30th Anniversary Academic Sessions, Faculty of Medicine-2021

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Plenaries, Symposia and free papers presented at the 30th Anniversary Academic Sessions, held on 28-31st October 2021, Faculty of Medicine, University of Kelaniya to celebrate the 30th Anniversary of Faculty of Medicine

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    Barriers to pre-clinical distance learning during the covid-19 pandemic and their impact on academic motivation
    (Faculty of Medicine, University of Kelaniya, Sri Lanka, 2021) Ekanayake, N.; Kariyawasam, A.
    Introduction: With transition to e-leaming; despite many advantages of it, no studies have focused on obstacles accounting for losing academic interest, especially in freshman years of Medicine. Objectives: To explore unseen barriers to online medical education and their influence on academic motivation. Methods: An online survey was conducted among pre-clinical medical students of Sri Lankan state universities. Responses collected from 250 volunteers were descriptively analysed. Results: All students had some kind of smart device with internet access. Though self¬studying time had increased overall, the percentage of students who spent less than 2 hours per day on it had increased from 12% to 16%. Yet time spent entertaining in social media had significantly escalated. When rated on a five-point scale, 98.8% of the students found poor time management and lack of self-discipline as a barrier. Addiction to Internet/ gaming with poor academic concentration, physical interferences (e.g., noise, violence and limited space) and excess responsibilities at home were other frequent problems faced by the respondents. 63.3% had joined online classes regularly while paying attention but the other proportion could not pay attention as in physical sessions. Work overload, lack of peer learning, distractions from family, and lack of physical interaction with teachers had notably influenced losing academic motivation. About 39% firmly believed that distance learning had lowered their academic performance than during the pre-pandemic period. Conclusions: Absence of a conducive learning environment discouraged students to a great extent. Hence, successful implementation of e-leaming for medicine requires a more engaging and in-depth approach.
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    Knowledge, attitudes, and barriers towards evidence-based practice among government sector physiotherapists in Sri Lanka
    (Faculty of Medicine, University of Kelaniya, Sri Lanka, 2021) Perera, S.L.P.
    Introduction: Implementing Evidence Based Practice (EBP) in government hospitals will be useful for the patients as they can receive the best available treatment with the best possible clinical outcomes which also improves the reputation of the government hospitals. Objectives: Aim of this study was to assess the knowledge, attitudes, and barriers toward EBP among government hospital physiotherapists in Sri Lanka. Methods: A cross sectional descriptive study was conducted among 264 physiotherapists in 39 government hospitals in Sri Lanka between the periods of 18th November to 23rd December 2019. A pre-tested self-administered questionnaire was used to gather information on Knowledge, Attitudes and Barners. Results: Among the 264 physiotherapists who participated in the study, 1.5% (n=4) had poor knowledge, 22.7% (n=60) had average knowledge and 75.8% (n=200) had good knowledge. Attitudes towards EBP were positive among 87.9% (n=232) while 11.7% (n=31) had neutral attitudes and 0.4% (n=l) had negative attitudes towards practice of EBP. The main barriers to practicing EBP were identified as insufficient resources, insufficient number of physiotherapists in the service, lack of facilities, lack of time and lack of practice. Conclusions: Physiotherapists in Sri Lanka had positive attitudes and good knowledge towards EBP, and they are inclined towards incorporating evidence into their clinical practice.
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    Attitude and practice on hospital information system among nurses working at teaching hospital, Jaffna
    (Faculty of Medicine, University of Kelaniya, Sri Lanka, 2021) Jayasekara1, J.G.A.; Thabotharan, D.; Coonghe, P.D.A.; Sathees, S.
    Introduction: Teaching Hospital Jaffna, started to use A.D.T. (admission, discharge, transfer) type Hospital Information System. Nurses having a key role in this system. From this perspective, the researchers intend to describe the attitude and practice of nurses in the Hospital Information System (HIS) who are works in Teaching Hospital Jaffna. Objectives: To describe practice on Hospital Information System and influencing socio¬demographic factors among staff nurses working in Teaching Hospital Jaffna. Methods: The study was carried out as a hospital based descriptive cross-sectional study which was done among 373 of Nurses working at Teaching hospital, Jaffna. Data collected through self-administrated questionnaire. SPSS version 25 was used to analysed the data. Whole population was included. Results: Among participants 51.82% were had a good practice on H.I.S. Age, the highest level of nursing education, the highest level of education in Information Technology, years of employed as a nurse, owned a personal computer, owned a personal smart phone and usability of health care apps, had statistically significant influence on level of practice. (P value <0.05). Conclusions: More opportunities to improve computer literacy and training programs on H.I.S. will be improve the practice of nurses.
