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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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 Awareness of noise-induced hearing loss and usage of hearing protective devices among 18 to 35 years old residents in Puttalam, Sri Lanka(University of Kelaniya, Sri Lanka, 2022) Fathima, I.F.; Ileperuma, L.D.Background: Noise-induced hearing loss (NIHL) is the most common and preventable type of hearing loss. Exposure to NIHL contributes to causing hypertension, sleep disturbance, fatigue, and annoyance in addition to hearing loss. Preventive measures are available to mitigate such adverse effects. Implementing such preventive measures is desirable but often not achieved in our community. Objectives: This study aimed to evaluate the awareness of noise-induced hearing loss and usage of hearing protective devices among 18 to 35-year-old residents in Puttalam Sri Lanka. Methods: This was a descriptive cross-sectional study. A self-administered web-based questionnaire, consisting of 4 sections focusing on demographic details of participants; awareness of Noise-induced Hearing Loss; noise, exposure, and usage of hearing protective devices were used to collect data from the target population. A purposive sampling method was used to recruit voluntary participants for this study. The gathered data were analyzed quantitatively. Results: 100 participants (46 males, 54 female) aged between 18 – 35 years from Puttalam participated in this study. Hearing loss was regarded as a significant issue by 48% of participants of whom 63% were females and 37% were males. The study group included 42% of graduates and 61% of the total were employed. Regarding noise-induced hearing loss, 95% of participants believed that exposure to loud noise could cause hearing loss. 52% of participants felt that all age groups were at risk of NIHL. Around 53% of participants reported that they had used hearing protective devices. Conclusion: The results of this study show the need for action by the relevant authorities to enhance individuals’ knowledge of noise-induced hearing loss and recommend the usage of hearing protective devices. There is insufficient awareness regarding using hearing protective devices in a noisy environment. This study indicates the potential need for education within the population of Puttalam.Item Self-ear cleaning and associated risk of ear injuries and ear related symptoms among students in the University of Kelaniya, Sri Lanka(University of Kelaniya, Sri Lanka, 2022) Ranathunaga, R.M.L.C; Ileperuma, L.D.Background: Self-ear cleaning (SEC) is recognized as a common habit where it tends to remain a hidden healthcare complication with respect to its potential ability to compromise the integrity of the ear by causing damage to the hearing apparatus. This has high prevalence rates among low- and middle-income countries compared to high income countries. Objectives: To determine prevalence, practices and associated risk of ear injuries and ear related symptoms following SEC among students in the University of Kelaniya, Sri Lanka. Methods: A quantitative descriptive cross-sectional study was conducted within the University of Kelaniya (six faculties and one institute). The target population indicated was 11,672 where the purposive sampling technique was utilized to select participants. Data was collected from 170 internal undergraduate students with Sri Lankan nationality, regardless of their academic year of study. An online self-administered semi-structured questionnaire was used to collect data from the participants. Results: Prevalence of SEC was 98.8% among all students and all faculties/institute presented with a 100% prevalence rate except in the Faculty of Medicine (96.5%). The majority perceived SEC to be beneficial and a family influence regarding encouragement of the practice was observed. The commonest object used was cotton buds to self-clean ears and the majority of participants had engaged in this practice between 1-5 years. Ear wax was the commonest reason given to engage with SEC. 7.1% of the students reported ear injuries caused by forceful use of various objects to self-clean ears. Overall, no association was observed between SEC and ear injuries as well as with SEC and ear related symptoms. Nonetheless, a statistically significant association was obtained with each presenting ear, ear itchiness, feeling fullness of the ear after SEC (p=0.006, 0.008, 0.031) as well as with experiencing earache and feeling fullness of the ear with use of cotton buds (p=0.024, 0.021). Conclusion: SEC has a potential to cause damage to the ear structure. Large scale awareness programmes are recommended to be undertake from the lowest to the highest education levels due to a lack of knowledge presented regarding this habit.Item Experiences of mothers of children with hearing loss-a qualitative analysis(University of Kelaniya, Sri Lanka, 2022) Madushani, K.D. I; Ileperuma, L.D.Background: If the professional can determine what the mother thinks, feels and how to adapt to the child's condition, it can predict how effectively the treatments can be implemented. This study aimed to explore the experiences of mothers of children with permanent hearing loss. This included which coping strategies were used throughout their experience to adapt individually to the diagnosis of