Browsing by Author "Ediriweera, E.P.D.S."

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Ability to use computer software among new medical entrants to the Faculty of Medicine, University of Kelaniya
(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2016) Solangaarachchi, D.I.K.; Kumara, A.A.K.B.; Hettige, S.; Ediriweera, E.P.D.S.
BACKGROUND: Computer software is essential to enhance academic life of students. OBJECTIVES: To describe the level of confidence and ability on using computer software among new entrants to Faculty of Medicine, University of Kelaniya METHODS: Moodle based self-administered questionnaire was given to new entrants in 2015 and 2016 and their perception on the level of confidence, ability and usage were recorded. RESULTS: The results are described according to the 2015 (n=159) and 2016 (n=147) batches respectively. Proportion of males were 27% and 35%. Proportions who could install software in each batch was 20% (n=32 and 29) and could not were 15.7% (n=25) and 27.2% (n=40). Those who could and could not install a printer were 10.1% (n=16)/ 16.3% (n=24) and 30.8% (n=49)/ 34% (n=50) respectively. Proportions who could and could not install a pen drive were 28.9% (n=46)/ 40.1% (n=59) and 15.7% (n=25)/ 17% (n=25) respectively. Nine percent (n=14) and 13.6% (n=20) had used, 63.5% (n=101) and 50.3% (n=74)) were aware but had not used and 27.7% (n=44)) and 36.1% (n=53) were not aware of open source software. CONCLUSIONS: A majority of students had no awareness on software installation and pen drive scanning and have not used open source software at the point of entry to the Medical Faculty.
Accessing a Moodle based Learning Management System and Exam Performance by Medical Students: A Retrospective Analysis.
(Faculty of Computing and Technology, University of Kelaniya, Sri Lanka., 2017) Hettiarachchi, W.G.; Hettige, S.; Ediriweera, E.P.D.S.; Chandrathilake, M.N.; de Silva, N.R.
Considering the high computer literacy of students and the need for being students centred, the MBBS programme of University of Kelaniya introduced a Moodle-based learning management system (LMS) as a supplementary component to its blended delivery approach of the curriculum. Accordingly, LMS is a parallel component to the curriculum delivered face-to-face. Each module of learning in the curriculum is represented in the LMS by giving lecture notes, PowerPoint presentations, web links and assignments. The broad aim of this study is to determine the relationship between the extent of interactively of learners with LMS and their exam performance. First-year medical students (172 from 2016 intake and 166 from 2017 intake) at University of Kelaniya were considered for the analysis. Student’s access to LMS during the first two modules of the MBBS curriculum and the results of the first continuous assessment were compared. Total LMS access for each student during the two modules were calculated by counting the number of views in the course log. The particular course logs of LMS were downloaded and filtered out the details pertaining to students in the above two modules in both batches. Total access during the two modules were calculated for individual student and used for the analysis. Continuous assessment results ranged from grades A to F and we assigned sequential numerical marks in the descending order from 6 to 1 to denote grade A to F. Total LMS access with respect to assessment grades were visualized using boxplots and median with interquartile ranges were calculated. Association between LMS access and assessment grades were investigated. Statistical analysis was done in R. Median (interquartile range) of LMS access of the students were 43.0 (12.25 – 72.0) times. The number of results grades for the students as follows; A – 3, B – 41, C – 117, D – 122, E – 51 and F – 4 and the respective number of median (interquartile range) access to LMS for the above grades were 110.0 (102.0 – 113.0), 51.0 (21.0 – 76.0), 49.0 (16.0 – 76.0), 39.0 (11.0 – 64.75), 29.0 (6.0 – 59.5) and 6.5 (3.0 – 16.0). There was significant correlation between LMS access and results grades (rho = 0.2, P < 0.01). Students with grade A showed significantly higher LMS access compared to the rest of groups. There was no difference in LMS access between students with grades B and C, C and D, D and E, D and F or E and F. However, grade B showed significantly higher LMS access compared to grades D, E and F; and grade C showed significantly higher LMS access compared to grades E and F. The findings demonstrate that students’ interaction with LMS were significantly associated with the performance in the examination. The learning management system has a positive impact on student performance.
Bordete//a pertussis specific Immunoglobulin G antibody levels among asymptomatic individuals aged 4-24 years admitted to two selected hospitals in Sri Lanka
(Sri Lanka College of Microbiologists, 2015) Sigera, L.S.M.; Perera, J.; Samaranayake, D.; Ediriweera, E.P.D.S.
