Browsing by Author "Perera, M.S."

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Abdominal pain predominant functional gastrointestinal diseases: association with child abuse, traumatic life events and quality of life
(Wiley Blackwell Scientific Publications, 2012) Devanarayana, N.M.; Rajindrajith, S.; Karunanayake, A.; Nishanthini, S.; Perera, M.S.; Benninga, M.A.
BACKGROUND/AIMS: Abdominal pain predominant functional gastrointestinal diseases (AP-FGD) have significant repercussions on affected individuals. Aims of this study were to assess its association with traumatic life events and child abuse, and its impact on quality of life. METHODS: Children aged 13–18 years were randomly selected from 3 schools in Western province of Sri Lanka. A previously validated, self administered questionnaire was used to collect information on gastrointestinal symptoms, traumatic life events, exposure to abuse, healthcare consultation and quality of life (QOL). AP-FGD were diagnosed using Rome III criteria. RESULTS AND DISCUSSION: A total of 1365 children were recruited [males 749 (54.9%), mean age 14.2 years and SD 1.22 years]. AP-FGD were found in 243 (17.8%) children [Irritable bowel syndrome in 70 (5.1%), functional dyspepsia in 11 (0.8%), abdominal migraine in 26 (1.9%) and functional abdominal pain in 146 (10.7%)]. Prevalence of AP-FGDs were significantly higher in those exposed to traumatic life events (37.9% vs. 3.1%, p = 0.03), sexual abuse (35.3% vs. 17.3%, p = 0.01), physical abuse (19.7% vs. 12.6%, p = 0.0003), and emotional abuse (27.4% vs. 16.9%, p < 0.0001). Health care consultation was significantly higher in children exposed to physical abuse (26.4% vs. 0.0%, p = 0.03). QOL scores for physical (85.7 vs. 89.6), emotional (71.7 vs. 79.4), social (85.9 vs. 92.3) and school (74.3 vs. 81.1) function domains were significantly lower in children with AP-FGD who were exposed to emotional abuse (p < 0.05). QOL scores for school function domain was lower in children exposed to physical abuse (77.8 vs. 83.6, p = 0.03). CONCLUSIONS: Traumatic life events and child abuse in any form are significantly associated with higher prevalence of AP-FGD. Children exposed to physical abuse are more likely to seek healthcare for abdominal pain. Children with AP-FGD, exposed to emotional abuse, have significantly poor quality of life in all four domains.
Association between functional gastrointestinal diseases and exposure to abuse in teenagers
(Oxford University Press, 2014) Devanarayana, N.M.; Rajindrajith, S.; Perera, M.S.; Nishanthanie, S.W.; Karunanayake, A.; Benninga, M.A.
Abdominal pain-predominant functional gastrointestinal diseases (AP-FGD) are common in children and commonly attributed to exposure to child abuse. However, this relationship has not been studied in teenagers, and the main objective of the current study was to assess it. Teenagers were recruited from four randomly selected schools in Western province of Sri Lanka. Data were collected using a validated self-administered questionnaire. AP-FGD were diagnosed using Rome III criteria. A total of 1850 teenagers aged 13-18 years were included. Three hundred and five (16.5%) had AP-FGD. AP-FGD were significantly higher in those exposed to sexual (34.0%), emotional (25.0%) and physical (20.2%) abuse, than in those not abused (13.0%, p < 0.001). Those with AP-FGD exposed to abuse had a higher severity score for bowel symptoms (30.8% vs. 24.7% in not abused, p < 0.05). This study highlights the importance of identifying exposure to abuse in management of teenagers with AP-FGD. © The Author [2014]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
Children and adolescents with constipation: Do they have different personalities?
(Wiley Blackwell Scientific Publications, 2012) Ranasinghe, N.; Rajindrajith, S.; Devanarayana, N.M.; Warnakulasuriya, T.; Nishanthini, S.; Perera, M.S.
