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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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 Transient severe thrombocytopenia with SARS-Cov-2 (COVID-19) infection in pregnancy(Sri Lanka college of Obstetricians & Gynaecologists, 2021) Jayawardane, I.A.; Piyadigama, I.; Solangaarachchi, H.; Williams, S.A 24-weeks pregnant woman in her 2nd pregnancy presented with mild COVID symptoms and new onset rapidly progressive severe thrombocytopenia with a nadir of 20×109/L. She did not have any bleeding manifestations and the platelet counts recovered over 3 days without the need of steroids or immunoglobulin treatment. COVID-19 infection may cause transient severe thrombocytopenia, and this has not been previously reported in second trimester of pregnancy. We speculate the cause to be immune mediated. Other causes for severe thrombocytopenia were excluded after comprehensive investigations. This raise concerns on thromboprophylaxis and anticoagulant use in early pregnancies infected with COVID-19. Assessing the platelet counts at least two occasions few days apart of an infected patient may be a safer approach if continuing anticoagulants.Item Impact of COVID-19 on the mental health of frontline and non-frontline healthcare workers in Sri Lanka(The Sri Lanka Medical Association, 2021) Baminiwatta, A.; de Silva, S.; Hapangama, A.; Basnayake, K.; Abayaweera, C.; Kulasinghe, D.; Kaushalya, D.; Williams, S.INTRODUCTION: Healthcare workers (HCWs) are at risk of mental health problems during a pandemic. Being stationed at the frontline or not may have implications on their mental health. OBJECTIVES: The aims of this study were to assess depression, anxiety and stress among HCWs, to explore differences between frontline and non-frontline workers, and to investigate associated factors. METHODS: In this cross-sectional study, frontline and non-frontline HCWs were recruited from a COVID-19 screening hospital in Sri Lanka. Mental health impact was assessed using Depression, Anxiety and Stress Scale (DASS-21). Sociodemographic data and perceptions of social and occupational circumstances were gathered. Categorical variables were analyzed using Chi square and logistic regression. Odds ratios were calculated for the effect of different perceptions on psychological morbidity. RESULTS: A total of 467 HCWs participated, comprising 244 (52.2%) frontline and 223 (47.8%) non-frontline workers, with female preponderance (n=341, 77%). Prevalence of depression, anxiety and stress among HCWs were 19.5%, 20.6%, 11.8%, respectively. Non-frontline group showed a higher prevalence of depression (27% vs. 11%, p<0.001), anxiety (27% vs. 14%, p=0.001) and stress (15% vs. 8%, p=0.026). Being married, having children, living with family and higher income were associated with better psychological outcomes. Perceived lack of personal protective equipment, inadequate support from hospital authorities, greater discrimination, and lack of training to cope with the situation predicted poor mental health outcomes, and non-frontline HCWs were more likely to hold such perceptions. CONCLUSION: Addressing factors leading to negative psychological outcomes in HCWs should be a key concern during this pandemic. KEYWORDS: COVID-19, Mental health, Hhealthcare workers, Frontline, Depression, Anxiety, StressItem Telepsychiatry' in the time of COVID-19: Overcoming the challenges(Wolters Kluwer Medknow Publications, 2020) Perera, S.R.; Gambheera, H.; Williams, S.ABSTRACT: Telepsychiatry, the application of telemedicine in the field of psychiatry is defined as the use of electronic communication and information technologies to provide or support clinical psychiatric care at a distance. COVID 19 and its implications related to physical distancing for patients and service providers has made tele-psychiatry and e-consultations an attractive option. Psychiatry, more than any other field in medicine stands to benefit through tele-psychiatry as a physical examination may not be always necessary to arrive at a diagnosis. Some have gone on to suggest that tele psychiatry is likely to replace in person psychiatric assessments pertaining to certain clinical situations. The article reviews the existing evidence for tele-psychiatry and addresses the challenges and pitfalls in the South Asian context. © 2020 Indian Journal of Psychiatry Published by Wolters Kluwer-Medknow.