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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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 hearing impairment among school children in the Gampaha District of Sri Lanka(Sri Lanka College of Paediatricians, 2021) Perera, P.J.; Kasturiratne, A.; Sakalasuriya, S.Background: Normal hearing in a child is vital for acquisition of language skills, literacy, educational achievements, socialization and overall school performances. Globally, data on prevalence of childhood hearing impairment (HI) is sparse and Sri Lanka is not an exception. Objectives: To describe the prevalence of HI among Sri Lankan school children and to assess the feasibility and effectiveness of a screening programme. Method: A descriptive cross sectional study was conducted in Gampaha district, covering all educational zones. Screening for HI, in randomly selected 984 students was carried out at schools using otoscopy, pure tone audiometry and oto-acoustic emission. Children who failed at least one screening test were invited for a diagnostic testing carried out at the Faculty of Medicine, Ragama. Results: Out of 984 students, 270 (27.4%) failed one or more screening tests. Out of this 199 children 73.7% turned up for the diagnostic testing and 40 (20.1%) were diagnosed to have HI. Minimal or mild HI was present in 32 (80%), three (7.5%) had severe and another three (7.5%) had profound HI. With correction for the children who defaulted the diagnostic test, prevalence of all types HI in this student population was 5.5%. Conclusions: In this student population in the Gampaha district, prevalence of all types HI was 5.5%. The HI was mild in 80%, severe in 7.5% and profound in 7.5%.Item Hypocalcaemia leading to supra ventricular tachycardia in a three-month old Sri Lankan infant with vitamin D deficient rickets: a case report(Sri Lanka Medical Association, 2017) Fernando, M.P.; Perera, P.J.; Muthukumarana, O.J.; Uyangoda, K.No Abstract AvailableItem Socio-economic impact on Sri Lankan families managing a child with cerebral palsy(World Wide Journals(Ahmedab -India), 2016) Perera, P.J.; Fernanado, M.D.Cerebral palsy (CP) is a condition that limits a child’s ability to move, maintain balance and posture. Dependency thus ensues, cause significant detrimental effects on the quality of life of CP children and their families. In a cross sectional descriptive study, socio-economic impact on Sri Lankan families managing a CP child was studied. An interviewer administered questionnaire was used to collect data 300 families with CP children were studied. The majority were from the low to low middle income groups. Significant negative socio-economic impacts on the families were identified in terms of the time spent on the child, economic loss due effects on employment, cost of managing the child, marital disharmony and effects on other siblings. A well structured social welfare system is in need to support Sri Lankan families with CP children to minimize the negativeItem Child with Trisomy 13, inherited from paternal translocation, rob(13;14)(q12.1;q11.2)(World Wide Journals(Ahmedab -India), 2016) Perera, P.J.Item Growth parameters of Sri Lankan children during infancy: A comparison with world health organization Multicentre growth reference study(Centro de Estudos do Crescimento e do Desenvolvimento do Ser Humano, 2014) Perera, P.J.; Fernanado, M.P.; Ranathunga, N.; Sampath, W.; Samaranayake, R.; Mettananda, S.OBJECTIVES: growth monitoring (GM) is an important intervention ensuring wellbeing of children. If GM to be meaningful it is essential to have reference standards appropriate for that population. In Sri Lanka growth charts based on WHO multi centre growth reference study (MGRS) are used for GM. This study was carried out to ascertain the appropriateness of MGRS charts for GM in Sri Lankan children. METHODS: out of a birth cohort of 2215 children, 250 from each sex were invited for a followed up. Children were examined at 2, 4, 6, 9 and 12 months, to measure weight and length. Statistical characteristics of weight and length for each sex were calculated and compared with MGRS data. RESULTS: out of babies invited to participate in the study 244 boys and 241 girls responded initially. Out of this 85% of boys and 86% of girls completed the follow up. Weight and length of both sexes deviated significantly at all ages from MGRS data. CONCLUSION: MGRS data seems to be inappropriate for monitoring growth of Sri Lankan childrenItem Knowledge on mother to child transmission of HIV among newly registered antenatal mothers in MOH area Ragama(Sri Lanka College of Venereologists, 2014) Perera, H.P.; Wickramasuriya, C.D.; Perera, P.J.; Pathmeswaran, A.Sri Lanka has remained a low prevalent country for HIV for past three decades. One important aspect of maintaining this low prevalence is preventing mother to child transmission (MTCT) of HIV. As highly effective strategies are now available to reduce the risk of MTCT, early diagnosis of HIV in antenatal mother is important. Good knowledge about HIV and MTCT will promote mothers