Browsing by Author "Mettananda, D.S.G."

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Animal bites in children: reasons for delay in seeking medical help
(Sri Lanka Medical Association, 2008) Peiris, M.A.C.; Perera, K.P.J.; Adhihetty, D.; Goonewardena, A.R.; Mettananda, D.S.G.
OBJECTIVE: To describe the clinical characteristics of animal bites in children and to determine the reasons for delay in seeking medical help DESIGN, SETTING AND METHODS: A descriptive study was conducted at the North Colombo Teaching Hospital in 2007. Consecutive children admitted following animal bites were recruited into the study until a sample of 100 was achieved. Children with snake and insect bites were excluded from the study. Data on clinical characteristics and treatment were obtained using an interviewer schedule. RESULTS: Sixty-five (65%) subjects were males. Mean age of children was 6.8(SD=3.2) years. Majority (88%) of bites were by dogs while cats, rats, monkeys and squirrels were responsible for the others. 68% of animals (67% of dogs) were domestic animals but only 14% were vaccinated. None of the domestic cats or squirrels was vaccinated. 72% were provoked bites and 81% had major exposures. Face, hands and fingers were the commonest places of bites. Following the bite 89% had washed the bite-site with soap and water and 6% had used antiseptics for cleaning. 75% came to the hospital within 24-hours while 16% presented after 72 hours. Commonest reason for delay was ignorance. There was no significant association between the delay in presentation and age or sex of the child, maternal educational level, number of children in the family, distance to the hospital, type of animal or the degree of exposure. CONCLUSION: Eighty-six percent of animal bites in children were by unvaccinated animals. One-fourth of children were brought to the hospital after 24 hours and the commonest reason for delay was ignorance.
A Child with Morquio syndrome and mixed mitral valve disease
(Sri Lanka Medical Association, 2008) Mettananda, D.S.G.; Fernando, A.D.
No Abstract Available
Clinical characteristics and fate of neonates born before 34 weeks of gestation: a case-controlled study
(Sri Lanka Medical Association, 2008) Mettananda, D.S.G.; Rajindrajith, S.; Adhihetty, D.; Goonewardena, A.R.; Adikari, A.M.C.; Pannala, W.S.; Devanarayana, N.M.; Mettananda, K.C.D.
OBJECTIVES: To describe and compare the socio-de mo graphic and clinical characteristics, problems and outcome of premature neonates born before 34 weeks of gestation. DESIGN, SETTING AND METHODS: A case-controlled study was conducted at the special care baby unit (SCBU) and the university obstetric unit of North Colombo Teaching Hospital from January to December 2006. All neonates born before 34 weeks of gestation were recruited as cases and a randomly selected group of term neonates were recruited as controls into the study after obtaining maternal consent. Data were collected by interviewing mothers and using patient records, RESULTS: Seventy cases and an equal number of controls were recruited. 40(57.1%) cases and 30(42.9%) controls were males. Mean birth weight was 1.44(SD=0.46) kg for cases and 2.94(SD=0.35) kg for controls. Multiple pregnancy [OR-14.3, 95%CI=1.8-113.1] and monthly family income less than Rs.l0, 000/= [OR=2.6, 95%CI:=l.l-5.8] carried a significantly higher risk of deliveries before 34 weeks. Increased risk was also detected in subjects with obstetric [OR=4.2, 95%CI=2.0-8.8)] and fetal [OR=11.0, 95%CI=3.6-33.6] complications. Maternal blood group, maternal education level and social class assessed by father's occupation did not have any association with deliveries before 34 weeks. Mean 1-minute APGAR was significantly lower in neonates born before 34 weeks [7.2(SD=2.9)] than controls [9.7(SD=0.5) J (p<0.001), and the same was true for the score at 5 minutes. All cases were admitted to the SCBU and were kept in incubators. The stay in SCBU ranged from 1 to 110 days (mean 15.1, median 9.0 & mode 1, 0 days). 37(53%) had jaundice whereas 45.7%, 28.6% and 24.3% had sepsis, surfactant deficient lung disease and apnoea respectively. 67(95.7%) neonates needed oxygen, 12.9% were ventilated and 80% were given antibiotics. Twelve (17.1%) died while the rest (82.9%) were discharged. CONCLUSIONS: Multiple pregnancies, presence of maternal or fetal complications and low family income were associated with increased risk of deliveries before 34 weeks of gestation. Jaundice, sepsis, surfactant deficient lung disease and apnoea were the commonest problems in babies born before 34 weeks of gestation. Nearly one fifth of them died during the neonatal period.
