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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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 Retinoblastoma patients treated in Sri Lanka from 2014 to 2020: epidemiology, clinical status and correlates of lag time in seeking tertiary care services(BioMed Central, 2024) Kugalingam, N.; De Silva, D.; Abeysekera, H.; Nanayakkara, S.; Tirimanne, S.; Chandrasekharan, V.; Jayawardana, P.L.BACKGROUND Retinoblastoma (RB) is a tumour of children < 5 years with a incidence of 1 in 20,000. Around 20 RB cases are diagnosed yearly in Sri Lanka, a lower middle-income country with high literacy levels and healthcare free at point of delivery. Incidence, local and systemic severity and mortality related to RB are reportedly high in low- and middle- income countries in comparison to higher income countries. Aims of this study were to describe demographic, socioeconomic, and clinical characteristics of Sri Lankan RB patients attending the designated RB unit at the Lady Ridgeway Hospital (LRH), Colombo between January 2014 to December 2020, and determine correlates of lag time (LT) for first tertiary care visit after detecting the first symptom/sign.METHODS Two descriptive cross-sectional studies (DCSS) were conducted, one on 171 RB patients with demographic and clinical data collected between 2017 and 2020. In 2021, the second DCSS took place where socioeconomic and further demographic data were collected using telephone interviews, recruiting a subgroup of 90 (53%), consenting and contactable RB patient/ parent pairs. Bivariate and multivariable analyses were applied to determine correlates of LT of > 4 weeks for first tertiary care visit. Results were expressed as odds ratios and 95% confidence intervals.RESULTS LRH survey (N = 171): Median age at diagnosis was 15 months (range 1-94 months; IQR: 8-27); 89 (52%) were females. Groups D and E tumours were 25.7% (n = 44) and 62.6% (n = 107) respectively with 121 (71%) enucleations. The number of deaths were 2 (1.2%). Telephone survey (N = 90): Proportion with LT of > 4 weeks for first tertiary care visit was 58% (n = 52). None of the putative risk factors (ethnicity, parental educational level, socioeconomic status, distance from residence to tertiary care unit and receiving financial assistance) were associated with LT in both analyses.CONCLUSION Despite a high proportion with groups D and E tumours and enucleations, mortality rate was low, most likely due to availability of designated tertiary care. No correlates for LT of > 4 weeks for tertiary care presentation were identified. Early RB detection needs rigorous implementation of screening strategies and increased awareness among primary care health workers and parents.Item Mortality in an urban cohort in Ragama, Sri Lanka(BMJ Publishing Group, 2011) Vithanage, P.V.T.S.; Panapitiya, P.A.S.; Padmakumara, N.; Hemantha, S.; Kasturiratne, K.T.A.A.; Wickremasinghe, A.R.; Pathmeswaran, A.; Pinidiyapathirage, M.J.INTRODUCTION: The leading causes of mortality in Sri Lanka are due to chronic diseases. We describe the mortality patterns in a 35–64-year-old urban cohort resident in Ragama, Sri Lanka and followed over 3 years. METHODS: A follow-up study was conducted among 2986 35–64 year olds randomly selected from the Ragama Medical Officer of Health area, Sri Lanka. A baseline survey was conducted from January to September 2007 and a follow-up survey was conducted from March to November 2010. Mortality data were obtained from next of kin and cause of death was verified from death certificates. RESULTS: There were 49 deaths during 9186.46 person years of observations. Of the 49 deaths, 11 were due to myocardial infarctions, 5 were due to strokes, 5 were due to other ischaemic heart disease and the rest included 6 due to cancer and 2 due to train accidents. The increase in mortality in men occurs after 45 years and in females it is observed later on. Mortality among men was more than twice as much as females (RR 7.96 vs 3.17 per 1000 person years). All cause mortality was significantly higher in diabetics. Mortality was not associated with hypertension, dyslipidaemia, smoking, central obesity, obesity or physical activity. Conclusions Diabetes Mellitus was significantly associated with all cause mortality. Other associations may have not been significant due to the small number of deaths.