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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty

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    Maternal perception of adequacy of mother's milk among mothers giving birth at a teaching hospital in Sri Lanka
    (Sage Publications, 2019) Rodrigo, R.; Rodrigo, A.; Liyanage, N.; Hathagoda, W.; Hewavitharana, U.
    BACKGROUND: Sri Lanka boasts high rates of early and exclusive breastfeeding. Perceived inadequacy of milk, a global problem, is the main cause for early cessation of breastfeeding. Research Aims: The aims of this study are to (a) determine the prevalence, (b) identify the risk factors, and (c) ascertain the association that maternal psychological distress has with perceived inadequacy of milk (PIM), among mothers during the early postpartum period. Identifying and addressing modifiable risk factors for PIM may improve mothers' satisfaction with breastfeeding. METHODS: A cross-sectional descriptive study of mothers ( n = 249) during the first week after birth was conducted at Colombo North Teaching Hospital (Ragama, Sri Lanka) from May 1, 2016, to June 10, 2016. Participants were recruited when the infant was more than 24 hours but less than 7 days old. A self-administered questionnaire, including the six-item Kessler Psychological Distress Scale, was used. RESULTS: The majority of mothers (78%) perceived their milk quantity to be adequate. A family member telling mothers that their milk supply was low had the most significant associations with perceived inadequacy. Other associations were antenatal maternal complications and birth by cesarean section. Kessler scores indicating psychological distressoccurred in 26% of all participating mothers, with a higher mean score in those with PIM. CONCLUSIONS: Sri Lankan family members should be educated further about normal patterns of milk production during the postpartum period. The authors recommend that PIM be included in screening tools for postpartum depression in Sri Lanka.
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    Psychological morbidity and resilience associated with tinnitus in a Sri Lankan population
    (Sri Lanka Medical Association, 2017) Herath, T.C.K.A.; Chandrasekara, A.; Illeperuma, L.D.; Rodrigo, A.
    INTRODUCTION & OBJECTIVES: Tinnitus, the perception of noise or ringing in the ears, is a common and disabling condition. It often results in anxiety and depression. While it is believed to be common in Sri Lanka, no study has investigated this phenomena. This study aimed to describe the nature of tinnitus among patients attending the otorhinolaryngology (ENT) clinics in selected hospitals in Sri Lanka to determine the psychological morbidity associated with tinnitus and to investigate the factors influencing resilience among them. METHODS: This was a descriptive cross-sectional study. All the consenting adult patients with complaint of tinnitus who attended ENT clinics in Kandy, Kalubowila and Mathale hospitals were assessed using a self-administered questionnaire. Psychological morbidity was assessed using the validated GHQ-12 and Beck Depression Inventory (BDI). RESULTS: Of 93 patients included in the study, majority (56%) were females. Their average age was 55.1years and they have had tinnitus for 2.1years on average. While 63.5% reported tinnitus to be subjectively distressing, 63.4% noted it to be significantly interfering with daily activities. None of them had psychiatric illness prior to the onset of tinnitus. Yet, 62.4% reported psychiatric caseness and 47.3% had depression. Loudness of tinnitus, subjective distress, disturbance to sleep and daily activities due to tinnitus, had significant association with psychiatric caseness/depression. Constant pursuit of happiness was associated with resilience but religiosity and mindfulness were not. CONCLUSION: Tinnitus is a distressing illness associated with a significant functional impairment and psychiatric morbidity. Harnessing resilient factors would improve the quality of life for patients with tinnitus in Sri Lanka
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    A randomized, double blind, placebo controlled trial on effectiveness of preemptive analgesia with paracetamol on reduction of occurrence of headache after electro convulsive therapy
    (Sri Lanka Medical Association, 2016) Isuru, L.L.A.; Rodrigo, A.; Wijesekera, C.; Premasinghe, S.; Wijesinghe, C.A.; Ediriweera, D.S.; Kuruppuarachchi, K.A.L.A.
