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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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 Prevalence of menopausal symptoms and their impact on daily activities: A community based longitudinal study in Ragama, Sri Lanka(Sri Lanka College of Obstetricians & Gynaecologists, 2016) Heenatigala, C.S.N.; Gunathilaka, S.N.M.P.K.; Dias, T.D.; Palihawadana, T.S.; Motha, M.B.C.; de Silva, H.J.OBJECTIVES: To determine the prevalence and severity of menopausal symptoms among women. DESIGN,SETTING AND METHODS: A community-based cross sectional study was done in a study population of a larger ongoing longitudinal study named ‘Ragama Health Study’. Randomly selected 954 women from Ragama Medical Officer of Health (MOH) area were included. Data was collected using a self-administered questionnaire. Impact on daily activities by menopausal symptoms were scored using a scale from 1-10.RESULTS: Out of 954 women in the study, 814(85.3%) were postmenopausal. Age of the population distributed from 41-74 years with mean of 59.51 years. Mean age of onset of the menopausal symptoms was 52.16(SD=8.095) years. Among the symptoms inquired, the domain of sexual activity contained the most commonly experienced symptom, decreased libido, with a 65.4% (n=937) positive responses while 20.5% of women experienced vaginal dryness.. Mean score on impact on daily activities by this was 7.79(SD 2.36). Psychosocial symptoms of forgetfulness, bad temper, irritability and poor concentration was present in 60.5%, 33.8%, 25.4% and 24.8% of positive responses respectively. Mean scores on impact on daily activities by psychosocial symptoms lied within the range of 4.55-5.52. Presence of experiencing hot flushes and increased sweating were 24.8% and 22.1% with a mean score of effect on daily activities at 5.24 and 5.65, respectively. CONCLUSIONS The rate of menopausal symptoms among this perimenopausal age group was significant and the impact on daily activities in this population was comparable to the global contextItem Prevalence of menopausal symptoms and their impact on daily activities: A community based longitudinal study in Ragama, Sri Lanka(Sri Lanka College of Obstetricians & Gynaecologists, 2016) Heenatigala, C.S.N.; Gunathilaka, S.N.M.P.K.; Dias, T.D.; Palihawadana, T.S.; Motha, M.B.C.; de Silva, H.J.OBJECTIVE: To determine the prevalence and severity of menopausal symptoms among women. DESIGN, SETTING AND METHODS: A community-based cross sectional study was done in a study population of a larger ongoing longitudinal study named ‘Ragama Health Study’. Randomly selected 954 women from Ragama Medical Officer of Health (MOH) area were included. Data was collected using a self-administered questionnaire. Impact on daily activities by menopausal symptoms were scored using a scale from 1-10. RESULTS: Out of 954 women in the study, 814(85.3%) were postmenopausal. Age of the population distributed from 41-74 years with mean of 59.51 years. Mean age of onset of the menopausal symptoms was 52.16(SD=8.095) years. Among the symptoms inquired, the domain of sexual activity contained the most commonly experienced symptom, decreased libido, with a 65.4% (n=937) positive responses while 20.5% of women experienced vaginal dryness.. Mean score on impact on daily activities by this was 7.79(SD 2.36). Psychosocial symptoms of forgetfulness, bad temper, irritability and poor concentration was present in 60.5%, 33.8%, 25.4% and 24.8% of positive responses respectively. Mean scores on impact on daily activities by psychosocial symptoms lied within the range of 4.55-5.52. Presence of experiencing hot flushes and increased sweating were 24.8% and 22.1% with a mean score of effect on daily activities at 5.24 and 5.65, respectively. CONCLUSIONS: The rate of menopausal symptoms among this perimenopausal age group was significant and the impact on daily activities in this population was comparable to the global context.Item A study on the rate of symptoms of pelvic floor dysfunction among healthy women in pre and post-menopausal age and its impact on their day-to-day life.(Sri Lanka College of Obstetricians & Gynaecologists, 2016) Pieris, K.V.M.; Prasanga, D.P.G.G.M.; Dias, T.D.; Palihawadana, T.S.; Motha, M.B.C.; de Silva, H.J.OBJECTIVES: Aim of the study was to analyze the rate of symptoms of pelvic floor dysfunction, the presence of pelvic organ prolapse and to study how the symptoms affect the day to day life activities in a population of women living in the Ragama Medical Officer of Health (MOH) area. DESIGN, SETTING AND METHODS: A community-based cross sectional study was done in a study population of a larger ongoing longitudinal study named ‘Ragama Health Study’. Randomly selected 951 women from Ragama Medical Officer of Health (MOH) area were included. The symptoms of pelvic floor dysfunction were elicited using a self-administered questionnaire and a vaginal examination was performed to assess the presence and grade of pelvic organ prolapse. RESULTS: Among the 951 women 881(92.6%) did not have symptoms of pelvic floor dysfunction. Among the symptomatic women (n=70), urgency was the commonest symptom (26.8%) while 23.5% admitted urinary