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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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 Non-alcoholic fatty liver disease: confronting the global epidemic requires better awareness(Wiley-Blackwell, 2009) de Silva, H.J.; Dassanayake, A.S.No Abstract availableItem Coconut fats(Sri Lanka Medical Association, 2006) Amarasiri, W.A.D.L.; Dissanayake, A.S.In many areas of Sri Lanka the coconut tree and its products have for centuries been an integral part of life, and it has come to be called the "Tree of life". However, in the last few decades, the relationship between coconut fats and health has been the subject of much debate and misinformation. Coconut fats account for 80% of the fat intake among Sri Lankans. Around 92% of these fats are saturated fats. This has lead to the belief that coconut fats are 'bad for health', particularly in relation to ischaemic heart disease. Yet most of the saturated fats in coconut are medium chain fatty acids whose properties and metabolism are different to those of animal origin. Medium chain fatty acids do not undergo degradation and re-esterification processes and are directly used in the body to produce energy. They are not as 'bad for health' as saturated fats. There is the need to clarify issues relating to intake of coconut fats and health, more particularly for populations that still depend on coconut fats for much of their fat intake. This paper describes the metabolism of coconut fats and its potential benefits, and attempts to highlight its benefits to remove certain misconceptions regarding its use.Item Knowledge and awareness about gynaecological cancer(Sri Lanka College of Obstetricians and Gynaecologists, 2003) Padumadasa, S.; Goonewardene, M.INTRODUCTION: Gynaecological cancer (excluding breast cancer) accounts for about 10% of new cancer cases in women and 12% of cancer deaths. lack of awareness is a major factor in women with gynaecological cancer presenting to a doctor late. OBJECTIVE: to assess the knowledge and awareness about gynaecological cancer, SETTING, SUBJECTS AND METHOD: a total of 516 conse¬cutive women who attended the university gynaecology clinic at teaching hospital, mahamodera, galle during august and september 2002 were administered a pretested structured questionnaire. RESULTS: the knowledge about gynaecological cancer presenting as abnormal vaginal bleeding was poor. two-hundred and thirty six (45.8%) women thought that as one approaches menopause, irregular vaginal bleeding was normal. only 185 (35.8%) women knew that post-menopausal bleeding was abnormal. only 163 (31.5%) women knew that post-coital bleeding might be a symptom of cancer. two hundred and forty one (46.7%) women had heard about the cervix. only 89 (17.3%) knew that early marriage was a risk factor for cervical cancer while only 143 (27.7%) knew that multiple sexual partners was a risk factor for cervical cancer. only 27 (5.2%) were aware of the cervical smear. although 363 (70.3%) had heard about hormone replacement therapy (hrt), only 38 (7.4%) knew that there was an association with the occurrence of breast cancer and only 63 (12.2%) knew that there was a high risk of endometrial cancer if used inappropriately. only 134 (26.0%) women had heard about ovarian cancer. CONCLUSION: the knowledge about gynaecological cancer in women attending the university gynaecology clinic was poor. educational programmes in schools and community intervention programmes should be considered to increase the awareness about gynaecological cancer.Item Compliance with the mass chemotherapy program for lymphatic filariasis(Sri Lanka Medical Association, 2001) Kasturiratne, K.T.A.A.; Premaratna, B.A.H.R.; Pathmeswaran, A.; de Silva, N.R.; de Silva, H.J.OBJECTIVE: To evaluate compliance with the single dose mass chemotherapy program for control of filariasis, and to determine factors influencing compliance in the Gampaha district. DESIGN: A prospective study employing a pre-tested self-administered questionnaire. METHODS: Four groups comprising individuals over one year old with residence in the Gampaha district for over one year were surveyed. Data collection was started two weeks after the mass chemotherapy program. RESULTS: 2300 questionnaires were distributed, 1983 (86.2 percent) were returned, and 1935 (84.1 percent) were sufficiently complete for analysis (857 males; mean age 39 years, SD equal 19.5). Over 96 percent had heard of filariasis and the mass chemotherapy program, but only 60.3 percent of those over 11 years of age were aware of asymptomatic carriage of the parasite. 