Browsing by Author "Perera, N."

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Abdominal pain-predominant functional gastrointestinal diseases in children and adolescents: prevalence, symptomatology, and association with emotional stress
(Lippincott Williams and Wilkins, 2011) Devanarayana, N.M.; Mettananda, S.; Liyanarachchi, C.; Nanayakkara, N.; Mendis, N.; Perera, N.; Rajindrajith, S.
BACKGROUND AND OBJECTIVE: Functional gastrointestinal disorders (FGD) are common among children, but little is known regarding their prevalence in developing countries. We assessed the prevalence of abdominal pain-predominant FGD, in addition to the predisposing factors and symptomatology, in Sri Lankan children. PATIENTS AND METHODS: A cross-sectional survey was conducted among a randomly selected group of 10- to 16-year-olds in 8 randomly selected schools in 4 provinces in Sri Lanka. A validated, self-administered questionnaire was completed by children independently in an examination setting. FGD were diagnosed using Rome III criteria. RESULTS: A total of 2180 questionnaires were distributed and 2163 (99.2%) were included in the analysis (1189 [55%] boys, mean age 13.4 years, standard deviation 1.8 years). Of them, 270 (12.5%) had at least 1 abdominal pain-predominant FGD. Irritable bowel syndrome (IBS) was seen in 107 (4.9%), functional dyspepsia in 54 (2.5%), functional abdominal pain in 96 (4.4%), and abdominal migraine (AM) in 21 (1.0%) (2 had AM and functional dyspepsia, 6 had AM and IBS). Extra intestinal symptoms were more common among affected children (P < 0.05). Abdominal pain-predominant FGD were higher in girls and those exposed to stressful events (P < 0.05). Prevalence negatively correlated with age (r = -0.05, P = 0.02). CONCLUSIONS: Abdominal pain-predominant FGD affects 12.5% of children ages 10 to 16 years and constitutes a significant health problem in Sri Lanka. IBS is the most common FGD subtype present. Abdominal pain-predominant FGD are higher in girls and those exposed to emotional stress. Prevalence of FGD decreased with age. Extra intestinal symptoms are more frequent in affected children.
Attitudes towards Sri Lankan English lexis and grammar
(Department of English, University of Kelaniya, 2015) Perera, N.
In Sri Lanka, English has long been a language of authority granting access to the higher classes of society. However deviating from the “British” standards and speaking Sri Lankan English is not always regarded in a positive light. The research was conducted to explore the acceptance, the notions on grammatical accuracy and lexical validity of Sri Lankan English among undergraduates and graduates of the University of Kelaniya. The findings are compared with responses from the older users of English. It is seen that both the younger generation and the older generation hold a more permissible attitude towards the use of English, which can be attributed to the increased acceptance and the popularity of Sri Lankan English. However there is less willingness to bend certain hard core rules, especially grammar rules and rules governing the pronunciation of words.
The Changing Composition: Are Young SLE Speakers Familiar with Youtube Slang?
(Faculty of Graduate Studies, University of Kelaniya, Sri Lanka, 2016) Perera, N.
Sri Lankan English (SLE) has been widely used by native SLE speakers for several decades. So far, SLE was believed to be influenced by the vernacular languages of the country, which consists of, but not limited to, Sinhala, Tamil and Malay. However, of late, the composition of the language has been changing and the vocabulary is one area where the change is seen distinctly. The researcher has focused on the use of slang by young SLE speakers for the current study. Slang terms usually make a trending entry into the vocabulary. In terms of SLE, the researcher has observed that there is an influence of slang used internationally on the slang terms used by the young SLE speakers, as SLE speakers are ‘connected’ to the world and come in contact with online slang terms. For the purpose of the study the domain of YouTube was selected, as it gives access to unscripted clips of speech. This quantitative study investigates if the young SLE speakers are familiar with some of these slang terms. The data for the study was collected from YouTube videos from the channel named HigaTV. It is the vlog channel (video log channel) of Ryan Higa who is the nineteenth most subscribed YouTuber. The slang terms selected from the videos were used in a questionnaire. The survey was administered online among 150 participants and 75 responses were used for the data analysis. The respondents expressed their familiarity with each word in the questionnaire, which was measured using a three point Lickert scale with the choices very familiar, familiar and not at all familiar. From a total of 19 words, eight were very familiar to more than 50% of the population while six others were marked ‘very familiar’ by more than 35% of the population. In a further analysis of the meanings of the words ‘duct tape’ and ‘legit’, more than 50% of the respondents stated that they knew the words. However, some meanings they associated with the words were not the same as the meanings in the videos. The majority of the respondents were from Colombo and suburbs. Hence it was concluded that, within the population, the young SLE speakers are familiar with some slang terms used by YouTubers and some of those terms are even used by the SLE speakers in their conversations. The research is however limited to identifying the speakers’ familiarity with the slang terms and does not provide an in depth analysis of the use of these terms. Future work on the topic could explore the familiarity of the slang terms among other age groups and also of speakers from different geographical locations.
