Browsing by Author "Ratnayake, G."

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Clinical outcome of patients having neo-adjuvant therapy(NAT) for rectal cancer: a case control study
(The College of Surgeons of Sri Lanka and SAARC Surgical Care Society, 2003) Wijesuriya, S.R.E.; Deen, K.I.; Hewavisenthi, J.; Ratnayake, G.
INTRODUCTION: From July i 999 we have employed NAT on a selective basis in the management of rectal cancer. OBJECTIVE: To explore the value of NAT in patients with rectal cancer in the short term. To study the effect of Neo Adjuvant Therapy for rectal carcinoma in the short term. METHODS: Two abdomino perineal resections and 24 anterior resections were done in the NAT group and 5 and 2 l in the no NAT group. There were 2 perioperative deaths in NAT group and one in the no NAT group (P 0.75). There were 7 Cancer related deaths in the NAT group and 6 in the no NAT group (P = l). The survival was 15 month (5 -45) for the NAT group and 16 (3 -54) for the non NAT group (P = I). There were no difference in the recurrences (2 vs 4 P ""0.67) metastasis (4 vs 4 P = 1) or complication (8 vs 2 p =0.08) abdomino perineal resections were performed in 2 patients in the NAT group and 5 in the no NAT group. Anterior resections were performed in 24 patients and 24 patients in NAT and no NAT groups. CONCLUSION: Overall there was no significant difference in the clinical out come between those given NAT and those not given.
The prevalence of urinary and sexual dysfunction following rectal excision
(The College of Surgeons of Sri Lanka and SAARC Surgical Care Society, 2003) Perera, M.T.P.R.; Ratnayake, G.; de Silva, G.S.; Deen, K.I.
INTRODUCTION: With improved survival following rectal excision for cancer and focus on nerve sparing operation, recent interest has centered on urinary and sexual dysfunction. OBJECTIVE: To identify the prevalence of urinary and sexual dysfunction in patients after rectal excision.METHODS: 43 patients (17 male, median age 55 years, range 24 to 74) underwent anterior resection (23), restorative proctocolectomy (13), abdomino-perineal excision (04), and rectal excision as part of subtotal colectomy (03). Structured interview was performed at least 03 months after stoma closure. Data were compared with age and gender matched controls. Statistical evaluation was by the McNemar test and test of proportions. Significance was assigned to a P value <0.05. RESULTS: Median (range) duration after operation was 28 months (8 - 84). Preoperatively, urinary function was similar in patients and controls. After operation, a significant number of patients had transient urinary dysfunction [urinary symptoms, pre vs post; 07 (16%) vs. 28 (65%) p< 0.05]. Long-term prevalence of poor stream and urinary hesitancy after operation were significant [poor stream; pre vs. post- 6 vs. 16: P=0.006 and hesitancy; pre vs. post - 6 vs. 18: P=0.004]. Sexual function was also significantly reduced in patients after operation [sexually active; pre vs. post- 29 vs. 17: P=0.004]. Fourteen (9 male,5 female) of 29 (48%) reported transient abstinence from sexual activity 6 months after operation whilst eight of 29 (27 .5%) reported more permanent abstinence (lack of interest-6, dyspareunia-1, erectile failure/ retrograde ejaculation - 7). CONCLUSION: Counseling regarding sexual and urinary function should be an integral part of the pre-operative work-up in patients having rectal excision
Sri Lankan medical officers’ attitudes towards the elderly: a pilot study
(Postgraduate Institute of Medicine University of Colombo, 2022) Fernando, R.; Ratnayake, G.; Liyanage, N.; Fonseka, M.; Perera, I.; Kuruppuarachchi, K.A.L.A.; Hapangama, A.
Ageism among doctors influences treatment options and care of the elderly. Attitudes of Sri Lankan doctors towards the elderly have not been studied previously. This descriptive cross-sectional study using Fraboni’s scale of ageism explored doctors' attitudes towards older people in three selected hospitals in Sri Lanka and the relationship of such attitudes with demographic, employment, education and training-related factors. No association between the attitude of doctors toward the elderly and the factors studied in this pilot study were found.