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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty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 Availability of rehabilitation services for communication disorders in Sri Lanka: a cross-sectional survey(BMJ Publishing Group Ltd, 2023) Caldera, A.V.; Wickremasinghe, R.; Munasinghe, T.U.; Perera, K.M.N.; Muttiah, N.; Tilakarathne, D.; Peiris, M.K.R.R.; Thamilchelvan, E.; Sooriyaarachchi, C.; Nasma, M.N.; Manamperige, R.M.; Ariyasena, A.D.K.; Sumanasena, S.P.OBJECTIVES: To describe the rehabilitation services available for communication disorders in Sri Lanka and to estimate the adequacy of the services in provinces and districts of the country. SETTING: The study considered government and private institutions, which provide rehabilitation services for communication disorders in Sri Lanka. PARTICIPANTS: Institutions providing services of speech-language pathologists, audiologists and audiology technicians in Sri Lanka. PRIMARY AND SECONDARY OUTCOME MEASURES: We investigated the number of government hospitals and private institutions, which provide speech-language pathology and audiology services in Sri Lanka as the primary outcome measure. A number of speech-language pathologists, audiologists and audiology technicians working in the institutions were obtained from records and institution-based inquiries to identify the adequacy of the services in the country as the secondary outcome measure. RESULTS: Of the 647 government hospitals that provide free healthcare services in the country, 45 and 33 hospitals had speech and language therapy and audiology units, respectively. Government hospitals do not have audiologists but only have audiology technicians. The number of speech and language therapists and audiology technicians in the government sector per 100 000 population in the country was 0.44 and 0.18, respectively. There were wide variations in specialist to population ratio between districts. 77 private centres provide speech therapy services in 15 out of the 25 districts; 36 private centres provide audiological evaluations in 9 districts. CONCLUSIONS: The number of specialist speech and language therapists and audiologists is not sufficient to provide adequate rehabilitation services for communications disorder for the Sri Lankan population. Not recruiting audiologists to the government sector affects the management of hearing impairment in the affected.Item A survey on current knowledge and practices of teleaudiology among audiology professionals in Sri Lanka(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2021) Geeganage, V.; Jayasena, B.Introduction: With the advancement of technology and resources, telehealth is becoming a prominent method of providing audiology services across the world. Teleaudiology services in Sri Lanka are evolving and still is an under addressed area of local literature compared to other telehealth applications in medical sector. Objectives: To describe the current knowledge and practices of teleaudiology and factors affecting planning and implementation of teleaudiology in Sri Lanka. Methods: This is a descriptive cross-sectional study conducted among 104 (n=104) audiology professionals employed in public and private setups across the country using an online self-administered questionnaire. Results: The study yielded a response rate of 83.87% and majority (75.0%) of the participants were female. Age distribution of participants was between 25 and 45 years. Majority (79.8%) reported awareness on teleaudiology while 32.7% of them utilised it. Initiation of teleaudiology was influenced by COVID-19 pandemic. Reported uses of teleaudiology were predominantly counselling, education, hearing aid related rehabilitation, and prevention as individual or group sessions, utilising hybrid telehealth model. More than 75.0% of the services were centralised within Western province in private centres. Despite practices, several challenges were reported as influencing teleaudiology, including lack of facilities as major challenge while reporting several benefits. Conclusions: The findings of the study indicate the availability of teleaudiology in Sri Lanka however it is restricted to certain geographic areas and to certain services. This study sheds lights on current teleaudiology practices with an emphasis on factors affecting, which will assist in improving services further.Item Knowledge, practices, hearing-related symptoms among students exposed to leisure noise of a Sri Lankan University.(2018) Ileperuma, L.D.BACKGROUND AND RATIONALE: Exposure to excessive noise is a major cause of hearing disorders (Crandell et al., 2004). Leisure time noise can be one of the most important reasons for the development of noise induced hearing loss in the young population (Landälv, Malmström & Widén, 2013). Recent studies have revealed that the risk of experiencing hearing loss due to discotheque music, rock concerts, and music from personal music players in teenagers and young adults has increased (Sliwinska-kowalska, 2012). In the Sri Lankan context, there is a dearth of literature regarding knowledge practices and hearing related symptoms among university students exposed to leisure noise. Therefore, this study focused to describe university students’ level of knowledge on leisure noise exposure, hearing protection methods, activities and situations in which university students being exposed to, can cause damage to their hearing and to determines the association between tinnitus and other hearing related symptoms and leisure noise exposure among university students. METHODOLOGY: This descriptive cross-sectional study included 131 2nd year