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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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
8 results
Search Results
Item Screen addiction among children and adolescents and the self-efficacy of mothers in screen use management during the COVID-19 lockdown in Sri Lanka(Sri Lanka College of Psychiatrists, 2023) Baminiwatta, A.; Nanayakkara, T.D.; Fernando, A.; Wijethunga, S.BACKGROUND: The prevalence of problematic screen use (PSU) or “screen addiction” among children and adolescents may have escalated during the COVID-19 pandemic. The self-efficacy of the mothers in managing screen use in their children may play an important preventive role in children developing PSU. AIMS: This study aimed to assess PSU among children aged 4-18 years during the lockdown period imposed during the COVID-19 pandemic and to explore the association between PSU and self-efficacy of mothers in managing screen use. METHODS: An online survey was conducted using social media groups among mothers of children aged 4-18 years. The PSU in their children was measured using the Problematic Media Use Measure (PMUM), and maternal self-efficacy in managing screen use was assessed using the Parental Screen Use Management Scale (PSUMS). The two questionnaires were translated and validated into Sinhala prior to this study. RESULTS: A total of 320 mothers responded to the survey. Based on the PMUM cut-off score, 25.3% of the children were found to have PSU. PSU was inversely correlated with maternal self-efficacy in managing screen use (r=-0.63, p<0.001). All three subscales of the PSUMS; reactive management (r=-0.56, p<0.001), proactive management (r=-52, p<0.001), and monitoring (r =-45, p<0.001), were significantly correlated with PSU. Younger age at screen use onset showed a marginal correlation (rho=-0.11, p=0.05) with PSU. The child’s age, gender and the educational level of the mother were not associated with PSU. CONCLUSION: Maternal self-efficacy in managing screen use among children was associated with lower PSU in children.Item Violence against children(Samudra Medical Publications, 2022) Fernando, A.; Randeny, S.No abstract availableItem Psychometric properties of the Sinhala version of the Swanson, Nolan, and Pelham rating scale (SNAP-IV) parent form in healthy children and children with ADHD(Elsevier, 2023) Abhayaratna, H.C.; Ariyasinghe, D.I.; Ginige, P.; Chandradasa, M.; Hansika, K.S.; Fernando, A.; Wijetunge, S.; Dassanayake, T.L.OBJECTIVE: The present study aimed to translate and adapt the Parent Form of the MTA Version of the Swanson, Nolan, and Pelham ADHD/ODD rating scale (SNAP-IV) into Sinhala and examine its psychometric properties. METHOD: The MTA version of the SNAP-IV was translated into the Sinhala language by adhering to the WHO translation and adaptational process. The final Sinhala SNAP-IV (S-SNAP-IV) was administered to parents of 412 healthy children and adolescents (age: 6-18 years), and 272 children and adolescents with ADHD (age: 4-19 years). Internal consistency and factor structure of the S-SNAP-IV were determined in each sample. RESULTS: Conforming to that of the original English version, the S-SNAP-IV showed a three-factor structure (inattention, hyperactivity/impulsivity, and oppositional defiant disorder) in each sample, except for three item deviations (10,11, and 13) in the healthy sample. The S-SNAP-IV showed excellent internal consistency in the total sample (Cronbach's alpha = 0.97), healthy sample (Cronbach's alpha = 0.90), and the clinical sample (Cronbach's alpha = 0.94). The S-SNAP-IV also showed good discriminative validity: Only 1.5% of the healthy sample exceeded the cut-off scores in any domain, whereas all newly diagnosed, unmedicated children were S-SNAP-IV positive in at least one domain. CONCLUSIONS: The findings suggest that the three-factor model fits the S-SNAP-IV, and it clearly distinguishes children with ADHD from non-ADHD children. We conclude that the S-SNAP-IV possesses satisfactory psychometric properties-consistent with the MTA English version and its translations into other languages-making it a reliable and valid instrument for screening children with ADHD.Item Measuring antenatal depressive symptoms across the world: A validation and cross-country invariance analysis of the Patient Health Questionnaire-9 (PHQ-9) in eight diverse low-resource settings(American Psychological Association, 2022) Murray, A.L.; Hemady, C.L.; Do, H.; Dunne, M.; Foley, S.; Osafo, J.; Sikander, S.; Madrid, B.; Baban, A.; Taut, D.; Ward, C.L.; Fernando, A.; Thang, V.V.; Eisner, M.; Hughes, C.; Fearon, P.; Valdebenito, S.; Tomlinson, M.; Pathmeswaran, A.; Walker, S.Measures that produce valid and reliable antenatal depressive symptom scores in low-resource country contexts are important for efforts to illuminate risk factors, outcomes, and effective interventions in these contexts. Establishing the psychometric comparability of scores across countries also facilitates analyses of similarities and differences across contexts. To date, however, few studies have evaluated the psychometric properties and comparability of the most widely used antenatal depressive symptom measures across diverse cultural, political, and social contexts. To address this gap, we used data from the Evidence for Better Lives Study-Foundational Research (EBLS-FR) project to examine the internal consistency reliability, nomological network validity, and cross-country measurement invariance of the nine-item version of the Patient Health Questionnaire (PHQ-9) in antenatal samples across eight low-resource contexts. We found that the PHQ-9 scores had good internal consistency across all eight countries. Correlations between PHQ-9 scores and constructs conceptually associated with depression were generally consistent, with a few exceptions. In measurement invariance analyses, only partial metric invariance held and only across four of the countries. Our results suggest that the PHQ-9 yields internally consistent scores when administered in culturally diverse