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Darshana, W. D. "Improvement of Health and Safety in Construction Sites in Sri Lanka." Engineer: Journal of the Institution of Engineers, Sri Lanka 50, no. 1 (2017): 53. http://dx.doi.org/10.4038/engineer.v50i1.7244.
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Rajapaksha, Tharindu Ishanka, and Lalitha S. Fernando. "An analysis of the standards of the government websites of Sri Lanka." Transforming Government: People, Process and Policy 10, no. 1 (2016): 47–71. http://dx.doi.org/10.1108/tg-09-2013-0036.
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Purpose This paper aims to identify the reasons for the lower ranking of the Online Service Index of Sri Lanka under the United Nations E-Government Readiness Index. The study is conducted as a comparative study on selected Asian countries and suggests remedial measures for the improvement of the status of e-government of Sri Lanka. Design/methodology/approach In this regard, as the sample of websites ranked according to the Online Service Index of the United Nations, five government websites of Sri Lanka, India, Bangladesh and Singapore were selected. They are the national portal and the websites of the five Ministries: The Ministry of Education, Finance, Health, Labor and of Social Services. Asian countries selected are India, Bangladesh and Singapore including Sri Lanka. Observation method was the mainly used method for data collection. The websites were evaluated in contrast with the help of the “Main features reviewed by the United Nations E-government Survey” as the checklist. Substantial description and scoring methods were used for the analysis of the data and the presentation of the findings of the study. Findings Thus, several weaknesses of the online services of the government websites of Sri Lanka were identified. Among them, the major reasons identified for the lower rank of the Sri Lankan Online Service Index were, for example, the inability to identify the exact website of national portal, the lack of accessibility or usability features, the weaknesses in the active maintenance of the “Contact us” feature, service-delivery capability features, citizen participation and also interconnectedness features. The above weaknesses have been the key/root causes for the decline of the rank of the Online Service Index of Sri Lanka. Research limitations/implications From five government websites, selected three foreign Asian countries were in focus because of practical limitations. Another difficulty faced in the analysis and comparison of the websites was that the information with regard to the United Nations evaluation methodology/criteria has not been adequately provided. Practical implications The findings of this study provide information for the policy makers, web standards, evaluation criteria developers and almost all the government organizations to address key issues related to this field for the maximization of citizen participation, the enhancement of the service-delivery capabilities and accessibility features of websites to improve the online services of the government. This study unfolded several areas for the future researchers. Those researches can also be conducted based on sub indexes of the United Nations E-Government Readiness Index. The same method could be used to examine Human Capital Index, Telecommunication and Infrastructure Index and Citizen Participation Index. This research could also be expanded through observations of foreign countries. Originality/value This paper provides an overview of the quality of government websites of Sri Lanka compared to the selected Asian countries. Through the utilization of this scoring method, four major weaknesses that contribute to the lower ranking of the online service of Sri Lanka were identified with suggestions indented for the improvement of the government websites.
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Patabendige, Malitha, Suneth Buddhika Agampodi, Asanka Jayawardane, Denagamage Jayamini Wickramasooriya, and Thilini Chanchala Agampodi. "Perceptions on respectful maternity care in Sri Lanka: Study protocol for a mixed-methods study of patients and providers." PLOS ONE 16, no. 5 (2021): e0250920. http://dx.doi.org/10.1371/journal.pone.0250920.
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Background Over the past few decades, interest in providing and measuring Respectful Maternity Care (RMC) has increased markedly. Sri Lanka is reportedly shown to have better maternal health statistics and studies on quality improvement are lacking in this unique population. We aim to describe healthcare providers’ perceptions and women’s expectations, perceptions and their gaps in service provision regarding RMC in Sri Lanka. Methods A descriptive cross-sectional study with a mixed-methods approach comprising of qualitative component followed by a quantitative component will be conducted in Castle Street Hospital for Women (CSHW) and De Soysa Hospital for Women (DSHW), Colombo, Sri Lanka. Healthcare providers (HCP- doctors, nurses and midwives) and vaginally delivered postnatal women (in postnatal wards and postnatal well-baby clinics) will be recruited through convenience sampling. In-depth interviews will be conducted with each of the four categories. Thematic analysis will be adopted to analyze qualitative data and the findings will further be used to improve the quantitative phase questionnaires. Self-administered questionnaire will be administered to a 378 vaginally delivered postnatal women [quota sampling across ten wards], exploring demographic details, and maternal opinion on various aspects of RMC. Locally validated Women’s Perceptions of RMC tool (WP-RMC) will also be used to measure the level of RMC among these postnatal women along with the questionnaire 01. Qualitative findings will be used for cognitive validation of the WP-RMC into the Sri Lankan setting. Discussion This study will explore HCP’s and women’s expectations, perceptions and their gaps in service provision regarding RMC in two maternity hospitals in Sri Lanka. Assessment of the quality of care with regards to RMC have not been reported previously in this setting.
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Kumara, Jeewaka Saman. "Non-traditional Security Disputes of Sri Lanka." International Journal for Innovation Education and Research 3, no. 3 (2015): 1–14. http://dx.doi.org/10.31686/ijier.vol3.iss3.323.
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From the 1970s onwards, social constructivists criticized the intense narrowing of the field of security studies imposed by the military and nuclear obsessions of the Cold War. Further, they argued that these traditional issues have not disappeared, but that other, non-military sources of threat now seemed more pressing. Hence, the nature and magnitude of security within the states should be considered from different angles such as economic security, food security, health security, environmental security, personal security, community security and political security. In the context of small states, the issue of security has multiple dimensions in the complexities of the state. Apart from the traditional aspect of security threats of small states, the non-traditional aspect is very important to identify the security threats of small states. One of the most important aspects of non-traditional security thus, is that people should be able to live in a society that honours their political security. In this broader context this study makes an effort to answer whether the political security of Sri Lanka is being challenged in the context of power political paradigm. Further the research problem has been answered by using standard research tool including descriptive and analytical methods and also the research involves both qualitative and quantitative methods. As a developing small state, Sri Lanka is an electoral democracy. The 1978 constitution vested strong executive powers in the president, who is directly elected for a six-year term and can dissolve Parliament. The prime minister heads the leading party in Parliament but otherwise has limited powers. The 225-member unicameral legislature is elected for a six-year term through a mixed proportional-representation system. Elections are open to multiple parties, and fair electoral laws and equal campaigning opportunities ensure a competitive political process. Despite the war’s completion and an improvement in security throughout Sri Lanka, the situation of political security remained grim. Some observers’ charge that centralizes approach of the ruling party of the Government of Sri Lanka has led to a lack of protection of political security. In this broader context, there is an argument that the situation of political security of Sri Lankan remains grim.
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Withanachchi, Nimnath, Wimal Karandagoda, and Yujiro Handa. "A performance improvement programme at a public hospital in Sri Lanka: an introduction." Journal of Health Organization and Management 18, no. 5 (2004): 361–69. http://dx.doi.org/10.1108/14777260410560820.
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Thadchanamoorthy, V., and Kavinda Dayasiri. "Challenges in Diagnosis of ChronicOsteomyelitis : ACase Report from Sri Lanka." International Journal of Human and Health Sciences (IJHHS) 5, no. 1 (2020): 118. http://dx.doi.org/10.31344/ijhhs.v5i1.246.
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The prevalence of osteomyelitis has been continuously decreasing in children with improvement of health care services and introduction of Hemophilus and Pneumococcal vaccines. Despite this, diagnosis and management of osteomyelitis are often a challenge to pediatricians as well as orthopedic surgeons. We report a 13-year old boy who had been treated as for rheumatic fever over 2 years with Benzathene penicillin, but ultimately turned out to have chronic osteomyelitis of right tibia. Evidence of chronic osteomyelitis was radiologically confirmed by X-ray and Computerized tomogram (CT) of right tibia and pus cultures grew staphylococcus aureus. Clinical features and biochemical markers completely resolved upon debridement of pus and intravenous antibiotics. He is currently on follow up at the orthopedic and pediatric clinics in the local hospital.International Journal of Human and Health Sciences Vol. 05 No. 01 January’21 Page: 118-121
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Dawson, Angela J., Kumuda Wijewardena, and Ellie Black. "Health and education provider collaboration to deliver adolescent sexual and reproductive health in Sri Lanka." South East Asia Journal of Public Health 3, no. 1 (2014): 42–49. http://dx.doi.org/10.3329/seajph.v3i1.17710.
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The complex nature of adolescent sexual and reproductive health (ASRH) determinants demands a multidisciplinary and intersectoral approach. Collaborative approaches are central to the delivery of quality health care and services but the focus is often health sector specific. Few research studies have explored the views and experiences of health workers and teachers and examined how ASRH services and information are provided by professionals across the education and health sector. Sri Lanka has made considerable progress towards addressing the Millennium Development Goals (MDG), however, there are still gaps reflected in adolescent health, social indicators, and the delivery of services. Enhancing the collective efforts of teachers and health professionals may help to improve the quality and use of services and ASRH knowledge. This study aimed to identify the experiences, needs, knowledge, attitudes and practices of primary healthcare and education professionals and the strategies that best support them to deliver sexual and reproductive health information, education, counseling and clinical services to Sri Lankan adolescents. Qualitative and survey data were gathered from 65 nurses, midwives, public health inspectors, medical officers, teachers, counselors and principals in the district of Kalutara. Knowledge, attitudes and service gaps were identified in relation to contraception and policy guiding practice. Participants highlighted concerns with confidence, roles and training that were said to affect student access to appropriate health services. ASRH Collaborative practices were noted across the sectors and strategies suggested for improvement. Findings suggest that inter-professional educa-tion and training may provide opportunities to enhance collaboration supported and guided by appropriate policy, supervision and job descriptions (i.e. roles and responsibilities). South East Asia Journal of Public Health 2013; 3(1): 42-49 DOI: http://dx.doi.org/10.3329/seajph.v3i1.17710
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Skuse, David. "Practising psychiatry in Sri Lanka: challenges and opportunities." BJPsych International 20, no. 1 (2023): 1. http://dx.doi.org/10.1192/bji.2022.28.
