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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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
4 results
Search Results
Item Case of mixed - type intraductal papillary - mucinous neoplasm of pancreas highlighting the need of multidisciplinary approach(University of Kelaniya, Sri Lanka, 2021) Pathirage, C.K.Mixed-Type Intraductal Papillary-Mucinous Neoplasms (MT– IPMNs) of pancreas are rare mucin producing papillary growths involving the Main Pancreatic Duct (MPD) and Branch Ducts (BD). Among other subtypes, MT-IPMNs are the most challenging in determining the ideal therapeutic strategy. A 56-year-old female presenting with severe acute epigastric abdominal pain due to acute on chronic pancreatitis was diagnosed with a cystic lesion in the pancreatic head by Contrast Enhanced Computed Tomography (CECT) imaging. Further imaging, interventions or follow-up were not offered. The patient presented four years later with a similar presentation to be subjected to pancreaticoduodenectomy following diagnosis of IPMN through Magnetic Resonance Cholangiopancreatogram (MRCP) and Endoscopic Ultrasound (EUS) imaging. The report highlights the necessity for heightened consideration of the role of MRCP as a determinant of the management strategy and the awareness of indications for surgery in MT-IPMNs in the Sri Lankan surgical setting.Item Accessibility challenges for the disabled community accessing public health care services and disability care institutions in Ragama Medical Officer of Health area(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2021) Pathirage, C.K.; Padmasiri, U.G.M.; Nuvvarapakshage, N.S.R.P.; Panditharatne, W.D.; Hewawardhane, S.N.; Phuntsho, T.; Perera, K.M.N.Introduction: Ragama Medical Officer of Health (MOH) area is a developing center for the disabled with the National Rehabilitation Hospital and the specialized disability care institution targeting children. It also hosts the main teaching hospital in the district and a school for disabled children. Visual, walking and audibility impairments account for the highest number of disabled individuals in the country. Ragama MOH area is a developing hub for all these communities. Objectives: The objective of this study is to describe access-related challenges for the disabled community accessing public health care services and disability care institutions in Ragama MOH area. Methods: This is the qualitative study component of a larger study which also quantitatively assessed the compliance of the settings using an observational checklist. This component focused on the qualitative evaluation of accessibility-related challenges. Independent research team members interviewed 15 service providers, disabled and community stakeholders sampled purposively using semi-structured questionnaires. Data was analysed using thematic analysis method. Results: Financial constraints were identified as the main constraint for development of accessibility. “Dependence”, “gaps in awareness” and “negative attitudes” in order of perceived importance, revealed to hinder empowerment of the disabled on demanding for better access. Prioritisation of one disability was identified as a significant determinant for reduced access for individuals with multiple disabilities. Service providers were perceived to have the greatest power to address the challenges in their respective settings. Conclusions: Empowering clients to demand for improvement of accessibility and engaging primary service providers in development processes will lead to improvement of the existent challenges.Item Accessibility to disability-care institutions and public health services in Ragama Medical Officer of Health Area(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2021) Pathirage, C.K.; Padmasiri, U.G.M.; Nuwarapakshage, N.S.R.P.; Panditharatne, W.D.; Hewawardhane, S.N.; Phuntsho, T.; Perera, K.M.N.Introduction: Ragama Medical Officer of Health (MOH) area is a developing centre for the disabled with the National Rehabilitation Hospital and the specialized disability care institution targeting children. It also hosts the main teaching hospital in the district and a school for disabled children. Objectives: The objective was to describe compliance of identified settings related to disability health services in the Ragama MOH Area with current accessibility regulations. Methods: This is the quantitative component of a larger study which explored accessibility challenges and perceptions of service providers and the clients as well. This component assessed identified 16 settings including all disability care institutions, public health care services and selected access-points in Ragama MOH area using an observational checklist based on ‘disabled persons’ accessibility regulations act no. 1, 2006’. Photographic documentation of accessibility was performed. Data analysis utilized descriptive statistics based on a score of 1 for complete compliance and 0 for non-compliance. Results: Accessibility for visually impaired and signage for the disabled reported the lowest compliance with a score of 0% across all assessed settings. Highest compliance was observed related to pathways and corridors which scored 93.3%. Specific shortcomings and strongholds of accessibility in each institution were identified. Only one institution specializing in children with disabilities displayed a total compliance of 61.11%. The road network accessing the institutions portrayed less than 5% compliance with the recommended standards. Conclusions: Failure to meet accessibility regulations as expected in a developing hub such as Ragama MOH area emphasizes the need for greater attention to disabled accessibility in the country.Item Is accessibility to centers of disability care in the emerging hub for disability healthcare services of the Western Province truly challenging?(College of Community Physicians of Sri Lanka, 2021) Pathirage, C.K.; Padmasiri, U.G.M.; Nuwarapakshage, N.S.R.P.; Panditharatne, W.D.; Hewawardhane, S.N.; Perera, K.M.N.Background: Ragama Medical Officer of Health (MOH) area is a sanctum of disability care hosting the main teaching hospital in the district, National Center for Children with Disabilities, National Rehabilitation Hospital and a school for disabled children. The objectives were to describe compliance of above institutions with current accessibility regulations and access-related challenges for the disabled community. Methods: A mixed-methods study was performed by qualitative evaluation of accessibility-related challenges and quantitative assessment of the aforementioned institutions and access-points. The qualitative component collected data from 6 service providers 4 disabled individuals and 5 community stakeholders sampled purposively by the research team. In-depth interviews used a semi-structured questionnaire guide. Data was analyzed using thematic analysis method. The quantitative component utilized an observational checklist based on 'disabled persons accessibility regulations act no.1, 2006' under the themes of public institutions, road network and access-points and accessibility for the visually impaired. Data analysis utilized descriptive statistics allocating a score of 1 for compliance and 0 for non-compliance. Results: Financial constraints were identified as the main challenge along with “Dependence”, “Gaps in awareness” and “Negative attitudes”. The highest level of compliance to the imposed regulations was only 61.1% portrayed by the institution specializing in children with disabilities. Accessibility for the visually impaired showed 0% compliance across all institutions. The public road network failed to exceed a compliance of 5%. Conclusions: Failure to meet anticipated excellence of accessibility in a developing hub such as Ragama MOH area emphasizes on the need for prioritization of disabled accessibility in Sri Lanka.