Detection of human strongyloidiasis among patients with a high risk of complications attending selected tertiary care hospitals in Colombo, Sri Lanka using molecular and serological diagnostic tools
(BioMed Central, 2024-10) Weerasekera, C.J.; Gunathilaka, N.; Menike, C.; Anpahalan, P.; Perera, N.; De Silva, N.R.; Wickremasinghe, R.
BACKGROUND Strongyloidiasis a neglected tropical disease is known to cause severe disease among immunosuppressed and has not been studied extensively in Sri Lanka. Parasitological diagnostic approaches based on faecal microscopy and culture often fail to detect low-intensity infections. This study investigates the presence of strongyloidiasis among selected immunocompromised individuals using parasitological, molecular and serological techniques.METHODS Adult patients with immunocompromising conditions admitted to three tertiary care hospitals in Sri Lanka were recruited. A faecal sample and 2 ml of venous blood were collected. The faecal samples were subjected to direct faecal smear and cultures (agar plate, charcoal and Harada-Mori) and polymerase chain reaction (PCR) using species specific primers designed for Strongyloides stercoralis. The presence of Strongyloides IgG antibodies was tested in the collected serum samples using DRG Strongyloides IgG enzyme-linked immunosorbent assay (ELISA) kits. The PCR products of the positive samples were sequenced using Sanger sequencing method.RESULTS A total of 260 patients were recruited to this study, out of which 160 provided faecal samples and 122 provided blood samples. Out of the 160 faecal samples, none were positive for strongyloidiasis by direct smear, charcoal and Harada-Mori cultures. Only one sample (0.6%) was positive by agar plate culture. Out of the 123 samples subjected to PCR, 14 (11.4%), including the culture positive patient, were positive for S. stercoralis. Sequencing results of the PCR products indicated 100% similarity to S. stercoralis. Out of the 122 serum samples subjected to ELISA, 20 (16.4%), including the culture positive patient, were positive for Strongyloides IgG antibodies. However, sociodemographic, exposure factors, clinical features were not significantly associated with the presence of strongyloidiasis infection.CONCLUSIONS Strongyloidiasis is present among the immunocompromised population in Sri Lanka, even in the absence of a significant relationship with associated factors. It is advisable to screen such patients with highly sensitive tests such as PCR for early diagnosis and treatment.
Effectiveness of providing health education to caregivers of hospitalized children with asthma for the prevention of recurrent attacks: a quasi-randomized trial
(Informa Healthcare, 2020) Perera, N.; Abeysena, C.
OBJECTIVE: To determine the effectiveness of health education intervention for caregivers of children with asthma, focused on preventing recurrent attacks and improving knowledge. METHODS: A quasi-randomized trial of 177 caregivers of asthmatic children was conducted in government hospitals in a district of Sri Lanka. At the time of discharge from the hospital, a health education booklet was prepared and given to the caregivers in the intervention group, along with individual explanation and discussion. The caregivers' knowledge of asthma and preventive practices was assessed. The primary outcome was the proportion of children with recurrent attacks of asthma who needed doctor visits during the three month post discharge period. The intention-to-treat principle was applied for data analysis.RESULTS: In comparison to the control group, the intervention group had a 76% significant reduction in visits to the doctor for recurrent attacks (95% CI:45%-90%) and a 75% significant reduction in hospital admissions required for asthmatic children (95% CI:16%-93%) at the end of three months of intervention. The mean score of knowledge of asthma in the intervention group was 1.73 units higher at three months (p < 0.01) and 1.47 units higher at six months (p < 0.01) than the control group. The mean score of preventive practices for asthma in the intervention group was 1.25 units higher at three months (p = 0.02) and 1.15 units higher at six months (p < 0.01) versus the control group.CONCLUSION: Health education intervention significantly decreased doctor and hospital visits at three months. In addition, caregiver knowledge of asthma and preventive practices also improved. TRIAL REGISTRATION NUMBER: SLCTR/2010/007.
