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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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 Canine filaria species in selected lymphatic filariasis endemic and non-endemic areas in Sri Lanka(Springer International, 2022) Rathnayake, S.; Chandrasena, N.; Wijerathna, T.; Mallawarachchi, H.; Gunathilaka, N.Subperiodic brugian filariasis and dirofilariasis show a rising trend in Sri Lanka posing a threat to public health. As information was limited on canine filaria species in Sri Lanka, we studied the filaria parasites among dog populations in lymphatic filariasis (LF) endemic and non-endemic regions by microscopy and molecular methods. Thick blood smears (TBSs) were performed among 295 dogs presenting to veterinary clinics for surgical or sterilization procedures in Galle (LF endemic) and Mullaitivu (LF non-endemic) districts, of which 55.6% were positive for any microfilariae. We identified Dirofilaria repens (50.8%) and Brugia spp. (20.6%) by microscopy, which, included mono-infections (D. repens 35.3% and Brugia spp. 5%) and co-infections (15.6%). Infections in Galle and Mullaitivu were 61% and 44.9% respectively. The brugian filariasis rate was significantly higher among canines in LF endemic Galle district (29.9%) than in Mullaitivu (LF non-endemic) (1.1%) (P < 0.001), while D. repens infections were comparable in both districts. Genomic DNA extracted from 10% of microfilariae positive TBSs was amplified using pan-filarial primers targeting the internal-transcriber-spacer region-2 (ITS-2). Sequencing of amplicons confirmed the presence of D. repens (89.28%), Brugia pahangi (7.14%) and B. malayi (3.57%) infections. The phylogeny constructed and analysed in MEGA X indicated genetic variability among D. repens and B. pahangi isolates from Sri Lanka. With this study, we were able to report B. pahangi infections for the first time in Sri Lanka.Item Caregivers knowledge on "aphasia" based on 'life participation approach to aphasia model; A Sri Lankan experience(Sri Lanka College of Internal Medicine, 2019) Jayarathna, T. V.; Rathnayake, S.; Mettananda, K.C.D.INTRODUCTION: Caregiver knowledge on 'aphasia' is very important in successful rehabilitation of aphasic patients. There are no published data on this from Sri Lanka. OBJECTIVES: We aimed to describe knowledge on aphasia of caregivers caring post-stroke aphasia patients based on 'life participation approach to aphasia (LPAA) model. METHODS: We studied knowledge on aphasia of caregivers caring post-stroke aphasic patients at 3 state sector speech and language therapy clinics of Gampaha district from March to April 2019.Data on language & related impairments and communication & language environment were collected using an interviewer administered questionnaire. Data were analyzed using SPSS version 22. RESULTS: 35 caregivers (male-13 (37.1%), mean age 50.4 ± 16.8) caring aphasia patients for more than 1year were interviewed. All were close relatives of the patients. 77% had studied only up to grade-10. 64.7% knew the primary medical diagnosis and 60% knew the organ involved. However, 68.6% had never heard the term "aphasia". Only 51.4% appreciated aphasia is a language problem. 57% thought it is a memory problem while 14% thought it is a psychiatry problem. Caregivers' knowledge about expressive language was good; 79%, 92%, 96% knew the correct levels of speech, reading and writing skills of patients compared that identified by speech & language therapists (SLT). However, knowledge about comprehensive language was not satisfactory; 88.6% thought their clients can't obey comprehensive commands but it was 42% according to SLTs. CONCLUSION: Knowledge on aphasia of caregivers of this Sri Lankan cohort is not satisfactory. Formal education of caregivers seems a way forward in successful rehabilitation programs.Item The Adaptation and Validation of Stroke and Aphasia Quality of Life (SAQOL-39) Scale for the Sinhala Language in the Sri Lankan Context.