Medicine

Permanent URI for this communityhttp://repository.kln.ac.lk/handle/123456789/12

This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty

Browse

Has files: NoSubject: search.filters.subject.Adolescent

Search Results

Now showing 1 - 10 of 25
  • No Thumbnail Available
    Item
    Child and Adolescent Mental Health Services (CAMHS) in a lower-middle income country: A survey from Sri Lanka.
    (SAGE Publications, 2023) Rohanachandra, Y.M.; Chandradasa, M.; Dahanayake, D.M.A.
    No abstract available
  • No Thumbnail Available
    Item
    It’s normal to drink, isn’t it? a qualitative study on factors influencing adolescent drinking in Sri Lanka
    (Sri Lanka Medical Association, 2021) Athauda, L.K.; Pereis-John, R.; McCool, J.; Ameratunga, S.; Wickremasinghe, A.R.
    Introduction and Objectives In Sri Lanka, adolescent drinking behaviour has been linked to parental, family influence as well as culture and living location. While proximal level social determinants play an important part in influencing adolescent drinking, determinants operating at the distal level have not been discussed adequately. This study aimed to describe the factors influencing adolescent drinking among school going adolescents in the Colombo District. Methods Focus Group Discussions (FGD) were conducted separately for males and females in selected Public Health Midwife (PHM) areas in the Colombo District. A semi structured interview guide facilitated the discussion. Transcripts were translated, transcribed and managed on NVivo 12. Inductive thematic analysis was used to interpret the ideas expressed in the FGDs. Results Fifty adolescents (24 females and 26 males) aged between 16-17 years participated in eight FGDSs. The findings elaborate one overarching theme: it’s normal to drink, isn’t it? Media, culture and society contributed towards building social norms around adolescent drinking. Based on the perception of normalcy around drinking, adolescents were inclined to test their limits and experiment with alcohol, while being influenced by peers. However, they also experienced some restraints, in terms of law, family and culture, which made them question the normalcy around drinking. Conclusion Adolescents engage in social learning, through their distal environment which creates norms and aspirations. Peer engagement facilitates social capital which also contributes towards their decisions to drink. Distal level social determinants are important contributory factors of adolescent alcohol use. Restrictions within this environment may restrict their drinking
  • No Thumbnail Available
    Item
    Experience of required foreign specialist training: The lived experiences of Sri Lankan trainee child and adolescent psychiatrists in Australia
    (Elsevier, 2021) Chandradasa, M.; Dahanayake, D.; Rohanachandra, Y.
    No Abstract Available
  • No Thumbnail Available
    Item
    Factors influencing alcohol use among adolescents in South Asia: A Systematic review
    (Piscataway, NJ, 2020) Athauda, L.K.; Peiris-John, R.; Ameratunga, S.; McCool, J.; Wickremasinghe, R.
    OBJECTIVE: Alcohol is the leading cause of disability-adjusted life years among 15- to 19-year-olds globally; yet, social and structural determinants of alcohol use among adolescents in low- and middle-income countries are largely unknown. Given that a quarter of the global adolescent population lives in South Asia, this systematic review aims to identify factors influencing alcohol use among 10- to 19-year-olds living in South Asia (Afghanistan, Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan, and Sri Lanka). METHOD: We systematically searched eight databases (SCOPUS, MEDLINE, EMBASE, CINAHL Plus, Cochrane Library, PsycINFO, AMED, EBSCO Host), gray literature, and relevant websites for studies reporting influences at psycho-individual, family, school, peer, neighborhood, or country levels. QATSDD (Quality Assessment Tool for Studies with Diverse Designs) was used for quality assessment. The study protocol was registered with PROSPERO (CRD42017084773). RESULTS: Twenty-three studies were eligible for inclusion. Male gender, age greater than 14 years, depression, religious belief, parental/family members' drinking, reduced parental attention, peer-drinking/pressure/approval, and urban neighborhood were associated with increased risks of adolescent drinking. No information was available from Afghanistan, Bhutan, Bangladesh, Pakistan, and Maldives. There is little evidence available on the determinants at a national (legislature, industry, and media), school, and personality level. CONCLUSIONS: The distal determinants of alcohol use among adolescents living in South Asia are largely unknown. As adolescent drinking behaviors change in response to social media and industry influence, more evidence is needed to reflect the South Asia context.
  • No Thumbnail Available
    Item
    A Juvenile sex offender with Attention Deficit Hyperactivity Disorder
    (BbW Publisher, 2018) Chandradasa, M.; Hettiarachchi, D.; Fernando, R.; Gunathilake, M.; Wijetunge, S.; Tennakoon, A.