The effects of corporate governance on financial performance
(Department of Accountancy, University of Kelaniya, 2015) Perera, N.
Attention to corporate governance has quite a long history since the seminal paper on the subject of the “principal – agent problem” by Meckling (1976). They argued that the existence of the principal – agent problem as a consequence of the separation of ownership and control raises a conflict of interest between the interests of managers and shareholders. The financial crisis in 2008 and high sketch financial dishonours tends to have concentration of academic researches, policy makers, regulatory institutions and investors to study the level of corporate governance practices and its effect on firm’s financial performance. Mostly, the quality of corporate governance can be assessed on the basis of the principals of disclosures and transparency, relationship with stakeholders including shareholders, policies and compliance, structure and the characteristics of board of directors and the ownership and control structure. According to Black (2006) worthy corporate governance practices strengthen the firm financial performance. This research empirically examines the quality of corporate governance (CG) practices in Sri Lankan listed private banks and their impact on firm’s financial performance in the context of an emerging market such as Sri Lanka. To evaluate the level of corporate governance practices at an identified firm, this study construct a corporate governance index (CGI) which involves four scopes: disclosure and transparency, composition of the board of directors, shareholders’ rights and investor relations, ownership and control structure. Based on a sample of 10 private banks listed on the Colombo Stock Exchange (CSE) in Sri Lanka, the effects of corporate governance on financial performance are assessed. Tobin’s Q is used to evaluate the firm’s financial performance.
Evaluating an AAC training for special education teachers in Sri Lanka,a low- and middle-income country.
(Taylor & Francis, 2018) Muttiah, N.; Drager, K. D. R.; McNaughton, D.; Perera, N.
A majority of people with disabilities live in low- and middle-income countries where communication services for individuals with complex communication needs are scarce. It is essential that communication partners of individuals who have complex communication needs receive training to support communication. To address this issue, the current study evaluated an augmentative and alternative communication training for special education teachers living in a low- and middle-income country, Sri Lanka. The training was based on four key practices identified when training in low- and middle-income countries: investigate learner needs, provide contextually relevant instructional content, use engaging instructional activities, and assess the impact of instructional activities. This investigation implemented an interrupted time-series design with nine teacher-student dyads. Special education teachers were taught to provide evocative communication opportunities. Following the training, all nine special education teachers significantly increased the number of evocative communication opportunities provided to students with complex communication needs. Additionally, all nine students with complex communication needs significantly increased their number of communication turns.
Incidental diagnosis of strongyloidiasis in a patient with hepatic metastasis
(Sri Lankan Society for Microbiology, 2023) Weerasekera, C.J.; Menike, C.W.; Anpahalan, J.P.; Senevirathne, S.A.A.; Perera, N.; de Silva, N.R.; Wickremasinghe, D.R.
Strongyloides stercoralis is a soil-transmitted helminth infecting humans that can cause hyperinfection and disseminated disease in the immunocompromised host. This case report describes a 56-year-old patient, diagnosed with hepatic metastasis, who was screened for strongyloidiasis by faecal culture. The agar plate culture became positive on the third day of incubation, demonstrating characteristic tracks and yielding rhabditiform larvae. The charcoal and Harada-Mori cultures were negative. The patient was treated with albendazole for 7 days but declined further follow up.
Knowledge on primary and secondary prevention of asthma among caregivers of asthmatic children admitted to paediatric wards in Gampaha District.
(College of Community Physicians of Sri Lanka., 2019) Perera, N.; Abeysena, C.
