Browsing by Author "Jayasinghe, Y.C."

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Acute poisoning in the paediatric age group in North-Central province of Sri Lanka
(Sri Lanka Medical Association, 2013) Dayasiri, M.B.K.C.; Jayamanne, S.F.; Jayasinghe, Y.C.
INTRODUCTION AND OBJECTIVES: There is little data on poisoning in the paediatric age group in the North Central Province (NCP) of Sri Lanka. Objective of this study was to identify characteristics, risk factors and outcome of poisoning in the paediatric age group in the NCP. METHODS: All children presenting with either accidental or deliberate poisoning, to all paediatric casualty units at the Anuradhapura and Polonnaruwa Teaching Hospitals, over a period of 8 months from March 2012 were studied. Information was obtained from clinical interviews, focus group discussions, clinical observation and clinical records. RESULTS: Of the 167 children, 53% were male and 91% were below six years of age. Parents were agricultural workers in 25% and 51% had been educated up to GCE O' Level. Poisoning was mainly accidental (97%). Commonest poison was kerosene oil (24.9%). Reasons for delay in seeking medical help included lack of transport (14%), poor knowledge (12%), lack of awareness regarding urgency (12%) and financial constraints (8%). Complications included acute liver injury (4.2%), chemical pneumonitis (3.6%), and convulsions (1.8%). There were no deaths. Inadequate supervision by parents 87.5%, improper storage of household chemicals 52% and medicines 40% were common risk factors. CONCLUSIONS: Acute poisoning in children mostly occurred due to inadequate supervision by parents and improper storage of chemicals and medicines. Community education and safe storage of chemicals and medicines will reduce the incidence of poisoning in the paediatric age group.
Markers of metabolic syndrome among 14 year old adolescents in the Ragama Medical Officer of Health area
(Sri lanka Medical Association, 2015) Jayasinghe, Y.C.; Kasturiratne, A.; Niriella, M.A.; Kottahachchi, D.C.; Rajindrajith, S.; Pathmeswaran, A.; de Silva, H.J.; de Silva, S.T.
INTRODUCTION AND OBJECTIVES: Metabolic syndrome (MetS) is strongly associated with cardiovascular disease and diabetes. Local data on MetS do not cover the adolescent population. Our study describes clinical and biochemical markers of metabolic syndrome among adolescents in the Ragama Medical Officer of Health area. METHOD: Fourteen year old adolescents resident in the Ragama Medical Officer of Health area were invited to the study through the public health network. Socio-demographic and anthropometric data of adolescents who presented were collected by trained data collectors. Relevant bio-chemica! assays were conducted in the fasting state. Prevalence of identified markers of the MetS was determined. RESULTS: 508 adolescents participated [263 (51.8%) girls]. The median age at menarche among the girls was 12 years. 46 (18.8%) boys and 55 (20.9%) girls had a BM1 greater than age-sex equivalent of 23 kgrrr2 in adults. 39 (15.9%) boys and 95 (36.1%) girls had a waist circumference above the MetS cut-off for age and sex. 17 (6.9) boys and 16 (6.1%) girls had elevated triglycerides while none had decreased HDL. Two (0.8%) girls had fasting plasma glucose above lOOmg/dl. Eight (3.3%) boys and six (2.3%) girls had elevated blood pressure. One girl was positive for three of the five diagnostic criteria of MetS giving a prevalence of 2 per 1000. Only 190 (77.6%) boys and 159 (60.5%) girls were free of alt five markers of MetS. CONCLUSION: Our findings show that markers of MetS are prevalent in this urban adolescent population. These data provide a basis for planning interventions at community and school level.
Patterns and risk factors of acute poisoning among children in rural Sri Lanka
(Sri Lanka Medical Association, 2014) Dayasiri, M.B.K.C.; Jayamanne, S.F.; Jayasinghe, Y.C.
INTRODUCTION AND OBJECTIVES: This controlled prospective study identifies the patterns and risk factors of acute poisoning in the paediatric age group in rural Sri Lanka. METHODS: All children presenting with a history of acute poisoning to the paediatric units of Anuradhapura Teaching .Hospital were included. Age and gender matched controls without any identifiable chronic medical conditions were recruited from the same population over the same duration. Data were collected using clinicai interviews, focused group discussions, and Bed Head Ticket based records over a period of eighteen months from March 2012 to September 2013. RESULTS: Analysis was based on 307 children with acute poisoning and 250 controls. Sixty percent of children with acute poisoning were males and most were between 2-4 years (49%). Odds ratios were calculated for each of the 24 risk factors proposed and each was used to create a logistic regression model together with age and gender. Application of Chi Square test in this model revealed inadequate supervision by the parents as the commonest risk factor (p< 0.001, Cl=95%) associated with acute poisoning. Other risk factors which showed a significant association (p< 0.001, Cl=95%) included unsafe storage of household chemicals, unsafe storage of medicines, poor extended family support, presence of poisonous plants in the neighborhood and poor maternal education. CONCLUSIONS: Children become victims of acute poisoning mostly secondary to inadequate supervision, unsafe environment and unsafe storage of poisons. As these risk factors are significantly associated with poisoning, community education, safe storage and assurance of safe environment should be evaluated.
