Conferences and Symposia

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Conference papers presented at Conferences and Symposia organized by the Faculty of Medicine are collected under this subcommunity

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Ability to use computer software among new medical entrants to the Faculty of Medicine, University of Kelaniya
(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2016) Solangaarachchi, D.I.K.; Kumara, A.A.K.B.; Hettige, S.; Ediriweera, E.P.D.S.
BACKGROUND: Computer software is essential to enhance academic life of students. OBJECTIVES: To describe the level of confidence and ability on using computer software among new entrants to Faculty of Medicine, University of Kelaniya METHODS: Moodle based self-administered questionnaire was given to new entrants in 2015 and 2016 and their perception on the level of confidence, ability and usage were recorded. RESULTS: The results are described according to the 2015 (n=159) and 2016 (n=147) batches respectively. Proportion of males were 27% and 35%. Proportions who could install software in each batch was 20% (n=32 and 29) and could not were 15.7% (n=25) and 27.2% (n=40). Those who could and could not install a printer were 10.1% (n=16)/ 16.3% (n=24) and 30.8% (n=49)/ 34% (n=50) respectively. Proportions who could and could not install a pen drive were 28.9% (n=46)/ 40.1% (n=59) and 15.7% (n=25)/ 17% (n=25) respectively. Nine percent (n=14) and 13.6% (n=20) had used, 63.5% (n=101) and 50.3% (n=74)) were aware but had not used and 27.7% (n=44)) and 36.1% (n=53) were not aware of open source software. CONCLUSIONS: A majority of students had no awareness on software installation and pen drive scanning and have not used open source software at the point of entry to the Medical Faculty.
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.
Acquisition of Reading Skills of Sinhala Vowel Modifiers among Pre-School Leavers and Grade One Leavers in Gampaha District
(Faculty of Medicine, University of Kelaniya, 2014) Perera, B.M.R.K.; Williams, C.; Wijeratne, L.
Vowel modifiers are a very important feature in Sinhala written language, which are used with consonants to make different sound syllables. They always appear in word medial or final positions to represent the associated vowel sounds; they can be used before, after, on top, bottom or around the consonant (Dissanayaka, 2005). The main objective of this study was to identify teachers’ expectations in children’s performance, in terms of reading vowel modifiers at pre-school level and grade one leaver level, as well as to identify the actual performance level of children. A quantitative cross-sectional exploratory study was done in four selected schools in the Gampaha District. The sample comprised of forty pre- school leaver level students, eighty grade one leaver level students, eight pre-school teachers and eight grade one teachers. Teachers’ data were collected using a self-administered questionnaire and a record sheet to mark the expected level for the whole class. Children were tested individually using a Sound Blending and Meaning Picture Card Test (SBMPT) with the same record sheet to mark their performance. The results reveal that teachers’ expected level of children’s performance in reading vowel modifiers were 0% and 100% for preschool and grade one leaver levels respectively. Average scores for pre- school children on SBMPT was 0% and most of the grade one children were able to obtain 100% for vowel modifier / ɑ:/ at syllable level. The least performance was noticed with /o: / at 88%. Acquisition of the skills in reading vowel modifiers was not associated with gender, but was significantly associated with age. i.e., when age of the children increased the percentage of vowel modifiers they acquire also increased proportionally. In conclusion, it was found that most of the pre-school leavers have not acquired reading skills in terms of vowel modifiers and the majority of the grade one leavers have mastered most of the vowel modifiers.
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.
Adapting the colorado learning difficulties questionnaire into sinhala for the local context
(University of Kelaniya, Sri Lanka, 2022) Abeyrathne, M.K.A.U.; Danthanarayana, N.D.
Background: In Sri Lanka, there are only limited standardized tools to assess for learning difficulties. The purpose of this study was to translate, cross-culturally adapt, and validate the Colorado Learning Difficulties Questionnaire (CLDQ) into the Sinhala language. Objectives: The main objective was to translate and cross-culturally adapt the CLDQ into the Sinhala Language for children aged between 6 to 10 years. The study assessed the content validity, known group validity, and reliability and examined the association between scores of the tool and background variables. Methods: A Delphi study was conducted to cross-culturally adapt the CLDQ and a cross-sectional study was undertaken to assess the reliability and validity of the CLDQ. There were 30 parents of children with learning difficulties in a clinical setting in the Gampaha district and 30 parents of children with typical development aged between 6-10 years in a school setting in the Gampaha district using convenience sampling. Two Delphi rounds were conducted with 8 experts to adapt the questionnaire. The data was collected using an online survey. Results: The mean age of both groups was 8 years. The content validity was excellent in the translated and adapted CLDQ. It had excellent reliability in the group of children with learning difficulties. There was a significant difference in CLDQ scores between the normative and clinical groups, which emphasized known group validity. There was no significant difference in CLDQ scores and the gender of participants in the clinical group. There was a significant negative correlation between CLDQ scores and the duration of accessing therapy services by children with learning difficulties. Conclusion: This tool was effectively translated, adapted, and validated. It has excellent content validity and high reliability for children with learning difficulties. The tool was able to discriminate the children with learning difficulties via known group validity. It strongly correlated negatively with the tool's final score and access to therapy. The relevant information from the parents on their child’s earning difficulties could be gathered using this translated, adapted, and validated tool.
