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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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.
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.
Acute effect of l-theanine on visual attention in a traffic-related reaction task in sleep-deprived young adults: A double-blind placebo-controlled, crossover study
(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2021) Karunaratne, U.W.; Karunarathne, D.T.; Kariyawasam, H.K.
Introduction: L-theanine is a non-protein-forming amino acid found in tea. Limited evidence suggests that it improves selective attention. Sleep deprivation impairs attention and psychomotor reactions, potentially affecting automobile driving. Objectives: To determine whether L-theanine improves neurobehavioral measures of visual attention in acutely sleep-deprived healthy adults in a traffic-based recognition reaction time task. Methods: In a double-blind, placebo-controlled, counterbalanced, two-way crossover study, we compared the effects of a single 200-mg dose of L-theanine with a placebo (150 ml of distilled water) on a computerised, traffic-scene-based visual recognition reaction time task in 24 acutely sleep-deprived healthy volunteers (13 males, 11 females) aged 20- 25 years. The participants made speeded button-presses to imminent accident scenes presented on a computer-screen (i.e., hits), while ignoring safe scenes. They were tested pre-dose and 45 minutes post-dose, each treatment administered one week apart. Results: Hit rates were more than 90% in all sessions, and were similar in two treatments, pre- vs post-dose. Importantly, L-theanine significantly reduced (p=0.014) false alarm counts (i.e., responses to safe scenes), whereas placebo did not (p>0.05). L-theanine reduced reaction time to imminent accident scenes by 38.65ms (p=0.007), and placebo by 19.08ms (p=0.016), thus L-theanine showing a 20-ms advantage over placebo. Conclusions: L-theanine improves selective visual attention by improving information processing speed and target-distractor discriminability. This is consistent with previous fMRI findings, where L-theanine suppressed distractor-processing and default-mode- network activity of the brain in visual selective attention tasks. Concurrent recording of brain electrophysiology in future experiments will provide a neurophysiological basis for these attentional effects.
Administering Sinhala Pedi-EAT to detect feeding difficulties in children with disabilities: Evidence from a university clinic in Sri Lanka
(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2021) Priyadarshana, S.
Introduction: Dysphagia in children with disabilities leads to aspiration and has a long¬term impact on a child’s development. The Sinhala Paediatric Eating Assessment Tool (Pedi-EAT) is a parent-report instrument developed to assess symptoms of feeding problems in children aged 6 months to 7 years. Objectives: To determine feeding related concerns of paediatric cohort with disabilities and the association between Sinhala Pedi-EAT scores and parental feeding experience of children with disabilities. Methods: A descriptive cross-sectional survey was conducted at the MDT clinic for children with disabilities and their families at a university clinic. The study population included parents of children between 6 months-7 years attending the MDT clinic from November to December 2019. The Sinhala Pedi-Eat was administered to 410parents of children with disabilities. Results: The most prevalent feeding concerns under the physiologic symptoms was cough during or after mealtime (71%, n=291). Under the problematic mealtime behaviours, rejection of the foods (54%, n=221) was the commonest. Mealtime was longer than 45 minutes for majority of the children (61%, n=149). They were red flagged for a diagnosis of dysphagia. Children who were diagnosed with developmental disorders (72%, n=296) presented higher risk for having dysphagia. Conclusions: Highest scored feeding difficulties were under the problematic mealtime behaviours of Pedi-EAT questionnaire. Educating parents/ caregivers regarding helpful and unhelpful behaviours on child’s feeding will aid in managing problematic feeding behaviours in children. Pedi-EAT can be reliably used to screen feeding difficulties in children in Sri Lankan clinical context.
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.
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.
Antibiotic Prescription and Resistant Pattern in Wards of Professorial Unit and Intensive Care Unit of Colombo North Teaching Hospital
(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2021) Azhar, M.
Introduction: Antibiotic resistance is a global issue and increasingly reported in the health care setting of Sri Lanka. Moreover, there is evidence to support unnecessary usage of antibiotics resulting in development of resistance. Objectives: To evaluate the prescription of five specific antibiotics (ciprofloxacin, cefuroxime, cefotaxime, meropenem, co-amoxiclav) in the professorial medicine, pediatric, surgical ward, intensive care units and orthopaedics ward and to assess the development of resistance to those antibiotics over a 6-month period (January 2019 to June 2019). Methods: This is a descriptive cross-sectional study conducted from 1st of January to 30th of June 2019. Number of prescribed antibiotics for 5 antibiotics (from the inward drug registry) and culture samples recorded as resistance for those antibiotics (from antibiotic sensitivity test registry in Microbiology laboratory) in the above units were taken as the study population. Descriptive statistics was used to analyse the results. Results: According to the results co-amoxiclav (43%) is the highest prescribed antibiotic followed by ciprofloxacin (23%), cefuroxime (13%), cefotaxime (11%) and meropenem (10%). Ciprofloxacin, cefuroxime, and cefotaxime are mostly prescribed by the orthopedic ward while co-amoxiclav and meropenem are mostly prescribed in professorial surgical and medical wards. The highest rate of resistance with prescribed amount is observed with ciprofloxacin and lowest with meropenem. The resistance percentage has a positive linear relationship with the prescribed amount. Coliforms has the highest percentage of resistance in all five antibiotics. Conclusions: Co-amoxiclav is the most commonly prescribed antibiotic in all four units while Ciprofloxacin has the highest overall resistance rate with the prescribed amount. Resistance rate steadily increases with the amount of antibiotic prescribed. Coliforms have the highest percentage of resistance to all five antibiotics.