INTRODUCTION: Pertussis continues to circulate in the community and cases among adolescents and adults have been increasing. Waning of pertussis-specific immunity following natural infection or immunisation may contribute to the persistent circulation. Even though it is not included in the extended programme of immunization in Sri Lanka, the booster doses including the adolescent booster dose of dTap, (acellular pertussis) are included into the list of recommended immunizations in several countries. Even though the protective titre yet not established, information on immunity to pertussis in this age group is needed before any vaccination policy can be considered. OBJECTIVES: To determine the antibody levels against pertussis toxin to determine the need and the optimal age for booster immunization. METHODS: The quantitative determination of specific IgG antibodies to Bordetella pertussis toxin was done by the ELISA using sera of 385 asymptomatic individuals aged 4-24 years admitted to surgical units of Lady Ridgeway Hospital, Colombo and Colombo South Teaching Hospital, Kalubowila. Mann-Whitney U test and Kruskal-Wallis test were used in analysis and p<0.05 was taken as significant. RESULTS: Median age was 12 years (IQR 8-19) with 212 (55.1 %) females. The median (IQR) anti PT antibody level was 3.31 lU/ml (0.73-15.12) and 352 (91%) had anti PT level <55 ID/ml. Median {IQR) anti PT levels were 3.18 ILJ/ml (0.591 -8.00) for 4-7 years, 1.43 Ill/ml (0.336-6.27) for 8-11 years, 4.28 lU/ml (0.978-13.39) for 12-15 years, 6.14 lU/ml (1.44-63.25) for 16-19 years and 4.89 lU/ml {1.11 -16.78) for 20-24 years and all of these difference were statistically significant (Spearman Correlation Coefficient P=0.0121). Females (p<0.003) and those having a sibling above 12 years (p=0.017) had significantly higher anti PT lev els. CONCLUSION: The majority of the study population, especially 8 to 11 years age group had very low anti PT IgG levels. The infection may occur in early adolescents, A booster dose of acellular pertussis vaccine could be considered.
Bordetella pertussis serological profile among asymptomatic individuals aged 4-24 years.
(Sri Lanka Medical Association, 2014) Sigera, L.S.M.; Perera, J.; Samaranayake, D.; Ediriweera, E.P.D.S.
INTRODUCTION AND OBJECTIVES: To determine the antibody levels against pertussis toxin to determine the need and the optimal age for booster immunization. METHODS: The quantitative determination of specific IgG antibodies to Bordetellajiertussistox'm was done by the ELISA using sera of 385 asymptomatic individuals aged 4 -24 years admitted to surgical units of Lady Ridgeway Hospital, Colombo and Colombo South Teaching Hospital, Kalubowila. Mann-Whitney U test and Kruskal-Waliis test were used in analysis and p<0.05 was taken as significant. RESULTS: Median age was 12 years {IQR 8-19) with 212 (55.1%) females. The median (1QR) anti PT antibody level was 3.31 lu/ml (0.73-15.12) and 352 (91%) had anti PT level <55 lU/ml. Median {IQR) anti PT levels were 3.18 ILJ/ml (0.591-8.00) for 4-7 years, 1.43 lU/ml (0.336-6.27) for 8-11 years, 4.28 lU/ml (0.978-13.39) for 12-15 years,6.14 lU/ml (1.44-63.25) for 16-19 years and 4.89 lU/ml (1.11-16.78) for 20-24 years and this difference was statistically significant (p=0.000). Females (p<0.003) and those having a sibling above 12 years (p=0.017) had significantly higher anti PT levels. CONCLUSIONS: The majority of the study population, especially 8 to 11 years age group had very low anti PT IgG levels. The infection may occur in early adolescents. A booster dose of acellular pertussis vaccine could be considered.
Can a composite index predict ischaemic heart disease risk?
(Sri Lanka Medical Association, 2012) Ediriweera, E.P.D.S.; Samita, S.
INTRODUCTION: Ischaemic heart diseases (IHD) are the leading cause of death worldwide and it accounts for 12.2% of the total deaths globally. Although the individual risk factors of IHD are well understood, the possibility of predicting the risk of IHD of an individual at a given time is less understood. Aims: To develop an index to predict the risk of IHD based on individual biological parameters. Methods: Secondary data of 217 individuals were analysed. Multivariate and logistic regression techniques were used to construct a composite index (CI) based on standardised measurements of lipid profile, fasting blood sugar, systolic and diastolic blood pressure. Two sample ttest and 95% confidence interval based on composite index scores were used to compare the two groups and define a cutoff point. Results: Mean [±SE] of the CI scores for undiagnosed and diagnosed IHD individuals were 0.013 [+0.014] and -0.1 [±0.041] respectively. The mean scores of the two groups were significantly different (p=0.008) and the confidence intervals for undiagnosed and diagnosed groups were -0.181 to -0.019 &-0.016 to 0.042 respectively. Accordingly, cut off point was estimated as - 0.018. CONCLUSIONS: The CI score can be used to distinguish those who are at risk from those who are risk free. Since the CI is based on several variables, the tests are more powerful compared to those based on individual variables. The CI approach has to be evaluated in several other study settings for verification. With some detailed studies, working cut off point can be established.