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    Knowledge and attitudes on basic life support and associated factors, among selected nursing schools/ nursing faculties in Sri Lanka
    (Faculty of Medicine, University of Kelaniya, Sri Lanka, 2021) Thoradeniya, V.; Munasinghe, S.; Thilakarathna, G.; Jayasena, A.; Wijesooriya, N.
    Introduction: Basic Life support (BLS) skills are an essential part of the medical curriculum which are utilized to save lives in emergency situations. Objectives: To determine the knowledge and attitudes in BLS and factors associated with those, among nursing students in selected nursing schools/faculties in Sri Lanka. Methods: A descriptive cross-sectional study was conducted among a convenient sample of 325 nursing students using a pre-tested online questionnaire. Descriptive statistics and chi-square tests were used in data analysis. Results: Out of 317 valid responses, 46.4% had good knowledge while 53.6% had good attitude on BLS. The majority were females (89.3%), Sinhalese (96.2%) and Buddhists (91.2%). Majority were from nursing schools (63.7%) and were in 3rd academic year (45.7%). Among the students 71.9% had had lectures, 34.7% had experienced and 40.7% had participated in training programmes related to BLS. Non-westem province residence (p=0.010), academic year (p=0.011), BLS lectures (p=0.001), experience (0.009), practical training (0.010) were significantly associated with good knowledge. Following were statistically significantly associated with good attitude towards BLS. Religion (p= 0.027), non-westem province residence (p= 0.000), academic year (p= 0.003), having BLS lectures (p= 0.046), training programmes (p= 0.001), experience (p= 0.033), practical training (p=0.003), time since last training (p=0.005) Conclusions: From the study-population 46.4% had good knowledge & 53.6% had good attitudes towards BLS. Religion, non-westem province residence, academic year, lectures, training programs, experience in BLS were associated with good knowledge & attitudes. Therefore, implementation of more training programs, lectures on BLS is recommended.
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    Views of patients admitted to professorial units of Colombo North Teaching Hospital, regarding issues related to personal space and privacy during clinical training in of medical students
    (Faculty of Medicine, University of Kelaniya, Sri Lanka, 2021) Senanayake, K.
    Introduction: Medical students acquire clinical competency through training in wards. Cooperation of patients is the key for successful clinical training. In Sri Lanka, most patients are supportive towards medical students. However, it is importantly to the know feelings of patients about their personal space and privacy been invaded by students. Objectives: To describe how patients admitted to professorial units of North Colombo Teaching Hospital feel about their personal space and privacy been invaded by medical students during clinical training. Methods: A descriptive cross-sectional study was conducted between 11.01.2021 to 25.01.2021, involving 384 patients. Stratified sampling according to the percentage of admissions to each unit, was employed to select the study population. Patients were asked about their feelings during interactions with medical students. Data collection was via telephone interviews, using an interviewer administrated questionnaire. Results: There were 51.8% females and 48.2% males. 86.9% had no concerns about students asking their personal information. 83.5% felt comfortable about students observing, when doctors examined them. 82.03% did not feel embarrassed when genitalia were examined by a student of the same gender, but when it was the opposite gender, only 67.71% felt comfortable. 88.02% didn’t mind a student’s performing clinical procedures, if supervised by an experienced person. Only 75.78% felt comfortable with medical students assisting during surgeries. Conclusions: Attitude of most patients was positive towards medical students. However, some had concerns about students performing procedures, assisting surgeries and examining genitalia. It is important for students to respect the personal space and privacy of patients.
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    Infection control and hand hygiene (ICHH) practices of Audiolog* service providers in the Western Province of Sri Lanka
    (Faculty of Medicine, University of Kelaniya, Sri Lanka, 2021) Wijethunga, R.
