Browsing by Author "Ratnayake, S."

Now showing 1 - 8 of 8

Current Clinical Practice on Dysphagia Management in Sri Lankan Context: Speech - Language Therapists’ Perspective
(Faculty of Medicine, University of Kelaniya, 2014) Priyadarshani, K.W.K.N.; Ratnayake, S.
The field of speech language therapy is a relatively new, developing service in Sri Lanka. Since the establishment of the service, no researches have been conducted to identify Speech-Language Therapists’ (SLT) perception of the practice on dysphagia management. The objectives of the study were to identify training and current clinical practice on dysphagia management, to describe the challenges faced by the SLTs when managing dysphagic clients and to describe the coping strategies used by SLTs to overcome the challenges they faced when managing dysphagic clients. A descriptive cross-sectional study design was implemented. All SLTs who were practicing in Sri Lanka were included. A semi-structured, self-administrative questionnaire that included both qualitative and quantitative components was used. Among 44, 86%, (n=38) of SLTs saw clients with dysphagia in their caseload. Thirty-two (32) SLTs saw adults, 28 SLTs saw paediatrics and only seven (7) SLTs saw neonates with dysphagia. Assessing neonates was the most significantly challenging area. Lack of clinical exposure, limited recognition of SLT service among medical professionals and lack of awareness among clients and families on the gravity of the problems associated with dysphagia were also identified as significant challenges. Only 47.5%% (n=18) SLTs had participated in CPDs to improve their skills relevant to dysphagia and 13.88% (n=5) liaised with overseas SLTs. Adding a section or module for neonatal dysphagia management in the academic curriculum, developing a recognized body to conduct training to enhance the SLTs’ skills and knowledge, establishing a formal framework to gain internationally required clinical norms of practicing in Sri Lanka, continuing awareness programs with relevant professionals for the benefit of the society and continuing further researches on the particular area were recommended.
A Descriptive Study on Profile of Clients with Dysphagia Referred to Speech Therapy Units in Two Government Hospital Settings
(Faculty of Medicine, University of Kelaniya, 2014) Weerasinghe, W.A.M.A.; Ratnayake, S.
The study was aimed at identifying commonly presented initial symptoms and feeding method on the initial session of dysphagic clients. A descriptive cross-sectional study design was used with a retrospective chart review. Data of 100 completed records of dysphagic patients who were above the age of 12 years were studied. Participants included patients referred to speech therapy units of two hospital settings within a 6-month period. Mean and standard deviation of age of the participants was 61.12 years and 14.36 years respectively. Median time duration between on set to referral is 11 days. Most prevalent cause for dysphagia was cerebrovascular accident (79%). Additionally, progressive neurological disorders and ‘other’ causes were observed. 32% were in severely dysphagic, while another 32% were moderately severe and 9% were mild. Of all the participants, oral and pharyngeal phase was affected in 52% of participants. At the time of admission to the speech therapy unit, 58% of patients relied only on non-oral feeding methods. Commonly presented symptoms were impaired trigger (63%), coughing (52%) and voice quality changes (29%). According to chi square test, there was no association between presence / absence of dysarthria and severity of dysphagia. Most of the clients were older and referrals were taking a long duration. The study findings suggest the importance of early referral and also the need to generate awareness about the symptoms to help in early identification. Recommendations are made such that screening assessment should be done for all stroke clients to identify any risk of aspirations.
Evaluation of the Survival of Dendrobium crumenatum Swartz. Pollen Stored at Different Temperatures
(International Postgraduate Research Conference 2019, Faculty of Graduate Studies, University of Kelaniya, Sri Lanka, 2019) Silva, W.E.R.; Attanayake, R.; Ratnayake, S.; Senanayake, S.P.
