Browsing by Author "Perera, K.P.J."

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Animal bites in children: reasons for delay in seeking medical help
(Sri Lanka Medical Association, 2008) Peiris, M.A.C.; Perera, K.P.J.; Adhihetty, D.; Goonewardena, A.R.; Mettananda, D.S.G.
OBJECTIVE: To describe the clinical characteristics of animal bites in children and to determine the reasons for delay in seeking medical help DESIGN, SETTING AND METHODS: A descriptive study was conducted at the North Colombo Teaching Hospital in 2007. Consecutive children admitted following animal bites were recruited into the study until a sample of 100 was achieved. Children with snake and insect bites were excluded from the study. Data on clinical characteristics and treatment were obtained using an interviewer schedule. RESULTS: Sixty-five (65%) subjects were males. Mean age of children was 6.8(SD=3.2) years. Majority (88%) of bites were by dogs while cats, rats, monkeys and squirrels were responsible for the others. 68% of animals (67% of dogs) were domestic animals but only 14% were vaccinated. None of the domestic cats or squirrels was vaccinated. 72% were provoked bites and 81% had major exposures. Face, hands and fingers were the commonest places of bites. Following the bite 89% had washed the bite-site with soap and water and 6% had used antiseptics for cleaning. 75% came to the hospital within 24-hours while 16% presented after 72 hours. Commonest reason for delay was ignorance. There was no significant association between the delay in presentation and age or sex of the child, maternal educational level, number of children in the family, distance to the hospital, type of animal or the degree of exposure. CONCLUSION: Eighty-six percent of animal bites in children were by unvaccinated animals. One-fourth of children were brought to the hospital after 24 hours and the commonest reason for delay was ignorance.
Community prevalence of childhood asthma and atopy
(Sri Lanka Medical Association, 2005) Perera, K.P.J.; Rathnayake, A.; Wickramasinghe, N.; Muthukumarana, S.
OBJECTIVES: To estimate prevalence of childhood asthma, allergic rhino conjunctivitis and eczema in the community using an interviewer administered questionnaire. To estimate the extent of prophylaxis usage in asthma. SETTINGS: A cross sectional descriptive study in 2003. METHOD: Sample consists of children between 6 months to 13 years (n=2005) in 4 PHM areas randomly selected from Ragama. Diagnosis was based on presence of symptoms in preceding 12 months. Information gathered using a pre-tested questionnaire. Study was ethically approved. Data analysis - Epi Info version 6. RESULTS: Mean age was 6.7 years and 52% were males. Asthma prevalence was 13%. Prevalence in infancy - 4%, 1-5 years -13%, 5-10 years - 15% and 10- 13 years - 11%. Prevalence in males -14%. In females -11% (p=0.03). Lifetime prevalence - 19%. Current wheezing rate - 1.6%. Prevalence of allergic rhinitis - 5%, allergic conjunctivitis 3% and eczema 0.8%. Of all asthmatics, 70% were mild intermittent, 23% mild persistent and 7% moderate persistent. 49% of those who required prophylaxis were already on prophylaxis. Of them, 92% on steroid inhalers. CONCLUSIONS: Prevalence of asthma and allergic rhinitis and eczema are less than when reported by parents (Parent reported prevalence were 23%, 11% and 3% respectively). The majority of asthma was mild intermittent type. Usage of prophylactic medications was nearly 50%.
Cut off value of TSH for early prediction of poor neurodevelopment of 5 to 9 year old children in Sri Lanka
(Sri Lanka Medical Association, 2012) Abeysuriya, V.; Perera, K.P.J.; Kasturiratne, A.; Wickremasinghe, A.R.
