Browsing by Author "Fernando, M."

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An ABO-incompatible living donor liver transplant in an infant with acute liver failure in the Sri Lankan setting
(The Sri Lanka Medical Association, 2023) Fernando, M.; Tillakaratne, S.; Gunetilleke, B.; Liyanage, C.; Appuhamy, C.; Weerasuriya, A.; Dissanayake, J.; Siriwardana, R.
Liver transplant (LT) is the standard therapy for medically refractory acute liver failure (ALF). Finding a deceaseddonor graft in an emergency is challenging and often overcome by living-donation. Blood group matching is practised for LT though ABO-incompatible liver transplant (ABOi-LT) is performed inselected circumstances. We report an infant who underwent successful ABOincompatible living donor LT for ALF of unknown aetiology. This being the country’s first ABOi-LT, the youngest LT recipient to date and the youngest receiving emergency LT for ALF; we describe the novel experience at a resource-limited setting in Sri Lanka (SL).
Accuracy of measuring axillary temperature using mercury in glass thermometers in children under five years: a cross sectional observational study
(Scientific Research Publishing Inc, 2014) Perera, P.; Fernando, M.; Mettananda, S.; Samaranayake, R.
BACKGROUND: Measuring axillary temperature with mercury in glass thermometers is continued in clinical practice though there are many limitations. This is mainly due to convenience and cost. This study was conducted to ascertain the accuracy of measuring axillary temperature with mercury thermometers in preschool children. METHODS: Axillary temperature was measured in 250 preschool children using standardized mercury thermometers. Time taken to record the final temperature and its correlates were assessed. RESULTS: Time taken to record the final temperature extended up to six minutes. This duration varied according to age, body mass index and body temperature, but a significant variation was noted only with age. CONCLUSIONS: Measuring axillary temperature with mercury thermometers is subjected to error. They need to be replaced with suitable alternatives.
Achieving millennium development goal 4 in 2015: are we really on track?
(Sri Lanka College of Paediatricians, 2011) Mettananda, S.; Rajindrajith, S.; Warnakulasuriya, T.; Fernando, M.; Devanarayana, N.M.; Gunawardena, N.K.
INTRODUCTION: Millennium development goal (MDG) 4 aims to reduce under 5 mortality by two thirds from 1990 (22.2 per 1000 live births) to 2015 (7.4 per 1000 live births). In achieving this, proper and accurate description of the causes of deaths is crucial. OBJECTIVES: To describe the timing, causes and distribution of under 5 child deaths in Sri Lanka and to predict the likelihood of achieving MDG 4. DESIGN, SETTING AND METHOD: Information regarding all under 5 child deaths between 2002-2006 was obtained from the Registrar Generals' Department. Place, sex and age at death were retrieved. Causes of deaths documented accordingly to the ICD-10 classification were reclassified into clinically relevant and user-friendly categories. Mortality rates and predictions for 2015 were calculated using Microsoft Excel. RESULTS: A total of 26,273 deaths have occurred during 2002-2006 [55% neonatal, 21% post-neonatal infant and 24% child (l-5year)]. Tsunami wave in 2004 had caused 2,868 (11%) deaths and they were excluded from further analysis. Prematurity had caused 4,603 (31.8%) neonatal deaths; 2389 (16.5%) were due to infections and 1149 (7.9%) were due to birth asphyxia. Congenital anomalies have contributed to 1830 (12.6%) neonatal deaths, of which, the majority [1389 (9.6%)] were heart diseases. Leading causes for post-neonatal infant deaths include congenital anomalies [1772 (35%)], infections [1516 (29.9%)] and trauma [393 (7.7%)]. in children, 910 (23.4%) deaths were due to infections (10.2% respiratory, 2.0% gastroenteritis and 0.9% dengue). One fifth of deaths were due to congenital anomalies of which half were due to heart defects. Trauma/ accidents and malignancies had contributed to 731 (18.8%) and 279 (7.1%) deaths respectively. Colombo district reported the highest number of deaths (24%). More males (54.7%) have died compared to females. Reduction in mortality rates were observed from 2002-2006; neonatal mortality from 8.3 to 7.6, infant mortality from 11.4 to 10.4 and under 5 mortality from 13.7 to 12.3. Projections of data showed that the neonatal, infant and under 5 mortality rates in 2015 would be 4.6, 6.7 and 7.7 per 1000 live births respectively. CONCLUSIONS: Prematurity was the leading cause of neonatal mortality. Congenital heart diseases are an important cause of death throughout childhood. Trauma and accidents contribute to a significant proportion of child deaths. Predictions from data suggest that Sri Lanka may fall marginally short of achieving MDG 4.