    BACKGROUND: Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder manifesting in early life. These children are more vulnerable to sexual abuse as victims and offenders. This is a case report of a teenager with previously undiagnosed ADHD presenting with an alleged act of sexual offending. CASE REPORT: According to the 14-year-old accused, he has engaged in penetrative anal intercourse with another schoolmate. that similar past incidents had involved a teenage male relative and insertion of foreign bodies to his anus repeatedly by him. On assessment the accused had features of inattention, such as difficulty in sustaining attention, failing to finish work and features of impulsivity, such as difficulty waiting for his turn and intruding on others. He was diagnosed with ADHD according to Diagnostic and Statistical Manual of Mental disorders (DSM 5) clinical criteria which were supported by the Sinhalese adaptation of the Swanson, Nolan and Pelham questionnaire. The assessment of the non-verbal intelligence was in the normal range, but his school performance was far below the average. DISCUSSION: Undiagnosed ADHD contributes to academic impairment and inappropriate sexual behaviour. It is possible that the described adolescent’s impulsiveness and inattention contributed to his academic failure and risky sexual behaviour. Early detection and proper management of this disorder may have reduced the risk of such behaviour in him.
  • No Thumbnail Available
    Item
    High-functioning autism in a Sri Lankan youth with High-functioning autism in a Sri Lankan youth with Langer-Giedion syndrome.
    (Lippincott Williams & Wilkins, 2018) Chandradasa, M.; Williams, S.
    The trichorhinophalangeal syndrome is a rare genetic disorder with a classical clinical triad of sparse hair, bulbous nose, and short digits. There are three known phenotypes, and the type II with exostoses in long bones is known as Langer-Giedion syndrome. Here, we describe a 28-year-old Sri Lankan male with Langer-Giedion syndrome and high-functioning autism. The karyotype found a microdeletion of the long arm of chromosome 8 with mosaicism [46,XY/46,XY,del(8)(q24.1q24.3)]. This is probably the first report of Langer-Giedion Syndrome with autism and the first report of the genetic syndrome from Sri Lanka. Furthermore, we could only access one previous report of the same microdeletion, which was from an autopsy of a 36-week-old infant.
  • No Thumbnail Available
    Item
    Haemoglobin variants, iron status and anaemia in Sri Lankan adolescents with low red cell indices: A cross sectional survey
    (Academic Press, 2018) Rodrigo, R.; Allen, A.; Manamperi, A.; Perera, L.; Fisher, C.A.; Allen, S.; Weatherall, D.J.; Premawardhena, A.
    Iron deficiency complicates the use of red cell indices to screen for carriers of haemoglobin variants in many populations. In a cross sectional survey of 7526 secondary school students from 25 districts of Sri Lanka, 1963 (26.0%) students had low red cell indices. Iron deficiency, identified by low serum ferritin, was the major identifiable cause occurring in 550/1806 (30.5%) students. Low red cell indices occurred in iron-replete students with alpha-thalassaemia including those with single alpha-globin gene deletions. Anaemia and low red cell indices were also common in beta-thalassaemia trait. An unexpected finding was that low red cell indices occurred in 713 iron-replete students with a normal haemoglobin genotype. It is common practice to prescribe iron supplements to individuals with low red cell indices. Since low red cell indices were a feature of all forms of α thalassaemia and also of iron deficiency, in areas where both conditions are common, such as Sri Lanka, it is imperative to differentiate between the two, to allow targeted administration of iron supplements and avoid the possible deleterious effects of increased iron availability in iron replete individuals with low red cell indices due to other causes such as α thalassaemia.
  • No Thumbnail Available
    Item
    Zoophilia in an adolescent with high-functioning autism from Sri Lanka
    (Blackwell Science, 2017) Chandradasa, M.; Champika, L.
    OBJECTIVE: Zoophilia is a rare paraphilic disorder with intense sexual urges involving animals. Autism is characterised by impairments in social communication and repetitive, restricted behaviours (RRB). Reported cases of zoophilia are limited worldwide, and zoophilia in autism is rarer. METHOD: This is a case report describing this unique and relatively unrecognised association in a male adolescent from Sri Lanka. RESULTS: A 17-year-old boy diagnosed with autism has average intelligence and academic capabilities. He had spent increasing time at his grandparents' cattle house. First, he was found masturbating near the cows and later having penetrative intercourse with a heifer. The shocked parents first sought traditional healing in the form of 'thovil', a demonic ritual of exorcist nature. Later, clinical evaluation found intense sexual urges towards cattle, which had led to marked distress and academic impairment. Sex hormone profile was normal. The adolescent was treated with a combination of cognitive-behaviour therapy and a selective serotonin reuptake inhibitor. CONCLUSION: We postulate that his persistent social difficulties contributed to the development of a paraphilic disorder. Unlike with his RRBs, he was markedly distressed about this sexual behaviour. Further research is required to explore this rarely reported, potential association.
