Browsing by Author "Jayasinghe, C.Y."

Now showing 1 - 6 of 6

Impact of corticosteroid therapy on lifestyles in asthmatic children from Sri lanka
(Indian Pediatrics, 2010) Karunasekera, K.A.W.; Fernando, A.D.; Jayasinghe, C.Y.
This study was conducted to ascertain the impact of inhaled corticosteroids therapy (ICS) in alleviation of lifestyle restrictions in 200 asthmatic children. 90 children on ICS were reviewed at 3 months. Restrictions on bathing, food, play activities and school attendance were found in <70%. These were not related to asthma severity. Following ICS, reduction in symptoms, hospital admissions, outpatient visits and nebulizations were noted between 67% -73%. Restrictions on bathing, food, play activities and school attendance had been waived off in 23% -55%. We conclude that ICS significantly alleviated symptoms and lifestyle restrictions. However, the reduction on lifestyle restrictions was less than symptom control.
Kerosene Oil Poisoning among Children in Rural Sri Lanka
(Hindawi Pub. Corp., 2017) Dayasiri, M.B.K.C.; Jayamanne, S.F.; Jayasinghe, C.Y.
INTRODUCTION: Kerosene oil poisoning is one of common presentations to emergency departments among children in rural territories of developing countries. This study aimed to describe clinical manifestations, reasons for delayed presentations, harmful first aid practices, complications, and risk factors related to kerosene oil poisoning among children in rural Sri Lanka. METHODS: This multicenter study was conducted in North-Central province of Sri Lanka involving all in-patient children with acute kerosene oil poisoning. Data were collected over seven years from thirty-six hospitals in the province. Data collection was done by pretested, multistructured questionnaires and a qualitative study. RESULTS: Male children accounted for 189 (60.4%) while 283 (93%) children were below five years. The majority of parents belonged to farming community. Most children ingested kerosene oil in home kitchen. Mortality rate was 0.3%. Lack of transport facilities and financial resources were common reasons for delayed management. Hospital transfer rate was 65.5%. Thirty percent of caregivers practiced harmful first aid measures. Commonest complication was chemical pneumonitis. Strongest risk factors for kerosene oil poisoning were unsafe storage, inadequate supervision, and inadequate house space. CONCLUSIONS: Effect of safe storage and community education in reducing the burden of kerosene oil poisoning should be evaluated. Since many risk factors interact to bring about the event of poisoning in a child, holistic approaches to community education in rural settings are recommended.
Patterns and outcome of acute poisoning among children in rural Sri Lanka
(BioMed Central, 2018) Dayasiri, M.B.K.C.; Jayamanne, S.F.; Jayasinghe, C.Y.
BACKGROUND: The burden of poisoning among children is largely underexplored in rural Sri Lanka. This study describes the patterns of demographic characteristics, poison related factors, clinical management and outcome following acute poisoning among children (9 months- 12 years) in rural Sri Lanka. METHOD: This hospital based multi-center study included Anuradhapura Teaching hospital, Polonnaruwa District General hospital, and 34 regional hospitals within Regional Director of Health Services in North Central province of Sri Lanka. The study assessed clinical profiles, poison related factors, clinical management, complications, harmful first aid practices, reasons for delayed management, complications and outcomes following acute poisoning over 7 years. RESULTS: Among 1621 children with acute poisoning, the majority were in preschool age group. Household chemicals were accountable for 489 acute poisonings (30.2%). The most common poison was kerosene oil, followed by paracetamol. Most events occurred within their own domestic premises. Potentially harmful first aid measures were practiced by approximately one third of care givers. Reasons for delayed presentation at emergency center included lack of concern by family members regarding the urgency of the situation and lack of knowledge regarding possible complications. Complications were observed in 12.5% and the most common complication was chemical pneumonitis. CONCLUSIONS: Children with acute poisoing in rural Sri Lanka were predominantly preschoolers. They are poisonined mostly within their own housing premises. Kerosene oil, in addition to being the most common poison, had additional risks of aspiration pneumonia following potentially hazadrous first aid measures practised by the care givers. Complications though rare were potentially preventable by community education and awareness on timely attention to seek medical care, and avoidance of harmful first aid practices. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12887-018-1246-0) contains supplementary material, which is available to authorized users.
Patterns of acute poisoning with pesticides in the paediatric age group
(Springer, 2017) Dayasiri, K.C.; Jayamanne, S.F.; Jayasinghe, C.Y.