Analysis of neonatal deaths in Sri Lanka from 2002 to 2006
(Sri Lanka Medical Association, 2011) Mettananda, S.; Warnakulasuriya, T.; Fernando, M.; Devanarayana, N.M.; Rajindrajith, S.
INTRODUCTION AND OBJECTIVES: To describe the causes, timing and distribution of neonatal deaths in Sri Lanka from 2002 to 2006. METHODS: Information on all neonatal deaths occurred from 2002 to 2006 (5 calendar years) in the entire country was obtained from the Registrar Generals' Department. Place of death and age at death were retrieved. Causes of death documented as 429 different diagnoses according to the ICD-10 classification were reclassified into clinically relevant and meaningful categories. Results: A total of 14,487 neonatal deaths occurred during the 5-year period with a mean of 2897.4 deaths per year; of which 8159 (56.32%) were males. One third of them (4904) died within 24 hours of life and 11,318 (78.12%) were early neonatal deaths. Number of deaths gradually decreased with increasing age. Colombo district reported 3334 (23.0%) deaths. Prematurity and related complications were the cause for 4603 (31.77%) deaths whereas 2389 (16.49%) deaths were due to infections. Proportion of deaths due to infections has gradually decreased from 20.23% in 2002 to 11.84% in 2006. Congenital anomalies contributed to 12.63% (1830) deaths and the majority of those deaths (1389-9.59%) were due to congenital heart diseases. Birth asphyxia had caused 1349 (7.93%) neonatal deaths. Tsunami wave in 2004 has led to 36 (0.25%) neonatal deaths. CONCLUSIONS: Preventable causes such as prematurity, infections and congenital heart diseases are still leading causes of neonatal deaths in Sri Lanka. Targeted healthcare reforms are urgently needed to address these issues.
Auditory and visual hallucinations in an adolescent following orthotopic liver transplantation
(Sri Lanka College of Psychiatrists, 2024-10) Chandradasa, M.; Abeyrathne, M.; Sithara, P.; Kodithuwakku, K.; Fernando, M.
No abstract available
A Case of dapsone-Induced severe agranulocytosis causing life-threatening skin Sepsis in a Sri Lankan child with borderline Leprosy: A success story!
(Hindawi Pub. Corp, 2019) Fernando, M.; Kankananarachchi, I.; Navabalasooriyar, P.; Herath, B.; Punchihewa, P.
Leprosy is a common skin disease in Sri Lanka which is being increasingly diagnosed due to the existing successful public health programme. Dapsone is a drug which holds unique pharmacological properties where it serves as both anti-inflammatory and antimicrobial agents. Of its main adverse effects, agranulocytosis is a serious consequence which is reported mainly in adults and elderly. We report a 7-year-old child who sustained life-threatening skin and subcutaneous tissue sepsis because of dapsone-induced agranulocytosis. Besides, this case highlights the importance of meticulous monitoring of cell counts due to the risk of neutropenia and the natural history of cell recovery following occurrence of neutropenia. Though high mortality rate has been described in most of the similar cases reported, the child we describe made a complete recovery following severe neutropenic sepsis.
Challenges faced in establishing a pediatric liver transplant program in a lower‐middle‐income country with free healthcare service
(Wiley, 2024) Fernando, M.; Tillakaratne, S.; Gunetilleke, B.; Liyanage, C.; Appuhamy, C.; Weerasuriya, A.; Uragoda, B.; Welikala, N.; Ranaweera, L.; Ganewatte, E.; Dissanayake, J.; Mudalige, A.; Siriwardana, R.