Prevalence and risk factors for childhood wheezing in Ragama Medical Officer of Health area: an ongoing, community based study
(Sri Lanka Medical Association, 2013) Jayasinghe, Y.C.; Karunasekera, K.A.W.; Kumarendran, B.
INTRODUCTION AND OBJECTIVES:Atopic disease is an important public health problem and local data is essential for formulating treatment guidelines and policy planning . Objectives were to determine the prevalence and severity of wheezing among children less than 13 years of age, and to identify risk factors and triggers for wheezing. METHODS: The study commenced in September 2012 and is ongoing. The target study population was 3000 subjects. Data were collected using an interviewer administered questionnaire. RESULTS: There were 2411 participants, of them 388 (16.1%) were categorised as 'ever had wheezing', 226 (9.4%) had at least one wheezing episode within the past 12 months and 28 (1.2%) were currently having wheezing. Of those who 'ever had wheezing', 103 (27.4%) had activity induced wheeze or cough, 199 (52.8%) had nocturnal cough, 208 (55.2%) had wheezing on exposure to airborne allergens. In 94.7% symptoms improved with treatment, 60 (16%) deteriorated when treatment was stopped. Seasonal variation in wheezing, was seen in 215 (57.2%), 243 (72.5%) had wheezing with upper respiratory tract infection. Prematurity was a risk factor for 'ever had wheezing' (OR = 1.85, 95% CI: 1.2 -2.9). Paternal smoking during pregnancy (OR = 0.95, 95% CI: 0.8-1.2) or thereafter, was not a risk factor for wheezing. Wheezing was significantly associated with coexisting atopy, family history of atopy, and antibiotic usage during pregnancy. CONCLUSIONS: Prevalence of wheezing in our study is comparable to that in Asia of 16%. The risk factors and triggers of wheezing are similar to that in other studies. However we found no link between antenatal or postnatal exposure to cigarette smoke and childhood wheezing.
Prevalence and risk factors for Non-Alcoholic Fatty Liver Disease among an urban aging adult Sri Lankan population – Ragama Health Study 7-year follow up
(Sri Lanka Medical Association, 2015) Niriella, M.A.; Kasturiratne, A.; de Silva, S.T.; Perera, K.R.; Subasinghe, S.K.C.E.; Kodisinghe, S.K.; Priyantha, T.A.C.L.; Vithiya, K.; Kottachchi, D.; Ranawaka, U.K.; Jayasinghe, Y.C.; Rajindrajith, S.; Dassanayake, A.S.; de Silva, A.P.; Pathmeswaran, A.; de Silva, H.J.
INTRODUCTION AND OBJECTIVES: A previous community based study reported a prevalence of 33% for non-alcoholic fatty liver disease (NAFLD) among and urban adult Sri Lankan population. In this follow up study of the same population after 7 years, e reassessed the prevalence and risk factors for NAFLD. METHODS: The study population consisted of 42-71 year old adults, originally selected by stratified random sampling. NAFLD was diagnosed on established ultrasound criteria for fatty liver, safe alcohol consumption (<14 units/week for men, <7 units/week for females) and absence of hepatitis B and C markers. Anthropometric measurements, blood pressure (BP) and body fat distribution estimates were made. HbA1c, fasting serum lipids, serum alanine aminotransferase (ALT) and serum creatinine (SCr) with estimated glomerular filtration rate (eGFR) were determined. CKD was defined as eGFR<60ml/min/1.72m2 (KDIGO/KDOQI classification). RESULTS: of the 2985 original study participants, 2155(72.2%) (1244[57.7%] women, mean age 59.2 years [SD, 7.7]) participated in the present study. 1322 [mean age 58.9 years (SD, 7.6), 483(53.0%) men and 839(67.4%) women] had NAFLD. On multivariate analysis, obesity, abnormal body fat distribution, elevated systolic BP, raised plasma triglycerides, and low HDL were independently associated wth NAFLD. Raised diastolic BP, raised HbA1c, raised ALT and presence of CKD were not associated with NAFLD. CONCLUSION: The prevalence of NAFLD among adults in this aging urban Sri Lankan community has increased over 7 years and is independently associated with constituent features of the metabolic syndrome.
