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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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 Anal incontinence during postpartum period: a community based cross sectional study(College of Community Physicians of Sri Lanka, 2009) Rajeshkannnan, N.; Pathmeswaran, A.INTRODUCTION: Anal incontinence is regarded as the "unvoiced symptom". It has a negative impact on the quality of life of the sufferer. The commonest cause in women in the reproductive age group is child birth and it is important to determine the burden of anal incontinence and identify possible risk factors in order to improve the quality of intra partum and postpartum care. OBJECTIVE: To determine the frequency and severity of anal incontinence among post partum mothers in Vavuniya district and to identify factors associated with it. METHODS: A community based cross sectional study was conducted. Sample included all mothers (hospital and home deliveries) who had completed postpartum period between 1st August and 30th September 2007. They were identified from the "expected date of delivery" registers maintained by Public Health Midwives (PHMs). Data were collected by trained PHMs at the respondents' houses using an interviewer administered questionnaire. RESULTS: The mean age of the 540 postpartum mothers interviewed was 28 (range: 16 - 44) years. Majority 78 % (n=423) were Sri Lankan Tamils, 13 %(n=68) Sinhalese and remaining 9%(n=49) Moors. Thirty nine percent (n=209) of them were primi parous. Eighty one percent (n=435) had a normal vaginal delivery and 79% (n=344) of them had an episiotomy. Eighty nine mothers complained of anal incontinence giving a prevalence of 16.5% (95% Cl: 13.4 - 19.6). Among them 94.4% (n=84) considered it as a minor problem and only 39.3% (n=35) had consulted a health worker for the symptom. Risk factors for anal incontinence according to descending order of risk included, having an episiotomy (OR= 5.06; 95%CI: 2.60-9.86), vaginal delivery (OR=4.58; 95% Ci: 1.63-12.84), primi parity (OR= 3.45; 95% Cl: 2.25 -5.21), family income above Rs5000/- per month (OR-1.92; 95% Cl: 1.21 - 3.04) and duration of labour (OR= 1.81; 95% Cl : 1.15-2.87) CONCLUSION: Anal incontinence is not an uncommon symptom in postpartum mothers and majority of affected individuals avoid seeking medical attention. Factors associated with increased risk of anal sphincter damage should be considered during delivery and an attempt should be taken to reduce it.Item Knowledge and practices on selected non communicable diseases among GCE Advanced Level students in state schools, Maharagama(College of Community Physicians of Sri Lanka, 2009) Gamage, A.U.; Jayawardana, P.OBJECTIVE: To assess the knowledge on selected non communicable diseases (NCDs) and practices related to prevention of selected NCDs among GCE Advanced Level (A/L) students attending government schools in the Maharagama education division. METHODS: A descriptive cross sectional study was conducted among year 13 students (A/L) attending state schools in Maharagama education division. A total of 634 students were selected from 9 schools which had at least one class in a given stream. Stratified sampling was done according to stream of study and the number needed from each stratum was decided according to probability proportionate to size. Cluster sampling was conducted when the number of classes in each stream was more than one. A self administered questionnaire was used to gather information on socio demographic data, practices, knowledge on NCDs and sources of information. Height and weight measurements were recorded. Each practice was analysed separately, either based on the indulgence or on a cut off score. A composite score of >60% was considered as good overall knowledge. RESULTS: Of the 634 respondents 45.3% (n=287) were males. The mean age was 18.4(SD±0.38) years. Knowledge: The proportion with good overall knowledge was 43% (95%CI: 39%-46.9%) [n=272]. Good overall knowledge was significantly higher among non Sinhalese (88%; n=5) and science stream students (65%; n=85) (p< 0.001). Practices: Proportion of students who had a healthy diet was 43% (n=275) and adequate physical activity was 20% (n=129). Three percent (n=18) were current smokers, all of whom were males and 10% (n=61) of males and 2% (n=12) of females were current users of alcohol. Proportion of females was significantly higher in relation to healthy dietary habits (52.2%; n=181 versus 32.8%; n=94 ), non smoking (100%; n=347 versus 93.7%; n=269) and non alcohol consumption (96.5%; n=335 versus 78.7%; n=226) and males in relation to adequate physical activity (27.5%; n=79 versus 14.4%; n=50). Schools (41%; n=233) were the major source of information on NCDs and preferred sources were healthcare workers (34%; n=201) and schools (32%; n=192). CONCLUSION: Proportion of year 13 A/L students with good knowledge and practices was low and recommend awareness raising programs.