INTRODUCTION AND AIMS: To assess the relationship between TSH and neuro-development of children between 5- 9 years of age and to identify the cutoff value of TSH for early prediction of poor neuro developmental outcome. METHODS: A descriptive cross sectional study was carried out in 20 randomly selected estates in the Ratnapura district of Sri Lanka from August to December 2010. A validated neurodevelopment assessment tool was used to assess the neuro-development of 1683 randomly selected children. Neuro¬development was expressed as a General Quotient (GQ) score and a score <100 was identified as evidence of poor neuro-development Of 1683 children screened, 519 were randomly selected with consent from the parents; blood was assayed for TSH using the 3rd generation TSH Chemiluminescent immunometric assay. ROC curve analysis was used to find out the cut off value of TSH that best predicts poor neuro¬development in children. RESULTS: Of 519 children whose TSH levels were assayed, 494 had TSH levels within the normal range between 0.60 to 5.40 ulU/ml, of whom 16% had a GQ score <100. There was a significant association between TSH levels and neuro-development [p=0.0001). The best cutoff value of TSH to predict a GQ score <100 was 1.5 p.IU/ml. [Area under cure=73.4%, sensitivity= 97.0% and specificity =70.6%). CONCLUSIONS: The best cutoff value of TSH for prediction of poor neuro-development in children 5 to 9 years of age is 1.50 p.IU/ml.
Development and validation of a tool to assess neuro-developmental outcome of 5-9 year old children in Sri Lanka
(2009) Abeysuriya, V.; Wickremasinghe, A.R.; Perera, K.P.J.; Kasturiratne, A.; Poddalgoda, I.
Objective: To determine the validity and reliability of a tool which has been developed based on Griffiths Mental Development scale (GMDS) to assess the neuro-developmental outcome of 5-9 year old children in Sri Lanka. Design: Descriptive cross sectional study Setting: Randomly selected five primary schools of the Medical Officer of Health (MOH) area in Ragama, Pediatrics Out patient clinic at Colombo North Teaching Hospital in Ragama and the Department of Pediatrics at the Faculty of Medicine, University of Kelaniya. Method: The study population consisted of two groups. Group A had 60 children. This sample consisted of 20 children who have been clinically diagnosed as having poor neuro-development and 40 children with normal neuro development. They were assessed using the developed neurodevelopment assessment tool at Colombo North Teaching Hospital, Ragama to determine the cutoff value for poor and normal neuro- developmental outcome. The ROC curve analysis was used to determine the statistical significant of the cutoff GQ value which identify the poor and normal neuro developmental outcome of children by the tool. Group B had 100 primary school children (n=100) who were selected from Ragama MOH area. It consisted of 50 children with the high educational performance and 50 with the poor performance based on teacher’s assessment based on student performance reports. The group B has been used to re-asses the validity of the developed tool with the identified cut off GQ value. History of birth and development, family history, teachers’ records, school performance, clinical examination and aptitude test were used to determine neuro-developmental outcome of children by the pediatrician. Result: A cut-off value of GQ 100 (P<0.05) was identified to differentiate children with poor and normal neuro-developmental outcome (sensitivity 100% and specificity 100%). Reliability of identified cutoff value was tested by administrating the tool to the selected primary school children. Out of 50 poor educational performance children who were identified by the teachers’ only 36 were below GQ 100. There were 31 children who were clinically diagnosed as having poor neruo-development by the pediatrician and all of them had GQ of below 100 (Sensitivity 100%). Conclusion: The developed neuro-developmental outcome assessment tool is a valid and reliable instrument to screen neuro developmental outcome of Sri Lankan children aged between 5-9 years.
Effect of indoor air pollution due to solid fuel combustion on childhood respiratory diseases
(Sri Lanka Medical Association, 2014) Ranathunga, R.A.N.; Perera, K.P.J.; Nandasena, Y.L.S.; Kasturiratne, A.; Sathiakumar, N.; Wickremasinghe, A.R.
Introduction and objectives: To determine the association between indoor air pollution and respiratory symptoms in children under 5 years of age. Methods: A prospective study was conducted over a 22 month period in the Ragarna MOH area. All children under 5 years in the selected households were followed up for 12 months and data on respiratory symptoms were extracted from a symptom diary. Sodoeconomic data of the households and main fuel type used for cooking was recorded. Air quality measurements were made in a sub sample of househords. Results: 262 children were followed up. The incidence of lower respiratory tract infections (RR-1.513, 95% C.t= 1.071-2.158) and infection induced asthma (RR-1.758, 95% C.l= 1.159-2.718) were significantly higher among in children resident in households using biomass fuel compared to children resident in households using LPG and electricity. The incidence of asthma attacks, rhinitis exacerbations and rhino conjunctivitis exacerbations were not associated with exposure to indoor air pollution. Houses which used biomass fuel had significantly higher concentrations of CO (3.27 vs. 1.49) and PM2.5 (1.14 vs. 0.31} compared to houses using LPG and electricity for cooking but CO2 concentration was not higher. Conclusions: CO and PM2.5 concentrations are significantly higher in households which use biomass fuel for cooking. There is a 1.5 times higher risk of lower respiratory tract infections and 1.8 times higher risk of infection induced asthma among children resident in households using biomass fuel for cooking compared to children in households using LPG or electricity.
