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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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 Item Prenatal and early childhood biomass smoke exposure and child neuro-developmental outcomes(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2016) Godamunne, P.For many families in developing countries such as Sri Lanka, burning wood is the cheapest and most available source of cooking and heating fuel. However the household air pollution (HAP) resulting from burning of bio mass fuel is hazardous to children’s health. The numerous chemicals contained in wood smoke have been shown to have adverse effects on various aspects of children’s health. While the impact of HAP on children’s lung function, allergic diseases and childhood cancer has been investigated fairly extensively, less attention has been paid to the impact of exposure to wood smoke on neurodevelopment. The developing nervous system is especially vulnerable to environmental toxins and elevated levels of incomplete combustion products of wood smoke such as carbon monoxide are known to have neurotoxin effects. An ongoing collaborative study between the Faculty of Medicine, University of Kelaniya and the University of Alabama at Birmingham aims to assess the impact of prenatal and postnatal exposure to HAP on children’s neurodevelopment. HAP exposure is determined through questionnaires and measurement of PM2.5, PM1.0, PM10, CO and NO2. Neurodevelopment of children is assessed at birth and then at regular intervals up to 36 months using the Bayley Scales of Infant and Toddler Development. Preliminary results from this study add to the growing body of evidence on the impact of HAP on children’s neurodevelopment.Item Developing a tool to screen for disability among pre-school children: preliminary results(Sri Lanka Medical Association, 2014) Perera, K.M.N.; Wijerathne, L.; Jayasinghe, C.; Kasturiratne, A.; Hettiarachchi, S.; Fonseka, R.; Jayasena, B.N.; Siriwardhena, D.; Godamunne, P.; Dahanayake, W.; Pathmeswaran, A.; Wickremasinghe, A.R.INTRODUCTION AND OBJECTIVES: To develop and validate a tool that can be used by pre-school teachers to identify disabilities in the pre-school age group. METHODS: A multidisciplinary team was formed and the initial tool was developed^ Consensual validity was achieved by using nominal group technique and the tool was pre-tested in the Ragama MOH area. To assure criterion validity, the tool was used to screen all the children in the pre-school age group (2-5 years) in an MOH area randomly selected from the Anuradhapura District. The screened positives .were referred to an expert panel for confirmation of diagnosis and follow-up if required. RESULTS: Thousand nine hundred children were invited for screening and 1536 participated (478 2-3 years, 495 3-years, 560 > 4 years of age) and 267 (17.4%) were referred to the expert panel. Out of the referrals, majority (38.9%) had multiple disabilities. Hearing and speech difficulties were seen in (29.6%). Psycho social problems (11.6%), disabilities and other diseases (19.8%) accounted for the rest. The response rate for confirmation by experts was 64%. The predictive value of a positive test was 79.5%. The prevalence of disabilities among the screened pre-school age group was 88 per 1000 (95% Cl= 74 to 103). CONCLUSIONS: This tool can be used to screen children in the pre-school age for disabilities.Item Translational research for diabetes self-management in Sri Lanka: A randomized controlled trial(Elsevier, 2015) Jayasuriya, R.; Pinidiyapathirage, M.J.; Jayawardena, R.; Kasturiratne, A.; de Zoysa, P.; Godamunne, P.; Gamage, S.; Wickremasinghe, A.R.AIMS: The study tested the hypothesis that a theory driven Diabetes Self-Management (DSM) intervention delivered by trained nurses would result in a clinically significant improvement in glycaemic control. METHODS: Patients with an HbA1c >7.5% (58mmol/mol) and free of diabetes complications were enrolled into a randomized controlled trial (n=85). Intervention consisted of four sessions and monthly follow up for 6 months. Biochemical tests, and diet and physical activity assessments were done in both groups. Analysis of covariance was used to test the effectiveness of the intervention. RESULTS: At 6 months, there was a significant difference (P=0.001) in HbA1c between the groups controlling for baseline values and other variables. Based on the primary outcome, 28% in the intervention group achieved the target value of 6.5% HbA1c, compared to 8% in the "usual care" group (P<0.001; η2=0.65). The reduction in total energy intake and increase in physical activity was significant in the intervention group between baseline and follow up. CONCLUSIONS: The DSM intervention has resulted in a clinically significant impact on glycaemia, change in diet and physical activity, and has demonstrated the feasibility of using it within existing care arrangements in a developing country setting. Copyright © 2015 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.Item Comparison of performance of Sri Lankan and US children on cognitive and motor scales of the Bayley scales of infant development(Biomed Central, 2014) Godamunne, P.; Liyanage, C.; Wimaladharmasooriya, N.; Pathmeswaran, A.; Wickremasinghe, A.R.; Patterson, C.; Sathiakumar, N.BACKGROUND: There is no validated scale to assess neurodevelopment of infants and children in Sri Lanka. The Bayley III scales have used widely globally but it has not been validated for Sri Lankan children. We administered the Cognitive and Motor Scales of the Bayley III to 150 full-term children aged 6, 12 and 24 months from the Gampaha District of Sri Lanka. We compared the performance of Sri Lankan children 6, 12 and 24 months of age on the cognitive and motor scales of the Bayley III with that of US children. RESULTS: Compared to the US norms, at 12 months, Sri Lankan children had significantly higher cognitive scores and lower gross motor scores, and at 24 months significantly lower cognitive scores. The test had a high test-retest reliability among Sri Lankan children. CONCLUSIONS: There were small differences in the cognitive and motors scores between Sri Lankan and US children. It is feasible to use Bayley III scales to assess neurodevelopment of Sri Lankan children. However, we recommend that the tool be validated using a larger representative sample of all population groups.