Browsing by Author "Samarasekera, A."

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Child abuse and neglect; who gets abused and who abuses them?
(Sri Lanka Medical Association, 2005) Fernando, A.D.; Karunasekera, K.A.W.; Fernando, L.; Samarasekera, A.
OBJECTIVES: To study the socio-demographic characteristics of victims of child abuse and characteristics of the perpetrators. Study Design: A descriptive study. METHOD: A prospective study of 112 victims of child abuse presenting to the University Paediatric Unit, Ragama from January 2000 to August 2004. The study evaluated characteristics of victims and perpetrators. Ethical approval was obtained. Data Analysis: Epi info version 6. RESULTS: Mean age of the victims was 9.7 years. 79% were females. Ethnicity-91% Singhalese, 5%Muslims and 4%Tamils. 82% resided in Gampaha District. Education of father and mother respectively - 5% and 11%-not attended school, 32% and 34%-primary education, 52% and 50%-ordinary level and 11% and 9%-advanced level. Social class -46%-unskilled, 26%-poorly skilled, 18%-skilled and 10%-lesser professionals. Monthly income (Rs.) -6% <2000, 37% 2000-5000, 33% 5000-10,000 and 24% >10,000. Marital status- 64%-married, 27%-divorced, 6%-unmarried and living together, 3%-single. Amongst married parents, 20% of mothers and 6% of fathers were abroad. Caregiver to the victim- 47%-both parents, 15%-mother, 15%-father, 14%-relatives and 9%-others. Consumption of alcohol by father -59%. Characteristics of perpetrators- 98% were known to the victims and in 24% the perpetrator was the father. Number of perpetrator/s- 86%-one, 5%-two, 5%-three, 4%-more than 3. Perpetrator being drunk at the tine of abuse in 31%. Amongst sexually abused, 26% were acts of incest. Of those 70% by father. CONCLUSIONS: The most vulnerable victims of abuse are shown to be 10-year-old females. Majority came from low social and educational backgrounds, In <5Q%, both parents cared for the child. 98% of perpetrators were trusted persons and in nearly a quarter it was the father.
A comparative descriptive study on adolescents presented to Ragama and Anuradhapura Teaching Hospitals for medico-legal examination with a history of 'sexual activity'
(Faculty of Medicine, University of Kelaniya & Plan International, 2008) Edirisinghe, P.A.S.; Perera, W.N.S.; Paranithran, P.; Perera, B.P.P.; Samarasekera, A.; Waidarathna, M.D.; Jayasena, A.S.
INTRODUCTION: Adolescents engaged in sexual activity are brought for medico-legal examination as they are minors. Though some have consented for sexual activity, it is not legally acceptable. The perpetrators include boyfriends, relatives, known persons and strangers. The 'boyfriend' group is unique as the consent is not obtained by illegal means. OBJECTIVE: To find out potential predisposing factors that contribute to 'consensual' or 'non consensual' sexual activity of adolescents and to find out how 'consensual' and 'non consensual' sexual activity affects sexual health of adolescents. METHODS: A retrospective descriptive study was done using records maintained at the offices of the Judicial Medical Officers of Ragarna and Anuradhapura. The data was analyzed using SPSS statistical package. RESULTS: 202 and 154 victims examined between 2000 to 2006 at Ragama and Anuradhapura were analyzed. Male to female ratio was 1:10 in Ragama and 1:24 in Anuradhapura. The most vulnerable age group for sexual activity was 14-15 years. The majority of cases were from the low socio-economic strata. Vaginal intercourse was the most preferred sexual activity; the likelihood of an adolescent from Anuradhapura to have penetrative sex was 2.47 times more as compared to an adolescent from Ragama. Boyfriend was the assailant in 39% and 37% of cases in Ragama and Anuradhapura respectively. 63 % of victims from Ragama had eloped as compared to 19% from Anuradhapura. In both groups, nearly half of the cases had a relationship less than 6 months. An adolescent having sexual activity with a relative was 2.31 (95% CI 1.36-3.93) times greater in Anuradhapura as compared to Ragama. There were 18 and 16 pregnancies in Ragama and in Anuradapura, respectivly. 61 cases from Ragama had psychological symptoms and signs after the incident. CONCLUSIONS: Adolescents are more susceptible to engage in sexual acts around 14 years. Consented sexual activity with a boy friend resulting in legal action is a significant social problem. The high incidence of sexual activity with relatives and known persons indicate the vulnerability of adolescents to engage in sexual activity in their own environments.
Injury, fatal and nonfatal: explosive injuries
(Elsevier Ltd, 2016) Edirisinghe, A.; Samarasekera, A.
Injuries and effects on the human body due to explosions in general, and in modern warfare in particular, have certain patterns which can be identified and classified depending on their causation, properties of the explosive material and device used, motive, and the target. Predetermined action plans together with disaster preparedness and response are important for proper and effective medico legal management of dead bodies and survivors after an explosion, and the key to success is a coordinated multidisciplinary and humanitarian approach.
A profile of child abuse and neglect in a tertiary care hospital
(Sri Lanka Medical Association, 2005) Fernando, A.D.; Karunasekera, K.A.W.; Fernando, L.; Samarasekera, A.
OBJECTIVES: To study the pattern of child abuse and neglect. To evaluate the management and the Outcome of such victims STUDY DESIGN: A descriptive study METHOD: The sample consists of 112 victims of child abuse referred to the University Paediatric Unit, Ragama Hospital, from January 2000 to August 2004. The study prospectively evaluated types of abuse, their characteristics, management of victims and outcome. Ethical approval was obtained. RESULTS: 24% had more than one type of abuse. Categories of abuse were: 70% -sexual, 33% -physical, 16% -neglect, 14% -emotional and 6% -child labour. Amongst sexually abused, 62% had penetrative sex, 8% became pregnant, 4% had sexually transmitted diseases, 5% had severe degree perineal/peri-anal tears, and 37% had psychological disturbances at the time of presentation. 39% came for follow up assessment after 6 months. Amongst them, 60% had psychological disturbances, amongst physically abused, 19% had fractures. Amongst all victims, the mean duration of hospital stay was 29 days. Management outcome: 46% sent back to parents, 11% to extended family member/s, 38% to Children's Homes and 5% to others. CONCLUSIONS: 24% had more than one type of abuse. The commonest type was sexual abuse. The majority of them had penetrative sex and 8% became pregnant. Psychological disturbances were found in the majority of victims of sexual abuse on follow up. 57% of victims were able to continue to live with their parents/extended family.
Pseudo-convulsions in a child subjected to abuse
(Sri Lanka Medical Association, 2003) Edirisinghe, A.; Samarasekera, A.
No Abstract available