Oral Presentations

Surgical Site Infections in Adult Patients Undergoing Surgeries in General Surgical Units of Teaching Hospital, Karapitiya

Thu, 05 Dec 2019 00:00:00 GMT

Surgical Site Infections in Adult Patients Undergoing Surgeries in General Surgical Units of Teaching Hospital, Karapitiya Udara, Y.M.S.; Hewawasam, S.P. Background: Surgical Site Infection (SSI) is one of the major complications in patients undergoing surgeries. SSI leads to increased hospital stays, readmissions and additional health care cost. Objectives: To determine the incidence of SSI and associated risk factors in adult patients undergoing surgeries in general surgical units of Teaching Hospital, Karapitiya (THK). Further this study was aimed to study the pattern of development of SSI following surgeries and identify causative pathogens where possible. Methodology: A prospective cohort study was conducted between September to December 2018. A total of 332 enrolled subjects were followed-up for 30 days post-surgery. Chi-square test was used to assess the associations of each variable with SSI and bivariate logistic regression to assess the predictors of developing SSI. Results: Out of the 332 patients, 33 (9.94%) developed SSI. It was found that incidence of SSI was influenced by comorbid conditions such as diabetes mellitus (OR=3.02) and anaemia (OR=3.83). Length of preoperative hospital stay (OR=0.33), transfusion of blood (OR=4.89), use of drain (OR=4.73) and duration of surgery (OR=0.27) were found as the influencing procedure related risk factors. Majority (87.9%) of all SSIs developed within two weeks following the procedure. In 5 cases out of 33, SSI was diagnosed without microbiological evidence. The predominant pathogen responsible for the development of SSI in the study was Coliform spp. (36%). This was followed by Escherichia coli (25%). Conclusions: Both patient-related and procedure-related factors play a role in the development of SSI at general surgical units of THK. In contrast to other studies Coliform spp. was the predominant causative pathogen for the development of SSI in the study.

Short-term effect of Home based Vestibular Rehabilitation to Improve Dizziness Severity and Handicap

Thu, 05 Dec 2019 00:00:00 GMT

Short-term effect of Home based Vestibular Rehabilitation to Improve Dizziness Severity and Handicap Colonne, C.A.U.T.; Jayasuriya, C. Background: Improving the quality of life in patients with vestibular related dizziness is a challenge. However, there are growing evidence to support the use of vestibular rehabilitation (VR) to improve dizziness severity and handicap. Objectives: To evaluate the effectiveness of a home based VR in physical, emotional and functional disability in patients with chronic dizziness. Methodology: A pretest-posttest study was conducted at the ENT unit of the National Hospital of Sri Lanka. Patients (n=22) with chronic vestibular dysfunction were allocated into either a VR group (n=12) or a control group (n=10). Patients in the VR group were treated with a home based VR program with additional telephone support for six weeks, while the patients in the control group received simple eye and head exercises. Dizziness Handicap Inventory-Sinhala (DHI-S) was used to assess the symptom and disability of patients before and after the VR program. The intergroup comparison was done by Wilcoxon signed-rank test and the intragroup comparison by Mann-Whitney U test. The McNemar-Bowker test and the chi-square test were used to assess the intra-group and inter-group pre and post DHI severity respectively. Results: There were no significant differences in demographic or clinical features and any pre test outcome measures between the two groups (p>.05). The VR group presented significant improvements in all sub scales of DHI-S (functional, emotional, physical and total) and DHI severity at the end of the program compared with the control group (p<.05). The control group did not show a significant improvement in any post-test outcome measures (p>.05). Conclusions: This home-based VR program is beneficial in treatment of chronic dizziness due to peripheral vestibular dysfunctions while overcoming the limitations of time, resources and facilities available in the hospitals in Sri Lanka.

