University of Kelaniya

BACKGROUND Diet is widely recognized as a significant contributor to the development and exacerbation of gastroesophageal reflux disease (GERD) symptoms. However, evidence on the impact of specific dietary factors remains inconsistent. AIM To identify the dietary and nutritional correlates of GERD symptoms in Sri Lankan adults. METHODS A cross-sectional analytic study was conducted on 1200 adults aged 18-70 years, recruited through stratified random cluster sampling across all 25 districts of Sri Lanka. Data was collected using interviewer-administered, country-validated tools: A GERD symptom screening tool and a food frequency questionnaire. Anthropometric measures (weight, height, abdominal and hip circumferences) were obtained using calibrated and sensitive instruments. Subjects having heartburn and/or regurgitation at least once per week were diagnosed to have GERD. They were compared with those without GERD (controls). RESULTS In our population (n = 1200, mean +/- SD age: 42.7 +/- 14.4 years, 46.1% males), significant dietary triggers of GERD symptoms included oily foods, bread, wheat, coffee, and sour or vinegar-based foods (P < 0.001, chi(2) test). Meal-related behaviors such as skipping breakfast, consuming late-night snacks (P < 0.001), and lying down within two hours after eating (P = 0.038) were also associated with GERD. No significant differences were observed between GERD and control groups in anthropometric measures, food portion sizes, or overall caloric and nutrient intake (P > 0.05). Total daily fat and fiber intake showed no correlation with GERD symptoms; however, bloating was associated with higher fat and fiber intake, greater fruit and vegetable consumption, and higher body mass index. These findings highlight dietary patterns and habits distinctive to the Sri Lankan population, where frequent consumption of oily and wheat-based foods may contribute to GERD symptom prevalence. CONCLUSION Some dietary items, such as oily foods, wheat, coffee, and sour/vinegar foods, and diet-related habits, such as fat intake, skipping breakfast, and lying down after meals, have a significant association with GERD symptoms as previously reported around the world. Bread is significantly associated with GERD symptoms in Sri Lankan adults, which has not been reported previously. Contrary to common belief, there was no significant association between GERD and nutrient intake or obesity. In addition, not only participants fulfilling criteria for GERD, but even controls were affected by food items triggering heartburn. Thus, lifestyle modifications based on diet and dietary habits are integral to managing GERD symptoms.

Solitary rectal ulcer syndrome (SRUS) is a gastrointestinal disorder with a varied range of clinical, endoscopic and histological features. It is often misdiagnosed as inflammatory bowel disease or rectal malignancy. This review aims to outline a practical approach to diagnosing and managing SRUS. The aetiology remains unclear, with contributing factors such as mucosal prolapse, ischemia, paradoxical puborectalis contraction, and digital trauma. Diagnosis involves a comprehensive approach, including clinical history, digital rectal examination, endoscopy, histopathology, and physiological studies. Treatment includes lifestyle modifications, biofeedback therapy, topical agents, sclerotherapy, and surgical intervention for refractory cases. Ongoing surveillance is necessary, especially in patients at high risk for recurrence. Management of SRUS should be individualised and multidisciplinary, particularly in patients with psychiatric comorbidities or during pregnancy, where invasive interventions are minimised. Further research and standardised treatment protocols for SRUS are needed.

Biological invasions, driven by the spread of non-native species, have become a critical global issue because of their far-reaching ecological and socioeconomic impacts. Effective communication of the risks of biological invasions is essential for implementing robust policy and legislation and gaining public support for conservation efforts. However, current policies often suffer from fragmentation and ineffectiveness, largely due to inadequate risk communication and complex multi-level governance. To address this challenge, we develop a global framework designed to enhance clearer communication about biological invasion risks. The framework contextualizes key terms across three domains in invasion science: species invasiveness, risk analysis, and decision support tools. Using both diffusion-of-English and ecology-of-language paradigms, and following a three-step process involving preliminary consensus, AI querying, and ground-truthing with final consensus, we validate the framework in 70 non-English languages which, together with English, have official status in at least one country and collectively cover all 195 countries worldwide. Our findings reveal that while terminology for risk analysis is well established, terminology for species invasiveness and, especially, for decision support tools remains underdeveloped in many languages, hindering effective communication and policy implementation. Our framework underscores the importance of cultural and political neutrality. By promoting clearer risk communication among scientists, policymakers, and the public globally, we aim to reduce policy fragmentation and foster enhanced collaboration in risk mitigation. We recommend expanding multilingual decision support tools to include the full risk analysis process: risk identification, risk assessment, and risk management. This will support intergovernmental mitigation efforts and promote a unified global response to biological invasions.

Sinhala is an alpha-syllabic language. However, majority of dyslexia screening tools are developed in English. Despite growing evidence on language skills associated with dyslexia, a linguistically and culturally appropriate standardized tool is not available for Sinhala-speaking children. This study aimed to develop and validate a screening instrument to identify early signs of dyslexia, focusing on language-based skills in children aged 4–6 years. The Red Flags for Early Detection of Dyslexia in Sinhala (REaDDS) tool was developed through two phases. Study 01 encompassed tool development, Delphi review, pilot testing, and pretesting. Study 02 focused on psychometric evaluation. The REaDDS tool comprises a test kit, administration manual, and score sheets, assessing four domains: (1) phonological processing, (2) morphology, (3) other language skills, and (4) visual processing and cognitive abilities. The initial 24 subsets were refined to 19 following expert review and pilot testing during Study 01. In Study 02, the refined tool was administered to 214 typically developing children and 125 with dyslexia. Validity and reliability analyses were conducted using data from 57 typically developing children and 79 with dyslexia aged 6–6.99 years. Cronbach’s alpha values ranged from 0.777 to 0.930, indicating acceptable to excellent internal consistency. Inter-rater reliability was strong (ICC = 0.75–0.90), and sensitivity and specificity were acceptable across domains (AUC > 0.75). Item-level Content Validity Index (I-CVI) values exceeded 0.78 for all items. The REaDDS tool represents the first comprehensive, language-based, user-friendly, standardized dyslexia screening instrument for Sinhala, with evidence of validity and reliability.

This paper examines how young Buddhist monks in Sri Lanka (aged 18-24) navigate same-sex encounters and relationships within their institutional religious disciplinary prohibition. It critically engages the disjunction between the Buddha's early P & amacr;li Canon - which does not explicitly condemn same-sex intimacy - and postcolonial, Protestant-influenced Buddhist institutions that strictly forbid the sexual activity, reinforced by colonial penal codes, Victorian morality, and heteronormative patriarchal norms. Drawing on a qualitative constructivist ontology and interpretivist epistemology, the study is based on in-depth interviews with 30 young male monks (2022-2024), and was approved by Newcastle University (Ref: 6997/2018). Findings reveal that many young Buddhist monks experience same-sex intimacy as emotionally fulfilment, yet this produces psychological conflict as they wrestle with embodied desire, religious harm, and institutional silence. The research also highlights systemic issues such as sexual abuse, harassment, ragging, and substance use as coping mechanisms tied to suppressed sexuality and histories of exploitation. It calls for renewed scholarly and institutional engagement, arguing that inclusive interpretations of sexual ethics are essential for fostering stigma-free sexual health education and public discourse in contemporary Sri Lanka.