Comparison of hazard of death following surgery for colon versus rectal cancer
(Sri Lanka Medical Association, 2016) Ediriweera, E.P.D.S.; Kumarage, S.; Deen, K.I.
INTRODUCTION: Prognosis in cancer is usually assessed by use of Kaplan-Meier survival function estimate curves, which reflect survival, or the proportion of patients that will remain alive after a particular event at a given time. By contrast, hazard function represents the proportion expected to be deceased among those surviving at a given time after an event. OBJECTIVES: To evaluate survival and hazard of death, in patients with colon cancer (CC) and rectal cancer (RC), as indices of prognosis. METHODS: Colon and rectal cancer patients who underwent surgical resection with curative intent from 1996 to 2011 were studied. The hazard of death and survival patterns were assessed with Weibull Hazard models and Kaplan- Meier survival function estimate curves. RESULTS: There were 119 CC and 250 RC patients included in the study. Median (Inter-quartile range: IQR) age of both groups was 58 (49 - 66.5) years. The median (IQR) followup time was 30 (12 - 72) months for CC and 30 (13 - 70) months for RC. Both groups were similar in comparison with regard to age (p=0.96), gender (p=0.56), tumour stage (p=0.33), vascular invasion (p=0.69), lymphatic invasion (p=0.33), perineural invasion (p=0.94), degree of tumour differentiation (p=0.38) and preoperative carcinoembryonic antigen levels (p=0.77). CC showed better overall survival compared to RC (p=0.03) with a 5-year survival rate of 72% versus 60% respectively. After curative resection, CC showed a 6% decrease in hazard of death with time compared with RC which showed a 1% increase in the hazard of death with time. CONCLUSIONS: Among patients who underwent resectional surgery, CC had a better prognosis than RC.
Computer literacy among new medical entrants to the Faculty of Medicine, University of Kelaniya
(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2016) Hettige, S.; Gunarathne, M.G.S.S.; Ediriweera, E.P.D.S.
BACKGROUND: Computer literacy is essential for students. OBJECTIVES: To assess the level of computer literacy among new entrants to the Faculty of Medicine, University of Kelaniya. METHODS: Moodle based self-administered questionnaire was given new entrants (159 in 2015 and 147 in 2016). RESULTS: The results are described according to the 2015 (n=159) and 2016 (n=147) batches respectively. Proportions who had used computers were 99% (n=157) and 98% (n=144). Those who had formal training in computer literacy were 68% (n=108) and 65% (n=96) and 46% (n=73) and 45% (n=66) were in possession of paper qualifications related to the training undergone. Proportions who used computers daily were 19% (n=31) and 31% (n=46) and 9% (n=14) and 13% (n=19) used it ≤once/month. Students’ perceptions on their ability to use computers were as follows: 1) Competent - 14%(n=23) and 17% (n=25), 2) Average - 75%(n=119) and 78%(n=114) and 3) Poor - 11%(n=17) and 5%(n=8). Relevance of computer literacy for medical students was as follows: 1) Essential - 48%(n=77) and 56%(n=82), 2) Very important - 42%(n=66) and 36%(n=53) and 3) Reasonably important - 9%(n=15) and 8%(n=12). Only two (1%) students from 2015 batch stated that computer literacy is of very little important to function as a doctor. CONCLUSIONS: Majority had used computers before entering the Medical Faculty and almost two thirds has had formal training and less than one half had paper qualifications on computer literacy. Majority believed computer literacy is important for them as medical students as well as doctors.
Effectiveness of prophylactic central compartmental neck dissection in papillary thyroid cancer
(College of Surgeons of Sri Lanka, 2015) Atulugama, N.S.; Bandaranayake, B.M.V.C.; de Silva, G.K.S.; Ariyapala, K.S.K.; Ediriweera, E.P.D.S.
INTRODUCTION: Standard treatment for Papillary thyroid cancer is Total Thyroidectomy (TT) and selective block dissection for node positive disease. Incidence of central compartmental nodal (CCN) involvement esimated to be 30-70% though preoperative staging is suboptimal due to anatomical location. Therefore, many advocate Prophylactic Central Compartmental Neck Dissection (PCCND) as a staging and therapeutic procedure, but others believe no added therapeutic value despite higher incidence of complications. MATERIAL AND METHODS: All pathological reports of patients who have undergone TT with PCCND for Papillary thyroid cancer in a single unit from 2014 January to 2015 June was collected and entered into a database. Clinical node negativity was considered when both examination and pre-op USS was negative. This is a single unit experience and our routine practice is to do PCCND in all clinically node negative disease patients. Pearson's chisquare test and Fishers exact statistical tools were used to assess predictors of CCN involvement. P < 0.05 was considered as significant. RESULTS: Total of 27 cases found and 20 (74%) cases didn't reveal a single positive node. Nineteen had unifocal disease of thryroid and only 5 (26%) had ipsilateral CCN positivity. Six patients had multifocal disease and 3 had positive CCN disease. Positive predictors of CCN: Clinical stage, Multifocal disease, Histological type, Vascular invasion and age are not significantly associated. Fourteen (52%) patients had at least 1 parathyroid gland included in the specimen. CONCLUSIONS: Nearly 3/4 of patients undergo unnecessary PCCND. Further studies are needed assess the predictors of CCN involvement.