1289 (66.6percent) out of the total sample surveyed (1935 individuals) had obtained the diethylcarbamazine tablets, and 1221 (63.1 percent) had taken the drug. Of the possible demographic factors that could have influenced compliance only educational level seemed to play an independent significant role, compliance being lowest at both extremes of educational level. The main problem with compliance was obtaining the drug from distribution centres. CONCLUSIONS: Compliance with the mass chemotherapy program to control filariasis needs improvement. Strategies should include a better system for distributing the drug, and altering the content of the publicity material used by the program to target less compliant groups, and improve aspects of knowledge regarding filariasis that seem inadequate at present.Item Driving and epilepsy in Sri Lanka(Elsevier-W.B. Saunders, 1998) Seneviratne, S.L.; Gunatilake, S.B.; Adhikari, A.A.D.N.W.; de Silva, H.J.Regulations regarding driving for patients with epilepsy vary from country to country. They are well implemented in developed countries, but this is not the case in countries such as Sri Lanka. The aims of this study were to study characteristics of a cohort of patients with epilepsy who were driving or riding a vehicle at present, and study the attitudes of a representative sample of doctors, patients with epilepsy and the general population regarding aspects of driving by patients with epilepsy. Patients with epilepsy attending the medical clinics at the Colombo North General Hospital, Ragama, who were driving, were given a questionnaire and interviewed in order to assess their seizure characteristics. Another questionnaire was administered to epileptic patients visiting the clinics, a sample from the general population (relatives visiting in-patients at the University Medical Unit selected randomly), doctors working at the General Hospital in Ragama and the Base Hospital in Negombo, and general practitioners in the Gampaha district, where these two hospitals are situated, which was designed to assess their views regarding driving by persons with epilepsy. Of the patients with epilepsy interviewed 24.8% were presently driving a vehicle, of them 51% were riding a motorcycle. The attitudes of the general public and patients to driving by epileptic patients were at opposite ends of the spectrum; 97% of the general public being opposed to driving by persons with epilepsy, while epileptics themselves being of the view that the rules should be lax. Doctors thought that there should be some regulations against driving by epileptic patients. These facts must be considered when setting implementable regulations regarding driving by epileptics in developing countries.Item Use of early aspirin in suspected acute myocardial infarction by General Practitioners in Sri Lanka(Elsevier, 1997) Seneviratne, S.L.; Gunatilake, S.B.; de Silva, H.J.Early low dose aspirin therapy is beneficial in myocardial infarction (MI). This study investigated the use of early aspirin therapy in patients with suspected MI by General Practitioners (GP). Patients with MI who were referred to our unit by GPs were studied to see whether aspirin therapy had been initiated before referral. A questionnaire was sent to GPs to test their attitudes and practices regarding early aspirin therapy in suspected MI. Our results indicate that few patients with MI had been given early aspirin therapy. Only a minority of GPs were aware of the benefits of early aspirin therapy in MI, and very few prescribed it. Even when it was prescribed, the dose and route of administration were wrong in most instancesItem Reporting notifiable diseases: methods for improvement, attitudes and community outcome(Oxford University Press, 1997) Seneviratne, S.L.; Gunatilake, S.B.; de Silva, H.J.Notification is an important source of health information. However, it suffers from the serious limitation of under-reporting, especially in 'third world' countries. The aims of this study were to assess the impact of a special notification nurse and ward notification register on the rate of notification from a general medical unit, the knowledge and attitudes of intern medical officers regarding notification, and the community outcome of notification in a Sri Lankan setting. Overall, appointment of a special nurse improved notification rates from 9.7 percent to 62.1percent, and the addition of a special ward notification register further improved the rate to 95.1 percent The results also indicated that, although a majority of intern medical officers were aware of notifiable diseases and the importance of notification, only a few of them always notified notifiable diseases. One of the main reasons given for this was that the majority of them felt that no useful action was taken on notifications by the preventive health authorities, a view that was held because there was no feedback information regarding the notifications. However, during the period of this study nearly 80 percent of all notifications were successfully investigated by the relevant medical officer of health office. The appointment of a nurse dedicated to notification and introduction of a ward notification register could greatly improve notification rates. Better communication between curative and preventive health sectors would improve attitudes of doctors regarding notification.