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.
Assessment and comparison of knowledge, attitudes and practices on usage of paracetamol among people (both males and females) within 20-30 years and 50-60 years attending Outpatient Department at Divisional Hospital, Wellawa
(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2021) Galhenage, T.S.; Gangoda, E.W.W.M.M.B.; Hewawasam, H.H.A.U.; Hiran, J.K.H.; lllangasinghe, H.M.M.P.K.; Dassanayake, A.S.
Introduction: Paracetamol possesses analgesic and antipyretic properties and is considered as one of the most commonly used over the counter medications worldwide. Despite its favourable safety profile, intentional and unintentional acute overdose of paracetamol attributes to potentially fatal organ damage. Objectives: To assess and compare knowledge, attitudes and practices on paracetamol usage and associated factors among young (20-30yrs) and older adults (50-60yrs) attending the Outpatient Department (OPD) at Divisional Hospital (DH), Wellawa. Methods: A Descriptive cross-sectional study was conducted using an interviewer administered questionnaire among 424 patients who attended the OPD at DH, Wellawa. These categorical data were described using percentages and significant associations were determined using T test. The analysis was processed through SPSS software. Results: Participants in the 20-30 years and 50-60-year age groups had 98.6% and 91.8% above average knowledge respectively, 89.2% and 94.3% above average attitudes respectively, 59.2% and 49.5% above average practices respectively on paracetamol usage. There was no statistically significant association between knowledge, attitude and practices with gender. However, according to the T test, only practices were found to have a statistically significant association with age. Conclusions: A majority of the participants from both age groups had an above average knowledge and attitudes on paracetamol usage. Although a majority from 20-30-year age group had an above average practices, only a minority from 50-60-year age group had above average practices on paracetamol usage. Furthermore, there was a statistically significant association only between practices and age.
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.
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.
Association of depression, anxiety and stress among outpatients with rheumatoid arthritis at a tertiary care hospital in Sri Lanka; a cross-sectional study
(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2021) Wijewantha, K.S.L.; Wijewardena, D.L.T.M.; Wijethunga, W.T.N.K.; de Silva, N.L.; Fernando, S.D.
Introduction: Depression, anxiety and stress and their associated factors, in patients with rheumatoid arthritis, vary across regions. Sri Lankan studies assessing the prevalence and associations of these factors are lacking. Objectives: To describe the prevalence and factors associated with depression, anxiety and stress among patients with Rheumatoid arthritis at specialised Rheumatology clinics of the National Hospital Sri Lanka. Methods: A cross-sectional study was carried out at three rheumatology clinics at the National Hospital of Sri Lanka. Sociodemographic and clinical data including the Clinical Disease Activity Index (CDAI) was recorded using an interviewer-administered questionnaire. The validated Depression, Anxiety, Stress Scale-21 was used. Analysis was done using descriptive analysis and chi-square. Results: The prevalence of depression, anxiety and stress in the study cohort (n= 118) was 50.93%, 57.41% and 47.17% respectively. Majority of the patients were in the moderate (39%) and high disease activity groups (36%). Increased prevalence of all three was observed with reduced functional status. Depression was observed among those > 60 years (p=0.035) and with CDAI >22.1 (p=0.004). Anxiety was observed with increased CDAI >22.1 (p=0.023). Stress was associated with unemployment (p=0.009) and morning stiffness > 60 minutes (p=0.001). Diabetes (p=0.016), ischemic heart disease (p= 0.042) and dyslipidaemia (p=0.005) were adversely associated with depression. Anxiety was associated with dyslipidaemia (p=0.005). Conclusions: Prevalence of depression, anxiety and stress is high and interferes with the quality of life and disease prognosis. Disease activity, functional deterioration as well as the presence of co-morbidities are associated with these mental health issues.
An attempt to study the behavior of plasma Hemoglobin in post transfusion iron chelated state in beta thalassemia major patients at Thalassemia Unit Kurunegala
(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2021) Adikari, A.A.S.R.; Nawarathna, N.H.LA.; Fernando, K.M.I.; Abeypala, B.M.P.P.M.; Kottahachchi, D.U.; Gunathilaka, S.
