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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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
10 results
Search Results
Item Clinical practice of vitamin D screening and supplementation in pregnancy in Asia-pacific countries: A cross-sectional study(Elsevier, 2023) Lee, R.W.K.; Chng, A.L.B.; Tan, K.H.; Shub. A.; Tan, T.; Ling, L.S.; Kuma, K.; Siew, C.Y.; Ting, W.; Myint, S.S.; Judistiani, R.T.D.; Shah, M.; Madulid-Sison, L.; Andres-Palencia, B.; Pagilagan-Palma, E.; Banu, L.A.; Boriboonhirunsarn, D.; Dias, T.D.BACKGROUND: Vitamin D deficiency is common in pregnant women. There is scarce information in the Asia-Pacific region on the understanding of vitamin D screening and supplementation in pregnancy among health care professionals. METHODS: We performed a cross-sectional study among health care professionals who are part of the Integrated Platform for Research in Advancing Metabolic Health outcomes of Women and Children (IPRMAHO) international study group on their understanding and perception of Vitamin D screening and supplementation in pregnancy. The cross-sectional survey comprised 4 main sections: demographics, existing policies, nutrient supplementation in pregnancy and various practices on screening, treatment and perceptions, with a total of 22 questions. A total of 15 responses were obtained from attendees from distinct health facilities across eleven participating Asia-Pacific countries. RESULTS: Majority of the surveyed hospitals (11/15, 78.6 %) did not have a national policy or regional guideline regarding Vitamin D screening and supplementation in pregnancy. More than half of respondents were (9/14, 64.3 %) were unsure of the percentage of women seen with Vitamin D deficiencies each year and were unsure of Vitamin D dosage prescribed to pregnant women with (8/15, 53.3 %) or without (6/14, 42.9 %) Vitamin D deficiency. Vitamin D was rarely prescribed in pregnancy when compared to other nutrient supplements such as folic acid and iron. Majority of respondents (9/11, 72.7 %) indicated that their hospital did not screen for Vitamin D deficiencies in pregnancy, even amongst high risk pregnant women. Nevertheless, majority of respondents indicated a need (12/15, 80.0 %) for a guideline or consensus regarding Vitamin D screening and supplementation in pregnancy. CONCLUSION: While majority of the surveyed hospitals did not have a national policy or regional guideline regarding Vitamin D screening and supplementation in pregnancy, majority of respondents indicated a need for the policy or guideline. There were varying clinical knowledge gaps and different perceptions on Vitamin D screening and supplementation in pregnancy among healthcare professionals.Item Evaluation of cervical length by transabdominal and transvaginal scans during early pregnancy.(Sri Lanka college of Obstetricians & Gynaecologists, 2021) Ruwanpura, L.; Wickramasinghe, J.B.; Marasinghe, P.; Ratnayake, G.M.; Dias, T.D.; Silva, D.ABSTRACT: Objective To compare the measurements and the client-preferences of transabdominal scan (TAS) and transvaginal scan (TVS) in assessing cervical length. Method A validation study with a cross sectional component on patient-preferences was conducted among 568 pregnant women with a period-of-amenorrahea between 11+0 to 22+6 weeks. Pre- and post-void TAS and a post-void TVS measurements were taken. Receiver Operating Characteristics (ROC) curves were generated to assess the detection of short cervix using pre and post-void TAS at different lengths of the cervix. Results The mean (SD) age of the participants was 28.4(5.7) years with a mean gestation age of 14+1 weeks. The mean (SD) cervical lengths detected by the pre-void TAS, post-void TAS and TVS were 32.2 (5.8)mm, 28.9 (5.8) mm and 34.4 (5.3) mm respectively. Factors with significant association with a higher TVS cervical length were; increasing age (p<0.001), higher gravidity (p<0.001), higher parity (p<0.001) and higher number of vaginal deliveries (p<0.001). The TAS and TVS measurements significantly correlated with each other (p<0.001). Post-void TAS could not obtain measurement in 49.47% of attempts. The shortest cervical length can be detected by pre-void TAS was 26mm with an ideal cut-off of 33mm. For post-void TAS the shortest length was 28mm with an ideal cut-off of 28.16mm. Majority preferred TAS over TVS. Conclusion Pre-void TAS can predict a cervical length of 26mm or less with 87.5% sensitivity whereas the shortest length predicted by post-void is relatively longer. Nearly in half, a valid post-void TAS could not be recorded. Client preference was more favorable for TAS. KEYWORDS: Ultrasound, Cervical length, Screening, Preterm labourItem Nutcracker syndrome in pregnancy: a worrying presentation of a benign condition(Sri Lanka Medical Association, 2017) Motha, M.B.; Palihawadana, T.S.; Dias, T.D.; Wijesinghe, P.S.Item Do teenager prefer contraception or termination?