ABSTRACT: BACKGROUND: Liver transplant is the cure for children with liver failure. Sri Lanka is a lower-middle-income country with a predominant free, state health system. Pediatric liver transplant program in Sri Lanka is still in the budding state where the initial experience of the program is yet to be documented. METHODS: A retrospective review was performed including the clinical characteristics of all pediatric liver transplant recipients of Colombo North Centre for Liver Diseases since the inception of the program from June 2020 to May 2023. RESULTS: There were 14 PLT performed in 3 years. The median recipient age and weight were 8 years (6 months–15 years) and 23.3 kg (6.4–49.2), respectively. The majority were boys (64%). All were from low-income backgrounds. Indications for LT were acute liver failure (5/14), decompensated chronic liver disease (5/14), and acute on chronic liver failure (4/14). Underlying liver diseases were Wilson disease (6/14), autoimmune liver disease (3/14), biliary atresia (2/14) and progressive familial intrahepatic cholestasis type 3 (1/14), and unknown etiology (2/14). The majority were living donor liver transplants (86%). Of the living donors, 42% (5/12) were Buddhist priests. There were three immediate deaths and two late deaths. The 3-month survival was 78%, and overall survival was 64%. Living donor transplants carried a higher success rate (92%) compared to diseased donor transplants (0%; 2/2). CONCLUSIONS: Initial experience of pediatric liver transplant program of Sri Lanka is promising despite being established in a free healthcare system amidst the crisis circumstances.
A child with intravenous immunoglobulin-resistant Kawasaki disease who responded to intravenous methyl prednisolone
(Sri Lanka College of Paediatricians, 2019) Kankananarachchi, I.; Wickramasinghe, P.; Fernando, M.; Pussagoda, K.; Dissanayake, R.; Morawakkorala, R.; de Silva, H.
No abstract available
Feeding practices among children attending child welfare clinics in Ragama MOH area: a descriptive cross-sectional study
(BioMed Central, 2011) Perera, P.J.; Fernando, M.; Warnakulasuriya, T.; Ranathunga, N.
BACKGROUND: Feeding during early childhood is important for normal physical and mental growth as well as for health in later life. Currently, Sri Lanka has adopted the WHO recommendation of exclusive breastfeeding for six months, followed by addition of complementary feeds thereafter, with continuation of breastfeeding up to or beyond two years. This study was conducted to evaluate the current feeding practices among Sri Lankan children during early childhood. METHODS: This study was a descriptive cross-sectional study conducted in the Ragama Medical Officer of Health (MOH) area. It was conducted between 10 August 2010 and 30 October 2010. Children between the ages of 24 and 60 months, attending child welfare clinics, were included in the study on consecutive basis. An interviewer-administered questionnaire was used to collect data regarding socio-demographic characteristics and feeding practices. RESULTS: There were 208 boys and 202 girls in the study population. Of them, 255 (62.2%) were exclusively breastfed up to 6 months. Younger children had a statistically significant, higher rate of exclusive breastfeeding compared to older children. Three hundred and fifty one (85.6%) children had received infant formula, and it was started before the age of 6 months in 61 children, and in 212 before one year. Sugar was added to infant formula in 330 (80.4%) children, and out of them 144 had sugar added within first year of life. Complementary foods were started before 4 months in 29 (7%) children. Of the 410 children, 294 (71.7%) were breastfed beyond 2 years and 41.6% of them were breastfed at regular intervals throughout the day. Three hundred and thirty eight (82.6%) children were receiving overnight feeding of either breast milk or infant formula even after 2 years. CONCLUSIONS: Though a high rate of exclusive breastfeeding was observed in this study population, there are many other issues related to feeding during the early years of life that need immediate intervention. Too early introduction of complementary food, using infant formula without an indication, adding sugar to infant formula, too frequent breastfeeding and overnight feeding of older children are among them.
Feeding practices of children attending well baby clinics in Ragama MOH area: a descriptive cross sectional study
(Sri Lanka Medical Association, 2011) Perera, K.P.J.; Fernando, M.; Warnakulasuria, T.; Ranathunga, N.
