Medicine
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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty
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Item Domain-Specific learning among medical students(Basic Medical Scientists Association, 2012) Perera, D.; Ramanayake, R.P.J.C.; de Silva, A.H.W.; Sumanasekara, R.D.N.; Jayasinghe, L.R.; Gunasekara, R.; Chandrasiri, P.Background: The aim of this study was to investigate undergraduate medical student’s domain-specific learning. Method: The research tool was a structured essay question formulated to assess factual and affective knowledge and application and synthesis of knowledge .The question was administered to 151 students. Results: Mean score on the recall question was significantly higher than the other two domains. Total scores of female students were significantly higher than male students (P<0.05). Gender-wise difference in scores was not significant in any specific domain area. There was no significant relationship between factual knowledge and total scores. However, there was a significant linear relationship between total scores and the two areas of affective knowledge (r=0.78) and application and synthesis of knowledge (r=0.6). Findings indicate that affective knowledge and application of knowledge are closely related to overall acquisition of knowledge (P<0.0005). Conclusion: Teaching and assessment in higher-order knowledge domains and affective knowledge needs to be developed. Questions dealing with affective knowledge and testing higher-order cognitive abilities are more discriminatory than questions testing at the recall level.Item Seroprevalence of hepatitis C virus in thalassaemic patients and patients who undergo long-term haemodialysis(Sri Lanka College of Microbiologists, 2009) Jayamaha, C.J.S.; Senanayake, C.P.; Manamperi, A.; Chandrasiri, P.; Karunanayake, L.BACKGROUND: Hepatitis C virus (HCV) is a major global health problem. Multiple blood transfusions and long-term haemodialysis are associated with HCV transmission. OBJECTIVE: To determine the seroprevalence of HCV in thalassaemic patients and patients who undergo long-term haemodialysis. METHODOLOGY: Study group consisted of 228 thalassaemic patients and 183 patients who undergo long-term haemodialysis. A sample of blood was collected from all the patients and tested for HCV antibody with a third generation ELISA. Repeatedly reactive samples were subjected to one step reverse transcriptase-PCR. RESULTS: Prevalence of anti-HCV antibodies among thalassaemic patients and haemodialysis patients were 3.95% (9/228) and 1.09% (2/183) respectively. Mean number of blood transfusions among anti-HCV positive patients was 139.91 compared to 53.88 in anti-HCV negative patients (p<0.01). Mean number of haemodialysis cycles among anti-HCV positive patients was 197.0 compared to 51.15 in anti-HCV negative patients (p=0.000). In thalassaemic cohort, 52.2% were not screened for either HBV or HCV infection. In haemodialysis cohort this value was 27.3%. CONCLUSIONS: The presence of anti-HCV antibodies was significantly associated with the number of blood transfusions and number of haemodialysis cycles. Screening for viral hepatitis markers was not satisfactory in either cohort. It is recommended that patients be screened for hepatitis B and C viruses prior to dialysis/ transfusion and at specific intervals. Screening donor blood for anti-HCV antibodies should be made mandatory to decrease the HCV infection among multitransfused patients. ACKNOWLEDGEMENTS: Financial assistance by National Health Research Council & Roche Pharmaceuticals.Item Evaluation of teaching and learning in family medicine by students: a Sri Lankan experience(Medknow, 2015) Ramanayake, R.P.J.C.; de Silva, A.H.W.; Perera, D.P.; Sumanasekera, R.D.N.; Gunasekara, R.; Chandrasiri, P.BACKGROUND: Family Medicine occupies a prominent place in the undergraduate curriculum of the Faculty of Medicine, University of Kelaniya, SriLanka. The one month clinical attachment during the fourth year utilizes a variety of teaching methods. This study evaluates teaching learning methods and learning environment of this attachment. METHODOLOGY: A descriptive cross sectional study was carried out among consenting students over a period of six months on completion of the clinical attachment using a pretested self administered questionnaire. RESULTS: Completed questionnaires were returned by 114(99%) students. 90.2% were satisfied with the teaching methods in general while direct observation and feed back from teachers was the most popular(95.1%) followed by learning from patients(91.2%), debate(87.6%), seminar(87.5%) and small group discussions(71.9%). They were highly satisfied with the opportunity they had to develop communication skills (95.5%) and presentation skills (92.9%). Lesser learning opportunity was experienced for history taking (89.9%), problem solving (78.8%) and clinical examination (59.8%) skills. Student satisfaction regarding space within consultation rooms was 80% while space for history taking and examination (62%) and availability of clinical equipment (53%) were less. 90% thought the programme was well organized and adequate understanding on family medicine concepts and practice organization gained by 94% and 95% of the students respectively. CONCLUSIONS: Overall student satisfaction was high. Students prefer learning methods which actively involve them. It is important to provide adequate infrastructure facilities for student activities to make it a positive learning experience for them.Item Rate of stunting among a sample of postwar resettled families in the Vanni region: a study from the Mullativu District(Sri Lanka Medical Association, 2013) Ramanayake, R.P.J.C.; Sumanasekera, R.D.N.; de Silva, A.H.W.; Perera, D.P.; Chandrasiri, P.; Gunasekera, R.; Jayasinghe, L.R.The Department of Family Medicine, University of Kelaniya conducted a health camp in Puthukudiyiruppu in March 2011. Height and weight measurements were carried out and data of 303 participants were analysed. The rate of stunting among children below six years in this population was 62% compared to 19.3% nationally. Thirty four percent of children and adolescents (6-18yrs) were underweight and 21.4% of adults had a BMI less than 18.5kg/m2.Item Knowledge of location of organs in the body among patients attending a university family practice in Sri Lanka(2013) Ramanayake, J.; Perera, D.; de Silva, A.; Sumanasekera, D.; Jayasinghe, L.R.; Gunasekera, R.; Chandrasiri, P.Introduction: The referral letter is the interface between the primary and secondary/tertiary levels of care. It facilitates the referral process and is beneficial for optimizing patient care. In Sri Lanka a referral letter is not essential to consult a Specialist. In this scenario, the quality as well as the number of referral letters encountered in practice needed to be explored. Objectives: To describe Specialists' views on the quality of referral letters received, perceived advantages of referral letters and to identify other modes of communication between General Practitioners and Specialists. Methods: Conducted in 2013, this study consisted of in-depth interviews using a semi-structured format, with 21 purposively selected Specialists representing a range of specialties. They included clinicians and university academics from both the government and the private sector. Analysis was by generating a thematic framework based on the recurrent themes and issues which was then applied to the textual data. Results: Most patients consulted Specialists without a referral letter and also the few letters received were of poor clarity, lacking important information and scribbled in illegible hand. Main themes identified as advantages of referral letters were: impart important information about the patient, clear description of the initial condition and treatment given, reduced consultation time, prevents delays in diagnosis and reduced healthcare costs by reducing polypharmacy and repetition of investigations. Some of the other modes of communication suggested by Specialists were via telephone, SMS, fax and email. Conclusions: The general belief amongst Specialists is that referral letters are an important part of the patient care system. This has not been adequately utilized by the primary care providers in Sri Lanka, despite the numerous advantages described. Also consideration needs to be given to newer modes of emerging information communication technology