    Introduction: Clinical audiology settings are vulnerable to infection. Therefore, audiology service providers should have adequate knowledge and training for infection control and hand hygiene practices. Objectives: This study aims to investigate knowledge, practices and attitudes towards ICHH practices of Audiology service providers in the Western province of Sri Lanka. Method: A descriptive study was conducted for audiology service providers in the Western province of Sri Lanka using a self-administrative questionnaire in 2021. The main study was conducted after receiving ethical clearance from the ethical review committee of the Faculty of Medicine, University of Kelaniya. Results: All participants were aware about their clinical setting being exposed to infection. Majority of the participants (93.33%) were aware of at least one ICHH policy, guideline. Less than half of the participant (43.33%) had ICHH training. Most of the participants apply more than one method to clean and disinfect devices which are used for clinical practices. Furthermore, 53.33% of participants used to dispose general and clinical waste separately but all the clinical waste together. Majority of participants have mentioned that it is vital to include ICHH training to audiology education system and having annual infection control training. Conclusions: Knowledge and training for ICHH practices should be increased. A national infection control policy and guideline should be implemented and an annual infection control program should be held in order to assess the progress and to disseminate the knowledge.
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    Non-alcoholic fatty liver disease in the South Asian Region: A systematic review and meta-analysis
    (Faculty of Medicine, University of Kelaniya, Sri Lanka, 2021) Withanage, M.Y; Niriella, M.A.; Ediriweera, D.; de Silva, S.T.; de Silva, A.P.; de Silva, H.J.
    Introduction: Non-alcoholic fatty liver disease (NAFLD) is the commonest chronic liver disease worldwide. Objectives: We estimated the overall prevalence and effect sizes of associations for NAFLD among adults in South Asia. Methods: We searched for search terms “Prevalence of NAFLD (Non-Alcoholic Fatty Liver Disease)” AND “South Asia” AND individual South Asian countries from January 2004-May 2021 in PubMed database. Strict eligibility criteria were applied. Gender, urban or rural setting, general population and individuals with metabolic diseases stratified analysis. A random-effects meta-analysis was performed. Results: Out of 158 studies, selected 25 studies from five countries (Bangladesh, India, Nepal, Pakistan and Sri Lanka) were included with 15,758 participants, of whom 4703 had NAFLD. The pooled NAFLD prevalence was 40.5% [95% CI 33.7-47.5] in overall, 26.2% [95% CI 18.7-4.4] in general population, 21.9% [95% CI 14.4-30.5] in rural communities, 32.9% [95% CI 22.8-43.8] in urban communities, 54% [95% CI 46.4-61.5] in individuals with one or more metabolic abnormalities and 11.1% [95% CI 7.1-16] among non-obese population. 41.4% of NAFLD patients were non-obese. Gender specific prevalence was similar. Prevalence of NAFLD among individuals with metabolic disease was significantly higher than the general population (p<0.0001). A significant association with NAFLD was found for metabolic syndrome, general obesity, central obesity, diabetes mellitus, dysglycemia, dyslipidemia and hypertension. Conclusions: The overall prevalence of NAFLD among adults in South Asia is high, especially in urban populations and those with metabolic abnormalities. Targeted health¬strategies should be implemented in the region to address this.
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    Association between knowledge and preventive behaviors regarding osteoporosis among a high-risk population in the National Hospital of Sri Lanka
    (Faculty of Medicine, University of Kelaniya, Sri Lanka, 2021) Wickramasinghe, D.G.; Wickramaarachchi, S.G.; Wickramasinghe, N. G.
    Introduction: Recent literature reveals a relationship between anti-epileptic drugs and decreased bone density, predisposing epileptic patients to osteoporosis. Objectives: This study was carried out to determine the association between knowledge and preventive behaviours regarding osteoporosis among the patients aged over 18 years visiting the Epilepsy Unit in NHSL. Methods: This descriptive cross-sectional study with an analytical component was conducted among 120 epileptic patients on anti-epileptic drugs, using random sampling. An interviewer administered questionnaire with sociodemographic details, knowledge and eight preventive behaviours regarding osteoporosis was used to collect data. The score of the knowledge section was graded as ‘poor’ (<40%), ‘average’ (41-60%) and ‘good’ (>60%) knowledge. Chi-squared test was used to determine associations between knowledge and engagement in preventive behaviours. The p value of less than 0.05 determined the significance. Results: All participants responded and a majority (58.3%) were female. Only eight (6.7%) had a prior diagnosis of osteoporosis at the time. The majority (n=65, 54.2%) had poor knowledge with a mean-score of 37.77% (SD=±18.67). The majority engaged in 6 out of 8 of the preventive behaviours regardless of awareness. The only significant association was between the knowledge level and consumption of milk/cheese/yoghurt at least once every7 2 days as a preventive behaviour (p<0.05). Conclusions: The study shows a lack of knowledge and awareness regarding osteoporosis among the high-risk population of anti-epileptic drug users was unfortunate and could lead to the failure of early prevention of osteoporosis, thus the need for implementing measures to increase the awareness and engagement in prevention of osteoporosis.
