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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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 Work-related health problems and their associated factors among teachers in schools of Western Province(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2021) Gurusinghe, A.; Perera, H.; Perera, S.; Samaraweera, R.; Subasinghe, S.; Amarasinghe, C.; Alagiyawanna, D.; Goonewardena, S.Introduction: The teaching profession is characterized by high levels of stress and physical complaints. These occupation-related health problems affect the effectiveness of teachers influencing the quality of education. Objectives: To describe the proportion of work-related health problems among teachers and their associated factors in selected schools in Western province. Methods: A descriptive cross-sectional study involving teachers aged 20-60 years old, who have one-year work experience in Western province. Data was collected using a structured self-administered questionnaire via a google form. Data was analysed using SPSS software version 26.0. P value less than 0.05 was considered as significant. Results: A total of 239 participated and there was a significant female predominance (82.8%). Mean age was 38.17 years (SD= 9.014). The common ergonomic problems reported are leg pain (45.2%), vocal discomfort (42.3%) and back pain (33.5%). The majority of females experienced leg pain (49%). The common co-morbidity reported was respiratory diseases (20.5%). Wearing high heel shoes (p= 0.02) and walking long distances in a school day (p= 0.002) were statistically significant with leg pain. There was significant association between vocal discomfort and using blackboards (p<0.05). Older age, BMI above 23, teaching experience exceeding 10 years, increasing number of working periods and walking long distances in a school day were associated with high prevalence of back pain (p<0.05). Conclusions: Majority had ergonomic problems and most of them were females. Remedial measures should be given to teachers to counteract these ergonomic problems which hider their teaching and thereby the quality of life.Item Stigma related to mental health issues – a study among adolescents in Sri Lanka(Sri Lanka College of Psychiatrists, 2020) Attygalle, U.R.; Perera, H.; Jayamanne, B.D.W.INTRODUCTION: It is well known that stigma is a key contributory factor for delayed help seeking in mental health issues. This in turn has led to poor outcomes amongst those who suffer from mental health issues. In Sri Lanka, large studies on stigma amongst adolescents are limited. AIMS: This study aims to describe the attributes of stigma in relation to selected mental health issues amongst adolescents. METHODS: This is a descriptive cross-sectional study focusing on data collected from 1002 adolescents. The data was collected using a questionnaire based on the Children's Attribution Questionnaire (AQ-8-C). Case vignettes depicting depression with suicidal ideation, social phobia, psychosis and a physical health issue, namely diabetes, was used. RESULTS: The study revealed that the likelihood of providing help was significantly higher with regards to mental health issues compared to diabetes (p<0.001), while the likelihood of avoiding a mental health patient was higher in psychosis compared to the other vignettes (p<0.001). Those with a personal or family history of mental health issues had a higher tendency of avoiding or being angered by such patients, or considering the person in the mental health vignette to be dangerous (p<0.05). CONCLUSIONS: Adolescents in this cohort stated they were more likely to help in the case of a person with a mental health issue, compared to someone with diabetes. They were more likely to stay away from those with psychosis, compared to those with other mental health issues. Exposure to mental health issues did not appear to lower the stigma associated with these disorders. KEYWORDS: Adolescents, Stigma, Attitudes, Mental healthItem The Diversity of midgut bacteria among wild-caught Phlebotomus argentipes (Psychodidae: Phlebotominae), the Vector of leishmaniasis in Sri Lanka(Hindawi Pub. Co., 2020) Gunathilaka, N.; Perera, H.; Wijerathna, T.; Rodrigo, W.; Wijegunawardana, N.D.A.D.ABSTRACT: Phlebotomus argentipes is the main suspected vector for leishmaniasis in Sri Lanka. Investigations on the presence of aerobic bacteria in the gut of sand flies which evidence a potential approach to control leishmaniasis transmission through a paratransgenic strategy are still not available for the local sand fly populations. Field-caught unfed female sand flies collected from three selected