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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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 A Cross sectional survey of adherence, perceived efficacy and side effects of methylphenidate among children at a teaching hospital in Sri Lanka(Sri Lanka College of Psychiatrists, 2018) Jayamaha, G.; Perera, W.M.T.M.; Herath, T.A.; Rodrigo, A.INTRODUCTION:Attention deficit hyperactivity disorder (ADHD) is the most commonly diagnosed psychiatric condition in childhood, which if untreated may have a negative effect on education, peer relationships and family disharmony. Methylphenidate is an effective treatment for ADHD, although its use is limited by poor compliance and side effects. Studies on effects of side effects on efficacy, and adherence of methylphenidate in developing countries are scarce. METHODS: We assessed the adherence, efficacy, and side effects of methylphenidate in children and adolescents treated at a child and adolescent psychiatry clinic of North Colombo Teaching Hospital, Ragama. We gathered information from guardians of the children treated with methylphenidate for at least 2 months, using an interviewer administered questionnaire. RESULTS: Among the 149 participants, a majority were males and the mean age of the population was 10.4 years. More than 52% participants reported 100% compliance with methylphenidate, but only 12% complied with non-pharmacological therapies. While 75% believed the medication to be effective, only 17% perceived psychosocial strategies to be useful. Poor appetite (44%) was the most common side effect of methylphenidate and 43% did not report any side effect. There was a negative correlation between compliance with methylphenidate and the occurrence of poor appetite, as well as with not increasing the initial dose. DISCUSSION: The results of this study suggest that methylphenidate is an effective and well-tolerated treatment for children in Sri Lanka with ADHDItem Validity of the Sinhala version of the general health questionnaires item 12 and 30: Using different sampling strategies and scoring methods(Ibn Sina Academy of Medieval Medicine & Sciences, 2016) Abeysena, H.T.C.S.; Jayawardana, P.L.; Peiris, M.U.P.K.; Rodrigo, A.OBJECTIVE: To determine the criterion validity of the Sinhala version of the General Health Questionnaire-12 (GHQ-12) and GHQ-30 employing different sampling designs and scoring methods. METHODS: This was a descriptive cross-sectional study including 374 patients. The GHQ-30 was completed by the participants using likert scale and then converted into standard score. The ‘Clinical Examination’ was done blindly to the GHQ score as the reference standard. Total study sample was considered as a representative sample taken consecutively. Case-reference design included 126 cases and 126 randomly selected controls based on reference standard. Test result-based designs included two groups of positive and negative GHQ, based on the optimal cut-off level. Cut-off levels were determined by using three criteria. In addition stratum specific likelihood (SSLR) ratio also considered. RESULTS: Applying consecutive sampling design, for the GHQ-12, the optimal cut-off levels were 9/10 using likert score and 2/3 using standard score and for the GHQ-30, 25/26 using likert score and 6/7 using standard score. The optimal cut-off level depends on the different sampling designs employed in addition to criteria for determining cut-off levels. The SSLR of>1 was useful for determining optimal cut-off level. Irrespective of the scoring methods, application of case-reference design tends to be overestimation of the specificity with high threshold values and test result-based design tends to be overestimation of the sensitivity, compared to consecutive sampling. Using likert scoring method, the sensitivities were higher than standard scoring method. CONCLUSIONS: The optimal cut-off levels depend on the sampling design and the scoring method employed and criteria to determine cut-off levels.