children's hearing loss and support and services received to adapt to the diagnosis were studied. Methods: This was a qualitative study using a phenomenological approach. Individual semi-structured interviews were conducted virtually. A thematic analysis was used to analyse the data. The study population was fifteen mothers of children with permanent childhood hearing loss (PCHL). Three mothers of children with PCHL were recruited for the pilot study and twelve mothers were recruited in the main study. Mothers of children with other co-existing impairments such as cognitive, physical disabilities and mothers with hearing impairment were excluded from the study. Results: The study revealed six major themes: initial thoughts, initial reactions, current challenges, coping strategies, expectations, and support and services received. Additionally, six subthemes also emerged, in which four types of coping strategies were identified: problem-focus, emotional-focus, social support and religious focus. Two subthemes were identified under the support and services received: satisfied experiences and dissatisfied experiences. Conclusions: Parental involvement is a vital part of the management process of children with disabilities. Based on the mother's positive adaptation to the child’s condition, parental involvement in the children can be judged. The themes identified explained the experiences of mothers' adaptation to the child’s hearing loss and the support and services received for mothers to adapt to the child's hearing loss. If professionals understand what mothers are thinking and feeling, it follows that they will be able to work more effectively in their treatment collaborations with mothers of children with hearing loss.Item Hearing status and noise exposure levels of workers at a laundry plant in Sri Lanka(Korean Academy of Audiology, 2022) Ileperuma, L.D.; Ranawakaarachchige, I.Purpose The aim of this study was to determine the hearing status and noise exposure levels of workers at a laundry plant in Sri Lanka. Methods A descriptive cross-sectional study was done to determine the noise levels workers were exposed to during their shifts, to evaluate hearing-related complaints, to evaluate audiometric measures of the workers, and lastly to determine the association between the job category and hearing status. The study included 107 workers between the age of 20~50 years. Noise levels of the laundry plant were measured and data was gathered via an interviewer-administered questionnaire and screening and diagnostic hearing tests were performed. Results The minimum and maximum noise levels were 63.1 dBA and 100.3 dBA. Among workers, 40.18% indicated abnormal audiograms. Among those who had abnormal audiograms, 31.77% were diagnosed with noise induced hearing loss (NIHL) in the right ear while 28.03% had NIHL in the left ear. Conclusion There was no significant association between the degree of hearing loss and exposure duration of the workers as well as hearing status with reference to the job category. However, the workers in the dryer and hydro sections were at high risk for NIHL, as the mean Leq levels at the laundry plant exceeded the 85 dBA action level recommended by the Occupational Safety and Health Administration (OSHA). Hence it can be concluded that laundry plants are hazardous occupational settings for hearing loss, thus preventive measures, such as hearing conservation programs must be adopted for the well-being of workers.Item Auditory brainstem response for Sri Lankan children under 5 years of age: Normativedata(College of Otorhinolaryngologists and Head and Neck Surgeons of Sri Lanka, 2021) Ileperuma, L.D.; Weerasinghe, V.S.; Wickremasinghe, A.R.Abstract For years Sri Lankan Audiologists resorted to western norms in the interpretation of Auditory Brainstem Response (ABR) in the absence of national standards. The study focused on establishing normative data on ABR for Sri Lankan children below 5 years. ABR was performed on 258 healthy children between 6 weeks and 5 years of age to gather data on absolute latencies and inter-peak latencies.All inter-aural differences were within 0.2-0.4ms. The mean inter-aural difference for the study sample was significantly small (-0.0204ms to 0.0286ms). Mean values of absolute latencies for waves I, III, V for the 6-week age group at 30dBnHL were 3.33 ms, 5.91 ms and 8.27 ms respectively. Mean values of inter-peak latencies of wave I-III, III-V, I-V were 2.08 ms, 2.36 ms and 4.76 ms respectively for the 6-week age group at 30 dBnHL. The normative ABR data obtained in this study may be used across audiology clinics in Sri Lanka as a baseline measurement to diagnose hearing loss among children from infancy to 5 years of age when children are tested in their natural sleep and insert earphones are used. The mean value plus 2 standard deviations for each ABR measure may be used as the upper limit cutoff values. Hence this study helps eliminate misdiagnosis and under-diagnosis of hearing loss in children.Item Hearing status and noise exposure levels of workers at a washing plant in Dankotuwa, Sri Lanka.