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Publisher: Sri Lanka Journals Online (JOL)
Date: 25-01-2023
Abstract: Introduction: Sri Lanka adopted various control measures to stop the spread of COVID-19 including early detection by widespread testing, contact tracing and isolation. However, some people were not willing to accept testing due to several reasons. This is the first study from Sri Lanka conducted to determine people’s level of willingness to undergo a COVID-19 swab test. Method: This cross-sectional study was conducted among 427 non-COVID-19 patients who visited the outpatient department at a Teaching hospital in northern Sri Lanka. Data collection was done over a one month period in July 2021. The data collected was entered and analysed using SPSS version 28. Results: The mean age of the participants was 43.4, and a majority of the participants were female (62.8%). A significant proportion of the participants (37.9% CI: 34.3-43.6) were not willing to accept the test to screen for COVID-19. Among the 162 patients who were not willing to accept the test, 56.2% reported fear regarding testing, and 37.6% reported fear of getting a positive result. A significant association was observed between people’s willingness to accept the test and their gender (P-0.022) and knowledge of the test (P-0.001). Conclusion: As a considerable proportion of participants were not willing to accept COVID-19 screen testing, and people’s knowledge regarding testing significantly influenced their acceptance of such testing, this study concludes that the public can be educated further about the COVID-19 infection, identifying the symptoms of disease by themselves, available testing methods, the importance of testing early and how they will be treated if they get positive test results.
Publisher: Sri Lanka Journals Online (JOL)
Date: 30-12-2021
Publisher: Elsevier BV
Date: 10-2014
DOI: 10.1016/J.IJID.2014.04.014
Abstract: The aim of this study was to determine the demographic, clinical, and notification data of suspected dengue fever (DF) and dengue hemorrhagic fever (DHF) cases admitted to Jaffna Teaching Hospital, Sri Lanka. The data were collected from bed head tickets of all patients presenting with clinically suspected DF/DHF from October 2009 to September 2010. A total of 1085 clinically suspected DF/DHF cases were identified, with high numbers occurring during December 2009 to March 2010. The majority of the reported patients were females (n = 550, 50.7%) and approximately three-quarters of the patients (n = 797, 73.5%) were adults. All had fever, but fever spikes were noted in only 129 cases (11.9% 95% confidence interval (CI) 10.1-13.9%). Over 50% of cases had vomiting (95% CI 47.5-53.5%). Haemorrhages were noted in 266 (24.5%), with gum bleeding in 99 patients (37.2%). Low white blood cell and platelet counts were noted in 27.1% and 85.6% of cases, respectively. Of the 1085 cases, only 24 (2.2%) were screened for dengue IgM/IgG and only 458 cases (42.2%) were notified to the Epidemiology Unit, Ministry of Health, Sri Lanka. The absence of laboratory diagnosis and poor notification to the Epidemiology Unit were the major drawbacks noted.
Publisher: Sri Lanka Journals Online (JOL)
Date: 16-08-2022
DOI: 10.4038/AJIM.V1I2.49
Abstract: Background: Anaemia in older adults is a common medical problem but it is often not evaluated as a sole clinical entity and its importance is undermined. The gravity of anaemia in older adults and its impact on other diseases is not well known in Sri Lanka. Methods: This was a cross-sectional descriptive study where data was extracted retrospectively from the database and clinical records of patients who were referred to the haematology unit of Teaching Hospital Jaffna, Sri Lanka for the evaluation of anaemia, from September 2020 to February 2021. The common types of anaemia, their severity, aetiological classifications and association with other diseases were analysed. Results: A total of 1121 medical records of patients above 60 years were analysed during the study period. The main source of referrals was from medical wards. The female to male ratio was 51.2:48.8.The majority belonged to the age group of 60-69 years. Two-third of the patients had normocytic anaemia (70.3%) followed by microcytic (23.7%) and macrocytic anaemia (6.0%). A moderate degree of anaemia was seen commonly, but 28.3% were found to have severe anaemia. Aetiological classification revealed anaemia of chronic disease as the commonest type of anaemia in older adults accounting for 37% of the study s le, followed by multifactorial aetiology and iron deficiency anaemia. Common chronic diseases identified along with anaemia were diabetes, hypertension, ischaemic heart disease and chronic kidney disease. Conclusions: Normocytic anaemia was the commonest type identified and the majority were of a moderate degree. Though the commonest aetiological cause identified is anaemia of chronic disease, there was a considerable percentage of multifactorial causes indicating the need to be on the lookout for other possibilities. Identifying the prevalence of anaemia in all hospitalised older adult patients in the local setting, the causes and the impact on chronic and acute illnesses will immensely help in the management of older adult patients and improve their quality of life.
