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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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 Gender distribution of editors in psychiatry journals of South Asia(lsevier/North-Holland Biomedical Press, 2022) Arafat, S.M.Y.; Amin, R.; Baminiwatta, A.; Hussain, F.; Singh, R.; Kar, S.K.; Mubashir, A.S.No abstract availableItem Female victims and female perpetrators: medical students' narratives of gender dynamics and professionalism dilemmas.(Springer Netherlands, 2020) Shaw, M.K.; Chandratilake, M.; Ho, M.J.; Rees, C.E.; Monrouxe, L.V.ABSTRACT: Medicine is a gendered discipline, in which women, both as patients and practitioners, have often held subordinate positions. The reproduction of dominant gender biases in the medical setting can negatively impact the professional development of medical students and the wellbeing of patients. In this analysis of medical students' narratives of professionalism dilemmas, we explore students' experiences of gender bias in hospital settings. Seventy-one students participated in 12 group interviews, where they discussed witnessing or participating in various activities that they thought were professionalism lapses. Within the dataset, 21 narratives had a distinctly gendered component broadly pertaining to patient dignity and safety dilemmas, informed consent issues, and female student abuse. Interestingly, perpetrators of such acts were commonly female healthcare professionals and educators. Although students recognized such acts as professionalism lapses and often expressed concern for patient wellbeing, students did not intervene or report such acts due to hierarchical cultural contexts, and at times even reproduced the discriminatory behavior they were criticizing. This raises concerns about medical students' professionalism development and the extent to which gender bias is ingrained within particular medical systems. The normalization of disrespectful and abusive treatment of female patients poses immediate and future consequences to the wellbeing and safety of women. Furthermore, the same socio-cultural values that sustain these acts may account for perpetrators often being women themselves as they strive to overcome their subordinate position within medicine.Item Post war psychological morbidity among internally displaced, married females in Northern Sri Lanka(OMICS International, 2016) Attidiya, D.S.R.; Wickremasinghe, A.R.; Balasuriya, A.; Ediriweera, E.P.D.S.; Manuelpillai, S.; Williams, S.BACGROUND: A three-decade long conflict between the government military and Tamil rebels in Sri Lanka ended in 2009 with the defeat of the rebels. The civilians were the most affected in the war with reports of scant respect for human rights on both sides of the warring factions. OBJECTIVE: To conduct a cross-sectional study to assess the prevalence of psychiatric morbidity among married females in two villages in Northern Sri Lanka that was affected significantly in the last phase of the war. METHOD: All married females in two resettled villages in the Mannar District were interviewed by trained data collectors using the translated K-10 and PSSR-17 questionnaires to estimate the prevalence of post-traumatic stress disorder (PTSD) and depressive disorder. All families in these villages were from internally displaced camps where they had been living for more than a year after having been displaced from their homes and having experienced direct war trauma for weeks. Data was collected from 135 married females between March to May 2011 with ethical approval for the study. RESULTS: Criteria for diagnosis of severe PTSD were met in 57% of all participants and all participants had at least mild symptoms of PTSD. The screening tool for depression showed 63% to have significant depressive symptoms. Both depressive and severe PTSD features were present in 24%. Nearly 73% of participants were having either depression or severe PTSD. CONCLUSION: Psychiatric morbidity was high in the post-conflict period, in a highly vulnerable population of married females.Item Serum adiponectin levels in overweight and obese women; discrimination between insulin resistance and abdominal obesity(American Association for Clinical Chemistry, 2016) Chackrewarthy, S.; Medagoda, K.; Marasinghe, E.; Wijayasinghe, S.INTRODUCTION: Insulin resistance and abdominal obesity are both associated with lower serum adiponectin concentrations. Since insulin resistance and abdominal obesity are related, the extent to which the association of adiponectin with insulin resistance is dependent on its relationship with abdominal obesity is not clear. The present study investigated the association between insulin resistance and abdominal obesity in its relationship with serum adiponectin. METHODS : Eighty-eight overweight or obese women (BMI>23) in the age group 35-65 years were enrolled. Anthropometric measurements, blood pressure were recorded and a fasting blood sample was obtained for biochemical parameters. Insulin resistance (IR) was quantified by homeostasis model assessment of insulin resistance (HOMA-IR). Abdominal obesity was assessed by waist circumference (WC). Subjects were divided according to WC quartiles: Q1) WC < 89cm (n = 21); Q2) WC 89-96cm (n = 21); Q3) WC 97-102cm (n = 25); and Q4) WC > 102cm (n = 21) and on the basis of insulin resistance. Data were analysed by SPSS 16.0. RESULTS: The mean serum concentration of adiponectin in women were 5.93±1.9 µg/mL. In linear regression analysis, significant correlates of serum adiponectin were serum insulin (r = -0.439, p=0.000) and insulin resistance (r = -0.415, p0.05). High-density lipoprotein (HDL) correlated positively with adiponectin level (p 2.5) subjects had significantly lower (p< 2.5) subjects irrespective of the level of abdominal adiposity. CONCLUSION: High adiponectin levels are associated with insulin sensitivity and a favourable lipid profile. Serum adiponectin levels are more tightly linked with insulin resistance than with abdominal obesity.Item Association between pain and disability in patients with chronic mechanical low back pain(Sri Lanka Medical Association, 2015) Perera, G.L.R.S.; Wijayaratne, L.S.; Senarath, U.; Dissanayake, P.H.; Karunanayake, A.L.; Dissanayake, V.H.W.INTRODUCTION AND OBJECTIVES: Low back pain is the leading cause of years lived with disability in developed countries as well as in South Asian countries. The aim of this study is to evaluate the association between the intensity of pain and disability in patients with chronic mechanical low back pain (CMLBP) who attended the rheumatology clinic, National Hospital of Sri Lanka (NHSL). METHOD: This is a descriptive study on 675 patients with CMLBP who attended the rheumatology clinic, NHSL, from May 2012 to May 2014, recruited according to inclusion and exclusion criteria. Intensity of pain was measured using the 101-point numerical pain rating scale (NRS) and the disability was measured using the modified Oswestry Disability Index (MODI). A multiple linear regression model adjusted for age, gender, level of education, duration and frequency of pain and duration of treatment was used to assess the association between the intensity of pain and disability. RESULTS: Majority (482, 71.4%) were females. Mean age was 49.19 ± 11.75 years. Mean score for NRS was 46.79 ± 20.38 and for MODI was 31.77 ± 14.16, while 84.3% had daily pain. Intensity of pain was positively associated with the disability (p<0.01) and the standardized regression coefficient was +0.627 after adjusting for confounders. Frequency of pain, female gender and aging were positively associated with disability (p<0.05) while level of education, and durations of pain and treatment did not reach significant level. Conclusion: Intensity of pain explains 63% of the disability associated with CMLBP. Frequency of pain, female gender and age were also associated with disability.