(2017) Subasinghe, R.A.I.A.; Ileperuma, L.D.ABSTRACT: Noise is one of the most common causes of hearing loss. The World Health Organization estimates that 10% of the world population is exposed to sound pressure levels that could potentially cause Noise Induced Hearing Loss (NIHL) and among them 16% were found to be associated with occupational noise. The Recommended Exposure Limit (REL) for occupational noise exposures should be 85 dB(A) for 8 hours. Among the working populations who could be affected by NIHL, washing plant workers are a specific group as they are exposed to high noise levels. The findings of this study will contribute to building a knowledge based platform for a hearing conservation policy for the washing plants in Sri Lanka. This study mainly focused on determining the hearing status and noise exposure levels of workers at a washing plant in Dankotuwa, Sri Lanka. A descriptive cross sectional study design was implemented to determine the noise levels the workers were exposed to during their shifts, to evaluate hearing related complaints and audiometric measures of the workers and to determine the association between the job category and the hearing status. The study included 107 of workers engaged in different job categories within the age range of 20-50 years, males and females at a washing plant. Purposive sampling was used to recruit participants to the study. The noise measurements inside the washing plant were taken, an interviewer administered questionnaire was employed and findings of the hearing screening test and diagnostic hearing tests (Pure tone Audiometry, speech Audiometry, tympanometry and Oto Acoustic Emission testing were used) were obtained. Noise levels were found to be 69.9 to 100.3 dB(A). Among washing plant workers 43 (40.18%) were found with altered audiograms. Among those who have altered Audiograms 34 (31.77%) were found to have Noise Induced Hearing Loss (NIHL) in the right ear and 30 (28.03%) were found to have NIHL in the left ear. 37 (34.57%) workers were diagnosed with NIHL. Washing plants are hazardous occupational settings resulting in hearing loss, thus preventive measures, such as hearing conservation programs must be adopted.Item Knowledge, practices, hearing-related symptoms among students exposed to leisure noise of a Sri Lankan University.(2018) Ileperuma, L.D.BACKGROUND AND RATIONALE: Exposure to excessive noise is a major cause of hearing disorders (Crandell et al., 2004). Leisure time noise can be one of the most important reasons for the development of noise induced hearing loss in the young population (Landälv, Malmström & Widén, 2013). Recent studies have revealed that the risk of experiencing hearing loss due to discotheque music, rock concerts, and music from personal music players in teenagers and young adults has increased (Sliwinska-kowalska, 2012). In the Sri Lankan context, there is a dearth of literature regarding knowledge practices and hearing related symptoms among university students exposed to leisure noise. Therefore, this study focused to describe university students’ level of knowledge on leisure noise exposure, hearing protection methods, activities and situations in which university students being exposed to, can cause damage to their hearing and to determines the association between tinnitus and other hearing related symptoms and leisure noise exposure among university students. METHODOLOGY: This descriptive cross-sectional study included 131 2nd year students representing faculties of Medicine, Science, Commerce and Management Studies, Humanities and Social Sciences of the University of Kelaniya, Sri Lanka. Simple random sampling was used to select the total study sample. Probability proportional to size sampling technique was used to decide the number of participants from each faculty. Quantitative data collection was carried out using a self-administered questionnaire. Appropriate statistical tests were performed using SPSS 22 software. RESULTS: 13 (10%) students from medical faculty, 24 (18%) from science faculty, 26 (20%) from commerce and management studies faculty, 27 (21%) from humanities faculty and 41 (31%) from social science faculty participated in this study. The results showed that although majority (88.55%) of students considered excessive leisure noise exposure can damage their hearing, a minority (22.90%) of the students considered that hearing loss caused by excessive noise exposure cannot be cured. A substantial number (46.56%) of students had heard about hearing protective devices, while a very low number of students (02.00%) had used them when they were exposing themselves to loud noise. The most frequently exposed situations were listening to music using MP3 players (90.08%), watching movies at film theatres (73.28%) and attending musical shows and concerts (46.56%). Majority (54.24%) of students use middle 1/3 (33.33% to 66.67% of the loudness) of the rating scale to listen to music using MP3 Player and the level can be consider as somewhat loud or loud. Discomfort in the ear(s), blocking sensation or fullness in ear(s), tinnitus and reduction of hearing were the most prominent hearing-related symptoms after being exposed to leisure noise. A significant relationship could be found between blocking sensation and listening to music using MP3 Player; and discomfort in ears and attending musical shows and concerts. CONCLUSIONS: Even though majority of students considered excessive leisure noise exposure can damage their hearing, their motivation on the usage of most effective hearing protection methods was considerably low. Therefore, hearing conservation programs for younger students should be developed to address the effects of leisure noise exposure on hearing and hearing protection.Item Hearing status among 20-45-year-old bus drivers and conductors of the Kadawatha bus station, Sri Lanka.