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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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 Approach to study the efficacy and safety of new complementary and alternative medicine formulations: Lesson during COVID-19 from Sri Lanka(Wolters Kluwer - Medknow, 2023) Pilapitiya, S.; Jayasinghe, S.; Silva, A.; Wickremasinghe, R.; Paranagama, P.; de Silva, J.; Lekamwasam, S.; Kularatne, S.A.M.; Wanigasuriya, K.; Kaluthota, S.; Sumathipala, S.; Rathnnasooriya, C.; Siribaddana, S.COVID-19 affected Sri Lanka from early 2020, a time of considerable ignorance accompanied by wide media coverage of a devastating epidemic in Italy and Europe. Many were attracted to complementary and alternative medicine (CAM) or traditional medicine (TM) in this desperate situation. Several preparations were claimed to be effective against COVID-19 globally. Dammika Bandara Syrup© was one such preparation promoted for preventing and treating SARS-CoV-2 infection. It was based on bees' honey, pericarp and mace of Myristica fragrans (nutmeg), the seed of Foeniculum vulgare and fresh rhizome of Zingiber officinale, all believed to have anti-viral properties. Following an unpublished clinical study claiming efficacy, Dammika Bandara Syrup© gained wide media publicity and political patronage. The producer claimed of Goddess Kali revealing the formula added an anthropological, cultural, and religious complexity to the issue. The demand for the product increased rapidly as a debate raged both in public and in the parliament on utilizing such products in combating COVID-19. The Department of Ayurveda, which is statutorily responsible for regulating CAM/TM had to respond to the situation. The legislation to regulate such indigenous medicinal products was weak, and the crisis deepened as thousands converged to the production facility, defying mobility restrictions introduced to control COVID-19. This led to the Ministry of Health requesting academics to form a team and conduct a clinical trial to prove its efficacy. This paper outlines the process and issues faced during the regulatory approval for the trial in a polarized political environment. Some health professionals accused the researchers of bowing to political pressure and questioned the scientific justification for the trial. However, the team considered this as an opportunity to streamline a path for research into CAM/TM therapies in situations such as COVID-19. Several processes were identified and addressed, such as the provisional registration of CAM preparations, assessing the potential efficacy of a CAM product, confirmation of authenticity and safety, standardization and supervision of production respecting cultural identities, obtaining approval for human use, choice of comparators, and ethical issues. We believe the study has helped set standards and a benchmark for CAM and TM research in Sri Lanka.Item Perceived impact of the COVID-19 pandemic on psychiatric training among final-year medical undergraduates in Sri Lanka: an online survey of students from eight universities(American Psychiatric Press, 2022) Baminiwatta, A.; Dayabandara, M.; de Silva, J.; Gadambanathan, T.; Ginige, P.; Premarathne, I.; Rajapaksha, H.; Wickramasinghe, A.; Sivayokan, S.; Wijesinghe, C.Objective: This study aimed to assess the perceived impact of the COVID-19 pandemic on undergraduate psychiatry training in Sri Lanka and to explore several potentially associated factors. Methods: An online survey was distributed among students from eight medical schools who recently faced their final exam. Their perceptions on the impact of the pandemic on the psychiatry training and exam performance were rated on a 10-point scale. Resilience was assessed using a two-item scale. Results: A total of 644 students responded (69.5% female, mean age=27.5 years). Among them, 164 (25.5%) reported being quarantined; 25 (4%) reported becoming infected with COVID-19; and 170 (28.6%) reported ward closure for over a week during the clerkship. Greater impact was reported for patient availability (mean=7.08), mental status assessments (mean=6.3), developing rapport (mean=6.2), and diagnostic skills (mean=5.9), whereas the impact on peer-learning (mean=5.5) and self-study (mean=3.6) was relatively lower. Impact on clinical components of the final exam (mean=6) was rated higher than on theory components (mean=4.5). The majority (70.3%) reported that COVID-19-related stress affected their exam preparations. Higher resilience predicted lower perceived impact on all aspects of training/exam performance. Female gender and ward closure predicted greater impact on diagnostic skills, overall training, and clinical exam performance, whereas being quarantined predicted greater impact on peer-learning and self-study. Conclusion: The pandemic has significantly affected the undergraduate psychiatry training in Sri Lanka, particularly its clinical components. Increasing clinical exposure to patients, managing students' stress, and building their resilience should be key concerns for medical educators during the pandemic.