INTRODUCTION AND OBJECTIVES: Feeding during early childhood is important for growth and health. Objectives of this study were to evaluate the current feeding practices during first few years of life among Sri Lankan children. METHODS: A descriptive cross sectional study conducted in Ragama MOH area during the period of 10th august 2010 and 30th October 2010. 410 children between 2 -5 years of age, attending well baby clinics were included in the study. Interviewer administered questionnaire was used to collect data regarding socio-demographic characteristics and feeding practices. Open ended questions were used. SSPS version 16 was used for data analysis. RESULTS: The study population consisted of 208 boys and 202 girls. 62.2% children were exclusively breastfed for 6 months. 351 have received formula milk. 61 had formula milk started before the age of 6 months and 212 by one year. 330 children had sugar added to formula milk. 144 of them had sugar added within first year. 29 children had complementary food started before 4 months. 294 mothers continued to breastfeed beyond 2 years and 41.6% of them were breast feeding at regular intervals. 82.5% children were receiving overnight feeding either as breast milk or formula beyond 2 years. . CONCLUSIONS: Though high rate of exclusive breast feeding is prevalent in Sri Lanka, there seem to be other issues related to feeding. Too early introduction of complementary food, adding sugar to formula, prolonged breast feeding too frequently and prolonged overnight feeding are among them.
Fifty liver transplants: a single centre experience of haemodynamic management in liver transplantation for cirrhosis [part 1]
(College of Surgeons of Sri Lanka, 2021) Gunetilleke, B.; Ranamuni, R.; Jayaweera, D.; Welikala, N.; Kerner, V.; Munasinghe, N.; Withanage, R.; Wickremasinghe, N.; Hewage, S.; Wijesuriya, N.; Rodrigo, U.; Mudalige, A.; Fernando, M.; Hettiarachchi, D.; Dissanayake, J.; Niriella, M.; Dassanayake, A.; Thilakaratne, S.; de Silva, J.; Siriwardana, R.; WIjesuriya, R.; Liyanage, C.
ABSTRACT: Cirrhosis with end stage liver disease (ESLD) is a leading cause of non-communicable disease related deaths in Sri Lanka. Liver transplantation is the only curative treatment for patients with ESLD. The complex multisystem involvement and unique cardiovascular profile characteristic of ESLD present formidable challenges during liver transplantation. Management of the rapid and varied hemodynamic changes during surgery requires an in depth understanding of the physiological effects of each intervention. Based on the current literature and the experience gained at our center during the management of 50 liver transplants, we present optimization strategies and perioperative hemodynamic interventions which we use to ‘Fast track’ recovery following liver transplantation. KEYWORDS: Liver transplantation, cirrhosis, non-alcoholic fatty liver disease, alcohol related liver disease
Fifty liver transplants: a single centre experience of haemodynamic management in liver transplantation for cirrhosis [part 2]
(The College of Surgeons of Sri Lanka, 2021) Gunetilleke, B.; Ranamuni, R.; Jayaweera, D.; Welikala, N.; Kerner, V.; Hettiarachchi, D.; Munasinghe, N.; Withanage, R.; Wickremasinghe, N.; Hewage, S.; Fernando, M.; Hettiarachchi, D.; Niriella, M.; Dassanayake, A.; Thilakaratne, S.; Wijesuriya, R.; Liyanage, C.; Siriwardana, R.; Dissanayake, J.; Wijesuriya, N.; Rodrigo, U.; Rodrigo, U.; Mudalige, A.; de Silva, J.
Globally, an estimated one million deaths occur annually due to complications of cirrhosis. Cirrhosis with end stage liver disease [ESLD] is a leading cause death due to non- communicable diseases in Sri Lanka. Non-alcoholic fatty liver disease [NAFLD] and alcohol related liver disease [ARLD] are the principal causes of ESLD due to cirrhosis in Sri Lanka. Liver transplantation remains the only curative treatment for such patients. Multiorgan dysfunction and hemodynamic instability characteristic of ESLD adds to the complexity of perioperative care in liver transplantation. Maintenance of stable hemodynamics including optimal hemostasis forms the core of the anaesthetic strategy in liver transplantation.
