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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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 Psychological stress and associated factors among adults in the quarantine families following COVID-19 in Kurunegala district, Sri Lanka(College of Community Physicians of Sri Lanka, 2021) Rajapaksha, R.M.N.U.; Abeysena, H.T.C.S.; Jayasooriya, S.P; Pushpalal, G.C; Dissasnayake, M.; Wijesingha, S.; Athukorala, P.; de Mel, N.Background: Psychosocial-stress for a newly-emerged contagious-disease of the COVID-19 needs to be evaluated. The aim of the study was to assess the prevalence of psychosocial-stress and associated predictors in the home-quarantine families following the COVID-19 outbreak. Method: A descriptive cross-sectional study was conducted among randomly selected 403 Quarantined adults in Kurunegala district from May to July 2020 during the first wave of the COVID-19 outbreak. The suspected index-cases and known patients with mental-health abnormalities were excluded. The GHQ-30, a validated screening tool, was used to assess psycho-social status. The scores were given as 0-0-1-1 for each item in GHQ30, out of which a score of ≥6 was considered as adults under psychosocial-stress. The binary Probit model and multivariate-regression model were used to assess the associated factors.Results: The response rate was 96.5% (n=389). The prevalence of psychological stress was 37%(n=144; 95% CI = 32.6 – 42.4). The probit model shows the likelihood of influence of the factors affecting the prevalence, and the Odds-Ratio was examined. The multivariate-regression model was 2 significant at F (12, 309) = 3.86, R = 12.95 (n=322). The results of the best fitting regression model th depicted that the associated determinants including arrived in Sri Lanka after 10 of March 2020, within 5 days of exposure to a COVID-19 patient, stayed at a quarantined-centre and male-gender were statistically significant (p<0.05) factors of predicting the psychosocial stress. Conclusion: The prevalence of psychosocial stress among the home-quarantined adults following COVID-19 are significantly high and the factors that determine the stress are likely to occur in the significant predictors.Item Association between childhood constipation and exposure to stressful life events: a systematic review(Blackwell Scientific Publications, 2022) Liyanarachchi, H.; Rajindrajith, S.; Kuruppu, C.; Chathurangana, P.; Ranawaka, R.; Devanarayana, N.M.; Benninga, M.A.BACKGROUND: Several cross-sectional studies have reported an association between childhood constipation and exposure to stressful events. We planned to systematically review the literature on constipation and its associated stressful events. METHODS: PubMed, Embase, and PsycINFO databases were searched (until February 2021) using standard search terms related to "constipation" and "stress" from 0 to 18 years that describe the association between psychological stressors and constipation. Studies were screened using pre-designed eligibility criteria. Studies that fulfilled the criteria were reviewed in a full-text format. The quality assessment of selected articles was conducted using standard methods. KEY RESULTS: Of 2296 titles and abstracts screened, 38 were included in the full-text review. Out of that, 15 articles were included in this systematic review. There were 2954 children with constipation, and the age range was from 6 months to 16 years. Exposure to home-related stressors (divorce or separation of parents, severe illness in family, and parental job loss) school-related stressors (including being bullied at school, change in school, separation from the best friend at school, and failure in an examination), exposure to child maltreatments and exposure to war/civil unrest were associated with childhood constipation. CONCLUSIONS AND INFERENCES: Exposure to day-to-day home- and school-related stressors, to child maltreatment, and to civil unrest is associated with constipation in children and adolescents. These factors need to be explored during clinical evaluation of children with constipation. KEYWORDS: adolescents; child maltreatment; children; civil unrest; constipation; stress.Item The Association between adverse life events and abdominal pain-predominant functional gastrointestinal disorders.(Lippincott Williams & Wilkins, 2015) Devanarayana, N.M.; Rajindrajith, S.; Benninga, M.A.BACKGROUND: Abdominal pain-predominant functional gastrointestinal disorders (AP-FGIDs) are a common public health problem in children. The precise aetiology of AP-FGIDs is far from clear. Psychological stress and all forms of child abuse are known predisposing factors to develop AP-FGIDs. The main objective of this study is to study the association between adverse life events (ALEs) and development of AP-FGIDs. METHODS: A cross sectional, school based study was conducted in Gampaha district of Sri Lanka. All children aged 13-18 years were recruited from four randomly selected semi-urban schools in the district after obtaining consent from parents, school administration and children themselves. A translated and validated, self-administered questionnaire consisting of four parts was used for data collection. Part I was the Rome III questionnaire for functional gastrointestinal disorders, self-report form for children above 10 years. Part II was a questionnaire on exposure to adverse life events. Part III was the Sinhala (the native language) version of the PedsQL, Pediatric Quality of Life Inventory 4.0 (Generic Core Scales). Part IV was the Child Somatization Inventory. The questionnaire was administered under examination setting to ensure confidentiality and privacy. Research assistant were present during filling the questionnaire for provide assistance and verifications. AP-FGIDs were defined using