Medicine
Permanent URI for this communityhttp://repository.kln.ac.lk/handle/123456789/12
This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty
Browse
25 results
Search Results
Item Effective use of an innovative learning method: a perspective from a Sri Lankan setting(South East Asia Regional Association for Medical Education (SEARAME), 2025-01) Dayasiri, K.; Kiridana, V.; Mudiyanse, R.INTRODUCTION Numerous medical schools have incorporated humanities and narrative medicine into their curricula to cultivate compassion and foster essential interpersonal abilities in medical students. These progressive educational approaches prove effective in cultivating empathy, ethical conduct, and professionalism among future healthcare practitioners. METHODS This qualitative study was conducted at the Faculty of Medicine, University of Kelaniya to study the effectiveness of an innovative learning method in enhancing active learning, critical thinking and personal professional development amongst first-year medical students. Newly graduated medical students, following exposure to a Training of the Trainer (TOT) program, served as facilitators for the training program, and insights from facilitators were gathered through audio-recorded focus group discussions. Following this, a thematic analysis was conducted to explore the interplay and correlations among the identified domains. RESULTS The study revealed that facilitators experienced a sense of empowerment after participating in the facilitator training program. They acknowledged that learning about learning itself was a novel experience, which they hadn't encountered during their time as students. Further, the findings indicated that junior medical graduates can successfully undergo training to facilitate a combination of five innovative active learning methods aimed to boost critical thinking and personal professional development among fresh medical students, resulting in high levels of acceptance and satisfaction among the facilitators. CONCLUSION The results of this study support the idea that training facilitators can improve their skills in delivering programs that promote critical thinking and active learning among first-year medical graduates. Feedback from newly graduated medical professionals acting as facilitators indicated that with enthusiasm and motivation, junior healthcare workers could be successfully trained to facilitate in settings with limited resources.Item Effect of Mindfulness Meditation on Symptoms of Stress and Depression in Cancer outpatients of Sri Lanka. (MeSADISC study)(Ibn Sina Medical College, 2025-01) Dayasiri, K.; Rajapakshe, D.; Goonewardane, N.D.V.; Jayarathne, COBJECTIVES This intervention study aimed to evaluate mindfulness meditation as a method of treatment for cancer outpatients for stress reduction and control of symptoms of depression and to find out effects of socio demographic differences.METHOD Cancer outpatients were randomly selected on separate clinic dates at the National Cancer Institute of Sri Lanka and were enrolled as cases (n=44) and controls (n=30). Volunteers followed training sessions once weekly in addition to home based mindfulness meditation. All participants were asked to complete the “Beck’s Depression” and “Symptoms of Stress” questionnaires prior to intervention and at each session. Controls were assessed based on the identical questionnaire at start and end of 9 weeks. Both groups were heterogeneous in age, sociodemographic characteristics and cancer types / stage.RESULT At the end of the intervention, patients in the intervention group had significantly lower scores of depressions and stress. Reduction in Beck’s depression score was from 33.21 to 24.56 (p<0.001) in the treatment group, compared to 34.5 to 32.34 (p>0.05) in the control group. Reduction in Symptoms of Stress Inventory from 21.21 to 10.76 (p<0.001) was seen in the intervention group, compared to 22.50 to 25.5 increase in controls. Significant changes (p<0.05) were seen in all age categories, gender, education, income and levels of social interactions.CONCLUSION Mindfulness meditation programme was effective in decreasing levels of depression and stress in people with cancer, irrespective of socio-demographic backgrounds and cancer types or stages.Item Presentation of disseminated neuroblastoma mimicking Bell’s palsy: a case report(BioMed Central, 2025-01) Gunawardana, S.; Jogaprajahpan, G.; Dayasiri, K.BACKGROUND Neuroblastoma is an embryological malignancy of neural crest cells that may have diverse presentations owing to direct effects, metastases, or paraneoplastic syndromes. Facial nerve palsy is an extremely rare presentation of neuroblastoma.CASE PRESENTATION A previously healthy 1-year-and-10-month-old Sinhalese girl presented with difficulty in closing her left eye for 2 weeks, preceded by deviation of her mouth to opposite side. Initial physical examination was