Browsing by Author "Alwis, L.W.G.R."

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Neonatal septicaemia : the incidence, symptomatology and microbiology
(Sri Lanka Medical Association, 1998) Karunasekera, K.A.W.; Pathirana, D.; Alwis, L.W.G.R.
INTRODUCTION: The awareness of incidence and aetiology of septicaemia plays an important role when implementing preventive measures. The identification of offending organism helps to guide the initial antibiotic therapy which should be started immediately as the progression of early symptoms to death could occur in less than 24 hour. OBJECTIVES : To assess incidence and to identify' clinical presentations and offending organisms of neonatal septicaemia. METHODS : This study was carried out in the University Paediatric Unit, Colombo North Teaching Hospital Ragama from January to December 1996. Neonates with positive blood cultures and those having septicaemia clinically with negative blood cultures were included in the study. Data was analysed by Epilnfo version 6. RESULTS : 98 babies were diagnosed to have septicaemia during the study period. The incidence of septicaemia in the University Obstetric Unit was 24.4 per 1000 livebirths (98 out of 3851 live bom babies) and the case fatality rate was 11.2%. The incidence was significantly higher in babies with low birth weight (LBW) and in those born following instrumental delivery (p<0.01). 21.4% of babies developed septicaemia on first day of life, 74.5% between 2-7 days and 4.1 % after first week. The common presenting features were fever 61.2%, jaundice 52%, lethargy 37.8%, refused feeding 25.5%, coffee grounds vomiting 22.4% and fits 12.2%. The common bacteria identified were Klebsiella 29.2%, Staphylococcus aureus 16.9%, E.coli 5.6%, Coliform bacilli which could not be identified further 13.5% and non haemolytic streptococci 8.2%. The common sensitive antibiotics were Amikacin 88.9%, Amoxycillin + ClavuL'oic acid 183%, Ceftriaxone 78.1%, Netilmicin 63.9%, Gentamicin56.4% and Ceftazidime55.2%. CONCLUSIONS : This study shows that septicaemia is an important cause of morbidity in babies w ith LBW and those with instrumentation at birth. Our study confirms the nonspecific presentation of septicaemia. The finding of high incidence of late septicaemia and septicaemia due to Klebsiella and Staph. aureus indicates that most babies acquired it from the hospital.
Risk factors of childhood asthma: a Sri lankan study
(Oxford University Press, 2001) Karunasekera, K.A.W.; Jayasinghe, J.A.C.T.; Alwis, L.W.G.R.
A case-control study was carried out to evaluate the genetic and environmental risk factors of childhood asthma in a group of Sri Lankan children. Three hundred cases (admitted with symptoms of asthma) and 300 age-matched controls were compared over a period of 23 months commencing in January 1996. Family history of atopy, feeding habits in infancy, bronchiolitis in infancy, passive smoking, exposure to dust and dampness, and exposure to pet animals were studied as risk factors for asthma. The risks associated with social factors were also studied. The risk associated with variables were calculated using the chi-squared test in the bivariate analysis and the forward logistic regression model in the multivariate analysis. Parental asthma, asthma in a sibling and in a relative, parental allergic rhinitis, discontinuation of breastfeeding after 6 months in infancy, bronchiolitis in infancy, living in a dusty environment, and a father with primary education compared to secondary education were independently associated with an increased risk of asthma (p 0.05). This study reinforces the view that asthma has a multifactorial aetiology. Influence of paternal asthma is more than that of maternal asthma. As a preventive measure continuation of breastfeeding beyond 6 months is important.