Browsing by Author "Kuruppu, C."

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Association between childhood constipation and exposure to stressful life events: a systematic review
(Blackwell Scientific Publications, 2022) Liyanarachchi, H.; Rajindrajith, S.; Kuruppu, C.; Chathurangana, P.; Ranawaka, R.; Devanarayana, N.M.; Benninga, M.A.
BACKGROUND: Several cross-sectional studies have reported an association between childhood constipation and exposure to stressful events. We planned to systematically review the literature on constipation and its associated stressful events. METHODS: PubMed, Embase, and PsycINFO databases were searched (until February 2021) using standard search terms related to "constipation" and "stress" from 0 to 18 years that describe the association between psychological stressors and constipation. Studies were screened using pre-designed eligibility criteria. Studies that fulfilled the criteria were reviewed in a full-text format. The quality assessment of selected articles was conducted using standard methods. KEY RESULTS: Of 2296 titles and abstracts screened, 38 were included in the full-text review. Out of that, 15 articles were included in this systematic review. There were 2954 children with constipation, and the age range was from 6 months to 16 years. Exposure to home-related stressors (divorce or separation of parents, severe illness in family, and parental job loss) school-related stressors (including being bullied at school, change in school, separation from the best friend at school, and failure in an examination), exposure to child maltreatments and exposure to war/civil unrest were associated with childhood constipation. CONCLUSIONS AND INFERENCES: Exposure to day-to-day home- and school-related stressors, to child maltreatment, and to civil unrest is associated with constipation in children and adolescents. These factors need to be explored during clinical evaluation of children with constipation. KEYWORDS: adolescents; child maltreatment; children; civil unrest; constipation; stress.
Epidemiology of aerophagia in children and adolescents: A systematic review and meta-analysis
(Public Library of Science, 2022) Rajindrajith, S.; Gunawardane, D.; Kuruppu, C.; Dharmaratne, S.D.; Gunawardena, N.K.; Devanarayana, N.M.
Background: Aerophagia is a common functional gastrointestinal disorder among children. The disease leads to symptoms related to air in the intestine leading to burping, abdominal distension, and excessive flatus. We aimed to perform a systematic review and a meta-analysis to assess the epidemiology of aerophagia in children. Methods: We conducted a thorough electronic databases (MEDLINE, EMBASE, PsycINFO and Web of Science) search for all epidemiological surveys conducted in children on aerophagia. All selected studies were assessed for their scientific quality and the extracted data were pooled to create a pooled prevalence of aerophagia. Results: The initial search identified 76 titles. After screening and in depth reviewing, 19 studies representing data from 21 countries with 40129 children and adolescents were included in the meta-analysis. All studies have used standard Rome definitions to diagnose aerophagia. The pooled prevalence of aerophagia was 3.66% (95% Confidence interval 2.44-5.12). There was significant heterogeneity between studies [I2 98.06% with 95% Confidence interval 97.70-98.37). There was no gender difference in prevalence of aerophagia in children. The pooled prevalence of aerophagia was highest in Asia (5.13%) compared to other geographical regions. Conclusion: In this systematic review and meta-analysis, we found aerophagia has a significant prevalence across the world.
How do we define normal bowel frequency from newborn to teens?:A Bayesian meta-analysis
(Wiley, 2024-12) Munasinghe, S.; Manathunga, S.; Hathagoda, W.; Kuruppu, C.; Ranasinghe, P.; Devanarayana, N. M.; Baaleman, D. F.; Benninga, M. A.; Rajindrajith, S.
OBJECTIVES Defecation disorders are a common pediatric problem and bowel frequency is crucial in identifying them. The aim of this analysis is to define normal bowel frequencies in healthy children ranging from newborns to adolescents. METHODS A literature search was conducted using MEDLINE, SCOPUS, EMBASE, Cochrane Library, and Web of Science from their inception to February 2024, aiming to identify studies reporting bowel habits of healthy children (0–18 years). A Bayesian distribution modeling approach was adopted to pool the mean frequency of bowel opening using inverse-variance weighing. A subgroup analysis and a meta-regression were performed with Bayesian generalized additive mixed distributional models. The methodological quality of the articles was evaluated using the Newcastle–Ottawa Scale modified for cross-sectional studies. RESULTS Seventeen studies were included in the analysis, including 22,698 children aged from 0 to 18 years. The subgroup meta-analysis showed mean bowel frequencies for newborns, 1–6 months, 6–12 months, 1–2 years, 2–5 years, and over 5 years are 3.24 (95% credible interval [CrI]: 2.83–3.63), 1.99 (95% CrI: 1.77-2.19), 1.66 (95% CrI: 1.45–1.88), 1.53 (95% CrI: 1.37–1.7), 1.15 (95% CrI: 0.99–1.31), and 1.02 (95% CrI 0.88–1.18), respectively. Between studies, heterogeneity demonstrated a near-normal distribution with a mean of 0.16 and a 95% CrI of 0.04–0.28. The variance of the distribution of mean bowel frequency reduced with age. DISCUSSION In this Bayesian meta-analysis, we found that younger children have a higher bowel frequency. The reported bowel frequencies for each age group could serve as normal values in clinical practice to differentiate health and disease.
Impact of COVID-19 outbreak on the number of invasive procedures in Institute of Cardiology, National Hospital of Sri Lanka -A descriptive longitudinal study
(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2021) Kuruppu, C.; Gunawardena, R.; Dunuwille, A.; Ranasinghe, G.; Fernando, N.; Mendis, S.; Fernando, M.; Wijewardena, A.; Prabath, I.H.D.S.
Introduction: Covid-19 pandemic has significantly affected healthcare services worldwide with a similar impact on invasive procedures, in Institute of Cardiology, National Hospital of Sri Lanka (NHSL). Objectives: To analyse the impact of Covid-19 outbreak on therapeutic cardiology interventions, both elective and emergency, by comparing frequencies of procedures done during the initial affected year and immediate previous year. Methods: A Retrospective longitudinal descriptive study was carried out on frequencies of invasive therapeutic cardiology procedures during the period of 2019 March to 2021 February, at Cardiology Unit, NHSL. Pre-formed data collection sheets were filled using hospital registries. Final analysis was done by Microsoft-Excel 365. Results: Total number of procedures done in affected year was 4690 compared to 6096 in previous year. In April 2020, which was the most affected month, 52 cumulative procedures have been done in comparison to 427 procedures in April 2019. By August 2020 number of procedures has increased to 668 in compared to 486 in August 2019. Total of elective procedures were 3751 and 5061 in affected and non-affected years respectively. Similarly, the number of emergency procedures was 1035 in immediate previous year and 939 during Covid pandemic. Conclusions: Study has highlighted a significant impact on invasive therapeutic cardiology procedures, especially on electives, by the onset of the Covid-19 pandemic, especially during the period of lockdown. However, there has been a compensatory increase in procedures once lockdown was over, partially compensating for the numbers. There has been less impact on emergency procedures, the numbers of which have remained relatively constant.