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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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

Search Results

Now showing 1 - 10 of 21

Measles infection in lady Ridgeway hospital in 2013: a case control study
(Sri Lanka College of Paediatricians, 2015) Navageevan, N.; Punchihewa, P.M.G.; Kumarendran, B.; Hathagoda, K.L.W.; Galappaththi, A.G.A.R.; Jayathilaka, A.
BACKGROUND:A measles outbreak was reported in 2013 in the Lady Ridgeway Hospital for Children (LRH).OBJECTIVES:To describe the epidemiology of measles among paediatric patients admitted to LRH. DESIGN, SETTING AND METHOD:This case control study, conducted among patients admitted to LRH, recruited 167 clinical cases and 693 controls of six to 24 months age. All the clinically positive cases admitted to any of the six paediatric medical units during January to June 2013 and four patients admitted following each case were included. Data was gathered from the bed head tickets using data extraction sheet and by telephone interview. Significance was assessed at 5% level.RESULTS:Of the 140 clinical cases with available reports, 126 (90%) were positive for measles lgM (confirmed cases - CC). The CC included 75 (60%) males, 48 (38%) aged up to 9 months and 50 (40%) aged 10 to 12 months. Clinical features among the CC include high fever (100%), rash (100%), cough (94%), coryza (83%), conjunctivitis (63%), Koplik spots (14%), post measles staining (31%), diarrhoea (48%) and vomiting (31%). Complications among the CC included at least one complication (68%), pneumonia (65%) and 2 cases of death. Of the 47 CC with positive contact history, 41 had contacts in the hospital. Of the 28 cases aged above 12 months, 23 did not receive measles vaccine.Measles status was associated with measles vaccination status among children above 12 months of age (P<0.001), contact history (P<0.001), ethnicity (P<0.001) and mother's education (P<0.01). There was no evidence for an association of measles infection status with sex (p=0.9), income (p=0.3) and weight for age (p=0.2). CONCLUSIONS: • Around 78% cases were below 12 month old. • Majority of cases above 12 month of age did not receive measles vaccine. • Majority of cases had contact history in the hospital.
Reproductive health knowledge among Arts students in the University of Kelaniya
(Sri Lanka Medical Association, 2018) Premasiri, D.G.A.L.; Premathilaka, N.T.K.; Priyadarshana, M.A.I.; Pussellage, A.C.; Rai, S.; Kumarendran, B.
INTRODUCTION AND OBJECTIVES: Formal learning ofreproductive health for Arts undergraduates is limited to GCE Ordinary Level. This study aimed to describe the knowledge on reproductive health among first year students in Faculty of Arts, University of Kelaniya. METHODS: This descriptive cross sectional study was carried out among 200 students selected using simple random sampling at Faculty of Arts, University of Kelaniya during May 2017 using a self-administered questionnaire. Data was analysed in SPSS. Each correct answer scored one, and each wrong/not responded scored zero giving a maximum total score of 68. RESULTS: Among the study participants, total scores ranged from 27 to 62. The median score was 45.5. 93.1 % of females and 94.4% of males were able to score more than 50% for the questionnaire and there were significant findings related to the level of knowledge on different domains ofreproductive health. There is no evidence for association between level of knowledge and the sex (p=0.6)..Effective sources of information in descending order were books, magazines, friends, films, pornography, siblings, parents and teachers. The preference and availability of teachers, parents and siblings were low.The three commonly believed myths were: 'bathing during menstrual periods can reduce bleeding and it is harmful' (32%), 'bleeding after the first intercourse is a definite marker of virginity' (30%) and 'oily food should be avoided during menarche' (25%).CONCLUSION: The overall level of knowledge on reproductive health was satisfactory. The level of knowledge on common sexual and reproductive myths that prevail in Sri Lanka was not satisfactory.
Bypassing primary healthcare facilities among admissions to medical wards, Teaching Hospital, Kandy
(Sri Lanka Medical Association, 2018) Jeyasuthan, M.; Kumarendran, B.
