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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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 Study on immunity against Hepatitis B in children after vaccination during infancy(Sri lanka Medical Association, 2015) Perera, K.P.J.; Hapugoda, M.; Fernando, K.M.D.; Dimal, D.A.INTRODUCTION AND OBJECTIVES: Hepatitis B vaccine is given in Sri Lanka to all infants at 2, 4,6 months. As a low prevalent country the risk of acquiring Hepatitis B is more likely during adolescence and later. It is important to know whether immunity produced by vaccination during infancy last up to this stage, or a booster dose is needed to augment the immune response. METHOD: With informed written consent and assent from children, 150 ten year old school children with evidence of Hepatitis B vaccination during infancy, were tested for Hepatitis B antibody status using ELISA. Children who had an antibody titre less lOmlU/mL were offered a free booster dose. Antibody levels were retested one month after the booster. RESULTS: 128 (67%) had an antibody titre above 10m ID/ml. All children with a titre <10mlU/ml, accepted the booster dose. All children who received the booster had an antibody response above 10mlU/l, while (72%) had a titre >100mlU/l. CONCLUSION: Vaccination against Hepatitis B during infancy appear to produce protective level of antibodies at ten years of age. Even the children with antibody titres below protective level produced a sharp rise in titres with a booster dose. As this response could be expected with a natural infection, booster dose to augment the immune response produced by vaccination during infancy is not needed.Item The validation of the Sinhala version of the Kessler psychological distress scale (K10) to screen for psychiatric morbidity(Sri Lanka Medical Association, 2008) Wijeratne, L.T.; Williams, S.S.; Peris, M.U.P.K.; de Silva, N.R.; Hapuarachchi, H.A.C.; Perera, K.P.J.; Kawamura, N.; Wickremasinghe, A.R.BACKGROUND: The Kessler psychological distress scale (K10), used in epidemiological surveys, measures psychological distress. High scores in community surveys are associated with anxiety and affective disorders, and to a lesser extent, with other psychiatric disorders. OBJECTIVE: To validate the Sinhala translations of the long (K10) and short (K.6) versions of the Kessler psychological distress scale. DESIGN, SETTING AND METHODS: The English version of K10 was translated into Sinhala. Content and face validity was assessed by experts. The scales were pre-tested and modified accordingly. The Sinhala versions of K6 and K10, and the Structured Clinical Interview Schedule were administered to 20 adults with major psychiatric illnesses diagnosed by two clinicians independently, and to a random sample of 25 apparently normal people from the community. SPSS (Version 11) was used for the analysis. RESULTS: The ROC curve for the K10 contained 96.1% of the area under the curve of 0.961 (95% CI 90.4%-100%). A cut off score of 22 for the K10 yielded a sensitivity of 93.8% and a specificity of 82.6%. The ROC curve for the K6 contained 90.1% (95% CI 80.5% - 99.7%) of the area under the curve. For the K6, a cut off score of 13 gave a sensitivity of 88.2% and a specificity of 72%, The total number of days that the patient could not attend to regular work and responsibilities was significantly correlated with both the K10 (p=0.041) andK6 (p=0.023). CONCLUSION: The Sinhala version of the K10 and K6 questionnaires can be used to screen for psychological distress.Item Animal bites in children: reasons for delay in seeking medical help(Sri Lanka Medical Association, 2008) Peiris, M.A.C.; Perera, K.P.J.; Adhihetty, D.; Goonewardena, A.R.; Mettananda, D.S.G.OBJECTIVE: To describe the clinical characteristics of animal bites in children and to determine the reasons for delay in seeking medical help DESIGN, SETTING AND METHODS: A descriptive study was conducted at the North Colombo Teaching Hospital in 2007. Consecutive children admitted following animal bites were recruited into the study until a sample of 100 was achieved. Children with snake and insect bites were excluded from the study. Data on clinical characteristics and treatment were obtained using an interviewer schedule. RESULTS: Sixty-five (65%) subjects were males. Mean age of children was 6.8(SD=3.2) years. Majority (88%) of bites were by dogs while cats, rats, monkeys and squirrels were responsible for the others. 68% of animals (67% of dogs) were domestic animals but only 14% were vaccinated. None of the domestic cats or squirrels was vaccinated. 72% were provoked bites and 81% had major exposures. Face, hands and fingers were the commonest places of bites. Following the bite 89% had washed the bite-site with soap and water and 6% had used antiseptics for cleaning. 75% came to the hospital within 24-hours while 16% presented after 72 hours. Commonest reason for delay was ignorance. There was no significant association between the delay in presentation and age or sex of the child, maternal educational level, number of children in the family, distance to the hospital, type of animal or the degree of exposure. CONCLUSION: Eighty-six percent of animal bites in children were by unvaccinated animals. One-fourth of children were brought to the hospital after 24 hours and the commonest reason for delay was ignorance.