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    Accessibility challenges for the disabled community accessing public health care services and disability care institutions in Ragama Medical Officer of Health area
    (Faculty of Medicine, University of Kelaniya, Sri Lanka, 2021) Pathirage, C.K.; Padmasiri, U.G.M.; Nuvvarapakshage, N.S.R.P.; Panditharatne, W.D.; Hewawardhane, S.N.; Phuntsho, T.; Perera, K.M.N.
    Introduction: Ragama Medical Officer of Health (MOH) area is a developing center for the disabled with the National Rehabilitation Hospital and the specialized disability care institution targeting children. It also hosts the main teaching hospital in the district and a school for disabled children. Visual, walking and audibility impairments account for the highest number of disabled individuals in the country. Ragama MOH area is a developing hub for all these communities. Objectives: The objective of this study is to describe access-related challenges for the disabled community accessing public health care services and disability care institutions in Ragama MOH area. Methods: This is the qualitative study component of a larger study which also quantitatively assessed the compliance of the settings using an observational checklist. This component focused on the qualitative evaluation of accessibility-related challenges. Independent research team members interviewed 15 service providers, disabled and community stakeholders sampled purposively using semi-structured questionnaires. Data was analysed using thematic analysis method. Results: Financial constraints were identified as the main constraint for development of accessibility. “Dependence”, “gaps in awareness” and “negative attitudes” in order of perceived importance, revealed to hinder empowerment of the disabled on demanding for better access. Prioritisation of one disability was identified as a significant determinant for reduced access for individuals with multiple disabilities. Service providers were perceived to have the greatest power to address the challenges in their respective settings. Conclusions: Empowering clients to demand for improvement of accessibility and engaging primary service providers in development processes will lead to improvement of the existent challenges.
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    Accessibility to disability-care institutions and public health services in Ragama Medical Officer of Health Area
    (Faculty of Medicine, University of Kelaniya, Sri Lanka, 2021) Pathirage, C.K.; Padmasiri, U.G.M.; Nuwarapakshage, N.S.R.P.; Panditharatne, W.D.; Hewawardhane, S.N.; Phuntsho, T.; Perera, K.M.N.
    Introduction: Ragama Medical Officer of Health (MOH) area is a developing centre for the disabled with the National Rehabilitation Hospital and the specialized disability care institution targeting children. It also hosts the main teaching hospital in the district and a school for disabled children. Objectives: The objective was to describe compliance of identified settings related to disability health services in the Ragama MOH Area with current accessibility regulations. Methods: This is the quantitative component of a larger study which explored accessibility challenges and perceptions of service providers and the clients as well. This component assessed identified 16 settings including all disability care institutions, public health care services and selected access-points in Ragama MOH area using an observational checklist based on ‘disabled persons’ accessibility regulations act no. 1, 2006’. Photographic documentation of accessibility was performed. Data analysis utilized descriptive statistics based on a score of 1 for complete compliance and 0 for non-compliance. Results: Accessibility for visually impaired and signage for the disabled reported the lowest compliance with a score of 0% across all assessed settings. Highest compliance was observed related to pathways and corridors which scored 93.3%. Specific shortcomings and strongholds of accessibility in each institution were identified. Only one institution specializing in children with disabilities displayed a total compliance of 61.11%. The road network accessing the institutions portrayed less than 5% compliance with the recommended standards. Conclusions: Failure to meet accessibility regulations as expected in a developing hub such as Ragama MOH area emphasizes the need for greater attention to disabled accessibility in the country.
Faculty of Medicine, University of Kelaniya