Factors affecting the compliance of SLMA asthma prophylactic guidelines in children
(Sri Lanka Medical Association, 2001) Karunasekera, K.A.W.; Perera, K.P.J.
INTRODUCTION: Guidelines to use prophylactic drugs in childhood asthma were laid down by SLMA in 1995. Yet a fair number of children we come across in clinical practice are not on prophylactic agents, though they are indicated. OBJECTIVE: To determine the compliance with SLMA asthm a prophylactic guidelines among patients admitted with asthma and to determine the socio-demographic factors affecting compliance. METHODS: All consecutive admissions to the university paediatric unit, Ragama Hospital between January 1996 and February 1998 with asthma (356) were included. Children admitted several times during the study period were included only on the 1st admission. Diagnosis of asthma was made clinically by-a consultant paediatrician. Details regarding frequency of asthma, severity, sleep disturbances, number of admissions to hospital, school absenteeism and use of prophylactic agents were obtained together with socio-demographic data. Chi-squared test was used as the statistical test. RESULTS: Only 18.2% of 251 children for whom asthma prophylactics were indicated were using prophylactic agents. 67.3% had one indication, 28.3% had two and 3.98% had three indications to use prophylaxis. Older age, male sex and monthly income of more than Rs.lO,000/= were found as significant factors for adhering to SLMA guidelines for asthma prophylaxis (p<0.05). Parental education and occupation did not show any significant association with the use of prophylaxis (p>0.05). CONCLUSIONS: Among the children in this study, boys older children and children from households with a monthly income over Rs. 10,0007= were more likely to use prophylactics.
Feeding practices of children attending well baby clinics in Ragama MOH area: a descriptive cross sectional study
(Sri Lanka Medical Association, 2011) Perera, K.P.J.; Fernando, M.; Warnakulasuria, T.; Ranathunga, N.
INTRODUCTION AND OBJECTIVES: Feeding during early childhood is important for growth and health. Objectives of this study were to evaluate the current feeding practices during first few years of life among Sri Lankan children. METHODS: A descriptive cross sectional study conducted in Ragama MOH area during the period of 10th august 2010 and 30th October 2010. 410 children between 2 -5 years of age, attending well baby clinics were included in the study. Interviewer administered questionnaire was used to collect data regarding socio-demographic characteristics and feeding practices. Open ended questions were used. SSPS version 16 was used for data analysis. RESULTS: The study population consisted of 208 boys and 202 girls. 62.2% children were exclusively breastfed for 6 months. 351 have received formula milk. 61 had formula milk started before the age of 6 months and 212 by one year. 330 children had sugar added to formula milk. 144 of them had sugar added within first year. 29 children had complementary food started before 4 months. 294 mothers continued to breastfeed beyond 2 years and 41.6% of them were breast feeding at regular intervals. 82.5% children were receiving overnight feeding either as breast milk or formula beyond 2 years. . CONCLUSIONS: Though high rate of exclusive breast feeding is prevalent in Sri Lanka, there seem to be other issues related to feeding. Too early introduction of complementary food, adding sugar to formula, prolonged breast feeding too frequently and prolonged overnight feeding are among them.
Genetic and environmental risk for asthma in children aged 5-11 years
(Sri Lanka College of Paediatricians, 2005) Karunasekera, K.A.W.; Perera, K.P.J.; Perera, M.T.P.R.; Abeynarayana, J.
