Faculty of Medicine
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- ItemChemical and Biological Warfare(2010) Fernando, D. M. G.; De Alwis, L. B. L.
- ItemPrevealence of behavioral and emotional problems among seven to eleven year old children in selected schools in Kandy district, Sri Lanka(Elsivier, 2014) Ginige, P.; Tennakoon, S. U. B.; Wijesinghe, W. H. M. K. J.; Liyanage, L.; Herath, P. S. D.; Bandara, K.Background Behavioral and emotional problems comprising internalizing, externalizing and mixed disorders consist of psychiatric disorders in childhood and adolescents. Prevalence rates of 8.3% for preschoolers, 12.2% for preadolescents and 15.0% for adolescents have been reported from around the world. This study aimed to measure the prevalence of emotional and behavioral disorders in 7–11 year-old school children studying in Kandy District Sri Lanka which was a first for the geographic area. Method This was a community based study at the primary section of the selected schools. The questionnaire, Child behavior Checklist-Sinhala (CBCL-S) was administered in a group setting to the main caregiver of 562 subjects selected randomly. The questionnaire identified problems in 8 subscales under three main sub categories : internalizing, externalizing and other. Data were analyzed using The Syndrome Scales for Boys and Girls developed for analyzing the questionnaire CBCL. Results Indicated a prevalence of 13.8% of emotional and behavioral problems in the study population. 8.8% of children showed internalizing problems and 8.8% externalizing problems. These findings are in line with the prevailing rates from previous studies of the world. Children in school types 1AB and 1C had less emotional and behavioral problems compared to type 2 and 3 schools. Limitations Only 20 schools in KEZ and Sinhala speaking population of the Kandy were studied. Conclusions This study showed the extent of childhood emotional and behavioral problems and also confirms that the schools with advanced level classes have lesser problems amongst primary children
- ItemRepeated episodes of physical child abuse(2010) Fernando, D. M. G.; Dayaratne, K. M. P. L.INTRODUCTION According to Berard Knight the ‘child abuse syndrome” exists when an infant or child suffers repetitive physical injuries inflicted by a parent or guardian, in circumstances that exclude accident.' Physical abuse represents approximately 70% of child abuse cases and may range from minor bruises to fatal hacmatomas. We report a case where the child has been repeatedly released into the same hazardous environment, in spite of a diagnosis of physical child abuse being made by pediatricians and judicial medical officers. The child has been subjected to repeated abuse resulting in multiple hospital admissions with 7 long bone frictures, multiple rib fractures and other life threatening injuries in her short life span of 20 months,
- ItemForensic aspect of dental attrition and age estimation(2005) Ranasinghe, Ranasinghe Arachchige Sisira KumaraEstimation of age in the living and dead is an important task in routine medico-legal practice. Age could be estimated by studying the stages of tooth development and eruption by histological, morphological and radiological methods up to 18 — 20 years of age. The only macroscopic method in which age could be estimated using teeth after the age of 18 years is by dental attrition which is defined as wearing of the tooth surface due to masticatory forces. Available literature reveals several studies on the estimation of age using dental attrition in other countries but no studies have been carried out in Sri Lanka. The present study was carried out in two medical institutions in the Gampaha District during the period from January 2002 to December 2003. The study sample consisted of 500 patients selected on a random basis from 2250 individuals attending the out patient’s departments (OPD). The sample was divided into 5 different age groups. A Data Recording Sheet was used to collect the socio-demographic and attrition data. Attrition scores were recorded by the investigator throughout the study using Takei’s method with certain modifications. Individuals under 20 years of age, living outside the Gampaha District, in severeillnesses and marked malocclusion and jaw deformities were excluded from the study. In addition some were excluded due to inadequate number of teeth in the oral cavity and poor compliance. Mean attrition scores were calculated separately for males and females in each age group. In general, differences in the attrition scores between males and females were not statistically significant. Comparison o f attrition s cores b etween different educational groups did not show any significant differences. Mean attrition scores between betel chewers and non-betel chewers were also compared. Although the attrition scores in betel chewers were higher differences between the the values were not statistically significant. Further studies are recommended with larger samples. Regression lines were drawn using attrition scores for three groups of teeth separately for maxilla and mandible for all five age groups. With the help ofthe regression c urves equations were obtained to estimate age of individuals having different groups of teeth. Common attrition patterns s were prepared in a form of a chart separately for maxillary and mandibular teeth. The equations and charts obtained from this study could be used in the estimation of age in the living and dead especially in medico-legal work.
- ItemPredictors of the development of myocarditis or acute renal faliure in patients with leptospirosis(2012) Dassanayake, Dinesh L. B.; Wimalaratna, Harith; Nandadewa, Damith; Nugaliyadda, Asanka; Ratnatunga, Champa N.; Agampodi, Suneth B.Background: Leptospirosis has a varied clinical presentation with complications like myocarditis and acute renal failure. There are many predictors of severity and mortality including clinical and laboratory parameters. Early detection and treatment can reduce complications. Therefore recognizing the early predictors of the complications of leptospirosis is important in patient management. This study was aimed at determining the clinical and laboratory predictors of myocarditis or acute renal failure. Methods: This was a prospective descriptive study carried out in the Teaching Hospital, Kandy, from 1st July 2007 to 31st July 2008. Patients with clinical features compatible with leptospirosis case definition were confirmed using the Microscopic Agglutination Test (MAT). Clinical features and laboratory measures done on admission were recorded. Patients were observed for the development of acute renal failure or myocarditis. Chi-square statistics, Fisher’s exact test and Mann-Whitney U test were used to compare patients with and without complications. A logistic regression model was used to select final predictor variables. Results: Sixty two confirmed leptospirosis patients were included in the study. Seven patients (11.3%) developed acute renal failure and five (8.1%) developed myocarditis while three (4.8%) had both acute renal failure and myocarditis. Conjunctival suffusion - 40 (64.5%), muscle tenderness - 28 (45.1%), oliguria - 20 (32.2%), jaundice - 12 (19.3%), hepatomegaly - 10 (16.1%), arrhythmias (irregular radial pulse) - 8 (12.9%), chest pain - 6 (9.7%), bleeding - 5 (8.1%), and shortness of breath (SOB) 4 (6.4%) were the common clinical features present among the patients. Out of these, only oliguria {odds ratio (OR) = 4.14 and 95% confidence interval (CI) 1.003-17.261}, jaundice (OR = 5.13 and 95% CI 1.149-28.003), and arrhythmias (OR = 5.774 and 95% CI 1.001-34.692), were predictors of myocarditis or acute renal failure and none of the laboratory measures could predict the two complications. Conclusions: This study shows that out of clinical and laboratory variables, only oliguria, jaundice and arrhythmia are strong predictors of development of acute renal failure or myocarditis in patients with leptospirosis presented to Teaching Hospital of Kandy, Sri Lanka. Keywords: Myocarditis, Acute renal failure, Leptospirosis