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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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 The Outcome of preterm labour and preterm prelabour rupture of membranes after oral salbutamol or nifedipine SR(Sri Lanka College of Obstetricians and Gynaecologists, 2005) Padumadasa, S.; Goonewardene, M.RATIONALE: Preterm labour (PTL) and preterm prelabour rupture of membranes (FT - PLROM) are still a problem. Several tocolytics with varying doses have been tried in the treatment. OBJECTIVE: To compare the effectiveness and safety of oral salbutamol and nifedipine SR in the management of PTL and PT - PLROM. DESIGN AND SETTING: A randomised controlled trial from 15 May 2002 to 30 April 2003 at the University Obstetric Unit, Teaching Hospital, Galle. SUBJECTS AND METHOD: One hundred and fourteen consecutive women who presented with PT - PLROM or fulfilled the diagnostic criteria for PTL-more than one uterine contraction occurring within ten minutes and the cervix effaced and greater than 1cm, and without any contraindications for tocolysis, were randomly assigned to receive either oral salbutamol 4 mg 8 hourly or nifedipine SR 20 mg 12 hourly for 48 hours. The first author was unaware of the treatment regimen until the final analysis. Three doses of dexamethasone 8 mg 12 hourly were also given. MAIN OUTCOME MEASURES: The time interval upto delivery, birth weight of the baby, admissions to premature baby unit, perinatal deaths and adverse maternal effects were assessed. RESULTS: Forty-eight women received salbutamol and 66 received nifedipine SR. Between the two groups there were no significant differences in the basic characteristics, the mean period of gestation, the frequency of uterine contractions and the cervical dilatation in the subjects. Delivery occurred after a mean of 9.7 days SD 14.7 (salbutamol group) and 14.6 days SD 21.0 (nifedipine SR group) (P=0.2). In the salbutamol group 75% delivered within 9.5 days while in the Nifedipine SR group it took 28.0 days for 75% of the subjects to deliver. The mean birth weight of the babies in the nifedipine SR group (2.47 kg, SD 0.68) was significantly higher (P=0.04) than that of the babies in the salbutamol group (2.18 kg, SD 0.67). There were six perinatal deaths in the salbutamol group but only two deaths in the nifedipine SR group (P=0.06). Adverse effects were more common with salbutamol; tremors (54% versus 5%), palpitations was significantly higher (P=0.04) than that of the babies in the salbutamol group (2.18 kg, SD 0.67). There were six perinatal deaths in the salbutamol group but only two deaths in the nifedipine SR group (P=0.06). Adverse effects were more common with salbutamol; tremors (54% versus 5%), palpitations (46% versus 9%), nausea (10% versus 5%) compared to nifedipine SR. Headache was commoner with nifedipine SR (26% versus 10%). CONCLUSIONS: If oral to colytics are used in women with preterm labour or preterm prelabour rupture of membranes nifedipine SR is apparently better than salbutamol with regard to adverse maternal effects. There may be a delay in delivery and an increase of the birth weight of the baby with nifedipine SR treatment. (46% versus 9%), nausea (10% versus 5%) compared to nifedipine SR. Headache was commoner with nifedipine SR (26% versus 10%). CONCLUSIONS: If oral tocolytics are used in women with preterm labour or preterm prelabour rupture of membranes nifedipine SR is apparently better than salbutamol with regard to adverse maternal effects. There may be a delay in delivery and an increase of the birth weight of the baby with nifedipine SR treatment.Item Prevalence of asthma and atopic symptoms in children aged 5-11 years(Sri Lanka College of Paediatricians, 2003) Karunasekera, K.A.W.; Perera, K.P.J.; Perera, M.T.P.R.; Abeynarayana, J.OBJECTIVE: To assess prevalence of asthma and atopic symptoms in a group of school children aged 5-11years and to look at prevalence of usage of asthma medications. SETTING: Three schools in Gampaha District in August 1998. METHOD: A questionnaire translated into Sinhala was distributed to parents/guardians of 2195 children aged 5-11 years in Grades 1-5 of the schools and the filled questionnaires were collected through class teachers. Asthma, allergic rhinitis and eczema were defined using the clinical criteria of the International Study of Asthma and Allergic Conditions (ISAAC). Data was analysed using Epi Info version 6. Chi squared test and Chi squared test for trend were used for significance testing. RESULTS: Return rate of questionnaire was 93%. Sixty six percent were completed by mother, 30% by father and rest by guardian. Prevalence of asthma was 23% and of exercise induced asthma 11%. Prevalence rate of allergic rhinitis was 10% and eczema 3%. Within the specific group of asthma, in response to leading question "Has your child had asthma" only 19% of parents gave a positive answer. Prevalence of asthma in males did not significantly differ from that in females (p=0.5). A decreasing trend of asthma was observed with increasing age in girls (p less than 0.05). Eighty four percent of asthmatic children were using salbutamol orally and 9% without asthma in study population were also using salbutamol. CONCLUSIONS: One in 5 children aged 5-11 years in study population had asthma but parental perception about asthma was poor. More than 80% of asthmatics had some medications for the disease.