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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2012 - 20132

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    To identify the role of haemoglobin, pack cell volume and puise pressure in predicting fluid leakage in patients with dengue who consume adequate amounts of fluids
    (Sri Lanka Medical Association, 2012) Ranjan, P.; Ragupathy, A.; Miththinda, J.K.N.D.; de Silva, H.J.
    INTRODUCTION: Early detection of fluid leakage is important in identifying patients who are likely to develop shock syndrome in dengue. As patients are advised to consume adequate amounts of fluids such behaviours may alter the clinical and haematological parameters predicting fluid leakage. Methods: fn 102 confirmed dengue patients admitted to a single medical unit, CNTH, Ragama from September 2011,quantity and quality of fluids consumed, Hb, PCV, pulse pressure(PP) and their percentage rise or decline were documented and compared between those who developed and did not develop third space fluid accumulation(TSFA) [either pieural effusions, ascites or both detected by ultrasonography]. RESULTS: In 102 patients (52 males) with mean age 28.3(SD=11.8) years, TSFA was detected in 34/95(37%) on follow up. fn those who developed TSFA and did not develop TSFA, average consumption of water 620cc/day vs 491cc/day fp=0.14); solutes 1461cc/day vs 1481cc/day (p=0.83); the mean(SD) values of highest Hb 14.66(1.82)g/dl vs 14.28(1.6)g/dl (p=0.3) and highest PCV 44.16 (5.19) vs 43.4 (4.5) 0=0.46); pulse pressure 29.9mmHg vs 28.4 0=0.29); The maximum percentage rise in Hb 8%vs 4.6% (p=0.02); PCV 8.6% vs 4.5% 0=0-006); mean pulse pressure drop 6.9% vs 5.9% 0=0.84). Conclusions: In the presence of fluid consumption the quality or quantity of fluids consumed did not seems to contribute to TSFA. A single value of Hb, PCV or pulse pressure was not helpful in predicting early fluid leakage. While percentage reduction in pulse pressure was not helpful, percentage rise in Hb and PCV remained predictive of early fluid leakage in dengue.
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    Cluster randomized trial of the impact of school based deworming and weekly iron supplementation on haemoglobin level of plantation primary school children
    (College of the Community Physicians of Sri Lanka, 2013) Ebenezer, R.; Gunawardena, N.K.; Kumarendran, B.; Pathmeswaran, A.; de Silva, N.R.
    BACKGROUND: School-based deworming and iron supplementation are being promoted as effective interventions to deal with the high prevalence of anaemia among school children. OBJECTIVE: The objective of this study was to determine the effectiveness of school based deworming and weekly iron supplementation on increasing the haemoglobin level of primary school children in the plantation sector in Sri Lanka. METHODS: A placebo-controlled cluster randomized trial was conducted in which the treatment group received a single dose of 500 mg mebendazole and 6-months of weekly iron supplementation (200 mg ferrous sulphate) while the control group received placebo for both anthelmintic and iron. The tablets were administered by the class teacher. Children attending grade 4 in schools in the plantation sector were recruited. The treatment arm was allocated with 813 children attending 49 schools and the placebo arm with 808 children attending 49 schools. Height, weight and haemoglobin were measured at baseline and after 6-months. A regression model adjusting for the cluster design was used to assess the effectiveness of the intervention on the haemoglobin level. In order to increase the precision of the estimates, various background variables were controlled for in regression models. RESULTS: Complete data were available for 633 children in the treatment group and 613 children in the control group. The mean age was 9 years and 6 months and 52% of them were males. In the treatment arm 98% had received mebendazole and over 80% had received 16 doses of iron. A reduction in the prevalence of soil-transmitted helminth (STH) infection (from 25.1% to 16.4%) was found in the treatment group, with significant differences between treatment and control groups in the levels of Ascaris and Trichuris. There was a small non-significant reduction in the mean haemoglobin level (at baseline 12.6g/dl, sd - 1.2) of both groups. No impact of treatment was found on haemoglobin levels. CONCLUSIONS: Though the intervention was effective in reducing the prevalence of STH infection there was no evidence of effectiveness in increasing haemoglobin levels.