INTRODUCTION: Asthma is considered to be one of the major public health problems. The accurate knowledge of caregiver on asthma is important for the management. OBJECTIVES: To describe the knowledge on primary and secondary prevention of asthma among caregivers of asthmatic children admitted to the paediatric wards in the district of Gampaha. METHODS: A descriptive cross-sectional study was carried out among 577 caregivers of inward asthmatic children. Pre-tested interviewer- and self-administered questionnaires were used to assess the knowledge on asthma. The grand score of knowledge on asthma was calculated out of 34. The 75th percentile value was considered to differentiate ‘good’ knowledge from ‘poor’ knowledge. Multiple logistic regression was applied to determine the factors associated with poor knowledge on asthma. Results were expressed in adjusted odds ratio (aOR) and 95% confidence interval (CI). RESULTS: The mean score for knowledge on asthma was 20.6 (SD=4.42) ranging from 7 to 30. Among the caregivers, 369 (64%) had poor knowledge on asthma. Low educational level of the caregiver (aOR=2.48; 95% CI=1.59, 3.86) and being under prophylaxis treatment for less than one year (aOR=2.49; 95% CI=1.50, 4.13) were the determinants of poor knowledge on asthma. CONCLUSIONS: Majority of the caregivers’ knowledge on asthma was poor. The caregivers’ low educational level and shorter duration of prophylaxis treatment for the children were associated with poor knowledge on asthma.
Management of a threatened reef to establish its ecosystem sustainability through inter-agency coordination mechanism: A case from Kayankerni, Eastern Coast of Sri Lanka
(4th International Research Symposium on Pure and Applied Sciences, Faculty of Science, University of Kelaniya, Sri Lanka, 2019) Weerasinghe, K. D. I.; Kumara, P.B.T.P.; Perera, N.; Subasinghe, M. M.; Gunasekara, A. M. J.
Sri Lanka is considered as one of the biodiversity hotspots in the world due to its richness and tremendous value of biodiversity. Among these hotspots Kayankerni Coral Reef Ecosystem, located in Eastern coast of Sri Lanka off Kalkudha in Batticoloa district (approx. 7º59.500N, 81º32.000E) is another healthier coral reef ecosystem with vibrant coral, vertebrate and invertebrate diversity. This research focused on determining the species diversity and abundance of corals and ornamental fish species and current threats towards the ecosystem. Further, to explore possible management measures in order to overcome identified risks through Inter-Agency Coordination Mechanism (IACM) aiming to establish a sustainable management mechanism. Species diversity and abundance were determined by using Point Intercept Transect (PIT) method by using five 50m length transects covering the study site. Shannon-Weiner Index (H), Evenness and Dominance were calculated. Current threats on the coral reef and their mitigation measures were identified using questionnaires, informal discussions, and workshops. Highest H is 0.7802 encountered in transect three, while lowest H is 0.4502 in transect four. There are 35% of Acropora branching species, 25% of Montipora foliose species and 24% of Acropora digitate species while 44% of Surgeon fish, 21% of Parrot fish and 21% of Butterfly fish. 42% of total coral cover, 48% of dead coral cover and 10% of bleached coral cover indicated that the need of immediate management mechanism to avert major threats such as bottom set nettings and dynamite fishing. Kayankerni coral reef ecosystem was declared as a Marine Protected Area (MPA) by the gazette on 11th of April 2019 (gazette number 2118/59) under the Fauna and Flora Protection Ordinance (chapter 469) as an outcome of this study
Medical students' perception and attitudes on operating theatre learning experience in Sri Lanka
(Elsevier, 2023) Wijesinghe, K.; Lunuwila, S.; Gamage, H.; Gooneratne, T.; Munasinghe, B.N.L.; Harikrishanth, S.; Nandasena, M.; Perera, N.; Jayarajah, U.
OBJECTIVE: The operating room is a unique learning experience that has visual, aural, kinesthetic learning stimuli and provides benefits to the medical students such as development of sound clinical knowledge and skills, and gaining personal insight into ones' career choice. However, this can be a challenging place due to the unfamiliar learning environment. We aimed to study the Sri Lankan Medical students' perception and attitudes on operating theatre learning experience. DESIGN AND SETTING: A descriptive cross-sectional survey was carried out among medical students undergoing surgical clinical training on the perspectives of the teaching and learning experience in the operating theatre in Sri Lanka. PARTICIPANTS: Our study group consisted of 390 medical students from four different medical faculties in Sri Lanka representing all levels of surgical clinical rotations. RESULTS: A majority of the students had actively participated in the operating theater. Despite this, the students' clarity of the learning outcomes and expectations in a theatre varied greatly. Majority of the students felt that the surgeons were willingly to teach but also noted that there was no standardization in teaching. This study clearly shows a significant correlation between positive emotions and surgical teams welcoming attitude towards the medical students. Long standing hours were considered a negative emotion by a majority of students. We also observed that theatre environment can be physically and mentally exhausting. CONCLUSIONS: Thus, empathy, feeling welcome and giving breaks to refresh can go a long way in making the learning experience better. Regular feedback to trainers on students' perception of the theatre experience is important to value the students' opinion and improve the quality of the surgical theatre. We strongly recommend initiation of clear induction sessions with introduction of well-structured teaching learning activities in the operating theatre.
