Browsing by Author "Kulasinghe, I.R.M.M."

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Cut-off Scores for International Consultation on Incontinence Modular Questionnaire on Vaginal Symptoms (ICIQ-VS) in Sinhala and Tamil
(Sri Lanka College of Obstetricians & Gynaecologists, 2017) Amarasekara, A.M.A.K.G.; Ekanayake, C.D.; Pathmeswaran, A.; Wijesinghe, P.S.; Liyanage, L.L.C.; Kulasinghe, I.R.M.M.; Perera, H.S.S.
INTRODUCTION: It is clinically beneficial to have cut-off scores for screening questionnaires, above which a patient can be referred for further evaluation at a specialist center especially in developing countries. OBJECTIVE: To calculate cut off scores for ICIQ-VS-Sinhala and ICIQ-VS- Tamil questionnaires. METHODS: The ICIQ-VS- Sinhala and ICIQ-VS-Tamil was administered to women attending the gynaecology clinics at North Colombo teaching hospital, Ragama, District General hospitals, Mannar and Vavuniya. The vaginal symptoms score (VSS), sexual symptoms score (SSS) and the quality of life score (QoL) were analysed against the clinician’s diagnosis of significant prolapse using receiver operating characteristic curves (ROC). Results: The AUC (area under curve) for ROC curves of VSS, SSS and QoL for ICIQ-VS-Sinhala were 0.89 (p<0.001), 0.64 (p<0.02) and 0.75 (p<0.001) respectively. The AUC for ROC curves VSS, SSS and QoL of ICIQ-VS-Tamil were 0.88 (p<0.001), 0.70 (p<0.02) and 0.82 (p<0.001) respectively. The optimal MCIDs for ICIQ-VS-Sinhala were VSS ≥≥ 8 (sensitivity 88.1%, specificity 73.9%), SSS ≥ 1 (sensitivity 59%, specificity 65%), QoL ≥ 3 (sensitivity 77.8%, specificity 60.4%) while for ICIQ-VS-Tamil VSS ≥ 9 (sensitivity 87.1%, specificity 80.9%), SSS ≥ 1 (sensitivity 76.5%, specificity 61.1%) and QoL ≥3 (sensitivity 77.8%, specificity 79.8%). CONCLUSION: Both questionnaires yielded promising cut off scores for VSS, SSS and QoL. Cut-off scores of VSS ≥9, SSS ≥1 and QoL≥3 for ICIQ-VS-Tamil and VSS ≥8, SSS ≥1 and QoL ≥3 for ICIQ-VS-Sinhala can be used as a guide for specialist referral when using ICIQ-VS to screen for pelvic floor dysfunction in Sri Lanka.
Cut-off scores for international consultation on incontinence modular questionnaire on vaginal symptoms (ICIQ-VS) in sinhala and tamil
(Sri Lanka College of Obstetricians & Gynaecologists, 2017) Amarasekara, A.M.A.K.G.; Ekanayake, C.D.; Pathmeswaran, A.; Wijesinghe, P.S.; Liyanage, L.L.C.; Kulasinghe, I.R.M.M.; Perera, H.S.S.
INTRODUCTION: It is clinically beneficial to have cut-off scores for screening questionnaires, above which a patient can be referred for further evaluation at a specialist center especially in developing countries. Objective: To calculate cut off scores for ICIQ-VS-Sinhala and ICIQ-VS- Tamil questionnaires. METHODs: The ICIQ-VS- Sinhala and ICIQ-VS-Tamil was administered to women attending the gynaecology clinics at North Colombo teaching hospital, Ragama, District General hospitals, Mannar and Vavuniya. The vaginal symptoms score (VSS), sexual symptoms score (SSS) and the quality of life score (QoL) were analysed against the clinician’s diagnosis of significant prolapse using receiver operating characteristic curves (ROC). RESULTS: The AUC (area under curve) for ROC curves of VSS, SSS and QoL for ICIQ-VS-Sinhala were 0.89 (p<0.001), 0.64 (p<0.02) and 0.75 (p<0.001) respectively. The AUC for ROC curves VSS, SSS and QoL of ICIQ-VS-Tamil were 0.88 (p<0.001), 0.70 (p<0.02) and 0.82 (p<0.001) respectively. The optimal MCIDs for ICIQ-VS-Sinhala were VSS ≥≥ 8 (sensitivity 88.1%, specificity 73.9%), SSS ≥ 1 (sensitivity 59%, specificity 65%), QoL ≥ 3 (sensitivity 77.8%, specificity 60.4%) while for ICIQ-VS-Tamil VSS ≥ 9 (sensitivity 87.1%, specificity 80.9%), SSS ≥ 1 (sensitivity 76.5%, specificity 61.1%) and QoL ≥3 (sensitivity 77.8%, specificity 79.8%). CONCLUSION: Both questionnaires yielded promising cut off scores for VSS, SSS and QoL. Cut-off scores of VSS ≥9, SSS ≥1 and QoL≥3 for ICIQ-VS-Tamil and VSS ≥8, SSS ≥1 and QoL ≥3 for ICIQ-VS-Sinhala can be used as a guide for specialist referral when using ICIQ-VS to screen for pelvic floor dysfunction in Sri Lanka.
Fetal cardiac ultrasonography: An optimum gestational age of assessment
(Sri Lanka College of Obstetricians & Gynaecologists, 2017) Perera, M.N.I.; Kulasinghe, I.R.M.M.; Dias, T.D.
OBJECTIVES: To identify the ability of acquiring fetal cardiacimages at different gestational age windows using ultrasound scan. DESIGN, SETTING AND METHOD: This was a prospective descriptive study using ultrasound machine “Alpinion EC-15 V4.0” and “Toshiba Aplio 300”. Fetal cardiac views at gestational age from 11 to 30 weeks were obtained by an expert in obstetric fetal echo. Low risk women with singleton pregnancy were recruited. The sample was stratified into 5 gestational age windows between 11 and 28 weeks. Ability to view four chambers, right and left out flow tracts, three vessels, aortic arch, ductal arch and superior and inferior vena cavae at each gestational window was assessed. RESULTS: A total of 313 pregnant women were analyzed. All seven fetal cardiac images were obtained at the gestational age of 18 weeks to 25+6. There was a sub-optimal acquisition of the three vessels and SVC/IVC (96.3%) at 26-30 weeks. Six out of seven cardiac images were possible in more than 80% of cases from 14 to 17+6 weeks. At the gestational age between 11 weeks to 13+6, the ability to view four chambers was 92.98% and the ability to view the rest of the images was as follows: right out flow tract – 38.6%, left outflow tract – 42.11%, three vessels - 38.6%, aortic arch- 36.84%, ductal arch- 35.09%, superior and inferior vena cavae-5.26%. CONCLUSION: Ability of acquiring fetal cardiac views was best at 18 to 25+6. Cardiac image acquisition is sub optimum in early gestations and beyond 26 weeks.