Browsing by Author "Samaranayake, R."

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Accuracy of measuring axillary temperature using mercury in glass thermometers in children under five years: a cross sectional observational study
(Scientific Research Publishing Inc, 2014) Perera, P.; Fernando, M.; Mettananda, S.; Samaranayake, R.
BACKGROUND: Measuring axillary temperature with mercury in glass thermometers is continued in clinical practice though there are many limitations. This is mainly due to convenience and cost. This study was conducted to ascertain the accuracy of measuring axillary temperature with mercury thermometers in preschool children. METHODS: Axillary temperature was measured in 250 preschool children using standardized mercury thermometers. Time taken to record the final temperature and its correlates were assessed. RESULTS: Time taken to record the final temperature extended up to six minutes. This duration varied according to age, body mass index and body temperature, but a significant variation was noted only with age. CONCLUSIONS: Measuring axillary temperature with mercury thermometers is subjected to error. They need to be replaced with suitable alternatives.
Growth parameters of Sri Lankan children during infancy: A comparison with world health organization Multicentre growth reference study
(Centro de Estudos do Crescimento e do Desenvolvimento do Ser Humano, 2014) Perera, P.J.; Fernanado, M.P.; Ranathunga, N.; Sampath, W.; Samaranayake, R.; Mettananda, S.
OBJECTIVES: growth monitoring (GM) is an important intervention ensuring wellbeing of children. If GM to be meaningful it is essential to have reference standards appropriate for that population. In Sri Lanka growth charts based on WHO multi centre growth reference study (MGRS) are used for GM. This study was carried out to ascertain the appropriateness of MGRS charts for GM in Sri Lankan children. METHODS: out of a birth cohort of 2215 children, 250 from each sex were invited for a followed up. Children were examined at 2, 4, 6, 9 and 12 months, to measure weight and length. Statistical characteristics of weight and length for each sex were calculated and compared with MGRS data. RESULTS: out of babies invited to participate in the study 244 boys and 241 girls responded initially. Out of this 85% of boys and 86% of girls completed the follow up. Weight and length of both sexes deviated significantly at all ages from MGRS data. CONCLUSION: MGRS data seems to be inappropriate for monitoring growth of Sri Lankan children
Head circumference during infancy in a birth cohort of Sri Lankan children: are we using the correct chart?
(Sri Lanka Medical Association, 2014) Perera, P.J.; Fernando, M.P.; Samaranayake, R.
INTRODUCTION: Measuring head circumference and plotting it in centile charts is a routine practice in paediatrics. However if wrong charts are used, serious misinterpretations can ensue. OBJECTIVES: This study was carried out to ascertain the appropriateness of charts used in Sri Lanka. Out of a birth cohort of 2215 children, 250 from each sex were invited for a follow up study. Head circumference was measured at 2, 4, 6, 9 and 12 months. Statistical characteristics of head circumference for each sex, at each age were calculated. RESULTS: At the first follow up 244 boys and 241 girls were assessed. Out of this, 85% of boys and 86% of girls completed the follow up. CONCLUSIONS: Head circumference of both sexes deviated significantly at all ages from the charts available in the Child Health Developmental Record (CHDR). Head circumference charts available in the CHDR are inappropriate for use in Sri Lankan children.
Interaction of malaria with a common form of severe thalassemia in an Asian population
(National Academy of Sciences, 2009) O Donnell, A.; Premawardhena, A.; Arambepola, M.; Samaranayake, R.; Allen, S.J.; Peto, T.E.; Fisher, C.A.; Cook, J.; Corran, P.H.; Olivieri, N.F.; Weatherall, D.J.
