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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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 Follow-up of patients with stroke(Sri Lanka Medical Association, 2003) Gunatilake, S.B.; Karunaratne, A.; Gnanathilake, G.K.; Silva, H.K.M.S.BACKGROUND: Stroke is the commonest cause of adult disability. Information about the long-term outcome following a stroke is important for planning rehabilitation services. No long-term follow up studies looking at prognosis are available from Sri Lanka. Aims: To study the follow up pattern of a cohort of stroke patients admitted to hospital. METHODS: We planned a follow up assessment of all first-ever stroke patients admitted to the University Medical Unit in the North Colombo Teaching Hospital. This is an on-going study and was started on August 15, 2001. Validated Rankin Disability scale was used to grade the disability of patients at the time of discharge, and at follow-up. Follow-up defaulters were contacted by telephone or letter. This paper presents the data on the follow-up of the first 100 patients. RESULTS: During the period between August 15, 2001 and November 15, 2002, 152 patients with stroke were admitted. Of the first 100 patients all have completed six months after the stroke and of them 14 have died, and 58 have attended the six-month follow up with 28 defaulting. At discharge from hospital 34 were having minor or no disability (group 1) and 61 were having moderate or severe disability (group 2). Of the. 58 who attended the six-month follow up 44 were in group 1 and 14 were in group 2. Of the defaulters 7 were in group 1 and 21 were in group 2. Six-month follow-up rate was 72%. CONCLUSIONS: Follow up rate was inadequate despite incentives given to attend. 14 of the patients came for follow up despite a severe disability. Of the 28 defaulters 21 had a severe disability at discharge and only six were from remote areas. Reason for default is not clear from our study.Item Stroke patient's knowledge about stroke(Sri Lanka Medical Association, 2001) Gunatilake, S.B.; Biyanwila, C.; Liyanage, B.BACKGROUND: Little is known about stroke patient's general knowledge about stroke symptoms, risk factors, pathology and available treatments. This information is important for implementation of preventive programs. OBJECTIVE: This study attempts to determine the knowledge of stroke patients about the illness after they were discharged from hospital. METHODS: Consecutive patients attending the outpatient clinics following discharge from hospital after a first-ever stroke were included in the study. A structured, standardised interview using a questionnaire was performed by two doctors. Age and sex matched patients attending the clinic for non-vascular illnesses were used as a control group. RESULTS: During a period of two months 48 patients were recruited. Of them 17 had been educated upto GCE ordinary level. All 48 patients knew of at least one stroke symptom and over 90% knew that paralysis, speech disturbance and walking difficulty are stroke symptoms. Only 20 (42%) knew that the primary organ involved was the brain and of them only five knew that a stroke is due to thrombosis or haemorrhage. Thirteen patients (27%) were not aware of any risk factors and 33 (73%) knew that hypertension is a risk factor. Smoking was identified as a risk factor by 21 (44%), but 29 (60%) didn't know that stopping smoking reduces the stroke risk. Only 30 patients (62%) knew that stroke can be prevented and 37 (77%) said that stroke is an emergency. All except four patients had sought medical advice the same day. CONCLUSIONS: Our patients have a good knowledge of stroke symptoms and seek medical advice early. Awareness of risk factors are average but the knowledge about the organ involved and the pathology was poor.