Browsing by Author "Rambukwella, R."

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    Pregnancy outcome of mothers with gestational mellitus in a tertiary care centre; Sri Lanka
    (Sri Lanka College of Obstetricians & Gynaecologists, 2018) Rathnayake, K.; Rambukwella, R.; Dias, T.
    INTRODUCTION: Reported prevalence of Gestational Diabetes Mellitus (GDM) varies from 0.6% in China to 15% in Indianborn Australians. Evidence is increasing that GDM raises the risk of adverse clinical consequences in the fetus. Good glycaemic control is known to reduce the adverse outcomes. Even though, highly improved outcomes have been reported, reflected by a dramatic decline in maternal and perinatal morbidity and mortality over the past few years, debate persists on the care of pregnant women with GDM. OBJECTIVES: The objectives of this study were to determine the pregnancy outcomes of gestational diabetes mellitus in Sri Lankan population. METHODS: Cohort of pregnancies diagnosed with GDM (n=389) according to WHO criteria were followed up for completion of their pregnancy with 1344 pregnant women registered in the period between 2015 to 2016 in Obstetric unit in Colombo North Teaching Hospital, Sri Lanka. RESULTS: Significant risk of adverse events were observed for macrosomia (RR = 1.32, 95% CI 1.24 - 2.22; p<0.002), large for gestational age (RR = 1.54; 95% CI 1.35 - 1.89; p<0.001), preeclampsia (RR = 1.14, 95% CI 1.04 - 1.23; p<0.03), caesarean delivery (RR = 1.15, 95% CI 1.07 - 1.56: p<0.001) and Neonatal Intensive Care Unit (NICU) admissions (RR = 1.12, 95% CI 1.05 - 1.28; p<0.004). Perinatal mortality (RR = 1.57, 95% CI 0.76 - 2.92; p = 0.2) was not significantly associated with GDM. CONCLUSION: Gestational Diabetes should be controlled, in order to reduce both the maternal and neonatal complications, and accordingly reduce the burden on neonatal care.
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    Success and challenges of health systems resilience-enhancing strategies for managing Public Health Emergencies of International Concerns (PHEIC): A systematic review protocol
    (BMJ Publishing Group Ltd, 2022) Rajapaksha, R.M.N.U.; Khatri, R.B.; Abeysena, C.; Wijesinghe, M.S.D.; Endalamaw, A.; Thomas, T.K.; Perera, N.; Rambukwella, R.; de Silva, G.; Fernando, M.; Alemu, Y.A.
    Introduction: Health systems resilience is the ability to prepare, manage and learn from a sudden and unpredictable extreme change that impacts health systems. Health systems globally have recently been affected by a number of catastrophic events, including natural disasters and infectious disease epidemics. Understanding health systems resilience has never been more essential until emerging global pandemics. Therefore, the application of resilience-enhancing strategies needs to be assessed to identify the management gaps and give valuable recommendations from the lessons learnt from the global pandemic. Methods: The systematic review will be reported using the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA-P) protocols guideline. Reporting data on World Health Organization (WHO) health system building blocks and systematic searches on resilience enhancing strategies for the management of Public Health Emergencies of International Concerns (PHEIC) after the establishment of International Health Regulations (IHR) in 2007 will be included. The search will be conducted in PubMed, Scopus, Web of Science and Google Scholar ETHICS AND DISSEMINATION: Ethics approval and safety considerations are not applicable. Pre-print of the protocol is available online, and the screening of the articles will be done using Rayyan software in a transparent manner. The findings will be presented at conferences and the final review's findings will be published in a peer-reviewed international journal and will be disseminated to global communities for the application of successful management strategies for the management of future pandemics.