    INTRODUCTION: Electro convulsive therapy (ECT) is a safe and effective treatment for a wide range of psychiatric disorders. However, its utility is mainly limited by side effects and stigma. Post ECT headache is one of the commonest side effects of ECT. There is little evidence to suggest Pre-ECT analgesia would prevent the occurrence of post ECT headache. OBJECTIVES: Objective was to compare the incidence and severity of the post ECT headache of the patients who had paracetamol 1g, 2hrs before the induction of anaesthesia with those who had a placebo. METHOD: This was a double-blind, placebo controlled trial. Sixty two patients were given placebo and 73 received paracetamol tablets. Ethical approval was granted by an Ethics Review Committee, University of Kelaniya, and the trial was registered in the clinical trial registry (SLCTR/2015/27). Post ECT headache was measured 2 hours after the administration of ECT by a visual analogue test and verbal descriptive scale. Variables were tested for normality and Mann-Whitney U test was used to compare groups. Subsequent analysis was non-parametric, with Mann-Whitney U test. RESULTS: Both intervention and controlled groups had comparable baseline demographic and clinical variables. One third (34%) of the paracetamol group experienced post ECT headache, while 62% of the placebo group experienced same. There was a statistically significant reduction in the incidence and severity of post-ECT headache in the test group (p <0.05). This remained significant after confounding factors were adjusted for in the regression analysis for the duration of illness and headache during this episode. CONCLUSIONS: Preemptive analgesia with paracetamol, 2hours beforeECT, reduces post ECT headache and this could be routinely practiced to ameliorate ECT induced headache.
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    Internet gaming disorder among adolescents
    (Dr. K. C. Chaudhuri Foundation, co-published by Springer India, 2017) Chandradasa, M.; Rodrigo, A.
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    Comparison of suicide rates in Sri Lanka during and after the civil war
    (SAGE Publishing, 2013) Rodrigo, A.; Owada, K.; Wainer, J.; Baker, R.; Williams, S.
    No Abstract Available
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    Recent trends in psychotherapy training among psychiatrists in the UK, Australia and New Zealand
    (Sage Publishing, 2013) Rodrigo, A.; Majoor, J.; Minson, F.; Jayakody, K.
    No Abstract Available
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    Have primary mental health teams lived up to their expectations?
    (Sage Publishing, 2013) Rodrigo, A.; Foo, L.; Majoor, J.
    OBJECTIVE: Primary Mental Health Teams (PMHTs) were established in Victoria in 2002 to integrate psychiatric services into primary care. This study aimed to evaluate the characteristics of patients referred to Eastern Health PMHT, the effectiveness of management plans and referrer satisfaction. METHOD: Retrospective case note review of referrals (116) made to the PMHT from January to August 2010 and analysis of returned satisfaction surveys (105) from referrers between January 2006 and August 2010. RESULTS: The mean age of patients was 40 years with 55% being female. The commonest primary diagnosis was depression (41%). The majority of patients (59%) had multiple psychiatric diagnoses. The response time for telephonic consultation was 1.4 days and 13.2 days for an initial patient consultation. Psychotherapy was the most frequently recommended treatment (85%). Average treatment period was 6.8 weeks and the majority of patients (93%) were discharged back to the primary referrer. Referrers were satisfied with PMHT services and average improvement of patients on the Health of the Nation Outcome Scales was 2.3. CONCLUSION: Our study suggests that PMHTs have embedded psychiatric services within primary care settings, with high levels of referrer satisfaction and patient improvement
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    Stamping the message: psychiatric themes in philately
    (Sage Publishing, 2012) Rodrigo, A.; Majoor, J.
    OBJECTIVE: The objective of this article is to examine the representation of psychiatric themes within medical philately (stamps) over a recent seven-year period. METHOD: Examination of all stamps issued from 1 January 2002 to 31 December 2009 worldwide took place using the World Association for the Development of Philately Numbering System (WNS) on the Universal Postal Union website. RESULTS: During the study period, 596 stamps with medical themes were issued around the world. Common psychiatric themes included: psychoactive substance use, recreational drug messages, 'anti-tobacco' and human emotions. Notable people, the World Psychiatry Congress and intellectual disability also featured prominently. CONCLUSIONS: Philately may have a role in anti-stigma campaigns within psychiatry. The highest number of medical stamps havepsychiatric themes, yet this potential resource may not be currently utilised to maximal benefit. Philately is being adapted to the electronic age of communication.
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    Imposing restrictions on pornography: its potential impact and effectiveness in Sri Lanka
    (Sri Lanka College of Psychiatrists, 2011) Waduge, R.; Rodrigo, A.; Peiris, U.
    The government of Sri Lanka recently introduced many measures to limit the accessibility and availability of pornography in the country including censorship of websites containing sexually explicit material and active prosecution of Sri Lankans who appeared on such websites Available evidence suggests that pornographic consumption among Sri Lankan adolescents is considerable and such exposure may influence sexual attitudes and activity including sexual aggression in youth. However the current evidence on the beneficial effects of censorship of pornography is less than convincing. The authors believe that warm, communicative parent-child relationship and open discussion about sexual matters at home and at school could be more effective than restrictive measures such as censorship and punitive legislation
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