In many Asian populations, the commonest form of severe thalassemia results from the coinheritance of HbE and beta thalassemia. The management of this disease is particularly difficult because of its extreme clinical diversity; although some genetic and adaptive factors have been identified as phenotypic modifiers, the reasons remain unclear. Because the role of the environment in the course of severe thalassemia has been neglected completely and because malaria due to both Plasmodium falciparum and Plasmodium vivax has been prevalent in Sri Lanka, we carried out a pilot study of patients with HbE beta thalassemia that showed high frequencies of antibodies to both parasite species and that 28.6% of the children had DNA-based evidence of current infection with P. vivax. Malarial antibodies then were assessed in patients with HbE beta thalassemia compared with those in age-matched controls. There was a significant increase in the frequency of antibodies in the thalassemic patients, particularly against P. vivax and in young children. There was also a higher frequency in those who had been splenectomized compared with those with intact spleens, although in the latter it was still higher than that in the controls. The thalassemic patients showed significant correlations between malaria antibody status and phenotype. Patients with HbE beta thalassemia may be more prone to malaria, particularly P. vivax, which is reflected in their clinical severity. Because P. vivax malaria is widespread in Asia, further studies of its interaction with HbE beta thalassemia and related diseases are required urgently as a part of ongoing thalassemia control programs.
Pattern of physical growth during first six months of life among a cohort of babies living in Gampaha district, Sri Lanka
(2013) Perera, P.; Fernando, M.; Mettananda, S.; Samaranayake, R.
Introduction: Current WHO recommendation is to continue exclusive breast feeding (EBF) up to six months. Main concern regarding this recommendation is, whether EBF supports rapidly growing infant with adequate nutrition. Methods: A cohort of randomly selected new-borns was followed up at two, four and six months, to study feeding pattern and physical growth. Feeding practices and socio-demographic data were collected using an interviewer administered questionnaire. Weight & length were measured using standard techniques. Results: EBF rates were very high in this cohort of children. One main reason to stop EBF was growth faltering. Only some children showed a catch up growth by stopping EBF. At two, four and six months, weight faltering rates among EBF babies were, 11.1%, 20.1% and 13.2% respectively. Length faltering had a similar pattern, but with a higher rate at all ages. Conclusions: EBF up to six months did not cause growth faltering in the majority. In the majority, no identifiable cause for growth faltering was found. Possible genetic influence on growth faltering was not considered when stopping EBF
Using red cell indices as a screening test for the detection of haemoglobin E trait in population screening for haemoglobin disorders
(Sri Lanka Medical Association, 2005) Premawardhena, A.; Samarakoon, S.; Perera, U.; Samaranayake, R.; Arambepola, M.
INTRODUCTION: When screening populations for haemoglobin E trait, which is found in up to 5% in some regions in Sri Lanka, some believe that the full blood count with red cell indices, demonstrating hypochromasia and microcytosis (MCV<80fl and MCH< 27pg), is not sensitive enough, as up to 5% may be missed. If this is true, more complicated and expensive tests will be necessary to detect Hb E trait. There are no studies which have attempted to test the efficacy of red cell indices as a screening test for Hb E trait in Sri Lanka AIMS: To test the sensitivity of the full blood count with red cell indices as a screening test for the detection of haemoglobin E trait MATERIALS AND METHODS: Individuals diagnosed to have Hb E trait by the usage of high performance liquid chromatography (HPLC) - (Bio Rad) had their red cell indices measured using an automated cell counter (Coulter, Act Diff III) RESULTS: 47 Individuals with Hb E trait were identified using HPLC analysis. 28 were females (59%). The haemoglobin levels ranged from 10.5 to 15.4 g/dl. (Mean 12.6). There was only one individual with an MCV of 80, whilst the rest had values below that. MCV values ranged from 58-80fl. There were 3 individuals with an MCH over 27 (27.4, 28.8 and 27.4). The individual with an MCV of 80 had an MCH of 27.4. CONCLUSIONS: In this ongoing study we found that by using a cutoff point for MCV at 80ft up to 2% of individuals with Hb E trait will be missed. As the screening test needs to be more sensitive than this, we suggest that by using a slightly higher cutoff point for the MCV (eg. 81 fl) we would still be able to detect individuals with Hb E trait using red cell indices, thus minimizing cost.