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 The establishment of a population-specific reference value for the ruler drop test for the clinical assessment of reaction time(Elsevier, 2023) Rajapaksha, S.; Kitulwatte, I.; Senarathne, U.; Edirisinghe, A.; Perera, P.BACKGROUND: Reaction time (RT) is the interval between a stimulus and an appropriate voluntary response in an individual. Alcohol is known to result in delayed RT. In Sri Lanka, an alleged drunken driver is legally subjected to a medico-legal examination to confirm or exclude impairment. The guideline for examining a drunk person in Sri Lanka includes the ruler drop test (RDT) as a test of RT. RDT is a simple test of visual reaction time in which the subject attempts to stop a falling ruler, and the height fallen is used to determine the time taken to react to the event. However, a formal study has yet to be carried out to establish population-specific reference values to interpret RDT results. METHODS: A cross-sectional descriptive study was conducted using 903 adults ≥18 years. A nonparametric approach was applied for deriving the reference values based on an inter-percentile interval. RESULTS: The study population consisted of 56.6% females, and the mean age of the participants was 41.6 years. Most (95%) of the study population could catch the ruler at or less than 40.0 cm of average height. The average height on RDT increased from younger to older age groups. However, subgrouping based on other variables, including sex, age, and alcohol consumption, did not show any statistically significant difference. CONCLUSIONS: The population-specific cut-off limit to identify alcohol intoxication by RDT in a Sri Lankan adult is 'average height' >40 cm.Item Pattern of physical growth during first six months of life among a cohort of babies living in Gampaha district, Sri Lanka(2013) Perera, P.; Fernando, M.; Mettananda, S.; Samaranayake, R.Introduction: Current WHO recommendation is to continue exclusive breast feeding (EBF) up to six months. Main concern regarding this recommendation is, whether EBF supports rapidly growing infant with adequate nutrition. Methods: A cohort of randomly selected new-borns was followed up at two, four and six months, to study feeding pattern and physical growth. Feeding practices and socio-demographic data were collected using an interviewer administered questionnaire. Weight & length were measured using standard techniques. Results: EBF rates were very high in this cohort of children. One main reason to stop EBF was growth faltering. Only some children showed a catch up growth by stopping EBF. At two, four and six months, weight faltering rates among EBF babies were, 11.1%, 20.1% and 13.2% respectively. Length faltering had a similar pattern, but with a higher rate at all ages. Conclusions: EBF up to six months did not cause growth faltering in the majority. In the majority, no identifiable cause for growth faltering was found. Possible genetic influence on growth faltering was not considered when stopping EBFItem Constipation and functional faecal retention in a group of school children in a district in Sri Lanka(Sri Lanka College of Paediatricians, 2009) Rajindrajith, S.; Devanarayana, N.M.; Mettananda, S.; Perera, P.; Jasmin, S.; Karunarathna, U. A.; Adihetti, D.; Goonewardena, R.OBJECTIVE: To assess the prevalence of constipation and functional faecal retention among a group of school children in Gampaha district of Sri Lanka. METHOD: This is a cross sectional survey. A validated, self-administered questionnaire was distributed to randomly selected children, aged 10-16 years, in a semi-urban school in Gampaha District of Sri Lanka. Constipation was defined using Rome III criteria and Paris Consensus on Childhood Constipation Terminology (PACCT). Functional faecal retention was diagnosed using Rome II criteria. RESULTS: A total of 441 questionnaires were distributed and 429 (97.3%) responded (53.1% males, mean age 12.4 years, SD 1.5 years). According to Rome III criteria and PACCT, 46 (10.7%) had constipation. Prevalence of constipation was higher in males (14.5%) compared to females (6.5%) [OR 2.45, 95% CI 1.19-5.1, p=0.012]. Twenty three (5.4%) had functional faecal retention. CONCLUSIONS: Chronic constipation is a significant problem, affecting approximately 10% of children in a semi-urban school in Gampaha district. It is commoner among males. Both Rome III criteria and PACCT are effective in diagnosing childhood constipation in epidemiological studiesItem A Pilot study on assessment of racial affinity of Sri Lankan population using discriminant function statistics and a few established morphological racial traits(Elsevier Science Ireland Ltd, 2009) Perera, P.; Pathmeswaran, A.Determination of racial affinity was not considered in investigations of unidentified bones in Sri Lanka until recently. Post-Tsunami exhumation of mass graves to identify Japanese and Europeans tourists highlighted the lack of anthropological data to separate them from Sri Lankans. OBJECTIVE: The objective of this study is to determine the racial affinity of the Sri Lankan population using few well documented anatomical traits and Giles and Elliot's discriminant function analysis. METHODOLOGY: Following measurements were obtained from 38 skulls. Basion-Prosthion length, Maximum length, Maximum breadth, Basion-Bregma height, Basion-Nasion height, Bizygomatic breadth, Prosthion-Nasion height and Nasal breadth. RESULTS: Giles and Elliot (1963)'s discriminant functions developed to determine ancestry were used. In addition, few well-established morphological racial traits were also observed. Separate discriminant functions developed by Giles and Elliot to differentiate American white skulls from black skulls and white skulls from native Indian skulls were used. Five skulls had the measurements of blacks and another five had the measurements of Native Americans. The rest had measurements of American whites. 24 skulls had 'medium' (intermediate triangle) nasal openings. Nasal root contour was low to moderate in height (tented) in 22 skulls. Nasal spine was small in 31 skulls and nasal sill was blurred in 27 skulls. CONCLUSION: Discriminant functions developed by Giles and Elliot identified the majority of skulls in this study as belong to Caucasians but only few skulls had obvious Caucasian morphological traits. However, there were few skulls showing clear Negroid and Mongoloid morphological features. Finally this study showed that the formulae developed by Giles and Elliot can be used to differentiate Sri Lankan skulls from those of American Indians and Blacks.Item Scars of torture: a Sri Lankan study(Elsevier, 2007) Perera, P.Interpretation of scars of torture is not an easy task as our understanding of evolution of scars of different methods of torture is still in its infancy. The objectives of this study were to produce the features of a typical scar of a few selected methods of torture and determine their characteristic distribution. To achieve this, 100 medico-legal records of victims of torture examined at the Judicial Medical Officer's Office, Colombo between 1998 and 2001 were perused. Scars caused by seven selected methods of torture were taken into consideration. They were, assault with both non-pliable and pliable blunt objects, cigarette burns, burns with heated solid objects and molten plastic, ligature application with different forms of suspension and cuts with sharp objects. Total number of scars analyzed in this study was 1846, which included 740 scars of non-pliable blunt weapons, 182 of pliable blunt weapons, 102 of ligature, 59 of molten polythene, 55 of heated objects and 82 of razor blades and knives. Typical scars of each method of torture and their characteristic distribution were determined.Item Physical methods of torture and their sequelae: a Sri Lankan perspective(Elsevier, 2007) Perera, P.Methods of torture vary from country to country and sometimes within regions in the same country. Knowing torture methods used in a country or region assists in evaluating injuries, scars and other chronic sequelae of torture. Medical records of 100 victims of torture examined between 1998 and 2001 in the Judicial Medical Officer's Office in Colombo, Sri Lanka, were perused to gather data on torture methods used in Sri Lanka during that period. Altogether 68 methods of torture had been used on these victims. They included assault with blunt and sharp weapons, burns with lighted cigarettes, 'dry submarino', kicking, 'wet submarino', 'hanging', electric torture, 'falaka' and many more. However, only 18% of victims had any physical residual effects, highlighting the typical objective of torture, which is inflicting maximum pain without causing serious injury or death.