INTRODUCTION AND OBJECTIVES: Bypassing of health institutions is a major concern in healthcare. This study aimed to estimate the proportion and to determine the factors associated with bypassing primary health care facilities among admissions to medical wards, Teaching Hospital, Kandy (THK). METHODS: This descriptive cross sectional study was carried out during March & April 2015 among 380 patients selected using systematic sampling from medical wards, THK. Patients transferred from other hospitals were excluded data was collected using an interviewer administered questionnaire and analysed using SPSS. 'By-passer” is defined as a person admitted to medical ward, THK without seeking treatment from a state facility closest to home.RESULTS: Of the 596 patients accessed, 216 patients transferred from other hospitals were excluded. Of 380 non• transferred patients, 162 patients were by-passers (42.6%, 95% CI: 37.7 to 47.6%). Mean age of the respondents was 57.72 years. Majority of the respondents (78.4%, n=l27) were married and 51.2% (n=83) did not have job,46.9% (n=76) of them had primary education. By-passing was associated with age group (p=0.03), educational level (P=0.02), category of employment (p=0.002) and monthly income (p<0.001). Availability of facilities for diagnosis and treatment, adequacy of medical supplies, competent health staff, severity of the illness, patient friendly approach of staff, use of latest technologies and self-satisfaction due to unknown reasons were cited as reasons for by-passing.CONCLUSION: By-passing was around 2 in 5 admissions in medical wards of THK and was associated with age, education, employment and monthly income. Participants indicated their reasons for by-passing.
Effectiveness of mebendazole and health education in control of pinworm infection among children living in low income settlements
(Sri Lanka Medical Association, 2017) Kumarendran, B.; Pathmeswaran, A.; de Silva, N.R.
INTRODUCTION & OBJECTIVES: We aimed to evaluate the effectiveness of mebendazole (MBZ) mass treatment and health education in reducing reinfection with pinworm among children living in low income settlements (LIS). METHODS: A factorial cluster-randomized, controlled trial was conducted during January to May 2014, to compare the effectiveness of MBZ 100mg for positive cases versus mass treatment, and routine versus special health education. 1257 children aged 3-7 years, from 48 clusters of LIS in the Colombo Municipal Council area, were selected using cluster sampling. Perianal cellophane adhesive swabs (CAS) were examined for pinworm eggs. About 2-3 weeks after collection of the first sample (CAS1), depending on the intervention arm, eligible participants were given MBZ. Second sample (CAS2) was collected a week after administration of the first dose (MBZ1). Second dose (MBZ2) was given two weeks after MBZ1. Third sample (CAS3) was collected a week after MBZ2, and a fourth sample (CAS4) was collected 12 weeks after MBZ2. RESULTS: Sample collection rate was 94%, 80%, 75% and 73%, for CAS1, CAS2, CAS3 and CAS4 respectively. Overall egg positivity reduced from 42.5% to 10% following MBZ1, and to 6.8% following MBZ2, but increased to 29.3% at 12 weeks following MBZ2. In logistic regression, reinfection rate at 12 weeks after MBZ2 (i.e. those who were CAS3 negative but CAS4 positive) was associated with baseline pinworm egg positivity (OR=1.2) and BMI for age Z score (OR=0.96), but not with intervention arm. CONCLUSION: MBZ is effective in reducing pinworm egg positivity, but re-infection is common.
Prevalence of pinworm infection among children living in low income settlements in Colombo Municipal Council area
(Sri Lanka Medical Association, 2017) Kumarendran, B.; Pathmeswaran, A.; de Silva, N.R.
INTRODUCTION & OBJECTIVES: Pinworm (Enterobius vermicularis) infection is associated with overcrowding and poor personal hygiene. We aimed to estimate the pinworm egg positivity (EP) rate among children living in low income settlements (LIS) in the Colombo Municipal Council (CMC) area, as there is no empirical evidence of prevalence. METHODS: This descriptive cross-sectional study was conducted during January - March 2014 as part of a clinical trial. Study population included children aged 3-7 years living in LIS in the CMC area for at least one year. Cluster sampling was used to select 1257 children, who were tested for pinworm infection using perianal cellophane adhesive swabs (CAS). Each child’s principal caretaker was educated to take the swabs early morning, immediately after awakening, on two consecutive days. CASs were examined by experienced technicians. EP was defined as EP on at least one of the two CAS. RESULTS: Sample collection rate was 94.3% (n=1185). Overall EP was 42.5 % (95% CI 39.7 - 45.4), but only 20.8% showed EP on both days. In logistic regression analysis, EP was associated with socioeconomic score (OR = 0.98), age of the child [from 3 years to 7 years] (OR= 1.02), BMI for age Z score (OR= 0.97) and increasing number of children aged 3 to 7 years in a household (OR= 1.05). CONCLUSION: A high proportion of 3-7 year old children living in LIS in the CMC area have pinworm infections. Prevention and control of this infection in LIS in the CMC area should be strengthened.
Randomized placebo-controlled trial of the efficacy of mebendazole polymorphs in the treatment of hookworm infections
(Sri Lanka College of Microbiologists, 2013) Gunawardena, N.K.; Kumarendran, B.; Manamperi, N.H.; Senarathna, B.P.; Silva, M.; Pathmeswaran, A.; de Silva, N.R.
