Conference Papers
Permanent URI for this collectionhttp://repository.kln.ac.lk/handle/123456789/6561
This collection contains abstracts of conference papers, presented at local and international conferences by the staff of the Faculty of Medicine
Browse
7 results
Search Results
Item Ecology of healthcare: Symptom prevalence and health care seeking behaviour in Gampaha District, Sri Lanka(Sri Lanka Medical Association., 2019) Withana, S. S.; Mendis, K.; Nandasena, S.; Wickremasinghe, A.R.INTRODUCTION & OBJECTIVES: In 20 J 5, the Ministry of Health reported that 55 million outpatient visits were made to government OPDs and estimates 100 million visits by 2027. We studied the community symptom prevalence, associated factors and the trends in healthcare seeking behaviour in the Gampaha district. METHODS: A community-based prospective study, using a participant held symptom diary and interviews was conducted from May to June 20 J 8 in three Public Health Midwife areas each from Raga ma (urban) and Mirigama (rural) MOH areas. RESULTS: We invited 2330 individuals from 557 households and 2046 participated. Majority were: females. (n=l 127, 55.1%). Highest recruitment was from Mirigama area (n=1207, 59%). Of the study population 1919 (93.8%) reported at least one symptom. Phlegm (n=4871, 7.2%) had the highest frequency, musculoskeletal symptoms were the highest (26.8%) as a group. Females had a higher symptom prevalence (p = 0.001). Employment, income, having a chronic disease and distance to healthcare institution were significantly (p < 0.05) associated with both symptom prevalence and healthcare seeking behaviour. How the symptoms were managed: Ignored symptoms (n=l53, 8%), Self-care (n=560, 29.2%) and Seeking healthcare (n=924, 48.1%). Majority (n=763,82.6%) sought allopathic treatment, of whom 515 (55.7%) chose private sector ambulatory care. Of the 43 (2.2%) hospital admissions, 28 (65%) were to government hospitals. CONCLUSION: People in Gampaha District have a high symptom prevalence (93.8%) and healthcare seeking behaviour (48.1%) compared to USA which was (80%) and (32.7%) respectively. Gender did not influence the healthcare seeking behaviour. Majority (55%) preferred private allopathic ambulatory care.Item Pub Med and Google Scholar perspectives of the Ceylon Medical Journal: Analysis from 2002 - 2016(Sri Lanka Medical Association, 2018) Mendis, K.; Solangaarachchi, D. I. K.; Weerabaddana, C.INTRODUCTION: Revisiting our analysis published in 2002, a bibliometric analysis of the Ceylon Medical Journal(CMJ) was done. METHOD: CMJ citations from 2002-2016 were downloaded in PubMed/MEDLINE format and written to a MS• Access database using 'PubMed Grabber' software from Kelaniya. For analysis, advanced PubMed queries and Google Scholar (for H-Index and cross-check author publication details) were used. RESULTS: 87~ citations were authored by 1666 authors. However, only 441 had more than one citation. Annual citations decreased from 71 (2002) to 61 (2016). Range 51-71, mean 58.6 and mode 51. Publications types: Journal Articles 685 (75%), Case Reports 281 (32%), Letters 210 (24%), Reviews 19 (2%), Clinical Trials 25(3%). Classification of citations by ICD-10 main chapters using Medical Subject Headings [MeSH]: infections and parasitic 156 (17.7%), endocrine, nutritional and metabolic 119 (13.5%), neoplasms 111 (12.6%), nervous system 101 (11.5%), digestive system 90 (10.2%). Authors with the highest number of articles were: [CMJ articles in PubMed, All articles in PubMed, H-Index] de Silva HJ [30,150,41] Lamabadusuriya SP [22,26,4] Pathmesweran A [22,64, 17] Senanayake MP [18,28, 9] de Silva NR (17,45,26] Kuruppuarachchi KA [16,24,7] Jayasinghe-_S_ [ 16, 189, 19] . CONCLUSION: The number of annual citations in CMJ is decreasing. For 1225 (73%) authors, publishing in the CMJ was a one-time affair. Case reports (32%) and letters (24%) totalled 56%. The vast majority of the top ranked CMJ authors had more citations in journals with a higher 'journal impact-factor' than CMJ. This may be one reason that CMJ is yet to have an impact-factor. Our method depends on the accuracy and consistency of author name, affiliation, and the key words submitted by authors.Item Morbidity pattern and process of care at a teaching hospital outpatient department in Sri Lanka(Sri Lanka Medical Association, 2017) Mendis, K.; de Silva, A.H.W.; Perera, D.P.; Withana, S.S.; Premasiri, B.H.S.; Jayakodi, S.INTRODUCTION & OBJECTIVES: There