Browsing by Author "Gunasekera, D.P.S."

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Effect of mebendazole therapy in pregnancy on birth outcome
(Lancet Publishing Group, 1999) de Silva, N.R.; Sirisena, J.; Gunasekera, D.P.S.; Ismail, M.M.; de Silva, H.J.
BACKGROUND: In areas endemic for hookworm, routine antenatal mebendazole therapy could greatly reduce the prevalence of anaemia in pregnancy. At present, however, this is not a widely accepted control strategy because of a lack of data on the safety of the drug. We assessed the effect of mebendazole therapy during pregnancy on birth outcome. METHODS: A cross-sectional study was done in Sri Lanka, where prescription of mebendazole to women in the second trimester of pregnancy is recommended. Two hospitals were chosen for the study, and women who gave birth there between May, 1996, and March, 1997, were recruited. We compared the rates of major congenital defects, stillbirth, perinatal death, and low birthweight (less or equal 1500 g) among babies of mothers who had taken mebendazole during pregnancy with those whose mothers had not taken an anthelmintic (controls). FINDINGS: The rate of major congenital defects was not significantly higher in the mebendazole group than in the control group (97 [1.8 percent] of 5275 vs 26 [1.5 percent] of 1737; odds ratio 1.24 [95 percent CI 0.8-1.91], p equal 0.39). Among 407 women who had taken mebendazole in the first trimester (contrary to medical advice), 10 (2.5 percent) had major congenital defects (odds ratio vs controls 1.66 [0.81-3.56], p equal 0.23). The proportions of stillbirths and perinatal deaths were significantly lower in the mebendazole group (1.9 vs 3.3 percent, 0.55 [95 percent CI 0.4-0.77]), as was the proportion of low-birthweight babies (1.1 vs 2.3 percent 0.47 [95 percent CI 0.32-0.71]). INTERPRETATION: Mebendazole therapy during pregnancy is not associated with a significant increase in major congenital defects, but our results indicate that it should be avoided during the first trimester. This therapy could offer beneficial effects to pregnant women in developing countries, where intestinal helminthiases are endemic.
Effects of hospitalization in children of parents working in foreign countries
(SAARC Psychiatric Federation, 2013) Kuruppuarachchi, K.A.L.A.; Wijeratne, L.T.; Gunasekera, D.P.S.; Karunasekera, K.A.W.
INTRODUCTION: Increasing number of females in Sri Lanka leave their families to work in the Middle East. This leads to disruption in the family structure and the attachment process. Effects of this can be long lasting and is likely to be seen at events that can be considered stressful in a child’s life. Admission to hospital has been shown to be a stressful experience for children. METHODOLOGY: Behavioural problems in hospitalized children who have one or more parent working in the Middle East were compared with hospitalized children who are not separated from their parents. The prevalence of deteriorating school performance and failure to gain weight were also compared in the two groups. RESULTS: Behaviours such as irritability, aggression, poor sleep and low mood were seen more in children who had one or more parent working in the Middle East. Deteriorating school performance and weight loss were also seen more in this group. CONCLUSION: Long term separation from a parent results in acute behavioural problems seen at times of stress as well as more long-term effects.
Psychological impact on children and families of middle east Workers
(Sri Lanka Medical Association, 2000) Karunasekera, K.A.W.; Kuruppuarachchi, K.A.L.A.; Gunasekera, D.P.S.
INTRODUCTION: Many Sri Lankans work in the Middle East leaving behind their children and spouses. This may lead to many psycho-social problems. OBJECTIVES: 1. Evaluate the association between behavioural symptoms of children and the Middle East employment of parents. 2. Detect the psycho-social impact on the remaining partner. METHOD: All consecutive children (n=88) who were admitted to the Professorial Paediatric Unit, Ragama Hospital, whose parents were employed in the Middle East were screened using a validated behavioural check list to detect behavioural problems in children over a period of 15 months from July 1996. Age- and sex-matched controls were used from the community (n=I55). Chi-squared test was used for statistical analysis. RESULTS: Following behavioural problems (equivalents) were associated with children whose parents were in the Middle East: avoiding people, weight loss, irritability, unacceptable tempertantrums and aggressiveness, sleep disturbances, social withdrawal, emergence of phobias, overactivity, poor school performances (p<0.01), and anorexia (p=0.02). The association of truancy was not significant (p=0.4). Amongst the remaining spouse (father), substance abuse (alcohol, cigarette and heroin) was significant (p<0.05) compared with the control. In families of Middle East workers, men were poorly educated (up to Grade 5) (p<0.05) compared with the control. CONCLUSIONS: This study shows that there was a significant relationship between behavioural equivalents of either depressive illness or emotional disorder of children whose parents were employed in the Middle East. Furthermore, the remaining spouse (father) tended to misuse substances. The majority of men in those families were poorly educated.