DESIGN: A cross sectional analytical study. METHOD: Data were collected from children aged 5-11 years in 3 schools in Gampaha District. 441 children with asthma and 1510 without asthma were evaluated for following risk factors viz. family history of atopy, gender, duration of breast feeding, commencement of formula in infancy, dusty home environment, passive indoor cigarette smoking, presence of firewood smoke in bedroom when cooking, burning of mosquito coil and incense stick/powder and presence of pets at home. Data were analyzed using Epi info version 6 and SPSS package. Chi Squared test was used in bivariate analysis and forward logistic regression was used to adjust confounding factors. RESULTS: Risk of asthma in child (on bivariate analysis) was increased when father has a history of asthma (odds ratio (OR) 6.4 (95% confidence interval (CI) 3.2 -13.2), mother has a history of asthma (OR 4.4, CI 2.6 -7.5), sibling has asthma (OR 4.3, CI 2.0 - 9.7), father has a history of allergic rhinitis (OR 2.0, CI 1.5-2.8), mother has a history of allergic rhinitis (OR 2.5, CI 1.9-3.4) and sibling has allergic rhinitis (OR 3.4, CI 2.1-5.4). Asthma risk was significantly increased with following environmental factors: non continuation of breast feeding beyond first 6 months in infancy (OR 1.5, CI 1.2-1.9), presence of firewood smoke in bedroom when cooking (OR 1.4, CI 1.1- 1.9), use of mosquito coil (OR 1.5, CI 1.2 -1.9) and dusty home environment (OR 1.8, CI 1.4-2.3). After adjusting for confounding factors, paternal history of asthma, maternal history of asthma, allergic rhinitis in mother and sibling, non continuation of breastfeeding beyond first 6 months of life and dusty environment remained significant with increased risk of asthma (p < 0.01). CONCLUSIONS: This study reinforces that asthma has a multifactorial aetiology. Childhood asthma is influenced by paternal asthma more than maternal asthma. Significant modifiable environmental factors in this study were duration of breastfeeding in infancy and dusty home environment
Iodine concentration of household salt and its effect on serum TSH level of children aged 5- years
(Research Symposium 2010 - Faculty of Graduate Studies, University of Kelaniya, 2010) Abeysuriya, V.; Wickremasinghe, A.R.; Perera, K.P.J.; Kasturiratne, A.
Objective To describe the effects of household practices of salt usage on Iodine concentration in salt and the relationship between low Iodine concentration of salt and serum thyroxin level of children aged 5- years. Method A descriptive cross sectional study was carried out in two phases in 2randomly selected estates in the Ratnapura district from August to November, 2009. In phase one, using a pre-tested interviewer administered questionnaire, 1683 households were surveyed to identify the pattern of salt usage. Salt samples of these houses were tested for adequacy of iodine concentration (>30ppm of Iodine) using standard rapid iodine test kits. In phase two, blood samples of 51randomly selected children aged 5-years, from the same estates were taken after obtaining informed written consent from parents and serum TSH levels were assayed. Ethical clearance was obtained from the Ethics Committee of the Faculty of Medicine, University of Kelaniya. Results 36.4% of households purchased salt from the retail boutique closest to them. Purchase from shops in town, shops in the village, and estate cooperative shops was reported by 27.7%, 24.4% and 13.3%. Salt powder was used by 54.5% households while salt crystals were used by the rest. 82.7% did not wash salt before use 9.6% kept salt containers near the fire place. 38.8% households stored salt in plain glass bottles and 19.3% in dark coloured glass bottles. Usage of coconut shells and plastic bottles were 21.4% and 20.4%. Adequate iodine levels were present in 88.7% of household salt samples tested. Inadequate levels ofiodine was associated with keeping the container near fire place, use of glass containers to store salt and washing salt before use (p<0.01 for all variables). The place of purchase was not associated with the iodine level. The mean TSH levels of children whose household salt had an adequate iodine level (> 3ppm) was significantly lower (n=4171.861.11 IU/ml) from that of children whose household salt had an inadequate iodine level (< 30ppm) (n=1023.291.26 IU/ml). Conclusion Place of purchase has no effect on iodine concentration of household salt. Storing salt near the fire, use of glass containers to store salt and washing before use reduces its iodine concentration significantly. Household salt with an inadequate iodine concentration was associated with higher serum TSH levels in children 5-years of age.