incontinence and 16.1% of women experienced fecal incontinence. Among the women with such symptoms of pelvic organ prolapse only 5.6% complained ofthese interfering with their sexual activities while 10.8% admitted them having an effect on their day-to-day activities. Pelvic organ prolapse was not elicited on clinical examination in 32.1% of symptomatic women while 60.7% had a prolapse up to the hymen and 7.2% had a prolapse beyond the level of hymen. CONCLUSIONS: Rate of symptoms of pelvic floor dysfunction was around 7.5% among this sample of women in peri and postmenopausal age. Urinary incontinence and fecal incontinence were the most frequent symptoms. Only a few symptomatic women considered this to have an effect on their sexual function(5%) and day-to-day activities (10%). More than two thirds of women with symptoms had genital prolapse with over 7% having a significant prolapse protruding beyond the hymen.Item Benign intracranial hypertension (BIH) in pregnancy(Sri Lanka College of Obstetricians and Gynaecologists, 2010) Pathiraja, P.D.M.; Motha, M.B.C.; Wijesinghe, P.S.INTRODUCTION: Benign intracranial hypertension (BIH) is a rare disorder of unknown aetiology that is most often seen in obese women of reproductive age. BIH is a syndrome of increased intracranial pressure without hydrocephalus or a mass lesion with elevated cerebrospinal fluid {CSF} pressure. Both pregnancy and exogenous estrogens are thought to promote BIH or worsen it. CASE REPORT 1: A 32-year old mother in her third pregnancy with two living children presented at 38 weeks of gestation. She was diagnosed to be having BIH after her second pregnancy. She had used oral contraceptive pills for five years. She was on Acetazolamide 0.5 mg twice a day. She delivered a 2960g baby by elective caesarean section under general anaesthesia. CASE REPORT 2: A 37-year old mother in her third pregnancy with two living children presented at 40 weeks of gestation. Her first two babies were delivered vaginally and thereafter she was on oral contraceptive pills for seven years. She was diagnosed to be having BIH for the last two years and was on lumboperitoneal shunt after laminectomy. She went into spontaneous labour and it was augment with oxytocin. The baby was delivered vaginally and the second stage of the labour was shortened by applying low cavity forceps. DISCUSSION: The method of treatment should aim to preserve vision and to improve symptoms. The medical therapy includes weight control, diuretics, steroids, analgesics and surgical methods were optic nerve sheath fenestration and lumboperitoneai shunt. Case reports indicate that pregnant women can go into normal vaginal delivery, and decisions regarding the mode of delivery and anesthesia should be based within a multidisciplinary approach. The use of outlet forceps has been suggested to prevent prolonged second-stage labour. Spinal anesthesia has been shown to be safe and effective in a patient without prior LP shunt. In pregnant women with a preexisting LP shunt, general anesthesia for cesarean section has been recommended due to potential damage to the shunt during spinal needle insertion.Item Recurrent pregnancy loss and thrombophilia.(Sri Lanka Medical Association, 2014) Motha, M.B.C.; Palihawadana, T.S.; Perry, D.J.No Abstract availableItem Systemic lupus erythematosus and pregnancy--a challenge to the clinician(Sri Lanka Medical Association, 2009) Motha, M.B.C.; Wijesinghe, P.S.No Abstract AvailableItem A Clinical guide for early detection of dengue fever and timing of investigations to detect patients likely to develop complications(Oxford University Press, 2009) Premaratna, R.; Pathmeswaran, A.; Amarasekera, N.D.D.M.; Motha, M.B.C.; Perera, K.V.H.K.K.; de Silva, H.J.We aimed to identify clinical features that would be useful for case detection and the appropriate timing of investigations and hospital admissions in patients with short-duration fever, suspected to be dengue fever (DF). Of 928 adult patients with short-duration fever admitted to Colombo North Teaching Hospital, Sri Lanka during February-June 2004, one in four were randomly selected for assessment of the severity of six clinical features: headache, body aches, vomiting, retro-orbital pain, generalised weakness (scale 0-9) and skin erythema (grade 1-5). There were 148 DF patients (95 males, mean age+/-SD: 28+/-12 years) and 54 non-DF patients as controls (44 males, mean age+/-SD: 25+/-11 years). All symptoms assessed (cut-off >or=5) and skin erythema (>or=grade 2) had a good positive predictive value for DF. However, erythema had the best negative predictive value, helping to differentiate DF from other short-duration fevers. More than 95% of patients with dengue had a platelet count above 50000/microl until the third day of illness. The platelet counts were significantly reduced when erythema, fever, vomiting and generalised weakness were persistent. In conclusion, erythema elicited by hand impression may help in the prediction of DF, and follow-up blood counts are indicated when symptoms persist.Item Liver dysfunction in pregnancy(Sri Lanka College of Obstetricians and Gynaecologists, 2005) de Silva, H.J.; Motha, M.B.C.; Wijesinghe, P.S.No Abstract Available