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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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 Study on victims of child abuse: A study conducted in two teaching hospitals in Sri Lanka(College of Forensic Pathologists of Sri Lanka, 2021) Dharmadasa, L.S.; Kitulwatte, I.D.G.; Priyanath, D.C.; Gunathilaka, M. A.C.; Silva, L.S.K.D.; Kumari, M.K.J.K.INTRODUCTION: Child abuse is a global public health problem and proper intervention strategies need a greater understanding of risk factors that can contribute to it. This study was conducted in order to identify the undetected contributory factors that lead to child abuse cases. METHODOLOGY: All children (less than 18 years of age) who were brought for medico legal examination with alleged abuse to two reputed teaching hospitals during a period of 1 and ½ years were included. Required details were obtained through an interviewer administered questionnaire after obtaining the consent. RESULTS: Out of the 186 children, more than 80% presented following sexual abuse and the majority (n=173) were females. Further, n=118 (75%) of the victims of child sexual abuse were between the age group of 13 to 15 years. Moreover, 75% of the victims of sexual abuse were from low income families. Parents of 100% of the victims of physical abuse and 60% of the victims of sexual abuse had educational qualifications below ordinary level. 82% of the victims of physical abuse were having dysfunctional family background, specially use of ethanol by parents (65%). Parental separation was the form of family dysfunction that was associated with sexual abuse. Conclusion: Poor income, poor parental education and dysfunctional family background could be identified as predisposing factors for child abuse. However, the association of these factors vary with different types of child abuse, thus preventive strategies should be planned accordingly.Item Physical, sexual and emotional abuse during childhood: Experiences of a sample of Sri Lankan young adults(Elsevier Science Inc, 2018) Chandraratne, N.K.; Fernando, A.D.; Gunawardena, N.Abuse during childhood is a human tragedy leading to lifelong adverse health, social, and economic consequences for survivors. This descriptive, cross-sectional study aimed to determine the prevalence of childhood physical, sexual and emotional abusive experiences among students (aged 18-19 years) in a Sri Lankan district. Multistage cluster sampling was used to select a sample of 1500 students. Experiences of physical, sexual and emotional abuse and age at abuse, perpetrators, consequences and severity were assessed using a version of ISPCAN Child Abuse Screening Tool-Retrospective Version (ICAST-R) which was culturally adapted and validated by the authors for use amongst Sinhalese students. The prevalence of the various forms of abuse during childhood was as follows: physical: 45.4% (95% CI: 42.9-7.9); sexual: 9.1% (95% CI: 7.6-10.5); emotional: 27.9% (95% CI: 25.7-30.2). The corresponding percentages of individuals categorized as having experienced severe or very severe abuse were as follows, physical: 0.3% (2/672); sexual: 4.05% (3/135); emotional: 8.8% (36/412). Experience of physical abuse was more prevalent amongst male students (54.8% vs. 38.3%) as was emotional abuse (33.9% vs. 23.2%), whereas experience of sexual abuse was more prevalent amongst female students (11.5% vs. 6.4%). Parents and teachers were the commonest perpetrators of physical and emotional abuse. Most of the sexually abusive acts were committed by neighbors or strangers. Some physically abusive acts were more frequent at earlier ages than emotional and sexual abusive acts, which were more common in late adolescence. The results indicate the necessity of targeted interventions to address this public health issue.Item Child abuse and abdominal pain - Is there an association?(Sri Lanka Medical Assosiation, 2012) Devanarayana, N.M.; Rajindrajith, S.; Mettananda, S.; Weerasooriya, W.A.L.K.; Hathagoda, K.L.W.; Lakmini, B.C.; Subasinghe, S.M.V.; de Silva, D.G.H.INTRODUCTION AND AIMS: It is believed that there is an association between abdominal pain and child abuse. The main objective of this study was to assess this association in Sri Lankan school children. METHODS: Children aged 13-18 years were randomly selected from a semi-urban school in Gampaha district. A previously validated, self administered questionnaire was used to collect socio-demographic data and information on gastrointestinal symptoms, child abuse and exposure to other stressful events. Severity of symptoms was recorded using a validated, visual analogue scale. Children with abdominal pain were categorized into abdominal pain predominant functional gastrointestinal disorders (AP-FGD) using Rome III criteria. RESULTS: A total of 490 children were recruited [males 254 (51.8%), mean age 15.2 years and SD 1.64 years]. Forty eight (9.8%) fulfilled Rome lit criteria for AP- FGD (functional dyspepsia=3, functional abdominal pain=25, irritable bowel syndrome=15 and abdominal migraine=5). The number of children exposed to physical, emotional and sexual abuse, were respectively 119 (24.3%), 109 (22.2%) and 18 (3.8%). Prevalence of AP-FGD was significantly higher in those exposed to sexual (26.7% vs. 9.3% in controls, p=0.42) and emotional (16.5% vs. 8.3%, p=0.046) abuse, but not physical abuse (11.8% vs. 9.2%, p=0.69). AP-FGD type associated with sexual abuse was irritable bowel syndrome (15.4% vs. 2.7%, p=0.02). Mean scores obtained severity of abdominal pain were higher in children exposed to sexual (27.9 vs. 13.2, p=0.002) and emotional abuse (22.1 vs. 11.4, p<0.001). CONCLUSIONS: Chronic abdominal pain prevalence and severity were significantly higher in children exposed to sexual and emotional abuse.Item Child abuse: the role of psychiatrists(Sri Lanka College of Psychiatrists, 2015) Rodrigo, A.; Liyanage, N.