Prediction of spirometry parameters using chest circumference in Sri Lankan boys aged 8-16 years

Introduction: Most normative standards for spirometry are established based on height, weight and body mass index. We have investigated chest circumference as an alternative to height for interpretation when accurate height measurements cannot be obtained. Methods: This is a cross-sectional study conducted in Sri Lankan boys aged 8-16. Spirometry measurements were taken adhering to American Thoracic Society/European Respiratory Society 2005 recommendations. Data analysis was performed with SPSS Version 18 for Windows. Correlations (Pearson correlation coefficient) between lung volumes and chest circumference were evaluated. Subsequently, multiple regression analysis was performed between lung volumes and the predictor variables. Results: Six hundred and eighty-two (n = 682) boys with acceptable spirograms were included in the final analysis. Chest circumference was significantly correlated to height as well as spirometry parameters. Therefore, reference equations were established based on chest circumference and age. Discussion and Conclusions: Chest circumference could be considered as competent as height in predicting lung flows and volumes in Sri Lankan males aged 8 to 16, and it could be used as an alternative parameter in situations where height cannot be measured precisely

Mental health literacy in adolescents: ability to recognise problems, helpful interventions and outcomes

Abstract Background Although mental health literacy has been widely studied in adults, there are still relatively few studies on adolescent populations. In Sri Lanka, adolescents account for about one fifth of the population. Current evidence shows that most mental health problems diagnosed in adulthood begin in adolescence. There is also growing evidence that the trajectories of these disorders can be altered through early recognition and intervention. Although, help-seeking for mental health problems is known to be poor in adolescents, mental health literacy improves help-seeking. It is also known that adolescents may act as agents of change regarding mental health in their wider communities. Thus, mental health literacy in adolescents is an important aspect of community mental health initiatives. The objective of this study was to describe aspects of mental health literacy in terms of ability to recognise problems, helpful interventions, helpful referral options and outcomes in a target adolescent population in Sri Lanka. The association between socio economic variables and recognition of mental health problems was also examined. Methods This descriptive cross sectional study used a pretested questionnaire on 1002 adolescents aged between 13 and 16, where mental health literacy was assessed using 4 case vignettes. The vignettes represented depression with suicidal ideation, social phobia, psychosis and diabetes, where the last was for comparison. Results The response rates for recognition as a mental health problem was 82.2% (n = 824) for the vignette depicting depression, 68.7% (n = 689) for the psychosis vignette and 62.3% (n = 623) for the social phobia vignette. “Talking to the person”, was responded to as helpful by 49.9% (n = 500), for the depression vignette followed by 49.8% (n = 499) for social phobia, 39.5% (n = 396) for psychosis and 19.5% (n = 195) for the diabetes vignette. The response rate for exercise being a helpful intervention was 25% (n = 251) for the diabetes vignette, followed by 21% (n = 210) for social phobia, 18.7% (n = 187) for psychosis vignette and 18.4% (n = 184) for the depression vignette. While 70.2% (n = 704) responded that there would be benefit in seeing a doctor for the diabetes vignette, the response rates for psychosis was 48.5% (n = 486), and for both depression and social phobia it was 48.2% (n = 483). The responses for the persons in the vignettes becoming better with treatment was 81.4% (n = 816) for the diabetes, 79.5% (n = 797) for depression, 75.6% (n = 758) for psychosis and 63.4% (n = 636) for the social phobia vignette. A statistically significant association was found between the income level of the family and appropriate recognition as mental health problems, for all the 3 mental health related vignettes. Conclusions The ability to recognise mental health problems, helpful interventions and outcomes in this population was comparable to those of adolescent populations in other countries, with some exceptions. The main differences were in relation to the identification and interventions in response to the psychosis and social phobia vignettes

Predictive value of persistent NS1 antigen positivity beyond 3rd day for dengue haemorrhagic fever in Sri Lankan children

