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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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.
Awareness of zoonotic infections and preventive measures and the practice of those measures among farm workers in a livestock farm, Galle
(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2021) Gunawardhana, T.; Gunwardhane, B.
Introduction: Livestock farm workers are at higher risk of emerging and re-emerging zoonotic infections. To mitigate the risk, awareness of diseases and practice of preventive measures is important. Objective of the study was to assess the awareness of zoonotic infections and preventive measures and practice of those measures among farm workers in a livestock farm, Galle. Methods: A cross sectional study was conducted among 108 farm workers of a selected farm, Galle. Awareness of existence of zoonotic infections, disease specific knowledge on ‘leptospirosis’, ‘rabies’, ‘brucellosis’, ‘swine & avian influenza’ and practice of preventive measures at their work setting (i.e., hand washing, personal protective equipment usage, disinfectant usage) were assessed using an interviewer administered questionnaire. Using Chi-square test, associations with knowledge and practices were assessed. Results: Response rate was 100%. Leptospirosis, rabies and swine and avian influenza were known diseases to majority (99.1%, 97.2% and 86.1% respectively) of participants. Most of them had good knowledge on disease specific questions: leptospirosis 98.2%, rabies 88.9% and swine & avian influenza 70.4%. But brucellosis was known by 4.6% while only 0.9% were having good knowledge about brucellosis. With regards to the practices of preventive measures, majority (92.6%) displayed good practices. Statistically significant associations between socio demographic factors (i.e., level of education, time spent with animals in a day, monthly income) and awareness of zoonotic infections or practices of preventive methods could not be found (p =0.05). Conclusion: Awareness of farm workers on zoonotic infections were satisfactory. Further encouragement is preferred to continue better practices.
Identifying influential determinants for non-communicable diseases among school children using Health Promotion approach
(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2021) Thilokshika, R.M.S.; Guruge, G.N.D.
Introduction: World Health Organisation (WHO) estimates for deaths attributed to non- communicable Diseases (NCD) in Sri Lanka have increased up to 75% of total deaths. NCD cause more than three quarters of all deaths and nearly 1 in 5 people die prematurely from NCD. According to the views of school children and staff and observations, NCD risk was high in Wallisinghe Harishchandra Maha Vidyalaya in Anuradapura District. Objective: To empower school children to identify influential determinants for non- communicable disease through the health promotion approach. Methods: A community-based study was conducted with a group of school children (n =15) who are in the age range 12-15 years. Interactive discussions were facilitated with school children about current NCD risk among children and identified most influential structural determinants to address to reduce NCD risk. Observation of behavioural patterns, measuring BMI of school children also helped to identify influential determinants. Results: Eighteen determinants were identified through discussion including peer influence, lack of experience, media influence, poor awareness of parents and children, food preparation methods of children. Five determinants were identified through observation including availability of packed foods in shops, junk food consumption among children, fixable price of junk foods. Six determinants were prioritized by them according to the criteria like importance, changeability, magnitude, majority view and easiness to address. Those included poor awareness of parents and children, peer influence and media influence. Conclusions: School children were successfully able to identify influential determinants for non- communicable diseases. Health promotion approach is effective in enabling school children to identify the determinants of non-communicable diseases.
Effect of a play-based training program on interactive skills of caregivers of children with autism
(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2021) Wanniachchi, P.M.; Sumanasena, S.
