Browsing by Author "Silva, R. L."

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    Aerophagia in children is associated with emotional ill-treatment.
    (Lippincott Williams & Wilkins, 2015) Rajindrajith, S.; Silva, R. L.; Devanarayana, N.M.
    BACKGROUND: Aerophagia is a functional gastrointestinal disease characterized by air swallowing, abdominal distension, excessive flatus and belching. The aetiology of this disorder is not clear. Previous studies have suggested an association between aerophagia and psychological stress. We aimed to assess the association between emotional ill-treatment and aerophagia. METHODS: A cross sectional survey was conducted in 4 provinces of Sri Lanka. Children aged 13-18 years were selected from schools in these provinces. A validated, self-administered questionnaires were used for collect data on functional gastrointestinal disease including aerophagia and emotional ill-treatment. Aerophagia was defined using the Rome III criteria. RESULTS: A total of 1069 questionnaires were included in the final analysis (males 508 [47.5%], mean age 15.3 years, SD 1.8 years). One hundred and thirty six (136) children had aerophagia. Prevalence of aerophagia was significantly higher in children who experienced emotional ill-treatments (43 (23.2%) vs. 160 (17.1%), p < 0.0001). Emotional ill-treatments that were significantly associated with aerophagia include, teasing by others (54.1% vs. 45.0%, p < 0.0001), humiliation (38.2% vs. 20.3%, p < 0.0001), treating inferiorly by others (22.8% vs. 11.1%, p < 0.0001), threatening to abandon (8.8% vs. 2.6%, p < 0.0001), threatening destroy belongings (14.0 vs. 4.5%, p < 0.0001), and forcing to do unwanted deeds (9.6% vs. 3.9, p = 0.003). Parenting factors such as refusal of attending to emotional needs (8.8% vs. 3.0%, p < 0.001), refusal to look at (6.6% vs. 0.7%, p < 0.0001), refusal of hugging (10.5% vs. 5.6%, p = 0.03), and not appreciating achievements (5.9% vs. 2.1%, p < 0.0001) were significantly common among children with aerophagia. CONCLUSIONS: Aerophagia in children is associated with emotional ill-treatments. Attending to child's emotional needs likely reduce the prevalence of aerophagia and its consequences.
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    Molecular diagnosis of velo-cardio-facial syndrome among sri lankan patients with congenital cardiac defects
    (Sri Lanka College of Paediatricians, 2015) Tevarajan, I.; Ranaweera, D. M.; Perera, S.; Samarasinghe, D.; Morawakkorala, R.; Silva, R. L.; de Silva, D.; Chandrasekharan, N.V.
    Velo cardio facial Syndrome (VCFS) is caused by a 3 Mb deletion of chromosome 22qll.2. Its multiple clinical features include orofacial clefting, congenital cardiac defects (especially conotruncal),developmental delay and learning difficulties. Hypoparathyroidism and thymic hypoplasia are associated. Dysmorphic features include expressionless face, prominent nose, narrow eyes and long fingers/ toes. Clinical diagnosis is difficult due to its variability making molecular diagnosis essential but this is often too expensive for widespread use. We have developed a less expensive semi-quantitative PCR method for diagnosing VCFS and report preliminary results in congenital cardiac defect patients.OBJECTIVE: • Identify the 22qll.2 deletion syndrome among a selected group of children with typical cardiac defects • Describe clinical features of affected cases DESIGN, SETTING AND METHOD: TweIve children (6 males, mean age 3y lmo) with conotruncal congenital cardiac anomalies or cardiac defects associated with other clinical feature of VCFS were .recruited following informed consent from parents. Ethical approval had been granted for this study. A blood sample was obtained for DNA extraction and the clinical data recorded. Molecular diagnosis was performed using semi-quantitative PCR. RESULTS: Three cases were positive for the deletion. Their cardiac anomalies were an interrupted aortic arch,tetralogy of Fallot and right sided aortic arch. None had palatal anomalies and two (67%) had learning difficulties. None had a positive family history. Only one had facies that were typical. The negative cases included six with aortic arch anomalies, none with clefting and 4 with learning difficulties(44). Two had a family history suggestive of VCFS and two had typical facial features. CONCLUSIONS: Three out of the 12 children were positive for the 22qll.2 deletion.