students representing faculties of Medicine, Science, Commerce and Management Studies, Humanities and Social Sciences of the University of Kelaniya, Sri Lanka. Simple random sampling was used to select the total study sample. Probability proportional to size sampling technique was used to decide the number of participants from each faculty. Quantitative data collection was carried out using a self-administered questionnaire. Appropriate statistical tests were performed using SPSS 22 software. RESULTS: 13 (10%) students from medical faculty, 24 (18%) from science faculty, 26 (20%) from commerce and management studies faculty, 27 (21%) from humanities faculty and 41 (31%) from social science faculty participated in this study. The results showed that although majority (88.55%) of students considered excessive leisure noise exposure can damage their hearing, a minority (22.90%) of the students considered that hearing loss caused by excessive noise exposure cannot be cured. A substantial number (46.56%) of students had heard about hearing protective devices, while a very low number of students (02.00%) had used them when they were exposing themselves to loud noise. The most frequently exposed situations were listening to music using MP3 players (90.08%), watching movies at film theatres (73.28%) and attending musical shows and concerts (46.56%). Majority (54.24%) of students use middle 1/3 (33.33% to 66.67% of the loudness) of the rating scale to listen to music using MP3 Player and the level can be consider as somewhat loud or loud. Discomfort in the ear(s), blocking sensation or fullness in ear(s), tinnitus and reduction of hearing were the most prominent hearing-related symptoms after being exposed to leisure noise. A significant relationship could be found between blocking sensation and listening to music using MP3 Player; and discomfort in ears and attending musical shows and concerts. CONCLUSIONS: Even though majority of students considered excessive leisure noise exposure can damage their hearing, their motivation on the usage of most effective hearing protection methods was considerably low. Therefore, hearing conservation programs for younger students should be developed to address the effects of leisure noise exposure on hearing and hearing protection.Item Hearing status among 20-45-year-old bus drivers and conductors of the Kadawatha bus station, Sri Lanka.(2018) Ileperuma, L.D.ABSTRACT: Bus drivers and conductors are a group working in noisy environments having a risk of developing occupational hearing loss. The hearing status of 86 bus drivers and conductors was evaluated comprehensively via diagnostic testing. Age and duration of work were the main factors contributing to their reduced hearing levels. Bilateral high frequency hearing loss was commonly seen in this population. BACKGROUND: Noise is a significant occupational health hazard in the transportation industry (Duarte et al. 2014). Bus drivers and bus conductors are a group affected by occupational hearing loss due to traffic noise, difficulty in sound protection methods, poor maintenance of vehicles and roads (Guardiano et al., 2012). It is important to evaluate the hearing status of Sri Lankan bus drivers and bus conductors comprehensively for the establishment and enforcement of proper regulations in the transportation sector to ensure health and safety of this population. METHOD: This descriptive cross sectional study recruited 86 bus drivers and bus conductors between 20 and 45 years from the Kadawatha bus station by purposive sampling. Data were collected from May to October 2015 through an interviewer-administered questionnaire, otoscopic examination, Distortion Product Otoacoustic Emission (DPOAE) hearing screening and diagnostic evaluation which included several hearing tests such as pure tone audiometry, speech audiometry, tympanometry, reflexometry and diagnosticDistortion Product otoacoustic emission (DPOAE) test. Data were analyzed by descriptive and inferential statistics using SPSS version 22. RESULTS: 79.1% failed the hearing screening test; 89.8% of bus drivers and 64.9 % of bus conductors. Probable factors/causes for failing the hearing screening test were, being a bus driver, age above 40 years, having a working experience as a bus driver or a bus conductor for more than 10 years and having a habit of listening to loud music. All tested by the diagnostic hearing evaluation had some form of hearing loss; 32.3% had NIHL. Age above 40 years, working experience of more than 10 years, daily travelling hours greater than 5, playing a sound system in the bus, having a habit of alcohol consumption and a history of noisy occupation and they could be associated factors for hearing loss. CONCLUSION: Tinnitus, ear fullness, headache and difficulty in hearing in noisy setting are the common complaints reported by this group. Bus drivers were the most affected group. Bilateral high frequency hearing loss was common. Age and working experience were the main factors contributing to reduced levels of hearing in this population. RECOMMENDATIONS: A pre-employment hearing evaluation and periodic follow up tests are recommended. Further in-depth studies can be conducted to measure noise levels of the bus drivers’ working environment such as inside buses, place of control and other parking places. Further studies can also be conducted to identify other causative factors for hearing loss such as whole body vibration and Carbon Monoxide exposure. It is also important to conduct education programs in order to raise awareness among bus drivers, bus conductors and their authorities on the risk of developing hearing loss and its potential implications.