Browsing by Author "de Silva, R.L.S.K."

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    Adequacy and relevance of medical records of patients admitted following Medico-legally significant trauma
    (College of Forensic Pathologists of Sri Lanka., 2020) Priyanath, D. C.; Dharmadasa, L.S.; de Silva, R.L.S.K.; Gunathilaka, M.M.A.C.C.; Nanayakkara, E.H.H.G.; Shakoor, M.S.; Samarawickrama, S.; Kitulwatte, I.D.G.; Edirisinghe, P.A.S.
    INTRODUCTION: Details mentioned in Bed head ticket (BHT) and investigations are taken into consideration when an opinion is made with regards to the medico legally significant trauma. Shortfalls of documents can lead to misdiagnosis or wrongful diagnosis. This study was conducted to find out the adequacy of records on BHTs and availability of investigations on patients who had been admitted following trauma with medico legal significance. METHODS: A prospective descriptive study was carried out on patents who were admitted following medico-legally significant trauma during a period of one year, from Aug 2017 to Aug 2018 by perusing their records. The adequacy of the documentation was assessed according to a pre-prepared scale. RESULTS: Analysis of on admission historical and preliminary details revealed that out of 1102 records, only 26% (n=286) had mentioned the time duration since the incident. Recorded cardiovascular stability on admission was above 86% (n=950) though level of consciousness was not mentioned by 19% (n=211). Nature of the injuries were correctly recorded by 65% (n=720) while the location of them were correctly recorded only by 29% (n=316). Surgical procedures were adequately mentioned only among 39% (n=425). CONCLUSIONS: The study revealed that there are gross inadequacies with regard to the records on BHTs made by the doctors. This can lead to limitations in addressing medico-legal issues and sometimes can result in wrong opinions leading to injustice. Need for continuous professional training with special attention to record keeping is highlighted. Further, the quality of records can be further improved with regular audits, continuous professional developmental activities and introducing a common format for documentation in admission, surgical procedures and investigations. KEYWORDS: Medico-legal issues, Medical record keeping, Adequacy, Investigations, BHT
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    Study on heart measurements of the people between the age 20-40 years present to the teaching hospital colombo north – post mortem study
    (Dept. of Forensic Medicine, New Delhi, 2021) de Silva, R.L.S.K.; Kitulwatte, I.D.G.; Priyanath, D.C.; Gunathilake, M.M.A.C.; Senanayake, T.A.A.W.; Kumari, M.K.J.K.
    Introduction: Presence of an enlarged heart provides a basis for determination of the cause and mechanisms of death. Gender, physical activity, and Body Mass Index (BMI) may affect the size of organs. Knowledge on such normal variations is needed in order to recognize the abnormalities.Objectives- This research was conducted to study the dimensions of the heart(heart weight, left ventricular thickness and valvular circumferences) among the young adult healthy deceased autopsies and evaluate their association with different variables.Methods:It was a descriptive cross-sectional study and 20-40 years of age healthy, young, adult, males and females in equal numbers who had died suddenly were studied by considering the inclusion and exclusion criteria. Details of the past history and the measurements were entered into a proforma and the anonymous data were used for analysis.Results: The study revealed that the mean values of the heart weight was 280.52g (SD+/- 42.60), it was 293.94g (SD+/-39.29) for males and 267.10g (SD+/-42.64) for females. There was no significant association of heart weight with gender (P= 0.46410). There was a significant association between BMI and the heart weight of the females (P= 0.0387), no such association for left ventricular wall thickness. Further, there was a significant difference of the tricuspid valve circumference among two genders and the values were 11.6cm (SD+/-0.82) for males and 10.7cm (SD+/-0.6) for females.Conclusions: Majority of the findings was consistent with the findings of the studies globally on Caucasians. Increased body mass index was significantly associated with increased heart weight among females which could probably be explained as a consequence of increased epicardial fat since there was no such association for left ventricular wall thickness