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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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
11 results
Search Results
Item Right adrenal Hematoma causing partial small bowel obstruction in a term neonate(The Jaffna Medical Association, 2023) Sanseevan, H.; Manivannan, S.; Thagshanaa, C.; Gayathri, S.; Dayasiri, M.B.K.C.; Srisaravanapavathan, N.; Nawarathne, M. V. D.Adrenal haematoma in the neonate commonly occurs during the first week of life and usually proceeded by either mechanical trauma or metabolic stresses including hypoxia, hypovolaemia, septicaemia and coagulopathy. Haematomas commonly present with abdominal mass, anemia and hypovolaemia. The authors report a large for gestational age male newborn who presented with partial small bowel obstruction following adrenal haematoma in a background of an otherwise uneventful vaginal delivery. Although this presentation is extremely rare, it is important to timely investigate all sick newborns with presentations which mimic acute surgical abdomen. Accurate diagnosis enables both avoidance of unnecessary surgical explorations and optimal conservative management.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 Patterns and outcome of acute poisoning among children in rural Sri Lanka(BioMed Central, 2018) Dayasiri, M.B.K.C.; Jayamanne, S.F.; Jayasinghe, C.Y.BACKGROUND: The burden of poisoning among children is largely underexplored in rural Sri Lanka. This 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: This hospital based multi-center study included Anuradhapura Teaching hospital, Polonnaruwa District General hospital, and 34 regional hospitals within Regional Director of Health Services in North Central province of Sri Lanka. The study assessed clinical profiles, poison related factors, clinical management, complications, harmful first aid practices, reasons for delayed management, complications and outcomes following acute poisoning over 7 years. RESULTS: Among 1621 children with acute poisoning, the majority were in preschool age group. Household chemicals were accountable for 489 acute poisonings (30.2%). The most common poison was kerosene oil, followed by paracetamol. Most events occurred within their own domestic premises. Potentially harmful first aid measures were practiced by approximately one third of care givers. Reasons for delayed presentation at emergency center included 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 the most common complication was chemical pneumonitis. CONCLUSIONS: Children with acute poisoing in rural Sri Lanka were predominantly preschoolers. They are poisonined mostly within their own housing premises. Kerosene oil, in addition to being the most common poison, had additional risks of aspiration pneumonia following potentially hazadrous first aid measures practised by the care givers. Complications though rare were potentially preventable by community education and awareness on timely attention to seek medical care, and avoidance of harmful first aid practices. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12887-018-1246-0) contains supplementary material, which is available to authorized users.Item Kerosene Oil Poisoning among Children in Rural Sri Lanka(Hindawi Pub. Corp., 2017) Dayasiri, M.B.K.C.; Jayamanne, S.F.; Jayasinghe, C.Y.INTRODUCTION: Kerosene oil poisoning is one of common presentations to emergency departments among children in rural territories of developing countries. This study aimed to describe clinical manifestations, reasons for delayed presentations, harmful first aid practices, complications, and risk factors related to kerosene oil poisoning among children in rural Sri Lanka. METHODS: This multicenter study was conducted in North-Central province of Sri Lanka involving all in-patient children with acute kerosene oil poisoning. Data were collected over seven years from thirty-six hospitals in the province. Data collection was done by pretested, multistructured questionnaires and a qualitative study. RESULTS: Male children accounted for 189 (60.4%) while 283 (93%) children were below five years. The majority of parents belonged to farming community. Most children ingested kerosene oil in home kitchen. Mortality rate was 0.3%. Lack of transport facilities and financial resources were common reasons for delayed management. Hospital transfer rate was 65.5%. Thirty percent of caregivers practiced harmful first aid measures. Commonest complication was chemical pneumonitis. Strongest risk factors for kerosene oil poisoning were unsafe storage, inadequate supervision, and inadequate house space. CONCLUSIONS: Effect of safe storage and community education in reducing the burden of kerosene oil poisoning should be evaluated. Since many risk factors interact to bring about the event of poisoning in a child, holistic approaches to community education in rural settings are recommended.Item Risk factors for acute unintentional poisoning among children aged 1-5 years in the rural community of Sri Lanka(Hindawi Pub. Corp., 2017) Dayasiri, M.B.K.C.; Jayamanne, S.F.; Jayasinghe, C.Y.BACKGROUND: Acute poisoning in children is a major preventable cause of morbidity and mortality in both developed and developing countries. However, there is a wide variation in patterns of poisoning and related risk factors across different geographic regions globally. This hospital based case-control study identifies the risk factors of acute unintentional poisoning among children aged 1-5 years of the ruralcommunity in a developing Asian country. METHODS: This hospital based case-control study included 600 children. Each group comprised three hundred children and all children were recruited at Anuradhapura Teaching Hospital, Sri Lanka, over two years (from February 2012 to January 2014). The two groups were compared to identify the effect of 23 proposed risk factors for unintentional poisoning using multivariate analysis in a binary logistic regression model. RESULTS: Multivariate analysis identified eight risk factors which were significantly associated with unintentional poisoning. The strongest risk factors were inadequate supervision (95% CI: 15.4-52.6), employed mother (95% CI: 2.9-17.5), parental concern of lack of family support (95% CI: 3.65-83.3), and unsafe storage of household poisons (95% CI: 1.5-4.9). CONCLUSIONS: Since inadequate supervision, unsafe storage, and unsafe environment are the strongest risk factors for childhood unintentional poisoning, the effect of community education to enhance vigilance, safe storage, and assurance of safe environment should be evaluated.Item Plant poisoning among children in rural Sri Lanka(Hindawi Pub. Corp., 2017) Dayasiri, M.B.K.C.; Jayamanne, S.F.; Jayasinghe, C.Y.Plant poisoning is a common presentation in paediatric practice and an important cause of preventable mortality and morbidity in Sri Lanka. The burden of plant poisoning is largely underexplored. The current multicenter study based in rural Sri Lanka assessed clinical profiles, poison related factors, clinical management, complications, outcomes, and risk factors associated with plant poisoning in the paediatric age group. Among 325 children, 57% were male with 64% being below five years of age. 99.4% had ingested the poison. Transfer rate was 66.4%. Most had unintentional poisoning. Commonest poison plant was Jatropha circus and poisoning event happened mostly in home garden. 29% of parents practiced harmful first-aid practices. 32% of children had delayed presentations to which the commonest reason was lack of parental concern regarding urgency of seeking medical care. Presence of poisonous plants in home garden was the strongest risk factor for plant poisoning. Mortality rate was 1.2% and all cases had Oleander poisoning. The study revealed the value of community awareness regarding risk factors and awareness among healthcare workers regarding the mostly benign nature of plant poisoning in children in view of limiting incidence of plant poisoning and reducing expenditure on patient management.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 Trends in pediatric in Anuradhapura district: A 171 tertiary care center experience(Faculty of Graduate Studies, University of Kelaniya, 2014) Dayasiri, M.B.K.C.; Jayamanne, S.F.; Jayasinghe, Y.C.; Senarathne, L.