Medical Officer of Health (MOH) areas (Polpithigama, Maho, and Galgamuwa) in Kurunegala District, Sri Lanka from August to December 2018 were used. Prokaryotic 16S ribosomal RNA partial gene was amplified and sequenced. Morphological identification revealed the presence of only one sand fly species, P. argentipes (n = 1,969). A total of 20 organisms belonging to two phyla (Proteobactericea and Furmicutes) were detected within the gut microbial community of the studied sand fly specimens. This study documents the first-ever observation of Rhizobium sp. in the midgut of P. argentipes. The presence of Bacillus megaterium, which is considered as a nonpathogenic bacterium with potential use for paratransgenic manipulation of P. argentipes suggest that it may be used as a delivery vehicle to block the vectorial transmission of Leishmania parasites. In addition, Serratia marcescens may be used as a potential candidate to block the parasite development in sand fly vectors since it has evidenced antileishmanial activities in previous investigations. Hence, further studies are required to gain full insight into the potential use of this bacterium in the control of Leishmania parasites through paratransgenesis.Item Tardive Dyskinesia in an 8-year-old child(Sri Lanka College of Psychiatrists, 2014) Chandradasa, M.; Champika, L.; Kotalawala, S.; Seneviratne, S.; Siriwardene, G.; Perera, H.Tardive dyskinesia (TD) is an uncommon presentation in children, which can be disabling and irreversible when it does occur. An 8 year old boy, with a diagnosis of autism spectrum disorder and borderline intelligence, developed features suggestive of TD on withdrawal of long-term haloperidol medication. After recommencing haloperidol at a lower dose his symptoms improved clinically and the Abnormal Involuntary Movement Scale score also decreased. Haloperidol was tailed off gradually and vitamin E was initiatedItem Sporadic cases of adult measles: a research article(BioMed Central, 2017) Premaratna, R.; Luke, N.; Perera, H.; Gunathilake, M.; Amarasena, P.; Chandrasena, T.G.A.N.BACKGROUND: Measles caused by a paramyxovirus, characterized by fever, malaise, cough, coryza conjunctivitis, a maculopapular rash is known to result in pneumonia, encephalitis and death. Fatal cases of measles in Sri Lanka are rare after implementation of the National Immunization Programme in 1984. Thereafter 0.1% case fatality rate was observed during October 1999-June 2000 which is a very low figure compared to other regional countries. Immunization guidelines were further revised in 2001, 2011 and in 2012 when additional immunization was recommended to age group 4-21 years; who are likely to have inadequate immunization, in order to achieve elimination of Measles by 2020. However, in 2013-2014, 4690 cases were reported and the majority were children less than 1 year of age. The occurrence in adults is hard to retrieve in published epidemiological reports, however had been 38% (out of 1008 patients) in the 3rd quarter of 2013. During this outbreak 73/101 (72%) reported from the North Central Province of Sri Lanka had been more than 12 years of age with 50% being more than 29 years. 14 Sri lankan adult patients [median age 32 years (range 25-48)] who presented sporadically from June 2014 to March 2016, with confirmed measles infection were enrolled retrospectively after informed consent. Details with regards to their clinical presentation, immunization and other relevant areas were collected using an interviewer administered questionnaire or using patient management records. RESULTS: The patients presented with high fever, headache, severe body aches, sore throat, dry cough, intense tearing, red eyes and posterior cervical lymphadenopathy over 3-5 days duration. Later they developed discrete maculopapular rash helping the diagnosis. They had a variable degree of leucopenia, lymphocytosis, thrombocytopenia and derangements in the liver functions mimicking any other acute febrile illnesses such as dengue, chikungunya, leptospirosis or Zika virus infection. CONCLUSION: At least a 3-5 day delay in the diagnosis was observed (even after the appearance of the rash in some patients), due to non-awareness of its occurrence, unfamiliarity of measles in adults, non-specific nature of the illness and non-availability of rapid diagnostics, risking transmission to the immune-compromised or non-immune staff or patients. Identification of the source of infection in these sporadic adult cases and their virologic surveillance and molecular epidemiology will be important to interrupt the transmission and to achieve the targeted elimination of measles from Sri Lanka by 2020.