Meta-analysis of global variations in grade of pT1 urothelial bladder cancer and supplementary evaluation of a Sri Lankan cohort
(The College of Surgeons of Sri Lanka, 2022) Malalasekera, A.P.; Ediriweera, D.; Goonewardena, S.; Perera, N.; Abeygunasekara, A.; Jayasekara, R.W.; Wettasinghe,T.K.; Dissanayake,V.H.W.D.; Lokuhetty, M.D.S.
Introduction Bladder cancer grading is fraught with ambiguity. We aimed to conduct a meta-analysis of grading of pT1 urothelial cancers and assess histopathology and outcomes in a Sri Lankan pT1 bladder cancer cohort. Patients and Method A meta-analysis of grading of pT1 urothelial cancers was conducted as per PRISMA guidelines. A second metaanalysis of the proportion of pTa/NMIBC at disease presentation was conducted to assess impact of delayed presentation on grading. Analysis was supplemented with data from a cohort of Sri Lankan patients. Results In the meta-analysis, the overall pooled pT1 HG prevalence was 75.3% [95% CI:68.3%-81.7%]. The pT1 HG prevalence was significantly higher (p=4.916878e-11) among the European, Japanese and Taiwanese studies at 90.1% [95% CI: 85.3%-94.0%] compared to the rest of the countries at 56.1% [95% CI:46.5%-65.4%]. The overall pooled pTa/NMIBC prevalence was 44.2% [95% CI:36.4%-52.1%]. The pTa/NMIBC percentage among Europe, China and Taiwan was 66.9%[95% CI:62.4%-71.2%] and it was 37.6% [95% CI:29.0%-46.6%] in Turkey and other Asian countries indicating a significant difference(P=1.08e-08). In the Sri Lankan cohort of 66 enrolled patients, 31(47%) had pT1, of which 61% were low-grade (LG). The 5-year progressionfree survival (PFS) of pT1 was 60.9%. In LG it was 85.7% and 22.2% in high-grade (HG) (P = 0.0006). Conclusion There is a global variation of percentages of pT1 LG versus HG disease in bladder cancer specimens at presentation which could be attributed to delay in treatment with stage migration, ethnic variations in tumour biology, and interobserver variability in assigning a grade of tumour, and needs further study.
A Method to Sort Official Correspondence through Natural Language Processing
(Department of Linguistics, University of Kelaniya, Sri Lanka, 2016) Weerasooriya, T.; Perera, N.
Natural language Processing (NLP) is a new branch of study in Computational Linguistics and the field has undergone rapid development over the past few decades. Keyword extraction is a popular application of NLP. The present study makes use of Stanford Core NLP, an NLP tool that enables Parts-of-Speech (POS) tagging in order to extract the keywords from official correspondence. POS tagging identifies all the parts of speech in a sentence and categorises them into the relevant grammatical categories. Capitalising on the grammatical uniformity of formal written English, the system is able to identify all the noun phrases and verb phrases of a sentence. Hence, the subject and the predicate of the sentence are isolated. Document sorting with regard to official correspondence is done through the system by analysing the „object‟ line of an official letter or the „subject‟ line of an e-mail, and listing the noun phrases and verb phrases. The document is then sorted to the relevant department. In order to prevent slips in the system, the remaining words of the „object‟ / „subject‟ lines are filtered through a keyword corpus. This increases the accuracy of the keyword extraction process. The present system proved to be more efficient that selecting keywords through a filter, as the POS tagging sorts and presents keywords in an order where the respondents are able to grasp the main idea of the sentence. The subsidiary list of words extracted through the key word corpus adds to the accuracy of the system. The present study is only limited to official correspondence in English. It could be modified to be adapted to other languages.
