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 Admission patterns and completeness of documentation of clinical features of head injuries in Accident and Emergency Unit of a Sri Lankan hospital for children(College of Community Physicians of Sri Lanka, 2009) Kumarendran, B.; Kumanan, T.INTRODUCTION: Accident and Emergency unit (AEU) of Lady Ridgeway Hospital for Children (LRH) provides outpatient care (OPD) and in-patient care (admissions). OBJECTIVE: To describe the pattern of admissions and completeness of documentation of clinical features of head injury cases admitted to AEU of LRH. METHODS: This was a clinical audit. Data on daily attendance at OPD and admissions from January 2003 - April 2009 were collected using bed head tickets, admission registers and monthly epidemiological reports at LRH. Pattern of admissions from 2003 to 2008 were described on a monthly and those from January to April 2009 on a daily basis. Completeness of documentation of clinical features of head injury was assessed using a check list developed for the purpose for 243 head injury cases admitted during March 2009. RESULTS: During 2003 to 2008, monthly attendance to OPD showed an increasing trend, while a reducing trend was observed in monthly admissions. During January to April 2009, median OPD attendance in morning (8am-2pm), evening (2pm-8 pm) and night (8pm-8am) shifts were 53(IQR:45,59), 35(IQR:32,40) and 15(IQR:12,17) respectively. Median admissions during these shifts was 9(IQR:7,11), 8(IQR:7,10) and 4(IQR:3,6) respectively. Number of medical officers listed for these shifts was 9, 7 and 2 respectively. Most admissions were for males (63.5%; n=445) and commonest age group was 2 to 3 years (26.2%, n=184). Proportion of head injury admissions for March 2009 was 34.7% (243/701). Date, time and signature were documented by, medical officers only in 30.9% (n =75), 10.3% (n=25) and11.1% (n=27) of BHTs. Documentation of presence/absence of selected symptoms on head injury included, nausea or vomiting (80.2%; n=195), unconsciousness (76.1%; n=185), headache (49.4%; n=120), fits (24.7%, n=60) and drowsiness (14.4%, n=35). Documentation of presence/absence of selected signs included site and side of injury in 41.6% (n = 101), diagram on site of injury in 8.6% (n=21), Glasgow Coma Scale (GCS) in 53.1% (n=123), clinical evidence of fracture in 63.8% (n=155) and ENT bleeding in 69.2% (n=178). CONCLUSION: Trend shows a rise in OPD attendance with a decline in IPC admissions. Documentation of clinical features of head injuries needs improvement.Item Sleep patterns among medical undergraduates in Faculty of Medicine, Ragama(College of the Community Physicians of Sri Lanka, 2013) Rajapaksha, R.M.D.S.S.; Ranathunga, R.M.D.C.; Ranaweera, R.K.M.D.S.P.; Randika, J.M.T.; Rathnayake, R.M.N.P.; Rathnayaka, K.M.S.P.; Kumarendran, B.; Pinidiyapathirage, J.M.INTRODUCTION: Sleep pattern has a proven role in the academic performances. OBJECTIVES: To assess sleep patterns and associated factors for different sleep patterns among medical undergraduates in Faculty of Medicine, University of Kelaniya (FMUK). METHODS: This descriptive cross sectional study was conducted among 311 medical undergraduates from second (n= 57), third (n=94), fourth (n=128) and final (n=32) years of FMUK. Data was collected by a group of six fourth year medical students during September 2011. Data were collected using a self-ad ministered questionnaire and analysed using Epi info and SPSS software. RESULTS: Of the 311 respondents, 65% were females. Majority (54.7%) of them stayed in university hostels while 34.1% were in private boarding places and 11.3% in their own houses. Median duration of reported sleep during the weekday was 6.5 hours (Inter Quartile Rage -IQR : 6 to 7) and 8.5 hours [IQR : 7.5 to 9.5) during weekends. Reported quality of sleep varied from good quality (58.5%), trouble in falling asleep (13.8%), nightmares (13.5%), snoring (8.4%) and talking in sleep (5.5%). A single student reported walking in sleep. At least one nap per day was reported among 60%. The most common sleep habit among participants was falling to sleep without knowledge (40.8%) followed by dozing on table while studying (36.3%), studying/reading on bed (33.8%) and drinking alcohol or smoking prior to be (0.6%). However the majority of study participants (44.7%) reported to wake up without difficulty. Decreased sleep was reported prior to examinations among 54% and increased sleep among 23.2%. Nearly half of the participants (46.6%), reported feeling sleepy during most of the lectures. Sleep during lecture was reported to be associated with the topic of lecture (n= 96), presentation skills (n= 249), voice (n= 158), and the appearance (n-35) of lecturer. Good quality of sleep was associated with female sex (p -0.04), students resides at their homes (p = 0.04) and not dozing on the table (p = 0.02). CONCLUSION: Students identified the factors associated with sleep during lectures. Good quality sleep was associated with female sex. residence at home and not dozing on table. Lecturers should consider the factors which are associated with sleep during lectures.Item Prevalence of osteoporosis in a sample of Sri Lankan urban population(Sri Lanka Medical Association, 2008) Karunanayake, A.L.; Salgado, L.S.S.; Abeysuriya, V.; Fernando, S.; Herath, H.M.R.P.; Kumarendran, B.; Premaratna, B.A.H.R.; Mahawithanage, S.T.C.BACKGROUND: Osteoporosis is characterized by low bone mineral density and