Prevalence of non-alcoholic fatty liver disease and its risk factors in an urban adolescent cohort in Sri Lanka
(Sri Lanka Medical Association, 2015) Jayasinghe, Y.C.; Rajindrajith, S.; Kasturiratne, A.; de Silva, S.T.; Niriella, M.A.; Perera, K.R.; Subasinghe, S.K.C.E.; Kodisinghe, S.K.; Priyantha, T.A.C.L.; Vithiya, K.; Pathmeswaran, A.; de Silva, H.J.
INTRODUCTION AND OBJECTIVES: High prevalence of non-alcoholic fatty liver disease (NAFLD) is reported among adults in Sri Lanka. Although limited data on childhood obesity is available, community prevalence of NAFLD and its risk factors among adolescents is unknown. We investigated the prevalence and risk factors for NAFLD in an urban adolescent birth cohort in Sri Lanka. METHODS: The study population consisted 14 year-olds, belonging to the birth cohort born in 2000, residing in the Ragama Medical Officer of Health area. NAFLD was diagnosed based on established ultrasound criteria. Anthropometric measurements, blood pressure (BP) and total body fat distribution (TBF) estimates were made. Fasting blood sugar, serum insulin, fasting serum lipid and serum alanine aminotransferase (ALT) levels were measured. Independent predictors of NAFLD were determined by multivariate analysis. RESULTS: 508 adolescents [263 (51.8%) girls] participated in the study. Overall 44 (8.7%) had NAFLD [22 (8.4%) girls]. 46 (18.8%) boys and 54 (20.5%) girls had a BMI above the equivalent of 23 kgm2in adults. 44 (17.1%) boys and 77 (29.3%) girls had elevated TBF. On multivariate analysis, having an elevated BMI [OR=10.1 (95% confidence interval: 3.9-29.2) and elevated TBF [OR=4.4 (95% confidence interval: 1.5-12.8)] were independently associated with NAFLD. CONCLUSION: The prevalence of NAFLD among adolescents in this urban Sri Lankan community is high, and is strongly associated with obesity and abnormal TBF. Despite elevated TBF being commoner in girls, we found no gender differences in prevalence of NAFLD among adolescents in this urban Sri Lankan community is strongly associated with obesity and abnormal TBF. Our findings emphasize the needs to access these risk factors through preventive and screening programs.
Snakebite in children: a two year retrospective review of victims admitted to a tertiary care hospital in sri lanka
(Sri Lanka College of Paediatricians, 2010) Jayasinghe, Y.C.; Kasturiratne, A.; Rajindrajith, S.; Samaraweera, S.A.S.G.; de Silva, H.J.
INTRODUCTION: Snakebite is an incident which causes great parental concern and medical unease, and envenomation is always more serious in a child. OBJECTIVE: To determine the pattern and characteristics of snake bites in children admitted to a tertiary care hospital in Southwest Sri Lanka. DESIGN, SETTING AND METHOD: A retrospective descriptive study was conducted to collect data on circumstances of the bite, clinical manifestations and management of paediatric victims of snakebite. Patient records of children admitted to the paediatric wards of Colombo North Teaching Hospital, Ragama, from January 2008 to December 2009 were reviewed. RESULTS: Our study population comprised 41 children (1.6 per 1000 admissions). Malerfemale ratio was 23:18. Mean age was 6 (SD=3.46) years. The bites were definite in 4 subjects and circumstantial (fang marks, signs of local and systemic envenomation) in the others. Twenty five (61%) were between 5 to 12 years of age. Nine (22%) bites occurred indoors and 13 (31.7%) in the home garden. In 12 (29.3%) the place of bite was not documented. In 42% the bite took place between 4pm-8pm. The snake species was identified by carers in 19 (46%) and confirmed by a doctor in 16 (39%) by identifying the dead snake. Of the 16 snakes brought for identification., 8 were hump-nosed vipers, 2 were Russell vipers, one was a krait and the rest were non-venomous species. Definite puncture marks were seen in 17 (41.4%) and were on the lower limbs in 11 (26.8%) and on the upper limbs in 6 (14.6%). First aid was given to 12 (29%) of the victims and the median time taken to reach hospital was 30 minutes (range 10 minutes to 15 hours). Nephrotoxicity developed in 1 (2.4%) (Russell viper bite). Antivenom was required by only 4 children in whom Russell viper bite was either suspected or confirmed. Three children developed reactions to antivenom. There were no deaths. None required intensive care. The median stay in hospital was 1 day (range 1-5 days) with 35 (94.6%) children being discharged home within 2 days. CONCLUSIONS: Snakebite in children was mainly diagnosed on circumstantial evidence, and mostly occurred in and around their homes. The outcome was good in all patients probably because the hump-nosed viper or non-venomous snakes were the offenders in most cases in this study.