Iodine concentrations of spring water and serum TSH levels in 5-year old children resident in the estates of the Ratnapura district
(Research Symposium 2010 - Faculty of Graduate Studies, University of Kelaniya, 2010) Abeysuriya, V.; Wickremasinghe, A.R.; Perera, K.P.J.; Kasturiratne, A.
Objective To determine the Iodine concentrations in drinking water sources of estate population of the Ratnapura district and to determine the association between iodine levels of drinking water and Thyroid Stimulating Hormone (TSH) levels in children aged 5-years. Method A descriptive cross sectional study was carried out in three phases in 2randomly selected estates in the Ratnapura district from September to November, 2009.In phase 1, 1683 households were surveyed to identify common drinking water sources in the selected estates. In phase 2, blood samples from 51randomly selected children aged of 5-years from same estates were taken to assay TSH levels after obtaining informed written consent from parents. In phase 3, water samples from 23 identified sources (wells, rivers and springs) were obtained and were and analysed for iodine (I) levels by the catalytic reduction method. Based on elevation from mean sea level, water sources were grouped, and mean TSH levels and water Iodine concentrations were correlated. Ethical clearance was obtained from the Ethics Committee of the Faculty of Medicine, University of Kelaniya. Result The main source of drinking water was water springs (83.7%), followed by pipe-borne water (14.6%), rivers (1.5%) and wells (0.2%). Spring water at low altitudes had significantly higher Iodine concentrations than those located at higher altitudes (p=0.002). The mean spring water Iodine concentrations according to altitude were as follows36.005.66 g/dl at 100-200m (n=2), 16.256.52g/dl at 201-300m (n=8), 7.754.11g/dl at 301-400m (n=4) and 3.831.60g/dl above 401m (n=6). The mean iodine levels of spring water (12.810.63g/dl) were significantly lower compared to other water sources (130.0112.12g/dl) (p=0.0001). The mean TSH levels of children according to altitude were as follows1.781.15IU/ml at 100-200m, 2.210.64IU/ml at 201-300m, 2.170.46IU/ml at 301-400m and 2.040.17IU/ml >401m. There was no association between TSH concentrations of children and iodine levels of spring water at different altitudes (p=0.69). Conclusions The majority in the estates consume spring water. The iodine concentration of spring water was significantly lower as compared to other water sources. Iodine levels of spring water were significantly higher at lower altitudes than at higher altitudes. There was no association between serum TSH levels in children aged 5-years and iodine levels of spring water at different altitudes.
Prevalence of asthma and atopic symptoms in children aged 5-11 years
(Sri Lanka College of Paediatricians, 2003) Karunasekera, K.A.W.; Perera, K.P.J.; Perera, M.T.P.R.; Abeynarayana, J.
OBJECTIVE: To assess prevalence of asthma and atopic symptoms in a group of school children aged 5-11years and to look at prevalence of usage of asthma medications. SETTING: Three schools in Gampaha District in August 1998. METHOD: A questionnaire translated into Sinhala was distributed to parents/guardians of 2195 children aged 5-11 years in Grades 1-5 of the schools and the filled questionnaires were collected through class teachers. Asthma, allergic rhinitis and eczema were defined using the clinical criteria of the International Study of Asthma and Allergic Conditions (ISAAC). Data was analysed using Epi Info version 6. Chi squared test and Chi squared test for trend were used for significance testing. RESULTS: Return rate of questionnaire was 93%. Sixty six percent were completed by mother, 30% by father and rest by guardian. Prevalence of asthma was 23% and of exercise induced asthma 11%. Prevalence rate of allergic rhinitis was 10% and eczema 3%. Within the specific group of asthma, in response to leading question "Has your child had asthma" only 19% of parents gave a positive answer. Prevalence of asthma in males did not significantly differ from that in females (p=0.5). A decreasing trend of asthma was observed with increasing age in girls (p less than 0.05). Eighty four percent of asthmatic children were using salbutamol orally and 9% without asthma in study population were also using salbutamol. CONCLUSIONS: One in 5 children aged 5-11 years in study population had asthma but parental perception about asthma was poor. More than 80% of asthmatics had some medications for the disease.