Dendrobiums have a high demand in the Sri Lankan floriculture industry as cut flowers and potted plants. Most Dendrobium cultivars found in the Sri Lankan market are imported from countries like Thailand, Singapore and Malaysia. Development of new cultivars and commercial cultivation of orchids has become a billion-dollar profitable industry in the world. In order to uplift the local orchid industry, cultivars with Sri Lankan identity should be developed. As Sri Lankan Dendrobiums have high floral diversity with economically important characters like fragrance, patterns and shapes, such characters could be introduced to the popular cultivars through breeding programs. Pollinia of these species and cultivars may not be always available throughout the year. Therefore, a suitable pollen storage method that maintains pollen viability and germinability, should be developed. The objective of this study was to develop a pollen preservation technique for Dendrobium crumenatum (E: Pigeon orchid, S: Sudu pareyi mal) by storing at different temperatures in order to use them in breeding programs. Pollen were collected into 0.2 mL tubes from fully opened fresh flowers at the onset of the anthesis around 7.00 – 8.00 am in July 2019. A set of pollen was dried in silica for 24 hours before storage and the other set was directly stored at -80 °C, -20 °C, -1 °C, 9 °C and 28 °C temperatures. Cryopreservation of pollen at -80 °C and -20 °C were also conducted in modified Murashige and Skoog medium (pH 5.7). Treatments were performed in triplicates. Samples of stored pollen were removed after 1, 3, 7, 14, 30 and 60 days and in vitro germinability and viability were tested in 10% sucrose and 2,3,5-Triphenyltetrazolium chloride (TTC) respectively. To confirm pollen viability and germinability, pollen of D. crumenatum stored at 9 °C were used in controlled cross pollination with Dendrobium ‘Pink Stripe,’ Dendrobium ‘Sonia Red’ and Dendrobium ‘Pink New Splash’. D. crumenatum had 54.97±12.22 % germinability and 76.0±4.58 % viability prior to storage. Pollen stored at subzero temperatures or subjected to cryopreservation lost viability and germinability. Pollen stored at 9 °C without drying, were viable for 14 days and produced pollen tubes (8.63±0.71 %). Although, percent in vitro germination of D. crumenatum pollen reduced to less than 20% after 7 days of storage (19.57±6.55 %) at 9 °C, pollination of stored pollen resulted in fruit set in Dendrobium ‘Pink Stripe,’ and Dendrobium ‘Pink New Splash’. This study found that seasonally flowering D. crumenatum pollen can be stored for short periods at 9 °C while maintaining their viability and germinability and can be used for cross pollination in breeding programs. However, subzero temperatures and cryopreservation may not be appropriate for storage of D. crumenatum pollen
The Impact of Dysphagia and its Management Strategies on Clients’ Life Style; Clients’ Perspective
(Faculty of Medicine, University of Kelaniya, 2014) Panterlyon, N.; Ratnayake, S.
Dysphagia refers to difficulty with delivering food from the mouth to the stomach (Logemann, 1998). Clients’ perceptions and their level of awareness of the condition needs to be explored in Sri Lanka in order to understand more effective methods of service delivery. A descriptive cross sectional study with both quantitative and qualitative components was undertaken with thirty-two participants. A semi-structured, interview administered questionnaire was used to gather data, which was developed with five speech therapists, currently practicing dysphagia in the Sri Lankan context, and ‘Swallowing quality of life questionnaires’ were referred to (SWAL-QOL and MDAI) during the process. According to their level of understanding, the dysphagia management focuses on improving general health, to improve swallowing function in particular and to prevent a life threatening risk. The mean score for the impact of dysphagia on ADL was 47.88 (SD=16.50) out of 100. The degree of impact on a client’s ADL does not depend on gender or the onset of the condition. Dysphagia has an impact on their emotional, functional and social life. Clients expect the speech therapists to help accelerate the recovery. The implications include organizing client supportive groups and workshops to minimize the emotional, functional and social impact.
Intervention Procedures and Outcome Measures of Neurogenic Dysphagic Clients seen by Speech and Language Therapists in Two Hospital Settings
(Faculty of Medicine, University of Kelaniya, 2014) Perera, K.D.R.D.; Ratnayake, S.
Dysphagia is a common problem in clients with neurological impairments. In Sri Lanka, managing dysphagic clients by speech therapists is a new and emerging field in the healthcare sector. However, no in-depth analyses concerning intervention procedures for neurogenic dysphagic clients have yet been conducted in the Sri Lankan context. Intervention procedures, outcome measures in use, and the discharge criteria of adult neurogenic dysphagic clients were studied retrospectively using 80 records of neurogenic dysphagic clients from two hospital settings. Semi-structured interviews were also conducted with the speech and language therapists working in the two selected hospital settings to identify their views on the intervention processes of managing dysphagic clients. Both compensatory and therapeutic modalities were used to manage 35 (43.75%) of clients whereas 29 (36.25%) of clients were managed using compensatory strategies only. Among the compensatory procedures, texture modification (n= 65, 81.25%) was identified as the most common strategy and swallow maneuvers were recommended less frequently (n=8, 10%). Outcomes were measured mainly through subjective measurements on level of aspiration, respiratory status, food intake, weight gain and hydration. The clients were discharged from therapy services when they were safe with oral feeds or when an alternative feeding method was recommended for a long duration. Intervention procedures were mainly based around a compensatory approach. Despite the limited resources in these settings, the speech therapists have been able to provide intervention for dysphagic clients and gain positive outcomes.
Managing and Caring for Clients with Dysphagia: Caregivers’ Perspective
(Faculty of Medicine, University of Kelaniya, 2014) Dissanayake, D.M.S.K.; Ratnayake, S.
