Variations in out-of-pocket spending and factors influencing catastrophic health expenditure of households with patients suffering from chronic conditions in four districts in Sri Lanka.

Introduction: Healthcare financing systems, dependent on out-of-pocket expenditure(OOPE), impose a heavy burden on those who use the services regularly, such as patients suffering from chronic diseases. High OOPE for health services leads to decreased utilization of the services and/or catastrophic health expenditure, which would significantly impede the achievement of Universal Health coverage.

Objective: We aimed to determine variations in OOPE and factors associated with Catastrophic Health Expenditure (CHE) of households with patients suffering from non-communicable diseases(NCDs) in four districts.

Exploring the Utility of Urinary Creatinine Adjustment for KIM-1, NGAL, and Cystatin C for the Assessment of Kidney Function: Insights from the C-KidnEES Cohort.

Normalization of urinary biomarkers of kidney injury is a common practice in clinical and research settings to account for variations in urine concentration, and urinary creatinine is often used as a reference. However, to date, there is no consensus on the adjustment of urinary biomarkers with creatinine, and both absolute and creatinine-adjusted biomarker levels are adopted for making interpretations of kidney health. Hence, the present study aimed to investigate the associations of urinary creatinine with three widely used kidney injury biomarkers, KIM-1, NGAL, and cystatin C, to validate the applicability of urinary creatinine as a reference for normalization.

Transcriptomic and behavioral analyses reveal unique target tissues and molecular pathways associated with embryonic exposure to low level glyphosate and metal mixtures in zebrafish.

Investigation of developmental molecular events following exposure to environmentally relevant agrochemical mixtures is critical to predicting their potential long-term ecological and human health risks. Here, we sought to uncover transcriptomic changes during zebrafish (Danio rerio) embryonic development following exposure to glyphosate and co-exposure to metals. Glyphosate is widely used globally with an allowable drinking water limit of 700 ppb.

Environmental fluoride exposure and implications on potential pediatric kidney health risks: an approach with urinary biomarkers.

Background: Environmental fluoride exposure at elevated levels is potentially linked to kidney injury, and may contribute to chronic kidney disease of uncertain etiology (CKDu) as a risk factor. However, this link remains unclear, and examining the risk of kidney damage from early life fluoride exposure may provide important insights. Hence, this study aimed to investigate associations of fluoride exposure with pediatric kidney health in CKDu impacted and unimpacted communities in Sri Lanka.

Prevalence of Chronic Kidney Disease of Uncertain Etiology Within Selected Farming Communities in Rural Sri Lanka.

Background: Chronic kidney disease of uncertain etiology (CKDu) is an emergent health concern, particularly in tropical farming communities in several global hotspots, including Sri Lanka. This particular nephropathy is characterized by a progressive decline in kidney function in the absence of conventional chronic kidney disease (CKD) risk factors such as diabetes mellitus, hypertension, and other identifiable kidney disorders. As it is almost asymptomatic at early stages, CKDu is mostly diagnosed at late stages with significant kidney damage.

Body mass index and implications for pediatric kidney health: a cross-sectional study with urinary biomarkers.

Background: Extremes of unhealthy body weight, particularly obesity, are known to increase the risk of chronic kidney diseases. However, the current knowledge of kidney health outcomes associated with unhealthy body weight remains incomprehensive, especially in pediatrics. Therefore, the present study aimed to evaluate body mass index (BMI) and its potential associations with kidney health in a selected subset of school students in Sri Lanka.

Environmental heat exposure and implications on renal health of pediatric communities in the dry climatic zone of Sri Lanka: An approach with urinary biomarkers.

Prolonged heat exposure during outdoor physical exertion can result in adverse renal health outcomes, and it is also supposed to be a driver of chronic kidney disease of uncertain etiology (CKDu) in tropical regions. School students are more likely to experience high heat exposure during outdoor sports practices, and the current knowledge on potential renal health outcomes associated with heat exposure carries many knowledge gaps. Hence, the present study aimed to perform biomarker-based assessment of the likelihood of pediatric renal injury focusing the communities in the dry climatic zone in Sri Lanka, where it prevails relatively harsh climate and high prevalence of CKDu.

Urinary biomarkers indicate pediatric renal injury among rural farming communities in Sri Lanka.

Pediatric renal injury is an emerging health concern in communities affected by chronic kidney disease of uncertain etiology (CKDu). Early detection of susceptibilities through highly sensitive and specific biomarkers can lead to effective therapeutic and preventive interventions against renal diseases. Here, we aimed to investigate the utility of kidney injury molecule (KIM-1) and neutrophil gelatinase-associated lipocalin (NGAL) in early detection of renal abnormalities in selected pediatric communities in Sri Lanka.

