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 Developing and pilot-testing an Oropharyngeal Dysphagia Screening Tool for children with cerebral palsy aged 4 – 6 years(Sri Lanka Medical Association, 2020) Hettiarachchi, S.; Ravihari, M.G.I.INTRODUCTION AND OBJECTIVES: Children with Cerebral Palsy (CP) demonstrate a variety of dysphagic symptoms. Speech and language therapists (SLTs) are mainly involved in the diagnosis and management of oropharyngeal dysphagia (OPD). Objectives were to develop a screening tool to detect OPD among children with CP aged 4 – 6 years, Pilot test the OPD screening tool with SLTs for children with CP aged between 4 – 6 years and to identify the test-retest reliability and inter-rater reliability of the developed screening tool. METHODS: The screening tool was developed based on the Dysphagia Disorder Survey (DDS) with the assistance of an expert panel of speech and language therapists (SLTs) and a pilot study. The study included 30 children with CP aged between 4;0 – 6;0 years. The OPD Screening Tool conduct together with expert SLTs to evaluate the inter-rater reliability and the study was conducted initially and 2 hours later by the researcher to evaluate test-retest reliability. RESULTS: The OPD Screening tool was shown to be reliable and applicable in detecting dysphagia amongst children with CP. The content validity was assessed by the five expert SLTs. The test-retest reliability and inter-rater reliability of the OPD Screening Tool was calculated and it was relatively high. CONCLUSION: The screening tool was shown to be a reliable tool and it was found to be a tool that easy administer in clinical setting to detect OPD in young children with CP.Item “Silent” white matter changes in brain MRI in patients with haemoglobinopathies and their clinical significance(Sri Lanka Medical Association, 2016) Premawardhena, A.P.; Ranawaka, U.R.; Hapangama, A.; Pathmeswaran, A.; Hettiarachchi, S.; Salvin, K.A.; Pilapitiya, T.; Sanjaya, G.; Oilvieri, N.F.; Weatherall, D.J.INTRODUCTION AND OBJECTIVES: Increasing interest has been directed to the study of white matter changes and lacunar infarcts in patients with haemoglobinopathies which are thought to be clinically silent. Previous studies suggest an association with splenectomy and thrombocytosis. The objective was to assess the association of white matter changes in patients with haemoglobinopathies. METHOD: Older patients with haemoglobinopthies attending the Hemals Thalassaemia Unit were assessed by a specialist neurologist and simultaneously had MRI brain. Relevant clinical, biochemical and hematological data were collected. A non-thalassaemic control group (age and sex matched) too were assessed. RESULTS: There were 82 patients (25 Thalassaemia Major,24 Intermedia and 33 Haemoglobin E b thalassaemia) and 19 controls. Mean age of the study group was 32yrs. 21 patients (26%) had MRI changes (20%,29%,27% in the three groups respectively) (p=0.73). 10% of controls had MRI changes. 12 (60%) of the patients with MRI changes were asplenic whilst 53.2% without changes were asplenic (P=0.138). There was no difference in the two groups with platelet counts. (Mean platelet count 581 Vs. 452 (p= 0.709) 58% of patients and 53% of controls had headache as a symptom. Headache was commoner among those with MRI changes (85% vs 51.6%; p=0.008). CONCLUSIONS: The white matter changes in MRI occurred in all three sub groups of thalassaemic patients studied in high frequency. To our knowledge, this is the first report of the association of MRI changes with neurological symptoms in thalassaemic patients. The higher frequency of headache in those with MRI changes suggest that these changes may not be silent as previously believed.Item Developing a tool to screen for disability among pre-school children: preliminary results(Sri Lanka Medical Association, 2014) Perera, K.M.N.; Wijerathne, L.; Jayasinghe, C.; Kasturiratne, A.; Hettiarachchi, S.; Fonseka, R.; Jayasena, B.N.; Siriwardhena, D.; Godamunne, P.; Dahanayake, W.; Pathmeswaran, A.; Wickremasinghe, A.R.INTRODUCTION AND OBJECTIVES: To develop and validate a tool that can be used by pre-school teachers to identify disabilities in the pre-school age group. METHODS: A multidisciplinary team was formed and the initial tool was developed^ Consensual validity was achieved by using nominal group technique and the tool was pre-tested in the Ragama MOH area. To assure criterion validity, the tool was used to screen all the children in the pre-school age group (2-5 years) in an MOH area randomly selected from the Anuradhapura District. The screened positives .were referred to an expert panel for confirmation of diagnosis and follow-up if required. RESULTS: Thousand nine hundred children were invited for screening and 1536 participated (478 2-3 years, 495 3-years, 560 > 4 years of age) and 267 (17.4%) were referred to the expert panel. Out of the referrals, majority (38.9%) had multiple disabilities. Hearing and speech difficulties were seen in (29.6%). Psycho social problems (11.6%), disabilities and other diseases (19.8%) accounted for the rest. The response rate for confirmation by experts was 64%. The predictive value of a positive test was 79.5%. The prevalence of disabilities among the screened pre-school age group was 88 per 1000 (95% Cl= 74 to 103). CONCLUSIONS: This tool can be used to screen children in the pre-school age for disabilities.