Browsing by Author "Ranasinghe, N."

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Children and adolescents with constipation: Do they have different personalities?
(Wiley Blackwell Scientific Publications, 2012) Ranasinghe, N.; Rajindrajith, S.; Devanarayana, N.M.; Warnakulasuriya, T.; Nishanthini, S.; Perera, M.S.
BACKGROUND AND AIMS: Children with constipation are known to have behavioral and psychological problems. This may partly be due to difference in their personality. Aim of this study is to assess the different personality traits in children having functional constipation. METHOD: We conducted a cross sectional survey in 5 schools in the Eastern province of Sri Lanka. Children and adolescents between 13–18 years were included in the study. Previously validated questionnaires were used to collect bowel habits and demographic data. Translated and validated personality assessment questionnaire (PAQ) was used to assess the personality. Rome III criteria were used to diagnose constipation. RESULTS AND DISCUSSION: A total of 1697 children were recruited [males 778 (45.9%), mean age 15.1 years and SD 1.66 years]. Prevalence of constipation was 6% (102 children). They were compared with 1018 normal children (controls). Seventy eight (76.5%) children with constipation and 426 (41.8%) of controls had PAQ scores above the normative value for Sri Lankan children (89) (p <0.0001). When the international normative value of 105 was used, 33 (32.4%) children with constipation and 111 (10.8%) of controls had psychological maladjustment (p < 0.001). Furthermore Children with constipation scored significant higher scores for different personality traits than controls. They include hostility and aggression (14.1 vs. 12.1 in controls p < 0.001), negative self esteem (11.7 vs. 10.2 in controls p < 0.001), negative self adequacy (11.7 vs. 9.5 controls p < 0.001), emotional unresponsiveness (12.7 vs. 11.1 controls p < 0.001), emotional instability (17.3 vs. 15.0 p < 0.001), and negative world view (12.1 vs. 9.9 controls p < 0.001). CONCLUSIONS: Children with constipation have significant psychological maladjustment than healthy controls. This maladjustment was prominent in hostility and aggression, negative self esteem, negative self adequacy, emotional unresponsiveness, emotional instability and negative world view domains. Addressing these issues is important in the management of children with constipation.
Embryological Remnants of the Thyroid Gland and their Significance in Thyroidectomy
(Jaypee Journals, 2014) Fernando, R.; Rajapaksha, A.; Ranasinghe, N.; Gunawardhana, D.
Embryological Remnants of the Thyroid and Their Significance in Thyroidectomy Prof Ranil Fernando The Thyroid gland develops from the floor of the primitive pharynx & parts of the ultimobranchial body and descends into the anterior triangles of the neck. It is functional around the 7th week of gestation. There are anomalies associated with the embryological development which give rise to recognizable clinical disease in patients. The Thyroid gland may be absent, fail to descend, remnants of descent left in the neck or the thyroid gland may descend too far. All these are well recognized clinical entities. In addition, there are three (3) significant embryological components which are well recognized and need to be identified and removed during Thyroidectomy. These are the Pyramidal lobe, Tubercle of Zuckerkandl, and the Thyrothymic remnants. It is important to carefully dissect and identify these embryological remnants not only to prevent recurrence, but also because these are in close proximity to important structures such as the recurrent laryngeal Nerve and parathyroid gland and they assist the surgeon in identifying these important anatomical structure that need preservation. Recurrent goitres are mainly due to the embryological remnants left behind especially in the subtotal thyroidectomy era. These recurrences can isolated or occur in combination. Commonly recurrence from all three remnants is found. In our experience the Pyramidal lobe recurrences and tubercle of Zuckerkandl are found in about 50- 60% of the patients and the Thyrothymic remnants are found in about 30- 40 % of the patients Surgery for recurrent disease is fraught with danger and a sound knowledge of embryological remnants will enable an experienced surgeon to undertake redo thyroid surgery safely.