Fate of premature neonates born before 34 Weeks of gestation: experience at a tertiary Care centre in sri lanka
(The Sri Lanka College of Paediatricians, 2008) Mettananda, D.S.G.; Rajindrajith, S.; Adhihetty, D.; Goonewardena, A.R.; Adikari, A.M.C.; Pannala, W.S.; Devanarayana, N.M.; Mettananda, K.C.D.
BACKGROUND: Neonates bom before 34 weeks of gestation are at risk of numerous complications and their management is technologically demanding. Despite advancements in other areas of medicine, neonatal intensive care facilities are still at a primitive stage even in tertiary care hospitals in Sri y Lanka, OBJECTIVE: To describe the clinical characteristics, problems and outcome of premature neonates born before 34 weeks of gestation. DESIGN, SETTING AND METHOD:A descriptive study was conducted in the Special Care Baby Unit (SCBU) of the North Colombo Teaching Hospital. All babies born before 34 weeks of gestation during me year 2006 were recruited, after obtaining maternal consent. Data was collected by interviewing mothers and using patient's records. RESULTS: Seventy neonates were recruited (male 57%). Of them 42 (60%) were delivered vaginally and 10 (14%) were born before 28 weeks of gestation. Mean birth weight was 1.44 (SD = 0.46) kg. All were admitted to the SCBU and were kept in incubators. The stay in SCBU ranged from 1 to 110 days (mean 15 days) and they were kept in incubators for an average of 5,8 days. Thirty seven (53%) had jaundice of whom 25 (36%) needed phototherapy but only one required exchange transfusion. Sepsis, surfactant deficient lung disease and apnoea were seen in 45.7%, 28.6% and 24.3% respectively. Four neonates each developed hypoglycaerma, anaemia and retinopathy of prematurity. Sixty seven (96%) neoaates needed oxygen, 13% were ventilated and 80% were given antibiotics. In 63% blood was taken for investigations more than 5 times. Twelve (17%) died while the rest (83%) were discharged. CONCLUSIONS: Jaundice, sepsis, surfactant deficient lung disease and apnoea were the commonest problems in babies born before 34 weeks of gestation. Nearly one fifth of them died during the neonatal period.
Impact of overcrowding on paediatric health problems in Chandigarh, India
(Sri Lanka Medical Association, 2008) Mettananda, D.S.G.; Mettananda, K.C.D.; Thakur, J.S.; Kumar, R.
OBJECTIVE: To determine the relationship between overcrowding and acute respiratory infections (ART) and diarrhoea in children. DESIGN, SETTING AND METHODS: A cross-sectional analytical study was conducted at the Urban Health Training Centre, Indira Colony, and Chandigarh, India in December 2004. All children under the age of 2 years attending the immunization clinic were recruited into the study. An interviewer schedule was used to collect data. Overcrowding, ARI and diarrhoea were defined using standard WHO definitions. RESULTS: Sixty children were recruited into the study. Mean age was 5.95 months. Thirty-three (55%) were boys. Forty-eight (80%) children belonged to the lowest social class. Thirty-five (58.3%) houses had only a single room and 39 (65%) households were overcrowded. Twenty-one (35%) children were exposed to passive smoking. Incidences of ARI and diarrhea during the past one month were 61.7% and 35% respectively. Children from overcrowded houses had significantly higher incidence of ARI compared to children from non-overcrowded houses (x2=4.5, p<0.05) but there was no such relationship with the incidence of diarrhoea (x2==1.3, p>0.05). There was no significant association between the incidence of ARI and passive smoking (x2= 1.239, p>0.05). CONCLUSION: Sixty-five percent of households in Indira Colony, Chandigarh are overcrowded. The study identified a significant association between overcrowding and the incidence of ARI but not with the incidence of diarrhoea.
Incidental finding of occult carcinoma in histology in total thyroidectomy for benign thyroid disease
(2006) Fernando, R.; Mettananda, D.S.G.; Kariyakarawana, L.
