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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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 Seroprevalence of hepatitis C virus in thalassaemic patients and patients who undergo long-term haemodialysis(Sri Lanka College of Microbiologists, 2009) Jayamaha, C.J.S.; Senanayake, C.P.; Manamperi, A.; Chandrasiri, P.; Karunanayake, L.BACKGROUND: Hepatitis C virus (HCV) is a major global health problem. Multiple blood transfusions and long-term haemodialysis are associated with HCV transmission. OBJECTIVE: To determine the seroprevalence of HCV in thalassaemic patients and patients who undergo long-term haemodialysis. METHODOLOGY: Study group consisted of 228 thalassaemic patients and 183 patients who undergo long-term haemodialysis. A sample of blood was collected from all the patients and tested for HCV antibody with a third generation ELISA. Repeatedly reactive samples were subjected to one step reverse transcriptase-PCR. RESULTS: Prevalence of anti-HCV antibodies among thalassaemic patients and haemodialysis patients were 3.95% (9/228) and 1.09% (2/183) respectively. Mean number of blood transfusions among anti-HCV positive patients was 139.91 compared to 53.88 in anti-HCV negative patients (p<0.01). Mean number of haemodialysis cycles among anti-HCV positive patients was 197.0 compared to 51.15 in anti-HCV negative patients (p=0.000). In thalassaemic cohort, 52.2% were not screened for either HBV or HCV infection. In haemodialysis cohort this value was 27.3%. CONCLUSIONS: The presence of anti-HCV antibodies was significantly associated with the number of blood transfusions and number of haemodialysis cycles. Screening for viral hepatitis markers was not satisfactory in either cohort. It is recommended that patients be screened for hepatitis B and C viruses prior to dialysis/ transfusion and at specific intervals. Screening donor blood for anti-HCV antibodies should be made mandatory to decrease the HCV infection among multitransfused patients. ACKNOWLEDGEMENTS: Financial assistance by National Health Research Council & Roche Pharmaceuticals.Item Rate of stunting among a sample of postwar resettled families in the Vanni region: a study from the Mullativu District(Sri Lanka Medical Association, 2013) Ramanayake, R.P.J.C.; Sumanasekera, R.D.N.; de Silva, A.H.W.; Perera, D.P.; Chandrasiri, P.; Gunasekera, R.; Jayasinghe, L.R.The Department of Family Medicine, University of Kelaniya conducted a health camp in Puthukudiyiruppu in March 2011. Height and weight measurements were carried out and data of 303 participants were analysed. The rate of stunting among children below six years in this population was 62% compared to 19.3% nationally. Thirty four percent of children and adolescents (6-18yrs) were underweight and 21.4% of adults had a BMI less than 18.5kg/m2.Item Knowledge of location of organs in the body among patients attending a university family practice in Sri Lanka(2013) Ramanayake, J.; Perera, D.; de Silva, A.; Sumanasekera, D.; Jayasinghe, L.R.; Gunasekera, R.; Chandrasiri, P.Introduction: The referral letter is the interface between the primary and secondary/tertiary levels of care. It facilitates the referral process and is beneficial for optimizing patient care. In Sri Lanka a referral letter is not essential to consult a Specialist. In this scenario, the quality as well as the number of referral letters encountered in practice needed to be explored. Objectives: To describe Specialists' views on the quality of referral letters received, perceived advantages of referral letters and to identify other modes of communication between General Practitioners and Specialists. Methods: Conducted in 2013, this study consisted of in-depth interviews using a semi-structured format, with 21 purposively selected Specialists representing a range of specialties. They included clinicians and university academics from both the government and the private sector. Analysis was by generating a thematic framework based on the recurrent themes and issues which was then applied to the textual data. Results: Most patients consulted Specialists without a referral letter and also the few letters received were of poor clarity, lacking important information and scribbled in illegible hand. Main themes identified as advantages of referral letters were: impart important information about the patient, clear description of the initial condition and treatment given, reduced consultation time, prevents delays in diagnosis and reduced healthcare costs by reducing polypharmacy and repetition of investigations. Some of the other modes of communication suggested by Specialists were via telephone, SMS, fax and email. Conclusions: The general belief amongst Specialists is that referral letters are an important part of the patient care system. This has not been adequately utilized by the primary care providers in Sri Lanka, despite the numerous advantages described. Also consideration needs to be given to newer modes of emerging information communication technology