The hazard of death decreases after surgical treatment for colon cancer but not after surgical treatment for rectal cancer
(Sri lanka Medical Association, 2015) Ediriweera, E.P.D.S.; Deen, K.I.
INTRODUCTION AND OBJECTIVES: Prognosis in cancer is usually assessed by survival patterns. In this study we evaluated both survival patterns and hazard of death as indices of prognosis to compare colon and rectal cancer. METHOD: Colon and rectal cancer patients who underwent surgical resection from 1996 to 2011 were studied using Kaplan-Meier survival function estimate curves and Weibull Hazard models. RESULTS; Of 369 patients {119 (32%) colon cancer and 250 (68%) rectal cancer), overall 5-year survival rate for colon and rectal cancer was 72% and 60% respectively (P = 0.03). For colon cancer, survival indices diminished when tumor disseminated outside the region of the colon (Stage IV), while in rectal cancer survival indices reduced as cancer progressed from stage I to I! and beyond. As expected, stage for stage survival for colon and rectal cancer were similar for stages 1 and IV (Stage 1, 5 year survival colon vs. rectum; 77% vs. 82% and stage IV; 25% vs. 22%). However, survival in intermediate stages (stage II and stage III) was better for colon cancer compared to rectal cancer (Stage M, 5 year survival colon vs. rectum; 81% vs. 62% and stage III; 70% vs. 55%). After curative resection, colon cancer showed a 6% decrease in hazard of death with time compared with rectal cancer which showed a 1% increase in the hazard of death with time. CONCLUSION: Overall, underwent curative resection, colon cancer had better survival indices compared with rectal cancer.
Health seeking behavior of snakebite victims in Sri Lanka: findings from an island-wide community-based study
(Sri Lanka Medical Association, 2014) Kasturiratne, A.; Pathmeswaran, A.; Gunawardena, N.K.; Ediriweera, E.P.D.S.; Wijayawickrama, B.A.; Jayamanne, S.F.; Isbister, G.; Dawson, A.; Lalloo, D.G.; de Silva, H.J.
INTRODUCTION AND OBJECTIVES: Health seeking behaviour of snakebite victims in the community has rarely been described and we investigated this as part of a community-based island-wide study on snakebite in Sri Lanka. METHODS: The national snakebite study was conducted in a!! 25 districts, in SriJ_anka in 2012/2013. 44,136 households were sampled in randomly selected clusters. In these households, any member reported to have experienced a snake bite within the preceding 12 months was considered a case. Data related to the health seeking behavior of snakebite were obtained using an interviewer-administered questionnaire. RESULTS: Among 165,665 individuals surveyed, 695 (60% males; median age 43 years) snakebite victims were identified. 323 (46.5%) had evidence of envenoming. 682 (98.2%) had sought health services after the bite. 381 (54.8%) sought allopathic medicine and 99.7% of them obtained this service from the state health sector, while 43.3% sought alternative medicine. The lowest rates of seeking allopathic medicine were seen in the Kalutara (8.7%) and Kegalie (10.7%) districts while highest rates were seen in the districts Mannar, Mullativu and Kilinochchi (100%). Puttalam (92.9%), Vavuniya (92.3%},) Ampara (89.5%), Jaffna (88.9%) and Anuradhapura (86.0%) also had high rates. 70.1% of the victims with envenoming sought allopathic medicine. Victims who had envenoming were significantly more likely to seek allopathic medicine (OR=3.35; 95% confidence interval 2.44-4.59) than those without envenoming. CONCLUSIONS: A considerable proportion of snake bite victims still seek alternative medicines in Sri Lanka.'A wide variation of practices exists across the country. Victims with envenoming are more likely to seek allopathic medicine.
ICT literacy among new medical entrants
(Sri Lanka Medical Association, 2016) Dassanayaka, I.P.E.U.; Bandara, M.R.P.M.; Hettige, S.; Ediriweera, E.P.D.S.
