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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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 Biofeedback with and without surgery for fecal incontinence improves maximum squeeze pressure, saline retention capacity and quality of life(Springer India, 2008) Munasinghe, B.N.L.; Rathnayaka, M.M.G.; Parimalendran, R.; Kumarage, S.K.; de Zylva, S.; Ariyaratne, M.H.J.; Deen, K.I.Item Quality of life of stoma patients: temporary ileostomy versus colostomy(Springer-Verlag, 2003) Silva, M.A.; Rathnayake, G.; Deen, K.I.Ileostomy for proximal diversion as a preferred option over colostomy has been a recent topic of interest. Our study evaluated the quality of life (QOL) of patients with a temporary ileostomy and compared it with that of patients with a temporary colostomy. The QOL of 25 patients with an ileostomy(median age 42 years, range 22-76 years) was compared with that for 25 patients with a colostomy (median age 44 years, range 18-70 years). Indications for a stoma were rectal carcinoma, trauma, inflammatory bowel disease, anastomotic leak, or incontinence following an operative procedure for rectal prolapse. The study was conducted at a median of 8 weeks (range 6-16 weeks) for ileostomy patients and of 9 weeks (range 5-17 weeks) for colostomy patients following stoma creation. A self-administered structured questionnaire was used, with responses obtained for 10 QOL questions on a visual analog rating scale (0-100 mm); they were graded good (71-100), satisfactory (31-70), or poor (0-30). Altogether, 22 (88%)patients with an ileostomy, compared with 16 (64%) patients with a colostomy, were able to purchase their stomal appliances ( p = 0.09, chi(2): NS). Effluent was tolerable in 18 (72%) patients with an ileostomy compared with 7 (28%) patients with a colostomy ( p = 0.002, chi(2)). Appetite was not affected in any of the patients with an ileostomy (100%), compared with 64% of patients with a colostomy ( p = 0.002, chi(2)), travel by public transport 32% compared to 28% with colostomy (NS), dress in 20% compared to 24% with colostomy (NS), and daily activities 28% compared to 24% with colostomy (NS). Moreover, 68% with an ileostomy did not have a problem with hygiene compared with 40% with a colostomy (NS); 95% with an ileostomy abstained from sexual activity compared with 81% with a colostomy ( p = 0.21, chi(2): NS). Both ileostomy and colostomy resulted in significant QOL impairment. However, with ileostomy, the effluent was more tolerable, had less of an impact on personal hygiene, and preserved the appetite compared with colostomy. There were no differences in travel, dress, daily chores, or sexual activity between the two groups.Item Faecal incontinence after vaginal delivery(Sri Lanka Medical Association, 2003) Deen, K.I.No Abstract AvailableItem Patients' experience and quality of life with a loop ileostomy(College of Surgeons of Sri Lanka, 2000) Wijesuriya, S.R.E.; Rathnayake, G.; Deen, K.I.Background: Temporary proximmal faecal diversion has been either loop ileostomy or loop colostomy. Recently, loop ileostomy has been preferred over loop colostomy. This study evaluated patient's quality of life with a temporary diverting loop ileostomy. Patients and methods: Life quality of 25 (8 males, median age 40 years, range 22-70 years) patients who underwent creation of a loop ileostomy at the university surgical unit of North Colombo General Hospital were evaluated using self-administrated structured questionnaire. Responses were obrained for ten life quality questions on visual analogue rating scale (0-100mm) and graded good (71-100), satisfactory (31-70) or poor (0-30). Results: Twenty four (96 percent ) patients were able to purchase their stoma appliances without much difficulty. Almost all patients reported a tolerable ileostomy effluent. Seventeen (94 percent ) of 18 patients reported abstinence from sexual activity. A loop ileostomy had no effect on appetite in 60 percent , travel by public transport on 20 percent , and dress in 8 percent , or activities of daily living in 20 percent of patients. Conclusion: A loop ileostomy seems to impair quality of life in most patients. Strained sexual relationships appear to be the most distressing problem. Most patients are able to bare the cost of their stoma appliances.