Introduction: Children with autism spectrum disorder (ASD) have impairments in social communication and interaction skills and show restricted repetitive behaviours. Evidence shows that early detection and parent mediated intervention programs lead to better social communication and functional outcomes highlighting parents as the most natural human resource. Objectives: To evaluate caregiver acquisition of interaction skills to engage with children aged 2-4 years with ASD during play following a parent training protocol and to describe associated socio-demographic factors Methods: Thirty (30) caregivers of newly diagnosed children aged 24-48 months, attending a multidisciplinary clinic were recruited. A mixed method research including pre¬post interventional study determined the acquisition of interactive skills following a 2 hour play based training program. Adapted Quality of Caregiver-Child Interactions for Infants and Toddlers (Q-CCIIT); checklist assessed pre-post caregiver-child interactions by 10- minutes video recordings of each child two weeks following the training. A questionnaire collected socio-demographic data. Data was analysed using nonparametric tests by SPSS software. Results: QCCITT percentage of mean scores improved significantly in all 30 caregivers (p<0.005) for all three areas assessed; support for social emotional development as an average 8.80 to 22.83, cognitive development 4.63 to 14.13 and language development 6.97 to 12.97. Age and education level of parents positively influenced the skills (p< 0.05). Conclusions: There was a significant improvement of caregiver interaction skills. Social emotional skills improvement was also significant.
Attitudes towards homosexuality, bisexuality and transgenderism among medical students of a Sri Lankan university
(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2021) Rajapaksha, J.S.R.L.; Rajapaksha, R.G.D.T.; Ranawaka, A.U.R.; Rangalla, R.D.M.P.; Ranwala, R.D.E.B.; Chandratilake, M.N.
Introduction: Lesbian, gay, bisexual, and transgender (LGBT) patients experience discrimination, insensitivity and ignorance about LGBT-specific health needs among healthcare providers. Developing the correct attitudes among medical students towards LGBT may help provide them with optimal healthcare. Objectives: This study aimed at assessing the attitudes of medical students towards LBGT community. Methods: A cross- sectional descriptive study was among all the medical students in the Faculty of Medicine, University of Kelaniya, Sri Lanka using a validated online questionnaire.3 The questionnaire focused on eight areas. The data was descriptively analysed and the demographic groups were compared. Results: 358 completed the survey. Their attitudes on traditional gender role and comfortability in interacting with LGBT people were moderate and they disagreed with negative LGBT social beliefs. They knew less about the origin of sexuality/gender of LGBT. Although they accepted LGBT as a part of diversity, they discouraged normalizing social practices of LGBT people. Their acceptance and association of LGBT was moderately positive. A minority has encountered LGBT in close social circles and the majority of them were batch-mates. Although males’ knowledge about the origin ot LGBT was higher, they favoured traditional gender roles more. The religious groups showed no differences. The favourability of attitudes towards LGBT reflected respondents' political ideology. Conclusions: Although medical students' knowledge on sexuality/gender basis ot LGBT is poor they have moderately favourable attitudes towards them. They accept LGBT as a part of social diversity but not their social practices. Poor knowledge, lack of encounters, cultural influences and political ideology may have influenced their attitudes.
Do young adults of Sri Lanka know what to do at a road traffic accident?
(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2021) Keerthi, L.D.; Senaratne, C.; Mendis, D.; Nisansala, H.; khans, M.X.N.; Chandima, T.
Introduction: Road traffic accidents (RTAs) are responsible for thousands of deaths in Sri Lanka per year. Time sensitive emergency management following an RTA is critical to reduce morbidity and mortality. Laypeople are the first responders in most of these situations, it is important to assess the knowledge among the young adult generations, about emergency management in an RTA. Objective: To assess the knowledge about emergency management in RTAs among A/L students in Colombo district. Methods: A descriptive cross-sectional study comprising 239 A/L students in Colombo district was conducted to describe the socio-demographic and other related factors associated with knowledge about emergency management following an RTA. Awareness about common practices was assessed and categorized using a validated scoring system as good and poor. Exclusion criteria included A/L students below 18 years of age and students of foreign A/L examinations such as London A/L Examination and EDEXCEL. Snowball sampling technique was used to collect data via a self-administered questionnaire by a google form. The significance level was set at 5%. Results: Majority (57.3%) of the students had poor knowledge about basic emergency management. Almost half of the population (46.9%) had never received any training related to management of RTA. A statistically significant association was found between knowledge and previous training on emergency management. Conclusion: Most of the participants had inadequate knowledge and training which indicates there is a necessity to improve knowledge and to implement training on emergency management among lay persons.