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.
Advances in lipid-modification for the prevention of vascular disease
(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2016) Armitage, J.
OBJECTIVES : 1. To understand the importance of different lipids to vascular disease risk and how genetics have helped 2. To reiterate the value and safety of statins as a first line therapy for lipid modification 3. To explain the potential role of newer lipid-lowering agents: PCSK9 inhibitors, cholesterol ester transfer protein inhibitors and small interfering RNAs to block lipid-related protein synthesis Observational studies indicate a clear, positive and continuous relationship between coronary heart disease risk and blood LDL- cholesterol levels and inverse associations with HDL-cholesterol. Recent genetic evidence also supports a causal role for CETP, lipoprotein (a) [Lp(a)], apoC3, ANGPLT3 and PCSK9 in vascular risk. Large, well-designed randomized trials of statins and meta-analyses of trials show that reductions of 20-25% in the risk of vascular events are seen per 1 mmol/L reduction in LDL-cholesterol, with larger reductions producing greater benefits. Statins are safe and well tolerated although the risk factors for the rare side-effect of myopathy need to be understood to allow their use most safely and effectively. The results of trials of HDL-raising have so far been disappointing, both because older drugs were toxic (niacin) and other studies may have been underpowered to detect plausible effects. An alternative explanation is that HDL-cholesterol is not causally related to vascular disease but only associated and there is supportive genetic data for this view. Newer agents such as monoclonal antibodies against PCSK9 and CETP inhibitors are currently in Phase 3 trials and clearly reduce LDL levels substantially with CETP inhibitors also increasing HDL-cholesterol and show promise for vascular risk reduction but are likely to be very expensive and are not yet proven. Results will emerge in the next couple of years.
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.
Anovulation as cause of infertility and novel methods of ovulation induction
(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2016) Palihawadana, T.S.
Infertility is known to affect one in six couples. Ovulatory dysfunction is a common underlying cause and is seen in approximately 38% of couples seeking infertility treatment. Polycystic ovary syndrome was the commonest underlying cause of anovulation and was seen in nearly 60% women. Hypogonadotropic hypogonadism and ovarian failure are uncommon causes of anovulation seen in only about 1-2% of women with anovulation. Clomifene citrate is the commonest medication used for induction of ovulation. It is successful in achieving ovulation in over three quarters of women with WHO group II anovulation. However, factors such as hirsutism, a high antral follicle count and a high LH:FSH ratio are associated with clomifene resistance. Aromatase inhibitor, letrozole, is a novel medication for induction of ovulation. It is successful in achieving ovulation in nearly 75% of women who respond to clomifene and 25% of women with clomifene resistance. Factors associated with resistance to letrozole included a high day2 LH level, hirsuitism and clomifene resistance had the highest association. The use of letrozole for augmentation of ovulation, in comparison to clomifene, resulted in a higher endometrial thickness and a trend towards monofollicle development. Gonadotropin (FSH) is used in induction of ovulation among women with resistance to oral medication. A low-dose step down regimen of rFSH, in comparison to a low-dose step-up regimen, showed a shorter duration of treatment, with no significant reduction in the total drug requirement. These findings have improved our understanding of different modes of induction of ovulation, which helps in further research and clinical practice.
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.
Antibiotic sensitivity patterns of Extended-Spectrum β-Lactamase urinary tract infections in Sri Lanka
(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2016) Sebastiampillai, B.S.; Premaratna, B.A.H.R.; Luke, W.A.N.V.; Wickramasinghe, R.D.S.S.; Gunathilake, M.P.M.L.; Miththinda, J.K.N.D.