OBJECTIVES: The incidence of occult carcinoma of thyroid varies from 1%-10% in the literature. These unexpected cancers do not show any pre or intra-operative indication of malignancy. Total thyroidectomy in benign thyroid disease is receiving wider acceptance. If a lesser surgery is performed and an occult carcinoma is detected a difficult therapeutic dilemma ensues. This study presents the incidence and clinical presentation of occult carcinomas in a series of total thyroidectomies performed for benign disease. METHODS: Analysis was performed on 55 patients who have undergone total thyroidectomy for benign diseases. Surgeries were performed at the University Surgical Unit of North Colombo Teaching Hospital by a single surgeon from January 2000 to August 2005. Clinical manifestations, surgical details and histological findings were obtained from the patients' records. RESULTS: Five cases of occult carcinomas were discovered with an incidence of 9.1%. Histology confirmed 2 papilary, 2 medullary and 1 follicular carcinomas. Mean age was 52.0 (SD ±13.3) years and 80% were females. Majority (80%) presented with multinodular goiters; 60% were euthyroid and 40% were hyperthyroid. Fine needle aspiration cytology confirmed benign aetiology in all. None of these patients developed transient or permanent complications following total thyroidectomy. CONCLUSIONS: Incidence of occult thyroid carcinoma is 9.1% in this series. None of the patients had problems following total thyroidectomy. The policy of performing total thyroidectomy in benign disease appears to be beneficial as it obviate the need for further surgery if an occult carcinoma is found.
Incidental occult carcinomas in total thyroidectomy for benign diseases of the thyroid
(Sri Lanka Medical Association, 2009) Fernando, R.; Mettananda, D.S.G.; Kariyakarawana, L.
BACKGROUND: Total thyroidectomy is increasingly recognised as the preferred surgical option for benign diseases of the thyroid. One factor contributing towards this change in policy is reports of incidental carcinomas in the resected specimens. METHODS: This was a prospective study of patients, who underwent total thyroidectomy for benign diseases of the thyroid at the University Surgical Unit, Colombo North Teaching Hospital from January 2003 to December 2005. RESULTS: There were 68 patients (67 females) aged 28 to 67 years (mean 44.2 (SD=11.1). In 6 (8.8%) patients, histological examination of the post-operative specimen showed incidental carcinomas: 2 papillary, 2 medullary and 2 follicular carcinomas. There was no significant difference in age, clinical presentation and functional thyroid status of patients with incidental carcinomas and those with histologically confirmed benign diseases. CONCLUSIONS: Occurrence of incidental thyroid cancers was 8.8% in this series, and they were difficult to predict pre-operatively. The policy of performing total thyroidectomy for benign disease of the thyroid obviates the need for further surgery if an incidental carcinoma is found.
An islandwide hospital based epidemiological survey of haemoglobinopathies and an assessment of standards of care in 23 centres
(Sri Lanka Medical Association, 2017) Premawardhena, A.P.; Mudiyanse, R.M.; Jifri, M.N.; Nelumdeniya, U.B.P.; Silva, D.P.S.I.; Nizri, A.H.M.; Rajiyah, M.O.F.; de Silva, T.U.N.; Pushpakumara, K.R.C.; Dissanayake, D.M.R.; Jansz, M.; Rifaya, M.I.; Navarathne, N.M.U.S.B.; Arambepola, W.W.M.M.; Thirukumaran, V.; Mendis, D.; Weerasekara, K.P.; de Silva, N.N.; Vaidyanatha, U.S.de.S.; Mettananda, D.S.G.; Oliveri, N.F.; Weatherall, D.J.
