique for contactless large-scale patient screening for diabetic foot complications. Objectives: To develop a device to use infrared images of diabetic foot plantar via semi-supervised image processing algorithm to detect areas with less blood flow Methods: Preliminary clinical testing was conducted using 6 diabetic subjects and 9 non-diabetic subjects. We developed a versatile system using piezoresistive array readout technology to assess plantar pressures. This was much cheaper and more flexible in data analysis than commercially available devices CJMS 2019; 56(II) This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. DOI: http://doi.org/10.4038/cjms.v56i2.4974 CJMS 2019; 56(II) 61 and delivered higher data acquisition rates. Finally, the system was verified using 10 normal subjects and 5 diabetic subjects with callus feet. Results: The system was able to successfully differentiate abnormal areas of the foot plantar with the implemented algorithm. It provided a rapid analysis of plantar pressure assessment achieving a maximum frame rate of 155 Hz for both static and dynamic measurements. The findings indicate significantly high mechanical stresses on foot plantar and postural disorders during standing, in diabetic subjects. Conclusions: We are in the process of developing a combined system to detect plantar pressure as well as low perfusion areas which may predict future diabetic foot disease. The device will be demonstrated at the venue for further assessment. Introduction: Pharmacokinetics (PK) deal with studying the time course of drug effect within the biological system of an individual. Population PK (PopPK) analysis describes the variability of drug concentrations within and between individuals in a particular population under different clinical conditions. This allows quantitatively predicting drug concentrations in the next patient receiving the drug. PopPK studies are sparse among patients in Sri Lanka. Objectives: To develop a PopPK model to predict amoxicillin concentration in blood in healthy Sri Lankan subjects and determine the typical values for absorption rate constant (Ka), volume of distribution, (Vd), elimination rate constant, (Ke) and lag time, (Tlag) for amoxicillin for Sri Lankan subjects using the model developed Methods: A total of 196 sample points from 14 individuals with 14 amoxicillin concentration-time points were used and the PopPK analysis was conducted using Phoenix WinNonlin, version 6.4. After an exploratory data analysis, initial estimates were obtained for the main PK parameters and the final model was developed and further refined for better fit and validated. Results: According to the final PK model, the typical values for Ka, Vd, Ke and Tlag were 0.834h -1 , 21.402L, 0.946h -1 and 0.420h, respectively. A single compartment PK model was successfully established for a single dose of oral amoxicillin 500 mg for the first time in a cohort of healthy Sri Lankans which is capable of accurately predicting PK parameters of amoxicillin. Conclusions: The model developed could be used in the future for advanced PopPK analysis using sparse clinical data among different patient groups as PopPK is an underused research area in Sri Lanka. The knowledge gained and study findings could potentially be used to improve the clinical outcomes through individualized prescribing of other medicines in the future.
doi:10.4038/cjms.v56i2.4974 fatcat:cwi75ghg35gdfg4de636v3pyme