Evolution of Elephant Clothes and use of Decorations in Kandy Perahara Sri Lanka: Special Reference to Sri Dhalada Maligawa Pageant
(Centre for Asian Studies, University of Kelaniya, Sri Lanka, 2016) Ranasinghe, N.
The Perahera tradition is one of the cultural identities of the Sri Lankan community. The Kandy Esala Maha Perahara is a main perahara ceremony which is conducted annually by the Sri Dhalada Maligawa. The Kandy perahara consists of traditional dancing items, drumming items and four Dewala Peraharas. In the Dhalada Maligawa perahara the elephant who carries the casket of the Tooth Relic is just second to the Diyawadana Nilame. This research focuses on identifying the elephant dress of the Maligawa Perahara. The elephant is the main character in the perahara pageant. However, there is no historical evidence or written documents that reveal reasons for their attire, importance of dress, use and motives for decorations, cultural beliefs and current practices that are important facts to transfer the knowledge to the future generation. This research will be helpful for future researchers. Studying the perahara pageant is a vast and complicated field which needs to be considered from different perspectives. The perahara consists of five perahera pageants; Maligawa Perahara, Natha Dewala Perahara, Katharagama Dewala Perahara, Paththini Dewala Perahara and Vishnu Dewala Perahara. This research focuses only on the Sri Dhalada Maligawa Perahara with special reference to the elephant’s clothes and use of decorations and its evolution. This research is based on the grounded theory method to gather data. Flowers (Lotus Nelum Mala) and Swans (Hansaya) are mainly used to decorate the body surfaces in the perahara pageant. Apart from that bo leaves, liyawela, sun and moon, peacock and different types of flowers were used. Princess Hemamala and Price Dantha are used to decorate the surface and it is the first human figure to be used in the decorations. The main findings of this research reveal that rules and regulations do not apply to decorations and motifs. However, it has a colour theme and mythical beliefs. When designing new things we need to allow theories and beliefs because it is a cultural event. It enhances our identity and our customs because of which it must have limitations.
Functional gastrointestinal diseases and psychological maladjustment, personality traits and quality of life
(BioMed Central, 2018) Ranasinghe, N.; Devanarayana, N.M.; Rajindrajith, S.; Perera, M.S.; Nishanthinie, S.; Warnakulasuriya, T.; de Zoysa, P.T.
BACKGROUND: Chronic abdominal pain is a common worldwide problem and known to be associated with psychological problems. This study evaluated the association between abdominal pain-predominant functional gastrointestinal disorders (AP-FGIDs), psychological maladjustment and personality traits in adolescents. METHODS: Adolescents aged 13-18 years were recruited from 5 randomly selected schools in Ampara district of Sri Lanka. AP-FGIDs were diagnosed using Rome III criteria. Translated and validated Rome III questionnaire (Child report form), personality questionnaire (PAQ) and PedsQL (Pediatric Quality of Life) inventory were used in data collection. Written consent was obtained from a parent and assent was obtained from every child recruited. The questionnaire was distributed in an examination setting to ensure confidentiality and privacy. Research assistants were present during data collection to assist on any necessary clarifications. RESULTS: A total of 1697 subjects were recruited [males 779 (45.9%), mean age 15.1 years, SD 1.6 years]. AP-FGIDs were present in 202 (11.9%). Those with AP-FGIDs had significantly higher mean scores for all personality traits (hostility and aggression, negative self-esteem, emotional unresponsiveness, emotional instability and negative world view), except dependency. Affected children had lower scores for all 4 domains of HRQoL (physical, emotional, social and school functioning), compared to controls (p < 0.05). When the cut off value for Sri Lankan children (89) was used, 66.3% with AP-FGIDs and 48.2% controls had PAQ scores within that of psychological maladjustment (p < 0.001). When the international normative value of 105 was used, these percentages were 27.2% and 14.2% respectively (p < 0.0001). The scores obtained for PAQ negatively correlated with scores obtained for HRQoL (r = - 0.52, p < 0.0001). One hundred and seventeen adolescents with AP-FGIDs (57.9%) had sought healthcare for their symptoms. Healthcare consulters had higher PAQ and lower HRQoL scores (p < 0.05). CONCLUSIONS: Adolescents with AP-FGIDs have more psychological maladjustment and abnormal personality traits than healthy controls. Affected adolescents with higher psychological maladjustments have lower HRQoL. Greater psychological maladjustment and lower HRQoL are associated with healthcare seeking behaviour in adolescents with AP-FGIDs.