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This month's issue of BJPsych International focuses on psychiatry in Sri Lanka, with articles on suggested improvements in education and training, the country's outdated legislation regarding involuntary psychiatric treatment, and the misuse of prescription medications.
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Prathapan, S., P. Fonseka, G. Lindmark, R. Prathapan, and A. Lokubalasooriya. "The need for quality improvement in diagnosing pregnancy induced hypertension in Sri Lanka." South East Asia Journal of Public Health 2, no. 2 (2013): 55–60. http://dx.doi.org/10.3329/seajph.v2i2.15952.
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Sri Lanka has shown relatively good maternal outcome indicators for a developing country. However, high maternal deaths from pregnancy induced hypertension and pre-eclamptic toxemia raise questions about the quality of detection and treatment at field antenatal clinics, which is the primary care setting for pregnant women. The objective of the study was to assess the quality of facilities and services provided at the field antenatal clinics to di-agnose pregnancy induced hypertension or pre-eclamptic toxemia. It was a cross-sectional study. This study was set in field antenatal clinics and was conducted in two stages based on the Lot Quality Assurance Sampling method. In the first stage 55 antenatal clinics were selected from 11 Medical officers of Health areas, and in the second stage 275 pregnant women were recruited from these 55 clinics. Quality of services and quality of facilities were assessed using observation checklists. The quality of facilities was better than the quality of services in the Colombo district. The quality of facilities was acceptable in all areas other than for the presence of the Medical Officer. The quality of services was unacceptable in all areas for history taking and examination. Investigation for urine albumin was also unacceptable in all the areas. The sensitivity for measuring the systolic blood pressure and the diastolic blood pressure were 57% (95% CI: 47.4%66.8%) and 16.7% (95% CI: 9.4%24%) respectively. Urgent steps should be taken to improve the quality of care in the substandard areas to reduce the leading cause of maternal mortality in Sri Lanka. DOI: http://dx.doi.org/10.3329/seajph.v2i2.15952 South East Asia J Public Health | Jul-Dec 2012 | Vol 2 Issue 2 | 55-60
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Gunawardana, Kennedy Degaulle. "An analysis of medical waste management practices in the health care sector in Colombo." Management of Environmental Quality: An International Journal 29, no. 5 (2018): 813–25. http://dx.doi.org/10.1108/meq-02-2018-0032.
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Purpose The purpose of this paper is to identify the type of waste generation and the management of waste in order to reduce pollution in the health care sector with special reference to Colombo, Sri Lanka. The paper further aims to determine the relationship between top management and staff attitudes toward waste management and to identify the level of technology used in medical waste management in various types of health care organizations. Design/methodology/approach A survey questionnaire was developed using the designed conceptual framework to achieve the objectives of the study. Findings The study identifies that, though governments provide legislations and regulatory support, organizations of any size must have a positive attitude, awareness, capability and technology to initiate improvements for waste management processes and be prepared to adapt to new trends. Developing positive attitudes and improved knowledge on changes in waste management technology will assist in encouraging organizations to invest in this area. Research limitations/implications The scope of this project is limited to private health care institutions in the Colombo district in Sri Lanka from where data were gathered. Originality/value Health care center waste management is a relatively new discipline in the Sri Lankan health sector. This study provides an opportunity for management to identify the level of waste generated by health care institutions and the methods followed for the disposal of waste. Environmental groups can gain benefit through this project, since they can identify whether the private institutes in the health care sector are following world-accepted methods in disposing of waste.
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Ranawaka, Udaya K. "Stroke Care in Sri Lanka: The Way We Were, the Way We Are, and the Way Forward." Journal of Stroke Medicine 1, no. 1 (2018): 45–50. http://dx.doi.org/10.1177/2516608518774167.
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Sri Lanka is a lower-middle–income country with a high Human Development Index. Stroke is a primary cause of death and disability in the country, and demographic and epidemiological transitions are likely to lead to a large increase in the burden of stroke. Although impressive health indicators have been achieved due to an excellent primary health-care structure, Sri Lanka has been slow to develop and expand modern stroke care. A majority of the patients with acute strokes are treated in state-sector hospitals where facilities for state-of-the-art acute stroke care are limited. Neurologists are low in number, and general physicians provide acute stroke care for most of the patients. Epidemiological data on stroke in Sri Lanka are scarce. Previous studies have shown low quality of stroke care and significant gaps in stroke awareness. Noteworthy gains have been made since the turn of the century, and recent trends in development of stroke care are promising. There is a clear need to improve manpower, infrastructure, and training that will lead to improvements in the existing services in terms of acute care, rehabilitation, and community support. More research data are needed to guide strategies to minimize the burden of stroke, and more concerted efforts are needed to make stroke care in Sri Lanka ready to face the challenges of the 21st century.
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Warnakulasuriya, Loretta S., Manel A. M. Fernando, A. V. Nihal Adikaram, et al. "Assessment of Nutritional Status in Sri Lankan Children: Validity of Current Anthropometry Cutoffs?" Asia Pacific Journal of Public Health 31, no. 7 (2019): 633–42. http://dx.doi.org/10.1177/1010539519872061.
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Despite socioeconomic improvement, undernutrition rates stagnate in Sri Lanka, while a slow rise in obesity and noncommunicable diseases (NCD) is seen. Inability to improve undernutrition and detection of NCD could be due to overdiagnosing stunting/wasting and underdiagnosing overweight/obesity. Obesity, being a risk factor for NCDs, needs correct tools for early diagnosis. Although body mass index (BMI) is a commonly used surrogate index, the validity of universal cutoffs is questioned. Evidence shows that body composition varies with ethnic origin and cutoff value reflecting fat mass (FM) varies in different ethnic groups. This study was conducted in 12 788, 5- to 15-year-old children from 8 schools in Negombo, Sri Lanka, to identify the validity of current anthropometric cutoffs. Obesity prevalence identified by body fat content was high. International BMI cutoffs had high specificity but varied sensitivity. Locally developed BMI cutoffs had high sensitivity and specificity. Validity of internationally developed anthropometric cutoffs in South Asian children is unsatisfactory; hence, locally/regionally developed anthropometric tools should be used for screening of obesity.
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Perera, Manuja, Chamini Kanatiwela de Silva, Saeideh Tavajoh, et al. "Patient perspectives on hypertension management in health system of Sri Lanka: a qualitative study." BMJ Open 9, no. 10 (2019): e031773. http://dx.doi.org/10.1136/bmjopen-2019-031773.
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IntroductionUncontrolled hypertension is the leading risk factor for mortality globally, including low-income and middle-income countries (LMICs). However, pathways for seeking hypertension care and patients’ experience with the utilisation of health services for hypertension in LMICs are not well understood.ObjectivesThis study aimed to explore patients’ perspectives on different dimensions of accessibility and availability of healthcare for the management of uncontrolled hypertension in Sri Lanka.SettingPrimary care in rural areas in Sri Lanka.Participants20 patients with hypertension were purposively sampled from an ongoing study of Control of Blood Pressure and Risk Attenuation in rural Bangladesh, Pakistan, Sri Lanka.MethodWe conducted in-depth interviews with patients. Interviews were audio-recorded and transcribed into local language (Sinhala) and translated to English. Thematic analysis was used and patient pathways on their experiences accessing care from government and private clinics are mapped out.ResultsOverall, most patients alluded to the fact that their hypertension was diagnosed accidentally in an unrelated visit to a healthcare provider and revealed lack of adherence and consuming alternatives as barriers to control hypertension. Referring to the theme ‘Accessibility and availability of hypertension care’, patients complained of distance to the hospitals, long waiting time and shortage of medicine supplies at government clinics as the main barriers to accessing health services. They often resorted to private physicians and paid out of pocket when they experienced acute symptoms attributable to hypertension. Considering the theme ‘Approachability and ability to perceive’, the majority of patients mentioned increasing public awareness, training healthcare professionals for effective communication as areas of improvement. Under the theme ‘Appropriateness and ability to engage’, few patients were aware of the names or purpose of their medications and reportedly missed doses frequently. Reminders from family members were considered a major facilitator to adherence to antihypertensive medications. Patients welcomed the idea of outreach services for hypertension and health education closer to home in the theme ‘Things the patients reported to improve the system’.ConclusionPatients identified several barriers to accessing hypertension care in Sri Lanka. Measures recommended improving hypertension management in Sri Lanka including public education on hypertension, better communication between healthcare professionals and patients, and efforts to improve access and understanding of antihypertensive medications.Trial registration numberNCT02657746.
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Peiris, Dilka Rashmi, Millawage Supun Dilara Wijesinghe, Balangoda Muhamdiramlage Indika Gunawardana, et al. "Mobile Phone-Based Nutrition Education Targeting Pregnant and Nursing Mothers in Sri Lanka." International Journal of Environmental Research and Public Health 20, no. 3 (2023): 2324. http://dx.doi.org/10.3390/ijerph20032324.
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Introduction: A woman’s nutrition during pregnancy and nursing affects the mother and the growing child. Similarly, the first two years of a child’s life are critical to their growth and development and are facilitated by optimum nutrition. Women’s nutrition-related knowledge, attitudes, and practices influence household food and nutrition security. Mobile health (mHealth) is a potentially effective health intervention in pandemic situations when physical gatherings are restricted. Objectives: To examine the effectiveness of a mobile phone-based nutrition education intervention targeting pregnant and nursing mothers in six Sri Lankan divisional secretariat areas. Method: This intervention was evaluated using a before and after within-subjects design. The intervention included 19 messages over four weeks sent via mobile phone, covering nutrition themes such as pregnancy care, infant and young child-feeding, diet, family care for mother and child, and cash management. The intervention was evaluated based on a quantitative survey using a structured interviewer-administered questionnaire and qualitative interviews using a semi-structured questionnaire. The study population was pregnant and nursing mothers. The objective of the qualitative interviews was to identify how respondents used messages and how satisfied they were with the project. The outcome measures were awareness/knowledge, attitudes, social norms, self-efficacy, behaviour intentions, and practices of pregnant and nursing mothers. Trained enumerators collected data using a mobile phone. Results: A total of 996 pregnant and nursing mothers participated in the pre-assessment survey, of which 720 completed the post-assessment. Most were nursing mothers (84.2% pre- and 78.9% post-assessment). Participants provided positive feedback on the intervention. Knowledge/awareness (t = −18.70, p < 0.01) and attitudes (t = −2.00, p < 0.05) increased when exposed to the intervention. Favourable improvements in the practices were also observed. Mothers’ practices related to breastfeeding and 24-h dietary diversity showed a statistically significant improvement. However, social norms and behaviour intentions did not significantly improve. The qualitative component also revealed favourable responses. Conclusion and Recommendations: The mobile intervention improved participants’ knowledge, awareness, attitude, and practices, but not social norms or behaviour intentions. This approach is recommended to be used on a larger scale in community settings. In addition, mobile technology could drive intervention in pandemic-related situations.