Analytical performance of glucometers as point of care testing devices in management of diabetes mellitus: a scoping review
(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2021) Thilakarathna, P.T.A.
Introduction: Diabetes Mellitus (DM) is a metabolic disorder causing chronic and life¬threatening complications in which 420 million people have suffered worldwide. The use of glucometers in blood glucose measurement as self-monitoring and point of care testing devices is common due to the rapid result generation and ability of using without professional knowledge. The accuracy and precision should be considered in the decision¬making of the survivor's condition using glucometer values. Objectives: This study aims to summarise the findings of the analytical performance of glucometers used in the management of DM. Methods: A literature review was conducted in the duration 01.01.2016 to 30.08.2021 within databases of Google Scholar and PubMed. The research articles in English were assessed. Six papers met the inclusion criteria of the review. The data extraction and appraisal were performed using the PRISMA checklist for scoping review. Results: The readings of glucometer and standard venous glucose tests had compared using con-elation, regression, or error grid analysis. The values of procedures had significant differences comparatively. The accuracy and precision had significantly altered substantially in low and high blood glucose values. Conclusions: This review suggests reaching critical medical decisions only by utilizing values of clinical laboratory standard methods. Continuous calibration and maintenance are remarkable in the accuracy and precision of glucometers.
Prevalence of distress and associated factors among G.C.E. A/L students in Gampaha District: A descriptive cross-sectional study
(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2021) Wickramarachchi, W.G.B; Wickramarachchi, B.
Introduction: GCE A/L examination is a highly competitive examination, owing to the limited opportunities for university entrance in Sri Lanka. Thus, A/L students are likely to experience high levels of distress. Objectives: To assess the prevalence of distress and associated factors among G.C.E A/L students in Gampaha District. Methods: In this cross-sectional study, 464 A/L students (66.8% female) from five randomly selected schools from Gampaha District were evaluated using General Health Questionnaire (GHQ)-30 and a demographic questionnaire. Students were stratified according to stream. Results: Almost half of the students (n=220, 47.41%) exhibited significant distress. The percentage of distress among male and female students were 45.5% and 48.4%, respectively. Among streams, technology stream had the highest prevalence of distress (61%, n=61), followed by mathematics (58.4% n=45). The chosen stream was unhappily studied by 54.1% (n=251), out of whom, 53% (n=133) were under distress. Among those who spent more than 70 hours with their families per week, only 42.6% (n=l 12) were under distress. Out of students who were studying for more than 50 hours per week (n=308), only 46.1% (n=142) were under distress. Conclusions: A high prevalence of distress was observed among A/L students in the selected district in Sri Lanka. Being unhappy with the selected stream and less time spent with families appear to be associated with greater distress. Uncertainty about future academic and career opportunities may have contributed to the higher prevalence of distress in the Technology stream students.
Selected obesity related non-communicable diseases (NCD’s), associated risk factors and knowledge on NCD’s among Buddhist monks and lay people in Colombo district, Sri Lanka
(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2021) Abeyratne, V.; Weerasooriya, S.D.; de Zoysa, D.N.P.; Thrimadura, R.D.; Kapuwella, I.
Introduction: Obesity related non-communicable diseases (NCDs) have become a global pandemic. Buddhist monks have been excluded from most studies on NCDs done in Sri Lanka. Objectives: This cross-sectional study is the first study conducted on Buddhist monks with the aim of comparing the presence of obesity related NCDs, associated risk factors and knowledge on NCDs and comparing them with laypeople in Colombo district. Methods: An interviewer-administered questionnaire was administered to 80 monks and male lay people each, aged 18-60 years. The collected data on the presence of NCDs, associated risk factors and knowledge were analyzed by chi-square and independent sample t-tests. Results: Diabetes was the commonest NCD among monks while both hypertension and diabetes were equally common in laypeople. Among monks, presence of NCDs increased with period of ordination and good knowledge on risk factors was associated with a higher percentage of adequate physical activity. Laypeople had greater overall knowledge on selected NCDs, and risk factors and this proportion increased with their education level. The presence of family history of NCDs was also higher among laypeople while fresh fruit consumption was low in both groups. Conclusions: The findings of this study indicate that a significant proportion of monks and lay people have at least one NCD and the knowledge of Buddhist monks on NCDs needs to be improved. More studies with greater sample sizes should be done to assess if the NCD prevalence increased with ordination period due to age or the different lifestyles that Buddhist monks lead.
