Journal/Magazine Articles
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This collection contains original research articles, review articles and case reports published in local and international peer reviewed journals by the staff members of the Faculty of Medicine
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Item Randomised, placebo-controlled trial on topiramate add-on therapy for weight reduction and symptomatology in overweight/obese persons with Schizophrenia(Elsevier Ltd, 2022) Chandradasa, M.; Ruwanpriya, S.; de Silva, S.; Rathnayake, L.; Kuruppuarachchi, K.A.L.A.Introduction: Higher cardiovascular mortality is seen with schizophrenia due to the disorder itself and antipsychotic use. South Asians are more vulnerable to developing metabolic disorders than others. Resource-limited settings in South Asia have only a few mental health professionals, and individualised case management is mostly unavailable. Therefore, there is less monitoring and personalised support for diet and physical exercise programmes. Topiramate is useful for weight reduction and improvement of psychopathology in schizophrenia. However, there has been only one previous randomised controlled trial (RCT) done in South Asia, which possesses a quarter of the world's population. Methods: We conducted a double-blind RCT in an outpatient setting in Sri Lanka. We compared topiramate 100 mg/day with a placebo in overweight/obese adults with schizophrenia who have been on antipsychotics for at least a year. We obtained monthly anthropometric measurements and assessed the symptomatology using the brief psychiatric rating scale (BPRS). Results: Fifty patients each in the topiramate and placebo arms completed the study. Topiramate add-on therapy led to significant weight/Body Mass Index reduction and improved symptomatology as measured by the BPRS compared to the placebo. The topiramate group had significantly more reporting of loss of appetite. Discussion: According to available data, this is the RCT with most participants assessing the use of topiramate in schizophrenia and only the second in South Asia. Topiramate was shown to be useful for weight reduction and symptomatic improvement in persons with schizophrenia in a resource-limited setting in South Asia.Item Near-death experiences in a multi-religious hospital population in Sri Lanka(Springer, 2018) Chandradasa, M.; Wijesinghe, C.; Kuruppuarachchi, K.A.L.A.; Perera, M.Near-death experiences (NDEs) are a wide range of experiences that occur in association with impending death. There are no published studies on NDEs in general hospital populations, and studies have been mainly conducted on critically ill patients. We assessed the prevalence of NDEs and its associations in a multi-religious population in a general hospital in Sri Lanka. A randomised sample of patients admitted to the Colombo North Teaching Hospital was assessed using the Greyson NDE scale and clinical assessment. Out of total 826 participants, NDEs were described by 3%. Compared to the NDE-negative participants, the NDE-positive group had a significantly higher mean for age and a ratio of men. Women reported deeper NDEs. Patients of theistic religions (Christianity, Islam and Hinduism) reported significantly more NDEs compared to patients from the non-theistic religious group (Buddhism). NDE-positive patient group had significantly higher reporting of a feeling 'that they are about to die', the presence of loss of consciousness and a higher percentage of internal medical patients. This is the first time that NDEs are assessed in a general hospital population and NDEs being reported from Sri Lanka. We also note for the first time that persons with theistic religious beliefs reported more NDEs than those with non-theistic religious beliefs. Medical professionals need to be aware of these phenomena to be able to give an empathic hearing to patients who have NDE.Item Ethno-psychopharmacology(Royal College of Psychiatrists, 2008) Hapangama, A.; Kuruppuarachchi, K.A.L.A.Item Burden of mental illness and the need for better undergraduate education in psychiatry(Sri Lanka Medical Association, 2014) Kuruppuarachchi, K.A.L.A.; de Silva, N.R.No Abstract AvailableItem Organic causation of morbid jealousy(Elsevier, 2011) Kuruppuarachchi, K.A.L.A.; Seneviratne, A.N.This article describes the organic contribution to morbid jealousy. Although the true prevalence of morbid jealousy is unknown, organic factors contribute significantly to its development. We present an assortment of five case histories to highlight the importance of organic causation in this phenomenon. The first two cases portray organic delusional disorder arising as an aftermath of cerebral infarcts. They are both associated with left sided brain lesions. Though organic processes generally respond poorly to treatment, case 3 (patient with head injury), is unusual as it describes a young man whose symptoms resolve on recovering from the effects of a head injury. Likewise, case 4 (patient with a meningioma) who made a complete recovery following surgery, emphasizes the need for early detection of reversible causes. The difficulty in identifying the common substrate for a phenomenon with such a wide variety of causations is amply displayed by the abundance of theories forwarded. The blurred demarcation between normal jealousy and pathological jealousy leads to further uncertainty. The excess representation of morbid jealousy in organic conditions is not enlightened by these theories. Organic pathology, by affecting the higher centers of the brain, may remove the control over instinctual behaviour. Evidence for this is hard to establish but the evolutionary perspective of jealousy akin to that of the animal kingdom alludes to possible explanations.Item A Case report of child sexual abuse - important points to ponder(Sri Lanka College of Psychiatrists, 2010) Kuruppuarachchi, K.A.L.A.; Wijesinghe, C.A.No Abstract AvailableItem Elder abuse and carer abuse: two sides of the same coin(Sri Lanka Medical Association, 2010) Kuruppuarachchi, K.A.L.A.; Wijesinghe, C.A.Comment on: Paranitharan P, Edirisinghe PA, Williams S. (Ceylon Med J. 2009; 54(1):1-3). No Abstract AvailableItem A Study of intimate partner violence among females attending a Teaching Hospital out-patient department(Sri Lanka College of Psychiatrists, 2010) Kuruppuarachchi, K.A.L.A.; Wijeratne, L.T.; Weerasinghe, G.D.S.S.K.; Peiris, M.U.P.K.; Williams, S.S.BACKGROUND: Intimate partner violence (IPV) is considered a public health problem with physical and psychological consequences. AIMS: To describe the prevalence of IPV among married females attending the out-patient department of North Colombo Teaching Hospital and their attitude towards abuse. METHODS: A pre-tested self-administered questionnaire on physical, verbal, sexual and emotional abuse was given to the first 50 consenting married females attending the out-patient department on each day for five consecutive days. Confidentiality of responses was assured and adequate privacy was provided for the questionnaires to be completed. RESULTS: Of the 242 participants 98(40.5%) reported some form of abuse by their male partner. Prevalence of abuse reported was physical abuse 19%, verbal abuse 23%, emotional abuse 23% and sexual abuse 7%. A quarter (26.9%) of those inflicted physical violence sought medical treatment for the injuries but only two of them divulged the reason for the injury to medical staff. More than three quarters (79%) of those abused were in the relationship for more than ten years. The majority of the females surveyed believed that violence by the male partner should be tolerated. CONCLUSIONS: IPV is a common problem that is poorly divulged to medical personnel. Attitudes regarding IPV have to be changed in order to reduce abuse significantly.Item Suicidal risk assessment and depression(Sri Lanka Medical Association, 2009) Kuruppuarachchi, K.A.L.A.; Wijesinghe, C.A.No Abstract AvailableItem Postnatal mental disorders(Sri Lanka Medical Association, 2009) Kuruppuarachchi, K.A.L.A.; Hapangama, A.No abstract Available