Department of Nursing

The impact of a culturally adapted lifestyle intervention on the glycaemic profile of mothers with GDM one year after delivery – a community-based, cluster randomized trial in Sri Lanka.

2024-07-08T00:00:00Z

The impact of a culturally adapted lifestyle intervention on the glycaemic profile of mothers with GDM one year after delivery – a community-based, cluster randomized trial in Sri Lanka. Sundarapperuma, Thamudi Darshi; Katulanda, Prasad; Wijesinghe, Champa J.; Hettiarachchi, Priyadarshika; Wasalathanthri, Sudharshani Abstract Background A woman with a history of GDM has a high risk of developing type two diabetes (T2DM) in her future life. Lifestyle modifications are known to attenuate the progression of GDM to T2DM. Therefore, the aim of this study was to assess the impact of a simple, cost effective, culturally acceptable lifestyle intervention programme on the trajectory towards T2DM in women with a history of GDM. Methods This cluster randomized trial was conducted in 100 postpartum women in three selected districts of Sri Lanka. The subjects were divided into intervention (n=50) and control groups (n=50) by cluster randomization method. A culturally adapted protocol (comprised of dietary and physical activity modifications) was administered to the intervention group. The glycemic profile was assessed using fasting and 2-hour post-OGTT plasma glucose and HbA1c, and insulin resistance by HOMA-IR at baseline and after one year of intervention. Results The mean age (SD) of the subjects in the intervention and control groups were 33.0 (5.1) and 34.3 (6.5) years respectively. All glycemic and insulin resistance parameters (i.e. Fasting plasma glucose- FPG, 2-hour postOGTT plasma glucose, HbA1c and HOMA-ir) were comparable (p>0.05) between the two groups at baseline. FPG, 2 h post OGTT, HbA1c and HOMA-ir values between intervention vs. control (p) at 12 months were 87.3 vs. 123.2 (<0.01); 106.5 vs. 156.1 (0.01); 5.3 vs. 6.8 (<0.01) and 0.9 vs. 2.3 (<0.01) respectively. All glycemic parameters showed a significant reduction in the intervention group at 12 months compared to baseline. In contrast, the control group showed a significant increase in FPG, 2-hour post-OGTT plasma glucose and HbA1c at 12 months compared to baseline. In multiple linear regression model adjusted for age, parity and family history, the control group showed an approximately 33 times risk of developing insulin resistance compared to the intervention group

Psychological disturbances encountered by the healthcare professionals, military professionals and general public in Sri Lanka during COVID-19 pandemic: a cross-sectional study

2023-05-31T00:00:00Z

Psychological disturbances encountered by the healthcare professionals, military professionals and general public in Sri Lanka during COVID-19 pandemic: a cross-sectional study Sundarapperuma,Thamudi Darshi; Gamage, Madushika Wishvanie Kodagoda; Rathnayake, Nirmala; Weeratunga, Eranthi Bimalee; Jagodage, Hemamali Madhushanthi Hirimbura Background The COVID-19 pandemic is a serious global health concern, posing a greater risk of psychological vulnerabilities for frontline healthcare workers (HCWs), military professionals and the general public around the globe. These psychological issues appear to be long lasting and heighten the risk of mental health disorders. Therefore, this study aimed to identify psychological problems encountered by HCWs, military professionals, and the general public in Sri Lanka during the COVID-19 pandemic.

Establishment of health information management system at Base Hospital Udugama

2022-12-01T00:00:00Z

Establishment of health information management system at Base Hospital Udugama Fernando, H.S.; Tharanga, K.J.M.D. Introduction Digitalization of health system offers more convenient, efficient, safe and quality patient care services with the advances in Science and technology. At present, many aspects of healthcare have incorporated with Information Technology applications such as for admissions, diagnostics, treatment, imaging, planning, monitoring, inventory management, and maintaining statistics. As a developing country, Sri Lanka is not much integrated with this technology and still manages healthcare services with paper-based system and retrieving patient records are difficult with this. As a secondary care Hospital, Base Hospital Udugama (BHU) planned to initiate Health Information Management System (HIMS) to improve efficiency, safety and quality of service. Objective Aimed to establish a HIMS at Out Patient Department of the BHU. Methods After several stakeholder meetings, planning unit of the hospital developed technical and structural plan to establish HIMS at BHU. The plan included establishment of internal network system, purchasing of hardware, preparation of registration room, recruitment and training of staff with the guidance of responsible authority. Results and Discussion With successful planning, good inter-sectoral coordination and effective communication with the ministry of health and provincial ministry officials the HIMS was established at Base Hospital Udugama in 2021. Once a patient is registered to the system, at the Out-Patient Department (OPD), an identity card would be issued with a barcode number that could be used in subsequent hospital visits. Through this networked system, the patient Registration room, Doctors’ consultation rooms, Laboratory, Outdoor dispensary, vaccination & dressing room, director’s office and health information unit were linked to each other. Producing this one-time registration card, patients will be able to continue treatment in subsequent visits and clinicians will be able to review past records by just scanning the barcode without re-registration. Conclusion With the implementation of HIMS, OPD at BHU converted to paperless OPD. Through HIMS system, waiting time, and drug issuing errors have been significantly reduced, and patient satisfaction, safety of the service and stock maintenance have been improved.

Enhancing Health System Resilience: Practical and Cost-effective Approaches to Face the COVID-19 Pandemic by Base Hospital UdugamaSri Lanka

2021-01-31T00:00:00Z

Enhancing Health System Resilience: Practical and Cost-effective Approaches to Face the COVID-19 Pandemic by Base Hospital UdugamaSri Lanka Tharanga, K.J.M.D.; Fernando, G.H.S. COVID-19 is a pandemic from pneumonia of unknown origin, first reported in Wuhan city China as information extracted from the World Health Organization. It was first reported in Sri Lanka on 27 January 2020 by a Chinese tourist. Handing the COVID-19 situation with scarce recourses within a limited time was challenging for the government hospitals. This paper aims to describe the practical and cost-effective actions implemented at the Base Hospital Udugama to enhance the health system resilience to prepare, respond to, and recover from the COVID 19 pandemic. We did a retrospective evaluation of the COVID-19 control project at the Base Hospital Udugama. The daily interventions carried out at the Base Hospital Udugama to prepare, respond and recover from the COVID-19 pandemic were documented in a journal. Also, we preserved evidence through photographs while collecting data from the routine hospital records. The temporally established COVID-19 coordinating committee managed all the activities. The committee increased awareness among staff and the public, maintained stock of Personal Protective Equipment, established preventive measures, established an isolation unit, arranged community sample collection, continued essential routine healthcare services and distribution of the clinic drugs to the doorsteps of the patients while protecting the Hospital staff against COVID-19. Even though the management of the COVID 19 pandemic was a challenge to the Base Hospital Udugama, with strong leadership and effective coordination with different units and departments within and beyond the hospital, it was possible to manage the response efficiently and effectively. We recommend enhancing the health system's resilience through timely investments in peripheral hospitals coupled with capacity building targeting multiple hazards, including pandemics.