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Zoysa, Mangala De. "Urbanization, Climate Change and Environmental Resilience: Experiences in Sri Lanka." Urban Studies and Public Administration 4, no. 1 (2021): p46. http://dx.doi.org/10.22158/uspa.v4n1p46.
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Urbanization in conjunction with climatic change affecting urban life and pose challenges to cities worldwide creating urban residents increasingly vulnerable to extreme weather and other natural disasters. Improvement of urban ecosystems provide cost-effective solution against negative impacts of climate change accelerated with high population pressure and promote resilience of urban dwellers. The cities in Sri Lanka are focused on improving land use planning and management of urban forest ecosystems for adaptation to and mitigation of climate change impacts with the rapid urbanization. This study attempts to ascertain the effects of urbanization, analyze the impacts of urbanization and climate change, and examine the environmental resilience with urban forests in Sri Lanka, reviewing the relevant literature. This paper explore the effects of urbanization in terms of increase population, land use change, rising greenhouse gas emissions and intensity of urban heat island. The impacts of urbanization and climate change are revealed as change of annual rainfall, urban warming, extreme weather events, and urban health hazards. Disaster resilient cities, sustainable urbanization, greening the cities, other environmental resilience strategies as well as institutional and policy setting are discussed for environmental resilience to urbanization and changing climate. Limiting CO2 emission, reducing land surface temperature, and controlling urban heat island effect are discussed under the other environmental resilience strategies. Institutional and policy setting is explained through popularizing urban forestry and developing policy support. Urban forestry strategies incorporating urban planning should be manifested in urban development policy in order to counteract the negative effects of climate change in the process of environmental resilience and sustainable urbanization.
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Gunawardena, Kasun C., Renee Jackson, Iva Robinett, et al. "The Influence of the Smart Glucose Manager Mobile Application on Diabetes Management." Journal of Diabetes Science and Technology 13, no. 1 (2018): 75–81. http://dx.doi.org/10.1177/1932296818804522.
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Background: Smartphone use is rapidly growing in developing countries, providing opportunity for development of new health-based mobile applications. The present study investigated the efficacy of a newly designed mobile application, Smart Glucose Manager (SGM), in Sri Lankan patients with diabetes. Methods: A total of 67 patients with access to Android smartphones were randomized into an SGM (n = 27) and a control group (n = 25). Glycosylated hemoglobin (A1c) levels were measured at baseline and every 3 months afterward. The SGM group utilized the application daily, while control-group patients were instructed to continue their standard methods of diabetes management. Independent t-tests were utilized to assess A1c differences at 3 and 6 months postrandomization. A1c improvement, defined as A1c at 6 months minus baseline, was compared with SGM usage to assess effectiveness of diabetic management. Results: At the 6-month follow up, the SGM group had significant lower A1c levels than the control group (7.2% vs 8.17%, P < .0001). For both groups, A1c values decreased from baseline to the 3 months (SGM: 9.52% to 8.16%, P < .0001; control: 9.44% to 8.31%, P < .0001). From 3 months to 6 months, the SGM group showed further improvement of A1c (−0.96% P < .0001), whereas the control group did not ( P = 0.19). A1c improvement was positively correlated with SGM usage ( R = .81, P < .001). Conclusion: The SGM, a mobile application specifically designed to support self-management of diabetes, appeared to show long-term improvement of A1c levels in patients with diabetes residing in Sri Lanka.
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De Silva, Nayanthara, Uthpala Rathnayake, and K. M. U. B. Kulasekera. "Under-reporting of construction accidents in Sri Lanka." Journal of Engineering, Design and Technology 16, no. 6 (2018): 850–68. http://dx.doi.org/10.1108/jedt-07-2017-0069.
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Purpose Under-reporting of occupational accidents is a common problem in many countries. This is mainly because of the shortfalls in accident reporting and recording systems. Construction industry being a hazardous industry, the rate of accidents is higher compared with other industries and apparently a high rate of under-reporting. The purpose of this paper is to investigate the rate of under-reporting, significant reasons for under-reporting and identify the shortcomings in the existing accident reporting system in Sri Lanka in aiming to recommend efficient mechanisms for occupational accident recording and reporting to construction industry. Design/methodology/approach Both secondary and primary data were tapped to gather required data. The secondary data were extracted from the records available in year 2014-2015 at the office of the commissioner for workmen’s compensation and the industrial safety division of the Department of Labor (DoL) to analyze the rate of under-reporting. The primary data were obtained through expert interviews to explore the gaps in reporting system and to identify mechanisms to reduce under-reporting. Findings The findings revealed 80 per cent of construction accidents are under-reported. Eight gaps in the current accident recording and reporting system and key recommendations at organizational and national level for its improvements were identified. Originality/value The findings provide an insight of occupational safety and health (OSH) practices in construction industry and it can be used as an eye opening flash for safety law-makers and practitioners to revisit the existing regulations and practices.
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Krishnapillai, Sooriyakumar, Sumangkalai Perinpanathan, and Sivashankar Sivakumar. "Households' willingness to pay for quality of drinking water in Jaffna area of Sri Lanka." Journal of Water Supply: Research and Technology-Aqua 69, no. 6 (2020): 629–38. http://dx.doi.org/10.2166/aqua.2020.031.
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Abstract Jaffna Peninsula of Sri Lanka depends on groundwater for drinking water. Supply of clean drinking water has become limited due to overuse of agrochemicals, widespread use of pit latrines, and seawater intrusion. The aim of this study is to estimate the willingness to pay for the attributes of water quality and supply. One hundred and twenty households were randomly selected in the study area. A choice modeling approach was employed. The result indicates that, on average, households' willingness to pay for the improvement of water quality is three times higher than their monthly payment. Households are willing to pay more for reduction in calcium than for reduction in nitrate and improvement of other attributes. The education level of households influences willingness to pay for the improvement of water quality more than the income level of households. There is high potential to finance for the improvement of the water quality from the households. Water supply and drainage board can afford to supply the drinking water at the WHO standard and charge price on a volumetric basis. The findings of this study would be useful for policymakers to set the appropriate price and policy to develop a sustainable project.
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Beane, Abi, Ambepitiyawaduge Pubudu De Silva, Priyantha Lakmini Athapattu, et al. "Addressing the information deficit in global health: lessons from a digital acute care platform in Sri Lanka." BMJ Global Health 4, no. 1 (2019): e001134. http://dx.doi.org/10.1136/bmjgh-2018-001134.
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Lack of investment in low-income and middle-income countries (LMICs) in systems capturing continuous information regarding care of the acutely unwell patient is hindering global efforts to address inequalities, both at facility and national level. Furthermore, this of lack of data is disempowering frontline staff and those seeking to support them, from progressing setting-relevant research and quality improvement. In contrast to high-income country (HIC) settings, where electronic surveillance has boosted the capability of governments, clinicians and researchers to engage in service-wide healthcare evaluation, healthcare information in resource-limited settings remains almost exclusively paper based. In this practice paper, we describe the efforts of a collaboration of clinicians, administrators, researchers and healthcare informaticians working in South Asia, in addressing the inequality in access to patient information in acute care. Harnessing a clinician-led collaborative approach to design and evaluation, we have implemented a national acute care information platform in Sri Lanka that is tailored to priorities of frontline staff. Iterative adaptation has ensured the platform has the flexibility to integrate with legacy paper systems, support junior team members in advocating for acutely unwell patients and has made information captured accessible to diverse stakeholders to improve service delivery. The same platform is now empowering clinicians to participate in international research and drive forwards improvements in care. During this journey, we have also gained insights on how to overcome well-described barriers to implementation of digital information tools in LMIC. We anticipate that this north–south collaborative approach to addressing the challenges of health system implementation in acute care may provide learning and inspiration to other partnerships seeking to engage in similar work.
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Wijerathna, YMAM. "Application of Biotechnology in Coconut (Cocos nucifera L.): Sri Lanka." Plant Tissue Culture and Biotechnology 25, no. 1 (2015): 103–16. http://dx.doi.org/10.3329/ptcb.v25i1.24130.
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With the growing of world population and industrialization there is rising demand for coconut?based health and beauty products. The producers might not be able to keep up this demand with the law production of coconut due to the land area under cultivation has declined from around 444,000 hectares to about 394, 840 hectares between 2000 and 2012 and the aging trees in coconut trees. So there is an urgent need for shifting to investigate how the use of recently developed biotechnological techniques can benefit the coconut industry. Here the describes recent utilization of (a) molecular markers, diversity and genetic improvements, (b) molecular detection and diagnosis of diseases; and (c) in vitro propagation in Sri Lanka and the future potential of biotechnology on the coconut industry.Plant Tissue Cult. & Biotech. 25(1): 103-116, 2015 (June)
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Han, Kyung Jung, Roma Subramanian, and Glen T. Cameron. "Listen before you leap: Sri Lankan health professionals’ perspectives on m-health." Health Informatics Journal 25, no. 3 (2017): 858–66. http://dx.doi.org/10.1177/1460458217725903.
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Given the increasingly widespread use of mobile phones in the developing world, the application of this technology for healthcare (also referred to as m-health) has tremendous potential. However, there is a need for more research on factors that influence the sustainable and scalable adoption of m-health in developing countries. To fill this gap, in this study, drawing on the theory of diffusion of innovation, we conducted in-depth interviews with 29 health professionals in Sri Lanka to understand their views on the benefits and barriers to adopting m-health. Participants had mixed views on the adoption of this technology. Reasons for m-health adoption included efficiency and usefulness in emergency situations. Barriers to adoption included risks for miscommunication/misinterpretation and lack of systems/policies for implementing m-health technology. With regard to the innovation-decision process, most participants appear to be in the stages of “persuasion” and “decision”; with regard to degree of innovativeness, interviewees comprise a mix of “early adopters” and “laggards.” Assuming mobile health apps afford improvements in health outcomes for developing countries, contextual factors in each national setting should inform design and implementation of m-health interventions.
