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 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 Effect of mebendazole threapy in pregnancy on birth outcome(Sri Lanka Medical Association, 1998) de Silva, N.; Sirisena, J.; Gunasekera, D.; de Silva, J.OBJECTIVES : A prospective, unmatched, case-control study was done to assess the safety of mebendazole threapy in pregnancy, a hitherto uninvestigated factor. DESIGN : All women delivering in the University Obstetrics Unit of the Ragama Teaching Hospital between May 1996 and, March 1997 were administered a questionnaire soon after delivery. Details of the birth and the baby were recorded; suspected defects were confirmed by a paediatrician. The incidence of congenital defects in babies of mothers who had taken mebendazole during the pregnancy was compared with the incidence among those who had not taken an anthelmintic (controls). Data analysis was done using Epi Info 6.03. RESULTS : Of 3688 women, 73.5% had taken mebendazole, 24.8% had not taken any any anthelmintic , 1.1% had taken an anthelmintic but could not identify it and 0.6% had taken pyrantel or albedazole. The incidence of birth defects was 2.36% {64/2711) in the mebendazole group compared with 2.3% (21/913) in the controls (odds ratio 1.03, 95% confidence limits 0.61 - 1.75). This difference was not statistically significant even when corrected for other known risk factors by stratified analysis . Data regarding timing of mebendazole threapy was available for 2660 women; 6.9% in the first trimester, 83.8% in the second, and 9.2% in the third. The incidence of birth defects among women who had taken mebendazole in the first trimester was 3.24% (6/185). giving an odds ratio of 1.42 against the controls; this was also not statistically significant.CONCLUSIONS : The use of mebendazole in pregnancy does not lead to a significant increase in the risk of congenital defects.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.