First paediatric live donor liver transplant in Sri Lanka with 1 year outcome : challenges for the future
(The College of Surgeons of Sri Lanka, 2021) Siriwardana, R.; Thilakarathne, S.; Fernando, M.; Gunetilleke, M.B.; Weerasooriya, A.; Appuhamy, C.
INTRODUCTION: Liver transplantation in the paediatric age group is demanding due to smaller body proportions and physiology. This paper describes the first successful paediatric liver transplant in Sri Lanka along with its one-year outcome. Describing the challenges faced during the process, we highlight the factors that need to be considered for a sustainable programme in the future. METHODOLOGY: A 9-year-old girl who had progressive familial intra hepatic cholestasis type 3 was referred to us with features of end stage liver disease. She was identified as a suitable candidate for liver transplantation. Her 38-year-old mother was selected as the donor, who was evaluated for suitability of a left lateral segment donation. RESULTS: The first paediatric liver transplantation was performed in July 2020. The child's mother donated the left lateral segment weighing 325g. During the postoperative period the child developed outflow tract obstruction at the hepatic venous anastomosis. This was managed with a percutaneously placed stent. Six months after transplant, she developed an acute rejection that required steroids. Treatment of rejection was complicated with multiple liver abscesses caused byAspergillus. The infection was treated with systemic antifungals and drainage. At one-year post transplant, the recipient had recovered from the trauma of surgery and had normal liver biochemistry, a patent hepatic venous stented anastomosis and complete resolution of the abscesses. We faced dual challenges in dealing with a live liver transplant donor and a young child who was the recipient. Our success, on this occasion, was underscored by the multidisciplinary contribution from specialists scattered across the island combined with state-public partnership. CONCLUSION: To offer a sustainable live donor liver transplant service for the future, many other aspects, beyond surgery itself, need to be addressed.
Fixed low-dose triple combination Antihypertensive Medication vs usual care for blood pressure control in patients with mild to moderate hypertension in Sri Lanka: A Randomized Clinical Trial
(American Medical Association, 2018) Webster, R.; Salam, A.; de Silva, H.A.; Selak, V.; Stepien, S.; Rajapakse, S.; Amarasekara, N.; Amarasena, N.; Billotm, L.; de Silva, A.P.; Fernando, M.; Guggilla, R.; Jan, S.; Jayawardena, J.; Maulik, P.K.; Mendis, S.; Mendis, S.; Munasinghe, J.; Naik, N.; Prabhakaran, D.; Ranasinghe, G.; Thom, S.; Thisserra, N.; Senaratne, V.; Wijekoon, S.; Wijeyasingham, S.; Rodgers, A.; Patel, A.; TRIUMPH Study Group
IMPORTANCE: Poorly controlled hypertension is a leading global public health problem requiring new treatment strategies. OBJECTIVE: To assess whether a low-dose triple combination antihypertensive medication would achieve better blood pressure (BP) control vs usual care. DESIGN, SETTING, AND PARTICIPANTS: Randomized, open-label trial of a low-dose triple BP therapy vs usual care for adults with hypertension (systolic BP >140 mm Hg and/or diastolic BP >90 mm Hg; or in patients with diabetes or chronic kidney disease: >130 mm Hg and/or >80 mm Hg) requiring initiation (untreated patients) or escalation (patients receiving monotherapy) of antihypertensive therapy. Patients were enrolled from 11 urban hospital clinics in Sri Lanka from February 2016 to May 2017; follow-up ended in October 2017. INTERVENTIONS: A once-daily fixed-dose triple combination pill (20 mg of telmisartan, 2.5 mg of amlodipine, and 12.5 mg of chlorthalidone) therapy (n = 349) or usual care (n = 351). MAIN OUTCOMES AND MEASURES: The primary outcome was the proportion achieving target systolic/diastolic BP (<140/90 mm Hg or <130/80 mm Hg in patients with diabetes or chronic kidney disease) at 6 