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Patabendige, M., S. R. Athulathmudali, and S. K. Chandrasinghe. "Mental Health Problems during Pregnancy and the Postpartum Period: A Multicenter Knowledge Assessment Survey among Healthcare Providers." Journal of Pregnancy 2020 (June 29, 2020): 1–7. http://dx.doi.org/10.1155/2020/4926702.
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Background. Mental illness related to pregnancy can have long-lasting consequences. Healthcare providers are often the most frequent medical contact with the potential for early detection of these. Objectives were to study the awareness regarding mental health problems during pregnancy and the postpartum period among healthcare providers. Methods. A cross-sectional study was carried out with healthcare providers including the nursing staff, midwifery staff, and medical officers working at obstetric wards in three tertiary care hospitals in Sri Lanka. A self-administered questionnaire assessed staff experience with mothers having mental problems, knowledge on mental health problems related to pregnancy, and knowledge about risk factors, common symptoms, and possible consequences on a five-point Likert scale from “Strongly Agree” to “Strongly Disagree.” Results. A total of 300 staff were approached and invited to participate. Only 152 responded to the questionnaire (response rate of 50.1%). Mean (SD) age was 35.8 (9.7) years and mean (SD) years of experience was 10.1 (9.1) years. Age more than 35 years of healthcare providers is associated with statistically significant (p=0.02) average knowledge scores on the consequences of maternal mental health problems. The symptom of “excessively worrying about baby’s health” had the lowest score across all three categories with an average of 34.2%. Only 42.8% have ever heard of EPDS. Overall awareness and knowledge about risk factors, symptoms, and consequences regarding pregnancy-related maternal mental health problems are generally good among the healthcare providers studied. However, some of the few aspects are not satisfactory. Health education of pregnant women, promoting regular in-service training sessions, improvement of infrastructure, and involvement of family members from the antenatal period were discussed by the majority. Conclusion. Despite good overall awareness and knowledge, application into practice with the utilization of validated assessments is poor. This may probably explain why Sri Lanka has a high prevalence of postpartum depression suggesting urgent attention.
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Ryu, Eun-sung. "A Study on the Improvement of Korean Tea Distribution Structure through Sri Lanka Tea Auction System." Association for International Tea Culture 57 (September 30, 2022): 59–82. http://dx.doi.org/10.21483/qwoaud.57..202209.59.
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This study analyzed Korean tea distribution structure and Sri Lankan tea auction system, which is the main sales method, to find a way to build a tea auction center suitable for domestic reality. For the analysis, the literature on the current status and problems of the Korean tea distribution market, the advantages of the Sri Lankan auction system, and the role of the broker as the subject of the auction were reviewed. As a result of the analysis, the distribution structure of Korean tea is an integrated management method that growers manufacture and sell directly, and consumer prices are determined by producers, not market principles. The price of tea formed in this way was generally high compared to the quality, and it caused the consumer's disregard, which became an obstacle to the expansion of tea consumption. In particular, the fact that no standardization of made tea specifications and sensory evaluation made the tea valuation results ambiguous. As a solution to these problems, legislation for the installation of domestic tea auction center, standardization of Korean made tea and sensory evaluation, and a plan for fostering auctioneers who can play the role of auction brokers were presented.
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Ranasinghe, Walithotage Gotabhaya, Abi Beane, Thamal Dasitha Palligoda Vithanage, et al. "Quality evaluation and future priorities for delivering acute myocardial infarction care in Sri Lanka." Heart 106, no. 8 (2019): 603–8. http://dx.doi.org/10.1136/heartjnl-2019-315396.
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AimThis study evaluates the quality of care for patients admitted with acute myocardial infarction (AMI) in a tertiary hospital in Colombo using the European Society of Cardiology Quality of Care Working Group’s guidelines (2017).MethodsA recently implemented electronic AMI registry m-Health tool was used for prospective data collection. Each patient was assessed for eligibility for each of the six domains of quality. Global Registry of Acute Coronary Events Risk Model for predicted probability of mortality, and scores for risk of bleeding complications (CRUSADE) and severity of heart failure (Killip classification) were calculated as per published guidelines. A composite measure of quality was derived from compliance with the six domains. Patients were followed up via telephone at 30 days following discharge to evaluate outcome and satisfaction. Organisational information was assessed by administrative review and interview.ResultsBetween March 2017 and April 2018, 934 patients with AMI presented to the cardiology department. The majority of patients (90.4%) presented with features of ST-elevation myocardial infarction (STEMI). Mean (SD) overall compliance with the composite quality indicator (CQI) was 44% (0.07). Compliance of ≥50% to the CQI was achieved in 9.8% of STEMI patients. The highest compliance was observed for antithrombotics during hospitalisation (79.1%) and continuous measure of patient satisfaction (76.1%). The lowest compliance was for organisational structure and care processes (22.4%).ConclusionThis study reports a registry-based continuous evaluation of the quality of AMI care from a low and middle-income country. Priorities for improvement include improved referral, and networking of primary and secondary health facilities with the percutaneous coronary intervention centre.
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van Melle, David T., Guus H. A. ten Asbroek, Sky Vanderburg, et al. "1637. Antibiotic Use in Lower Respiratory Tract Infections: Insights From Patient Interviews in Sri Lanka." Open Forum Infectious Diseases 6, Supplement_2 (2019): S597. http://dx.doi.org/10.1093/ofid/ofz360.1501.
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Abstract Background Antibiotic resistance is an emerging global public health threat with inappropriate use of antibiotics as one of the major drivers. In Sri Lanka, antibiotic consumption is increasing, while little is known about how patients perceive antibiotics. We conducted a qualitative study to better understand patients’ knowledge, perceptions, and attitudes toward antibiotics. Methods Semi-structured interviews were conducted in the local language (Sinhala) and audio recorded for 18 patients with lower respiratory tract infections (LRTI) admitted to a large, public tertiary care hospital in southern Sri Lanka. Interviews were transcribed and then translated into English. Translated interviews were analyzed for themes regarding care-seeking behavior, patients’ knowledge of disease etiology and treatment of LRTI. Results Almost all patients mentioned multiple care visits and polypharmacy prior to admission. When seeking care, patients mainly focused on finding a quick cure, mostly by visiting several different private physicians. However, self-medication was also common. Patients reused prescriptions for antibiotics, kept antibiotics for later use after prematurely stopping their course of treatment and bought antibiotics over-the-counter. Patients’ knowledge of disease etiology and antibiotics was poor. Most patients described non-microbial causes such as exposure to dust and cold weather for their illness. Only a few patients were aware of antibiotic resistance. Despite the desire to receive more information regarding disease and treatment, transfer of information between patients and physicians was limited and mainly confined to prescription instructions. Conclusion This qualitative study in Sri Lanka suggests inappropriate use of antibiotics is a multifactorial problem. Patients’ poor knowledge of disease and treatment, poor information transfer between physicians and patients, high demand for medicines, overprescribing by physicians, and self-medication were found as possible obstructive factors to improve antibiotic usage. To improve antibiotic use, a multifaceted approach is needed with improvement of awareness by patients, public, and physicians regarding antibiotic use and antibiotic resistance. Disclosures All authors: No reported disclosures.
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Adikari, Pamila, Sunil De Alwis, and Lilani Karunanayake. "Improving Report Generation and Delivery System of Microbiological Investigations at MRI – Sri Lanka with Concern to Turn-Around-Time, An Intervention Study." International Journal of Online and Biomedical Engineering (iJOE) 16, no. 09 (2020): 26. http://dx.doi.org/10.3991/ijoe.v16i09.13799.
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<p>Background: Clinical Bacteriology Laboratory (CBL) of the Medical Research Institute (MRI) is a National Reference Laboratory in Sri Lanka. The service improvement research project aimed at improving the report generation and delivery system. <br />Methods: The mixed-method applied to study the process. Gap identification and designing of the intervention used a qualitative approach. Quantitative methods measured the effectiveness of the improvements. A package of interventions based on total quality management (TQM) principles designed with all stakeholder participation. <br />Results: Delay in sample transport resulted from poor communication, lack of established mechanism and weak coordination between the transport unit and wards. The paper-based report generation process was disorganized, unreliable and error-prone. Additionally, the report delivery to Hospitals revolved on the incoming ambulance or government postal service a tied-up, poorly coordinated system. The interventions promoted coordinated communication. WHONET, a free windows based Laboratory Information System and database software, developed by the World Health Organization for microbiology laboratories installed to generate reliable and accurate automated reports. Reports in PDF format delivered to end-users by secured email. Timeliness, accuracy, quality and uniformity of reports improved. Improvement in post-intervention turn-around-time was statistically significant (p&lt;0.05). <br />Conclusion: The interventions based on TQM principles improved the process of report generation and delivery. Laboratory automation is a feasible and effective solution in the local setting. The end-user satisfaction perceived to be high on the improvements.</p>
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Ralapanawa, Udaya, Kameera Bopeththa, Noorika Wickramasurendra, Sampath Tennakoon, and Tomohiro Katsuya. "Hypertension Knowledge, Attitude, and Practice in Adult Hypertensive Patients at a Tertiary Care Hospital in Sri Lanka." International Journal of Hypertension 2020 (September 28, 2020): 1–6. http://dx.doi.org/10.1155/2020/4642704.