Introduction: Beta thalassemia major (pTM) patients require regular blood transfusions due to improper synthesis of normal hemoglobin. Objectives: The aim of this study is to make an attempt to examine the behavior of plasma hemoglobin of pTM patient in post transfusion iron chelated state. Methods: 145 patients from age 2-35 years (Male=l 13; Female=32) who were diagnosed with pTM selected for the study. Monthly haemoglobin values and 6-month Serum Ferritin (SF) values were obtained from their BHTs for two consecutive years. Correlations in between SF and haemoglobin were established using SPSS (version 20). The maximum and minimum pre-transfusion haemoglobin values (MaxPreHb and MinPreHb) were calculated for each month based on gender. Results: Most of the pre-transfusion haemoglobin values of patients lie within the 4-11 g/dl range and a statistically significant difference (p=0.021) is shown between MaxPreHb and MinPreHb. In gender wise analysis, it was shown that statistically significant differences were observed between MaxPreHb and MinPreHb of females (p=0.004) and males (p=0.013). The overall variation among MinPreHb (SD=0.81) is more compared with that of MaxPreHb (SD=0.53). The variation among MinPreHb of females and males (SD=0.71 and 1.75) is more compared with that of MaxPreHb (SD=0.40 and 1.75). However, there was no correlation between SF and haemoglobin. Conclusions: The data reveals, the group of haemoglobin around 5.0 g/dl indicates that those patients had not been compensated well by the blood transfusion. This may be due to excess haemolysis in that group. However, the other group of haemoglobin around 11.0 g/dl indicates the transfusion may have affected well.
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.
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.
Awareness and attitudes among nursing officers of National Institute of Mental Health, regarding the COVID 19; Descriptive cross-sectional study
(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2021) Dharamarathna, N.D.; Samarasekara, D.; Madubhashin, D.; Rupasena, S.; Rajapaksha, N.; Sansala, T.
Introduction: Individuals who seek inpatient hospital care due to COVID 19 infection are drastically increasing and nurses are crucial in caring for patients. Proper awareness and positive attitudes are the key pillars for pertinent caring of patients with COVID 19. Objectives: The study aimed to evaluate the awareness and attitudes towards COVID- 19 among nursing officers of National Institute of Mental Health (NIMH), Sri Lanka. Methods: A descriptive cross-sectional study was conducted among randomly selected 201 nurses of NIMH. A pretested self-administered questionnaire was used to collect data. Data were analysed using descriptive statistics and Pearson chi-square test. Overall awareness was categorised using modified Bloom’s cut-off point as good (80%-100%), moderate (50%-79%), and poor (< 50%). Results: The majority were female (92%) with a mean age of 31±6 years. Of participants, 40% reported a history of exposure to COVID 19 while 27% had quarantine. Nearly half of the participants (52%) had moderate awareness with a mean of 70±14 (range 20-90). Referring the COVID 19 guidelines (p=0.001) and working experience (p=0.04) was significantly associated with the awareness. The mean value of the attitudes was 61 ±6 (range 46-80) and 63% (n=127) had a neutral attitude towards COVID-19. Working in a medical ward (p=0.01) or COVID suspected ward (p=0.005) and experience of quarantine (p=0.01) were significantly associated with attitudes. Conclusions: Overall awareness and attitudes were at a moderate level among most. It is necessary to take measures to enhance the knowledge and attitudes towards COVID 19 among 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.
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.
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.
Community pharmacists’ knowledge, perception and practice towards adverse drug reaction reporting and the factors influence on them in Jaffna district, Sri Lanka.
(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2021) Thushiyananth, T.; Kalki, P.; Surenthirakumaran, R.
Introduction: Health care professionals are the prime source for spontaneous adverse drug reaction (ADR) reporting. An increase in over-the-counter drugs and self-medication practice rapidly increase the risk of ADR incidents in community pharmacy setup. Objectives: To assesses the community pharmacists’ knowledge, perception and practice towards adverse drug reaction reporting and the influencing factors in Jaffna district. Methods: This is a descriptive cross-sectional study with self-administered questionnaire which consist of five parts. All registered community pharmacists in Jaffna district were included in the study. The level of knowledge and perception was determined by the marks obtained by the pharmacists. The chi-square test and Fisher’s exact test were used to test the association of variables. Results: The response rate was 82.05% (N=64). Among the pharmacists, 40.6% had good knowledge on ADR reporting. Age (p=0.009) and work-experience (p=0.006) were statistically significant with knowledge. 75.0% of the pharmacists had good perception where, work-hours (p=0.040), work-experience (p=0.006) and work-position (p=0.013) were statistically significant association. Suspected and reported ADR in studied community pharmacists were 26.5% and 3.2% respectively. Prime reasons for not reporting ADRs were lack of patient complaints and doubt in the causality of a particular drug. 45.3% of the pharmacists were suggested that the frequent workshops would increase the ADR detection and reporting. Conclusions: Most of the pharmacists had poor knowledge and good perception but with very poor practice in ADR reporting. Junior pharmacists have more awareness in ADR reporting.