is paucity of published data regarding outpatient department (OPD) morbidity in spite of 55 million OPD visits to government hospitals in 2014. OPD morbidity has been assumed to be similar to indoor morbidity for two decades. The recent Ministry of Health focus to strengthen primary care skills of medical graduates, requires reliable data from primary care to align medical curricula towards this goal. This is an initial step to identify the primary care morbidity profile. METHODS: In a cross-sectional pilot study doctors trained as data collectors observed a representative sample of doctor patient encounters and recorded the reason for encounters (RFE) and process of care. The problem definition (PD) was provided by the consulting doctor. RFEs and PDs were later coded using International Classification of Primary Care (ICPC2). Analysis was done using ‘R Ver3.2.3’ programming language. RESULTS: A total of 2923 clinical encounters resulted in 5626 RFEs and 3051 health problems. Patients mean age was 39.1(±22) with 64.5% females. Top ranking PDs were (n=3051): acute upper respiratory infection (11.3%), other respiratory infection (8.1%), viral fever (4.7%), lower respiratory tract infection (4.7%), muscle symptoms and complaints (3.8%), gastritis (3.3%), bronchial asthma (2.6%), dermatitis (2.5%), fungal infections (1.6%) back pain (1.5%), sinusitis (1.4%), joint pains (1.2%) and tonsillitis (1.2%). Psychological problems accounted for 0.4% and no social problems were recorded. During 2923 encounters, 540 (18%) were referred to clinics and 66 (2.3%) admitted to hospital. Prescriptions were issued for 2349 (80%), examination carried out in 2322 (79%), advice given to 946 (32%) and investigations ordered for 348 (12%). CONCLUSION: The morbidity pattern of OPD patients is different from inpatients - almost two thirds were females and more than 30% were respiratory problems.Item Teaching and learning of communication skills through video consultations(Sri Lanka Medical Association, 1998) de Silva, N.; Mendis, K.; Nowfel, M.J.OBJECTIVE : To help students leam communication skills in a family practice setting through viewing of live video consultations critique of communication skills during a videotape replay of consultations METHOD : The University Family Medicine Clinic at the Faculty of Medicine, University Kelaniya provides the setting for learning of communication skills by third year medical students. During the two week Family Medicine attachment to this clinic, teaching and learning takes place through small group work and video consu Itations. The consultation between the family physician teacher and the patient from whom prior consent has been obtained is viewed live by 14 - 15 students in an adjacent seminar room. After observing a few such consultation's, the students in turn, practice communication skills by talking to patients while the consultation is video taped. The students whose consultation has been recorded on video has it replayed in the presence of the teacher and peers. A self-critique and constructive feedback by the group helps the student to learn from the strengths and weaknesses of his skills in communication. Learning through role pay by the students acting as the patient and doctor is dealt with a similar manner. RESULTS : At the end of appointment evaluation, the students rated this as the most preferred learning and teaching method(78%). Consent was refused by only two patients. CONCLUSION : This modern teaching and learning method which promotes active learning in a non threatening and supportive environment is interesting and suitable to use in the Sri Lankan context.Item One day general practice morbidity survey in Sri Lanka(Sri Lanka Medical Association, 1998) de Silva, N.; Mendis, K.OBJECTIVE : To identify people's needs from the reasons for encounter with family physicians, to illustrate the pattern of morbidity in general practice and determine the workload of general practitioners(GPs) in Sri Lanka METHOD : A random sample of GPs completed a Practitioner Profile Questionnaire (PPQ) and recorded in an encounter from (EF) the rcason/s for encounter (RFE) and problems defined during consecutive consultations on the fourth of July 1996. Central coding of the RFEs and problems defined \vas done using the International Classification of Primary Care (ICPC). RESULTS : Forty GPs (53.3%) completed the PPQ, while the response to the EF was 43.3%. The GP profile showed none below 