(Sri Lanka College of Obstetricians and Gynaecologists, 2007) Herath, H.M.R.P.; Dias, T.D.; Amarasinghe, W.L.INTRODUCTION: Teenage pregnancy is universal in all known societies past and present. One in four girls in the world becomes a mother before the age of 19 years. In Sri Lanka, 22.2% of maternal deaths due to illegal abortions were in this age group during 1996. Lack of knowledge regarding contraceptive methods is thought to be the main reason for not practicing proper contraception. On the other hand information about domestic violence in families with teenage mother is scares. OBJECTIVES: To describe the use of contraception, attempted pregnancy terminations and violence against women during the pregnancy among teenage mothers delivered at Teaching Hospital Peradeniya. METHOD: A prospective descriptive study was done on teenage mothers who delivered at teaching hospital Peradeniya from 1st of April 2005 to 31st of March, 2006, using interviewer administered questionnaire. RESULTS: There were 190 teenage mothers delivered during the study period. Data was collected from 186 of them. Among these teenage mothers Only 3(1.6%) has studied above GCE ordinary level. Only 28% ofwomen of the group have used any form of contraception, and of which 64% has used barrier methods of contraception. 80 (43%) of teenage mothers had thought of future contraception before they were discharged from the hospital. Termination of the pregnancy has been attempted by 9.1% of the study population. Of those who had'attempted termination 82.4% had not used any form of contraception. Male partners have assaulted 16.1% of teenage mothers during the pregnancy. CONCLUSION: The teenage pregnant mothers have poor educational background. The contraceptive use in the population was very low leading to unnecessary pregnancies and termination of pregnancies. Domestic violence in this population is fairly common.Item Precision of predicting expected date of delivery by ultrasound scan in comparison to last menstrual period(Sri Lanka College of Obstetricians & Gynaecologists, 2014) Wasalathilaka, C.; Kumari, S.D.T.L.; Palihawadana, T.S.; Herath, H.M.R.P.; Padumadasa, S.; Pathmeswaran, A.; Dias, T.D.INTRODUCTION: Estimation of the expected date of delivery (EDD)is important in management of pregnancy, as many clinical decisions would rely on the estimated gestation of the fetus. In routine clinical practice, this is done by either adding the duration of a pregnancy to the last menstrual period (LMP) or by assessment of fetal biometry by an early pregnancy ultrasound scan (USS). The accuracy of these methods can be assessed either by correlating the dates with people with a know date of conception, such as following IVF, or by study of the correlation with the date of delivery in a cohort of women who goes in to spontaneous labour. In this study we have assessed the accuracy of the two methods by the latter approach. The aim of this study was to assess the agreement of EDD calculated by LMP or USS, to the date of delivery in spontaneous labour. METHODS: This was a retrospective cohort study. 675 patients who had a spontaneous onset of labour were included in the analysis. USS fetal crown rump length was considered for gestational age assessment between 8 and 14 weeks and fetal head circumference considered thereafter. Their agreement of the date of delivery with the estimated expected date of delivery by LMP or USS was assessed. RESULTS: Spontaneous delivery was seen with 6 days of the USS EDD and 7 days of the LMP EDD in 50% of women and within 11days of USS EDD and 15days of LMP EDD among 75% of women. A delivery within 14 date of the EDD was observed in 93.7% when USS EDD was considered and it was only in 86.2% with the LMP EDD (OR 2.40, 95%CI 1.64-3.52). CONCLUSION: This study demonstrate that the USS EDD is more in agreement with the date of spontaneous delivery than the EDD estimated from LMP. This highlights the importance of dating USS in all pregnancies which would be helpful in management of pregnancy in late stages.Item Diabetes mellitus in pregnancy(Sri Lanka College of Obstetricians and Gynaecologists, 2015) Motha, M.B.C.; Dias, T.D.Item Invasive prenatal testing at a Tertiary Fetal Medicine referral center in Sri Lanka: A service evaluation audit(Sri Lanka College of Obstetricians and Gynaecologists, 2015) Padeniya, A.G.P.M.; Dias, T.D.Item Thyroid dysfunction in pregnancy(Sri Lanka College of Obstetricians and Gynaecologists, 2015) Motha, M.B.C.; Palihawadana, T.S.; Dias, T.D.Item Mirror syndrome: a rare presentation with a trisomy 21 fetus(Sri Lanka College of Obstetricians and Gynaecologists, 2014) Prasanga, D.P.G.G.M.; Dias, T.D.; Palihawadana, T.S.; Gunathilaka, S.N.M.P.K.; Herath, H.M.R.P.; Wasalathilaka, C.D.Item An Audit on Performance of Medical Students of the University of Kelaniya in Completing the Clinical Tasks during their Final(Sri Lanka College of Obstetricians and Gynaecologists, 2014) Palihawadana, T.S.; Motha, M.B.C.; Dias, T.D.; Wijesinghe, P.S.