months. Secondary outcomes included mean systolic/diastolic BP difference during follow-up and withdrawal of BP medications due to an adverse event. RESULTS: Among 700 randomized patients (mean age, 56 years; 58% women; 29% had diabetes; mean baseline systolic/diastolic BP, 154/90 mm Hg), 675 (96%) completed the trial. The triple combination pill increased the proportion achieving target BP vs usual care at 6 months (70% vs 55%, respectively; risk difference, 12.7% [95% CI, 3.2% to 22.0%]; P < .001). Mean systolic/diastolic BP at 6 months was 125/76 mm Hg for the triple combination pill vs 134/81 mm Hg for usual care (adjusted difference in postrandomization BP over the entire follow-up: systolic BP, -9.8 [95% CI, -7.9 to -11.6] mm Hg; diastolic BP, -5.0 [95% CI, -3.9 to -6.1] mm Hg; P < .001 for both comparisons). Overall, 419 adverse events were reported in 255 patients (38.1% for triple combination pill vs 34.8% for usual care) with the most common being musculoskeletal pain (6.0% and 8.0%, respectively) and dizziness, presyncope, or syncope (5.2% and 2.8%). There were no significant between-group differences in the proportion of patient withdrawal from BP-lowering therapy due to adverse events (6.6% for triple combination pill vs 6.8% for usual care). CONCLUSIONS AND RELEVANCE: Among patients with mild to moderate hypertension, treatment with a pill containing low doses of 3 antihypertensive drugs led to an increased proportion of patients achieving their target BP goal vs usual care. Use of such medication as initial therapy or to replace monotherapy may be an effective way to improve BP control.
Focal seizures as first presentation of Pepper syndrome in a six-week-old girl
(Sri Lanka College of Paediatricians, 2022) Sandakelum, U.; Balasubramaniam, R.; Fernando, M.; Gunasekera, S.; Ganewatte, E.; Fernando, S.; Dissanayake, D.
No abstract available
Hepatic and renal status of paediatric patients with thalassaemia
(Sri Lanka Medical Association, 2023) Wijenayake, W.; Pathiraja, H.; Thennakoon, R.; Fernando, M.; Bandara, D.; Mettananda, S.
INTRODUCTION: Thalassaemia is a chronic disorder affecting many organ systems. Although cirrhosis is a well-recognised complication, sub-clinical hepatic and renal dysfunction in thalassaemia are poorly studied. OBJECTIVES: We aimed to describe the hepatic and renal status and dysfunction of paediatric patients with thalassaemia. METHODS: A cross-sectional descriptive study was conducted at Kurunegala and Ragama Thalassaemia Centres during February and March 2023. All patients aged less than 16 years attending the thalassaemia centres were recruited. Data were collected using a data collection form by interviewing parents and perusal of clinical records and analysed using SPSS 27.0. Ethical approval was obtained from the Sri Lanka College of Paediatricians. RESULTS: Sixty-five patients (mean age-7.7; males-46%) were recruited. Of them 48(73%) had homozygous beta-thalassaemia and 17(26%) had HbE thalassaemia; 52(80%) were transfusion-dependent and 13(20%) were non-transfusion-dependent. Hepatomegaly and splenomegaly were found in 45(69%) and 30(46%), respectively. Regarding hepatic status, 34(52%) had high (>40IU/L) alanine transaminases, of which 8(12%) had >3-fold elevation of alanine transaminases. A higher proportion of children with HbE thalassaemia (71%) had elevated alanine transaminases compared to homozygous beta-thalassaemia (46%, χ2=3.0, p=0.07). Also, a higher proportion of children on deferasirox (57%) had elevated alanine transaminases compared to those who were not on the drug (27%, χ2=3.3, p=0.06). Four (5%) had <2+ proteinuria in urinalysis however, the urine protein: creatine ratio was normal in all. CONCLUSION: High alanine transaminases were noted in over 50% of paediatric patients with thalassaemia. HbE thalassaemia type and use of deferasirox were associated with high alanine transaminase levels.
Hepatology
(Samudra Medical Publications, 2022) Fernando, M.; Rajindrajith, S.