35 years and none qualified after 1984. The average daily workload was 74. It was estimated that GPs handle 26.5% of the primary care morbidity. Children accounted for 32% of consultations. There was a significantly higher proportion of children (pO.OOOI) and the elderly (p<0.05) in the consulting population compared to national statistics. In 2068 encounters, 3448 RFEs and 2087 problems had been recorded. By ICPC rubrics, 27 of the top thirty RFEs were for common symptoms. Acute illness, asthma, hypertension, diabetes and preventive care were among top twelve problems defined. CONCLUSION : The findings indicate the necessity to include family medicine/general practice in the undergraduate curriculum of all medical schools. Care of children and the elderly should receive priority in family training programmes. Suitable incentives may be necessary to motivate younger doctors to become GPs to meet the medical care needs of the community.Item Three decades of CMJ - an analysis using PubMed(Sri Lanka Medical Association, 2003) Mendis, K.; Weerabaddana, C.; Solangaarachchi, D.I.K.; Wanniarachchi, C.H.OBJECTIVE: The Ceylon Medical Journal (CMJ) is the only Sri Lankan medical journal that is indexed in MEDLJNE, the largest electronic bibliographic medical database. Publications in the CMJ from 1965 March to 2001 December were analyzed using the PubMed interface of MEDLINE. METHOD: Using PubMed we download the CMJ bibliography in MEDLINE format. Important tagged fields were written to a MS-Access database using a Visual Basic program. The analysis was done using Access-SQL and PubMed queries. RESULTS: There were 1472 citations by 1373 authors. The top 10 authors contributed 15.6% and the top 25, 30.1% of the articles. Lamabadusuriya SP(32), Uragoda CG(31), de Silva HJ(28), de Silva DG(23) and Lucas GN(22) were the top contributors. 944 authors had only one and 176 had two articles. Publications types were: 84.9% 'journal articles', 12.8% letters, 5.2% reviews and 5.1% historical articles. Randomized controlled trials were 0.7%, meta-analysis 0.1%. Articles were classified using 2 to 44 keywords (average 11.4, mode 9) from the MeSH vocabulary. Articles published that were classified under'broad disease categories were: Neoplasm ,174(11.82%), Cardiovascular 159(10.8%), Nervous system 157(10.67%), Endocrine, nutritional and metabolic 157(10.67%), Digestive system 151(10.26%), Musculoskeletal, skin and connective tissue 131(8.9%), Respiratory 113(7.68%). DISCUSSION: For the majority of the 1373 authors, publishing in the CMJ was a onetime affair whilst the top 50 authors contributed for nearly half (46.4%). A by-product of this research is an offline CMJ database system with menu driven search facilities, which will be a useful tool for researchers.Item Is the combination of Advanced Level aggregate, attempt, and IQ a better criteria for medical school selection?(Sri Lanka Medical Association, 2001) Jayawardana, D.R.K.C.; Mendis, K.INTRODUCTION: Admission criteria to Sri Lankan medical faculties are based on the Advanced Level (AL) aggregate and district. The student's medical school performance at examinations (MSPE) does i not correlate well with their AL marks. OBJECTIVE: To ascertain the association of medical school performance at examinations with IQ, AL aggregate and AL attempt. METHOD: The students of the first batch of the Faculty of Medicine, University of Kelaniya, were given Ravens IQ test during the final year. Subject marks in the first attempt at 2", 3rd and Final MBBS were extracted from the official records. Final MBBS total marks and grand total marks of all subjects, AL aggregate and the AL attempt were also recorded. Results were analysed using EPI 6. RESULTS: The AL aggregate did not have a significant correlation with MSPE either in the Final MBBS or with the grand total mark. A significant positive correlation was obtained between the mean IQ and the Final MBBS examination marks (p=0.006). Although there was a positive trend there was no significant correlation between the mean IQ and the grand total marks. The AL first attempt students fared significantly better in the Final MBBS (p~0.002) and throughout their undergraduate career (p=0.001).There was no significant correlation between AL attempt and IQ. CONCLUSIONS: Although traditionally AL marks are taken for university entrance, a higher mark at the AL did not correlate well with MSPE. IQ and AL attempt were better indicators of MSPE.