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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty

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    Telehealth services for children with neuro-developmental disabilities in the Asia-Pacific region: A systematic review
    (Oxford, 2024) Devagiri, B.; Ariyasena, A.D.K.; Siriwardhana, D.D.; Sumanasena, S.
    BACKGROUND: In recent years telehealth became a popular and a rational health service delivery approach, especially amidst multiple challenges posed while providing health care interventions during the COVID-19 pandemic. AIM: We synthesized available evidence on telehealth for managing children with NDDs in the Asia-Pacific region with the aim of identifying successful methods. METHODOLOGY: We systematically reviewed six electronic databases: MEDLINE, AMED, EMBASE, PsychInfo, Web of Science, and (CINAHL plus) using the keywords and database-specific subject headings from their inception to 25th August 2021. Review findings were synthesized narratively, and harvest plots were used to demonstrate the effect of interventions. The protocol and reporting the findings of this review adhered to PRISMA 2020 guidelines. PROSPERO registration: CRD 340690. RESULTS: We harvested 30,823 records; 17,563 duplicates were removed, and 196 full-text articles were assessed for eligibility. 16 studies with multiple research designs were included in the review. Eight were from the Pacific region and eight represented Asia. The interventions targeted families and children with a variety of NDDs (autism spectrum disorder, Down syndrome, cleft lip and palate, hearing impairment, cerebral palsy etc.) via telehealth. Telehealth packages consisted of direct and indirect methods of synchronous, asynchronous, and hybrid approaches. All studies used parent-led intervention strategies. Telehealth reported a positive effect in 7/16 studies while five showed a neutral effect. CONCLUSIONS: According to published evidence telehealth for children with NDDs is an evolving, evidence-based service facilitation modality in the Asia-Pacific region, with only a few published randomized controlled trials. The systematic review shows promising telehealth practices emerging across the region despite the diversity in NDDs studied.
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    Translation and cross-cultural adaptation of the quantitative checklist for autism in toddlers parental questionnaire into Sri Lankan tamil language
    (University of Kelaniya, Sri Lanka, 2022) Thevathasan, M.; Danthanarayana, N.D.; Yahampath., N.
    Background: The Quantitative Checklist for Autism in Toddlers (Q-CHAT) is a parent-report screening tool to detect autism spectrum disorder (ASD) symptoms in toddlers aged between 18-24 months. Early detection of ASD increases the chance of receiving timely intervention. The parent report questionnaire is a good way to screen for ASD. The Q-CHAT is a novel screening tool that has demonstrated to have various benefits over conventional screening techniques, because there is a lack of screening tools for the early screening of ASD traits in the Sri Lankan Tamil clinical context. Objectives: The objectives of this study were to translate and cross-culturally adapt the Quantitative Checklist for Autism in Toddlers Parental questionnaire into the Sri Lankan Tamil language. Methods: At the initial step of this study, the Delphi study design was used to translate and cross-culturally adapt into the Sri Lankan Tamil language and a cross-sectional study conducted for psychometric evaluation. Following this, an appropriate sample was selected, which included 30 typically developing Tamil speaking toddlers aged between 18-24 months and 30 ASD Tamil speaking toddlers aged between 18-24 months. Cronbach’s alpha coefficient was used to evaluate the internal consistency of the Tamil version of the Q-CHAT questionnaire. Furthermore, the Mann-Whitney U test was used to investigate whether the Tamil version of the Q-CHAT can adequately discriminate between typically developing toddlers and toddlers with ASD. Spearman’s’ rho correlation coefficient test was used to analyse the correlation between the background variables of toddlers with ASD and the Q-CHAT scores. Results: The typically developing group consisted of 30 toddlers with the mean age of 20.17 (SD=1.44) months and the ASD group included 30 toddlers with the mean age of 20.93 (1.05) months. The mean Q-CHAT score of the typically developing toddlers was 21.23 (SD=7.59) and the mean Q-CHAT score of toddlers with ASD was 53.30 (SD=6.88). The Cronbach’s alpha coefficient for the ASD group and the normative group was 0.64 and 0.07 respectively, which indicated poor reliability. Although the translated and adapted Q-CHAT had poor reliability, it can discriminate between the typically developing toddlers and toddlers with ASD since there was a statistically significant difference in Q-CHAT scores between the two groups. Conclusion: The Tamil version of the Q-CHAT has discriminative ability, and it can be used as a screening tool for detecting children who are at risk of autism. Further validation studies with large samples are required.
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    A Comparative study on medical comorbidities among children with autism spectrum disorder and controls in a children’s hospital.
    (Sri Lanka College of Paediatricians, 2017) Chandradasa, M.; Rohanachandra, Y.; Dahanayake, D.; Hettiarachchi, D.; Gunathilake, M.; Fernando, R.; Wijetunge, S.
    INTRODUCTION: Autism spectrum disorder (ASD) is a neurodevelopmental disorder, in which medical disorders are known to occur higher than in the general paediatric population. This may indicate either that the neurodevelopmental disorder is acting as a risk factor or sharing a common pathophysiological mechanism with the medical disorder. We could not access any publications focusing on medical comorbidities in autism from Sri Lanka. OBJECTIVE: To compare the prevalence and types of medical comorbidities between children with ASD and outpatient controls presenting to a children’s hospital in Sri Lanka. METHOD: This was an observational analytical study using a case control design. Seventy three consecutive new enrolments diagnosed as ASD at the child psychiatric services of Lady Ridgeway Hospital were recruited to the study group. An age and gender matched group of children presenting to the outpatient department with minor physical problems were recruited as the comparison group. The presence of a medical disorder was determined retrospectively by perusal of medical records. RESULTS: The prevalence of febrile seizures, epilepsy, bronchial asthma, atopic dermatitis and recurrent gastrointestinal symptoms in the child were higher in the ASD group compared to the control group. The differences of the rates between groups for bronchial asthma and recurrent gastrointestinal symptoms were statistically significant. Also, pregnancy induced hypertension and gestational diabetes mellitus in the mother was higher in ASD group. CONCLUSIONS: The probability of co-occurrence of certain medical disorders is significantly higher in children with ASD (neurological, respiratory, gastrointestinal and dermatological disorders) in comparison to controls.
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