BACKGROUND: Extended-spectrum β-lactamase (ESBL) producing organisms causing urinary tract infections (UTI) are increasing in incidence and poses a major burden to health care requiring treatment with expensive antimicrobials and prolonged hospital stay. The prevalence of ESBL producing organisms particularly in the Asian region remains unknown. OBJECTIVES: To identify common ESBL producing organisms and to evaluate the antibiotic sensitivity patterns of ESBL UTIs in Sri Lanka. METHODS: Patients admitted with ESBL-UTI to Professorial Medical Unit, Colombo North Teaching Hospital, Ragama over a period of 6 months from January 2015 were recruited. Their Urine culture and ABST reports were analysed after obtaining informed written consent. RESULTS: Of the 52 patients who consented to be on the study, 30 (57.7%) were males. Mean age was 64.11 (SD=12.59) years. E. coli was the commonest organisms (84.6%; n=44), causing the ESBL-UTI followed by Klebsiella (15.4%; n=8). Fifty (96.2%) patients were sensitive to meropenem, 38 (73.1%) to imipenem, 30 (57.7%) to amikacin and 24 (46.2%) to nitrofurantoin. Meropenem resistance was found in 2 (3.8%) cases which were due to infection with E. coli.These two patients had received multiple antibiotics including meropenem in the recent past for recurrent UTI. CONCLUSIONS: While E. coli and Klebsiella are the commonest ESBL producing organisms causing UTI, carbapenems remain as the first line therapy. However 3.8% prevalence of meropenem resistance among the study population should draw attention of clinicians and needs implementation of measures to prevent emergence of carbapenum resistant ESBL organisms.
Antinociceptive activity of aqueous extract of Psychotriasarmentosa leaves
(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2016) Ratnayake, W.M.K.M.; Chandrika, U.G.; Suresh, T.M.; Abeysekera, A.M.; Salim, N.
BACKGROUND: Adverse side effects caused by NSAIDS and other existing allopathic analgesic agents have made these drugs unwelcoming to many. The search for alternative therapies has intensified over the years. Consequently, the investigations on the efficacy of plant based drugs used in traditional medicine has been seen as a fruitful research strategy in the search for new analgesic drugs due to possibly lesser side effects as well as the low cost. Indigenous healers in Sri Lanka prescribe an aqueous extract of leaves of Psychotriasarmentosa (named “Gonica” in Sinhala; Family: Rubiaceae) for individuals who have been physically assaulted, indicating that it may possess potent analgesic and/or anti-inflammatory activity. OBJECTIVES: Previous studies have shown that aqueous extract of P. sarmentosa has significant anti-inflammatory activity and the general objective of the present study was to determine the antinociceptive activity of this preparation. METHODS: Acetic acid induced writhing method was conducted to evaluate the analgesic activity on male Wistar rats. Data analysis was carried out using one-way analysis variance (ANOVA) and results with p <0.05 were considered as statistically significant. RESULTS: The results showed that the treatment with 100 mg/kg of freeze dried aqueous extract of P. sarmentosa leaves significantly reduced the abdominal contractions induced by the intra-peritoneal administration of acetic acid solution when compared to the control. The percentage inhibition of it was found to be 44.4 % whereas it was 50.8 % for acetyl salicylic acid. CONCLUSIONS: These preliminary observations provide evidence for the antinociceptive properties of leaves of P. sarmentosa as claimed in folk medicine.
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 between Mobile Phone Usage and Hearing Sensitivity among Third Year Students; (of) University of Kelaniya, Sri Lanka
(Faculty of Medicine, University of Kelaniya, 2014) Sivaramalingam, V.; de Silva, D.
With advancement of Global System for mobile (GSM) communication, mobile phones (MP) have become an essential communication tool. Mobile networks operate in frequencies which fall in the microwave range of electromagnetic spectrum. The close proximity of a mobile phone antenna, radio frequency electromagnetic radiation can penetrate into organic tissues causing health hazards. In Sri Lanka, the number of MP users is over 20.3 million and the majority of users are young adults. Up to date, no study has been conducted regarding MP usage and its effects on hearing in Sri Lanka. The objective was to determine the association between MP usage and hearing sensitivity among third year students, University of Kelaniya, Sri Lanka. A descriptive cross sectional study was conducted among 223 students who filled a self-administered questionnaire regarding MP usage and hearing related symptoms. All participants underwent otoscopic examination, and a Distortion Product Otoacoustic Emission (DPOAE) screening at 3 kHz, 4 kHz and 5 kHz frequencies. The mean MP usage hour per day was 1.41 hours (SD 1.22) and the mean MP usage duration was 5.57 years (SD 1.72). The majority of students preferred the right ear for MP conversation, while highest prevalence of hearing loss was observed at 4 kHz (5.6%) and 5 kHz (6.7%) in the right ear. There was no significant difference in hearing loss between the ears of the two sides. A significant association between hearing loss and prolonged usage (more than 5.57years) of MP or excessive usage of MP (more than 1.41 hours per day) could not be found. Symptoms such as warmth, tinnitus, need of repetition and muffled sensation were associated with excess usage of MP.
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.