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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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 Associations between ADHD symptoms and maternal and birth outcomes: An exploratory analysis in a multi-country cohort of expectant mothers(SAGE Publications, 2022) Murray, A.L.; Taut, D; Baban, A.; Hemady, C.L.; Walker, S.; Osafo, J.; Sikander, S.; Tomlinson, M.; Toit, S.D.; Marlow, M.; Ward, C.L.; Fernando, A.; Madrid, B.; Van, T.V.; Tuyen, H.D.; Dunne, M.; Hughes, C.; Fearon, P.; Valdebenito, S.; Eisner, M.OBJECTIVE: ADHD symptoms can adversely impact functioning in a range of domains relevant for maternal well-being and fetal development; however, there has been almost no research examining their impact during pregnancy. We aimed to address this gap. METHOD: We used data (n = 1,204) from a longitudinal birth cohort study spanning eight countries to address this gap. RESULTS: ADHD symptoms in the third trimester of pregnancy were associated with lower social support from family (b = -0.16, p = .031), friends (b = -0.16, p = .024), and significant others (b = -0.09, p = .001); higher stress (b = 0.34, p < .001) and depressive symptoms (b = 0.31, p < .001), and increased likelihood of an unwanted pregnancy (b = 0.30, p = .009). Significant associations with tobacco use (b = 0.36, p = .023) and premature birth (b = 0.35, p = .007) did not survive correction for multiple comparisons and there were no significant associations with alcohol use, low birth weight, or unplanned pregnancy. CONCLUSION: Results suggest that women with ADHD symptoms could benefit from earlier, more regular screening for mental health difficulties and greater mental health support during pregnancy.Item A Cross sectional survey of adherence, perceived efficacy and side effects of methylphenidate among children at a teaching hospital in Sri Lanka(Sri Lanka College of Psychiatrists, 2018) Jayamaha, G.; Perera, W.M.T.M.; Herath, T.A.; Rodrigo, A.INTRODUCTION:Attention deficit hyperactivity disorder (ADHD) is the most commonly diagnosed psychiatric condition in childhood, which if untreated may have a negative effect on education, peer relationships and family disharmony. Methylphenidate is an effective treatment for ADHD, although its use is limited by poor compliance and side effects. Studies on effects of side effects on efficacy, and adherence of methylphenidate in developing countries are scarce. METHODS: We assessed the adherence, efficacy, and side effects of methylphenidate in children and adolescents treated at a child and adolescent psychiatry clinic of North Colombo Teaching Hospital, Ragama. We gathered information from guardians of the children treated with methylphenidate for at least 2 months, using an interviewer administered questionnaire. RESULTS: Among the 149 participants, a majority were males and the mean age of the population was 10.4 years. More than 52% participants reported 100% compliance with methylphenidate, but only 12% complied with non-pharmacological therapies. While 75% believed the medication to be effective, only 17% perceived psychosocial strategies to be useful. Poor appetite (44%) was the most common side effect of methylphenidate and 43% did not report any side effect. There was a negative correlation between compliance with methylphenidate and the occurrence of poor appetite, as well as with not increasing the initial dose. DISCUSSION: The results of this study suggest that methylphenidate is an effective and well-tolerated treatment for children in Sri Lanka with ADHDItem The Knowledge and attitude of primary school teachers in Sri Lanka towards childhood attention deficit hyperactivity disorder(Sri Lanka Medical Association, 2011) Rodrigo, M.D.A.; Perera, D.; Eranga, V.P.; Williams, S.S.; Kuruppuarachchi, K.A.L.A.OBJECTIVE: To assess the knowledge and attitudes towards attention deficit hyperactivity disorder (ADHD) among primary school teachers in the Gampaha District. METHODS: A descriptive cross sectional study was conducted in randomly selected schools of Gampaha district using a stratified sampling method. The knowledge and attitudes on ADHD were assessed by a self-administered questionnaire distributed among all the consenting primary school teachers in the selected schools. RESULTS: Total of 202 completed questionnaires of 210 distributed were returned. The majority showed good understanding about ill effects of ADHD, teachers' role in management and counterproductive effects of punishment. Three-fourths had a positive attitude towards behavioural therapy. However, only a minority had adequate knowledge about the presentation of ADHD and its treatment with medication. More than 80% of teachers believed that the parents were to be blamed for the child's ADHD. The majority of participating teachers also believed that behavioural disturbances caused by ADHD children were deliberate and malicious. Teachers who had training in child psychology recorded a significantly higher knowledge and had a more favourable attitude. CONCLUSIONS: The knowledge of ADHD and its treatment among primary school teachers needs to be improved. Particular focus should be on improving attitudes and disseminating the message that timely interventions can make a difference in the educational and social development of the child.