Applicability of Novel Urinary Biomarkers for the Assessment of Renal Injury in Selected Occupational Groups in Sri Lanka: A Comparative Study with Conventional Markers.

Screening approaches with more robust biomarkers, are of the utmost importance in the characterization of renal injuries, particularly among communities with high burdens of chronic kidney disease of uncertain etiology (CKDu). The present study aimed to assess the utility of two emerging biomarkers: kidney injury molecule (KIM-1) and neutrophil gelatinase-associated lipocalin (NGAL) in predicting renal injury in different occupational groups in Sri Lanka. A cross-sectional study was conducted with six occupational groups ( = 188): fisherfolk (FF), paddy farmers (PF), sugarcane farmers (SF), factory workers (FW) and plantation workers (PW) to assess the predictive performance of KIM-1 and NGAL against a CKDu patient (PT) group ( = 40).

Urinary cystatin C: pediatric reference intervals and comparative assessment as a biomarker of renal injury among children in the regions with high burden of CKDu in Sri Lanka.

Background: Cystatin C (Cys-C) is an emerging biomarker of renal diseases and its clinical use, particularly for screening the communities affected by chronic kidney disease of unknown etiology (CKDu), is hindered due to the lack of reference intervals (RIs) for diverse ethnic and age groups. The present study aimed to define RIs for urinary Cys-C (uCys-C) for a healthy pediatric population in Sri Lanka and in turn compare the renal function of the residential children in CKDu endemic and non-endemic regions in Sri Lanka.

Methods: A cross-sectional study was conducted with 850 healthy children (10-17 years) from selected locations for reference interval establishment, while a total of 892 children were recruited for the comparative study.

Urinary Biomarkers of Renal Injury KIM-1 and NGAL: Reference Intervals for Healthy Pediatric Population in Sri Lanka.

Emerging renal biomarkers (e.g., kidney injury molecule-1 (KIM-1) and neutrophil gelatinase-associated lipocalin (NGAL)) are thought to be highly sensitive in diagnosing renal injury.

One-Pot Reducing Agent-Free Synthesis of Silver Nanoparticles/Nitrocellulose Composite Surface Coating with Antimicrobial and Antibiofilm Activities.

Nitrocellulose with silver nanoparticle (AgNP/NC) composite was prepared using Ag(CHCO) and nitrocellulose without any reducing agent. The composite materials synthesized were spray coated onto glass substrates to obtain thin films. The AgNPs/NC composites were characterized by ultraviolet-visible, Fourier transform infrared, X-ray photoelectron spectroscopy, scanning electron microscopy, and transmission electron microscopy.

Occupational Paraquat and Glyphosate Exposure May Decline Renal Functions among Rural Farming Communities in Sri Lanka.

Extensive use of herbicides is common among rural agricultural workers in Sri Lanka. Recent studies have postulated their role in the development of chronic kidney disease of unknown etiology (CKDu). Paraquat and glyphosate are leading herbicides used by sugarcane farmers (SF), hence occupational exposure is inevitable.

The Utility of Novel Renal Biomarkers in Assessment of Chronic Kidney Disease of Unknown Etiology (CKDu): A Review.

Chronic Kidney Disease (CKD) is a globally prevalent non-communicable disease with significant mortality and morbidity. It is typically associated with diabetes and hypertension; however, over the last two decades, an emergence of CKD of unknown etiology (CKDu) has claimed thousands of lives in several tropical agricultural communities. CKDu is associated with gradual loss of renal function without initial symptoms until reaching complete kidney failure and eventually death.

Mechanistic Studies on the Insertion of Carbonyl Substrates into Cu-H: Different Rate-Limiting Steps as a Function of Electrophilicity.

We report mechanistic studies on the insertion reactions of [(NHC)Cu(μ-H)] complexes with carbonyl substrates by UV-vis and H NMR spectroscopic kinetic studies, H/D isotopic labelling, and X-ray crystallography. The results of these comprehensive studies show that the insertion of Cu-H with an aldehyde, ketone, activated ester/amide, and unactivated amide consist of two different rate limiting steps: the formation of Cu-H monomer from Cu-H dimer for more electrophilic substrates, and hydride transfer from a transient Cu-H monomer for less electrophilic substrates. We also report spectroscopic and crystallographic characterization of rare Cu-hemiacetalate and Cu-hemiaminalate moieties from the insertion of an ester or amide into the Cu-H bond.

Synthesis, Characterization and Antimicrobial Activity of Garcinol Capped Silver Nanoparticles.

