Conference Papers
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This collection contains abstracts of conference papers, presented at local and international conferences by the staff of the Faculty of Medicine
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Item Elder abuse among out patient department attendees in a tertiary hospital(Sri Lanka Medical Association, 2009) Edirisinghe, P.A.S.; Paranitharan, P.; Perera, W.N.S.; Shehan, W.BACKGROUND: Abuse of older people is a hidden problem in society. Older people are frightened or embarrassed to report its presence. The extent of the problem is not studied adequately in Sri Lanka. METHODS: A cross sectional descriptive study was conducted at the North Colombo Teaching Hospital, outpatient department on 530 consecutive adults over 60 years of age. The Hwalek-Sengstock Elder abuse screening test which was assessed for face validity and content validity among 50 older persons and modified, was used for data collection along with a brief demographic questionnaire. Those with a mini-mental state examination score of 23 or less were excluded from the study. Data was collected by trained medical officers after informed written consent from the subjects. Confidentiality of the information provided was assured. RESULTS: 348 females (65%) and 182 males (35%) were included in the study. The mean age was 68.5 years. 26 (5.6%) reported physical abuse of whom 14 (2.6%) had been struck, slapped or kicked and five had received medical attention for injuries. Three had made a Police complaint. Up to 136 (25%) had perceived emotional abuse. 53 (10%) had experienced derogatory remarks and 12 (2. 3%) had been threatened with punishment and institutionalisation. 20 (3.7%) claimed neglect and 116 (22%) claimed their caregiver was financially dependent on them. There was no significant difference among the sexes. CONCLUSIONS: Physical, emotional and financial abuse of elders is present in our study population. The numbers although small, may represent only the tip of the iceberg.Item A review of subarachnoid haemorrhage as a cause of death in forensic autopsies conducted in Edinburgh(Sri Lanka Medical Association, 2007) Edirisinghe, P.A.S.INTRODUCTION: Sudden death due to subarachnoid haemorrhage (SAH) has been frequently encountered in routine forensic autopsies all over the world. OBJECTIVE: To review autopsy reports on cases diagnosed as death due to SAH. Demographic data, medical aspects, events leading to death and underlying pathology were analysed and compared with previous autopsy studies. DESIGN, SETTING AND METHODS: Materials were gathered from a post-mortem report database maintained at the Section of Forensic Medicine, Division of Pathology, University of Edinburgh between 2000-2005. Events leading to death and details relating to medical history were gathered from the sudden death reports provided by the Police. RESULTS: 67 (0.8%J cases were diagnosed as deaths due to SAH out of 8,264 autopsies. Male to female ratio was 3:3.7. Majority of the victims were in their fifth or sixth decade. 51 (76%) cases had a rupture of a cerebral aneurysm while 6(9%) were related to trauma. 21(40%) had a past medical history of hypertension, ischaemic heart disease or a cerebro-vascular accident. Only two cases had a history of SAH with aneurysma! clipping. 19 cases recorded presence of additional unruptured aneurysm (2mm -10mm) at the autopsy. The majority of ruptured aneurysms were in posterior part of circle of Wiliis. CONCLUSIONS: Medicai and pathological causes of sudden death due to SAH have not changed despite the improvement of the imaging technology or increased availability to access medical information and adviceItem A comparative study of the causes of death given in two forensic institutions (Ragama and Edinburgh) and North Colombo Teaching Hospital: lessons we can learn from others(Sri Lanka Medical Association, 2007) Edirisinghe, P.A.S.; Perera, B.P.P.; Kitulwatte, I.D.G.INTRODUCTION: Writing the cause of death (COD) according to the WHO format using the International Classification of Diseases has been the accepted practice in order to create comparable national and international statistics. Objective: To analyse whether the forensic doctors and clinicians in the North Colombo Teaching Hospital (NCTH) and the doctors in the Section of Forensic Medicine, University of Edinburgh adhered to WHO proforma and ICD 10 when formulating COD. And to suggest changes if a need was shown by this study. DESIGN, SETTING AND METHODS: CODs written during a six month period in 2003/2004 were obtained from postmortem reports and counterfoils of declaration of death forms from forensic doctors and clinicians respectively. CODs from the Certificates of COD written by forensic doctors in Edinburgh were obtained during a six months period in 2004/2005. RESULTS: 21% of Edinburgh records (n=252) were found to have one or more errors in the COD, whereas CODs written by forensic doctors in NCTH (n=441) had 45% of errors. The main difference between Edinburgh and NCTH was the use of linking words to imply WHO pro-forma by NCTH forensic doctors. Although the clinicians of NCTH use the format of la, Ib, Ic and 2, 79 %( n=432) of CODs had errors. CONCLUSIONS: High error rate of the Sri Lankan sample was due to many reasons. Medical certification of COD according to WHO pro-forma not being a statutory duty, and the COD given by junior doctors without supervision were major reasons.