Prevalence of asthma and atopy among primary school children
(Sri Lanka Medical Association, 2001) Karunasekera, K.A.W.; Perera, K.P.J.
INTRODUCTION : Prevalence of asthma and atopy among school children in Sri Lanka is not known. Objectives : To estimate prevalence of asthma and atopy in children between 5-11 years and to determine the influence of sex and age on the prevalence of asthma. METHODS: A total of 2043 children between 5-11 years of 3 mixed schools in Gampaha district were screened for symptoms of asthma and atopy using a questionnaire in August 1998. Diagnosis of asthma was based on the presence of 3 symptoms of the following 5 in the preceding 12 months; cough at night, breathlessness, wheezing, persistent cough more than a week after common cold and cough and/or chest tightness during or after playing. Chi squared test and Chi squared test for trend were used for analysis. RESULTS: Prevalence of asthma symptoms were cough at night 22.1%, breathiessness 17.2%, wheezing 22.6%, persistent cough after common cold 29.9% and cough or chest tightness with playing 11%. Prevalence of asthma based on questionnaire was 17.1 %, allergic rhinitis 10% and eczema 2.5%. The prevalence of asthma in males was not significantly different from that of females (p=0.4). There was a decreasing trend of the prevalence of asthma with increasing age. This trend was significant in girls (p= 0.01) but not in boys. CONCLUSIONS: Nearly one fifth of primary school children suffer from asthma and 10% have allergic rhinitis. There was no significant gender difference in Jhe prevalence of asthma in primary school children. There was a decreasing trend of the prevalence of asthma with increasing age in girls but not in boys.
Prevalence of poor neuro-developmental outcome and hypothyroidism among 5-9 year-old children in the plantation sector of Sri Lanka
(Sri Lanka Medical Association, 2011) Abeysuriya, V.; Perera, K.P.J.; Kasturiratne, A.; Wickremasinghe, A.R.
INTRODUCTION AND OBJECTIVES: To describe the prevalence of poor neuro-developmental outcome and its relationship to hypothyroidism among 5-9 year-old children in the plantation sector of Sri Lanka. METHODS: This descriptive cross-sectional study was conducted in 20 randomly selected estates in the Ratnapura district. Using a validated tool based on Griffiths mental development scale, neruo-developmental outcome of 1683 children aged 5-9 years was assessed. The results were expressed using the General Quotient (GQ) score [GQ score<100 = poor neruo-developmental outcome]. A 2ml blood sample was obtained from a sub-sample of 519 children after obtaining informed written consent from the parents/guardians and TSH level was assayed. Presence of clinical symptoms of hypothyroidism and visible/palpable goitre were assessed among those who had a TSH>5.4 u-IU/ml (biochemical hypothyroidism). RESULTS: GQ<100 was identified in 9.4% of children and a high TSH (>5.4uTU/ml) was detected in 3.7% of children. Low TSH (<0.6uiU/ml) was detected in 1.2%. The prevalence of poor neuro-developmental outcome with high TSH was 2.1%. There was no association between TSH levels and age and sex. TSH level was significantly associated with neuro-developmental outcome (p<0.001). 15.8% of children with biochemical hypothyroidism had clinical symptoms of hypothyroidism and goitre was visible or palpable in 15.7%. Poor neuro-developmental outcome was present in 58% of these children. CONCLUSIONS: Poor neuro-developmental outcome was evident in a large proportion of children with biochemical hypothyroidism without clinical features of hypothyroidism. These findings indicate a link between poor neuro-development and sub clinical hypothyroidism which has not been described before.
Study on immunity against Hepatitis B in children after vaccination during infancy
(Sri lanka Medical Association, 2015) Perera, K.P.J.; Hapugoda, M.; Fernando, K.M.D.; Dimal, D.A.