BACKGROUND AND AIMS: Children with constipation are known to have behavioral and psychological problems. This may partly be due to difference in their personality. Aim of this study is to assess the different personality traits in children having functional constipation. METHOD: We conducted a cross sectional survey in 5 schools in the Eastern province of Sri Lanka. Children and adolescents between 13–18 years were included in the study. Previously validated questionnaires were used to collect bowel habits and demographic data. Translated and validated personality assessment questionnaire (PAQ) was used to assess the personality. Rome III criteria were used to diagnose constipation. RESULTS AND DISCUSSION: A total of 1697 children were recruited [males 778 (45.9%), mean age 15.1 years and SD 1.66 years]. Prevalence of constipation was 6% (102 children). They were compared with 1018 normal children (controls). Seventy eight (76.5%) children with constipation and 426 (41.8%) of controls had PAQ scores above the normative value for Sri Lankan children (89) (p <0.0001). When the international normative value of 105 was used, 33 (32.4%) children with constipation and 111 (10.8%) of controls had psychological maladjustment (p < 0.001). Furthermore Children with constipation scored significant higher scores for different personality traits than controls. They include hostility and aggression (14.1 vs. 12.1 in controls p < 0.001), negative self esteem (11.7 vs. 10.2 in controls p < 0.001), negative self adequacy (11.7 vs. 9.5 controls p < 0.001), emotional unresponsiveness (12.7 vs. 11.1 controls p < 0.001), emotional instability (17.3 vs. 15.0 p < 0.001), and negative world view (12.1 vs. 9.9 controls p < 0.001). CONCLUSIONS: Children with constipation have significant psychological maladjustment than healthy controls. This maladjustment was prominent in hostility and aggression, negative self esteem, negative self adequacy, emotional unresponsiveness, emotional instability and negative world view domains. Addressing these issues is important in the management of children with constipation.
Efficacy of a limb-care regime in preventing acute adenolymphangitis in patients with lymphoedema caused by bancroftian filariasis, in Colombo, Sri Lanka
(Academic Press, 2007) Wijesinghe, R.S.; Wickremasinghe, A.R.; Ekanayake, S.; Perera, M.S.
The efficacy of a programme of community home-based care (CHBC) for lymphoedematous limbs was evaluated among 163 lymphoedema patientsattending two filariasis clinics in Colombo. Each patient was interviewed and examined and his or her lymphoedema was graded during a baseline assessment, before the CHBC programme, and again, during a post-intervention assessment, after the patient had been in the programme for 1 year. The number of patients having entry lesions was 24% lower at the post-intervention assessment than at the baseline (P<0.001), with a reduction in the frequency of each type of entry lesion investigated. In the year the patients were in the CHBC programme, 30% fewer of them experienced at least one attack of adenolymphangitis (ADL; P<0.001), the mean number of ADL attacks/patient was lower (P<0.001), and the mean duration of each ADL attack suffered was slightly shorter (5.70 v. 5.84 days; P>0.05) than in the year before the baseline assessment. The reduction in the incidence of ADL attacks was greatest in the patients with the higher grades of lymphoedema. Approximately 66% of the patients perceived an improvement in their swollen limb post-intervention. Eleven patients had grade-II lymphoedema at baseline but only grade-I lymphoedema after being on the CHBC programme for a year (P=0.012). The programme appeared to increase the frequencies with which patients followed each of the limb-care measures considered and most of the measures for the home management of ADL attacks that were investigated. It is recommended that the CHBC programme be implemented as a national programme in Sri Lanka.
Functional gastrointestinal diseases and psychological maladjustment, personality traits and quality of life
(BioMed Central, 2018) Ranasinghe, N.; Devanarayana, N.M.; Rajindrajith, S.; Perera, M.S.; Nishanthinie, S.; Warnakulasuriya, T.; de Zoysa, P.T.