INTRODUCTION: Mebendazole has three polymorphic forms, identified as A, B and C. Animal studies and one previous study in humans have suggested that unlike polymorph C, polymorph A is ineffective in the treatment of hookworm and whipworm infections. OBJECTIVES: A randomized double-blind, placebo-controlled trial was carried out to compare the efficacy of single dose 500 mg tablets of pure mebendazole polymorph C with those containing a 1:1 mixture of polymorphs Aand C, for the treatment of hookworm infections. . DESIGN, SETTING AND METHODS: All eligible individuals living in 219 households in 8 estate divisions in Ratnapura District known to have a high prevalence of hookworm, were recruited after obtaining written, informed consent. A single faecal sample was obtained and examined the same day, using the Kato-Katz technique for quantification of intestinal nematode infections. Those who were found infected with hook¬worms were randomized to one of three treatment arms and requested to provide a second faecal sample 10-14 days after treatment. This was examined in the same manner as the first. RESULTS: A total of 892 individuals were recruited; 601 provided faecal samples; 214 were found positive for hookworm infection; 70, 74 and 70 individuals were randomized to treatment arms A (mixture of polymorphs A and C), B (pure polymorph C) and C (placebo) respectively. Follow-up faeca! samples were provided by 53,48 and 49 persons respectively in each treatment arm. The cure rates in the three treatment arms were 28.3%, 18.8% and 16.3% respectively; they were not significantly different from one another. Comparison of faecal egg count reductions (FECR) in the 3 treatment arms (86.1%, 84.5% and -6.6% in arms A, B and C respectively) showed that both mebendazole formulations performed significantly better than placebo, but there was no statistically significant difference between FECR with the two drug formulations. CONCLUSIONS: A single SOOmg dose of mebendazole, either as Polymorph C alone, or as a mixture of Polymorphs A and C, has little efficacy in curing hookworm infections. However, both formulations are significantly better than placebo in reducing the intensity of infection, with no statistically significant difference between the two formulations.
Neonatal hypothermia and associated factors in a special care baby unit
(Sri Lanka Medical Association, 2012) Krishnapradeep, S.; Kumarendran, B.; Bandara, S.
INTRODUCTION: Neonatal hypothermia is known to result in many adverse consequences. Aims: To estimate the incidence and associated factors of neonatal hypothermia METHODS: This cohort study followed up 125 neonates consecutively admitted to Special Care Baby Unit of Teaching Hospital, Peradeniya from November 2011 to January 2012. A paediatric registrar interviewed parents using a structured-questionnaire and direct observation using a check list. On admission, axillary body temperature was measured and graded using WHO classification. Results: Of the 125 neonates, 96 were admitted within first day of birth (78.6%) and 72 had low birth weight (57.6%). Neonates were admitted from operation theater (58, 46.4%), postnatal ward (34, 27.2%) and labour room (23, 18.4%). Median temperature on admission was 36.2 °C with 38.4% having moderate hypothermia (n=48), 19.2% cold-stress (n=24) and none with severe hypothermia. Risk of hypothermia was increased by prematurity (OR = 9.9, 95% CI: 4.2 - 23), low birth weight (OR= 6.8, 3.1 -15.1), being delivered by caesa-pean section (OR=4, 1.8 - 9.1), admission from operation theatre or labour room (OR =9.1, 3.9 - 21.4) and cold delivery room ( p < 0.001). Caesarean rate was higher among neonates admitted to PBU than all the children delivered (OR = 3.35, 2.2 - 5.1). Hypothermia increases risk of poor activity (OR =1.8, 1.4 - 2.4), poor feeding (OR= 7.2, 1.5 - 34.9), poor cry (OR = 1.9, 1.5 - 2.4), respiratory distress (OR= 1.5, 1.1 - 2.0) and hypoglycemia (OR = 1.6, 1.2 - 2.0).
Negative health effects of coconut-are they real at the population level?
(Sri Lanka Medical Assosiation, 2012) Athauda, L.K.; Kumarendran, B.; Kasturiratne, A.; Wickremasinghe, A.R.
INTRODUCTION: An ecological correlation study was carried out to assess the validity of incriminations on the effects of consumption of coconut products on deaths due to cardiovascular diseases (CVD) Aims: The aim was to evaluate the impact of consumption of coconut products on CVD death rates. Methods: Data from 1961 to 2006 were abstracted from different sources; coconut consumption from the FAO database, CVD deaths from reports of the Department of Census and Statistics, population data from the UN databases and per capita GDP from the World Bank database. Correlational and Regression analyses were carried out. RESULTS: From 1961 to 2006, the average consumption of coconut including copra was 66.19 kg/capita/year, the average consumption of energy was 271.47 kcal/ capita/ day and the average fat supply was 24.46 g/capita/ day. There was no increase in the per capita consumption of coconut products from 1961 to 2006 in Sri Lanka (range 54.1-76.2 kg/capita/year]. The CVD death rates and the proportionate mortality rate due to CVD have increased from 1961 to 2006. Consumption of coconut products was correlated with CVD death rates but no lags seen. CVD death rates were significantly associated with per capita GDP and percentage of urban population but not consumption of coconut products after adjusting for the other variables (R2=0.865J. CONCLUSIONS: Mortality due to cardiovascular diseases was significantly correlated with per capita GDP and percentage of urban population after controlling for other variables. The results do not provide any evidence that consumption of coconut products increases mortality due to cardiovascular diseases at the population level.