Dysphagia has been identified as a life threatening problem in many health care settings. The management of dysphagia usually involves a multidisciplinary team approach where caregivers, clients and various professionals contribute to the management. Caregivers came across a number of barriers during the caring process of dysphagia clients. The perception of the caregivers about the dysphagia, knowledge received by the professionals, effects and adaptations on social and personal life are important to consider as they have an impact on the management procedure in relation to dysphagia. A descriptive cross- sectional study design was implemented. Forty caregivers of neurogenic dysphagic clients who had been referred to the speech therapy unit in the last six months were recruited to the study using purposive sampling. The study consists of both qualitative and quantitative components. The data was collected through an interview administered through a semi structured questionnaire, which was analyzed using frequency analysis and thematic coding analysis. Majority (50%) of the professionals involved in advising caregivers were doctors and speech therapists. 18 doctors and 25 SLTs gave advice orally. Majority (n=14) of the caregivers preferred a combination of giving oral, written and practical advice. The frequency of following the adaptations on feeding techniques was limited as the caregivers thought it was not necessary to always follow the adaptations. Health, occupation, economy and social functions were found to be affected and required adaptations in the caregivers’ life. As most professionals in SL give advice orally, it is important to consider caregivers’ preferences. The importance of increasing awareness in following the adaptations on feeding and nutritional values among the caregivers is indicated in the study findings. The effects on caregivers’ social and personal life should also be considered in dysphagia management procedures.
Pollen biology and reproductive ecology of selected paleotropical dendrobiums and its commercial hybrids.
(Journal of Pollination Ecology, 2023) De Silva, R.; Herath, H.; Ratnayake, S.; Attanayake, R.; Senanayake, P.
Understanding the reproductive biology is of great importance in the development of novel hybrids in ornamental plants. Pollen fitness-related traits are crucial for the pollination success in any plant species including dendrobiums. The aim of the study was to determine and compare the fitness traits of ten commercial Dendrobium hybrids and two indigenous Dendrobium species, D. crumenatum and D. anosmum found in Sri Lanka. We measured pollen viability, pollen germinability, and fruit production after controlled pollination. The effect of storage temperature on D. crumenatum pollen viability was evaluated to establish a suitable pollen storage method to improve future breeding programmes, as the flowering of dendrobiums is seasonal. The reproductive ecology of selected dendrobiums was studied by the observations of visits of natural pollinators and by assessing floral morphology to predict their potential pollinators. Six commercial hybrids had non- viable pollen while D. crumenatum showed the highest pollen germinability under both in vivo and in vitro conditions. Ninety percent of the commercial hybrids failed in vitro pollen germination whereas under in vivo conditions 50% were successful. Self-incompatibility in D. crumenatum was observed in both hand-pollination and under natural pollination. Pollen of D. crumenatum can be stored for two weeks at 9°C maintaining viability and germinability. Selected dendrobiums have shown adaptations to melittophily, suggesting the pollination by bees. Findings indicated a reduction of male fitness in most of the commercial Dendrobium hybrids and a higher fruit set is seen in selfing than cross-pollination. The present study provides information for developing conservation strategies and future hybridization programmes in paleotropical dendrobiums.
A Retrospective Study on Perinatal Post Mortems
(Faculty of Graduate Studies, University of Kelaniya, Sri Lanka, 2016) Liyanage, S.K.; Mahendra, G.; Ratnayake, S.; Hewavisenthi, J.
A detailed post mortem examination is the key to the recognition of pathologies related to perinatal deaths. Post mortem findings assist the clinical team in confirming their clinical and radiological findings and the family for future pregnancy planning. However, this facility is still underutilized in Sri Lanka. Furthermore, examination of the placentas is an important aspect in recognizing the cause of perinatal death. The department of pathology, faculty of medicine, University of Kelaniya provides the perinatal pathology service to the Obstetrics and Gynaecology unit and the neonatal unit of the Teaching Hospital Ragama. This study was carried out in view of improving and expanding the perinatal pathology service provided by the department. Objectives were (1). To identify the number of perinatal post mortems (PPMs) reported over a period of six years. (2). To identify the number of PPMs that showed multiple congenital anomalies (3). To identify the number of PPMs accompanied by a placenta and the number of placentas with identifiable pathology. This was a retrospective study on already reported PPMs in the Department of Pathology, Faculty of medicine, University of Kelaniya, From January 2011 to August 2016. The PPM databases maintained in the department were used to extract data. A total of 118 PPMs were reported (2011-17, 2012-16, 2013- 17, 2014-21, 2015-31, 2016-16). 65 % (75/118) were premature deliveries. 56% (67/118) were performed following intrauterine deaths. 14 % (16/118) of PPMs showed multiple congenital anomalies. Placentas ware submitted for examination in 31 PPMs (31/118) and clinically significant placental pathologies were noted in 7/31 placentas (23%). 76/118 (64%) showed no gross abnormality in the fetus/baby and placenta was not available for examination in 72% (55/76). Major congenital anomalies were detected in 14% of PPMs. In majority of the PPMs, the placenta was not available for examination, therefore cannot exclude the possibility of placental pathology which might have led to the death.