Browsing by Author "Bandara, C."

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Efficacy of a low-cost multidisciplinary team-led experiential workshop for public health midwives on dysphagia management for children with cerebral palsy
(VU e-Publishing, Netherlands, 2018) Hettiarachchi, S.; Kitnasamy, G.; Mahendran, R.; Nizar, F. S.; Bandara, C.; Gowritharan, P.
PURPOSE: Over the past decade there has been a growing focus on offering appropriate training to healthcare professionals and caregivers to support safe feeding practices for children with cerebral palsy. Early and consistent multidisciplinary intervention is required to minimise the risks of aspiration pneumonia. The high incidence of complications from aspiration pneumonia among children with cerebral palsy in Sri Lanka has made it necessary to conduct low-cost multidisciplinary team-led dysphagia awareness workshops for healthcare professionals and caregivers.METHOD: A group of 38 Public Health Midwives (PHMs) was offered an experiential workshop by a small multidisciplinary team (MDT). To determine changes in knowledge, a self-administered questionnaire that included a video-based client scenario was administered pre- and post-workshop. The data were analysed statistically using non-parametric within-participant t-tests.RESULTS: The post-workshop responses to the questionnaire indicated a significant increase in the level of knowledge. This included positive changes in the understanding and knowledge of cerebral palsy (t (37) =-7.44, p=.000), effects of cerebral palsy on eating and drinking skills (t (37) =-3.91, p=.000), positioning (t (37) = -9.85, p=.000), aspiration (t (37) =-3.46, p=.001), food categorisation (t (37), -3.85, p=.000) and client video observation (t (37)-3.91, p=.000) at a p=.05 level of significance. While there was also an increase in the knowledge on general guidelines during mealtimes, this did not reach statistical significance.CONCLUSION: The low-cost MDT-led experiential workshop was effective in increasing knowledge of feeding and dysphagia-related issues in cerebral palsy among a group of PHMs. This workshop could serve as a model for training PHMs and Community-Health Workers across the country in order to reach the Sustainable Development Goal of ‘good health and well-being’ for children with cerebral palsy and all children experiencing feeding difficulties. Follow-up workshops and continued professional development courses for midwives on dysphagia care are strongly recommended, in addition to collaborative clinical practice
Gastric emptying and antral motility according to the subtypes of irritable bowel syndrome: a paediatric study
(Lippincott Williams & Wilkins, 2011) Devanarayana, N.M.; Rajindrajith, S.; Bandara, C.; Shashiprabha, G.; Benninga, M.A.
BACKGROUND: Irritable bowel syndrome (IBS) is a common paediatric functional gastrointestinal disorder. It is subtyped into diarrhoea predominant (IBS-D), constipation predominant (IBS-C), mixed (IBS-M) and untypable (IBS-U) IBS depending on stool consistency. Several studies have reported differences in colonic motility in children with different IBS subtypes. However, gastric motility has not been assessed according to subtypes yet. AIM: To assess gastric motility in children with different IBS subtypes using a non-invasive ultrasound method. METHODS: Seventy six children with IBS [33 (43%) males, age 4–14 years, mean 7.9 years, SD 3.0 years) referred to the Gastroenterology Research Laboratory, Faculty of Medicine, University of Kelaniya, Sri Lanka, for gastric motility studies and 20 healthy controls [8 (40%) males, age 4–14 years, mean 8.4 years, SD 3.0 years] were recruited. Children with IBS were divided into IBS-D(n=21), IBS-C(n=31), IBS-M (n=19) and IBS-U (n=5) according to Rome III definitions. None of the patients recruited had clinical or laboratory evidence of organic disorders. Liquid gastric emptying rate (GER) and antral motility parameters were assessed using a previously reported ultrasound method. RESULTS: Compared to healthy controls, the mean GER (43.8% vs. 66.2% in controls), amplitude of antral contractions (A) (56.4% vs. 89%) and antral motility index (MI) (5.1 vs. 8.3) were significantly lower and fasting antral area (FA) (1.6 vs. 0.6) was higher in children with IBS ( p<0.0001). Frequency of antral contractions (F) (8.9 vs. 9.3) did not show a significant difference between the two groups. Patients exposed to recent stressful life events had a significantly lower mean GER (40.3%), compared to those who were not (45.7%) ( p=0.03). No significant relationship was observed between severity of symptoms and motility abnormalities. No significant differences were found between IBS-D, IBS-C and IBS-M with respect to GER (42.%, 46.3%, 39.6%), FA (1.4 cm2,1.8 cm2, 1.8 cm2), A (53%, 58.9%, 51.8%), F (8.7, 8.9, 9.2) and MI (4.7, 5.3, 4.8). CONCLUSIONS: GER and antral motility parameters were significantly impaired in children with IBS compared to controls. No significant difference observed in gastric motility parameters between different IBS subtypes. GER was lower in those exposed to recent stressful events
Ultrasonographic assessment of liquid gastric emptying and antral motility according to the subtypes of irritable bowel syndrome in children
(Lippincott Williams and Wilkins, 2013) Devanarayana, N.M.; Rajindrajith, S.; Bandara, C.; Shashiprabha, G.; Benninga, M.A.
OBJECTIVES: Gastric motor abnormalities have been reported in adults with irritable bowel syndrome (IBS), commonly in constipation-predominant IBS (IBS-C); however, such studies are uncommon in children. Furthermore, differences of gastric motility have not been studied in children with different IBS subtypes. METHODS: Seventy-six children (33 [43%] boys, age 4-14 years, mean 7.9 years, SD 3.0 years) fulfilling Rome III criteria for IBS and 20 healthy controls (8 [40%] boys, age 4-14 years, mean 8.4 years, SD 3.0 years) were recruited (diarrhea-predominant IBS=21, IBS-C=31, mixed IBS=19, and unsubtyped IBS=5). Liquid gastric emptying rate (GER) and antral motility were assessed using an ultrasound method. RESULTS: Average GER (43.8% vs 66.2% in controls), amplitude of antral contractions (56.4% vs 89%), and antral motility index (5.1 vs 8.3) were lower and fasting antral area (1.6 vs 0.6) was higher in patients with IBS (P<0.0001). Frequency of antral contractions F (8.9 vs 9.3) did not show a significant difference. Patients exposed to stressful events had a significantly lower GER, compared to those not exposed to such events (P=0.03). Gastric motility parameters had no correlation with severity of symptoms. GER (42.6%, 46.3%, 39.6%), fasting antral area (1.4 cm², 1.8 cm², 1.8 cm²), amplitude of antral contractions (53%, 58.9%, 51.8%), frequency of antral contractions (8.7, 8.9, 9.2), and antral motility index (4.7, 5.3, 4.8) were not different among diarrhea-predominant IBS, IBS-C, and mixed IBS (P>0.05). CONCLUSIONS:GER and antral motility parameters were significantly impaired in children with IBS compared with controls. GER and antral motility parameters were not different between IBS subtypes. Copyright 2013 by ESPGHAN and NASPGHAN