INTRODUCTION AND OBJECTIVES: The ICT literacy has become a fundamental cornerstone of modern education, learning and health care delivery. This study aimed to evaluate the prior exposure on Internet, Email, Microsoft Office package, Social Networking (SN), Internet telephony (IT) and Cloud Storage Services (CSS) among new entrants to Faculty of Medicine, University of Kelaniya. METHOD: Moodle based self-administered questionnaire was given to new entrants during the orientation program. RESULTS: The results are described according to the 2015 (n=159) and 2016 (n=147) batches respectively. 99% had accessed Internet previously (n=157 and n=146, P=0.6). Those who surfed Internet daily were 42% (n=53, n=74, P<0.01)95% had email accounts (n=146, and n=144, P=0.02). 13% accessed emails daily (n=21 and n=19, P=0.94). 57% used CSS (n=82, n=92, P=0.05) and 94% had been SN (n=149, n=135, P= 0.53) and 62% used IT (n=99 n=99, P= 0.35). 98% had used MS WORD (n=156, n=143, P=0.63), 82% had used MS EXCEL (n=130,n=132,P=0.05) and 96% had used PPT (n=153,n=137,P=0.23) before entering to the University. There was no significant difference between usage of WORD and PPT (P=0.06) but significantly lower usage of EXCEL compared to WORD (P<0.01) and PPT (P=0.01). CONCLUSIONS: Majority of students had used internet and internet based services including email, CSS, SN, IT. Their exposure to MS office package was satisfactory. Daily Internet browsing and utilizing email were significantly (p<0.01 for each batch) lower in comparison to the number utilizing the services.CSS and IT we e not popular when compared to other services.
Implementation of an Online Histopathology Reporting System in the Department of Pathology, Faculty of Medicine, University of Kelaniya
(19th Conference on Postgraduate Research, International Postgraduate Research Conference 2018, Faculty of Graduate Studies,University of Kelaniya, Sri Lanka, 2018) Hettiarachchi, W.G.; Ediriweera, E.P.D.S.; Mahendra, B.A.G.G.; Liyanage, S.K.; Hewavinsenthi, S.J.D.S.; Ratnayake, R.M.U.S.
The Department of Pathology, Faculty of Medicine, University of Kelaniya provides histopathology reporting for the Colombo North Teaching Hospital (NCTH) as an honorable service. The department currently uses a standalone Microsoft access database to generate reports and it has limited data retrieval capabilities. A newer system was required to address the issues faced, mainly a prolonged turnaround time caused by lack of clinical data, inability to track delays in sample processing, delays in data entry and report dispatch. More efficient data retrieval for research purposes and monitoring of postgraduate training were also considered important. The aim of the work was to implement anonline histopathology reporting system that has facility to track the reporting stage, postgraduate evaluation and data retrieval for researches. Every report is attached with a diagnostic code that can be used in research purposes. A web-based application was developed that has ability to capture data at each step from specimen receiving from the surgery theatre until dispatch of reports. The system has developed to easily customizable to different settings. Thus, it has facility to add new reporting templates, anatomical sites, surgical specimens or diagnostic codes to system through web forms. Data entry was facilitated by using drop down menus and prompts. Standard templates for reports with option to edit were uploaded enabling quick report generation. It facilitates postgraduate supervision by enabling the trainer to determine the time taken, quality and quantity of work done by the trainees. Mainly open source scripting languages and databases were used to developed the system: PHP, HTML 5, CSS Javascript, Ajax and MySQL. The system hosted on the faculty intranet and available 24/7 from anywhere at the faculty. The system supports both windows and androids operating systems and the system can be accessed in desktop and tablet computers using any commonly used modern web browsers.
Individual risk factors of snakebites in Sri Lankan community
(Faculty of Graduate Studies, University of Kelaniya, 2015) Ediriweera, E.P.D.S.; Pathmeswaran, A.; Kasturiratne, A.; Gunawardana, N.K.; Jayamanne, S.F.; de Silva, H.J.; Diggle, P.J.
Sri Lanka has 92 identified snake species, and one of the highest snakebite incidence (SBI) rates in the world. According to hospital statistics about 37,000 patients are admitted to government hospitals annually as a result of snakebite. The aim of the present study is to identify individual risk factors for snakebite in Sri Lanka. Methodology A community-based island-wide study (―National Snakebite Study‖) was conducted in all nine provinces of Sri Lanka, with 5,000 households sampled in each province. All the residents of the selected households were included. One-year recall data for all permanent residents of that particular household was obtained regarding the experience of snakebite. Generalized linear models were used to model SBI. Individual-level gender, age, ethnicity, religion, income, education and employment were included as explanatory variables. Statistical analysis used the R programming language. Statistical significance was assessed at the 0.01 level. Results and conclusions Out of 125,391 participants, 63,604 (50.7%) were males. There was no SBI difference amongst 10-year interval age groups from 30 to 59, hence these three age groups were collapsed. High SBI was observed in the age 30-59 year group compared to age less than 20 (P<0.001), 20 to 29 (P<0.001), 60 to 69 (P<0.003) and over 70 (P<0.007), with lower SBI in the two extreme age groups. Males had higher SBI compared to females (P<0.001). Field workers had higher SBI compared to non-field workers (P<0.001). Ethnicity and income showed a significant interaction. Low income non-Sinhalese had high SBI compared to middle income (Rs. 5000-19,999, P<0.001) and high income (Rs.>20,000, P=0.001) non- Sinhalese, whereas Sinhalese had high SBI irrespective of their income status. In summary, the high risk categories for snakebites are males, field workers, 30 – 60 year individuals, Sinhalese and low income non-Sinhalese.