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Objective. Hypertension (HTN) remains a major risk factor for cardiovascular diseases globally. Despite considerable improvement in increasing awareness, treatment, and control of HTN, undiagnosed and uncontrolled HTN remains a major public health challenge. Our focus was on studying the knowledge, attitude, and practice regarding HTN in adult hypertensive patients at a tertiary care hospital in Sri Lanka. Methodology. A descriptive study on knowledge, attitude, and practice of hypertensive patients on antihypertensive medications attending the hypertensive clinic was carried out from January 2016 to June 2016 at THP. Results. The study was on a total of 371 hypertensive patients comprising 253 (68.2%) females and 118 (31.8%) males. Among the total participants, 12 (3.2%), all females, had never been to school. About half of them (47.7%) had not even reached GCE (ordinary level). More than two-thirds (77%) of the study population were aware of the complications of HTN as they were informed by a health care team member. About 74% of them were taking all their prescribed medications. Almost all (95%) patients had checked their blood pressure (BP) during the previous 12 months, and almost the same percentage had visited their doctor for BP checkups every 1–3 months. Conclusion. Our patients were well aware of the importance of regular follow-ups and also knowledgeable about the complications related to HTN. Almost 75% of the patients had optimum drug compliance. It was revealed that forgetfulness was the frequent cause for poor drug compliance.
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Katugampola, Sudharma L., Malcolm A. Fernando, and Somaratne Balasuriya. "Secular changes in growth centiles of children 0–5 years in the Hindagala Community Health Project, 1965–1989, Sri Lanka." Asia Pacific Journal of Public Health 8, no. 1 (1995): 35–41. http://dx.doi.org/10.1177/101053959500800107.
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The weights of 4, 792 infants and preschool children maintained at a family clinic in a rural area, over a period of 25 years from 1965 to 1989, were studied retrospectively. The data were analyzed by five-year birth cohorts. The 97th, 50th and 3rd centile curves were computed for the study sample. They were well below those of the National Center for Health Statistics (NCHS). Males were heavier than females for each centile. The secular variation was examined. It was observed that during the first year of life, the weight gain of the first three cohorts was significantly higher than the last two. From 12 to 48 months there was only a minimal change between cohorts. However, after 48 months, the last two cohorts showed an improvement in weight as compared to the other three. The boys in our study were far below the 50th centile for NCHS, fell to the 3rd centile around 20 months, and gradually declined further. The 97th centile for boys was above the 50th NCHS during the first year of life but fell thereafter until 60 months. The use of local standards at rural clinics is recommended for early detection of those at risk of growth retardation.
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Jayasinghe, Rasika Manori, Indika Priyanthi Thilakumara, Dhanushka Leuke Bandara, et al. "Sri Lankan dental students’ perspective on the effectiveness of e-learning." Asia Pacific Scholar 6, no. 4 (2021): 7–16. http://dx.doi.org/10.29060/taps.2021-6-4/oa2415.
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Introduction: E-learning resulted in a revolution in dental education with continuous educational experiences. General objective of this study was to assess the perspective of undergraduate dental students on effectiveness of e-learning in the Bachelor of Dental Surgery (BDS) programme. Specific objectives were to identify students’ opinion on the factors that promote e-learning, awareness on the effectiveness of using different platforms and social media, barriers imposed and suggestions for the improvement of e-learning in the BDS programme. Methods: This was a cross sectional descriptive study among undergraduate dental students of the Faculty of Dental Sciences, University of Peradeniya, Sri Lanka using a self-administered pre-tested questionnaire administered via a web-based survey form. Frequencies and percentages were obtained for categorical data and Chi-square test was used to determine the association between variables. Results: The majority received the e-learning experience well. Fifty-four percent of the participants felt it was better compared to traditional face-to-face learning and the difference between the semesters (p=0.000) and genders was statistically significant (p=0.000). Difference in overall satisfaction on e-learning material across the different semesters was statistically significant. Students felt that e-learning should be used as a supplementary tool mainly by means of procedural videos during delivery of the skill component. Fifty percent participants felt that conducting assessments online is fair for all the students. Conclusion: A positive learning experience was achieved through the e-learning modalities in comparison to traditional face-to-face learning though in terms of skills training, e-learning modalities should only be considered as a supplementary tool.
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Kapilawanse, Saman, R. P. Bichha, Sudath Samaraweera, et al. "Tuberculosis Among Young People on Rise in Sri-Lanka (An Analysis of Trend and Associated Factors)." SAARC Journal of Tuberculosis, Lung Diseases and HIV/AIDS 14, no. 2 (2018): 18–30. http://dx.doi.org/10.3126/saarctb.v14i2.19334.
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Introduction: A descriptive cross sectional study was carried out in 5 randomly selected districts i.e Gampaha, Kandy, Badulla, Nuwara Eliya and Ratnapura during the period of March to September 2014. The general objective of the study was to describe the trend of TB among young population over past 6 years in Sri Lanka and to determine contributory factors associated with TB among young population.Methodology: The study was carried out in two stages. The first stage was analysis of the trend of TB over the 6 year period of 2008-2014. The analysis of the trend was carried out using the existing secondary data at the Medical Records Division of the National Programme for Tuberculosis Control and Chest Diseases (NPTCCD). Trend was analyzed for new cases of TB patients of 15--34 years of age and separately for 15-24 and 25-34 age groups and for each type of new TB cases. The second stage was a descriptive cross sectional study which was carried out to determine the associated factors. All the patients (new/ retreatment)in age group of 15-34 years and registered at the selected district chest clinics with confi rmed TB were selected as the study subjects. Operational Definitions were used to identify confi rmed TB cases ie, Sputum smear positive TB, smear negative pulmonary TB and Extra pulmonary TB. The data were collected using a pre tested interviewer administered questionnaire by the District Tuberculosis Control Officers attached to the relevant District Chest Clinics.Result: The main findings of the study were, The two peaks of TB incidence were observed in the trend across age groups and first one was in the age group of 25-34 years second peak in the age group of 45-54.Overall trend of TB in the country is more towards the older age groups (over 45 years), but shift to younger age groups were observed in 15 out of 16 districts in the country. A total of 223 patients were included in the descriptive study. The highest proportion (34%) of study population was from the district of Gampaha while least proportion (10%) of it was from Nuwara Eliya. Nearly 53% of the study population was above 25 years of age with the sex ratio of 1:1. A majority (68%) of the study population was Sinhalese while nearly 70% of the study population has passed the O/L, A/L, Diploma or a degree. About one third of the study population was unemployed. Nearly half (50.4%) of the study population was having monthly income of about Rs. 20,000.00 or above. 31% of the study population were current or past alcohol consumers and 29% were smokers and 7% of the study population were current or past cannabis consumers. Majority (77%) of the study population were under-nourished while 14% of them were less than 15 kg/m2. Nearly three fourth (72%) of the study population have been diagnosed by a consultant. Statistically signifi cant associations were found between the age category and more than 3 family members (χ2=5.063, df=1, p<0.017), ethnicity (χ2=4.229, df=1, p<0.04), employment category (χ2=13.859, df=3, p<0.003). Statistically significant associations were not found between the age category and residing district (χ2=5.962, df=4, p<0.202) and type of house (χ2=1.875, df=1, p<0.110),Conclusion: The study recommends more detailed assessment regarding the dietary habits of the patients, Emphasis on community awareness regarding nutritional aspects. Improving the nutritional status among adolescents and young adults. Modification of risky life style factors, Improvement of socio economic status through enhancement of financial stability, minimizing overcrowding and improvement of housing conditions and involving of non NTP health care providers and health professionals for TB diagnosis and management through capacity building and awareness. SAARC Journal of Tuberculosis, Lung Diseases and HIV/AIDS, Vol. 14, No. 2, 2017, Page: 18-30
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Turner, D., S. Navaratnam, R. Surenthirakumaran, et al. "Global Health Strategy for Cancer: Think Globally, Act Locally! Building a Collaborative Partnership Between Manitoba (Canada) and Jaffna (Sri Lanka)." Journal of Global Oncology 4, Supplement 2 (2018): 152s. http://dx.doi.org/10.1200/jgo.18.36500.
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Background and context: The number of people diagnosed with cancer worldwide is estimated to double by 2035. The greatest increase is expected in low- and middle-income countries (LMIC) due to demographic changes, such as ageing and growing populations, and increasing exposure to risk factors. Approximately 8.8 million people die each year of cancer, or one in 6 deaths globally. The Canadian government has recently renewed its commitment as a progressive global citizen with efforts including improvement of global health equity. CancerCare Manitoba is the provincial agency responsible for cancer and blood disorders, including the delivery of a wide range of clinical services from prevention to screening to treatment and supportive services, as well as cancer surveillance, research, and education. CancerCare Manitoba has identified potential partnerships with governments, nongovernmental organizations, academic institutions, and funders to address current and future challenges related to global cancer control. This includes several LMIC partners who have expressed an interest in working with Manitoba on cancer-related issues. In this presentation, we will describe our plans and early experience with a team from the University of Jaffna, the northern region of Sri Lanka. With a focus initially on surveillance and cancer control planning, there is an excellent opportunity for mutual learning and advancement of programs for cancer surveillance and planning. Aim: To establish a local partnership by connecting Manitoba, Canada with an engaged team from the University of Jaffna, Sri Lanka to advance cancer surveillance and planning, and contribute to the “global war on cancer”. Strategy/Tactics: A phased approach is being taken to address locally identified needs for cancer control. CancerCare Manitoba staff will be part of the mentorship team working with local partners in Jaffna to ensure development of local capacity. Specifically, we will: initiate cancer surveillance and establish a cancer registry in Jaffna (building from a cross-sectional study → hospital based registry → regional registry); analyze data and report on patterns; and establish a strategic plan for cancer control. Program/Policy process: Early planning is underway, involving collaborators from Manitoba and Jaffna. A project proposal has been developed to provide scope and acquire seed funding. Outcomes: Success will be determined based on the context of each program, including: establishing a framework for cancer surveillance; satisfaction of local and international partners (e.g., the Global Cancer Surveillance unit at the International Agency for Research in Cancer); and production of reports as a basis for cancer control. What was learned: Early learnings include the importance of local engagement and dedicated mentorship to advance global health equity, manage challenges around (sustained) funding, and establish a foundation of motivated partners.
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Adikari, Pamila Sadeeka, Dileep De Silva, Sunil De Alwis, et al. "Improving recruitment process for nurses, professions supplementary to medicine and paramedical staff." Journal of Health Technology Assessment in Midwifery 3, no. 2 (2020): 94–98. http://dx.doi.org/10.31101/jhtam.1506.
