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 Association between faecal incontinence, child abuse, somatisation and health related quality of life(Belgian Society of Paediatric Gastroenterology, Hepatology and Nutrition (BeSPGHAN), 2013) Rajindrajith, S.; Devanarayana, N.M.; Benninga, M.A.AIMS : Faecal incontinence (FI) is an important lower gastrointestinal disease. Bad aroma around children with FI leads to rejection by peers, psychosocial isolation and learning difficulties. Aim of this study was to evaluate the association between FI, child abuse and health related quality of life (HRQoL) in children and adolescents. METHODS : Children aged 13-18 years were selected from four semi-urban schools in Gampaha district, Sri Lanka. A validated, self-administered questionnaire was used for data collection after obtaining consent from school authorities, parents and children themselves. Information regarding socio-demographic factors, gastrointestinal symptoms, child abuse, HRQoL and somatisation were collected. FI was defined as at least one episode of leaking of faeces in to the underwear per month. RESULTS: A total of 1807 children were included in the analysis [males/9.3 vs 53.8%), mean age 14.4years, SI.) 1.4 years]. Forty seven (2.6%) had FI. FT was significantly higher in boys (-74.49S vs. 25,6%% in girls, p < 0.0001)1. Prevalence of FI was significantly higher in those exposed to sexual abuse (17%.,. vs. 2.3% in non abused, p < 0.0.001)., emotional abuse i40.4% vs. 22.7%, p < 0.0001), and physical abuse (51% vs. 24:3.'%', p < 0.0001). Children with FI had higher mean somatisation score [mean 20.1, SD 14.5 vs. mean 9.3, SD 9.2 in those without FT (controls), p < 0.0001J. Children with FI had lower HRQoL scores for physical functioning (78.1 vs.'9:1:2.in controls, p < 0.0001), social functioning (78.4 vs. 92.6, p < 0.0001), emotional functioning (70.5 vs. 82.3, p < 0.0001) and school functioning (69.1 vs- 82.3, p < 0.0001) domains, and a lower overall HRQoL score (74.6 vs. 87.1, p < Q .0.001). CONCLUSIONS : FI in children shows a significant association with physical, sexual and emotional abuse. Children with FT have a range of somatic symptoms and a poor HRQoL score in physical, emotional, social and school functioning domains.Item Anal incontinence during postpartum period: a community based cross sectional study(College of Community Physicians of Sri Lanka, 2009) Rajeshkannnan, N.; Pathmeswaran, A.INTRODUCTION: Anal incontinence is regarded as the "unvoiced symptom". It has a negative impact on the quality of life of the sufferer. The commonest cause in women in the reproductive age group is child birth and it is important to determine the burden of anal incontinence and identify possible risk factors in order to improve the quality of intra partum and postpartum care. OBJECTIVE: To determine the frequency and severity of anal incontinence among post partum mothers in Vavuniya district and to identify factors associated with it. METHODS: A community based cross sectional study was conducted. Sample included all mothers (hospital and home deliveries) who had completed postpartum period between 1st August and 30th September 2007. They were identified from the "expected date of delivery" registers maintained by Public Health Midwives (PHMs). Data were collected by trained PHMs at the respondents' houses using an interviewer administered questionnaire. RESULTS: The mean age of the 540 postpartum mothers interviewed was 28 (range: 16 - 44) years. Majority 78 % (n=423) were Sri Lankan Tamils, 13 %(n=68) Sinhalese and remaining 9%(n=49) Moors. Thirty nine percent (n=209) of them were primi parous. Eighty one percent (n=435) had a normal vaginal delivery and 79% (n=344) of them had an episiotomy. Eighty nine mothers complained of anal incontinence giving a prevalence of 16.5% (95% Cl: 13.4 - 19.6). Among them 94.4% (n=84) considered it as a minor problem and only 39.3% (n=35) had consulted a health worker for the symptom. Risk factors for anal incontinence according to descending order of risk included, having an episiotomy (OR= 5.06; 95%CI: 2.60-9.86), vaginal delivery (OR=4.58; 95% Ci: 1.63-12.84), primi parity (OR= 3.45; 95% Cl: 2.25 -5.21), family income above Rs5000/- per month (OR-1.92; 95% Cl: 1.21 - 3.04) and duration of labour (OR= 1.81; 95% Cl : 1.15-2.87) CONCLUSION: Anal incontinence is not an uncommon symptom in postpartum mothers and majority of affected individuals avoid seeking medical attention. Factors associated with increased risk of anal sphincter damage should be considered during delivery and an attempt should be taken to reduce it.Item Faecal incontinence in Sri Lankan children and adolescents: an epidemiological survey(Sri Lanka College of Paediatricians, 2009) Rajindrajith, S.; Devanarayana, N.M.INTRODUCTION: Faecal incontinence is seen in 1-4% of children and has a significant impact on their quality of life. Community based studies on this important problem are scare. There is no data regarding prevalence of faecal incontinence from developing countries. OBJECTIVES: To detect the prevalence of faecal incontinence in Sri Lankan school children 10-16 years and factors associated with this condition. DESIGN, SETTING AND METHOD: This was a school based, island-wide, cross sectional survey. A validated, self-administered questionnaire was distributed to randomly selected children, aged 10-16 years, in 5 randomly selected schools, from 3 geographically and socio-economically different provinces in Sri Lanka. The questionnaire was filled under guidance of research assistants. Faecal incontinence was defined as defaecation into places inappropriate to the social context, at least once per month, for a minimum period of 2 months. Constipation was defined using Rome III criteria. RESULTS: A total of 2770 questionnaires was distributed and 2686 (96%) were included in the analysis. Of them 55 (2%) had faecal incontinence [male 43 (78%), mean age 11.96 years, SD 1.59 years]. Forty five (82%) had constipation associated faecal incontinence and 10 (18%) had non-retentive faecal incontinence. The highest prevalence was seen in children aged 10 years (5.4%). A significant negative correlation was observed between age and the prevalence of faecal incontinence (r=-0.893, p<0.01). Faecal incontinence was significantly higher in males (male 3.2%, females 0.9%), those exposed to recent school and family related stressful life events and those from lower social classes (p<0.05). Other symptoms associated with this condition were abdominal pain, nausea and vomiting (p<0.05). CONCLUSIONS: Faecal incontinence was seen in 2% of Sri Lankan children and adolescents aged 10-16 years. The majority had constipation associated faecal incontinence. It was more commonly seen in males, younger age, those from a lower social background and children who were exposed to stressful events.