Physical Barriers Encountered Within Hospitals by an Elderly Population in Accessing Healthcare: A Study Conducted at The North Colombo Teaching Hospital, Ragama, Sri Lanka.
(Access To and Through Education Conference, 2021) Edussuriya, T.N.; Dissanayake, K.D.M.R.H.; Fernando, V.S.T.H.; Fernando, W.S.; Fernando, W.N.N.; Perera, N.
As the population of Sri Lanka rapidly ages, the issue of equity and equality in accessing health care facilities for elderly is important. There are physical barriers for accessibility in healthcare facilities for them which can be corrected effortlessly in local context. Objective- To identify difficulties and physical barriers encountered by an elderly population in accessing healthcare at the North Colombo Teaching Hospital, Ragama, Sri Lanka. Descriptive study was carried out among 341 persons over the age of 60 years visiting the outpatient department and clinics. Interviewer administered questionnaire was administered and data was analysed using SPSS version 22. Demographic data showed mean age as 67 years of which 56% were males. 51% were accompanied by family member and 36% relied on another helper. 51% of them had mobility impairment and 25% had vision impairment. 28% had used assistive devices ranging from glasses (26.8%), crutches (22.3%) to wheel chairs (3.2%). Of persons using mobility assistive equipment, 85% thought that manoeuvrability was limited and could not reach the second floor (41%) without assistance. They complained of not noticing the information desk (33%), poor visibility of boards (25%), difficulties in identifying correct room (20%) and inadequate seating (50%). 1/4th of elderly thought facility to access washrooms was inadequate and were not disabled friendly. (45%) Elderly population has numerous difficulties and physical barriers while accessing health care facilities. Improvements in finding directions, manoeuvrability and physical facilities will help to provide equal and equitable health care services for the neediest people of the society.
Possible Application of Sickling Test in Haemoglobinopathy Screening of Sri Lanka.
(19th Conference on Postgraduate Research, International Postgraduate Research Conference 2018, Faculty of Graduate Studies,University of Kelaniya, Sri Lanka, 2018) Darshana, T.; Perera, N.; Manamperi, A.; Premawardhena, A.
The national screening programme for thalassaemia in Sri Lanka is currently using Full blood count (FBC) with red cell indices as the technique to identify haemoglobinopathies. This approach is likely to miss sickle haemoglobin (Hb-S) as it is well known that Hb-S is not associated with hypochromic microcytosis. Sickling test is a low cost microscopic screening test which detects sickle cell by its characteristic appearance. Therefore, the present study was undertaken to assess the performance of sickling test in identifying Hb-S among relatively high risk population in Hambantota district. A total of 581 school children (grade 11) were selected randomly from 5 schools in Hambantota district. 2 ml of EDTA blood sample was collected from each participant after obtaining informed assent and consent. Screening panel comprises with sickling test by sodium metabisulphite method, one tube osmotic fragility test, dichlorophenol indophenol test (DCIP), FBC and Zinc protoporphyrin test (ZPP). Haemoglobinphenotyping of each sample was confirmed by capillary electrophoresis technique. Four students out of 581 had sickle trait. Three other types of haemoglobinopathies were detected including β-thalassaemia trait (n=17), haemoglobin D trait (n=2) and haemoglobin E trait (n=1). 8% (n=44) had iron deficiency. All 4 cases with sickle trait were positive for sickling test and all other cases were negative. None of the Hb-S case demonstrated hypochromic microcytosis in FBC.The average time taken for red cells with Hb-S to assume the characteristic sickle shape was 28 minutes and 45 seconds. Sickling test demonstrated 100 % sensitivity and 100 % specificity in identifying sickle trait. Our results indicate depending solely on haemoglobin level and red cell indices is inappropriate since all of the sickle trait individuals would have been missed if sickling test was not done. Hence, the adaptation of sickling test can be recommended along with the Full Blood Count test when screening individuals for haemoglobinopathies in Sri Lanka
Predictive value of persistent NS1 antigen positivity beyond 3rd day for dengue haemorrhagic fever in Sri Lankan children.
(London : Biomed Central, 2019) Manamperi, M.; Jayamanne, B. D. W.; Somaratne, T.; Perera, N.; Fernando, L.
