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 Seizure patterns, preconception care and pregnancy outcomes in women with epilepsy in a tertiary care hospital(Journal of the Ceylon College of Physicians, 2020) Motha, M.B.C.; Palihawadana, T.S.; Jayasinghe, C.; Ranawaka, U.K.INTRODUCTION AND OBJECTIVES: Data on epilepsy in pregnancy is limited from South Asia and other resource-limited countries. We sought to describe seizure patterns, preconception care and pregnancy outcomes in women with epilepsy attending a Sri Lankan tertiary care hospital. METHOD: All pregnant women with epilepsy admitted to University Obstetrics Unit, Colombo North Teaching Hospital during the period January 2017 February 2020 were recruited. Data were collected by a single physician using an interviewer-administered questionnaire. RESULTS: Out of 9520 pregnant women screened, 63 had a history of epilepsy (prevalence 6.6/1000); 46% generalized epilepsy, 22.2% focal epilepsy. Of 38 women on antiepileptics at conception, only 44.7% were given folic acid 5 mg preconceptionally. 42.9% were seizure free over preceding 2 years. Majority (55%) had a seizure during current pregnancy (average number of seizures per patient: 1s1 trimester 1.85, 2nd trimester 2.2, 3rd trimester 2.95, postpartum 2.5). 18.4% of seizure events were attributed to sleep deprivation, and 2.7% to unsatisfactory drug compliance. 81.6% were on monotherapy at conception and 18.4% were on two antiepileptic. 22.2% had a hypertensive disorder of pregnancy and 9.5% spontaneous premature delivery. 33.3% underwent caesarian delivery. 1.58% each had a stillbirth and neonatal death. Low birth weight was seen in 42.9%. Major congenital malformations were found in 11.1% of newborns. CONCLUSIONS: Pre-conceptional folic acid coverage was poor. Seizures occurred in more than half of the women and were more common in third trimester and postpartum. Rates of hypertensive disorders, caesarean deliveries, low birth weight and congenital malformations were high.Item Family planning among Medically ill people in a sri lankan setting: a descriptive study(Sri Lanka College of Obstetricians and Gynaecologists, 2007) Palihawadana, T.S.; Fernando, W.S.; Mallawaarachi, W.P.P.K.; Attanayake, A.M.J.H.; Motha, M.B.C.; Wijesinghe, P.S.INTRODUCTION: Sri Lanka has a high contraceptive prevalence with a low total fertility rate. In spite of this, unmet need of family planning among medically ill people is observed in day to day clinical practice. Medical illnesses complicating pregnancy are a major cause of maternal morbidity and mortality in Sri Lanka. This is thought to result from non usage as well as use of methods with low efficacy. We studied the contraceptive usage among people suffering from medical illnesses as a preliminary survey of a large scale study. METHOD: The study was carried out at the medical clinics of the Colombo North teaching hospital from March to July, 2007. Those who suffer from medical conditions that could complicate a pregnancy were interviewed to find out the family planning practices and identify the limiting factors for uptake of modern methods. Sixty seven sexually active subjects who are in their reproductive age group were interviewed for the research purpose. RESULTS: Study population comprised of 55% of Buddhists, 38% Catholics and 6% Islamics. Mostly encountered medical conditions were diabetes mellitus (n=18), hypertension (n=15), Valvular heart disease (n=10) and thyroid dysfunction (n=6). Seven subjects were planning for a pregnancy at the time of interview though none of them had been advised that it is safe to do so. Nearly 80% (n-53) of subjects admitted to practicing family planning. However, among them 71% (n=38) were using the traditional methods of family planning, where calendar method was the most commonly used (43.3%) followed by withdrawal (20.8%) and the cervical mucous (75%) methods. Norplant was the most commonly used modern method (13.2%) while other methods used included combined contraceptive pill (9.4%), intrauterine contraceptive device (3.8%) and DMPA (1.9%). None of the study subjects practiced male or female sterilisation. Of the total study population 35.8% (n=24) had received family planning advice from the family health midwife after diagnosis of their condition, while only 6% (n=4) had such advice at the medical clinic. CONCLUSIONS: Though family planning is practiced by a high proportion of medically ill people, only a minority use modern methods. High prevalence of traditional family planning usage make this group vulnerable to unintended pregnancies due to the low efficacy of the methods used by them. Family planning advice does not seem to adequately reach this more deserving population. Possible reasons for this could be either the reluctance of field health workers to dispense modern methods of family planning to these people or the deficiencies in the family planning program to reach such special groups, thus stressing the point that such services should be integrated at the level of the medical clinic.Item A Clinical guide for dengue detection, appropriate timing of investigations and hospital admissions(Sri Lanka Medical Association, 2005) Premaratna, R.; Pathmeswaran, A.; Amarasekera, N.D.D.M.; Motha, M.B.C.; Perera, K.V.H.H.K.; de Silva, H.J.Abstract Available.