(19th Conference on Postgraduate Research, International Postgraduate Research Conference 2018, Faculty of Graduate Studies,University of Kelaniya, Sri Lanka, 2018) Karunathilake, K.M.M.G.S.L.; Rathnayake, S.; Ranawaka, U.K.Stroke and aphasia rehabilitation aims to improve the quality of life of the individuals affected. Aphasia is a disturbance of the language. Most of scales for measuring health-related quality of life in stroke exclude people with aphasia due to inability to communicate during the questionnaires. However, it is vital to identify the effect on quality of life among individuals with aphasia to provide proper rehabilitation. No reliable measure was developed in Sri Lankan context to analyze this, which became the research question of the present study. The Stroke and Aphasia Quality of Life Scale-39 which is the commonest, valid and reliable measures was used in assessing quality of life among aphasia and it was analyzed applying to the Sri Lankan context. The following were the aims of the study, translate and adapt the (SAQOL-39) Scale for the Sinhala Language in the Sri Lankan context, identify its reliability and validity, identify the relationship between the severity level of communication and the quality of life level and analyze the most affected domain among aphasia population. The original (English) version of the SAQOL-39 has been adapted and translated using Delphi method. The sociocultural and linguistically adapted Sinhala version was administered on a group of 35 patients with aphasia to examine the test-retest reliability, inter rater reliability internal consistency reliability as well as the concurrent validity of the instrument. The inclusion criteria of the study population were as following, Aphasia resulting from a stroke at least after 6 months from the onset and not with the evidence of psychiatric illnesses and cognitive difficulty. 10 patients were used for the test retest assessment. And for the inter rater reliability assessment 2 raters were used. The Sinhala version of SAQOL-39 exhibited high test-retest reliability (ICC =0.83) as well as the inter rater reliability (ICC=0.99). This instrument exhibited high internal consistency (Chronbach's∝ =0.845) and also the concurrent validity was examined with the WHOQOL BREF and found a significant correlation between SAQOL-39 and WHOQOL-BREF (r=0.75, p=0.000). The most affected domain of the aphasia patients as the communication domain was identified through this study and it was also identified that there is a significant positive correlation (r=0.685, p=0.000) between the severity level of aphasia and quality of life. Despite the small sample size, the Sinhala version of the SAQOL-39 showed good internal consistency, inter rater reliability, test-retest reliability and concurrent validity. The importance of communication ability in perceiving the quality of life in patients with aphasia has also been highlighted.Item Developing and validating a language assessment tool to diagnose aphasia in a Sri Lankan Sinhala speaking context(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2016) Rathnayake, S.Aphasia is an acquired communication disorder commonly present in stoke survivors. No standardized tests are currently available to identify aphasia in the Sri Lankan context. The objectives of this study were to identify language functions in Sinhala to be used as tasks in the tool; to identify the reliability of the developed tool and to identify the validity of the developed tool. Face validity and construct validity were achieved based on the Delphi-method. External validity was identified with concurrent and criterion validity. Data from 200 participants without aphasia (age ranges of 20-40, 41-60, 61-80, 80+ years) and 251 participants with strokes (PWS) were analyzed in the validation process. The reliability was achieved by reliability measures of internal reliability (IR) as Cronbach alpha (CA), split half reliability(SHR), test-retest (TR) and inter-examiner reliability (IER) using a sample of 30 participants with aphasia (PWA) and 60 PWS. No correlation was observed among total scores with age, educational or economy for participants without aphasia, but significant correlation was observed for PWA for age (-758) and education (0.490). The Delphi method resulted with 12 tasks and 69 items for the tool. IR for each task was calculated and CA was within the expected range (0.70-0.90) for 8 tasks and (04) four tasks needed revision. IER reliability was 0.99. TR reliability was 0.90. Two tests correlation was 0.86. ROC curve for 60 SWS was analyzed and that score (140) was used among another 251 PWS to diagnose aphasia and the results indicated sensitivity as 01 and specificity as 0.91 with gold-standard comparisons. In conclusion, the developed tool could be used as a clinically valid and reliable tool to diagnose aphasia in the Sri Lankan context.Item Sexual violence against women: a challenge(Sri Lanka Medical Association, 2014) Dias, T.; Kociejowski, A.; Rathnayake, S.; Kumarasiri, S.; Abeykoon, S.; Padeniya, T.