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The recruitment process of nurses, professions supplementary to medicine and paramedical staffs had been a lengthy and labourers work for the Ministry of Health and Indigenous Medical Services (MoHIMS) of Sri Lanka. The process affected the regular recruitment of mentioned staff categories. Flaws in this system contributed negatively to the country's shortage of human resources for health (HRH) as well as efforts to improve the healthcare service delivery. The aim of the study was to identify the gaps in the traditional paper-based recruitment system of the MoHIMS and to design a suitable intervention to improve the process and to assess the improvements brought about by the intervention. A service improvement project with full participation of stakeholders was planned by the Human Resource Coordination Division (HRCoD) of the MoHIMS. Qualitative methods were used to identify the gaps in the existing recruitment system and to gather the ideas for improvement. A computer based online recruitment system was implemented with the collaboration of the Department of Computer Science Engineering, Faculty of Engineering, University of Moratuwa. The perceived satisfaction of the stakeholders was reassessed by qualitative methods. Long lag between advertising and recruitment for training was revealed. Deficiencies such as, lack of transparency, negatively affected routine office processes, inability to validate examination results during application process and frustrated applicants leaving the training programs due to lengthy selection processes were also among the main gaps identified. The implemented online recruitment system was recognised by the stakeholders for its improved timeliness, transparency and minimal interference to the routine office functions. Service improvement projects to be successful, should be implemented with full stakeholder participation. Computer based online recruitment systems can be successfully implemented in public sector recruitments to improve the efficiency and transparency
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Senarathna, Mahesh, Sajith Priyankara, Rohan Jayaratne, Rohan Weerasooriya, Lidia Morawska, and Gayan Bowatte. "Measuring TrafficRelated Air Pollution Using Smart Sensors In Sri Lanka: Before And During A New Traffic Plan." GEOGRAPHY, ENVIRONMENT, SUSTAINABILITY 15, no. 3 (2022): 27–36. http://dx.doi.org/10.24057/2071-9388-2022-011.
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Motor vehicle emissions are the primary air pollution source in cities worldwide. Changes in traffic flow in a city can drastically change overall levels of air pollution. The level of air pollution may vary significantly in some street segments compared to others, and a small number of stationary ambient air pollution monitors may not capture this variation. This study aimed to evaluate air pollution before and during a new traffic plan established in March 2019 in the city of Kandy, Sri Lanka, using smart sensor technology. Street level air pollution data (PM2.5 and NO2 ) was acquired using a mobile air quality sensor unit before and during the implementation of the new traffic plan. The sensor unit was mounted on a police traffic motorcycle that travelled through the city four times per day. Air pollution in selected road segments was compared before and during the new traffic plan, and the trends at different times of the day were compared using data from a stationary smart sensor. Both PM2.5 and NO2 levels were well above the World Health Organization (WHO) 24-hour guidelines during the monitoring period, regardless of the traffic plan period. Most of the road segments had comparatively higher air pollution levels during compared to before the new traffic plan. For any given time (morning, midday, afternoon, evening), day of the week, and period (before or during the new traffic plan), the highest PM2.5 and NO2 concentrations were observed at the road segment from Girls High School to Kandy Railway Station. The mobile air pollution monitoring data provided evidence that the mean concentration of PM2.5 during the new traffic plan (116.7 µg m-3) was significantly higher than before the new traffic plan (92.3 µg m-3) (p < 0.007). Increasing spatial coverage can provide much better information on human exposure to air pollutants, which is essential to control traffic related air pollution. Before implementing a new traffic plan, careful planning and improvement of road network infrastructure could reduce air pollution in urban areas.
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Hewage, Sumudu, and Chrishantha Abeysena. "Housing improvements for health and associated socio-economic outcomes: evidence from a Cochrane Review and its application to Sri Lanka." Journal of the College of Community Physicians of Sri Lanka 23, no. 4 (2018): 127. http://dx.doi.org/10.4038/jccpsl.v23i4.8114.
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Janagan, S., R. M. Wickramarachchi, and M. De Silva. "AB1579-PARE THE EFFECTS OF A HEALTH EDUCATION PROGRAMME ON PATIENTS’ SYMPTOMS AND LIFESTYLE CHANGES IN PATIENTS WITH KNEE OSTEOARTHRITIS ATTENDING A TERTIARY CARE CLINIC IN SRI LANKA." Annals of the Rheumatic Diseases 81, Suppl 1 (2022): 1888.1–1888. http://dx.doi.org/10.1136/annrheumdis-2022-eular.5253.
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BackgroundOsteoarthritis is the major cause of joint pain and disability among middle aged and elderly with no disease specific treatment. Management includes analgesics, lifestyle changes and physical therapy.ObjectivesWe aimed to study the demographics of the patients and knowledge regarding osteoarthritis among those who attended our clinic with mechanical knee pain and the effects of a health education programme.MethodsPatients complaining of mechanical knee pain who were found to have examination findings suggestive of knee joint osteoarthritis were enrolled in this study (N-150). Where available diagnosis was confirmed by radiography. Data was collected when they attended a health education programme which focused on lifestyle changes in osteoarthritis including diet and exercise (n-76). An interviewer administered questionnaire regarding disease, dietary changes for reduction of weight and exercise was used to obtain data before and 3 months after the health education programme. Anthropometric measurements were taken using validated instruments. Data was analyzed using SPSS software.ResultsResponse rate was 50.67 %.The average age of the study population was 54.8 years and constituted of 92.1 % females. About one fifth of them had received only primary school and 50 percent were unemployed. The average BMI was 29.68 (SD-5) and average WOMAC score was 44.1 (SD -19.4).Their knowledge of healthy dietary habits, primarily to lose weight and exercises for knees were assessed before the health education programme and 3 months later.Table 1.Before health education3 months after health educationn7620BMI (average)29.6830.2Not aware of disease90%50%Aware of diet to reduce weight32%65%Aware of exercises5 %35%WOMAC score44.136.7There was no statistically significant correlation between WOMAC score and age, educational level or BMI.Though the knowledge regarding disease and lifestyle measures improved significantly(p< 0.05) following the health education program, there was no significant difference in the WOMAC score.ConclusionHealth education was seen to improve the knowledge regarding disease and lifestyle measures despite no significant improvement in the pain or disability scores.Further studies are needed to see the long term effects of health education.References[1]Jönsson, T., Eek, F., Dell’Isola, A., Dahlberg, L. E., & Ekvall Hansson, E. (2019). The Better Management of Patients with Osteoarthritis Program: Outcomes after evidence-based education and exercise delivered nationwide in Sweden. PloS one, 14(9), e0222657. doi:10.1371/journal.pone.0222657[2]Espanha M, Marconcin P, Campos P, et alPARE0005 Educational program for older adults with knee osteoarthritisAnnals of the Rheumatic Diseases 2017;76:1553.Disclosure of InterestsNone declared
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Liyanagamage, Donisha Shani Niharika Keembiya, Susanthi Jayasinghe, Anoja Priyadarshani Attanayake, and Veranja Karunaratne. "Acute and Subchronic Toxicity Profile of a Polyherbal Drug Used in Sri Lankan Traditional Medicine." Evidence-Based Complementary and Alternative Medicine 2020 (July 13, 2020): 1–12. http://dx.doi.org/10.1155/2020/2189189.
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A polyherbal drug composed of leaves of Murraya koenigii L. Spreng, cloves of Allium sativum L., fruits of Garcinia quaesita Pierre, and seeds of Piper nigrum L. is a popular drug which has been used by indigenous practitioners in Sri Lanka for the treatment of diabetes mellitus and dyslipidemia. The acute toxicity assessment was conducted, following a single oral dose of 0.25–2.0 g/kg in healthy rats, and rats were observed up to 14 days. The hot water extract (1.0 g/kg) and the water : acetone extract (0.5, 1.0, and 1.5 g/kg) were administered to Wistar rats for 28 days in the subchronic study. Hypoglycemic and antihyperglycemic activities (dose response studies) of cold water, hot water, and water : acetone extracts of the polyherbal mixture were evaluated at the doses of 0.5, 1.0, and 1.5 g/kg in healthy and streptozotocin-induced diabetic rats (70 mg/kg, ip), respectively. Acute toxicity study showed that the polyherbal drug did not cause any change in animals throughout the experimental period of 14 days. The administration of the hot water extract and the water : acetone extract of the polyherbal drug for 28 days did not produce changes in the selected biochemical and hematological parameters in Wistar rats (p > 0.05). The histological assessment corroborated the biochemical findings with no significant treatment-related changes in the kidney and liver. The treatment of polyherbal drug significantly lowered the serum glucose concentration compared to the diabetic control rats (p < 0.05) while it did not lead to a severe reduction of glucose concentration in healthy rats. The hot water and water : acetone extracts of the polyherbal drug showed a statistically significant improvement on total area under the glucose tolerance curve in diabetic rats (p < 0.05), reflecting dose-dependent antihyperglycemic effects of the drug. Based on the results, we conclude that the aforementioned antidiabetic polyherbal remedy is free of toxic/adverse effects at the equivalent human therapeutic dose in healthy Wistar rats and would be a safe therapeutic agent for long-term treatments.
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Chamila Kalubowila, Kasunee, D. L. Wanigarathne, P. A. D. D. S. Ponweera, G. K. P. Darshana, and S. S. A. B. M. S. K. Attanayake. "SARS-COV-2 AND TUBERCULOSIS CO-INFECTION: AUDIT ON PATIENT EXPERIENCE ON TREATMENT SERVICES AT THE NATIONAL HOSPITAL FOR RESPIRATORY DISEASES-WELISARA, SRI LANKA." International Journal of Advanced Research 10, no. 03 (2022): 805–11. http://dx.doi.org/10.21474/ijar01/14452.