antenatal populations; however, the meaning of the scores may vary. Thus, interpretation of PHQ-9 scores should consider local meanings of symptoms of depression to ensure that context-specific conceptualizations and manifestations of antenatal depressive symptoms are adequately reflected. (PsycInfo Database Record (c) 2022 APA, all rights reserved).Item Characteristics of tuberculous lymphadenitis(Sri Lanka Medical Association, 2010) Jawahir, A.G.M.; Kumarendran, B.; Fernando, A.OBJECTIVE: To describe the characteristics of tuberculous lymphadenitis (TBL) cases in Central Chest Clinic, Colombo. METHOD: This descriptive cross-sectional study was conducted in Central Chest Clinic, Colombo (CCC) using a structured format, from 49 consecutive TBL cases registered at CCC during November 2008 - January 2009. Data was analysed using SPSS soft-ware. TBL was diagnosed based on caseating granuloma in histology, TBL culture for AFB or FNA direct smear for acid fast bacilli and supported by Mantoux test and erythrocyte sedimentation rate (ESR). RESULTS: Majority were aged 21 - 40 years (n=29, 59.2%) and 51 % (n^ 25J were males. Four cases (8.2%) had past TBL. Of the tests, histology showed the highest sensitivity (85.7%), followed by Mantoux test (81.6%), smear (45.8%) and culture (13.3%). Although, smear or culture was not positive among seven TBL cases with non-caseating granuloma (14.3%), diagnosis of TBL was made based on higher mantoux tests ranging from 15 to 50 mm. One case had both TBL and PTB. ATT was continued for more than the standard period in 11 cases (22.4%) with surgical interventions (n=7), persistent lymph node (n=3) and drug induced hepatitis (n=l). Oral prednisolone was given to ten cases for persistent lymph node (n=7) or cutaneous reaction (n-1). All the cases (n=10) who received antibiotics had a surgical intervention. Cut-offs for ESR and Mantoux determined by ROC curves. CONCLUSION: At the Chest Clinic, Colombo the diagnosis of TBL is made commonly by histology and Mantoux test rather than a positive culture.Item Association of smoking with some aspects of pulmonary tuberculosis in Central Chest Clinic, Colombo(Sri Lanka Medical Association, 2011) Kajarajan, R.; Kumarendran, B.; Fernando, A.INTRODUCTION AND OBJECTIVES; to study the association of smoking with some aspects of sputum positive pulmonary tuberculosis (SP-PTB) in Central chest clinic, Colombo (CCC). Methods: This descriptive cross-sectional study recruited 99 consecutive SP-PTB patients (both new and re treatment) registered in CCC and produced treatment outcome as cured, treatment completion or treatment failures. Data were collected by the principal investigator using a questionnaire and data extraction sheet. Smoking status was categorised into ever smoked and never smoked. Pre-treatment sputum status was categorised as <1+ (scanty/ 1+) and >2+ (2+/S+). Chi-square test was used as significance test. RESULTS: Of the 29 female participants, only one had ever smoked in life. Hence, only males were included in the subsequent analysis. Among males, 56 (80.0%) answered as ever smoked and 21 (30.0%) were current smokers. Median age was 50 years (IQR: 45 to 60) among those ever smoked and 46 years (IQR: 21 to 51) among those never smoked. Smoking status was not associated with sputum status of first smear (p=0.53). Smoking status was significantly associated with sputum status of second smear (p=0.02), third smear (p=0.001) and pretreatment smear p=0.04). Association was not significant with smoking status and category of treatment (p=0.4), delay in sputum conversion (p=0.43), chest X-ray findings such as upper lobe infiltration (p=0.62), cavitation (p=0.1) and multiple lobe involvement (p=0.2). CONCLUSIONS: Prevalence of smoking was higher in patient with sputum positive pulmonary tuberculosis. Second and third sample showed significant positivity in smokers than non smokers.Item Filarial antigens detected in urine using the immunochromatographic card test(Sri Lanka Medical Association, 2006) Adikaram, N.D.; de Silva, N.R.; Fernando, A.; Fernando, D.; Lamabadasuriya, S.; Reid, C.B.No Abstract Available.Item Health status of primary school children in Sri Lanka(Sri Lanka Medical Association, 2005) Pathmeswaran, A.; Jayatissa, R.; Samarasinghe, S.; Fernando, A.; de Silva, R.P.; Thattil, R.O.; de Silva, N.R.OBJECTIVE: To assess health status of 9-10-year old school children in Sri Lanka. DESIGN: A cross-sectional, descriptive study. Schools were selected to obtain a sample representative at national and provincial levels and 20 children were randomly selected from Grade 5 classes in each school. MEASUREMENTS: Children were examined for Bitot's spots and goitre. Height, weight, and visual acuity were measured according to standard procedures. Haemoglobin level was measured using finger-prick blood and a HemoCue meter. Geohelminth infections were quantified by faecal examination using the modified Kato-Katz technique. Height for age Z-scores (HAZ) and body mass index (BMI) were calculated as indicators of nutritional status. RESULTS: Two thousand five hundred and twenty eight children (1351 boys) from 144 schools (140 state schools and four private schools) were examined. Nationally, 15.5% of children were stunted (HAZ lower than -2.0 SD); 52.6% were thin (BMI < 5th centile of age- and sex-matched reference population); 3.1% were overweight (BMI > 85th centile); 12.1% were anaemic; 0.3% had Bitot's spots; 3% had a visible or palpable goitre; 4.6% were shortsighted; and 6.9% had one or more soil-transmitted nematode infection. Among children on whom anthropometry, haemoglobin and faecal examinations were all done, 64.6% (1332/2063) were thin, stunted, anaemic or infected with worms. A much higher proportion of children in the Northern and Eastern provinces had health problems when compared to the other provinces. CONCLUSIONS: The majority of older primary schoolchildren in Sri Lanka are undernourished. Anaemia, vitamin A deficiency, iodine deficiency and soil-transmitted nematode infections affect a much smaller proportion of them.