Prevalence and risk factors for childhood wheezing in Ragama Medical Officer of Health area: an ongoing, community based study
(Sri Lanka Medical Association, 2013) Jayasinghe, Y.C.; Karunasekera, K.A.W.; Kumarendran, B.
INTRODUCTION AND OBJECTIVES:Atopic disease is an important public health problem and local data is essential for formulating treatment guidelines and policy planning . Objectives were to determine the prevalence and severity of wheezing among children less than 13 years of age, and to identify risk factors and triggers for wheezing. METHODS: The study commenced in September 2012 and is ongoing. The target study population was 3000 subjects. Data were collected using an interviewer administered questionnaire. RESULTS: There were 2411 participants, of them 388 (16.1%) were categorised as 'ever had wheezing', 226 (9.4%) had at least one wheezing episode within the past 12 months and 28 (1.2%) were currently having wheezing. Of those who 'ever had wheezing', 103 (27.4%) had activity induced wheeze or cough, 199 (52.8%) had nocturnal cough, 208 (55.2%) had wheezing on exposure to airborne allergens. In 94.7% symptoms improved with treatment, 60 (16%) deteriorated when treatment was stopped. Seasonal variation in wheezing, was seen in 215 (57.2%), 243 (72.5%) had wheezing with upper respiratory tract infection. Prematurity was a risk factor for 'ever had wheezing' (OR = 1.85, 95% CI: 1.2 -2.9). Paternal smoking during pregnancy (OR = 0.95, 95% CI: 0.8-1.2) or thereafter, was not a risk factor for wheezing. Wheezing was significantly associated with coexisting atopy, family history of atopy, and antibiotic usage during pregnancy. CONCLUSIONS: Prevalence of wheezing in our study is comparable to that in Asia of 16%. The risk factors and triggers of wheezing are similar to that in other studies. However we found no link between antenatal or postnatal exposure to cigarette smoke and childhood wheezing.
Cluster randomized trial of the impact of school based deworming and weekly iron supplementation on haemoglobin level of plantation primary school children
(College of the Community Physicians of Sri Lanka, 2013) Ebenezer, R.; Gunawardena, N.K.; Kumarendran, B.; Pathmeswaran, A.; de Silva, N.R.
BACKGROUND: School-based deworming and iron supplementation are being promoted as effective interventions to deal with the high prevalence of anaemia among school children. OBJECTIVE: The objective of this study was to determine the effectiveness of school based deworming and weekly iron supplementation on increasing the haemoglobin level of primary school children in the plantation sector in Sri Lanka. METHODS: A placebo-controlled cluster randomized trial was conducted in which the treatment group received a single dose of 500 mg mebendazole and 6-months of weekly iron supplementation (200 mg ferrous sulphate) while the control group received placebo for both anthelmintic and iron. The tablets were administered by the class teacher. Children attending grade 4 in schools in the plantation sector were recruited. The treatment arm was allocated with 813 children attending 49 schools and the placebo arm with 808 children attending 49 schools. Height, weight and haemoglobin were measured at baseline and after 6-months. A regression model adjusting for the cluster design was used to assess the effectiveness of the intervention on the haemoglobin level. In order to increase the precision of the estimates, various background variables were controlled for in regression models. RESULTS: Complete data were available for 633 children in the treatment group and 613 children in the control group. The mean age was 9 years and 6 months and 52% of them were males. In the treatment arm 98% had received mebendazole and over 80% had received 16 doses of iron. A reduction in the prevalence of soil-transmitted helminth (STH) infection (from 25.1% to 16.4%) was found in the treatment group, with significant differences between treatment and control groups in the levels of Ascaris and Trichuris. There was a small non-significant reduction in the mean haemoglobin level (at baseline 12.6g/dl, sd - 1.2) of both groups. No impact of treatment was found on haemoglobin levels. CONCLUSIONS: Though the intervention was effective in reducing the prevalence of STH infection there was no evidence of effectiveness in increasing haemoglobin levels.

Medicine

Browse

Filters

Settings

Sort By

Results per page

Search Results