Journal/Magazine Articles
Permanent URI for this collectionhttp://repository.kln.ac.lk/handle/123456789/13
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 How do we define normal bowel frequency from newborn to teens?:A Bayesian meta-analysis(Wiley, 2024-12) Munasinghe, S.; Manathunga, S.; Hathagoda, W.; Kuruppu, C.; Ranasinghe, P.; Devanarayana, N. M.; Baaleman, D. F.; Benninga, M. A.; Rajindrajith, S.OBJECTIVES Defecation disorders are a common pediatric problem and bowel frequency is crucial in identifying them. The aim of this analysis is to define normal bowel frequencies in healthy children ranging from newborns to adolescents. METHODS A literature search was conducted using MEDLINE, SCOPUS, EMBASE, Cochrane Library, and Web of Science from their inception to February 2024, aiming to identify studies reporting bowel habits of healthy children (0–18 years). A Bayesian distribution modeling approach was adopted to pool the mean frequency of bowel opening using inverse-variance weighing. A subgroup analysis and a meta-regression were performed with Bayesian generalized additive mixed distributional models. The methodological quality of the articles was evaluated using the Newcastle–Ottawa Scale modified for cross-sectional studies. RESULTS Seventeen studies were included in the analysis, including 22,698 children aged from 0 to 18 years. The subgroup meta-analysis showed mean bowel frequencies for newborns, 1–6 months, 6–12 months, 1–2 years, 2–5 years, and over 5 years are 3.24 (95% credible interval [CrI]: 2.83–3.63), 1.99 (95% CrI: 1.77-2.19), 1.66 (95% CrI: 1.45–1.88), 1.53 (95% CrI: 1.37–1.7), 1.15 (95% CrI: 0.99–1.31), and 1.02 (95% CrI 0.88–1.18), respectively. Between studies, heterogeneity demonstrated a near-normal distribution with a mean of 0.16 and a 95% CrI of 0.04–0.28. The variance of the distribution of mean bowel frequency reduced with age. DISCUSSION In this Bayesian meta-analysis, we found that younger children have a higher bowel frequency. The reported bowel frequencies for each age group could serve as normal values in clinical practice to differentiate health and disease.Item Epidemiological patterns and trends of paediatric snakebites in Sri Lanka(Biomed Central, 2024-12) Dayasiri, K.; Caldera, D.; Suraweera, N.; Thadchanamoorthy, V.; Hettiarachchi , M.; Denipitiya, T.; Bandara, S.OBJECTIVES This study aimed to analyse the epidemiological patterns of paediatric snake bites in Sri Lanka over a 4-year period (2020-2024).METHODS A multi-centre, retrospective observational study was conducted from June 2020 to June 2024 across nine governmental hospitals in seven provinces of Sri Lanka. Data were collected based on 757 children presenting with snake bites. The snake bites were analysed based on age, gender, and seasonal variations. Data on the type of snake involved, geographic variations and the temporal trends in snake bite occurrences were also analysed.RESULTS The mean age of the 757 children recruited to the study was 10.3 years (SD-5.00, range-0.1-17 years). Males (57.7%) were significantly more affected than females (42.3%) (p < 0.05). Visual identification confirmed the snake species in 58.4% of cases. The hump-nosed viper (16.7%), Russell's viper (14.7%), and common krait (12.9%) were the most common medically important snakes identified in the study. Seasonal peaks in snake bites occurred in May-July and November-December. An increasing trend in snake bite incidence was noted over the first three years, with a slight decline in the final year.CONCLUSION Paediatric snake bites in Sri Lanka show significant age, gender, and seasonal patterns. Targeted public health interventions are needed to mitigate the impact on children.Item Childhood constipation: Current status, challenges, and future perspectives(Baishideng Publishing Group, 2022) Rajindrajith, S.; Devanarayana, N.M.; Benninga, M.A.Constipation in children is a major health issue around the world, with a global prevalence of 9.5%. They present to clinicians with a myriad of clinical signs. The Rome IV symptom-based criteria are used to diagnose functional constipation. Functional constipation is also a huge financial burden for healthcare system and has a detrimental impact on health-related quality of life of children. There are various risk factors identified globally, including centrally connected factors such as child abuse, emotional and behavioral issues, and psychological stress. Constipation is also precipitated by a low-fiber diet, physical inactivity, and an altered intestinal microbiome. The main pathophysiological mechanism is stool withholding, while altered rectal function, anal sphincter, pelvic floor, and colonic dysfunction also play important roles. Clinical evaluation is critical in making a diagnosis, and most investigations are only required in refractory patients. In the treatment of childhood constipation, both nonpharmacological (education and de-mystification, dietary changes, toilet training, behavioral interventions, biofeedback, and pelvic floor physiotherapy), and pharmacological (osmotic and stimulant laxatives and novel drugs like prucalopride and lubiprostone) interventions are used. For children with refractory constipation, transanal irrigation, botulinum toxin, neuromodulation, and surgical treatments are reserved. While frequent use of probiotics is still in the experimental stage, healthy dietary habits, living a healthy lifestyle and limiting exposure to stressful events, are all beneficial preventive measures.Item Constipation in children: the Sri Lankan perspective(Sri Lanka Medical Association, 2021) Hathagoda, W.; Rajindrajith, S.; Devanarayana, N.No Abstract available