Publisher: Sri Lanka Journals Online (JOL)
Date: 22-06-2013
Abstract: To estimate the prevalence of postpartum anal incontinence (AI) and to highlight associated factors that account for variation in the prevalence in Vavuniya district in Northern Sri Lanka. A community based cross sectional study was conducted. S le included all mothers (hospital and home deliveries) who had completed postpartum period between 1st August and 30th September 2007. Participants were identified from the "expected date of delivery" registers maintained by public health midwives. Data were collected by trained public health midwives at the respondents' houses using an interviewer administered questionnaire. The mean age of the 540 postpartum mothers interviewed was 28 years (range: 16 - 44). Majority 78% (n=423) were Sri Lankan Tamils, 13% (n=68) Sinhalese and remaining 9% (n=49) Moors. Thirty nine percent (n=209) were primi parous, 81% (n=435) had a normal vaginal delivery and 79% (n=344) had an episiotomy. Out of 540 mothers, 16.5% (95% CI: 13.4 - 19.6) reported anal incontinence. Among them only 39.3% (n=35) had consulted a health worker for the symptom. In the bivariate analysis the following factors were significantly associated with anal incontinence: parity, history of an episiotomy, duration of labour >12hrs, mode of delivery (vaginal), family income and maternal age (teenage). But the multiple logistic regression analysis revealed only the episiotomy status as an independent risk factor (adjusted odd ratio: 3.4 (95% CI: 1.28 - 8.9). Anal incontinence is not an uncommon symptom in postpartum mothers and majority of affected in iduals avoided seeking medical attention. Factors associated with increased risk of anal sphincter damage should be considered during delivery and an attempt should be made to reduce it.
Publisher: Springer Science and Business Media LLC
Date: 25-10-2019
DOI: 10.1186/S13104-019-4740-Z
Abstract: This small scale cross-sectional study was done to identify the common systolic blood pressure pattern (dipping or non-dipping) among type 2 diabetic men with coexisting hypertension and erectile dysfunction(ED). A recent study in the same setting showed that prevalence of ED was high among diabetic men and co-existing hypertension was identified as an independent risk factor. There was a postulation about an association between ED and non-dipping nocturnal blood pressure pattern. So ambulatory blood pressure measurements (ABPM) was obtained for participants to test this prediction. Data was analysed using SPSS 25 Version. Among 29 participants who underwent ABPM, 21 showed non-dipping pattern of nocturnal systolic blood pressure (72.4% CI 54.3–86.3). Mean SBP of participants was 125.55 +_14.1 and Mean DBP was 81.5 + _12.82. There was no statistical difference observed in mean SBP and DBP between patients with dipping nocturnal SBP and non-dipping pattern (P 0.05). Variability of SBP was high among the participants (Mean SD-11.96 +/_2.74) and DBP also showed relatively high variability (SD-9.28 +/_2.9). Mean dipping percentage of the SBP during sleep was 5.54 +/_6.66. A significant difference in heart rate (HR) between patients with non-dipping and dipping pattern was noted (P-0.034).
Publisher: Public Library of Science (PLoS)
Date: 17-04-2013
Publisher: Sri Lanka Journals Online (JOL)
Date: 11-08-2021
Abstract: Hospital admissions due to non-coronavirus disease 2019 (nonCOVID-19) respiratory diseases decreased in Teaching Hospital Jaffna following social distancing, other public health measures (face mask wearing) and due to lock down implemented by authorities in 2020.
Publisher: Cureus, Inc.