INTRODUCTION & OBJECTIVES: There is no database for haemoglobinopathy patients in Sri Lanka resulting in imprecise knowledge about the distribution and standards of care among patients managed in different centres in the island. The prevention programme commenced in 2007 is not centrally monitored. METHODS: We carried out centre-wise visitation and data gathering of patients with haemoglobinopathies in 2015. 23 centres were visited by researchers who gathered information from patient records. RESULTS: Data was obtained of 1768 patients. Three centres had over 200 patients each and another three centres had between 50-100 patients. There were 8 centres with less than 10 patients each. Beta thalassaemia major (BTM) accounted for 1207 (68.26%) patients. There were 363 patients (20.53%) with Haemoglobin E-β thalassaemia. Sickle cell-β thalassaemia accounted for 51 patients (2.88%). The mean age of BTM patients was 13 years (range 2-44). Ethnic distribution of the haemoglobinopathies (82.5% Sinhalese, 12% Muslims and 5.2% in Tamils) was discrepant to the national ethnic data. Islandwide mean number of new births of all thalassaemics recorded showed a reduction from 66/year between 2004 - 2009 to 48/year between 2010 to 2015.Clinical record keeping was not systematic in most units thus complication rates were hard to obtain. Death data were available only in two units. CONCLUSION: This study identified significant inconsistencies in haemoglobinopathy care between centres. Existence of small centres needs to be recognized by the Ministry of Health. A reducing trend of new births over the last decade was observed.
Neonatal deaths in a tertiary care hospital in sri lanka
(The Sri Lanka College of Paediatricians, 2008) Pannala, W.S.; Adikari, A.M.C.; Mettananda, D.S.G.; Rajindrajith, S.; Devanarayana, N.M.
BACKGROUND: Neonatal mortality rate reliably assesses the level of perinatal care in a country. Lethal congenital malformations and extreme prematurity are the main causes of neonatal mortality in developed countries. Developing countries continue to lose neonates due to infections, malnutrition and birth asphyxia. OBJECTIVE: To describe the clinical characteristics, timing and causes of neonatal deaths Jn a tertiary care hospital in Sri Lanka, DESIGN, SETTING AND METHOD: A descriptive study was conducted at the Special Care Baby Unit of the University Paediatric Unit of North Colombo Teaching Hospital, Ragama. Data on all neonatal deaths which occurred from January 2006 to June 2007 were extracted from hospital records using a data collection form. RESULTS: Fifty-nine neonatal deaths were studied. All babies were born at hospitals and there were no home deliveries. Thirty (51%) were males and 42% were first born. Sixty six percent were deliveredpreterm including 13% delivered before 28 weeks. Mean birth weight was 1.81 (SD^O.87) kg. Twenty eight (47%) were delivered following an' uncomplicated antenatal period while 9 (15%) mothers had pre-labour rupture of membranes, 8 (14%) had pregnancy induced hypertension and 6 (10%) had antepartum haemorrhages. Fifty four percent were delivered vaginally and 41% by emergency caesarean section. Forty five (76%) needed resuscitation at birth. Eight (14%) newborns did not survive more than an hour and a further 16 (27%) died within the first 24 hours. Forty four (75%) died within one week. Twenty six (44%) died of complications of prematurity of which half had surfactant deficient lung disease. Other causes of death were sepsis (20%), congenital abnormalities (14%), meconium aspiration syndrome (12%) and birth asphyxia (10%). Pathological postmortems were done on 17 (29%). CONCLUSIONS: Seventy five percent of deaths occurred in the first week of life, 41% occurring within the first 24 hours. Forty four percent died of complications of prematurity. Birth asphyxia accounted for only 10% of deaths.
Neonatal deaths in a tertiary care hospital in Sri Lanka: a clinical audit
(Sri Lanka Medical Association, 2008) Pannala, W.S.; Adikari, A.M.C.; Mettananda, D.S.G.; Rajindrajith, S.; Devanarayana, N.M.
