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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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 study on maternal knowledge and practices on childhood anaemia and iron deficiency among mothers of children under 5 years in the Gampaha District(Sri Lanka Medical Association, 2021) Samararathna, R.; Gunaratne, A.V.C.; Mettananda, S.Introduction and objectives Childhood anaemia is a common health problem worldwide. Here, we aim to describe the maternal knowledge and practices on childhood anaemia among mothers of children under five years in the Gampaha district. Methods We performed a cross-sectional descriptive study in Gampaha district from December 2020 to February 2021. One immunisation clinic each from four Medical Officer of Health areas in the district was selected using stratified random sampling. Parents of all children aged between 6 months to 5 years attending clinics were recruited until the sample size was achieved. Data were collected using a self-administered questionnaire and analysed using multiple logistic regression. Ethics approval was obtained from Sri Lanka College of Paediatricians. Results A total of 392 mothers were recruited; 53% of their children were males. Only 131(33.4%) mothers had an accurate understanding of anaemia, while only 278(70.9%) and 113(28.8%) respectively could name at least one symptom and two causes of anaemia. 49(12.5%) could not name a single food rich in iron. Accurate understanding of anaemia was associated with maternal age over thirty years [OR=1.73(1.03-2.89);p<0.05] and maternal education level beyond grade ten [OR=3.20(1.90-5.40);p<0.001] whereas higher knowledge on symptoms of anaemia was associated with maternal employment [OR=2.39(1.31-4.37);p<0.01]. Acceptance of multiple micronutrient supplements was higher among mothers with accurate understanding of anaemia [OR=1.68(1.08-2.60);p<0.05]. Conclusion The knowledge of anaemia was higher among mothers who are older than thirty years, educated beyond grade ten and employed. Mothers with an accurate understanding of anaemia showed better compliance with multiple micronutrient supplements.Item COVID 19: Downstream effects on developmental care - A case report(College of Community Physicians of Sri Lanka, 2021) Samararathna, R.; Sandakelum, U.; Mettananda, S.Introduction: COVID-19 pandemic has had a global impact resulting in increased demand on health systems worldwide. This has invariably resulted in major downstream effects to paediatric developmental care that focuses on identifying and making early interventions to optimize the developmental potential of infants with neurological impairment. Here we present a patient with global developmental delay who had unacceptable delays in getting access to intervention programs due to COVID-19. Case study: A 14-month old girl is admitted with fever and two episodes of right-sided focal convulsions. She was born to healthy non-consanguineous parents without perinatal complications. She had subtle dysmorphism, central hypotonia, microcephaly and global developmental delay. Her developmental age was 6-8 months. Biochemical and microbiological investigations, including SARSCoV- 2 PCR and cerebrospinal fluid analysis, were negative. Her EEG showed theta waves suggesting a structural brain pathology. Further questioning revealed that the baby had not attended well-baby clinics as the clinics were not held due to the COVID-19 pandemic. The mother had identified the baby's developmental delay and had gone to a paediatric tertiary care centre three times. However, she was sent back without a proper assessment claiming that the baby's condition is non-urgent and advised to come back when the COVID-19 pandemic ends. Conclusions/ Lessons learnt: This case illustrates the impact of the COVID-19 pandemic on chronic disabling conditions of children. To minimise these downstream effects, the public health sector should create programs to improve family visits and increase the availability of staff-delivered developmental care.