deterioration in the micro architecture of bone. It predisposes individuals to increased risk of fractures of the hip, spine and other skeletal sites. Peripheral DEXA (P-DEXA) scans are ideal for mass screening of bone mineral density (BMD). OBJECTIVE: To determine the prevalence of osteoporosis and osteopenia in a sample of urban Sri Lankans. DESIGN, SETTING AND METHODS: A descriptive cross sectional study was conducted at the Faculty of Medicine, University ofKelaniya from July 2007 to October 2007. The study subjects were selected from 22 Gramasevaka Niladhari Divisions of the Ragama MOH area. From each division, people aged 35 to 65 years were randomly selected from the voters list and invited to participate in the study. A P-DEXA scan was used to measure the BMD of the left middle finger. A T score of <-2.5 was considered as osteoporosis, -1 to -2.5 as osteopenia. These two categories together were considered low BMD. A T score of > -1 was considered normal. RESULTS: There were 731 subjects with a mean age (SD) of 52.5 (7.5) comprising 60% females. The prevalences of osteoporosis and osteopenia were 14% and 29% respectively. 20% of females and 6% of males were affected with osteoporosis. The prevalence of osteoporosis was 7% among those <50 years and 20% among those >50 years. CONCLUSION: There was a high prevalence of low BMD in this urban population. Prevalence of low BMD was higher among females and those over fifty years.Item Prevalence of cancer in Jaffna, a population based study(Sri Lanka Medical Association, 2006) Lukumar, P.; Surinthirakumaran, R.; Kumarendran, B.; Pradeepan, B.M.BACKGROUND: Cancer is a disabling and in many cases fatal illness. The prevalence of cancer varies from one geographical area to the other. The objective of this study was to describe the prevalence of cancer in Jaffna district. METHODOLOGY: The present study was carried out in six out of seven Medical Officer of Health areas in Jaffna district. One hundred and twelve family health workers (FHW) were utilized to screen the population in the initial stage. Whenever FHW visited a home for her routine work she recorded total members living in the household, number of diagnosed cancer patients and number of suspected cancer patients. For each diagnosed and suspected cancer patient more details were recorded. This procedure was followed fromApril to July 2004. Each one of the suspected and diagnosed cases of cancers identified by the FHW was subsequently visited by a medical officer to confirm or exclude the diagnosis. Doubtful cases to the medical officers were seen by the oncologist. RESULT: A total of 251 987 persons were screened by 112 FHWs and 447 cancer patients (diagnosed in a tertiary care center) were identified. Prevalence of cancer in Jaffna district was 177.4 (per 100 000 populations). Breast cancer was the commonest cancer (50.8). Lip, oral cavity and pharynx (37.7) and female genital tract (22.62) were the second and third leading site for cancer respectively. CONCLUSIONS: High prevalence of cancer was observed in Jaffna. Breast, oral cavity, and female genital tract account for majority of the cancers.Item Randomized placebo-controlled trial of the efficacy of mebendazole polymorphs in the treatment of hookworm infections(American Society of Tropical Medicine and Hygiene, 2013) Gunawardena, N.K.; Kumarendran, B.; Manamperi, N.H.; Senarathna, B.P.; Silva, M.; Pathmeswaran, A.; de Silva, N.R.Mebendazole has three polymorphic forms, identified as A, B and C. It has been suggested that unlike polymorph C, A is ineffective in the treatment of hookworm and whipworm infections. A randomized doubleblind, placebo-controlled trial was carried out to compare the efficacy of single dose 500 mg tablets of pure mebendazole Polymorph C with those containing a 1:1 mixture of Polymorphs A and C, for the treatment of hookworm infections. All eligible individuals living in 219 households were recruited after obtaining written, informed consent. A single fecal sample was obtained and examined the same day, using the Kato-Katz technique for intestinal nematode infections. Those who were found infected with hookworms were randomized to one of three treatment arms and requested to provide a second faecal sample 10 - 14 days after treatment. This was examined in the same manner as the first. A total of 892 individuals were recruited; 601 provided fecal samples; 214 were found positive for hookworm; 70, 74 and 70 individuals were randomized to treatment arms A (mixture of polymorphs A and C), B (pure polymorph C) and C (placebo) respectively. Follow-up samples were provided by 53, 48 and 49 persons respectively in each treatment arm. The cure rates in the three treatment arms were 28.3%, 18.8% and 16.3% respectively; they were not significantly different from one another. Comparison of fecal egg count reductions (FECR) in the 3 treatment arms (86.1%, 84.5% and -6.6% in Arms A, B and C respectively) showed that both mebendazole formulations performed significantly better than placebo, but there was no statistically significant difference between FECR with the two drug formulations. It is concluded that a single 500mg dose of mebendazole, either as Polymorph C alone, or as a mixture of Polymorphs A and C, has little efficacy in curing hookworm infections. However, both formulations were significantly better than placebo in reducing the intensity of infection, with no statistically significant difference between the two formulations.