Abstract Objective Dengue haemorrhagic fever (DHF) is a major public health concern responsible for significant morbidity in both adult and paediatric populations in Sri Lanka. This study examined if persistent non structural protein 1 (NS1) antigen positivity beyond day 3 was predictive of the occurrence of dengue haemorrhagic fever. The patients were followed up during their in-hospital stay and the severity of the illness was classified according to the WHO classification. The NS1 antigen test was repeated after day 3 of the onset of illness, at least 2 days after the initial test. Results One hundred and fifty-seven patients were enrolled. Persistent NS1 antigen test positivity after day 3 of the illness was not predictive of subsequent development of DHF. Out of multiple other demographic and illness related factors assessed, only having a secondary dengue infection was associated with a high risk of DHF (relative risk = 3.077, 95% CI 1.361, 6.954). Persistent NS1 positivity on day 3 may not be indicative of disease severity. However results need to be confirmed by a larger study with quantitative NS1 testing

Bacterial profile and antibiotic susceptibility pattern of adult lower respiratory tract infections in Colombo, Sri Lanka

Introduction: Lower respiratory tract infections (LRTIs) remain the deadliest communicable disease around the world. This study was conducted to identify the bacterial etiology of LRTIs among patients who attended the Central Chest Clinic in city of Colombo, Sri Lanka and their antibiotic susceptibility profile to enable clinicians to take decisions on effective empirical antibiotics. Methods: Sputum samples were collected from 1,372 patients over the age of 18 years with suspected LRTIs during the year 2015. The samples were collected and processed according to standard laboratory procedures at the microbiology laboratory of the Medical Research Institute of Sri Lanka. Results: Most of reports (58%) were from patients diagnosed with infective exacerbations of chronic lung diseases. Out of all sputum cultures processed, 404 (29.4%) resulted positive for pathogenic bacterial organisms. Coliforms (n = 176, 43.6%), and Pseudomonas aeruginosa (n = 117, 29%) were the most common isolated bacteria, followed by Moraxella (n = 47, 11.6%), Haemophilus influenzae (n = 23, 5.7%), and Streptococcus pneumoniae (n = 18, 4.4%). The two most common bacteria isolated showed a high sensitivity for co-amoxyclav, quinolones, 3rd generation cephalosporins, carbapenems and aminoglycosides, while coliforms were highly resistant (98%) to ampicillin. S. pneumoniae showed a high resistance for penicillin (67%) and erythromycin (61%), while Haemophilus showed a good sensitivity to co-amoxyclav (96%). There was no significant correlation between rainfall and proportions of coliforms (r = - 0.152, P = 0.638) and Pseudomonas (r = 0.271, P = 0.395) during the year. Discussion and Conclusion: In our study, the most predominant pathogens recovered from LRTIs were P. aeruginosa and coliforms (Klebsiella spp.) as Gram negative, and S. pneumoniae as Gram positive bacteria. Co-amoxyclav, 3rd generation cephalosporins, quinolones and all second line antibiotics tested were the most efficient antibiotics in treatment of LRTIs, differently from ampicillin, erythromycin and penicillin that were not efficient antibiotics in treating this disease in our locality

Primary school teachers' readiness in identifying children with dyslexia : a national survey in Sri Lanka

Primary school teachers should be able to identify struggling learners who may have dyslexia type learning difficulties, in order to facilitate early intervention. Considering this importance, a nationwide survey was conducted in Sri Lanka with 705 primary school teachers among randomly selected schools in order to investigate teacher readiness to identify learners with dyslexia. Teacher readiness was measured based on three variables (a) teachers' self-reported basic knowledge of dyslexia, (b) their self-reported awareness of local tools and processes used to identify dyslexia and (c) their self-reported attitudes towards engaging in identifying dyslexia. Data were gathered through a structured questionnaire. Logistic regression analyses revealed that the participants had minimal readiness to engage in identifying learners with dyslexia. However, most of them showed positive attitudes towards actively engaging in identifying dyslexia