Medicine
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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty
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Item 6379 Pre-admission management of children presenting with febrile illness in a tertiary hospital of Sri Lanka(BMJ, 2024) Arunath, V.; Mettananda, S.OBJECTIVES To describe the symptoms and pre-admission management of children presenting with febrile illness to the Colombo North Teaching Hospital, Ragama, Sri Lanka.METHODS A retrospective descriptive study was conducted at University Paediatric Unit of Colombo North Teaching Hospital, Ragama, Sri Lanka. Data on pre-admission management of all children admitted with febrile illness from July to December 2019 were extracted from patient records. Children who were transferred from other units, children with chronic illnesses and children developed fever following vaccinations were excluded. Ethical approval was obtained from Ethics Review Committee of Sri Lanka College of Paediatricians and data was analysed using SPSS version 22.RESULTS A total of 366 children were admitted; 56% were males. Mean age was 53.5 ± 41.7 months and the majority were from Gampaha district. Mean duration of illness on admission was 3.6 ± 2.5 days. 236 (65.6%) patients had recorded fever spikes at home while 150 (60.7%) reported a contact history of fever. Common associated symptoms were cough (62.3%), cold (56%) and vomiting (39.6%). 199 (54.5%) underwent investigations prior to admission and full blood count was the commonest (47.5%) investigation. Although 357 (97.8%) had taken medication prior to admission, only 87.3% had consulted a doctor. 356 (97.3%) received paracetamol at home of which 24 (7.9%) and 123 (40.6%) received sub-therapeutic and supra-therapeutic doses respectively. Significantly higher proportion (44.9%) of children who consulted a doctor received appropriate dose of paracetamol compared to others (3.7%), (c2=11.9, p=0.003, p<001). Higher proportion children who had recorded fever spikes consulted a doctor (c2=3.99, p=0.046, p<0.05) and received therapeutic doses of paracetamol prior to admission (c2=4.94, p=0.026, p<0.05).CONCLUSION Use of sub- and supra-therapeutic doses of paracetamol was common before admission to the hospital. Recording temperature at home and medical consultation prior to admission were associated with appropriate dose paracetamol usage (p<005).Item Delayed-onset Sinus Node Dysfunction in a child victim of Russell's Viper Bite.(Asia Pub., 2020) Athapathu, A.S.; Arunath, V.; Aruppala, A.A.; Hoole, T. J.; Suntharesan, K.; Mettananda, S.ABSTRACT:Cardiac complications following envenomation by Russell's viper venom are uncommon. We describe a 14-year-old girl who developed delayed-onset sinus node dysfunction. She presented with mucosal bleeding, ptosis, and muscle weakness. Her 20-min whole blood clotting time and international normalized ratio were prolonged. The initial electrocardiogram showed sinus tachycardia. Her systemic manifestations responded to antivenom serum. After 24 h, she developed bradycardia and electrocardiography showed sinus node dysfunction with sinus arrest and an atrial escape rhythm. This case shows that arrhythmias can have a delayed onset even after resolution of other systemic manifestations, and even after treatment with antivenom serum. KEYWORDS: Arrhythmias; adolescent; cardiac; electrocardiography; sinus; snake bites; tachycardia; viperidae.Item Knowledge, attitudes and practices related to chronic childhood urinary tract infections among care givers of patients with urinary tract infections - a single centre experience(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2016) Arunath, V.; Gnanasekar, B.; Coonghe, P.A.D.; Sathiadas, M.G.BACKGROUND: Adequate knowledge, positive attitude and good practices of care givers of children with chronic urinary tract infections (UTI) are important for optimal management of the disease. OBJECTIVES: To describe the knowledge attitudes and practices related to management of chronic childhood urinary tract infections (UTI) and influence of socio economic and demographic factors on it among care givers of children with UTI attending a paediatric clinic in the Teaching Hospital of Jaffna. METHODS: A descriptive cross sectional study which included 172 care giver/patient pairs was conducted. A structurally prepared interviewer administered questionnaire was used to collect data from April to July 2014. Chi square test and independent sample t test were used for analysis. RESULTS: Among caregivers, 163 (94.8%) were females and among them 151 (87.8%) were mothers. The proportion with good knowledge about childhood UTI was 55.8%. More than two third of the participants had good knowledge on symptoms (73.8%), urine collection techniques (73.3%) and investigations (68.6%). Around two fifth of them had good knowledge regarding causes (44.8%) and treatment (46.5%). Of the participants, 84.9% were worried about their child’s illness. About 44% of care givers used napkins for their children and 81.4% of participants washed their child’s anal region front to back after defecation. One tenth of them used home remedies to manage UTI. Almost all brought their child to clinic regularly and received explanations about UTI. The factors significantly associated with mean of total knowledge score included care givers’ age, educational level, occupation, and monthly income. Knowledge of care givers was significantly associated with usage of home remedies and health education given by health professionals. CONCLUSIONS: Knowledge, attitude and practices of care givers were satisfactory but need to improve in certain aspects. Health education should be more effective and it should augment the awareness and eliminate misconceptions prevailing in the community.