INTRODUCTION AND OBJECTIVES: Hepatitis B vaccine is given in Sri Lanka to all infants at 2, 4,6 months. As a low prevalent country the risk of acquiring Hepatitis B is more likely during adolescence and later. It is important to know whether immunity produced by vaccination during infancy last up to this stage, or a booster dose is needed to augment the immune response. METHOD: With informed written consent and assent from children, 150 ten year old school children with evidence of Hepatitis B vaccination during infancy, were tested for Hepatitis B antibody status using ELISA. Children who had an antibody titre less lOmlU/mL were offered a free booster dose. Antibody levels were retested one month after the booster. RESULTS: 128 (67%) had an antibody titre above 10m ID/ml. All children with a titre <10mlU/ml, accepted the booster dose. All children who received the booster had an antibody response above 10mlU/l, while (72%) had a titre >100mlU/l. CONCLUSION: Vaccination against Hepatitis B during infancy appear to produce protective level of antibodies at ten years of age. Even the children with antibody titres below protective level produced a sharp rise in titres with a booster dose. As this response could be expected with a natural infection, booster dose to augment the immune response produced by vaccination during infancy is not needed.
A time for change; causes for neonatal eye discharge at university postnatal and paediatric baby unit, Colombo North Teaching Hospital
(Sri Lanka College of Obstetricians and Gynaecologists, 2010) Dayasiri, M.B.K.C.; Perera, K.P.J.
PURPOSE: Low prevalence of neonatal eye discharge is related to quality obstetric and early neonatal care and absence of maternal sexually transmitted infections. Corneal ulceration and staphyloma formation are already recognized complications of neonatal conjunctivitis and it can also lead to neonatal sepsis and subsequent severe complications. This study was aimed to identify the causes for neonatal eye discharge. METHODS: Retrospective study was carried out involving all the neonates who had eye discharge in the university post natal and pediatric baby unit, during past 2 years. Information was gathered from 138 cases with regard to onset of eye discharge, aetiology for eye discharge as confirmed by eye swab culture and, demographic factors. RESULTS: Majority had been acquired during the early neonatal period {1 st week=88%, 2nd week=8.7%). Common causes for eye discharge had been Staphylococcus aureus (48%), coagulase negative staphylococcus (33%). Methicillin resistant staphylococcal infection was present among 10%. Pseudomonas (1%) and Streptococcus (3%) were also reported in minority. CONCLUSIONS: Majority of the causes had been normal flora of the female genital tract. Prevalence of sexually transmitted infections was 0%. However, prevalence of MRSA was significantly high compared to other studies in literature. The fact that 12% had been occurred after 1 st week would suggest a nosocomial origin and needs revision of the hygienic practice in post natal care.
The validation of the Sinhala version of the Kessler psychological distress scale (K10) to screen for psychiatric morbidity
(Sri Lanka Medical Association, 2008) Wijeratne, L.T.; Williams, S.S.; Peris, M.U.P.K.; de Silva, N.R.; Hapuarachchi, H.A.C.; Perera, K.P.J.; Kawamura, N.; Wickremasinghe, A.R.
BACKGROUND: The Kessler psychological distress scale (K10), used in epidemiological surveys, measures psychological distress. High scores in community surveys are associated with anxiety and affective disorders, and to a lesser extent, with other psychiatric disorders. OBJECTIVE: To validate the Sinhala translations of the long (K10) and short (K.6) versions of the Kessler psychological distress scale. DESIGN, SETTING AND METHODS: The English version of K10 was translated into Sinhala. Content and face validity was assessed by experts. The scales were pre-tested and modified accordingly. The Sinhala versions of K6 and K10, and the Structured Clinical Interview Schedule were administered to 20 adults with major psychiatric illnesses diagnosed by two clinicians independently, and to a random sample of 25 apparently normal people from the community. SPSS (Version 11) was used for the analysis. RESULTS: The ROC curve for the K10 contained 96.1% of the area under the curve of 0.961 (95% CI 90.4%-100%). A cut off score of 22 for the K10 yielded a sensitivity of 93.8% and a specificity of 82.6%. The ROC curve for the K6 contained 90.1% (95% CI 80.5% - 99.7%) of the area under the curve. For the K6, a cut off score of 13 gave a sensitivity of 88.2% and a specificity of 72%, The total number of days that the patient could not attend to regular work and responsibilities was significantly correlated with both the K10 (p=0.041) andK6 (p=0.023). CONCLUSION: The Sinhala version of the K10 and K6 questionnaires can be used to screen for psychological distress.