normal, apart from left lower-motor-type facial nerve palsy. Initial laboratory investigations were also normal. A tentative diagnosis of Bell's palsy was made. However, magnetic resonance imaging of the brain was performed owing to the incidental detection of a painless bulge in the left zygomatic region with overlying skin bruising, in the absence of any preceding trauma. Magnetic resonance imaging of the brain revealed a soft-tissue mass in the left lateral orbital wall, extending to the body of the sphenoid and bulging into the left anterior fossa. Contrast-enhanced computed tomography of the abdomen, performed subsequently, showed an intra-abdominal large paravertebral soft-tissue mass. Histology of the abdominal mass confirmed poorly differentiated neuroblastoma.CONCLUSION Facial nerve palsy is well recognized to have a myriad of underlying etiologies, including hematological malignancies, solid tumors, and paraneoplastic syndromes. However, its timely diagnosis is often challenging in the absence of other supportive clinical features. These children need careful and thorough evaluation for malignancies before commencing steroids, especially when underlying malignancy is likely.Item Collodion baby successfully treated with acitretin(Sri Lanka College of Paediatricians, 2024-12) Suwarna, P.; Dayasiri, K.; Nawaratne, D.No abstract availableItem Acute hemolytic crisis complicated with ischemic cardiac injury and methemoglobinaemia following ingestion of naphthalene: a case report(BioMed Central, 2024-12) Dayasiri, K.; Pathiraja, H.; Thadchanamoorthy, V.BACKGROUND Naphthalene is an aromatic hydrocarbon that potentially produces methemoglobinaemia but rarely causes hemolysis, especially in children with underlying glucose-6-phosphate dehydrogenase deficiency. Although ingestion of a single moth ball by an older child may not be life threatening, it can be fatal if ingested by a toddler. CASE PRESENTATION A 2-year-old Singhalese boy developed acute severe hemolysis and methemoglobinaemia following ingestion of a mothball. On admission, the patient was ill and pale. The child was tachycardic and tachypnoiec with oxygen saturation of 76% on air. Blood investigations showed significant anemia, elevated reticulocytes, and evidence of hemolysis in a blood picture, along with elevated lactate dehydrogenase and indirect bilirubin. Child also had ST depressions on electrocardiogram examination with negative troponin-I. He was given four packed red blood cell (PRBC) transfusions and was successfully discharged in 3 days time following optimal supportive treatment. A glucose-6-phosphate dehydrogenase assay confirmed the diagnosis of glucose-6-phosphate dehydrogenase deficiency in this child: 0.9 U/gHb (4.0-13.0 U/gHb).CONCLUSION This case report highlights a rare life-threatening presentation of naphthalene ingestion in a child with previously undiagnosed glucose-6-phosphate dehydrogenase deficiency. Ingestion of even a single moth ball can be fatal in vulnerable children given the altered toxicokinetics of naphthalene in children.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 6460 Children’s perception of the health effects of climate change – a mixed-method study in urban Sri Lanka(BMJ, 2024) Dayasiri, K.; Anand, G.OBJECTIVES While children bear the least responsibility for global climate change, they suffer the most from its consequences, including a higher incidence of non-communicable diseases and exposure to natural disasters. The United Nations has emphasised that failing to act on climate change infringes upon children’s rights to live in a secure environment. Our study focuses on examining the perspectives of Sri Lankan adolescents on climate change, its effects, and their roles in addressing this issue.METHODS This mixed-method cross-sectional study involved 104 adolescents attending schools in Colombo, Sri Lanka. We randomly selected participants from both governmental and private schools and invited them to complete a self-administered questionnaire. The questionnaire covered their perceptions of climate change, their contributions to addressing climate change, and their views on the regional and global implications of climate change. Qualitative data analysis was conducted using a second-order descriptive analysis of themes.RESULTS 104 adolescents participated in the study and 75.8% were female children. Median age =17 years (range 13–19 years). Majority (93.1%) expressed concern about the potential future health impacts of climate change. While most adolescents correctly understood the concept of climate change, some revealed misconceptions about it. The major health impacts associated with climate change, as reported by the participants, included asthma, the rise of non-communicable diseases, skin conditions, cancer, and increased stress. Notably, 25% of the participants felt that they had not received education on climate change. Nearly 