Date: 07-10-2022
DOI: 10.7759/CUREUS.30047
Publisher: Sri Lanka Journals Online (JOL)
Date: 28-10-2021
Publisher: Springer Science and Business Media LLC
Date: 07-01-2017
Publisher: Research Square Platform LLC
Date: 17-01-2022
DOI: 10.21203/RS.3.RS-1203356/V2
Abstract: Background: The COVID-19 pandemic has spread across the globe from 2019 affecting millions of people physically, mentally, and socio-economically. The purpose of the study was to map out the mental health consequences of the COVID-19 pandemic and suggest recovery strategies. Methods: A qualitative inquiry into the mental health aspects of the COVID-19 pandemic using observations from working in busy health clinics, general practices, primary and community care setting, and dedicated COVID acute care wards during the pandemic in Australia, United Kingdom and Sri Lanka discussions with colleagues worldwide analyzing social and news media comments literature survey and experience of dealing with past disasters were used to map out mental health consequences and put forward recovery strategies. Results: In covid sufferers, neuropsychiatric symptoms lasting months, unrelated to respiratory insufficiency suggested brain damage due to vascular endothelial injury and/or cerebral venous thrombosis (CVT). A third went onto develop or have a relapse of a psychological or neurological conditions. In the general population, common consequences included common mental health disorders changing patterns of substance abuse including alcohol increased domestic violence and child abuse. Family relationships, interactions and understanding improved in many but minority had strained dynamics. Vulnerable groups included the elderly, women, youth children disabled frontline and health workers minorities and severely mentally ill. At the community level, there were signs of collective (mass) hysteria from panic buying to conspiracy theories, public shaming, fake news and disinformation spreading on social media and mass protests. There were also positive effects such as better understanding of bio-knowledge interventions (rapid vaccine production, contact tracing methods) and discoveries (mRNA Vaccines), health systems improvements (tele-health), online learning, gratitude toward heath care workers, increased social/community/family cohesion, closer international networking, reduction in suicide rates and drop in interstate and civil conflicts, road accidents, crime and communicable diseases with their resultant morbidity, mortality and mental health consequences. Conclusions: In view of the widespread mental health and psychosocial consequences from the COVID-19 pandemic, a community-based approach is suggested while treating more severe mental disorders at the primary care or specialist level.
Publisher: Hindawi Limited
Date: 05-12-2019
DOI: 10.1155/2019/6450281
Abstract: Visit-to-visit variability (VVV) is a relatively new concept in the hypertensive arena. Data regarding VVV are lacking in our region, and factors associated with VVV are rarely examined in previous studies. This study was conducted among 406 patients attended to the cardiology outpatient department of Teaching Hospital, Jaffna, Sri Lanka, in 2018 to assess the long-term variability of blood pressure (BP) by reviewing last six consecutive BP readings from the records retrospectively. Data regarding sociodemographic variables and behavioural factors such as medication adherence, physical activity, smoking, alcohol consumption, and relevant comorbidities were taken through an interviewer-administered questionnaire. Data were analysed by using SPSS version 25 and VVV of systolic blood pressure (SBP) matrix expressed as mean of SD and association were examined with various factors and VVV of SBP. SBP showed high VVV among the participants as expressed by mean of SD which was 13.06 ± 5.64. When comparing mean SD among the categories of different variables, female sex ( P = 0.023 ) and comorbidities such as diabetes mellitus (DM) ( P = 0.013 ), chronic kidney disease (CKD) ( P = 0.007 ), and risk of developing obstructive sleep apnoea (OSA) ( P = 0.04 ) showed significant variation. Medication adherence to prescribed hypertensive medication was a major issue even though significant association was not found with high VVV ( P = 0.536 ). The SD of SBP was then classified into high and low VVV groups by means of a cutoff point at the 50th percentile. Bivariate analysis by using Chi-squared test revealed comorbidities such as DM, CKD, and physical activity ( P = 0.044 ) were significantly associated with high VVV. Further multivariate regression analysis revealed that comorbidities such as DM and CKD have 1.561 times and 5.999 times more risk to show high variability, respectively. In conclusion, we recommend simple practical measures to achieve sustainable BP control among hypertensive patients with DM and CKD to minimize the VVV and improve their cardiovascular outcome.