Relationship between unexplained infertility and sedentary life style among women in urban city of Colombo; infertile female vs. fertile female
(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2021) Karunarathne, H.P.P.M.; Darshika, P.; Manike, M.M.V.K.; Priyadarshanie, M.N.; Fernanadopulle, R.C.
Introduction: Infertility is defined as the absence of conception after 12 months of regular, unprotected intercourse. Unexplained infertility is the infertility; whose cause remains unknown even after investigation. Any waking activity, such as sitting or leaning, with an energy expenditure of 1.5 metabolic equivalent task (MET) or less is considered as sedentary behaviour. Objectives: To identify the relationship between unexplained infertility and sedentary life style behavior among young female population in urban city of Colombo. Methods: A case-control study was conducted among 250 women (125-fertile /125- infertile) in the age group of 18-32 years, infertile women who were clinically diagnosed at Infertility clinics and Gynecology wards were selected. 1st trimester pregnant mothers were recruited as fertile women from 3 hospitals in Colombo district. Demographic details and medical history of the women were collected in an interviewer-administered female infertility questionnaire. International Physical Activity Questionnaire (IPAQ) short form was used to measure physical activity. Anthropometric measurements including Skin Fold Thickness (SFT) were obtained. Data were analysed using Pearson Chi-Square test. SPSS software version 23.0 was used. Results: The study included 125 infertile females and 125 fertile females aged 18-32 years. (Mean age = 28.67) There was a significant influence of over fat level (30.4%) measured using SFT for female infertility. A low level of IPAQ short form score (36.4%), women aged >28 years (p=0.0486), sedentary occupations (p=0.000) and age at menarche (p=0.044) were found to be associated with infertility [OR= 11.87. [Log (11.87) =1.07]. Conclusions: There is a relationship between unexplained infertility and sedentary life style behavior among women in urban city of Colombo infertility.
Anxiety and Depression among the patients with Dysphagia following Oral Maxillofacial and Neck surgeries in four selected hospitals in Western Province, Sri Lanka.
(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2021) Fernando, K.; Fernando, R.; de Silva, D.
Introduction: Undiagnosed anxiety and depression are obstacles to effective management of post-operative dysphagia. In Sri Lanka, the prevalence of anxiety and depression among patients with postoperative dysphagia is not known. Objectives: This study aimed at determining the severity and the stage of dysphagia, presence of anxiety and depression, and to identify the association between the severity and the stage of dysphagia with anxiety and depression following Neck, Oral & Maxillo-Facial (OMF) Surgeries. Methods: A cross-sectional study was conducted among 97 participants, with post¬operative dysphagia following OMF and Neck surgeries at four selected hospitals. Oral-motor and cranial nerve examination, the 3 ml water test, Cervical auscultation, Dysphagia Severity Rating Scale and Hospital Anxiety and Depression Scale were used for data collection. Results: Among the participants 51% presented with pharyngeal phase dysphagia and severe dysphagia. Prevalence of depression was 51% and anxiety was 38%, while 35% and 45% were at the borderline range respectively. With the increasement of dysphagia severity, high levels of anxiety and depression were noted. There was a statistically significant association between the severity of anxiety with severity of dysphagia (p< 0.05). Conclusion: Psychological burden is high among the participants with dysphagia following OMF and neck surgeries. Holistic management of dysphagia following OMF and neck surgeries, should include an assessment of the mental state of these patients and the treatment of anxiety and depression if required.
