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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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 Delayed psychological morbidity associated with snakebite envenoming(Public Library of Science, 2011) Williams, S.S.; Wijesinghe, C.A.; Jayamanne, S.F.; Buckley, N.A.; Dawson, A.H.; Lalloo, D.G.; de Silva, H.J.INTRODUCTION: The psychological impact of snakebite on its victims, especially possible late effects, has not been systematically studied. OBJECTIVES: To assess delayed somatic symptoms, depressive disorder, post-traumatic stress disorder (PTSD), and impairment in functioning, among snakebite victims. METHODS: The study had qualitative and quantitative arms. In the quantitative arm, 88 persons who had systemic envenoming following snakebite from the North Central Province of Sri Lanka were randomly identified from an established research database and interviewed 12 to 48 months (mean 30) after the incident. Persons with no history of snakebite, matched for age, sex, geograpical location and occupation, acted as controls. A modified version of the Beck Depression Inventory, Post-Traumatic Stress Symptom Scale, Hopkins Somatic Symptoms Checklist, Sheehan Disability Inventory and a structured questionnaire were administered. In the qualitative arm, focus group discussions among snakebite victims explored common somatic symptoms attributed to envenoming. RESULTS: Previous snakebite victims (cases) had more symptoms than controls as measured by the modified Beck Depression Scale (mean 19.1 Vs 14.4; p<0.001) and Hopkins Symptoms Checklist (38.9 vs. 28.2; p<0.001). 48 (54%) cases met criteria for depressive disorder compared to 13 (15%) controls. 19 (21.6%) cases also met criteria for PTSD. 24 (27%) claimed that the snakebite caused a negative change in their employment; nine (10.2%) had stopped working and 15 (17%) claimed residual physical disability. The themes identified in the qualitative arm included blindness, tooth decay, body aches, headaches, tiredness and weakness. CONCLUSIONS: Snakebite causes significant ongoing psychological morbidity, a complication not previously documented. The economic and social impacts of this problem need further investigationItem Post-traumatic stress in former Ugandan child soldiers(Lancet Publishing Group, 2004) Kuruppuarachchi, K.A.L.A.; Wijeratne, L.T.No Abstract Available.Item Conscription of children in armed conflict - a form of child abuse: a sudy of 19 former child soldiers(Wiley, 2001) de Silva, D.G.H.; Hobbs, C.J.; Hanks, H.Armed combat in childhood is a form of child abuse. It may lead to serious consequences, including post-traumatic stress disorder. The inherent emotional abuse and acts or omissions by caregivers may cause behavioural, cognitive, emotional or mental disorder in the child. Nineteen former child soldiers were interviewed in a rehabilitation centre using a standard questionnaire. Reasons for recruitment included: volunteered (18), hatred of enemy (revenge) (5), virtue of being a freedom fighter (martyrdom) (9), as a means of supporting their family (economic) (3). One child was abducted, 7 joined for fear of the ‘enemy’ abducting them, and in 5 a family member was killed by ‘enemy’ or own group. The children were involved in manual labour (15), guard duty (15), front-line fighting (7), bomb manufacture (5), setting sea/land mines (5) and radio and communication (2). Fifteen were trained in firearms and 14 in self-destruction. Twelve children attempted to or did run away and 11 refused to obey orders or argued. This led to various punishments, including kitchen duty, beatings, imprisonment, blackmail or death threats. A majority of the children felt sad and emotionally upset when they remembered their mother and family. Children's involvement in war, whatever the ‘justifications’ may be, should always be considered as forced, as they cannot truly comprehend their action in war. The responsibility must be taken by the adult caregivers. The following definition of the abuse of children in armed conflict is proposed: ‘The involvement of dependent, developmentally immature children and adolescents in armed conflict they do not truly comprehend, to which they are unable to give informed consent, and which adversely affects the child's right to unhindered growth and identity as a child’. Firm international agreement on guidelines for the lower age limit of recruitment of children into armed forces is required.Item Post-traumatic stress disorder after watching violent scenes on television(Sri Lanka Medical Association, 2000) Kuruppuarachchi, K.A.L.A.; Williams, S.S.; Gadambabathan, T.Case studies of 1) a 9 year old boy who became extremely fearful and lost interest in his school work after watching a stressful event on TV. 2) a 5 year old girl who became fearful and withdrawn, had nightmares after watching a similar event on TV. Post traumatic stress disorder is an intense prolonged and sometimes delayd reaction to extremely stressful events, characterised by persistent hyperarousal, re-experiencing of images of the event and avoidance of reminders.