(2018) Ileperuma, L.D.ABSTRACT: Bus drivers and conductors are a group working in noisy environments having a risk of developing occupational hearing loss. The hearing status of 86 bus drivers and conductors was evaluated comprehensively via diagnostic testing. Age and duration of work were the main factors contributing to their reduced hearing levels. Bilateral high frequency hearing loss was commonly seen in this population. BACKGROUND: Noise is a significant occupational health hazard in the transportation industry (Duarte et al. 2014). Bus drivers and bus conductors are a group affected by occupational hearing loss due to traffic noise, difficulty in sound protection methods, poor maintenance of vehicles and roads (Guardiano et al., 2012). It is important to evaluate the hearing status of Sri Lankan bus drivers and bus conductors comprehensively for the establishment and enforcement of proper regulations in the transportation sector to ensure health and safety of this population. METHOD: This descriptive cross sectional study recruited 86 bus drivers and bus conductors between 20 and 45 years from the Kadawatha bus station by purposive sampling. Data were collected from May to October 2015 through an interviewer-administered questionnaire, otoscopic examination, Distortion Product Otoacoustic Emission (DPOAE) hearing screening and diagnostic evaluation which included several hearing tests such as pure tone audiometry, speech audiometry, tympanometry, reflexometry and diagnosticDistortion Product otoacoustic emission (DPOAE) test. Data were analyzed by descriptive and inferential statistics using SPSS version 22. RESULTS: 79.1% failed the hearing screening test; 89.8% of bus drivers and 64.9 % of bus conductors. Probable factors/causes for failing the hearing screening test were, being a bus driver, age above 40 years, having a working experience as a bus driver or a bus conductor for more than 10 years and having a habit of listening to loud music. All tested by the diagnostic hearing evaluation had some form of hearing loss; 32.3% had NIHL. Age above 40 years, working experience of more than 10 years, daily travelling hours greater than 5, playing a sound system in the bus, having a habit of alcohol consumption and a history of noisy occupation and they could be associated factors for hearing loss. CONCLUSION: Tinnitus, ear fullness, headache and difficulty in hearing in noisy setting are the common complaints reported by this group. Bus drivers were the most affected group. Bilateral high frequency hearing loss was common. Age and working experience were the main factors contributing to reduced levels of hearing in this population. RECOMMENDATIONS: A pre-employment hearing evaluation and periodic follow up tests are recommended. Further in-depth studies can be conducted to measure noise levels of the bus drivers’ working environment such as inside buses, place of control and other parking places. Further studies can also be conducted to identify other causative factors for hearing loss such as whole body vibration and Carbon Monoxide exposure. It is also important to conduct education programs in order to raise awareness among bus drivers, bus conductors and their authorities on the risk of developing hearing loss and its potential implications.Item Subjective Evaluation of Perceived Sources of Noise Annoyance and Associated Ailments of Teachers in Selected Sinhala Medium Primary Schools in the Attangalla Education Division(Faculty of Medicine, University of Kelaniya, 2014) Devapaksha, E.; Ileperuma, L.D.; Siriwardhana, D.Noise levels in school premises have increased at present than in past years. In most countries, there are policies and regulations regarding noise exposure in school premises. However, Sri Lanka lacks significant research findings regarding noise exposure and outcomes in the educational settings.7 schools in the Attanagalla Educational Division were selected purposively and all teachers employed in those schools were included in the study. Data was collected via a self-administered questionnaire. A higher number of participants among the surveyed teachers were in the age range of 45-55 years. 85.83% of teachers considered noise to be annoying. The most presenting indoor noise source was students chatting in the class during lessons (33.03%). The most presenting outdoor noise source was traffic noise (9.17%). It showed that every participant who considered noise was annoying had reported at least one ailment. A significant amount of teachers had tiredness (74.31%) and vocal discomfort (67.69%). Less number of teachers complained of otologic symptoms (ear fullness-11.92%, Tinnitus- 13.77%, perception of reduced hearing sensitivity-13.77%). Noise in the school environment is the main annoying factor for teachers during their working hours. There was a low number of hearing impaired teachers (3.14%) reported among the surveyed teachers. It is difficult to figure out whether the hearing loss occurred with age or noise. Teachers’ awareness should be raised by implementing awareness programmes on noise and its hazards and noise control methods to school settings.