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 Efficacy of hydroxyurea in reducing the erythropoietic stress of ineffective erythropoiesis in transfusion dependent beta thalassaemia: A randomised, double-blind placebo-controlled clinical trial(Sri Lanka Association for the Advancement of Science, 2021) Yasara, N.; Premawardhena, A.; Perera, P.; Manamperi, A.; Mettananda, S.The unbalanced synthesis and accumulation of a-globin chains due to impaired synthesis of 0- globin results in the destruction of red blood cells (RBC) and erythroid precursors of patients with P-thalassaemia. This leads to an increased erythropoietic activity and ineffective erythropoiesis in the bone marrow of these patients. Hydroxyurea is a licenced medication that decreases the RBC destruction of patients with p-thalassaemia. However, its effect on erythropoietic stress is unclear. In this study, our objective was to evaluate the effect of hydroxyurea on erythropoietic stress of ineffective erythropoiesis in transfusion-dependent (TD) p-thalassaemia. This experimental study was carried out at the Thalassaemia Unit of Colombo North Teaching Hospital as part of a randomised, double-blind placebo-controlled clinical trial that evaluates the efficacy of hydroxyurea. We recruited 24 patients with TD p-thalassaemia who were taking hydroxyurea IQ- 20 mg/kg/day and 16 patients who were receiving a placebo. The erythropoietic stress of ineffective erythropoiesis was assessed by measuring serum soluble transferrin receptor (sTfR) levels before and six months after taking either hydroxyurea or placebo. Levels of sTfR were measured using a validated enzyme-linked immunosorbent assay. Paired t-test was used in the statistical analysis. Nineteen (79%) out of 24 patients who received hydroxyurea showed a reduction in sTfR level, of which 8 (33%) and 6 (25%) showed >25% and 10-25% reductions, respectively. A significant reduction in mean sTfR level was observed after hydroxyurea treatment (72.3±SD25.9) compared to pre-treatment levels (89.6士SD22.9), (pv0.01). Conversely, no difference in sTfR levels was seen in patients who received the placebo pre・(91.9土SD24.7) and post-treatment (96.4±SD19.4), (p=0.17). In conclusion, oral hydroxyurea significantly reduced the erythropoietic stress of ineffective erythropoiesis in patients with TD p-thalassaemia showing a promise as a treatment modality.Item Sequelae of BCG vaccination and effects of cleaning vaccine site with alcohol(Sri Lanka Medical Association, 2012) Perera, P.; Samaranayaka, G.; Samaranayaka, R.; Ranathunga, N.INTRODUCTION: In Sri Lanka, BCG vaccine is given during neonatai period. There are many myths regarding BCG vaccine among general public and sequelae of vaccination is not well documented in medical literature. AIMS: Objectives of this study were to describe the sequelae of BCG vaccination when given at neonatal period and to find out whether cleaning the vaccine site with 70% alcohol, affect its potency. METHODS: A prospective observational study was carried out at Ragama teaching hospital and 2 private hospitals in Gampaha district. 125 babies each from government and private sector were recruited for the study with the consent from parents. Vaccine was administered in the morning as well as evening, as required by the patient, by a consultant Paediatrician. Vaccine site was cleaned with 70 % alcohol and allowed to dry before vaccination. All babies were bathed on same day. Babies were followed up periodically until a scar was detected. RESULTS: 182 babies completed the follow up and all babies developed a scar. Time taken for a reaction varied but all babies had a reaction by 8 weeks and a scar by 14 weeks. 6 babies had fever within one week of vaccination but it was due to feeding failure or sepsis. None had adverse reactions attributable to the vaccine. CONCLUSIONS: Cleaning the vaccine site with alcohol does not affect the potency of BCG vaccine. Proper technique of administration is important for successful vaccination. Time of vaccination and bathing had no effect on efficacy or side effects.Item Knowledge of mothers regarding helminth infections and patterns of anthelminthic usage in children(Sri Lanka Medical Association, 2012) Perera, P.; Dissanayaka, D.; Fernando, M.; Ranathanga, N.INTRODUCTION: Intestinal helminth infections are a global problem. There are lot of misbelieves among people regarding helminth infections, which often leads to inappropriate use of anthelmintics. AIMS: To assess the knowledge of mothers regarding helminth infections and to describe the patterns of anthelmintic usage in children. METHODS: A descriptive cross sectional study was carried out at University Paediatric unit. Teaching hospital Ragama, during September 2011 to November 2011. Two Hundred children and their mothers admitted to the Paediatrics university unit with at least one child above 18 months were recruited with informed written consent. Socio-demographic data, availability of sanitary facilities and safe drinking water, knowledge on intestinal infections and practices related to anthelmintic treatment were collected using a pretested Interviewer administered questionnaire. RESULTS: Nearly all families had access to a safe toilet and 62% had safe drinking water. 84% of children had regular anthelmintic treatment and out of them 39.3% had 3 monthly, 55.3% six monthly and 5.3% annually. Out of them only 81.4% had risk factors to get helminth infections, while 36,9% had no evidence in the past of worm infection. There was no statistically significant association between regular anthelmintics usage and presence of risk factors (odds ratio 1.799, CI 0.849-3.815). Knowledge of mothers regarding transmission of worm infections and clinical features was poor. CONCLUSIONS: Considering the high literacy rate among Sri Lankan mothers knowledge about worm infections was surprisingly poor. A lot of children are receiving unnecessary anthelmintic treatment. Health education programs addressing these issues are indicated.Item Dental hygiene practices and the pattern of dental caries in preschool children in Ragama(Sri Lanka Medical Association, 2012) Perera, P.; Abeweera, N.; Fernanado, M.; warnakulasuria, T.W.; Ranathunga, N.INTRODUCTION: Dental caries is a common problem among preschool children, but often neglected as deciduas teeth are replaced later by permanent teeth. However, for many reasons, protecting deciduas teeth is very important. AIMS: The objectives of this study were to describe the prevalence of dental caries among preschool children and assess the utilization of dental care facilities. METHODS: A descriptive cross sectional study was done between August 2010 and October 2010 at child welfare clinics held in the Ragama MOH area. Consecutive children aged between 2 and 5 years attending the clinics were recruited with the consent of parents. An interviewer administered questionnaire was used to obtain data and the mouth was examined for caries. Total decayed-missing-filled (dmft) score and significant caries index (SIC) were calculated to describe the prevalence of dental caries. Care index was calculated to describe the use of dental services. RESULTS: Out of 410 children recruited, none had routine visits to a dentist. Though practices related to brushing teeth were satisfactory, 37.8% children in the study sample had caries. This increased to 68.8% by 5 years of age. Mean dmft score for the whole sample was 1.41 and SIC index was 4.09. The Care index was 4.72. The dmft score in girls was higher than boys. Incisors of the upper jaw were the mainly affected teeth. CONCLUSIONS: Prevalence of dental carries among this cohort of Sri Lankan preschool children is very high. The level of dental care for preschool children at present appears to be unsatisfactory.