The analysis of conversational features between the individuals with dementia and their communication partners in natural conversation
(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2021) Jinadasa, T.; Atapattu-Bakmeewewa, D.
Introduction: A successful conversation should have a continuation without communication breakdowns between the speaker and the Communication Partner (CP). Objective: The study was conducted to identify the conversational features between the Individuals with Dementia (ID) and their CPs during natural conversation. Methods: Mixed method exploratory design, including descriptive and inferential statistics analysis using Statistical Package for the Social Sciences software and qualitative thematic analysis was used. Results: Absence of topic maintenance, inability to engage in extended discourse and absence of repairing skills in IDs were more frequently observed Discourse Impairing Conversational Features (DICF) in IDs. The most frequently observed and helpful Discourse Building Conversational Feature (DBCF) used by partner was trying to figure out the meaning. A Mann-Whitney U test showed significant differences in the use of DICFs (Mann-Whitney U=30.500, Z=-3.449, p=0.001) and DBCFs (Mann-Whitney 035.500, Z—3.213, p=0.001) between the two groups. Perspectives of CP on the communication difficulties faced with ID were analyzed based on five primary themes; knowledge of dementia, difficulties faced by partners when communicating with ID, strategies used by partners to overcome communication difficulties, successful communication strategies used by partners and ID to overcome difficulties in communication. Conclusions: The findings provide a preliminary understanding of the communication difficulties and challenges experienced by ID and partner with particular reference to the local clinical scenario. Importantly it identifies strategies and features that are successful in maintaining natural conversations with ID and provides useful information to speech and language therapists to support ID to maintain their QoL within resource limited clinical settings.
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.
Knowledge, attitudes and practices on the use of European Number System and International Numbering System for coding food additives, among medical students of the Faculty of Medicine, University of Kelaniya.
(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2021) Ekanayake, E. M. J. C.; Fernando, W. I. U.; Gamage, D. G. H. N.; Gurung, S.N.; Ekanayake, S. P. N.; Subasinghe, C. W.
Introduction: E number system (ENS) and international numbering system (INS) are used in coding food additives (FA). FAs are substances added to the packaged food to preserve their flavour, smell, appearance and structure. Though, use of FAs are permitted by law, long term consumption is linked with a range of health issues such as allergies, obesity and cancers. Unfortunately, despite the evidence, consumers’ knowledge on this area is alarmingly low. Objectives: To assess the knowledge, attitudes and practices (KAP) on the use of ENS/INS for coding FAs among medical undergraduates of the Faculty of Medicine, University of Kelaniya Methods: This descriptive cross-sectional study was conducted among 384 students selected using stratified random sampling. Demographic and KAP data were obtained using self-administered questionnaire and was analysed using descriptive statistics. SPSS software version 25 was used. Results: Majority of the participants were aware of the FA (91.66 %). They read the package label (95.31 %), and valued quality over price irrespective of their gender, maternal education level and family’s monthly income (p>0.05). But 99. 48% of the participants were ill-informed of FA coding systems and didn't take ENS/INS into consideration when purchasing packaged food. While most participants (97.40%) were aware of the negative health effects of FAs, they lacked knowledge to corelate information embedded in ENS/INS with health and only 72.92% was willing to improve their knowledge. Conclusions: There is a general lack of knowledge amongst the respondents about INS/ENS and associated health risks. Increasing their KAP will be beneficial to all stakeholders including future patients.
The relationship between delaying physiotherapy intervention commencement and lymphedema among breast cancer survivors in Sri Lanka
(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2021) Weerarathne, B.O.K.; Samudika, V.G.G.; Arunakanthi, A.M.; Dabare, H.P.M.; Malaviarachchi, S.L.