Knowledge, Attitude and Practice of Cloud Storage among the Medical Students at Faculty of Medicine, University of Kelaniya
(19th Conference on Postgraduate Research, International Postgraduate Research Conference 2018, Faculty of Graduate Studies,University of Kelaniya, Sri Lanka, 2018) Hettige, S.; Hettiarachchi, W.G.; Solangaarachch, D.I.K.; Dasanayaka, I.P.E.U.; Ediriweera, E.P.D.S.
The rise of the healthcare spending on cloud services indicates the adaptation of the cloud technology in recent past. The aim of this study is to assess the attitudes and practice of cloud storage (CS) among the students at Faculty of Medicine, University of Kelaniya. Stratified sampling with proportional allocation was used to select students. Number of students selected from 1st to 5th year were 46, 49, 47, 50 and 43 respectively. A self-administered questionnaire was used to collect data after obtaining written informed consent. 261 returned questionnaires and 26 were removed due to incompleteness. Of 235, 75 (32%) were male students. 138 (59%) students were aware of CS, among them, 127 (92%) had used CS. 126 (54%) students believed CS is useful and 121(52%) students have used CS to save materials, among them (53%) for educational material, (36%) for personal information and (11%) for entertainment material. Among the students who were aware of CS, the main limiting factors of using CS were lack of time (40%) and knowledge (20%) and they were also concerned on limited accessibility (33%), lack of security (27%) and privacy (24%) in CS. Among the 41% who were not aware of CS, 74% mentioned that they would like to have training on CS and another 22% indicated that they are not interested on CS. The majority of students were aware of CS and lack of time and knowledge hinder CS usage. The accessibility, security and privacy are the main concerns about CS. Study shows majority of students are willing to learn on CS and teaching CS during undergraduate training would be beneficial to the students.
Mapping the risk of snakebite in Sri Lanka - A national survey with geospatial analysis
(Public Library of Science, 2016) Ediriweera, E.P.D.S.; Kasturiratne, A.; Pathmeswaran, A.; Gunawardena, N.K.; Wijayawickrama, B.A.; Jayamanne, S.F.; Isbister, G.K.; Dawson, A.; Giorgi, E.; Diggle, P.J.; Lalloo, D.G.; de Silva, H.J.
BACKGROUND: There is a paucity of robust epidemiological data on snakebite, and data available from hospitals and localized or time-limited surveys have major limitations. No study has investigated the incidence of snakebite across a whole country. We undertook a community-based national survey and model based geostatistics to determine incidence, envenoming, mortality and geographical pattern of snakebite in Sri Lanka. METHODOLOGY/PRINCIPAL FINDINGS: The survey was designed to sample a population distributed equally among the nine provinces of the country. The number of data collection clusters was divided among districts in proportion to their population. Within districts clusters were randomly selected. Population based incidence of snakebite and significant envenoming were estimated. Model-based geostatistics was used to develop snakebite risk maps for Sri Lanka. 1118 of the total of 14022 GN divisions with a population of 165665 (0.8%of the country’s population) were surveyed. The crude overall community incidence of snakebite, envenoming and mortality were 398 (95% CI: 356–441), 151 (130–173) and 2.3 (0.2–4.4) per 100000 population, respectively. Risk maps showed wide variation in incidence within the country, and snakebite hotspots and cold spots were determined by considering the probability of exceeding the national incidence. CONCLUSIONS/SIGNIFICANCE: This study provides community based incidence rates of snakebite and envenoming for Sri Lanka. The within-country spatial variation of bites can inform healthcare decision making and highlights the limitations associated with estimates of incidence from hospital data or localized surveys. Our methods are replicable, and these models can be adapted to other geographic regions after re-estimating spatial covariance parameters for the particular region.
North Colombo diverticular disease snap shot audit (VISTA study): a collaborative research initiative
(The College of Surgeons of Sri Lanka, 2023) Chandrasinghe, P.; Ediriweera, E.P.D.S.; Niriella, M.; Ranwaka, C.; Fernando, A.; Gunawardena, H.; Kumarage, S.
