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 A preliminary survey for filarial parasites among dogs and cats in mahawewa, puttalam and their vector identification(Elsevier, 2022) Nimalrathna, S.; Mallwarachchi, C.; Chandrasena, T.G.A.N.; de Silva, N.; Kimber, M.; de Silva, N.R.; Harischandra, H.PURPOSE This study investigated the prevalence of zoonotic filarial parasites within the canine and feline population in Mahawewa, Puttalam, and their vectors based on a brugian filariasis positive human case reported to the Anti-filariasis Campaign in January 2021.METHODS & MATERIALS All reachable dogs and cats, both stray and domestic, within a 500m radius of the index human case of brugian filariasis were screened for microfilaria using Giemsa stained thick blood smears prepared from capillary blood, obtained from an ear-lobe prick. Mosquito collection was done using a dog-baited trap, two window traps and a B.G. Sentinel trap from the same study site and identified using morphological keys. The head and the thorax regions of randomly selected mosquito specimens were dissected for morphological identification of larval filaria parasites via microscopy. RESULTS A total of nine dogs and three cats were surveyed, of which seven dogs and one cat had filarial infections. All the infected animals harbored B.malayi microfilariae, while four dogs and one cat were co-infected with Dirofilaria repens and two dogs with an unidentified species. A total of 119 mosquitoes were caught and identified by taxonomic keys using a dog-baited trap, two window traps and a B.G. Sentinel trap from the study site. Dissection of heads and thoraces of randomly selected 12 Mansonia annulifera, 18 Mansonia indiana 20 Mansonia uniformis and 8 Culex spp. revealed filarial larvae in M.annulifera (n=4, 33.33%), M. indiana (n=14, 77.78%), M. uniformis (n=10, 50.00%) and Culex spp.(n=5, 62.5%) via microscopy. CONCLUSION M.indiana was incriminated as a potential vector of filarial parasites for the first time in Sri Lanka. Preliminary evidence generated indicate a high prevalence of B.malayi and D.repens among dogs and cats in Mahawewa, Puttalam with an abundance of mosquito vectors mostly of Mansonia and Culex spp. This warrants further studies with a larger sample size and molecular identification of the filarial larvae within mosquito and animal samples, especially as re-emergence of brugian filariasis in humans is being reported after four decades of quiescence, and a zoonotic brugian parasite has been detected over the recent past, raising a concern from a one health perspective.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.Item Limitations of current measures used for selection of students to medical schools in Sri Lanka(Sri Lanka Medical Association, 2005) Pathmeswaran, A.; de Silva, N.R.; de Silva, N.; Edirisinghe, S.; Parameswaran, S.C.; Seneviratne, R.; Warnasuriya, N.; de Silva, H.J.INTRODUCTION: Policy regarding selection of students for admission to medical school in Sri Lanka is considered unsatisfactory by many. This study was carried out across all six medical schools in the country, to assess the extent to which selected factors at point of entry predict success in medical School. METHODS: The study sample consisted of all students selected by the University Grants Commission to study medicine in two consecutive entry cohorts. The 'A' level aggregate marks of these students, the district of entry, gender and candidate type (school/private) we're identified as entry point variables. Success in medical school was measured in four ways: the ability to pass the first Summative examination and the final examination at the first attempt, and the ability to obtain a class in either. Multiple logistic regression was used to assess the extent to which these entry point factors Could predict variability in outcome measures. RESULTS: The mean 'A' level aggregate among the 1740 students in the study sample was 282 (range: 212-356). The male: female ratios were 1.5 and 1.3 respectively in the two cohorts. 22% of students were private candidates, who were probably attempting the 'A' levels for the third time. Having a high A'level aggregate, being female, and being a school candidate were all independent predictors of success in all outcome measures. However, the aggregate score alone and candidate type each accounted for only 1-7% of the variation in performance in medical school. CONCLUSION: The only measure of academic performance used for selection of medical students is a weak predictor of success in our medical schools.