No abstract available
Image guided naso-jejunal tube placement in paediatric liver transplant patients in low resource settings: Feasibility, technique, and outcome
(Sri Lanka College of Paediatricians, 2024) Appuhamy, W.N.D.P.C.; Fernando, M.; Tillakaratne, S.B.; Gunathilake, M.B.; Ganewatte, E.; Gishanthan, S.; Jayakody, R.D.C.G.; Siriwardana, R.C.
No abstract available
The Impact of Corporate Brand Trust on Customer Adaptation of e-cash Mobile Payments in Sri Lanka
(Faculty of Commerce and Management Studies, University of Kelaniya, Sri Lanka, 2016) Madhushi, K.A.C.; Fernando, M.
Electronic Cash (e-Cash) Mobile Payment (m-payments), is an exciting e-commerce domain that has been rapidly developing recently in Sri Lanka. If E-Cash mobile payment efforts succeed to obtain customer adaptation, corporate brands will boost mobile money transfers as well as ambient intelligence telecommunication infrastructures in future Sri Lanka. The purpose of the research is to explore the impact of Corporate Brand Trust (CBT) on customers’ intention to adopt e-cash mobile payment systems to carry out financial services in Sri Lanka. This research applies on the Theory of Technology Acceptance Model (TAM) & Theory of Reasoned Action (TRA) which were extended to include Credibility, Integrity, Reliability and Benevolence dimensions of CBT model to analyze the customer behaviour on intention to use e-cash mobile payments in Sri Lanka. Perceived usefulness to eCash selected as a moderating factor on this research. The data was collected through questionnaire from a sample of 384 among Dialog eZcash and Mobitel mCash mobile payment user population in Colombo district. The empirical results show that the proposed behavioural model was appropriately adjusted, thus proving that there is a positive impact on customer adaptation towards e-Cash service provided by Dialog and Mobitel Telecommunication Service Providers, while also indicate that the Perceived Usefulness to E-cash has a significant moderating influence on relationship between CBT and CA. Sri Lankan Telecommunication service providers launched Cash mobile payments about 5 years back, and product awareness and customer adaptation is still limited towards hence this is a new service facilitation. This paper is a pioneer study to fill the gap between Dialog & Mobitel telecommunication service providers’ brand trust and customer adaptation and also has analysed at the same time the importance of the moderation effect of perceived usefulness of eCash mobile payment in Sri Lanka.
Impact of COVID-19 outbreak on the number of invasive procedures in Institute of Cardiology, National Hospital of Sri Lanka -A descriptive longitudinal study
(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2021) Kuruppu, C.; Gunawardena, R.; Dunuwille, A.; Ranasinghe, G.; Fernando, N.; Mendis, S.; Fernando, M.; Wijewardena, A.; Prabath, I.H.D.S.
Introduction: Covid-19 pandemic has significantly affected healthcare services worldwide with a similar impact on invasive procedures, in Institute of Cardiology, National Hospital of Sri Lanka (NHSL). Objectives: To analyse the impact of Covid-19 outbreak on therapeutic cardiology interventions, both elective and emergency, by comparing frequencies of procedures done during the initial affected year and immediate previous year. Methods: A Retrospective longitudinal descriptive study was carried out on frequencies of invasive therapeutic cardiology procedures during the period of 2019 March to 2021 February, at Cardiology Unit, NHSL. Pre-formed data collection sheets were filled using hospital registries. Final analysis was done by Microsoft-Excel 365. Results: Total number of procedures done in affected year was 4690 compared to 6096 in previous year. In April 2020, which was the most affected month, 52 cumulative procedures have been done in comparison to 427 procedures in April 2019. By August 2020 number of procedures has increased to 668 in compared to 486 in August 2019. Total of elective procedures were 3751 and 5061 in affected and non-affected years respectively. Similarly, the number of emergency procedures was 1035 in immediate previous year and 939 during Covid pandemic. Conclusions: Study has highlighted a significant impact on invasive therapeutic cardiology procedures, especially on electives, by the onset of the Covid-19 pandemic, especially during the period of lockdown. However, there has been a compensatory increase in procedures once lockdown was over, partially compensating for the numbers. There has been less impact on emergency procedures, the numbers of which have remained relatively constant.