Browsing by Author "Subasinghe, S.M.V."

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    Child abuse and abdominal pain - Is there an association?
    (Sri Lanka Medical Assosiation, 2012) Devanarayana, N.M.; Rajindrajith, S.; Mettananda, S.; Weerasooriya, W.A.L.K.; Hathagoda, K.L.W.; Lakmini, B.C.; Subasinghe, S.M.V.; de Silva, D.G.H.
    INTRODUCTION AND AIMS: It is believed that there is an association between abdominal pain and child abuse. The main objective of this study was to assess this association in Sri Lankan school children. METHODS: Children aged 13-18 years were randomly selected from a semi-urban school in Gampaha district. A previously validated, self administered questionnaire was used to collect socio-demographic data and information on gastrointestinal symptoms, child abuse and exposure to other stressful events. Severity of symptoms was recorded using a validated, visual analogue scale. Children with abdominal pain were categorized into abdominal pain predominant functional gastrointestinal disorders (AP-FGD) using Rome III criteria. RESULTS: A total of 490 children were recruited [males 254 (51.8%), mean age 15.2 years and SD 1.64 years]. Forty eight (9.8%) fulfilled Rome lit criteria for AP- FGD (functional dyspepsia=3, functional abdominal pain=25, irritable bowel syndrome=15 and abdominal migraine=5). The number of children exposed to physical, emotional and sexual abuse, were respectively 119 (24.3%), 109 (22.2%) and 18 (3.8%). Prevalence of AP-FGD was significantly higher in those exposed to sexual (26.7% vs. 9.3% in controls, p=0.42) and emotional (16.5% vs. 8.3%, p=0.046) abuse, but not physical abuse (11.8% vs. 9.2%, p=0.69). AP-FGD type associated with sexual abuse was irritable bowel syndrome (15.4% vs. 2.7%, p=0.02). Mean scores obtained severity of abdominal pain were higher in children exposed to sexual (27.9 vs. 13.2, p=0.002) and emotional abuse (22.1 vs. 11.4, p<0.001). CONCLUSIONS: Chronic abdominal pain prevalence and severity were significantly higher in children exposed to sexual and emotional abuse.
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    Respiratory problems since birth to 12 years: What is causing morbidity and mortality in Sri Lanka?
    (Sri Lanka College of Paediatricians, 2014) Karunasekera, K.A.W.; Fernando, A.F.; Subasinghe, S.M.V.; Lakmini, B.C.
    Background: Respiratory tract disorders cause significant mortality and morbidity in children worldwide. Objectives: To study the pattern of respiratory diseases and its seasonal variation amongst children admitted to hospital and assess causes of mortality due to respiratory diseases especially in children less than 5 years of age. Method: A descriptive study was conducted at the University Paediatric Unit, Colombo North Teaching Hospital during 2010 and 2011. All children below 12 years admitted with respiratory tract disease (ICD-10 classification) were recruited into the study. Data collection forms were filled by medical officers using patient records. Results: Out of 13,356 admissions, 2,651 (19.8%) were admitted with respiratory disease. Highest number of admissions (30.5%) was in the 1 month to 2 year age group and 4.4% of admissions were neonates. Common causes of admission included unspecified lower respiratory tract infections (LRTI) (44.1%), upper respiratory tract infections (URTI) (25.2%), bronchial asthma (11.5%) and bronchiolitis (7.0%). Incidence of bacterial pneumonia was 0.95%. Admissions due to respiratory diseases peaked in June (2010-20%, 2011-16%). Admissions with bronchial asthma were higher during the first half of year (2010-86.3%, 2011-80.5%). The total number of deaths was 24 and 87.5% of these deaths were in children under 5 years. Out of under 5 year deaths 17 (94.5 %) were early neonatal deaths. The common causes of mortality under 5 years were surfactant deficient lung disease (43%), meconium aspiration syndrome (24%) and severe respiratory failure due to hypoxic ischaemic encephalopathy (19 %). Conclusions: LRTI, URTI, bronchial asthma and bronchiolitis were the main contributory factors to the morbidity. Mortality due to respiratory causes was 0.9 % and was confined mainly to the neonatal period. Common causes of under-5 year deaths were surfactant deficient lung disease, meconium aspiration syndrome and respiratory failure due to hypoxic ischaemic encephalopathy