Snakebites in children - a five year retrospective review of victims admitted to two hospitals in Sri Lanka
(Sri Lanka Medical Association, 2012) Jayasinghe, Y.C.; Kasturiratne, A.; Somaraweera, S.A.S.G.; de Silva, H.J.
INTRODUCTION: Snakebite in children causes great parental concern and medical unease. AIMS: To determine characteristics of paediatric snakebite in two hospitals, in the wet zone (Colombo North Teaching Hospital (CNTH) and dry zone (Base Hospital Polonnaruwa-BHP). METHODS: A retrospective study collected data on snakebite by reviewing records of children admitted to CNTH and BHP from January 2007 to December 2011. RESULTS: There were 188 snakebite victims (CNTH 71, BHP 117).Similarities in the two cohorts were (CNTH and BHP -M:F=35:36and 64:53; mean age 6 years (SD3) and 7 years (SD3); definite bites 30(53.6%) and 39(37.5%); circumstantial evidence in 57(80.3%) and 84(71.8%);time of bite: between 4- 8pm 42.6% and 47.2%. Majority of confirmed bites were HNV (60%) in CNTH and Kraits (30.8%) in BHP. Differences in the cohorts were :place of bite: in and around the home, median time from bite to hospital, administration of first aid, antivenom use, intensive care, median (range) duration of hospitalization and deaths (CNTH vs BHP): 37(56.9%) and 29(27.6%),35 vs 102.5 minutes, 21.4% vs 1%, 5.6% vs 17.1%, 1.4% vs 5.1%, 1 (1-7) days vs 2 (1-13), 0 vs 3.4% (Krait bites). CONCLUSIONS: Snakebites occur in ambulatory children, diagnosed mainly on circumstantial evidence and occur in and around homes irrespective of geographic location. Clinical features and outcome depend on offending species and availability of resources.
A study on adolescent sexual & violent behaviour, drugs & alcohol abuse and its relationship to the past experiences
(Faculty of Medicine, University of Kelaniya & Plan International, 2008) Mettananda, D.S.G.; de Silva, D.G.H.; Jayasinghe, Y.C.; Waduge, T.R.W.; Pathmeswaran, A.; Abeysinghe, A.P.S.D.
Trends in paediatric poisoning in the North-Central Province of Sri Lanka
(University of Kelaniya, 2013) Dayasiri, M.B.K.C.; Jayamanne, S.F.; Jayasinghe, Y.C.
Introduction and Objectives: Evidence of paediatric poisoning, which is preventable, has been lacking in North-Central province (NCP) of Sri Lanka. This study identifies the trends in paediatric poisoning in NCP including the risk factors, complications, and the outcome of acute poisoning. Methods: All children with acute, accidental or deliberate poisoning admitted to paediatric wards at Anuradhapura and Polonnaruwa teaching hospitals were included in the study. They were assessed using clinical interviews, focus group discussions, clinical observations and bed head ticket based records over a period of eight months from March 2012. Results: Among 167 children 53% were male and 91% were below six years. The majority of parents were agricultural workers (25%) and 51% had received education upto ordinary level. Accidental poisoning was predominantly observed (97%) and the commonest poison was kerosene oil (24.9%). Reasons for delayed medical care included lack of transport (14%) and knowledge (12%), lack of concern regarding urgency (12%) and financial problems (8%). Complications included acute liver injury (4.2%), chemical pneumonitis (3.6%), and convulsions (1.8%) with zero mortality. Risk factor analysis revealed inadequate supervision by parents (87.5%) as the commonest risk factor. Poor storage of household chemicals (52%) and medicines (40%) were more common compared to other risk factors. Conclusions: Children become victims of acute poisoning mostly due to inadequate supervision by their parents and unsafe storage of poisons. Because of poor storage of medicines, household chemicals are increasingly associated with accidental poisoning. Therefore, community education and safe storage will reduce the incidence of paediatric poisoning.
Trends in pediatric in Anuradhapura district: A 171 tertiary care center experience
(Faculty of Graduate Studies, University of Kelaniya, 2014) Dayasiri, M.B.K.C.; Jayamanne, S.F.; Jayasinghe, Y.C.; Senarathne, L.