BACKGROUND: Chronic abdominal pain is a common worldwide problem and known to be associated with psychological problems. This study evaluated the association between abdominal pain-predominant functional gastrointestinal disorders (AP-FGIDs), psychological maladjustment and personality traits in adolescents. METHODS: Adolescents aged 13-18 years were recruited from 5 randomly selected schools in Ampara district of Sri Lanka. AP-FGIDs were diagnosed using Rome III criteria. Translated and validated Rome III questionnaire (Child report form), personality questionnaire (PAQ) and PedsQL (Pediatric Quality of Life) inventory were used in data collection. Written consent was obtained from a parent and assent was obtained from every child recruited. The questionnaire was distributed in an examination setting to ensure confidentiality and privacy. Research assistants were present during data collection to assist on any necessary clarifications. RESULTS: A total of 1697 subjects were recruited [males 779 (45.9%), mean age 15.1 years, SD 1.6 years]. AP-FGIDs were present in 202 (11.9%). Those with AP-FGIDs had significantly higher mean scores for all personality traits (hostility and aggression, negative self-esteem, emotional unresponsiveness, emotional instability and negative world view), except dependency. Affected children had lower scores for all 4 domains of HRQoL (physical, emotional, social and school functioning), compared to controls (p < 0.05). When the cut off value for Sri Lankan children (89) was used, 66.3% with AP-FGIDs and 48.2% controls had PAQ scores within that of psychological maladjustment (p < 0.001). When the international normative value of 105 was used, these percentages were 27.2% and 14.2% respectively (p < 0.0001). The scores obtained for PAQ negatively correlated with scores obtained for HRQoL (r = - 0.52, p < 0.0001). One hundred and seventeen adolescents with AP-FGIDs (57.9%) had sought healthcare for their symptoms. Healthcare consulters had higher PAQ and lower HRQoL scores (p < 0.05). CONCLUSIONS: Adolescents with AP-FGIDs have more psychological maladjustment and abnormal personality traits than healthy controls. Affected adolescents with higher psychological maladjustments have lower HRQoL. Greater psychological maladjustment and lower HRQoL are associated with healthcare seeking behaviour in adolescents with AP-FGIDs.
Gastric emptying and antral motility parameters in children with functional dyspepsia: association with symptom severity
(Wiley-Blackwell, 2013) Devanarayana, N.M.; Rajindrajith, S.; Perera, M.S.; Nishanthanie, S.W.; Benninga, M.A.
BACKGROUND AND AIMS: Functional dyspepsia (FD) is an important gastrointestinal problem with obscure etiology. Abnormal gastric motility is suggested as a possible pathophysiological mechanism for symptoms. The main objective of this study was to assess gastric motility in Sri Lankan children with FD. METHODS: Forty-one children (19 [46.3%] males, age 4-14 years, mean 7.5 years, SD 2.6 years) referred to the Gastroenterology Research Laboratory, Faculty of Medicine, University of Kelaniya, from January 2007 to December 2011, were screened. Those fulfilling Rome III criteria for FD were recruited. None had clinical or laboratory evidence of organic disorders. Twenty healthy children were recruited as controls (eight [40%] males, age 4-14 years, mean 8.4 years, SD 3.0 years). Liquid gastric emptying rate (GE) and antral motility parameters were assessed using an ultrasound-based method. RESULTS: Average GE (45.6% vs 66.2% in controls), amplitude of antral contractions (58.2% vs 89.0%) and antral motility index (5.1 vs 8.3) were lower and fasting antral area (1.5 cm(2) vs 0.6 cm(2)) was higher in patients with FD (P < 0.01). Frequency of antral contractions (8.8 vs 9.3) did not show a significant difference (P = 0.07). Scores obtained for severity of abdominal pain negatively correlated with GE (r = -0.35, P = 0.025). Children with FD, exposed to stressful events had higher fasting antral area (1.9 cm(2)) than those not exposed to stress (1.0 cm(2)) (P = 0.02). CONCLUSIONS: GE and antral motility parameters were significantly impaired in children with FD compared with controls. GE negatively correlated with severity of symptoms. This study points to disturbances in gastric motility as an etiological factor for FD. © 2013 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.
An investigative study to confirm that the pali language is composed of applied language features
(The Library, University of Kelaniya, Sri Lanka, 2023) Perera, M.S.
Applied languages often contribute to the communication of feelings. But Pali is not a language used today to communicate personal feelings. However, the main aim and purpose of this research is to prove with evidence that the Pali language was a practical language in Indian society during the Buddha's time since the Tipitaka literature always contains living language features. Using the Buddhist primary and secondary sources, the applied language features in the Pali language are analysed by outlining various factors and aspects. Employed research methodology. The vitality of a language should not be evaluated solely based on its current or sustained use by a linguistic community. Instead, it can be argued that both the value and the vitality of a language depend on its potential to fulfill the needs of its users. Today, many modern European languages have gained a prominent status, mainly because of the subject matter written in them. Yet, if the mother tongue of a particular linguistic community enables its members to access the same knowledgebase, they are unlikely to give more prominence to a foreign language. For example, the native speakers of languages such as Chinese, Russian, and Japanese who have access to current scientific knowledge in their own languages do not tend to ascribe a great deal of prominence to the English language, despite its status in today. This example suggests that the knowledgebase available in a particular language has a significant impact on its vitality and status. For the same reason, Pali has been recognized as an advanced, expedient and powerful medium for communicating the profound and subtle aspects of the teachings of the Lord Buddha.