Knowledge and Practices Related to Fire Safety and Their Associated Factors among Factory Workers at CEAT - Kelani International Tyres (Pvt) Ltd
(Faculty of Graduate Studies, University of Kelaniya, Sri Lanka, 2016) Ranasinghe, N.
According to the World Health Organization estimates, more than 250,000 deaths occur annually due to fire in the world. Fire at work place has been one of its main contributory factors. Apart from death, work related fire injuries lead to substantial social and economic cost to the victim and employers. To describe the knowledge and practices related to fire safety, and their associated factors among factory workers in Sri Lanka A cross-sectional study was carried out among 217 workers in the factory of CEAT-Kelani International Tyres (Pvt) Ltd having minimum work experience of one year, selected using simple random sampling. A pre-tested self-administered questionnaire used to collect data on knowledge on fire safety, use of fire safety practices and socio-economic characteristics. Marks were given for knowledge: Very good (100-80), Good (79-60), Average (59-40), Poor (Below 40) and practices: Satisfactory (100-75), Unsatisfactory (below 75). Associations of knowledge and practices were assessed using chi-square test. Response rate was 81.2%. The majority was Sinhalese (98%), married (77%) and educated up to Ordinary level examination (66%). 51% have had fire related accidents while 59% had never participated in fire drills. ‘Very good’ knowledge was seen with fire safety practices (39%), fire-fighting and basics on fire (20%) and first aid during fire (19%). Workers’ overall knowledge on fire safety was ‘satisfactory’ in 75%, with 17% having ‘very good’ knowledge and 58% having ‘good’ knowledge. None were in poor knowledge group. Majority of workers’ (89%) overall practices related to fire safety was ‘satisfactory’. Being a machine operator, more than ten years work experience, advanced level/ vocational training as highest education level, experience on fire accidents and their participation in fire drills were significantly associated with workers’ ’good’ level of knowledge on fire safety. However, a significant association was not seen between the use of fire safety practices and knowledge on fire safety with any socio-economic characteristic of the workers. Tyre factory workers showed satisfactory knowledge on fire safety and use of fire safety practices. Though knowledge was associated with many characteristics of workers, practices did not. Conducting fire training sessions and fire drills are necessary to improve their skills in practices related to fire safety.
Morphology of the tubercle of Zuckerkandl and its importance in thyroid surgery
(Sri Lanka Medical Association, 2015) Rajapaksha, A.; Fernando, R.; Ranasinghe, N.; Iddagoda, S.
The tubercle of Zuckerkandl (ZT) is an embryological remnant of the thyroid gland. Its close relationship to the recurrent laryngeal nerve (RLN) makes it an important surgical landmark. Presence and size of the ZT was prospectively assessed during thyroidectomies done at a single surgicalunit during 2013. Eighty patients were included in the study. Closest distance and relationship of the ZT to the RLN was measured. Median age was 48 years (range 20-75 years). The ZT was present in 72 (90%) patients at least on one side and 55 (69%) patients on both sides. Grade III tubercles were found in 17 (21.25%) patients. Average distance between RLN and the ZT was 1.2 mm posteriorly or posteromedially. In the majority (79%) RLN was lying at a distance of ≤1 mm. Pressure symptoms were present in 19 (23.75%) patients and it was not related to the presence of grade III tubercles (p = 0.207).
Personality assessment in children with abdominal pain predominant functional gastrointestinal diseases
(Wiley Blackwell Scientific Publications, 2012) Ranasinghe, N.; Rajindrajith, S.; Devanarayana, N.M.; Warnakulasuriya, T.; Nishanthini, S.; Perera, M.S.