  • No Thumbnail Available
    Item
    Association between faecal incontinence, child abuse, somatisation and health related quality of life
    (Belgian Society of Paediatric Gastroenterology, Hepatology and Nutrition (BeSPGHAN), 2013) Rajindrajith, S.; Devanarayana, N.M.; Benninga, M.A.
    AIMS : Faecal incontinence (FI) is an important lower gastrointestinal disease. Bad aroma around children with FI leads to rejection by peers, psychosocial isolation and learning difficulties. Aim of this study was to evaluate the association between FI, child abuse and health related quality of life (HRQoL) in children and adolescents. METHODS : Children aged 13-18 years were selected from four semi-urban schools in Gampaha district, Sri Lanka. A validated, self-administered questionnaire was used for data collection after obtaining consent from school authorities, parents and children themselves. Information regarding socio-demographic factors, gastrointestinal symptoms, child abuse, HRQoL and somatisation were collected. FI was defined as at least one episode of leaking of faeces in to the underwear per month. RESULTS: A total of 1807 children were included in the analysis [males/9.3 vs 53.8%), mean age 14.4years, SI.) 1.4 years]. Forty seven (2.6%) had FI. FT was significantly higher in boys (-74.49S vs. 25,6%% in girls, p < 0.0001)1. Prevalence of FI was significantly higher in those exposed to sexual abuse (17%.,. vs. 2.3% in non abused, p < 0.0.001)., emotional abuse i40.4% vs. 22.7%, p < 0.0001), and physical abuse (51% vs. 24:3.'%', p < 0.0001). Children with FI had higher mean somatisation score [mean 20.1, SD 14.5 vs. mean 9.3, SD 9.2 in those without FT (controls), p < 0.0001J. Children with FI had lower HRQoL scores for physical functioning (78.1 vs.'9:1:2.in controls, p < 0.0001), social functioning (78.4 vs. 92.6, p < 0.0001), emotional functioning (70.5 vs. 82.3, p < 0.0001) and school functioning (69.1 vs- 82.3, p < 0.0001) domains, and a lower overall HRQoL score (74.6 vs. 87.1, p < Q .0.001). CONCLUSIONS : FI in children shows a significant association with physical, sexual and emotional abuse. Children with FT have a range of somatic symptoms and a poor HRQoL score in physical, emotional, social and school functioning domains.
  • No Thumbnail Available
    Item
    Epidemiology of cyclical vomiting syndrome in a cohort of Sri Lankan children
    (The Korean Society of Neurogastroenterology and Motility, 2013) Devanarayana, N.M.; Rajindrajith, S.
    BACKGROUND/AIMS: Cyclic vomiting syndrome (CVS) is characterised by recurrent episodes of intense nausea and vomiting or unremitting retelling lasting for hours to days. Very little is known of its epidemiology in paediatric age group. The aims of this study were to assess the prevalence, clinical profile and risk factors of CVS m Sri Lankan children and adolescents. METHODS: This is a school-based cross sectional survey conducted in 8 randomly selected schools in 4 randomly selected provinces of Sri Lanka. Data were collected using a validated, self-administered questionnaire, which consisted of 3 parts; part 1 - socio-demographic data, part 2 - data on stressful and adverse life events, part 3 - Rome III questionnaire (self report form for children above 10 years) which was translated and validated for Sri Lankan children. It was administered in an examination setting and collected on the same clay. Trained research assistants were present during filling the questionnaire to verify doubts. CVS was diagnosed using Rome III criteria. RESULTS: A total of 2,163 children were recruited for the study (male 1189 (54.9%), age range LO to 16 years, mean 13.4 years, SD 1.8 years). In this study, CVS was seen in 18 (0.8%). There was no gender difference in prevalence of CVS (boys 1.0% vs. girls 0.6%, P > 0-05). A significantly higher prevalence of CVS was observed in children exposed to recent stressful life events such as being bullied at school (3.4% vs. 0.7% in not exposed), major illness in a close family member (1.9% vs. 0.6%), hospital-ization of the child for other illness (2.2% vs. 0.7%), frequent punishment by parents (3.3% vs. 0.7%) and domestic violence (2.9% vs. 0.8%). No association observed between CVS, and age, socio-economic status, family size and birth order. CONCLUSIONS; The prevalence of cyclic vomiting syndrome among Sri Lankan children and adolescents is 0.8%. This condition is more common in those exposed to emotional stress.
All items in this Institutional Repository are protected by copyright, with all rights reserved, unless otherwise indicated. No item in the repository may be reproduced for commercial or resale purposes.