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 The Prevalence of asthma in Sri Lankan adults((Wiley Blackwell Scientific Publications, 2016) Amarasiri, D.L.; Undugodage, U.C.M.; Silva, H.K.M.S.; Sadikeen, A.; Gunasinghe, W.; Fernando, A.; Wickremasinghe, A.R.; Gunasekera, K.D.BACKGROUND AND AIMS: Data on adult asthma is scarce in Sri Lanka. The objective of this study was to estimate the prevalence of asthma and related symptoms amongst adults in the general population. METHODS: A multi-centered, cross-sectional study was conducted using an interviewer-administered translated version of the screening questionnaire of the European Community Respiratory Health Survey from June to December 2013 in 7 provinces of Sri Lanka. Subjects were selected randomly from different regions by stratified sampling. The prevalence of asthma was defined as "wheezing in the past 12 months (current wheeze)", 'self-reported attack of asthma in the past 12 months' or 'current asthma medication use'. RESULTS: The study comprised 1872 subjects (45.1% males, 48.8% aged18-45 years) of which 12.2% were current smokers. In the total population, the prevalence of current wheeze was 23.9% (95% CI: 22.0%-25.9%), of self-reported asthma was 11.8% (95% CI: 10.3%- 13.2%) and of current asthma medication use was 11.1% (95% CI: 9.6%- 12.5%). The prevalence of asthma according to a positive response to either of the above questions was 31.4% (95% CI: 29.3%-33.4%) The prevalence of symptoms was higher in adults aged >45 years. Of those with current wheeze, 60.9% denied a diagnosis of asthma and only 38.2% admitted to use of asthma medication. In those with current wheeze, wheezing was the only symptom in 19.9% whereas 80.1% had at least one other respiratory symptom (tightness of chest, cough or shortness of breath) of which cough was the most common symptom. In those without current wheeze, self-reported asthma and current asthma medication use, 30%, 35.9% and 36.6% respectively had at least one other respiratory symptom. CONCLUSIONS: The prevalence of asthma in Sri Lankan adults is high in comparison with global data. A significant percentage of symptomatic individuals deny having asthma and are not on medication.Item Quality of ambulance care available for transfer of emergency patients to the National Hospital of Sri Lanka(College of Community Physicians of Sri Lanka, 2009) Nandasena, L.G.S.; Abeysena, C.OBJECTIVE: To describe quality of ambulance care available for transfer of emergency patients to the National Hospital of Sri Lanka. METHODS: A descriptive cross sectional hospital based study was carried out at the National Hospital of Sri Lanka (NHSL) from 15th August to 13th October 2008. All ambulances that arrived at the NHSL during the study period with-an emergency patient were selected. A self administered questionnaire was used to assess the knowledge, attitudes and skills of medical staff (n=35) who accompanied the patients in the ambulances. Knowledge was assessed according to internationally accepted three levels defined for Emergency Medical Technicians (EMT). Data related to delays during transportation were obtained from drivers (n=395) using an interviewer administered questionnaire. RESULTS: Of the 409 ambulances included, the patient was accompanied by a doctor in 4%(n=16), a nurse in 4%(n=15) and EMTs in 1%(n= 4) of the occasions. Knowledge of medical staff was 74.3 % (n:=26) each for EMT basic and intermediate levels and 65.7%(n=23) for paramedic levels (EMT third level). Self reported skills in performing laryngoscopy and intubation was 31.4 %(n=11) and defibrillation 48.6% (n=17). Good attitudes towards training needed in pre hospital care was 97%(n= 34), low cost involved in adopting certain life saving measures was 77%(n=27) and being optimistic of adopting life saving measures was 25.7%(n= 9). More than 15 minutes each had been spent between receipt of message and transferring the patient from the scene/ward to the ambulance and from latter to commencement of the journey on 19%(n= 75) and 6.9%(n=27) of the occasions respectively. Problems experienced by medical staff during transportation were, traffic delays in 40%(n=10), non availability of necessary equipment/drugs/facilities in the ambulance to manage the patient in 28%(n=7), lack of knowledge and skills regarding patient management in 36%(n=9) and deterioration of patient's condition during transportation in 36%(n=9) of occasions. CONCLUSION: In general, Knowledge in pre hospital and emergency medicine was good among doctors, nurses and EMTs, but some areas of knowledge and skills need to be improved. Attitudes in outcome of pre hospital care were relatively poor, compared to the attitudes in training and cost. Most problems encountered during transit are preventable.