60% reported feeling anxious over the issue of climate change. Regarding their contributions to addressing climate change, 29.8% of the children admitted that they had not taken sufficient actions. However, those who had acted mentioned activities such as tree planting, increased use of public transportation, and educating others about climate change. Almost half of the cohort were unaware of useful resources for learning about climate change. A significant 76% of the adolescents believed that adults were not actively taking measures to address climate change.CONCLUSION This study showed that children are evidently anxious over the issue of climate change. There is an urgent need for improved awareness of information sources among children through public health measures. It is essential for adults including those in the medical profession to serve as role models in educating and guiding children on how to make a positive impact on global climate change.Item Parental knowledge, attitudes and practices regarding safe handling and disposal of alcohol-based hand sanitizers and surface disinfectants in urban Sri Lanka(Ethiopian Pediatric Society, 2024) Dayasiri, K.; Pathiraja, H.; De Soyza, E.K.N.; Thadchanamoorthy, V.; Dassanayaka, S.J.S.INTRODUCTION Hand sanitizers were increasingly used in most households during the COVID-19 pandemic. This study aimed to assess knowledge and practices regarding the safe handling and disposal of alcohol-based hand sanitizers and surface disinfectants in urban Sri Lanka.METHODS A cross-sectional study was performed including parents of children admitted to North Colombo Teaching Hospital for a period of one year in August 2021. Data were collected regarding parental knowledge about the safe handling and disposal of hand sanitizers, and their health hazards by paediatric post-graduate trainees. All data were analyzed using SPSS 17.0. Chi-square test was used to find the association of overall knowledge and attitude scores with potential sociodemographic determining factors.RESULTS A total of 153 parents were recruited. The majority of mothers (126, 82.4%) and fathers (133, 86.9%) had attended up to secondary school. Approximately 113(73.9%) parents believed that pre-school children were the most vulnerable for accidental ingestion of sanitizers and 40 parents (26.1%) did not believe that sanitizer solutions can be accidentally inhaled by toddlers. Only 132 parents (86.2%) knew how to disinfect their home premises safely and 29 parents (18.9%) didn’t know how to store cleaning products safely. Overall, lower knowledge scores correlated with lower maternal education (p<0.05) and lower socio-economic status (p<0.05). The gender (p = 0.06) and age of the parent (>35 years versus <35 years) (p = 0.21) did not show a significant association. Attitude scores positively correlated with parental education (p<0.002) and socio-economic status (p<0.03). The gender (p = 0.12) and age of the parent (>35 years versus <35 years) (p = 0.07) did not show a significant association.CONCLUSION Overall knowledge and attitude scores in parents were associated with education level of parents and the level of socio- economic status. Gender and parental age did not show a significant association.Item Acute pericarditis in a child during the recovery period of multisystem inflammatory syndrome(The Sri Lanka Collage of Paediatricians, 2024) Lokuhewage, C.; Dayasiri, K.No abstract availableItem Management strategies for common viral infections in pediatric renal transplant recipients(Baishideng Publishing Group, 2024) Ranawaka, R.; Dayasiri, K.; Sandamali, E.; Gamage, M.Viral infections have been considered as a major cause of morbidity and mortality after kidney transplantation in pediatric cohort. Children are at high risk of acquiring virus-related complications due to immunological immaturity and the enhanced alloreactivity risk that led to maintenance of high immunosuppressive regimes. Hence, prevention, early detection, and prompt treatment of such infections are of paramount importance. Among all viral infections, herpes viruses (herpes simplex virus, varicella zoster virus, Epstein-Barr virus, cytomegalovirus), hepatitis B and C viruses, BK polyomavirus, and respiratory viruses (respiratory syncytial virus, parainfluenza virus, influenza virus and adenovirus) are common in kidney transplant recipients. These viruses can cause systemic disease or allograft dysfunction affecting the clinical outcome. Recent advances in technology and antiviral therapy have improved management strategies in screening, monitoring, adoption of prophylactic or preemptive therapy and precise treatment in the immunocompromised host, with significant impact on the outcome. This review discusses the etiology, screening and monitoring, diagnosis, prevention, and treatment of common viral infections in pediatric renal transplant recipients.
- «
- 1 (current)
- 2
- 3
- »