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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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 Impact of COVID-19 outbreak on the number of invasive procedures in Institute of Cardiology, National Hospital of Sri Lanka -A descriptive longitudinal study(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2021) Kuruppu, C.; Gunawardena, R.; Dunuwille, A.; Ranasinghe, G.; Fernando, N.; Mendis, S.; Fernando, M.; Wijewardena, A.; Prabath, I.H.D.S.Introduction: Covid-19 pandemic has significantly affected healthcare services worldwide with a similar impact on invasive procedures, in Institute of Cardiology, National Hospital of Sri Lanka (NHSL). Objectives: To analyse the impact of Covid-19 outbreak on therapeutic cardiology interventions, both elective and emergency, by comparing frequencies of procedures done during the initial affected year and immediate previous year. Methods: A Retrospective longitudinal descriptive study was carried out on frequencies of invasive therapeutic cardiology procedures during the period of 2019 March to 2021 February, at Cardiology Unit, NHSL. Pre-formed data collection sheets were filled using hospital registries. Final analysis was done by Microsoft-Excel 365. Results: Total number of procedures done in affected year was 4690 compared to 6096 in previous year. In April 2020, which was the most affected month, 52 cumulative procedures have been done in comparison to 427 procedures in April 2019. By August 2020 number of procedures has increased to 668 in compared to 486 in August 2019. Total of elective procedures were 3751 and 5061 in affected and non-affected years respectively. Similarly, the number of emergency procedures was 1035 in immediate previous year and 939 during Covid pandemic. Conclusions: Study has highlighted a significant impact on invasive therapeutic cardiology procedures, especially on electives, by the onset of the Covid-19 pandemic, especially during the period of lockdown. However, there has been a compensatory increase in procedures once lockdown was over, partially compensating for the numbers. There has been less impact on emergency procedures, the numbers of which have remained relatively constant.Item Female offenders with Psychiatric disorders(Sri Lanka College of Psychiatrists, 2015) Chandradasa, M.; Champika, L.; Mendis, S.; Fernando, F.BACKGROUND: Female offenders are characterised by higher rates of psychiatric morbidity. Studies in developed countries show an increase in the number of female prisoners in recent years. The objectives of this study were first to describe socio-demographic factors and rates of psychiatric morbidity in female offenders, and second, among females with psychiatric illness, to compare those with and without a history of offending. METHODS : A retrospective case control study was carried out among 71 alleged female offenders who had been admitted to the National Institute of Mental Health (NIMH), Sri Lanka over an 18 months period. Females attending an outpatient psychiatry clinic with no prior history of offending were considered as controls. Data were collected from court reports and patient records. RESULTS: Among the alleged offences, 63% were reported as ‘‘behavioural disturbance due to mental illness’’, and 14% as physical assault. The most common diagnoses among female offenders with psychiatric illness were schizophrenia (43%) and bipolar affective disorder (22%). Childhood sexual abuse was reported by 22% of cases compared to 12% of controls (p=0.08). Rates of marriage and employment were significantly lower among the female offenders with psychiatric illness, compared to the controls. CONCLUSION: Patterns of psychiatric illness among female offenders in Sri Lanka may differ from that of the West. Among females with psychiatric illness in Sri Lanka, being single, unemployed and use of alcohol is significantly associated with offending compared to controls. Further research is required to explore these findings.Item Splenic Syndrome in a young man at high altitude with undetected Sickle Cell Trait(Sage, 2018) Fernando, C.H.K.A.; Mendis, S.; Upasena, A.P.; Costa, Y.J.; Williams, H.S.A.; Moratuwagama, D.INTRODUCTION: Splenic syndrome is a rare presentation of sickle cell disease. It is important to rule out this possibility when an ethnically vulnerable patient presents with an acute abdominal symptoms in a background of precipitating events. CASE REPORT: A 26-year-old man who developed a severe abdominal pain at high altitude, found to have a tender splenomegaly. However, further inquiry revealed he is from an area where sickle cell disease is prevalent. Screening for sickle cell disease was positive. Radiological investigations confirmed a massive splenic infarction keeping with a diagnosis of splenic syndrome. Patient was managed conservatively. CONCLUSION: Sickle cell trait is considered a benign carrier state. However, rarely they can present with life-threatening conditions. Therefore, a high degree of clinical suspicion is required for early diagnosis of these specific entities to avoid increased morbidity and mortality of these patients.