BACKGROUND: Pesticides are identified as one of the dangerous poisons globally in children and are associated with increased short- and long-term morbidity. Pesticide poisoning is the most common method of self-poisoning among adults in rural Sri Lanka, and the clinical management is associated with significant healthcare costs to the country. There is however little data published on acute pesticide poisoning among children in rural Sri Lanka. The current study aimed to comprehensively evaluate clinical profiles, harmful first aid measures, emergency clinical management, complications and outcomes related to acute pesticide poisoning among children in the rural community of Sri Lanka. METHODS: This multicenter study was conducted in the North Central Province of Sri Lanka involving all children with acute pesticide poisoning and who were between 9 months and 12 years of age. Data were collected over 7 years (2007-2014), and children from 36 hospitals were recruited. Data collection was carried out by pretested, multi-structured, interviewer-administered questionnaires to identify clinical profiles of children, harmful first aid measures, emergency clinical management, reasons for delayed management, complications and outcomes of pesticide poisoning events. RESULTS: Among 1621 children with acute poisoning, 9.5% (155) comprised children with acute pesticide poisoning. Male children outnumbered female children, and the majority of children were less than 5 years. Most common pesticides implicated in poisoning of children were organophosphates and carbamates. Gastrointestinal and neurological symptoms were predominant clinical features. Limited transport and lack of concern regarding urgency among caregivers were leading reasons for delayed management. Most common location for poisoning was cultivation lands. Harmful first aid measures were practiced in 32.4%. 7.1% had intentional pesticide poisoning. The case fatality rate of all pesticide poisonings in the study was 1.9%. 58.1% of patients were transferred between regional hospitals and teaching hospital. Cardiac and respiratory arrests, aspiration pneumonia and convulsions were among the reported complications. CONCLUSIONS: Acute pesticide poisoning in paediatric age group (<12 years) is a relatively uncommon yet significant cause of child health-related morbidity and mortality in rural Sri Lanka. Patterns of poisoning represent the pattern of pesticide use by the rural community. The practice of harmful first aid measures by caregivers and delay in attending the emergency department may negatively impact patient outcomes.
Plant poisoning among children in rural Sri Lanka
(Hindawi Pub. Corp., 2017) Dayasiri, M.B.K.C.; Jayamanne, S.F.; Jayasinghe, C.Y.
Plant poisoning is a common presentation in paediatric practice and an important cause of preventable mortality and morbidity in Sri Lanka. The burden of plant poisoning is largely underexplored. The current multicenter study based in rural Sri Lanka assessed clinical profiles, poison related factors, clinical management, complications, outcomes, and risk factors associated with plant poisoning in the paediatric age group. Among 325 children, 57% were male with 64% being below five years of age. 99.4% had ingested the poison. Transfer rate was 66.4%. Most had unintentional poisoning. Commonest poison plant was Jatropha circus and poisoning event happened mostly in home garden. 29% of parents practiced harmful first-aid practices. 32% of children had delayed presentations to which the commonest reason was lack of parental concern regarding urgency of seeking medical care. Presence of poisonous plants in home garden was the strongest risk factor for plant poisoning. Mortality rate was 1.2% and all cases had Oleander poisoning. The study revealed the value of community awareness regarding risk factors and awareness among healthcare workers regarding the mostly benign nature of plant poisoning in children in view of limiting incidence of plant poisoning and reducing expenditure on patient management.
Risk factors for acute unintentional poisoning among children aged 1-5 years in the rural community of Sri Lanka
(Hindawi Pub. Corp., 2017) Dayasiri, M.B.K.C.; Jayamanne, S.F.; Jayasinghe, C.Y.
BACKGROUND: Acute poisoning in children is a major preventable cause of morbidity and mortality in both developed and developing countries. However, there is a wide variation in patterns of poisoning and related risk factors across different geographic regions globally. This hospital based case-control study identifies the risk factors of acute unintentional poisoning among children aged 1-5 years of the ruralcommunity in a developing Asian country. METHODS: This hospital based case-control study included 600 children. Each group comprised three hundred children and all children were recruited at Anuradhapura Teaching Hospital, Sri Lanka, over two years (from February 2012 to January 2014). The two groups were compared to identify the effect of 23 proposed risk factors for unintentional poisoning using multivariate analysis in a binary logistic regression model. RESULTS: Multivariate analysis identified eight risk factors which were significantly associated with unintentional poisoning. The strongest risk factors were inadequate supervision (95% CI: 15.4-52.6), employed mother (95% CI: 2.9-17.5), parental concern of lack of family support (95% CI: 3.65-83.3), and unsafe storage of household poisons (95% CI: 1.5-4.9). CONCLUSIONS: Since inadequate supervision, unsafe storage, and unsafe environment are the strongest risk factors for childhood unintentional poisoning, the effect of community education to enhance vigilance, safe storage, and assurance of safe environment should be evaluated.