the Rome III criteria. RESULTS: A total of 1792 children were included in the analysis (males 975 [54.4%], mean age 14.4 years, SD 1.3 years years). Out of them, 305 (17.0%) had AP-FGIDs. ALEs that showed a significant association with AP-FGIDs include, parental substance abuse (25.1% vs. 16.0% in controls, p = 0.015) and domestic violence (28.5% vs. 16.1%, p = 0.02). Children with AP-FGIDs exposed to ALEs have a higher somatization index compared to children not exposed to ALEs (16.9 vs. 13.4, p = 0.003), and a lower overall health-related quality of life (HRQoL) score (81.8 vs. 85.1, p = 0.02). The scores they obtained for psycho-social (86.4 vs. 92.4, p < 0.0001) and emotional (72.5 vs. 77.7, p = 0.03) domains of the HRQoL were also lower than that of children with no such experiences. CONCLUSIONS: Exposure to ALEs predispose children to develop AP-FGIDs. Experience of childhood ALEs deleteriously affects the HRQoL and somatization of children with AP-FGIDs.Item Abnormal personality traits in children with aerophagia(Lippincott Williams & Wilkins, 2015) Devanarayana, N.M.; Jayawickrama, N.; Gulegoda, I.C.; Rajindrajith, S.OBJECTIVE: The main objective of this study is to study the personality types in children with aerophagia. METHODS: A cross sectional survey was conducted in 8 randomly selected schools in 4 randomly selected provinces Sri Lanka. From each school, all children aged 13-18 years were selected after obtaining written consent from parents, school administration and provincial education office. Assent was obtained from all children recruited. Date were collected using a self-administered questionnaire administered under examination setting to ensure confidentiality and privacy. Questionnaire contained previously translated and validated Rome III questionnaire for functional gastrointestinal diseases (self-administered form for children above 10 years) and childhood personality assessment questionnaire. Trained research assistants were present during filling the questionnaire to provide assistance and to verify doubts. Aerophagia was defined using the Rome III criteria. Severities of individual symptoms were recorded in 100 mm visual analogue scale. RESULTS: A total of 1069 questionnaires were distributed and all of them were returned and included in analysis [males 508 (47.5%), mean age 15.3 years, SD 1.8 years years]. One hundred and thirty six (12.7%) fulfilled Rome III criteria for aerophagia and 933 children without aerophagia were considered as controls. Nineteen (13.8%) children with aerophagia and 71 (7.6%) controls had personality scores above the international cut-off value (105) for abnormal personality (p = 0.01). Children with aerophagia had significantly higher scores for different personality traits than controls; including hostility and aggression (13.2 vs. 12.2 in controls, p = 0.006), negative self-esteem (11.0 vs. 9.9, p < 0.0001), negative self-adequacy (10.6 vs. 9.6, p = 0.001), emotional unresponsiveness (10.5 vs. 9.6, p < 0.0001), emotional instability (16.9 vs. 15.7, p < 0.001), negative world view (10.9 vs. 10.1, p = 0.02) and total personality score (92.1 vs. 87.7, p = 001). In children with aerophagia, scores obtained for severity of bloating correlated with scores obtained for hostility and aggression (r = 0.22, p = 0.02). CONCLUSIONS: Children with aerophagia has abnormal personality traits and this fact may at least partly responsible for development and perpetuation of symptoms in them.Item Aerophagia in children is associated with emotional ill-treatment.(Lippincott Williams & Wilkins, 2015) Rajindrajith, S.; Silva, R. L.; Devanarayana, N.M.BACKGROUND: Aerophagia is a functional gastrointestinal disease characterized by air swallowing, abdominal distension, excessive flatus and belching. The aetiology of this disorder is not clear. Previous studies have suggested an association between aerophagia and psychological stress. We aimed to assess the association between emotional ill-treatment and aerophagia. METHODS: A cross sectional survey was conducted in 4 provinces of Sri Lanka. Children aged 13-18 years were selected from schools in these provinces. A validated, self-administered questionnaires were used for collect data on functional gastrointestinal disease including aerophagia and emotional ill-treatment. Aerophagia was defined using the Rome III criteria. RESULTS: A total of 1069 questionnaires were included in the final analysis (males 508 [47.5%], mean age 15.3 years, SD 1.8 years). One hundred and thirty six (136) children had aerophagia. Prevalence of aerophagia was significantly higher in children who experienced emotional ill-treatments (43 (23.2%) vs. 160 (17.1%), p < 0.0001). Emotional ill-treatments that were significantly associated with aerophagia include, teasing by others (54.1% vs. 45.0%, p < 0.0001), humiliation (38.2% vs. 20.3%, p < 0.0001), treating inferiorly by others (22.8% vs. 11.1%, p < 0.0001), threatening to abandon (8.8% vs. 2.6%, p < 0.0001), threatening destroy belongings (14.0 vs. 4.5%, p < 0.0001), and forcing to do unwanted deeds (9.6% vs. 3.9, p = 0.003). Parenting factors such as refusal of attending to emotional needs (8.8% vs. 3.0%, p < 0.001), refusal to look at (6.6% vs. 0.7%, p < 0.0001), refusal of hugging (10.5% vs. 5.6%, p = 0.03), and not appreciating achievements (5.9% vs. 2.1%, p < 0.0001) were significantly common among children with aerophagia. CONCLUSIONS: Aerophagia in children is associated with emotional ill-treatments. Attending to child's emotional needs likely reduce the prevalence of aerophagia and its consequences.Item Psychological distress among university students(Sri Lanka Medical Association, 2002) Kuruppuarachchi, K.A.L.A.; Williams, S.S.Comment on; Psychological distress among university students, Ceylon Med J. 2002 Jun;47(2):74-5. No Abstract Available