OBJECTIVE: To describe the clinical characteristics, timing and causes of neonatal deaths in a tertiary can centre in Sri Lanka. DESIGN, SETTING AND METHODS: A clinical audit was conducted on all neonatal deaths occurred at specia care baby unit of the university pediatric unit of North Colombo Teaching Hospital from January 2006 tc June 2007. Data were extracted from hospital records using a data collection form. RESULTS: Fifty-nine neonatal deaths were audited. All baies were born in hospitals and there were no home deliveries. Thirty (51%) were males and 42% were first borns. Sixty-six percent were delivered preterm while 13% were delivered even before 28 weeks. Mean birth weight was 1.81(SD=0.87) kg. Twenty-eight (47%) were delivered following an uncomplicated antenatal period while 9(15%) mothers had pre-labour rupture of membranes, 8( 14%) had pregnancy induced hypertension and 6( 10%) had antepartum haemorrhages. 54% were delivered vaginally and 41% were delivered by emergency caesarian section. Forty-five (76%) needed resuscitation at birth. Eight (14%) newborns did not survive more than an hour and 16 more (27%) died within the first 24-hours; 44(75%) died within one week. Twenty-six (44%) died of complications of prematurity of which half had surfactant deficient lung disease. Other causes of death were sepsis (20%), congenital abnormalities (14%), meconium aspiration syndrome (12%) and birth asphyxia (10%). Pathological postmortems were done on 17(29%). CONCLUSIONS: Three-quarters of deaths were early neonatal deaths and over 40% occurred within the first 24 hours. Nearly half died of complications of prematurity and asphyxia accounted only for 10% of deaths.
Profound thrombocytopenia and generalized hyperpigmentation following pyrimethamine use
(Sri Lanka College of Paediatricians, 2011) Senanayake, M.P.; Mettananda, D.S.G.; Vidyatilake, S.
No Abstract Available
Pseudohypoaldosteronism type 1 in an infant
(Sri Lanka Medical Association, 2011) Mettananda, D.S.G.; de Silva, K.S.H.
No Abstract Available.
Psychosocial outcomes of children and parents after renal transplantation.
(Sri Lanka College of Paediatricians., 2015) Ranawaka, P.R.D.; Abeysekera, C.K.; Gamage, M.P.; Illangasekara, O.R.; Silva, G.R.C.; Mettananda, D.S.G.; Pathmanathan, T.; Abeyagunawardena, A.S.
Introduction: Although some highlighted problems such as parental stress, child behavioural problems and financial instability occur after transplantation, much still remains unknown about the extent, nature, reasons and implications of family difficulties caused by renal transplantation in childhood. Objectives: To examine the psychosocial aspects, levels of parental stress and behavioural problems among children after renal transplantation and to study the predictors of psychosocial issues in the study sample. Design, setting and method: A cross sectional analytical study was conducted at the University Paediatric Unit of the Teaching Hospital, Peradeniya in September-October 2012. All patients who are being followed up at the post renal transplant clinic were recruited to the study. Data was collected using an interviewer-administered questionnaire and analyzed using SPSS 16.0. Results: Thirty-eight recipients of paediatric renal transplants were recruited. 67.5% were males. Feeling of happiness constantly or regularly was reported by 82.5% of children while irritability was a significant problem in 47.5%. Sleep disturbance was a recognized problem in 50% of children. At 2 years of transplantation 85 % of children had not attended school but at 5 years after transplantation school dropout was 10 %. This difference was statistically significant [X2=25.8, p<0.001]. 52.5% of parents had expressed their stress on a constant or regular basis. 37.5% of fathers had lost their jobs consequent to renal transplantation and 30% of families had a monthly income less than LKR 10, 000. Conclusions: 82.5% of children reported feelings of happiness on a constant or regular basis after renal transplantation. Non-attendance at school was observed in 85% at 2 years of transplantation but the school dropout was 10% at 5 years after transplantation. 52.5% of parents had expressed their stress on a constant or regular basis.
Recurrent urinary tract infections in females - a prospective analysis
(Sri Lanka Medical Association, 2012) Mettananda, K.C.D.; Ranaweera, A.; Mettananda, D.S.G.
INTRODUCTION: Urinary tract infection (UTI) is the commonest infection in women worldwide. Patients with co-morbidities or predisposing factors are at risk of developing recurrent UTI. They require hospitalisation, since causative organisms acquire resistance to first-line antibiotics and intravenous second-line antibiotics are indicated for complete eradication. Consequently, there is disturbance to lifestyle and loss of productivity for the patient. AIMS: To describe clinical profile and risk factors of female patients with recurrent UTI. Methods: All females admitted to the University Medical Unit at Teaching Hospital, Ragama from April 2011- March 2012, with >2 UTI occurring within the previous 12-months, were recruited. Data was collected using an interviewer-administered questionnaire. Results: 22 patients [mean age 48.8 years (SD+16.8, range 14-73]] fulfilled inclusion criteria. 16 (73%) were post-menopausal.13(59%) had diabetes, with poor control in 12. Other risk factors were constipation (27%), cystocele (14%), urinary calculi (9%) and hydronephrosis (9%). Urine culture was performed before antibiotics in 17(77%). 88% pre-treatment cultures were positive. 11(50%) had pyelonephritis during the current admission. 85% of diabetics had positive cultures compared to non-diabetics (77%) (p=0.55). Escherichia coll was the commonest pathogen (in 67.5%). Pyelonephritis was commoner among diabetics (61%) than non-diabetics (33%) 0=0.193). CONCLUSIONS: Post-menopausal women with poorly controlled diabetes are likely to have pyelonephritis when they develop recurrent UTI. Better glycaemic control, avoiding constipation and early treatment of structural abnormalities will reduce recurrent UTI in the at-risk population.
