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 Consumer knowledge and demand for antibiotics in Gampaha District(Sri Lanka Medical Association, 2005) Premaratna, R.; Weerasinghe, M.; Vipulanayake, T.; Mettananda, K.C.D.; Balasooriya, H.; de Silva, H.J.INTRODUCTION: Misuse of antibiotics in clinical practice is common. Patients' demand has been identified as a cause for wide use of antibiotics. Demand for antibiotics is affected by consumers' knowledge, attitudes, and medical practice. METHODS: Patients and their relatives attending out patient clinics in Colombo North Teaching Hospital and two private consultation clinics in the Gampaha District were interviewed using a pre¬tested questionnaire to study their knowledge of antibiotics and behavior during a febrile illness. RESULTS: Total population 763 [(487 females); Mean age 37.6 (SD; 15.9)]. Proper awareness of antibiotics was observed in 51/763(6.6%); with an increasing trend with level of education (LOE). More than 90% would accept any treatment prescribed by the doctor while antibiotics were expected by 64/763(8.3%) with no difference to LOE. During a febrile illness 563 (73.8%) visited a general practitioner within the first 2 days. Only 2 (0.3 %) claimed to have self-medicated with antibiotics. 376/487 (76%) females and 180/276 (65%) males expected some treatment without investigations. 67/487 (16%) of females and 34/276 (12%) males claimed they would have changed the doctor if there was no improvement in the first instance. Only 122/763 (16%) were aware of the cause for the most recent febrile illness they had suffered. CONCLUSIONS: In our population, knowledge of antibiotics, self medication and demand for antibiotics is lower than in European populations. Most of the patients are ready to accept any treatment prescribed and antibiotics were expected only by a minority. Therefore, patient behavior may not play a major role in the misuse of antibiotics.Item Reappraisal of symptoms and signs of uncomplicated β thalassemia trait(Sri Lanka Medical Association, 2005) Premawardhena, A.; Malewana, T.; Weerasinghe, M.; Arambepola, M.INTRODUCTION: Although considered a mild disorder, J3 thalassemia trait has been reportedly associated with symptoms of anaemia, while in other series hepatosplenomegaly has been reported as associated with this diagnosis. No controlled study has examined the symptoms and signs of individuals with {5 thalassemia trait and compared these with age- and sex-matched normal individuals. Materials and METHODS: We administered a questionnaire to 397 parents of children with J3 thalassemia major attending the National Thalassemia Centre in Kurunagala, Sri Lanka, and to 87 normal volunteers. All individuals underwent physical examination by the same investigator, as well as testing by automated cell counter, and HPLC. RESULTS: The mean age of the parents (33 years) and controls (29.5 years) was not significantly different. In parents with thalassemia trait, 20% of males and 42% of females complained of reduced exercise tolerance compared to 12.5% of males and 38% of females in the controls. The questionnaire revealed that 41% of parents, and 36% of controls, complained of recurrent headache; 18% of parents, and 15% of controls, complained of lethargy. Mean quality-of-life score, recorded formally by a linear analog scale, from 0 to 10 was 7.1 in parents and 7.2 in controls. CONCLUSIONS: These findings suggest that, by contrast to many reports in the older literature, in uncomplicated p thalassemia trait there appears to be no symptoms or signs greater than those observed in a normal control population.Item Genetic sequencing of the 56-kDa surface protein antigen gene of Orientia tsutsugamushi causing contemporary human scrub typhus at two sites in Sri Lanka(Sri Lanka Medical Association, 2014) Premaratna, R.; Blanton, L.; Samaraweera, D.N.; de Silva, G.N.N.; Kumara, T.A.D.N.; Liyanarachchi, M.S.; Weerasinghe, M.; Gunasekara, C.; Chandrasena, T.G.A.N.; Walker, D.; de Silva, H.J.INTRODUCTION AND OBJECTIVES: Genetic and antigenic characterisation of Orientia tsutsugamushi (OT) causing human disease in OT-endemic regions of Sri Lanka is not known. METHODS: Eschar biopsies (in age> 18 years} and buffy coat samples {in age<18 years) collected from patients with OT confirmed by IFA were further studied at the Rickettsia! Diseases Research Laboratory, Texas, USA by real time PCR (Orientia 47 kD} and nested PCR (Orientia 56 kD) amplification. DNA sequences were obtained for 56 kD gene amplicons and phylogenetic comparisons were analysed using currently available data in GenBank [Neucleotide substitution per 100 residues, 1000 Bootstrap Trials]. RESULTS: Twenty eschar biopsies (Balapitiya:19, Ragama:1} and eight buffy coat samples (Balapitiya:6, Ragama:2} examined by real time PCR revealed Orientiaamplicons in 16 samples. DNAsequences were obtained for the 56 kD gene amplicons in 12 eschars and 4 buffy coat samples. The genotypes of the Balapitiya samples revealed that, 7 exhibiting close homology with JP1 [distantly related to UT177 Thai (Karp related}], two had close homology with JGv and JG AF [distantly related to Kawasaki M63383], one had close homology with Gilliam strain, and five had close homology with Kato strain. The Ragama strain was closely related to Kuroki-Boryong L04956. CONCLUSIONS: We observed all three main OT genotypes in Sri Lanka, and the majority fell into Thai Karp related clade. These results demonstrate antigenic diversity of OT in the studied areas of Sri Lanka.Item Symptoms and signs of β thalassaemia trait: results of the first comparative study(Sri Lanka Medical Association, 2007) Premawardhena, A.P.; Weerasinghe, M.; Kottachchi, D.; Arambepola, M.; Katugaha, N.; Samarakoon, S.; Otivieri, N.F.; Weatherall, D.J.OBJECTIVE: Thalassaemia trait is considered a mild and asymptomatic condition. However patients with this disease may be symptomatic. Should these be attributed to the disease? Does pre-knowledge about the diagnosis affect patients' symptoms? Previous studies were affected by the lack of a control arm. This is the first controlled study which compares symptoms of (3 thalassaemia trait with matched controls and also looks at how prior knowledge of the disease affects symptoms. DESIGN, SETTING AND METHODS: We administered a questionnaire to 146 individuals who knew that they had thalasseamia trait (Group 1} and to 248 "normal" volunteers who did not know their "thalassaemic status". Eleven symptoms were assessed. All individuals were examined by the same investigator and had a full blood count from an automated analyzer and a thalassaemia screening with High Performance Liquid Chromatography (HPLC- Bio Rad). RESULTS: The FBC and HPLC data showed that of the 248 "normal" controls , 63 had p thalassaemia trait (Group 2), and a further 96 had MCV< 80 and MCH <27 without thalassaemia (Group 3), presumably due to iron deficiency. 89 had normal red cell indices and normal HPLC (Group 4). Comparison of the four groups showed that "anaemic symptoms" like headache, exercise intolerance and lethargy occurred in significantly higher numbers in Groups 1 and 2 compared to Group 4. Comparison of Group 1 and Group 3 did not show any significant difference suggesting a similar mechanism for symptoms. Group 2 did not differ significantly from Group 1 in anyway. CONCLUSIONS: The p thalasseamia trait can be a symptomatic disorder and the symptoms arc those of anaemia. Symptoms are not affected or caused by being aware of the diagnosis.