to take up HIV testing. Though mothers in this study population had a reasonably good education their knowledge about MTCT of HIV was poor.Item Effect of feeding practices on dental caries among preschool children: a hospital based analytical cross sectional study(HEC Press, Australia, 2014) Perera, P.J.; Fernando, M.P.; Warnakulasooriya, T.D.; Ranathunga, N.Feeding practices during early childhood play an important aetiological role in early childhood caries (ECC). The role of feeding practices in causation of ECC is debated. The objective of this study was to assess the aetiological role of feeding practices on ECC. A descriptive cross sectional study was conducted at a paediatric unit in Sri Lanka. Two hundred and eighty-five children between 36 to 60 months, admitted to the unit were randomly selected for the study. An interviewer administered questionnaire asked about socio-demographic characteristics and feeding practices. The mouths of children were examined for dental caries. Out of 285 children, 61% had exclusive breast feeding up to six months, 69% continued breast feeding beyond two years and 82% had overnight feeding after two years of age. One hundred and thirty-six children (47.7%) had dental caries with a mean deft score of 1.81. Overnight feeding with any type of milk beyond two years significantly increased dental caries incidence and severity. Children exclusively breast fed for six months or had breast feeding beyond two years had a higher prevalence of caries than children not exclusively breast fed or who were not breast feed beyond two years, but the difference was not significant. Overnight feeding with any type of milk beyond two years should be discouraged.Item Head circumference during infancy in a birth cohort of Sri Lankan children: are we using the correct chart?(Sri Lanka Medical Association, 2014) Perera, P.J.; Fernando, M.P.; Samaranayake, R.INTRODUCTION: Measuring head circumference and plotting it in centile charts is a routine practice in paediatrics. However if wrong charts are used, serious misinterpretations can ensue. OBJECTIVES: This study was carried out to ascertain the appropriateness of charts used in Sri Lanka. Out of a birth cohort of 2215 children, 250 from each sex were invited for a follow up study. Head circumference was measured at 2, 4, 6, 9 and 12 months. Statistical characteristics of head circumference for each sex, at each age were calculated. RESULTS: At the first follow up 244 boys and 241 girls were assessed. Out of this, 85% of boys and 86% of girls completed the follow up. CONCLUSIONS: Head circumference of both sexes deviated significantly at all ages from the charts available in the Child Health Developmental Record (CHDR). Head circumference charts available in the CHDR are inappropriate for use in Sri Lankan children.Item Benign intracranial hypertension following vitamin A megadose(Sri Lanka Medical Association, 2014) Perera, P.J.; Sandamal, Y.S.; Randeny, S.No Abstract available.Item Growth parameters at birth of babies born in Gampaha district, Sri Lanka and factors influencing them(World Health Organization, Regional Office for South-East Asia, 2013) Perera, P.J.; Ranathunga, N.; Fernando, M. P.; Warnakulasuriya, T.D.Background: Growth parameters at birth are important for clinical decision‑making. In Sri Lanka, the data from the World Health Organization (WHO) Multicentre Growth Reference Study (MGRS) are used to interpret these measurements. Materials and Methods: A descriptive cross‑sectional study was conducted between September and October 2010 in hospitals of Gampaha district, Sri Lanka. The weight, length and head circumference of all normal‑term babies born in the Gampaha district during this period were measured within 8 h of birth using standard techniques. Measurements were taken by medical graduates trained and supervised by a consultant paediatrician. Socio‑demographic data were obtained using an interviewer‑administered questionnaire. Results: Of the 2215 babies recruited, 1127 were males. The mean birth weight, mean length and mean head circumference at birth were 2.92 kg, 49.1 and 33.6 cm, respectively. Boys weighed and measured more than girls in all parameters, but the differences were not statistically significant. Growth parameters of babies included in this study deviated from that in the MGRS data. Mean values of MGRS data were between 75th and 90th centiles of this study population. Birth order, family income and maternal education were significantly (P < 0.01) associated with growth parameters. Contrary to common belief, growth parameters continued to increase progressively up to 41 weeks. Maternal age less than 20 years or more than 35 years was negatively associated with birth weight (P < 0.01). Conclusions: Growth parameters of new‑born babies deviated significantly from the values of the MGRS data. Growth characteristics of one population may not be applicable to another population due to variations in maternal, genetic and socio‑economic factors. Using growth charts not applicable to a population will result in wrong interpretations.