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Background:Patients who are well informed and motivated are more likely to utilize health services, thus, it improves adherence to medication. Hence, this audit aimed to improve the patient experience on treatment services at the National Hospital for Respiratory Diseases (NHRD), Welisara, Sri Lanka. Methods:Patients admitted from 15th August 2021 to 25th February 2022 to the NHRD and diagnosed with COVID-19 and tuberculosis (TB) co-infection were included. Twnety-two (22) process indicators were used and data were collected using a pretested self-administered questionnaire.Sixty-percent of thepatients had a good experience for each service received was the standard. Data were presented as frequency distributions and mean with their standard deviation (SD). Informed written consent was obtained prior to the data collection. Results: Out of 60 patients who were diagnosed with SARS-CoV-2 and TB co-infection, 59 were responded (response rate was 98.3%). A majority were males (n=47, 79.7%) and belonged to 41 to 60 age category (n=29, 49.2%). Ten indicators did not meet the standard. The highest experience was shown in perceived waiting time (mean 86.8, SD ± 8.8) and the lowest experience was shown in perceived time spent with the health care provider (mean 57.9, SD ± 11.8). More than half (n=31, 52.5%) of the patients reported overall good experiences on treatment services. However, age and gender did not show any significant relationship with the good experience of treatment services received (p>0.05). Conclusion: This audit shows the marginally good experience of treatment services received, but highlight areas such as time to discuss with the doctor, instructions on treatment given by the doctor and information given on available services on continuation of TB treatment are needed much improvement even in the pandemic situation.
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Triyoso, Triyoso, and Devi Ratna Sari. "Pengaruh Terapi Nonfarmakologi Air Minum Beralkali PH 8 Terhadap Penurunan Kadar Glukosa Darah Pada Pasien Diabetes Mellitus Tipe II Di Kelurahan Waykandis Bandar Lampung." JURNAL KREATIVITAS PENGABDIAN KEPADA MASYARAKAT (PKM) 5, no. 7 (2022): 2308–14. http://dx.doi.org/10.33024/jkpm.v5i7.4946.
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ABSTRAK Secara global dan internasional penyakit yang tidak menular merupakan permasalahan yang cukup serius dalam kesehatan masyarakat. Diabetes merupakan suatu ancaman untuk peningkatan kesehatan di Indonesia, karena bisa menyebabkan beberapa komplikasi penyakit yaitu kaki diabetes (gangrene) yang telah diaputasi, gagal jantung, gagal ginjal, gagal jantung, stroke serta dapat menyebabkan kebutaan pada penderita. Di dunia Indonesia menduduki peringkat ketujuh tertinggi bagi prevelensi pasien diabetes mellitus. Negara Indonesia merupakan peringkat kedua setelah Sri Lanka dengan Persentase kematian tertinggi akibat diabetes mellitus. Prevalensi jumlah orang dengan angka kejadian diabetes di negara Indonesia meningkat yaitu pada tahun 2007 berjumlah 4,7% dan pada tahun 2013 menjadi 5,9 %. Tujuan dari penyuluhan ini, peserta diharapkan mampu mengenal dan memahami penyakit Diabetes mellitus tipe II. Serta mampu mengatasi dan mengendalikan permasalah penyakit Diabetes Melitus Tipe 2 dan pencegahannya yaitu dengan mengkonsumsi air alkali ph 8. Sebelum dilakukan kegiatan penyuluhan pengetahuan peserta tentang diabetes mellitus tipe II hanya sekitar 50% kemudian dilakukan penyuluhan singkat menggunakan lembar balik dan leaflet pengetahuan peserta tentang diabetes melitus tipe II meningkat menjadi 75% pada masyarakat kelurahan waykandis Bandar Lampung. Kesimpulan terjadinya peningkatan pengetahuan setelah dilakukan kegiatan penyuluhan. Kata Kunci: Penyuluhan, Diabetes Mellitus Tipe 2, Air Minum Alkali PH 8 ABSTRACT Globally and internationally, non-communicable diseases are a serious problem in public health. Diabetes is a threat to health improvement in Indonesia, because it can cause several complications, namely amputated diabetic foot (gangrene), heart failure, kidney failure, heart failure, stroke and can cause blindness in sufferers. In the world, Indonesia ranks seventh highest for the prevalence of diabetes mellitus patients. Indonesia is ranked second after Sri Lanka with the highest percentage of deaths due to diabetes mellitus. The prevalence of the number of people with diabetes in Indonesia increased, namely in 2007 it was 4.7% and in 2013 it was 5.9%. The purpose of this counseling, participants are expected to be able to recognize and understand type II Diabetes mellitus. As well as being able to overcome and control the problem of Type 2 Diabetes Mellitus and its prevention by consuming alkaline water at pH 8. Prior to the outreach activities, participants’ knowledge about type II diabetes mellitus was only about 50%, then a brief counseling was conducted using flipcharts and leaflets of participants’ knowledge about diabetes mellitus. Type II increased to 75% in the waykandis village community, Bandar Lampung. The conclusion is that there is an increase in knowledge after counseling activities are carried out. Keywords: Counseling, Type 2 Diabetes Mellitus, Alkaline Drinking Water pH 8
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Galappatthy, Priyadarshani, Priyanga Ranasinghe, Chiranthi K. Liyanage, et al. "Core Prescribing Indicators and the Most Commonly Prescribed Medicines in a Tertiary Health Care Setting in a Developing Country." Advances in Pharmacological and Pharmaceutical Sciences 2021 (January 29, 2021): 1–8. http://dx.doi.org/10.1155/2021/6625377.
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Irrational prescribing is common, especially in developing countries. It is important to identify the magnitude of irrational use, to take necessary steps to promote rational prescribing. We identified core prescribing indicators and commonly prescribed medicines at ward settings (IW) and outpatients’ clinics (OPC) in a tertiary care hospital in Sri Lanka. A descriptive cross-sectional study was carried out at IW and OPC settings. Prescriptions were obtained from 5 major specialties (Clinical Medicine (CM), Gynaecology and Obstetrics (GO), Paediatrics, Psychiatry, and Surgery). The WHO core prescribing indicators were used to describe the pattern of prescribing, and the most commonly prescribed medicines were identified. A total of 1,318 prescriptions were analyzed. The five most commonly prescribed medicines were paracetamol (31.0%), omeprazole (20.6%), folic acid (18.3%), atorvastatin (16.2%), and salbutamol (15.3%). The average number of medicines per encounter was 4.8 ± 3.6 (IW: 5.7 ± 4; OPC: 3.8 ± 2.8; p < 0.001 ), with the highest IW (7.8 ± 4.2) and OPC (7.8 ± 2.7) values were from CM, being significantly higher than all other disciplines ( p < 0.05 ). Percentage encounters with an antibiotic or an injection was 26.4% and 30.1%, respectively, with IW being significantly higher than OPC ( p < 0.001 ). Percentage of medicines prescribed by generic name and from the essential medicine list (EML) was 90.1% and 91.1%, respectively, with no significant IW and OPC difference. In conclusion, a high degree of polypharmacy was noted. The use of injectable medicines, prescribing from the EML, and generic name prescribing was satisfactory; however, overall rational prescribing needs further improvement. Further investigation into the degree of rational prescribing associating it with clinical information will be important.
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Sumathipala, A., S. Siribaddana, M. R. N. Abeysingha, et al. "Cognitive-behavioural therapyv.structured care for medically unexplained symptoms: randomised controlled trial." British Journal of Psychiatry 193, no. 1 (2008): 51–59. http://dx.doi.org/10.1192/bjp.bp.107.043190.
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BackgroundA pilot trial in Sri Lanka among patients with medically unexplained symptoms revealed that cognitive-behavioural therapy (CBT) administered by a psychiatrist was efficaciousAimsTo evaluate CBT provided by primary care physicians in a comparison with structured careMethodA randomised control trial (n=75 in each arm) offered six 30 min sessions of structured care or therapy. The outcomes of the two interventions were compared at 3 months, 6 months, 9 months and 12 monthsResultsIn each arm, 64 patients (85%) completed the three mandatory sessions. No difference was observed between groups in mean scores on the General Health Questionnaire or the Bradford Somatic Inventory, or in number of complaints or patient-initiated consultations at 3 months. For both groups, all outcome measures improved at 3 months, and remained constant in the follow-up assessmentsConclusionsCognitive–behavioural therapy given by primary care physicians after a short course of training is no more efficacious than structured care. Natural remission is an unlikely explanation for improvements in people with chronic medically unexplained symptoms, but lack of a ‘treatment as usual’ arm limits further conclusions. Further research on enhanced structured care, medical assessment and structured care incorporating simple elements of CBT principles is worthy of consideration
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Manandhar, Amar B., Durga B. Karanjit, Govinda Tiwari, et al. "Experiences in Improving Efficiency of Energy and Other Resources in Metal Industries in Nepal." Journal of the Institute of Engineering 15, no. 3 (2020): 227–33. http://dx.doi.org/10.3126/jie.v15i3.32186.
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The construction sector uses various metals like steel (for frames, reinforced concrete), iron (wrought iron for beams, trusses, girders), aluminium (ceiling and walls, window frames, HVAC systems etc.) and copper (cladding, electrical wiring, oil & gas lines). Due to increasing pressure on various resources like energy, chemicals and raw materials, economic edge can be sustained only through high resource efficiency. Adopting resource efficient cleaner production (RECP) measures will improve economic and environmental performance, including reducing greenhouse gas emissions; in turn, this will make them less vulnerable to changes in external conditions and more competitive. With co-funding from the EU SWITCH-Asia Programme, the project METABUILD (www.metabuild-southasia.org) aims at implementing sustainable production processes and practices in 400 SMEs across Bangladesh, Nepal and Sri Lanka besides creating a conducive environment for further adoption of sustainable production processes in the metal products supply chain for the building and construction sector. In Nepal, the project has already engaged with 82 metal industries. These cover different sectors such as fabrication, wire drawing, electrical cables, re-rolling, galvanizing/electroplating, casting etc. and are in multiple locations viz. Kathmandu, Lalitpur, Morang, Sunsari, Rupandehi, Bara, Parsa, Kaski districts. RECP measures such as use of daylight, replacement of inefficient lights by LED lights, power factor improvement, furnace modification, waste heat recovery, insulation etc. have been implemented. These have led to savings in energy and raw materials, at the same time reducing generation of wastes from these participating industries and improvement of occupational health and safety (OHS). This paper will explain the mode of engagement with industries, details of the resource efficiency measures implemented and estimated saving.
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G., Kisokanth, Indrakumar J., Prathapan S., Joseph J., and Ilankoon I.M.P.S. "A preliminary study on diabetes self-management education and glycemic control among patients with diabetes mellitus." Journal of Nursing Education and Practice 9, no. 9 (2019): 98. http://dx.doi.org/10.5430/jnep.v9n9p98.
