Browsing by Author "Dilina, A.K.N."

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Feeding in children with cerebral palsy: preliminary results from an ongoing study at the Rheumatology and Rehabilitation Hospital, Ragama
(Sri Lanka Medical Association, 2017) Dilina, A.K.N.; Ediriweera, D.S.
INTRODUCTION & OBJECTIVES: Malnutrition is a common problem in children with cerebral palsy (CP) and can be associated with growth failure. This study was done to assess feeding patterns and caregivers’ perception on feeding children with CP. METHODS: A total of 42 children with CP at the Rheumatology and Rehabilitation Hospital, Ragama (RRH) were studied from March 2016 to March 2017. An interviewer-administered questionnaire was used to collect data. RESULTS: Median (IQR) age of children was 65 (37-117) months and 69% were males. 64.3% had spastic quadriplegia. 90% of children’s main caregiver was the mother. 19% were able to self feed, 12% could self feed but was slow and messy, 7% could self feed with assistance and 62% were entirely fed by the caregivers. 79% tolerated adult food, 17% were on coarsely mashed purees and 4% required well mashed purees. Median (IQR) daily feeding time was 110 (72-205) minutes in spastic quadriplegic children compared to 80 (60-110) minutes in other types of CP (p=0.17). 31% of caregivers expressed that feeding was stressful. 57% of caregivers believed that their child was underweight, 2% as just below normal weight and 10% as overweight. CONCLUSION: A total of 62% of children were entirely fed by the caregivers. Twenty one percent needed special food preparations. Median feeding time was relatively higher in spastic quadriplegics compared to other types of CP. Nearly one third of caregivers expressed that feeding was stressful. More than half of the caregivers believed that their children were underweight.
Nutritional status of patients with spinal cord injury admitted to the Rheumatology and Rehabilitation Hospital, Ragama
(Sri Lanka Medical Association, 2017) Dilina, A.K.N.; Lakmali, A.K.S.; Ediriweera, D.S.
INTRODUCTION & OBJECTIVES: Malnutrition is a common problem in hospitalized patients having chronic diseases with long periods of debilitation. There is limited data on the nutritional status of spinal cord injury (SCI) patients in Sri Lanka. METHODS: All the SCI patients admitted to the Rheumatology and Rehabilitation Hospital, Ragama (RRH) during September to November 2015 were studied. An interviewer-administered questionnaire was used. Mid upper arm circumference (MUAC) was measured to assess the body mass index (BMI) category and nutritional screening was done with the Malnutrition Universal Screening tool (MUST). RESULTS: There were 138 patients, median (IQR) age was 39 (27 to 57) years and 124 (90%) were males. The median (IQR) MUAC was 25 (22-27) cm and 23% were in the BMI category less than 20kg/m2 and 7% were in the BMI category more than 30kg/m2. 84 (61%) were at risk of undernutrition (MUST score 1 or more). 27 (19.5%) were at high risk of undernutrition (MUST score 2 or more), where the high risk was seen in 37.5% of bedbound patients compared to 12.27% in others (p<0.01). 44 (32%) of SCI patients had pressure ulcers and 38.6% of them were at high risk of undernutrition (MUST score 2 or more) compared to 10.6% in non-ulcer patients (p<0.01). CONCLUSION: Among SCI patients, 7% were obese and 23% were undernourished according to MUAC. According to the MUST score, more than half of the SCI patients were at risk of undernutrition and 19.5% were at high risk of undernutrition, where this was specifically seen in bedbound patients and patients with pressure sores.
Perception of self-weight among knee osteoarthritis patients
(Sri Lanka Medical Association, 2018) Dilina, A.K.N.; Ediriweera, E.P.D.S.
INTRODUCTION AND OBJECTIVES: Overweight and obesity are the major risk factors of osteoarthritis (OA). Weight reduction is important to treat OA and it is important to understand the perception of self-weight among patients to implement weight reduction programs and improve self-motivation for weight reduction. This study was done to assess the perception of weight among OA patients attending the RRH. METHODS: Systematic sampling was used to recruit 255 patients from the Rheumatoid and Rehabilitation Hospital, Ragama. A self-administered questionnaire was used to collect data. RESULTS: Median age of the patients was 57 (IQR: 50 - 65) years and 235 (92%) of them were females. Among them, 49.6% were obese (BMI > 30) and 36.6% (BMI between 25 and 30) were overweight. 78% knew their weight, of them, 78% had checked weight within last six months. 3% felt overweight was a sign of prosperity, 43% felt overweight disfigured them and 93% knew it was unhealthy. Recalled and measured weights showed significant correlation (P<0.01). Among obese, 55% knew they were considerably above the normal weight and 28% felt they were somewhat above the normal weight and 2% believed they were just above the normal weight. Among the overweight, 25% felt they were considerably overweight, 48% somewhat above normal weight and 12% felt they were just above normal weight. 15% of both obese and overweight believed they were overweight but could not quantify their weight. CONCLUSION: Majority among obese, and overweight perceived their weight and 93% believed overweight is unhealthy
Profile of spinal cord injuries among inward patients at the Rheumatology and Rehabilitation Hospital, Ragama
(Sri Lanka Medical Association, 2017) Dilina, A.K.N.; Ediriweera, D.S.
INTRODUCTION & OBJECTIVES: The global spinal cord injury (SCI) incidence is 40 to 80 per million. Data on SCI in Sri Lanka is sparse. This study describes the socio-demographic characteristics of SCI patients at the Rheumatology and Rehabilitation Hospital, Ragama (RRH). METHODS: All SCI patients admitted to the RRH during September to November 2015 were studied. An interviewer-administered questionnaire was used. Ethical clearance was obtained from the University of Kelaniya. ISCO-08 classification was used to classify the occupation category. RESULTS: There were 138 SCI patients. 124 (90%) of them were males, median age was 39 (IQR: 27 to 57) years and 11 (8%) were below 18 years. There were 50 (36%) elementary workers, 28 (20%) service and sales related workers, 10 (7%) machine operators and 26 (18%) were unemployed. Causes of spinal injury were as follows; 62 (45%) fall from a height, 35 (25%) road traffic accidents (RTA), 20 (14%) disease related, 5 (3.6%) each from assault, blunt trauma and spinal tumors. There were 63 (45.6%) thoracic, 57 (41.3%) cervical, 18 (13%) lumbar spinal injuries respectively. 90 (65%) were paraplegic and 48 (34%) were quadriplegic. 29% were bed bound, 58% could move in a wheelchair with support, 10% could move in a wheelchair without support and 2% could walk alone. CONCLUSION: SCI is common in young and middle aged adult male elementary workers. Common cause of injury was fall from a height followed by RTAs. Thoracic and cervical injuries were common and the majority were paraplegic patients. Health education programmes on safety measures to minimize SCI due to falls and RTAs in risk groups would be important in preventing the majority of SCI.