Knowledge and perceptions of filariasis in Colombo, Sri Lanka, among patients with chronic filarial lymphoedema
(Academic Press, 2007) Wijesinghe, R.S.; Ekanayake, S.; Perera, M.S.; Wickremasinghe, A.R.
Personality assessment in children with abdominal pain predominant functional gastrointestinal diseases
(Wiley Blackwell Scientific Publications, 2012) Ranasinghe, N.; Rajindrajith, S.; Devanarayana, N.M.; Warnakulasuriya, T.; Nishanthini, S.; Perera, M.S.
BACKGROUND AND AIMS: Chronic abdominal pain is a commonly associated with psychological problems. This study aimed to evaluate the personality traits in teenagers with abdominal pain predominant functional gastrointestinal diseases (AP-FGD). METHODS: Data regarding gastrointestinal symptoms, and personality assessment were collected from teenagers aged 13–18 years from 5 randomly selected schools in Ampare district of Sri Lanka. AP-FGD were diagnosed using Rome III criteria. Translated and validated personality assessment questionnaire (PAQ) was used to assess the total personality maladjustment score and personality domains; namely hostility and aggression, dependency, lack of self esteem, lack of self adequacy, emotional instability, emotional unresponsiveness, and negative world view. RESULTS AND DISCUSSION: A total of 1697 children were recruited [males 778 (45.9%), mean age 15.1 years and SD 1.66 years]. AP-FGD were seen in 202 (11.9%) teenagers. They were compared with 1051 normal children. When the cutoff value for Sri Lankan children (89) was used, 66.3% of with AP-FGD and 42.5% controls had PAQ scores within that of psychological maladjustment (p < 0.001). When the international normative value of 105 was used, these percentages were 27.2% and 11.2% respectively (p < 0.0001). Subgroup analysis revealed similar differences in all 4 subtypes of AP-FGD compared to controls (p < 0.05). Children with AP-FGD had significant higher mean scores for all personality domains compared to controls except for dependence (p < 0.05). Children with irritable bowel syndrome and abdominal migraine also showed similar results (p < 0.05). Apart from dependency and emotional instability children with functional dyspepsia were noted to have higher mean scores for all other personality domains (p < 0.05). In addition, children with functional abdominal pain had signifi cantly higher mean scores for all personality domains except dependency and negative world view (p < 0.05). CONCLUSIONS: Psychological maladjustment is significantly more common in all four subtypes of AP-FGD.
Physical disability and psychosocial impact due to chronic filarial lymphoedema in Sri Lanka
(BioMed Central, 2007) Wijesinghe, R.S.; Wickremasinghe, A.R.; Ekanayake, S.; Perera, M.S.
BACKGROUND: Information on the physical and psychosocial disability of lymphatic filariasis in Sri Lanka is scarce. Therefore this study was carried out to describe the physical disability and psychosocial impact associated with chronic lymphoedema in patients attending filariasis clinics in the Colombo district, Sri Lanka. METHODS: Four hundred and thirteen patients with lymphoedema of limbs attending filariasis clinics in Werahera and Dehiwala in the Colombo district were enrolled in the study after obtaining informed written consent. Data were collected using a pre-tested, interviewer-administered questionnaire and analyzed using SPSS. RESULTS: Majority (95%) of patients had lower limbs affected and there was a significant association with difficulty in walking (p = 0.023). The swollen limb affected the work of 87 (52%) of employed patients and 26 persons reported loss of job. Approximately 25% and 6% reported having problems interacting with the community and family, respectively and 8.7% felt that they were rejected by society. The swollen limb was perceived as a major problem by 36.8% of patients. Of the married persons, 5.7% and 6.2% reported sexual and marital problems respectively, due to their swollen limb/s. Of those who had marital problems, 77.3% reported sexual problems as well (p < 0.001). CONCLUSION: Lymphoedema significantly affects physical, psychological and social functioning in affected individuals. Morbidity control, in addition to control of physical disability, should target the psychosocial consequences.