INTRODUCTION Diverticulosis and diverticular disease (DD) is a common occurrence in clinical practice in the local setting with a lack of documented literature. A snapshot audit was conducted at North Colombo Teaching Hospital (NCTH) to ascertain the disease burden in clinical practice as a pilot study to assess feasibility and response rate for a nation wide snapshot audit. METHODOLOGY All surgical and gastroenterology units at NCTH were requested to enter the data between 1st January 2022 to 30th of June 2022 on all patients presenting with DD or those detected with diverticulosis during screening colonoscopy. Prospective data collection was done using RedCap© data capturing platform. RESULTS Out of the 8 units invited (general surgery – 5, GI surgery – 1, gastroenterology – 2), 5 units participated (general surgery – 2, GI surgery – 1, gastroenterology – 2); response rate is 62%. A total of 46 patient records (median age- 68 years; range 29- 86; female 51%) were received within 6 months. Of the total 54.3% had symptomatic uncomplicated diverticular disease (SUDD) while 33% were detected with diverticulosis at screening. Only 13% (n=6) required inward care (bleeding – 3, diverticulitis – 2, perforation – 1) and detected using colonoscopy in 4 and CT scan in 2. In the DD group, 20% (6/31) had complicated DD while 80% had Symptomatic Uncomplicated Diverticular Disease (SUDD). CONCLUSION In this pilot study, a majority of the patients with DD presented with SUDD while around 20% came with complicated DD. The response rate from collaborators was satisfactory. The secure online database usage is feasible and will be used for a national level study in the future to assess the disease burden in the healthcare setting in Sri Lanka.
Open Educational Resources (OER) and Social Media (SM) for Academic Information Seeking at Faculty of Medicine, University of Kelaniya
(International Postgraduate Research Conference 2019, Faculty of Graduate Studies, University of Kelaniya, Sri Lanka, 2019) Hettige, S.; Wickramaarachchi, G.K.; Dasanayaka, I.P.E.U.; Ediriweera, E.P.D.S.
Use of Open Educational Resources (OER) and Social media (SM) for academic information seeking is a common practice among modern undergraduates. There are limited data in Sri Lanka on OER and SM use as educational tools. This study aimed to evaluate the use of OER and SM for academic purposes among the medical students at Faculty of Medicine, University of Kelaniya. We undertook a cross sectional study at the Faculty of Medicine, University of Kelaniya. Stratified sampling with proportional allocation was used to select students from each batch and 287 students were recruited from 1st to 5th year. Informed written consent was obtained and a self-administered questionnaire was given. The questionnaire consisted of questions on OER and SM use in academic activities along with the frequency of usage. 257completed questionnaires were analyzed. Of 257 (89.6%) respondents, 185 (72.0%) were females. The OER and SM use in education were 92.5% (95%CI: 89.3% - 95.8%) and 89.0% (95%CI: 85.2% - 92.6%) respectively. Both findings were not significantly different by gender or between academic years. The reasons for using OER in education included: the availability of information at any time (38.1%), easiness to search (33.9%), availability of detailed information (17.3%) and updated information (7.2%). Wiki sites (89.0%) were the most popular OER followed by Slide Share (37.2%) and e-journals (20.3%). 3.8% participated in medical forums. 53.4% believed information in wikis are reliable. Facebook (79.8%) was the commonest SM platform followed by YouTube (60.3%) and Google+ (50.2%). 79.0% used SM to follow the medical related web sites. 76.3% used SM to join education groups. 41.2% used SM in academic discussions and sharing information with group of foreign students. 35.8% could not find academic information via SM due to the information overload. 31.1% mentioned that the SM disturbed concentration on their academic works. 12.5% did not trust the contents in SM. Students also searched the web to find the information. 58.9% trusted the information without considering the source and only 36.4% specifically searched the information in educational and government related sites. Majority of students have used OER and SM for academic purposes. Wiki sites and Facebook were the most popular OER site and SM platform among students. Majority students trusted the information found on web search without considering the credibility of sources. E-journals are not popular among students. The majority had followed the medical related web sites and joined educational groups via SM. Disturbances to academic works and difficulty in finding accurate information were major concerns in using SM. This study highlights the importance of improving information literacy among the medical students
Opportunities and challenges to reduce weight among knee osteoarthritis patients
(Sri Lanka Medical Association, 2018) Dilina, A. K. N.; Ediriweera, E.P.D.S.