BACKGROUND AND AIMS: Chronic abdominal pain is a commonly associated with psychological problems. This study aimed to evaluate the personality traits in teenagers with abdominal pain predominant functional gastrointestinal diseases (AP-FGD). METHODS: Data regarding gastrointestinal symptoms, and personality assessment were collected from teenagers aged 13–18 years from 5 randomly selected schools in Ampare district of Sri Lanka. AP-FGD were diagnosed using Rome III criteria. Translated and validated personality assessment questionnaire (PAQ) was used to assess the total personality maladjustment score and personality domains; namely hostility and aggression, dependency, lack of self esteem, lack of self adequacy, emotional instability, emotional unresponsiveness, and negative world view. RESULTS AND DISCUSSION: A total of 1697 children were recruited [males 778 (45.9%), mean age 15.1 years and SD 1.66 years]. AP-FGD were seen in 202 (11.9%) teenagers. They were compared with 1051 normal children. When the cutoff value for Sri Lankan children (89) was used, 66.3% of with AP-FGD and 42.5% controls had PAQ scores within that of psychological maladjustment (p < 0.001). When the international normative value of 105 was used, these percentages were 27.2% and 11.2% respectively (p < 0.0001). Subgroup analysis revealed similar differences in all 4 subtypes of AP-FGD compared to controls (p < 0.05). Children with AP-FGD had significant higher mean scores for all personality domains compared to controls except for dependence (p < 0.05). Children with irritable bowel syndrome and abdominal migraine also showed similar results (p < 0.05). Apart from dependency and emotional instability children with functional dyspepsia were noted to have higher mean scores for all other personality domains (p < 0.05). In addition, children with functional abdominal pain had signifi cantly higher mean scores for all personality domains except dependency and negative world view (p < 0.05). CONCLUSIONS: Psychological maladjustment is significantly more common in all four subtypes of AP-FGD.
Psychological maladjustment and quality of life in adolescents with constipation
(British Medical Association, 2017) Ranasinghe, N.; Devanarayana, N.M.; Benninga, M.A.; Dijk, M.V.; Rajindrajith, S.
OBJECTIVES: To assess psychological maladjustment in adolescents with functional constipation. STUDY DESIGN: We conducted a cross-sectional survey in five schools. Adolescents aged between 13 and 18 years were included in the study. Validated questionnaires were used to collect bowel habits and demographic data, health-related quality of life (HRQoL) and psychological maladjustment. Rome III criteria were used to diagnose constipation. RESULTS: 1697 adolescents were recruited (boys 779 (45.9%), mean age 15.06 years and SD 1.6 years). Prevalence of constipation was 6.7%, of whom 52 were boys (45.6%) and 62 were girls (54.4%). 38 adolescents (33.3%) with constipation and 230 controls (14.5%) had significant psychological maladjustment. Among seven different personality dimensions used to assess psychological maladjustment, children with constipation had significantly more deficits than controls in hostility and aggression (14.2 vs 12.6 in controls (mean difference 1.54, 95% CI (0.89 to 2.19) p<0.001), negative self-esteem (12.0 vs 10.5 in controls, mean difference 1.54 95% CI (0.96 to 2.06) p<0.001), negative self-adequacy (11.9 vs 9.8 controls, mean difference 2.07 95% CI (1.46 to 2.67) p<0.001), emotional unresponsiveness (12.9 vs 11.5 controls, mean difference 1.44 95% CI (0.84 to 2.04) p<0.001), emotional instability (17.1 vs 15.6, mean difference 1.53 95% CI (0.86 to 2.2) p<0.001) and negative world view (12.1 vs 10.2 controls, mean difference 1.91 95% CI (1.24 to 2.59) p<0.001). The total HRQoL of adolescents with constipation was lower than controls (70.6 vs 79.0 mean difference 9.48 95% CI (1.4 to 6.7) p<0.05). CONCLUSION: A significant proportion of children with constipation are suffering from psychological maladjustment.