Introduction: The recent cancer statistics in Sri Lanka evaluated breast cancer as the most common cancer among female population with cancers. Due to the better survival rate, Modified Radical Mastectomy surgery is an ideal surgical management for most of the breast cancer stages. Upper limb lymphedema is a known post-surgical complication which has long-life impact on breast cancer survivors that can be easily managed with early physiotherapy intervention. Objective: This study was aimed to identify the relationship between delaying physiotherapy intervention and lymphedema volume among breast cancer survivors at Apeksha hospital, Maharagama, Sri Lanka. Methods: 74 female breast cancer patients newly referred to the department of physiotherapy were recruited for this study. Patients undergone bilateral surgeries were excluded from the study. An interviewer-administered questionnaire was used to collect information of socio-demographic data and underwent surgical procedures. The severity of upper limb lymphedema was assessed by measuring the lymphedema volume according to the frustum model formula, using multiple circumferential measurements. International Society of Lymphology staging system was used to identify the distribution of lymphedema severity. Results: Within the sample, delayed period to commence physiotherapy after the surgery ranged from < 1 to 17 years. The lymphedema severity stages minimal, moderate and severe among the sample recorded as 37.8%, 50.0% and 12.2% respectively. A significant positive correlation was observed between delayed period to start physiotherapy and lymphedema volume (p=0.05, r= 0.75). Conclusions: The lymphedema volume increases with time of delayed physiotherapy intervention. Hence, the patients are required to participate in early physiotherapy intervention.
Assessment of knowledge and practices related to technical requirements recommended by ISO 15189:2012 standards among medical laboratory technology staff in tertiary care hospitals and institutions in Western Province, Sri Lanka
(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2021) de Silva, S.L.; Gunarathna, H. D. N. T; Rajakulasooriya, R. S. R.; Thambavita, D.
Introduction: Accuracy and reliability of laboratory test results is a great expectation and ISO 15189:2012 is the globally recognized standard for medical testing laboratories. In Sri Lanka most of the government sector laboratories not accredited for ISO 15189. Objectives: The objective of this study was to describe the existing level of knowledge and practices related to ISO 15189:2012 standard and to find out the barriers to follow its technical recommendations among Medical Laboratory Technology (MLT) staff in government tertiary care hospital laboratories and institutions in Western province, Sri Lanka. Methods: A descriptive cross-sectional study was carried out among senior MLTs working in 23 tertiary care units in the Western province. A pre-validated self-administered questionnaire was used to assess knowledge, practice and barriers to implement ISO standard. Score value for knowledge was calculated using 6 predetermined questions giving score of I or 0 for “yes” and “no” responses respectively. Results: Of the participated laboratories, 8% (2 Institutions) were accredited. Among the participants 34% had good knowledge about the ISO standard and 96.6% indicated training requirement on accreditation. Acceptable internal quality control activities and documentation practices were observed among 93.2% and 60% of the laboratories respectively. Lack of knowledge on ISO (68.3%) and training on documentation (64.86%) identified as the major barriers to follow ISO requirements. Conclusions: Study findings indicate the need for training programmes for medical laboratory staff to overcome the barriers identified which will facilitate implementing reliable medical laboratory service based on the ISO 15189 standard in the future.
Knowledge, challenges, quality of life and their associated factors among adult patients with Type 1 diabetes attending National Diabetes Centre - Rajagiriya
(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2021) Fernando, L.