Publisher: Research Square Platform LLC
Date: 15-12-2020
DOI: 10.21203/RS.3.RS-122005/V1
Abstract: Background: Prevalence of diabetes increasing world-wide particularly in low income countries. Management of diabetes sometimes requires insulin injection due to various reasons. Proper usage of insulin and injection techniques are important for diabetes control among who requires insulin. This study was aimed to assess current insulin practices and associated complications. Methods and material: This was a cross sectional study conducted among diabetes patients attended all medical clinics and Diabetic Centre in Jaffna teaching Hospital which is the only tertiary hospital in the Northern Sri Lanka in May 2020.Insulin practices retrieved by using interviewer administered questionnaire. Data was analyses by using SPSS 26. Results: Out of 360 patients 64.2% were female and mean age was 58.19 (12-89).Majority (61.9%) of them belongs to low income category and most (73.3%) of them using insulin more than 1 year. Main reason for the insulin initiation was oral hypoglycaemic failure (81.7%) and majority of them (80.0%) were using twice daily premixed insulin regime followed by daily basal insulin (11.4%) and basal bolus insulin (5.6%) regime. Most of the participants (81.4%) reported they do cleaning of the injection site before injection and 89.7% usually rotate the injection site. Approximately half of them (50.8%) inject themselves and majority use syringes (91.4%). Common injection site complications reported were skin changes (25%), followed by 15.3% persistent swelling (15.3%) and thinning of skin(7.8%). Angle of injection (P-0.039) and insulin regime (P .001) showed statistically significant association with skin changes.High proportion of participants 68.6% (95%CI: 63.7%-73.2%) experienced hypoglycaemia, using syringes 2.21 times (95%CI-1.05-4.64) more risk of compare to pen users and missing meals 2.22 times more risk of hypoglycaemic events (95%CI: 1.18-4.17). Majority of them reported reusing the needles for injection (83.6%) and 35% were disposing needle into common garbage pin. Conclusion: This study revealed significant gaps in current insulin practices from expected norm and hypoglycaemic events alarmingly high among participants. Exploring Continuous Glucose Monitoring Devices or flash monitoring can be a mitigation strategy and urgent attention from health professionals needed to improve the safe insulin practices.
Publisher: Springer Science and Business Media LLC
Date: 18-03-2020
DOI: 10.1186/S40795-020-00341-Y
Abstract: Vitamin D deficiency is common among post-menopausal women and it is important to treat vitamin D deficiency to prevent falls and fractures in patients with osteoporosis. Few studies examined the prevalence of vitamin D deficiency in general population of Sri Lanka but no studies to date done among post-menopausal women with osteoporosis in Sri Lanka. This is the first study in Sri Lanka of such kind conducted to evaluate the serum vitamin D levels among postmenopausal women. Cross-sectional study was conducted at the Endocrine Unit, Teaching Hospital Jaffna from January to December 2018. During this period 105 postmenopausal women who registered for bone density assessment were recruited to the study. Data collection was done by investigators and blood s le was taken from each participant by registered nurses and total 25-Hydroxy Vitamin D level (25(OH)-Vit D) was measured by competitive immunoassay with enhanced chemiluminiscence technique, levels were categorized and analysis was done using SPSS 26. Mean age of 105 postmenopausal women was 67.7 with minimum 33 and maximum 84 years. Mean total 25(OH)-Vit D was 27.5 (range11.7–52.5 ng/mL). 25(OH)-Vit D levels were adequate in only 36.2% (95%CI: 27–45), 44% had insufficient levels and deficiency was present in 19% (95%CI: 12–27) of postmenopausal women. Among total study participants 20% were vegetarian, 53, 76.2 and 64.8% were consuming milk, fish and egg respectively and 71.4% reported adequate level of sun exposure ( 30 min/day). Commonly reported vitamin D deficiency symptoms include paraesthesia (57.1%), bone-pain (55.2%), easy fatigability (54.3%), malaise (51.4%), muscle cr s (43.8%) and proximal myopathy (40.0%). Nevertheless, comparison of musculoskeletal symptoms between group with sufficient level and group with insufficient and deficient level showed no significant difference ( P 0.05). Among 71 participants (66.7%) who completed bone density assessment, 38% (95%CI: 27–49) showed osteoporosis. Vertebral Z score showed a significant correlation with 25(OH)-Vit D level (r-0.252, P-0.03). Prevalence of vitamin D deficiency is relatively high among the post-menopausal women with a provisional diagnosis of osteoporosis. It is essential to consider vitamin D supplementation when initiating treatment for osteoporosis. Hence, Vitamin D testing is desirable in decision making to treat or not to treat.
Publisher: Elsevier BV
Date: 05-2023
Publisher: Public Library of Science (PLoS)
Date: 25-01-2012
Publisher: Springer Science and Business Media LLC
Date: 10-01-2018
Location: Australia
No related grants have been discovered for Rajeshkannan Nadarajah.