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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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 Patterns of acute poisoning among children in rural sri lanka(Sri Lanka College of Paediatricians, 2015) Dayasiri, M.B.K.C.; Jayamanne, S. F.; Jayasinghe, Y. C.OBJECTIVE:The study describes the patterns of demographic characteristics, poison related factors, clinical management and outcome following acute poisoning among children (9 months - 12 years) in rural Sri Lanka.METHOD:The current multi-centre study was hospital based and involved the two major hospitals (Anuradhapura and Polonnaruwa), and 34 peripheral hospitals of the North Central province of Sri Lanka (NCP). Total period covered by the study was seven years. Major part of data collections was carried out at Anuradhapura hospital prospectively for two years using interviewer administered questionnaire based assessments.RESULTS:Among 1621 children, boys (59%) outnumbered girls and most were of preschool age group. Majority belonged to the farming community. Commonest poison and type of poison were kerosene oil and household poisons respectively in most studies. Both male and female children ingested pesticides least. Most had unintentional poisoning and incidents mostly occurred within their own house premises. First aid measures were practised by one third of care givers and there were six incidents of aspiration pneumonia as detrimental effects of first aid measures and guardians were unaware of these effects in all cases. Commonest reasons for delayed presentation at emergency centre had been lack of concern by family members regarding the urgency of the situation and lack of knowledge regarding possible complications. Complications were observed in 12.5% and commonest was chemical pneumonitis.CONCLUSIONS: •The victims of acute poisoning in this muli-centre study were predominantly preschoolers, and male children were at a higher risk. • They were poisonined mostly unintentionally and within their own housing premises. •Kerosene oil was the commonest poison with its additional risks of aspiration pneumonia following hazadrous first aid measures by care givers.Item A time for change; causes for neonatal eye discharge at university postnatal and paediatric baby unit, Colombo North Teaching Hospital(Sri Lanka College of Obstetricians and Gynaecologists, 2010) Dayasiri, M.B.K.C.; Perera, K.P.J.PURPOSE: Low prevalence of neonatal eye discharge is related to quality obstetric and early neonatal care and absence of maternal sexually transmitted infections. Corneal ulceration and staphyloma formation are already recognized complications of neonatal conjunctivitis and it can also lead to neonatal sepsis and subsequent severe complications. This study was aimed to identify the causes for neonatal eye discharge. METHODS: Retrospective study was carried out involving all the neonates who had eye discharge in the university post natal and pediatric baby unit, during past 2 years. Information was gathered from 138 cases with regard to onset of eye discharge, aetiology for eye discharge as confirmed by eye swab culture and, demographic factors. RESULTS: Majority had been acquired during the early neonatal period {1 st week=88%, 2nd week=8.7%). Common causes for eye discharge had been Staphylococcus aureus (48%), coagulase negative staphylococcus (33%). Methicillin resistant staphylococcal infection was present among 10%. Pseudomonas (1%) and Streptococcus (3%) were also reported in minority. CONCLUSIONS: Majority of the causes had been normal flora of the female genital tract. Prevalence of sexually transmitted infections was 0%. However, prevalence of MRSA was significantly high compared to other studies in literature. The fact that 12% had been occurred after 1 st week would suggest a nosocomial origin and needs revision of the hygienic practice in post natal care.Item Patterns and risk factors of acute poisoning among children in rural Sri Lanka(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2016) Dayasiri, M.B.K.C.The study describes the patterns, risk factors and outcome following acute poisoning among children (9 months - 12 years) in rural Sri Lanka. The current multi-center study was hospital based and involved two major hospitals (Anuradhapura and Polonnaruwa), and 34 peripheral hospitals of the North Central Province of Sri Lanka. Total period covered by the study was seven years. Data were collected using interviewer administered questionnaire based assessments. Among 1621 children, boys (59%) outnumbered girls and most were in preschool age group. Majority belonged to the farming community. Commonest poison and type of poison were kerosene oil and household poisons respectively. Most had unintentional poisoning and incidents mostly occurred within their own house premises. Inadequate supervision, unsafe storage, and unsafe environment were among most significant risk factors. Complications were observed in 12.5% and commonest was chemical pneumonitis. Victims of acute poisoning in paediatric age group are predominantly preschoolers, and male children are at a higher risk. Complications though rare are potentially preventable through community education regarding risk factors, timely attention to seek medical care and avoidance of harmful first aid practices.Item Acute poisoning in the paediatric age group in North-Central province of Sri Lanka(Sri Lanka Medical Association, 2013) Dayasiri, M.B.K.C.; Jayamanne, S.F.; Jayasinghe, Y.C.INTRODUCTION AND OBJECTIVES: There is little data on poisoning in the paediatric age group in the North Central Province (NCP) of Sri Lanka. Objective of this study was to identify characteristics, risk factors and outcome of poisoning in the paediatric age group in the NCP. METHODS: All children presenting with either accidental or deliberate poisoning, to all paediatric casualty units at the Anuradhapura and Polonnaruwa Teaching Hospitals, over a period of 8 months from March 2012 were studied. Information was obtained from clinical interviews, focus group discussions, clinical observation and clinical records. RESULTS: Of the 167 children, 53% were male and 91% were below six years of age. Parents were agricultural workers in 25% and 51% had been educated up to GCE O' Level. Poisoning was mainly accidental (97%). Commonest poison was kerosene oil (24.9%). Reasons for delay in seeking medical help included lack of transport (14%), poor knowledge (12%), lack of awareness regarding urgency (12%) and financial constraints (8%). Complications included acute liver injury (4.2%), chemical pneumonitis (3.6%), and convulsions (1.8%). There were no deaths. Inadequate supervision by parents 87.5%, improper storage of household chemicals 52% and medicines 40% were common risk factors. CONCLUSIONS: Acute poisoning in children mostly occurred due to inadequate supervision by parents and improper storage of chemicals and medicines. Community education and safe storage of chemicals and medicines will reduce the incidence of poisoning in the paediatric age group.Item Patterns and risk factors of acute poisoning among children in rural Sri Lanka(Sri Lanka Medical Association, 2014) Dayasiri, M.B.K.C.; Jayamanne, S.F.; Jayasinghe, Y.C.INTRODUCTION AND OBJECTIVES: This controlled prospective study identifies the patterns and risk factors of acute poisoning in the paediatric age group in rural Sri Lanka. METHODS: All children presenting with a history of acute poisoning to the paediatric units of Anuradhapura Teaching .Hospital were included. Age and gender matched controls without any identifiable chronic medical conditions were recruited from the same population over the same duration. Data were collected using clinicai interviews, focused group discussions, and Bed Head Ticket based records over a period of eighteen months from March 2012 to September 2013. RESULTS: Analysis was based on 307 children with acute poisoning and 250 controls. Sixty percent of children with acute poisoning were males and most were between 2-4 years (49%). Odds ratios were calculated for each of the 24 risk factors proposed and each was used to create a logistic regression model together with age and gender. Application of Chi Square test in this model revealed inadequate supervision by the parents as the commonest risk factor (p< 0.001, Cl=95%) associated with acute poisoning. Other risk factors which showed a significant association (p< 0.001, Cl=95%) included unsafe storage of household chemicals, unsafe storage of medicines, poor extended family support, presence of poisonous plants in the neighborhood and poor maternal education. CONCLUSIONS: Children become victims of acute poisoning mostly secondary to inadequate supervision, unsafe environment and unsafe storage of poisons. As these risk factors are significantly associated with poisoning, community education, safe storage and assurance of safe environment should be evaluated.