Recurrent urinary tract infections in females - a prospective analysis
(Sri Lanka Medical Association, 2012) Mettananda, K.C.D.; Ranaweera, A.; Mettananda, D.S.G.
INTRODUCTION: Urinary tract infection (UTI) is the commonest infection in women worldwide. Patients with co-morbidities or predisposing factors are at risk of developing recurrent UTI. They require hospitalisation, since causative organisms acquire resistance to first-line antibiotics and intravenous second-line antibiotics are indicated for complete eradication. Consequently, there is disturbance to lifestyle and loss of productivity for the patient. AIMS: To describe clinical profile and risk factors of female patients with recurrent UTI. Methods: All females admitted to the University Medical Unit at Teaching Hospital, Ragama from April 2011- March 2012, with >2 UTI occurring within the previous 12-months, were recruited. Data was collected using an interviewer-administered questionnaire. Results: 22 patients [mean age 48.8 years (SD+16.8, range 14-73]] fulfilled inclusion criteria. 16 (73%) were post-menopausal.13(59%) had diabetes, with poor control in 12. Other risk factors were constipation (27%), cystocele (14%), urinary calculi (9%) and hydronephrosis (9%). Urine culture was performed before antibiotics in 17(77%). 88% pre-treatment cultures were positive. 11(50%) had pyelonephritis during the current admission. 85% of diabetics had positive cultures compared to non-diabetics (77%) (p=0.55). Escherichia coll was the commonest pathogen (in 67.5%). Pyelonephritis was commoner among diabetics (61%) than non-diabetics (33%) 0=0.193). CONCLUSIONS: Post-menopausal women with poorly controlled diabetes are likely to have pyelonephritis when they develop recurrent UTI. Better glycaemic control, avoiding constipation and early treatment of structural abnormalities will reduce recurrent UTI in the at-risk population.
Socio-demograpfflc and clinical Characteristics of neonates born before 34 Weeks of gestation: a case control study
(The Sri Lanka College of Paediatricians, 2008) Mettananda, D.S.G.; Rajindrajith, S.; Adhihetty, D.; Goonewardena, A.R.; Adikari, A.M.C.; Pannala, W.S.; Devanarayana, N.M.; Mettananda, K.C.D.
BACKGROUND: Management of neonates born before 34 weeks of gestation demands special resources and'' facilities which are limited in Sri Lanka. Identification of pregnancies at risk of preterm deliveries will enhance the optimal use of these neonatal facilities by appropriate and timely referrals. Objective: To compare th'e socio-demographic and clinical characteristics of neonates born before 34 weeks of gestation with those of term neonates. DESIGN, SETTING AND METHOD: A case-control study was conducted at the university obstetric unit of the North Colombo Teaching Hospital in the year 2006. All neonates born before 34-weeks of gestation were recruited as cases and a randomly selected group of term neonates was recruited as controls into the study after obtaining maternal consent. Data was collected by interviewing mothers and using patient records. RESULTS: Seventy cases and an equal number of controls were recruited. Forty (57%) cases and 30 (43%) controls were males. Mean birth weight was 1.44 (SD=0.46) kg for cases and 2.94 (SD=0.35) kg for controls. Previous history of preterm deliveries was found in 06 (8.6%) cases and. 01 (1.4%) control. Multiple pregnancy [OR=14.3,95% 01=1.8-113] and monthly family income less than Rs.lO,000/= [OR=2.6, 95% Cr^Ll-5.8] carried a significantly higher risk of_deliveries before 34 weeks. Increased risk was also detected in subjects with obstetric [OR=4.2, 95% CI=2.0-8.8)] and fetal [OR=11.0, 95% CI=3.6-33.6] complications. Maternal blood group, maternal education level and social class assessed by father's occupation did not have any association with deliveries before 34 weeks. Mean 1-minute APGAR was significantly lower in neonates born before 34 weeks [7.2 (SD=2.9)] than controls [9.7 (SD=0.5)], (pO.OOl) and the same was true for the score at 5 minutes. CONCLUSIONS: Multiple pregnancies, presence of maternal or fetal complications and low family income were associated with increased risk of deliveries before 34 weeks of gestation. Apgar scores at 1 and 5 minute were lower in neonates born before 34 weeks of gestation.
