Browsing by Author "Weerasooriya, W.A.L.K."

Now showing 1 - 3 of 3

Central nervous system infections in a tertiary care hospital: disease patterns and difficulties in diagnosis
(Sri Lanka Medical Association, 2011) Ranawaka, U.K.; Harshani, M.L.; Fonseka, V.N.R.M.; Hathagoda, K.L.W.; Nawaratne, A.N.H.M.U.K.G.D.B.; Weerasooriya, W.A.L.K.; Samarakoon, S.M.S.B.; Thirumawalawan, K.; Premawansa, G.; Fernando, M.A.M.; de Silva, L.; Perera, K.V.H.K.K.; Dassanayake, K.M.M.P.; Wijesooriya, T.; Rajindrajith, E.G.D.S.
INTRODUCTION AND OBJECTIVES: Central nervous system (CNS) infections produce high morbidity and mortality, and effective treatment and outcome depend on precise microbiological diagnosis. We aimed to describe the pattern of CNS infections and accuracy of diagnosis in patients presenting to a tertiary care hospital. METHODS: We prospectively studied patients with suspected CNS infection admitted to medical and paediatric units of Colombo North Teaching Hospital over three years. Data related to demographic and clinical features, laboratory findings, treatment and immediate outcome. Diagnosis of CNS infection was categorised as definite, probable, possible, and uncertain. RESULTS: 426 patients (293 adults, 133 children) were studied [57.2% males, mean age (SD) years-adults 44(20), children 4(3.15)]. Of them, 27.5% had received antibiotics before admission. Blood cultures were done in 149 (35%) and only 14 were positive. Lumbar puncture was done in 347 (81.4%). CSF culture was positive only in two patients. CSF Gram stains and TB-PCR were all negative. The likely diagnosis was meningitis in 35.4%, encephalitis in 10.6% and a non-specific 'meningo-encephalitis' in 16.7%. A 'definite' microbiological diagnosis was made only in five patients. Diagnosis was considered 'probable' in, 53.7%, 'possible' in 8.7%, and 'uncertain' in 14.8%. An alternative diagnosis was found in 22% (13.6% adults, 40.6% children). Intravenous antibiotics (86.8%) and acyclovir (42.5%) were widely used on empiric grounds. CONCLUSIONS: Diagnosis of CNS infections is highly unsatisfactory with available facilities, even in a tertiary care setting. Better facilities are needed to improve aetiological diagnosis, and are likely to improve care and minimise treatment costs.
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.
A study to assess knowledge and attitudes on breast feeding of postnatal mothers in district General Hospital, Monaragala
(Sri Lanka Medical Association, 2011) Fernando, S.D.L.; Mettananda, S.; Hathagoda, K.L.W.; Weerasooriya, W.A.L.K.
INTRODUCTION AND OBJECTIVES: To describe the attitudes and knowledge on breast feeding of the postnatal mothers at District General Hospital (DGH), Monaragala. METHODS: Descriptive study was conducted at DGH-Moneragala from October to December 2010. Mothers of alternate babies admitted to the postnatal ward or mother baby unit were recruited to the study after obtaining written consent. Data were collected using an interviewer-administered, pre-tested questionnaire containing questions on socio-demographic data and attitudes and knowledge related to breast feeding on discharge or on the 7 postnatal day. Knowledge on breast feeding was scored from 0-10 using a 10-item questionnaire, with higher scores representing better knowledge. Ethical approval was obtained from the Ethics Committee of Uva Clinical Society. RESULTS: Data on 405 mothers were analysed of which 14.1% were aged less than 20 years, 80.5% had studied beyond grade 11, 54.8% had a monthly income more than Rs.l0, 000/=. Majority (89.6%) had received advice on breast feeding from midwife or nurse. Over 90% were aware of the concepts of exclusive breast feeding and demand feeding. But only 60% knew that the breast milk could be kept in the room temperature for 6 hours. 254 (62.7%) obtained a score above 8 on knowledge on breast feeding. Significantly higher proportion of mothers below the age of 20 years (X 2=10.0, /7=0.002), educated below grade 11 (Z 2=25.6, p<0.001), from families with monthly income Rs<10,000/= (X 2-9.3, p-0.003) and with one child (X 2=6.29,p=0.013) had scores below 8. CONCLUSIONS: Mothers with lower educational level, lower family income, aged below 20 years and with a single child had worse knowledge on breast feeding. Nearly half of the mothers did not have a good knowledge on storage of expressed breast milk.