OBJECTIVE:Dengue haemorrhagic fever (DHF) is a major public health concern responsible for significant morbidity in both adult and paediatric populations in Sri Lanka. This study examined if persistent non structural protein 1 (NS1) antigen positivity beyond day 3 was predictive of the occurrence of dengue haemorrhagic fever. The patients were followed up during their in-hospital stay and the severity of the illness was classified according to the WHO classification. The NS1 antigen test was repeated after day 3 of the onset of illness, at least 2 days after the initial test. RESULTS: One hundred and fifty-seven patients were enrolled. Persistent NS1 antigen test positivity after day 3 of the illness was not predictive of subsequent development of DHF. Out of multiple other demographic and illness related factors assessed, only having a secondary dengue infection was associated with a high risk of DHF (relative risk = 3.077, 95% CI 1.361, 6.954). Persistent NS1 positivity on day 3 may not be indicative of disease severity. However results need to be confirmed by a larger study with quantitative NS1 testing.
The presence of strongyloidiasis and associated risk factors in patients undergoing treatment at the National Cancer Institute, Maharagama, Sri Lanka
(Sri Lanka Medical Association, 2023) Weerasekera, C.J.; Menike, C.W.; Wimalasiri, U.; Wijerathna, T.; Jayathilake, D.C.C.; Somawardane, U.A.B.P.; Saravanamuttu, U.; Yoganathan, N.; Perera, N.; Gunathilaka, N.; de Silva, N.R.; Wickremasinghe, D.R.
INTRODUCTION: Strongyloides stercoralis can cause severe disease in the immunocompromised. Without a proper gold-standard diagnostic technique, strongyloidiasis is scarcely studied both globally and locally. OBJECTIVES: We aimed to estimate the prevalence of strongyloidiasis among immunocompromised adult patients and to identify risk factors. METHODS: This study was carried out between February to October 2022. A faecal sample and 2 ml of venous blood were collected from consented patients. Direct faecal smear, agar plate, Harada-Mori and Charcoal cultures were performed on the faecal samples. Qualitative Polymerase Chain Reaction (PCR) was performed on selected faecal samples using S. stercoralis targeting ITS1 region. Strongyloides IgG ELISA was carried out on the serum samples using DRG Strongyloides IgG ELISA kit. RESULTS: Collectively, 144 patients (males = 68, females = 76) provided blood/faecal sample or both. Relevant to strongyloidiasis-associated symptoms, some patients had diarrhoea (n=12) and eosinophilia (n=11). Some of them (n=74) had occupational or recreational exposure to soil as potential risk factors. Overall, 24 patients were positive for strongyloidiasis from one or more diagnostic method (5 PCR and 19 ELISA). There were zero culture or direct smear positives. There was no significant association between disease positivity with either of the clinical features or risk factors. CONCLUSION: The prevalence of strongyloidiasis in patients with malignancies was 16.66%. Strongyloidiasis is existent in the immunocompromised in Sri Lanka even in the absence of suggestive clinical features or regular exposure to risk factors. Screening immunocompromised patients with sensitive techniques such as PCR for timely diagnosis and treatment is recommended.
Prevalence of Personality Disorders in Late Adolescents with Drug Abuse
(Faculty of Graduate Studies, University of Kelaniya, Sri Lanka, 2016) Perera, N.
The world Health Organization defines health as “a state of complete physical, mental and social well-being, and not merely the absence of disease”. According to American Academy of Child and Adolescent’s Facts for Families, Late Adolescence is approximately between 19–21 years of age. Adolescence is a transitional stage of physical and psychological human development that generally occurs during the period from puberty to legal adulthood. In the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders, personality disorders are placed on Axis-ii in the multi axial scheme and defined through a set of general diagnostic criteria. Drug abuse is a chronic, often relapsing brain disease that causes compulsive drug seeking and use, despite harmful consequences to the addicted individual and to those around him or her. Research problem of the study was to search whether there is a prevalence of personality disorder in late adolescence with drug abuse. General objective is to prevalence of personality disorder in late adolescence with drug abuse. Specific objectives are to identify types of personality disorders in DSM IV and to identify most common personality disorder in late adolescence with drug abuse. This was a descriptive study. All participants were male. Interview based questioner was used for data collection and Used 120 participants in rehabilitation centers were interviewed. Approximately 79.2% clients were 19 years old, 16.7% were 20 years old and 4.2% were 21 years old in the sample.88.3% were unemployed and seeking work. 5% were full time students, 2.5% were part time employed, while full time employed and full time home makers were 1.7%. Approximately 83.3% were educated up to GCE(O/L), 7.5% were educated up to GCE(A/L), 5% were educated up grade 6- 10, 2.5% were in diploma level, while grade 1- 5 and graduate level were 0.8%. Among late adolescents who had personality disorder due to drug abuse, the majority were borderline affected personalities. Its valid percentage is 34.2%. Then valid percentage of dependent personality is 15%, Paranoid personality 14%, Avoidant personality 10%, Narcissistic personality 8%, and Schizotypal personality 6%. Further Obsessive compulsive personality 5%, antisocial personality 4%, Schizoid personality3% and histrionic personality 1%. These data show that there is a high prevalence of personality disorders in late adolescence with drug abuse.
