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 Sero-prevalence of rickettsial infections in patients with Parkinson’s disease(Sri Lanka Medical Association, 2017) Gunathilake, M.P.M.L.; Luke, N.; Benedict, S.; Wickremasinghe, S.; Ranawaka, U.K.; Premaratna, R.INTRODUCTION & OBJECTIVES: Role of infections in Parkinson’s disease (PD) pathogenesis has been proposed. A patient who had features of PD during scrub typhus infection fully recovered following treatment. Two years later, he developed features suggestive of early PD and raised the question, whether rickettsial infections could trigger development of PD. METHODS: In order to study the sero-prevalence of rickettsioses, a descriptive cross-sectional study was carried out in patients with diagnosed PD. Their IFA-IgG titres against O. tsutsugamushi (IFA-IgG-OT) antigens at 1:32 and 1:128 dilutions were compared with the population seroprevalence. Statistical analysis was performed using SPSS. RESULTS: A total of 35 patients; 20 (57.1%) males [mean age 62 years (SD 8.8)], 15 (42.9%) females [mean age 68.5 years (SD 7.4)]. Mean age at diagnosis of PD; males: 57.2 years (SD 9.7), females: 64.7 years (7.5). 10/35 (29.8%) had IFA-IgG-OT titre 1:32 (p=0.19 compared to population sero-prevalence of 19.8%) and one had a titre 1:128 (2.8% compared to population prevalence of 3.17%). At the time of assessment for sero-prevalence of rickettsioses, the mean (SD) duration of diagnosis of PD between IFA-IgG +ve vs IFA-IgG –ve were 4.3(3.9) vs 4.2(4.4) years. CONCLUSION: Although patients with PD had a higher percentage sero-prevalence compared to the population, it was not significantly different. The drawback of this study was the long duration of PD at the time IFA-IgG levels were done. Following up of patients who present with extrapyramidal features due to acute rickettsioses and assessing whether they later develop PD would help to arrive at conclusions.Item Attitudes of nurses in palliative care – A Sri Lankan study(Sri Lanka Medical Association, 2016) Silva, F.H.D.S.; Luke, N.; Piyarathne, S.P.M.L.R.; de Silva, S.T.INTRODUCTION AND OBJECTIVES: Care of terminally ill patients and their families by health care workers (HCW) is variable from person to person. The quality of care is influenced by attitudes that the provider holds towards the concept of palliation. There is no formal education or training of HCW in Sri Lanka. This study aimed to determine the attitudes of nurses towards the dying process of a patient in the context of palliative care. METHOD: Nurses working in general medical and surgical wards and critical care units at the Colombo North Teaching Hospital, Ragama were assessed with the Frommelt Attitudes Towards Care of the Dying (FATCOD) scale (a 30 item, 5 point Likert Scale) using a self administered questionnaire. A total of 105 volunteers (general ward – 53, critical care- 52) participated in this study. RESULTS: The total FATCOD score for nurses in general wards was 107.51 (+/- 12.3) while it was 110.64 (+/-15.4) for critical care nurses (range 30-150). The mean FATCOD score for nurses in general wards was 3.58 (+/- 0.49) while nurses in critical care units achieved 3.68 (+/- 0.52). There were no significant differences of the mean scores with regards to nursing grade or duration of service (p<0.05). Scores related to communication between nurses and patients/carers were observed to be low along with the score on family interference in patient care. CONCLUSIONS: The results of this study demonstrate lower scores in all questions when compared to studies done in developed countries. The importance of developing strategies to improve delivery of palliative care services is paramount.Item Factors associated with Urinary tract infections caused by extended spectrum β-lactamase (ESBL) producing organisms in Sri Lanka(Elsevier, 2016) Fernando, S.; Luke, N.; Wickramasinghe, S.; Sebastiampillai, B.; Gunathilake, M.; Miththinda, N.; Silva, S.; Premaratna, R.BACKGROUND: Urinary tract infections (UTI) caused by extended-spectrum β-lactamase (ESBL)-producing organisms are a major burden in clinical practice. Hospitalization in the past 3 months, antibiotic treatment in the past 3 months, age over 60 years, diabetes mellitus, Klebsiella pneumoniae infection, previous use of second or third-generation cephalosporins, quinolones or penicillins are known associations and risk factors for ESBL-UTI. METHODS & MATERIALS: A descriptive study was conducted over a period of 6 months from January - July 2015 recruiting patients with UTI caused by ESBL producing organisms, who were admitted to the Professorial Medical unit, Colombo North Teaching Hospital, Ragama Sri Lanka in order to identify risk factors and associations. Data were obtained using a pre-tested interviewer administered questionnaire and from relevant medical records after obtaining informed written consent. RESULTS: 52 patients were recruited; males 30 (57.7%), mean (SD) age 64.1(.12.6)years. Of them, 46 (88.5%) had diabetes mellitus, 32 (61.5%) had hypertension and 10 (19.2%) had chronic liver disease as comorbidities.20 (38.5%) had ultrasonographic evidence of acute pyelonephritis. At presentation16 (30.8%)had biochemical and/or ultrasonographic evidence of chronic or acute on chronic kidney disease. History of constipation was observed in 18 (34.6%), hospitalization during the past 3 months was seen in 24(46.2%)and history of urinary catheterization in 16(30.8%). Features of obstructive uropathy such as hydronephrosis, hydroureter and prostatomegaly were seen in 4 (7.7%) patients each. Antibiotic treatment within the past 3 months was observed in 32(61.5%);penicillins in 18(34.6%), 3rd generation cephalosporins in 16(30.8%),quinolones in 14(26.9%) and 2nd generation cehalosporins in 12 (23.1%). 18 (34.6%) had received more than one antibiotic within the past 3 months. 8(15.4%)patients studied were on prophylactic antibiotics for recurrant UTIs. None of them had recent Klebsiella pneumonia. CONCLUSION: Similar to other studies,diabetes mellitus, recent antibiotic treatment, hospitalization and catheterization were observed in our patients with ESBL-UTI. The fact thatonly 53.8% patients had received antibiotics at community level and 38.5% patients had never received antibiotics prior to developing ESBL-UTIsuggest high prevalence of ESBL producing organisms at community level.