Garcinol, a well-known medicinal phytochemical, was extracted and isolated from the dried fruit rinds of . In this study, garcinol has successfully used to reduce silver ions to silver in order to synthesize garcinol-capped silver nanoparticles (G-AgNPs). The formation and the structure of G-AgNPs were confirmed by UV-visible spectroscopy, transmission electron microscopy and Fourier transform infrared (FTIR) spectroscopy.

TEMPO-Mediated Catalysis of the Sterically Hindered Hydrogen Atom Transfer Reaction between (CPh)Cr(CO)H and a Trityl Radical.

We have demonstrated the ability of TEMPO to catalyze H· transfer from (CPh)Cr(CO)H to a trityl radical (tris( p- tert-butylphenyl)methyl radical). We have measured the rate constant and activation parameters for the direct reaction, and for each step in the catalytic process: H· transfer from (CPh)Cr(CO)H to TEMPO and H· transfer from TEMPO-H to the trityl radical. We have compared the measured rate constants with the differences in bond strength, and with the changes in the Global Electrophilicity Index determined with high accuracy for each radical using state of the art quantum chemical methods.

TiO₂ Nanoparticles from Baker's Yeast: A Potent Antimicrobial.

Titanium dioxide (TiO) has wide applications in food, cosmetics, pharmaceuticals and manufacturing due to its many properties such as photocatalytic activity and stability. In this study, the biosynthesis of TiO nanoparticles (NPs) was achieved by using Baker's yeast. TiO NPs were characterized by X-ray Diffraction (XRD), UV-Visible spectroscopy, Scanning Electron Microscopy (SEM), Transmission Electron Microscopy (TEM) and Energy Dispersive X-ray analysis (EDX) studies.

Isolation and characterization of Leptospira interrogans from two patients with leptospirosis in Western Province, Sri Lanka.

Leptospirosis is an endemic infectious disease causing considerable morbidity and mortality in Sri Lanka; however, reports on the isolation of Leptospira from infected patients in Sri Lanka have been largely unavailable since the 1970s. Two isolates were obtained and characterized from 100 blood cultures from leptospirosis-suspected patients. Phylogenic analysis of partial flaB gene sequences identified the isolates as Leptospira interrogans.

Insertion of Isonitriles into the M-C Bonds of Group 4 Dialkyl Complexes.

The 2,3-dimethylbutadiene complexes of Group 4 metals with constrained geometry (cg) ligands have been prepared and found to adopt a supine orientation with σ,π bonding. Treatment of cgTi(2,3-dimethylbutadiene) (1-Ti) with BuNC leads to the formation of a titana-aziridine (3) with a coordinated cyclopentenimine that arises from the formal [4+1] addition of the diene to the isonitrile. In contrast, the reactions of cgZr(2,3-dimethylbutadiene) (1-Zr) or cgHf(2,3-dimethylbutadiene) (1-Hf) with 2 equiv of BuNC or XyNC proceeded in a more sophisticated manner to yield unsymmetrical 2,5-diazametallacyclopentane derivatives (4, 6-Zr, and 6-Hf) or symmetrical 2,5-diazametallacyclopentene complexes (7-Zr and 7-Hf).

Determination of Antimicrobial Potential of Five Herbs used in Ayurveda Practices against and Methicillin Resistant .

Background: Medicinal plants are an important source of novel antimicrobial agents. Ayurvedic treatment involves the use of a variety of medicinal plants that merit investigation.

Aims: To investigate the antimicrobial activity of bark of (L.

Enhanced antibacterial activity of TiO nanoparticle surface modified with extract.

Background: The antibacterial activity of 21 nm TiO nanoparticles (NPs) and particles modified with () against Methicillin resistant was investigated in the presence and absence of light.

Results: Surface modification of TiO NPs with the adsorption of extract, causes to shift the absorption edge of TiO NPs to higher wavelength. TiO NPs, pericarp extract showed significant bactericidal activity which was further enhanced in contact with the TiO modified extract.

IgG4 related sclerosing sialadenitis- a retrospective analysis.

Background: IgG4 related disease rarely affects the salivary glands and clinically is often confused with salivary gland malignancy.

Method: This is a retrospective study comprising 137 cases of chronic sialadenitis diagnosed in a histopathology department over 4 years. The morphology was assessed by reviewing the histology slides and the incidence of IgG4 related sclerosing sialadenitis was calculated.

Aspergillus species: An emerging pathogen in onychomycosis among diabetics.

Introduction: Approximately, 33% patients with diabetes are afflicted with onychomycosis. In the past, nondermatophyte molds have been regarded as opportunistic pathogens; recently, Aspergillus species are considered as emerging pathogens of toenail infections. In Sri Lanka, the prevalence of Aspergillus species in onychomycosis among diabetics is not well documented.