Browsing by Author "De Silva, S."

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Causes, complications and short-term outcome of acute Kidney injury in a resource-limited setting
(SAGE-Hindawi Access to Research, 2025-12) Herath, N.; De Silva, S.; Liyanage, P.; Kumara, S.; Devi, S.; Abeysekara, V.; Mallawarachi, R.; Perera, S.; Karunathilaka, I.; Samarasinghe, S.; Weerakoon, K.
AIMS The outcome of acute kidney injury (AKI) depends on causes, patient factors and care received. We studied the causes, complications and 90-day outcomes of patients with AKI at a tertiary referral centre in Sri Lanka. METHODS Patients aged 18 years or older with AKI referred to nephrology services were analysed retrospectively. AKI severity was assessed using the KDIGO classification. Information was gathered from hospital and clinic records. RESULTS Of the 464 patients studied, 262 (56.5%) were males. The mean age of the study sample was 57.04 (SD 16.85) years. The majority (212-45.69%) were discharged with normal renal functions, 173 (37.28%) were discharged with impaired functions, and 79 (17.03%) died during hospital stay. There were 377 patients at 3 months follow-up; 331 (87.8%) had normalised renal function, 40 (10.6%) had not recovered fully and 6 (1.6%) had succumbed. Progression of AKI to chronic kidney disease or death was significantly high in patients aged > 60 years (p=0.017). More severe AKI was associated with type 2 diabetes (p=0.0042), hypertension (p < 0.0001) and multiple comorbidities (p=0.0014). Persons with no comorbidities had less severe AKI (p=0.0004). Even in the early stages of AKI, there was significantly high mortality (11% in AKI stages 1 and 2) which doubled in stage 3 (22%). Mortality was low in patients with prerenal causes of AKI (OR: 0.59, 95% CI: 0.35-0.99 and p=0.047). CONCLUSIONS AKI in elderly and comorbid patients has high morbidity and mortality. Identification of individuals who are at high risk of developing AKI is important for its prevention, early diagnosis and proper treatment. Limitations in infrastructure, manpower, local research, reporting and recording of AKI are key challenges in providing optimal care for AKI in Sri Lanka.
Do doctors really know about “hs-cTnI”? A comprehensive evaluation of knowledge regarding high-sensitivity cardiac troponin I (hs-cTnI) assay among medical officers in Gampaha district
(College of Chemical Pathologists of Sri Lanka, 2024) Fernando, N.; Fernando, K.; Gallage, T.; Dayanath, B.K.T.P.; De Silva, S.
INTRODUCTION AND OBJECTIVES The high-sensitivity cardiac troponin I (hs-cTnI) assay is a crucial diagnostic marker in the triage of patients presenting with chest pain. Notably, errors in interpreting the testing method have been identified among medical officers, leading to an increased likelihood of inaccuracies in testing and interpretation. This study aims to evaluate the level of understanding among medical officers regarding the hs-cTnI assay in relation to the most recent European Society of Cardiology (ESC) guideline released in 2020. METHODS A cross sectional questionnaire-based study was conducted at two government hospitals in Gampaha District during June 2022. A self-administered e-questionnaire was used to assess knowledge regarding hs-cTnI. Knowledge was measured through cumulative scoring of questionnaire responses, subsequently categorized as either good or poor knowledge. Scores below 60% were designated as poor, and vice versa. Descriptive statistics were employed for data summarization. RESULTS Out of 300 participants, 76% (227) responded. Only 14.5% (33/227) exhibited proficient knowledge of the analytical component, while 41.9% (95/227) demonstrated good knowledge of the clinical component. A score ≥60% on the analytical component knowledge correlated significantly with factors such as designation being a senior registrar or consultant (p<0.001), postgraduate enrolment (p<0.001), participation in continuous professional development programmes (p<0.001), and employment in a teaching hospital (p=0.025). Conversely, no significant associations were observed with age (p=0.066) or private practice (p=0.118). Clinical component knowledge scores ≥60% were significantly associated with age between 25 and 35 years (p=0.006), postgraduate enrolment (p<0.001), participation in continuous professional development programs (p<0.001), and employment in a teaching hospital (p=0.001) but not with doing private practice (p=0.170). CONCLUSIONS In Sri Lanka, medical officers’ analytical knowledge on the hs-cTnI assay seems lacking. Ongoing training programmes are essential to enhance their knowledge and proficiency in hs-cTnI testing.
Dressing of Sri Lankan Female School Teachers and Their Job Performance
(International Postgraduate Research Conference 2019, Faculty of Graduate Studies, University of Kelaniya, Sri Lanka, 2019) Jayasooriya, L.B.; De Silva, S.; Wanigasundera, P.
Scrupulous attention is paid to the details of clothing at the workplace, where many organizations have strict rules and regulations regarding the dress codes of the employees. Previous studies show that the dress codes of the employees have an impact on professionalism, efficiency, productivity at work, communication, social distance, safety, economy and self-satisfaction. Nonetheless, the majority of these studies have been conducted in the western populations, whereas data in Asian countries, which have contrasting cultural norms to the western world, are sparse. Therefore, this study was catered to examine how clothing of Sri Lankan female school teachers affects their job performances. A mixed method integrating qualitative interviews and secondary data analysis along with quantitative data derived from a self-administrated questionnaire were used for the study. Quantitative data were obtained from 100 female school teachers from Kandy and Colombo districts in Sri Lanka while 15 in-depth interviews were conducted to obtain qualitative data. Results revealed that evolution and current practice of the dress of females were more into promote nationalism and culture. Though the current dress of Sri Lankan school teachers is the Saree/Abaya, the majority preferred to wear casual dresses (54%). Wilcoxon Signed Rank test showed that casual dress is significantly comfortable compared to their traditional dress (p<0.05). There was a significant difference between efficiency in performing given four tasks wearing casual attire over traditional attire as per Wilcoxon Signed Rank test statistics(p<0.05). Thirty percent of teachers in the sample have faced accidents due to their current dress. They suggested that they would be more productive in teaching and performing extra-curricular activities if they wear casual dresses. Hence, the findings of this study suggest that a change in the current dress of female school teachers into a more relaxing and a convenient one which is easy to maintain, wear and handle would help the teachers enliven their dynamic role while creating avenues for positive changes in the education sector in Sri Lanka