Introduction: Literature on type 1 diabetes mellitus (T1DM) and its effects on daily living, financial, educational, psychosocial challenges and quality of life is scare in Sri Lanka. Objectives: To describe the knowledge, challenges, quality of life and their associated factors among adult patients with T1 DM attending National Diabetes Centre, Rajagiriya. Method: A descriptive cross-sectional study was conducted among 228 patients with T1DM, on treatment for at least one year duration attending National Diabetic Centre, Rajagiriya. Self-administered questionnaires were circulated as google forms. Descriptive statistics was performed and analysed. P<0.05 was taken as the significance level. Results: Majority (70%) were between 18-27 years of age with mean age 25.54 years (SD=5.690). Age of disease onset was less than 15 years among 82% of patients. Mean Knowledge scores on insulin therapy, emergency management and chronic complications were 67.76 (SD=0.49), 42.92 (SD=0.5) and 81.49 (SD=0.5) respectively. Overall knowledge, knowledge on insulin therapy and acute complications were statistically significant among those better educated (p<0.05). Majority (54.87%) had good quality of life. Majority encountered family issues (30.3%). Better quality of life was significantly associated with higher monthly income (p<0.05) Conclusions: Majority had satisfactory knowledge on insulin therapy and chronic complications but poor knowledge on acute complications. Those educated above O/L had better knowledge on insulin therapy and acute complications. Majority had good quality of life and those with higher income had a better quality of life.
Challenges and opportunities for inclusive education: Perceptions of parents of children with disabilities receiving speech and language therapy services in Colombo District
(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2021) Begam, N.; Daskon, L.
Background: There is evidence that suggest disability is an issue that prevents children from accessing mainstream education in Sri Lanka. Article 24 of United Nations Convention on the Rights of Persons with Disabilities (UNCRPD), which Sri Lanka has ratified, talks about Inclusive Education. However, United Nations Universal Periodic Review - Sri Lanka (2017) reports that it has failed to implement it sufficiently in practice. Objective: This study aimed to obtain a critical understanding of the challenges and opportunities for inclusive education of children with disabilities in Sri Lanka through the exploration of perceptions of parents of children with disabilities in the Colombo District. Methods: This qualitative study used twenty semi-structured interviews of a purposive sample of parents of children with disabilities who receive speech and language therapy services in Colombo District. Data was analyzed using a thematic analysis process. Results: Four major categories of challenges and four major categories of opportunities for inclusive education were identified: the identified challenges were negative attitudes and lack of awareness, parents’ dissatisfaction of inclusive education, lack of resources and ignorance. The identified opportunities were accommodations by education authorities, assistive devices and correctional medical interventions and recognition of the inherent capacity of children with disabilities. Conclusion: From the perspective of parents of children with disabilities, though there are some opportunities for inclusive education there are still multiple challenges that hinder the effective exercise of the right to inclusive education by children with disabilities under the Sri Lankan system.
Contribution of Postural Balance and Quadriceps Muscle Strength as Intrinsic Risk Factors of Falls in Healthy Older Adults; A Cross-Sectional Study from the Colombo District.
(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2021) Perera, A.; Landege, O.; Kandege, I.
Introduction: Falls are the main source of morbidity and disability in the elderly. Many falls in older adults are certainly multifactorial, resulting from the confluence of several intrinsic, environmental, behavioural, and activity-related factors. Objective: The study aimed to identify the contribution of postural balance and quadriceps muscle strength as intrinsic risk factors of falls in healthy older adults who resides in two elders’ homes in the Colombo district. Methods: A total of 60 elders who dwelt in Salina Alwis elders’ home and Sahana Udaya elders’ home were selected using a non-probability convenient sampling method. Healthy older adults aged 65 years or above who completed inclusion criteria participated in the study. Mini BESTest was used to assess postural balance. Left and right Quadriceps Muscle Strength (QMS) measurement was obtained by modified sphygmomanometer test. Falls history within the past 6 months was obtained through an interview administrated general assessment. Results: Mean age among elders was 76.67±6.23 years (56.7% female and 42.3% male). The mean values of average QMS and postural balance among the falls group were 116.00mmHg and 18.17 and among the non-falls group were 161.13mmHg and 22.57 respectively. Independent sample t-test showed the significant difference of means in average quadriceps muscle strength (p= 0.028) and postural balance (p= 0.031) among falls and non - fall a group respectively. Conclusion: Mean quadriceps muscle strength and postural balance in the falls group were lower than the non-falls group. Therefore, we can conclude that two intrinsic risk factors (postural balance and Quadriceps muscle strength) directly contribute to falls in healthy older adults.
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.