Browsing by Author "Dharmadasa, L.S."

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    Adequacy and relevance of medical records of patients admitted following Medico-legally significant trauma
    (College of Forensic Pathologists of Sri Lanka., 2020) Priyanath, D. C.; Dharmadasa, L.S.; de Silva, R.L.S.K.; Gunathilaka, M.M.A.C.C.; Nanayakkara, E.H.H.G.; Shakoor, M.S.; Samarawickrama, S.; Kitulwatte, I.D.G.; Edirisinghe, P.A.S.
    INTRODUCTION: Details mentioned in Bed head ticket (BHT) and investigations are taken into consideration when an opinion is made with regards to the medico legally significant trauma. Shortfalls of documents can lead to misdiagnosis or wrongful diagnosis. This study was conducted to find out the adequacy of records on BHTs and availability of investigations on patients who had been admitted following trauma with medico legal significance. METHODS: A prospective descriptive study was carried out on patents who were admitted following medico-legally significant trauma during a period of one year, from Aug 2017 to Aug 2018 by perusing their records. The adequacy of the documentation was assessed according to a pre-prepared scale. RESULTS: Analysis of on admission historical and preliminary details revealed that out of 1102 records, only 26% (n=286) had mentioned the time duration since the incident. Recorded cardiovascular stability on admission was above 86% (n=950) though level of consciousness was not mentioned by 19% (n=211). Nature of the injuries were correctly recorded by 65% (n=720) while the location of them were correctly recorded only by 29% (n=316). Surgical procedures were adequately mentioned only among 39% (n=425). CONCLUSIONS: The study revealed that there are gross inadequacies with regard to the records on BHTs made by the doctors. This can lead to limitations in addressing medico-legal issues and sometimes can result in wrong opinions leading to injustice. Need for continuous professional training with special attention to record keeping is highlighted. Further, the quality of records can be further improved with regular audits, continuous professional developmental activities and introducing a common format for documentation in admission, surgical procedures and investigations. KEYWORDS: Medico-legal issues, Medical record keeping, Adequacy, Investigations, BHT
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    Study on victims of child abuse: A study conducted in two teaching hospitals in Sri Lanka
    (College of Forensic Pathologists of Sri Lanka, 2021) Dharmadasa, L.S.; Kitulwatte, I.D.G.; Priyanath, D.C.; Gunathilaka, M. A.C.; Silva, L.S.K.D.; Kumari, M.K.J.K.
    INTRODUCTION: Child abuse is a global public health problem and proper intervention strategies need a greater understanding of risk factors that can contribute to it. This study was conducted in order to identify the undetected contributory factors that lead to child abuse cases. METHODOLOGY: All children (less than 18 years of age) who were brought for medico legal examination with alleged abuse to two reputed teaching hospitals during a period of 1 and ½ years were included. Required details were obtained through an interviewer administered questionnaire after obtaining the consent. RESULTS: Out of the 186 children, more than 80% presented following sexual abuse and the majority (n=173) were females. Further, n=118 (75%) of the victims of child sexual abuse were between the age group of 13 to 15 years. Moreover, 75% of the victims of sexual abuse were from low income families. Parents of 100% of the victims of physical abuse and 60% of the victims of sexual abuse had educational qualifications below ordinary level. 82% of the victims of physical abuse were having dysfunctional family background, specially use of ethanol by parents (65%). Parental separation was the form of family dysfunction that was associated with sexual abuse. Conclusion: Poor income, poor parental education and dysfunctional family background could be identified as predisposing factors for child abuse. However, the association of these factors vary with different types of child abuse, thus preventive strategies should be planned accordingly.