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This study was aimed to assess the effectiveness of diabetes self-management education (DSME) in the improvement of glycemic control among patients with type 2 Diabetes Mellitus (T2DM) in Batticaloa District, Sri Lanka. The study was a prospective interventional study and conducted as a preliminary study at medical clinic, Base hospital, Kaluwanchikudy, Batticaloa. Thirty patients with T2DM were included based on inclusion and exclusion criteria. A structured individual diabetes self-management education for 10 hours (one hour per week) was delivered to diabetic patients by the trained Nurse Health Educator. Glycosylate hemoglobin (HbA1c) was assessed as a main outcome measure and Fasting Blood Sugar (FBS), Body Mass Index (BMI) of each patient were also measured and recorded before and after the intervention. The respondent rate was 96.7% (n = 29). Majority of them were females (n = 25, 86.2%). A Wilcoxon signed rank test showed that DSME had a statistically significant reduction in HbA1c [8.60 (IQR 2.60) vs. 7.40 (IQR 2.10), p = .000] and FBS level [159.00 (IQR 77.50) vs. 134.00 (IQR 40.50), p = .002] at 3 months of intervention. The mean BMI at baseline was higher compared to 3 months of intervention [24.88 (SD ± 3.06) vs. 24.19 (SD ± 2.79)] which was statistically significant (p = .000). Majority of participants (n = 22, 75.9%) had improved their HbA1c level by ≥ 0.5% in 3 months. The diabetes self-management education is an effective measure in improving glycemic control and other clinical parameters among patients with T2DM. Thus, DSME needs to be implemented among clinic patients with T2DM for the better outcome and the preventions of complications.
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Perera, PMS, S. Shahmy, I. Gawarammana, and AH Dawson. "Comparison of two commonly practiced atropinization regimens in acute organophosphorus and carbamate poisoning, doubling doses vs. ad hoc: a prospective observational study." Human & Experimental Toxicology 27, no. 6 (2008): 513–18. http://dx.doi.org/10.1177/0960327108091861.
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There is a wide variation and lack of evidence in current recommendations for atropine dosing schedules leading to subsequent variation in clinical practice. Therefore, we sought to examine the safety and effectiveness of a titrated vs. ad hoc atropine treatment regimen in a cohort of patients with acute cholinesterase inhibitor pesticide poisoning. A prospective cohort study was conducted in three district secondary referral hospitals in Sri Lanka using a structured data collection form that collected details of clinical symptoms and outcomes of cholinesterase inhibitor pesticide poisoning, atropine doses, and signs of atropinization. We compared two hospitals that used a titrated dosing protocol based on a structured monitoring sheet for atropine infusion with another hospital using an ad hoc regime. During the study, 272 symptomatic patients with anticholinesterase poisoning requiring atropine were admitted to the three hospitals. Outcomes of death and ventilation were analyzed for all patients, 226 patients were prospectively assessed for atropine toxicity. At baseline, patients in the titrated dose cohort had clinical signs consistent with greater toxicity. This in part may be due to ingestion of more toxic organophosphates. They received less pralidoxime and atropine, and were less likely to develop features of atropine toxicity, such as delirium (1% vs. 17%), hallucinations (1% vs. 35%), or either (1% vs. 35%) and need for patient restraint (3% vs. 48%) compared with the ad hoc dose regime. After adjusting for the pesticides ingested, there was no difference in mortality and ventilatory rates between protocols. Ad hoc high dose atropine regimens are associated with more frequent atropine toxicity without any obvious improvement in patient outcome compared with doses titrated to clinical effect. Atropine doses should be titrated against response and toxicity. Further education and the use of a structured monitoring sheet may assist in more appropriate atropine use in anticholinesterase pesticide poisoning.
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Balasooriya, BPLR, and KPP Peiris. "Clinical effectiveness of Sphatikadi Prathisarana in the management of Sheetada (Gingivitis)." Journal of Ayurvedic and Herbal Medicine 7, no. 1 (2021): 19–23. http://dx.doi.org/10.31254/jahm.2021.7105.
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Oral diseases continue to be a major health problem in world-wide. In Ayurveda Sheethada, is one of Dantamulagatha (periodontal) disorder under the classification of Mukha roga (Oral diseases) as Susrutha Samhitha. Sheetada occurs due to vitiation of Kapha and Raktha dosa and can be correlated with marginal gingivitis on the basis of similarities of symptoms, involvement of anatomical structure, etiology and prognosis. Prevalence of Sheetada is higher among the elders though begins in early childhood. This study was focused to evaluate the effectiveness of Spatikadi prathisarana (massage or rub on the gums with mechanical pressure exerted in a specific direction with herbal powder) included in the text of Rajaushadasaraya for the management of Sheetada. Thirty patients were selected with individual written consent from the Shalakya OPD, Gampaha Wickramarachchi Ayurveda Teaching Hospital, Sri Lanka by using specific proforma. Two groups were randomly selected with irrespective of their sex, religion, habitat etc. Group A was treated with Spatikadi prathisarana and Group B was treated with Triphala Prathisarana as local application on gums. Rakthasrawa (bleeding gums), Krishnatha (discoloration), Shotha (oedema), Mukha daurgandhya (halitosis), Mrudutha (spongygums), Prakledatha (moistness) were considered as subjective criteria and as objective criteria improvement of Gingival Index (GI-S) and Gingival bleeding index (GBI-S) were studied before and after treatment. Statistically, Rakthasrava, Krishnatha, Shotha, Mukha Daurgandhya, Mrudutha were significantly reduced in group A as compare to Group B. As Objective Parameters Gingival Index (GI-S) and Gingival Bleeding Index (GBI-S) were statistically significant in both groups. Follow up study further confirmed that the recurrence rate in Group A was significantly lower than Group B.
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Fonseka, Sanjeewani, Dilan Dileepa Jayarathne Bandara, Dasun Chathumina Wickramaarachchi, Narankotuwe Gedara Kumudu Hasanka Heshani Narankotuwa, and Pallegoda Vithana Ranjith Kumarasiri. "Treatment of difficult-to-treat-dermatophytosis: results of a randomized, double-blind, placebo-controlled study." Journal of Infection in Developing Countries 15, no. 11 (2021): 1731–37. http://dx.doi.org/10.3855/jidc.14666.
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Introduction: Difficult-to-treat dermatophytosis is an emerging public health problem in Sri Lanka. Safe, effective and affordable treatment is needed to solve this problem. Therefore this study has assessed the effectiveness and safety of modified Whitfield ointment applied twice daily with oral griseofulvin 500 mg daily given over 8 weeks in patients with difficult-to-treat dermatophytosis.
 Methodology: A randomized, double-blind, within-patient-placebo-controlled trial was conducted in patients with clinico- mycologically (history, physical examination, direct light microscopy examination of scales in potassium hydroxide mount) confirmed difficult-to-treat dermatophytosis. Lesions were randomized to receive modified Whitfield ointment (5% benzoic acid and 5% salicylic acid) or emulsifying ointment. All patients were given oral griseofulvin 500mg once daily. The outcome measures were clinical assessment of disease severity, the total surface area of the lesions and the patient’s perception of the disease severity at baseline and every two weeks up to a maximum of 8 weeks.
 Results: Thirty patients completed the study. At two weeks, there was a statistically significant improvement in modified Whitfield ointment arm in the clinical assessment of disease severity and the patients' perception. There was a 7.59% reduction in the surface area of lesions in modified Whitfield ointment arm and a 5.83% increase in the surface area of lesions in the emulsifying ointment arm at two weeks. The difference between the two arms in surface area changes was not statistically significant (p = 0.107, df = 29).
 Conclusions: A combination of modified Whitfield ointment with griseofulvin is significantly effective, safe and affordable option for treating difficult-to-treat dermatophytosis in the tropics.
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Kawshalya, L. W. G., U. G. D. Weerasinghe, and D. P. Chandrasekara. "Evaluating Perceived Safety and Comfort in Urban Civic Spaces." Asian Review of Civil Engineering 11, no. 1 (2022): 1–13. http://dx.doi.org/10.51983/tarce-2022.11.1.3232.
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The urban public spaces play a vital role in the enhancement of quality of life of the urbanites. Recent studies explicitly demonstrate the fact that these limited spaces in the urban context directly impact on the physical, social, and psychological health of its users. But some of these spaces are often underused or neglected as a result of perceived danger and risk implicit by the arrangement of elements. This is common in many designed urban public spaces. This study focuses on three types of urban civic spaces as squares, plazas and forecourts which are vital on sustainable development of urban communities.Accordingly, this research intends to develop a framework to assess perceived safety and comfort in urban civic spaces. The process (literature) identified seven main attributes namely visual qualities, spatial configuration, pleasurability, inclusiveness, convenience, activities, and imageability. The 54 sub-attributes ascertained under the main attributes were scored through observations and direct user ratings. Expert weightages and significance scores obtained through the process finalizes an equation to calculate the final perceived safety and comfort levels of the urban civic spaces. Validation of this framework in the context of Sri Lanka depicted that Arcade Independence Square (Square) is more psychologically safer and comfortable for the users, followed by Echelon square (plaza)and Fort station forecourt (forecourt). The final scores produced by the developed framework reflects the current condition of the civic space elaborating the demands for improvements. The proper use of this framework will result in convivial, safer, comfortable, and user-friendly urban civic spaces.
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Karunathilake, Indika Mahesh. "Health Changes in Sri Lanka." Asia Pacific Journal of Public Health 24, no. 4 (2012): 663–71. http://dx.doi.org/10.1177/1010539512453670.
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Simpson, D. "Sri Lanka: batting for health." Tobacco Control 11, no. 4 (2002): 293—a—293. http://dx.doi.org/10.1136/tc.11.4.293-a.
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de Silva, Varuni, and Raveen Hanwella. "Mental health in Sri Lanka." Lancet 376, no. 9735 (2010): 88–89. http://dx.doi.org/10.1016/s0140-6736(10)61071-9.
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Fernando, Suman, Duncan Pedersen, and Chamindra Weerackody. "Mental health in Sri Lanka." Lancet 376, no. 9735 (2010): 89. http://dx.doi.org/10.1016/s0140-6736(10)61072-0.
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