Sociodemographic and health aspects of mothers in a paediatric ward
(Sri Lanka College of Paediatricians, 2005) de Silva, K.S.H.; Mettananda, D.S.G.; Athauda, T.
OBJECTIVES: To study a group of mothers in a paediatric ward and describe socio demographic profile, presence of existing disease, pulse and blood pressure (BP) profiles during hospital stay, psychological profile prior to admission and changes demonstrated during period of stay. METHOD: A descriptive, cross-sectional study was done in a ward at Lady Ridgeway Hospital for 6 weeks from May 2004. Five hundred mothers staying with their sick children were interviewed using a questionnaire dealing with various aspects. Mothers of children with chronic diseases needing regular admissions and those transferred to and from ward were excluded. Pulse rate and BP of mothers were recorded on admission, within 24 hours and on discharge. Psychological profile was assessed as psychological score, describing behaviour prior to admission, and acute stress score, analysing changes demonstrated during present admission. This was done using a scoring system on a standard questionnaire with 23 items and a modified one with 5 items where higher scores identified mothers reacting more to stressful situations. RESULTS: 476 (95.2%) questionnaires were analysed. Mean age of mothers was 32.1 years with a range of 17 to 52 years. 442 (92.9%) mothers had received secondary or higher education but 8 had never been to school. Monthly income was
A study on adolescent sexual & violent behaviour, drugs & alcohol abuse and its relationship to the past experiences
(Faculty of Medicine, University of Kelaniya & Plan International, 2008) Mettananda, D.S.G.; de Silva, D.G.H.; Jayasinghe, Y.C.; Waduge, T.R.W.; Pathmeswaran, A.; Abeysinghe, A.P.S.D.
Suitability of selection criteria as a measure of medical graduates: University of Colombo
(University of Colombo, 2006) Mettananda, D.S.G.; Wickramasinghe, V.P.; Kudolugoda Arachchi, J.; Lamabadusuriya, S.P.; Ajanthan, R.; Kottahachchi, D.
A prime obstacle faced by a medical educator is selecting the right student to be trained as a doctor, and the general consensus is that this is also the most difficult task. This study was designed to evaluate the effects of selected outcome measures on outcome performance of medical undergraduates of the University of Colombo. A retrospective cohort study was conducted using the performance (marks) of students of 4 batches GCE (A/L) 1993 through to 1996). GCE (A/L) aggregate marks, attempt of entry, district of entry, English language proficiency and sex were tested as predictors of success. Results of main assessments were considered as measures of success. Relationship between outcome measures and outcome predictors were assessed using the multiple logistic regression model. Data of 699 students were analyzed and 82% of students entered from the Colombo district. A higher percentage of first attempters (at GCE A/L) performed well and obtained classes. Entering medical school from first two GCE A/L examination attempts was a significant positive predictor of passing any examination (odds ratio 3.2 to 7.5) or obtaining honors (odds ratio 2.8 to 16.0). Attempt of entry predicted 5.4% of the outcome (pass or fail) in university performance. Correlation between the GCE A/L aggregate mark and the student's position in order of merit for the internship appointments was -0.37 (p<0.001). A combination of factors should be used in the selection process of students to embark on the undergraduate process as any single factor is a poor predictor of outcome of performance. We believe that the number of attempts allowed to sit for GCE A/L in order to gain entry to a medical school as well as other degree courses should be confined to two attempts.