Quality of Life of Patients on Hemodialysis

Thu, 05 Dec 2019 00:00:00 GMT

Quality of Life of Patients on Hemodialysis Samarasekera, P.W.G.D.P.; Wimalasooriya, S.B.A.C.; Wijewardhana, R.D.D.; Harshani, R.D.D.; Pushpakumari, R.H.D.P. Background: Quality of life (QoL) is one of the major issues and challenges in health care. Hemodialysis is a life sustaining treatment for patients with end stage renal disease. Hemodialysis can bring about significant impairment in health related QoL and outcomes. Objectives: To examine the physical, psychosocial and cultural factors associated with the QoL of patients on hemodialysis admitted to National Institute of Nephrology, Dialysis and Transplant (NINDT) in Maligawatta. Methodology: Quantitative approach and descriptive design was used. All registered patients (n=233) in NINDT were taken. KDQOL-SF36 questionnaire was used for data collection. SPSS version 23 was used for data analysis. Results: In this study, overall general health was fair in 52.2%. Limited physical functioning was present in 95.7% while role limitations with work were present in 92.7%. Body pain was present in 86.7% of patients while pain interfered with daily activities in 95.7%. Effects of kidney disease affected daily living in 71.3%. Sixty four percent (64.1%) did not have sound sleep while 63.4% had interference with social activities. Emotional wellbeing was affected in 94%. Cognitive functions were affected in 93.7%. Response rate was 18.7% regarding sexual activity. Conclusions: Many aspects of health of the participants‟ lives have been adversely affected by hemodialysis. Patients on hemodialysis experience various problems that may adversely influence their QoL. It is recommended that multidisciplinary intervention that includes medical, dietetic and psychosocial strategies that address factors associated with mental and physical QoL are warranted to reduce further health complications and to improve QoL. Educational interventions should be focused to improve their knowledge aiming to reduce physical health problems, to modify the attitudes and believes aiming to reduce the intensity of psychological and social health problems relating to the condition.

Prevalence of Postpartum Musculoskeletal Morbidity among Women who delivered their Babies in Teaching Hospital Peradeniya

Thu, 05 Dec 2019 00:00:00 GMT

Prevalence of Postpartum Musculoskeletal Morbidity among Women who delivered their Babies in Teaching Hospital Peradeniya Pavitha, V.; Chathura, R. Background: The true burden of maternal morbidity is still not known, because of the difficulty in accurately measuring maternal morbidity in the absence of a generalized definition and a standard identification criterion. Also because of the inaccuracy of vital records due to inadequate health information systems in developing countries. Objectives: This study aimed to find out the prevalence of postpartum musculoskeletal morbidity among women who delivered their babies in Teaching Hospital Peradeniya, to investigate the demographic characteristics association with the musculoskeletal morbidity, to assess the antenatal care visit and supplementation relation to the musculoskeletal morbidity and to find out the association between the postpartum complications and musculoskeletal morbidity. Methodology: In this descriptive cross-sectional study, convenient sampling method was applied to select 230 mothers as study participants. Percentages of different musculoskeletal morbidities were calculated using standardized musculoskeletal questionnaire tool. Body Mass Index (BMI) was calculated using height and the last recorded weight. Results: Most of the mothers (84.0%) were between 25 to 29 years old. More than half of the mothers (62.6%) were having parity of 2 to 4. About 80.4% of mothers had musculoskeletal morbidity. About 79.4% mothers had muscle pain and 70.4% of mothers reported joint pain. Most of the mothers had lower back pain (70.3%). Mothers had difficulties in daily activities (11.7%), trouble in walking (12.2%), difficulty in breast feeding (5.2%) and trouble with sleep due to these musculoskeletal morbidities. There was no statistically significant relationship (p=0.087) between BMI and musculoskeletal morbidity, between demographic characteristics and musculoskeletal morbidity. There was no association between antenatal care visit, supplements and morbidity (p=0.320). There was an association (p=0.021) between postpartum complications and musculoskeletal morbidity. Conclusions: The incidence of postpartum musculoskeletal morbidity was high, with lower back and upper back pain, and joint pain in knee, ankle, hip, wrist, elbow pain, and shoulder. There is no statistical association between demographic variables and morbidity. There is no association between antenatal care visit, supplements and morbidity. There is significant association between complications and morbidity.