INTRODUCTION AND OBJECTIVES: Osteoarthritis (OA) is the single most common cause of disability in older adults and overweight is a major risk factor of OA. Weight reduction is important to treat OA and it is important to understand the knowledge and attitudes among OA patients to implement interventional programs. 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 and anthropometric assessments were done. RESULTS: Median age of the patients was 57 (IQR: 50 - 65) years and 235 (92%) of them were females. 21 % mentioned that they do not want to reduce weight, of them, 41 % were overweight and 8% were obese. 19% wanted to reduce weigh due to disfiguration and 75% of patients knew overweight is related to OA, however, less than 35% knew the association between overweight and diabetes, hypertension and psychological disturbances. 25% did not know the causes for overweight and 45% believed it was familial. Only 43%, 41% and 38% mentioned that heavy meals, meals with high fat and sugar and lack of activity/exercise cause overweight/obesity respectively. 56% believed exercises were bad for OA and 40% did not know the suitable exercises. 8% mentioned that they felt embarrassed to exercise and 14% did not have time. CONCLUSION: There are considerable misconceptions of overweight and weight management among OA patients and one fifth did not want to reduce weight. It is important to conduct educational programs for these patients and encourage weight reduction.
Outcome of children transported for pediatric intensive care to a tertiary care setting in Sri Lanka
(Sri Lanka College of Paediatricians, 2016) Adhihetty, D.; Kitulwatte, N.C.; Hathagoda, K.L.W.; Weeraratne, C.T.; de Silva, S.; Ediriweera, E.P.D.S.
INTRODUCTION: Patient transport remains a necessary facet of today’s health care environment and transport conditions bear a major impact on the outcome. There is a recent move in Sri Lanka to establish retrieval teams. Thus, identifying problems faced by the present system will be of utmost importance in development of transport teams. OBJECTIVE: To evaluate the present system of transportation of sick children to the Medical Intensive Care Unit (MICU), Lady Ridgeway Hospital for Children (LRH), Colombo. METHOD: A prospective, descriptive, observational study of transferred patients was conducted at the MICU LRH, Colombo. All children admitted to MICU from 1st March 2014 to 1st June 2014 were included in the study. Data was collected using a self-administered questionnaire. The Wilcoxon significant rank test and the Chi squared test were utilized in statistical analysis. RESULTS: There were 200 patients comprising 105 (52.5%) out-of-hospital transfers and 95 (47.5%) in-hospital transfers. Of the admissions, 72% were live discharges while 28% expired; 42.5% of transfers were from the Colombo district. Pneumonia was the commonest diagnosis, occurring in 38.5%. The pre-transfer Paediatric Risk Mortality (PRISM) scores had a median of 12, mean of 13.7±7.8 and Q1-8 to Q3-18. The 12 hour PRISM scores, after excluding patients with PRISM scores of less than 5, showed a median of 14, mean of 18.5±11.7 and a ‘p’ value 0.0002. There was no outcome difference between in-hospital vs out-of-hospital transfers based on the Chi squared test. A written summary was available only in 61 (30.5%) patients. CONCLUSION: A rise in the PRISM score after transfer indicates that the patients had deteriorated during the transfer and transfer conditions need to be improved.
Outcome of minimally invasive procedures for early breast cancer
(College of Surgeons of Sri Lanka, 2015) Atulugama, N.S.; Bandaranayake, B.M.V.C.; de Silva, G.K.S.; Ariyapala, K.S.K.; Ediriweera, E.P.D.S.
INTRODUCTION: Worldwide incidence of stage I breast cancer is around 41%. For primary breast lesions management trend has changed from mastectomy to breast conservation (BCS) and for axillary staging from routine nodal dissection (ALND) to Sentinel Lymph node Biopsy (SLNB) in clinically negative axillae. In many studies it has been proven that this paradigm shift has brought increase patient satisfaction with less morbidity and with same oncological outcome. MATERIAL AND METHODS: Patients with early breast cancer and clinically negative axillae were prospectively analysed in a single unit from January 2013. They were offered breast conservation or mastectomy (on patient's request) with SLNB. We used Isolated Methylene Blue technique (IMBT) for SLNB. All patients followed up for 2 years with standard surveillance protocol and data comprising of pre-op evaluation, surgical data, histological details and surveillance were recorded in a database. RESULTS: Total number of patients included were 253. BCS was offered for 157 (62.05%) patients. Ninety five (60.5%) had Primary closure, 49(31.2%) had Volume displacements and 15 (9%) had Volume replacements. Twenty eight patients needed re-surgery immediately due to inadequate margins and 14 ended up in mastectomy. Out of mastectomy patients 6 had TRAM and 4 had LD immediate reconstructions. Median age for BCS 53yrs and mastectomy 54yrs. Only 3 patients had axillary recurrences but no breast recurrences during the study period. CONCLUSIONS: BCS and SLNB with IMBT can be offered for early breast cancer patients with non-inferior oncological outcome compared to standard treatment of mastectomy and axillary clearance.