Psychosocial Stress, standing time and overweight are risk. Factors for pregnancy induced hypertension: A case control study
(College of Community Physicians of Sri Lanka, 2011) Perera, N.; Abeysena, C.
OBJECTIVE: To determine the risk factors for pregnancy induced hypertension (PIH). METHODS: This was a case control study, carried out at Castle Street Hospital for Women during August to September 2006. Hundred mothers newly diagnosed as having PIH were chosen as cases and 100 mothers with uncomplicated preg¬nancies as controls. Both cases and controls had a period of amenorrhoea of >20 weeks. Psychosocial stress was measured using General Health Questionnaire 30 (GHQ) and the Modified Life Event Inventory (MLEl). Maternal socio-demographic information and other data were collected using an interviewer administered questionnaire and a record sheet. Multivariate logistic regression analysis was applied to control for confounders and the results were ex¬pressed as odds ratios (OR) and 95% confidence intervals (95%CI). RESULTS: After adjusting for confounding effect experience of 32 life events during pregnancy (OR:2.1, 95%CI:1.06-1O.9), a maternal BMI of325 kglm2 (OR:2.4, 95%CI:1.l-5.0), maternal age of328 years (OR:3.9, 95%C.I:2.0-7.5), history of ante partum haemorrhage (OR:3.4, 95%CI: 1.1-10.9) and standing for> 1.5 hours at one stretch (OR:3.4, 95%CI: 1.6¬7.4) had statistically significant associations with developing PIH. CONCLUSIONS: Psychosocial stress during pregnancy, being an overweight or obese women, age 328 years, history of antepartum haemorrhage and standing 31.5 hours at one stretch were risk factors for PIH.
Quality of care in the management of asthmatic children with regard to compliance with the guidelines in in-ward setting in a district of Sri Lanka: a descriptive study
(College of Community Physicians of Sri Lanka, 2020) Abeysena, C.; Perera, N.
INTRODUCTION: The quality of paediatric asthma management in the in-ward settings has not been assessed in Sri Lanka. OBJECTIVES: To describe the quality of care in the management of asthmatic children with regard to compliance with the guidelines. METHODS: A descriptive cross-sectional study was carried out in state hospitals with paediatric units in a district of Sri Lanka. A sample of 577 children diagnosed by a consultant paediatrician was selected. Eleven indicators were chosen by modified Delphi technique. Data collection instruments were an interviewer-administered questionnaire and a record sheet. Compliance with guidelines according to 11 indicators was expressed in percentages. RESULTS: The assessment of acute severity was 100%. The use of systemic corticosteroid at first prescription was 88.9% (n=513), whereas it was 69% (n=398) with oral steroid therapy and 54.5% (n=315) with long-term use of steroid inhaler. Assessment of chronic asthma severity was 31.2% (n=180). Caregivers who had received health education on triggering factors of asthma, on what to do during an asthma attack, and how to use the inhaler were 62.0% (n=358), 37.1% (214) and 68.8% (n=217), respectively. All patients have been issued a diagnosis card on discharge and among them, 74.4% (n=429)received a complete discharge summary and 90.6% (n=523) were scheduled for follow up appointments. CONCLUSIONS: Assessment of acute severity of asthma and the provision of diagnosis card on discharge were exceptional. Assessment of the severity of chronic asthma and providing health education for caregivers should be improved. Prescribing long term use of a steroid inhaler is to be revised. KEYWORDS: Children, Clinical, Indicators, Medication, Performance