The use of computer assisted learning (CAL) has enhanced undergraduate medical education. CAL improves performance at examinations, develops problem solving skills and increases student satisfaction. ...The study evaluates computer literacy among first year medical students in Sri Lanka.
The study was conducted at Faculty of Medicine, University of Colombo, Sri Lanka between August-September 2008. First year medical students (n = 190) were invited for the study. Data on computer literacy and associated factors were collected by an expert-validated pre-tested self-administered questionnaire. Computer literacy was evaluated by testing knowledge on 6 domains; common software packages, operating systems, database management and the usage of internet and E-mail. A linear regression was conducted using total score for computer literacy as the continuous dependant variable and other independent covariates.
Sample size-181 (Response rate-95.3%), 49.7% were Males. Majority of the students (77.3%) owned a computer (Males-74.4%, Females-80.2%). Students have gained their present computer knowledge by; a formal training programme (64.1%), self learning (63.0%) or by peer learning (49.2%). The students used computers for predominately; word processing (95.6%), entertainment (95.0%), web browsing (80.1%) and preparing presentations (76.8%). Majority of the students (75.7%) expressed their willingness for a formal computer training programme at the faculty.Mean score for the computer literacy questionnaire was 48.4 ± 20.3, with no significant gender difference (Males-47.8 ± 21.1, Females-48.9 ± 19.6). There were 47.9% students that had a score less than 50% for the computer literacy questionnaire. Students from Colombo district, Western Province and Student owning a computer had a significantly higher mean score in comparison to other students (p < 0.001). In the linear regression analysis, formal computer training was the strongest predictor of computer literacy (β = 13.034), followed by using internet facility, being from Western province, using computers for Web browsing and computer programming, computer ownership and doing IT (Information Technology) as a subject in GCE (A/L) examination.
Sri Lankan medical undergraduates had a low-intermediate level of computer literacy. There is a need to improve computer literacy, by increasing computer training in schools, or by introducing computer training in the initial stages of the undergraduate programme. These two options require improvement in infrastructure and other resources.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
To study the prevalence and define deferential risk factors for 'Resistant' hypertension (RHT) in a hypertensive population of South Asian origin.
A descriptive cross-sectional study was carried out ...among hypertensive patients attending clinics at the Cardiology Unit, Colombo from July-October 2009. All the patients with hypertension who provided informed written consent were recruited to the study (n = 277). A pre-tested interviewer-administered questionnaire was used for data collection. A binary logistic-regression analysis was performed in all patients with 'presence of RHT' as the dichotomous dependent variable and other independent co-variants.
Mean age was 61 ± 10.3 years and 50.2% were males. The mean of average systolic and diastolic blood pressures (BP) were 133.04 ± 12.91 mmHg and 81.07 ± 6.41 mmHg respectively. Uncontrolled BP was present in 41.1% (n = 114) of patients, of which RHT was present in 19.1% (n = 53). Uncontrolled BP were due to 'therapeutic inertia' in 27.8% of the study population. Those with diabetes mellitus, obesity (BMI > 27.5 kg/m2) and those who were older than 55 years were significantly higher in the RHT group than in the non-RHT group. In the binary logistic regression analysis older age (OR:1.36), longer duration of hypertension (OR:1.76), presence of diabetes mellitus (OR:1.67) and being obese (OR:1.84) were significantly associated with RHT.
A significant proportion of the hypertensive patients were having uncontrolled hypertension. Nearly 1/5th of the population was suffering from RHT, which was significantly associated with the presence of obesity and diabetes mellitus. Therapeutic inertia seems to contribute significantly towards the presence of uncontrolled BP.
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Dengue hemorrhagic fever (DHF) is a major cause of morbidity and mortality in tropical regions. Serum free calcium (Ca2+) is known to be important in cardiac and circulatory function. We evaluated ...association between serum Ca2+ level and severity of dengue.
A cross-sectional study was carried out at a tertiary care private hospital in Sri Lanka. A probable case of dengue was diagnosed and classified according to World Health Organization criteria and confirmed by either IgM antibody, PCR, or NS1 antigen detection. Socio-demographic details were collected using an interviewer-administered questionnaire.
The sample size was 135. The mean age was 26.1 years, and the majority were males (n = 80, 59.3%). DHF was diagnosed in 71 patients (52.6%). Mean serum Ca2+ level of the study population was 1.05 mmol/L (range 0.77-1.24). Mean serum Ca2+ was significantly higher in patients with dengue fever (DF) (1.09 mmol/L) than in those with DHF (1.02 mmol/L) (p < 0.05). A significant difference was observed between mean serum calcium levels of DHF I and DHF II. Prevalence of hypocalcemia in DHF and DF patients was 86.9% (n = 60) and 29.7% (n = 11), respectively (p < 0.05).
Serum Ca2+ levels significantly correlated with dengue severity. Serum Ca2+ levels were significantly lower and hypocalcemia was more prevalent in patients with DHF than in patients with DF. Further studies are required to determine whether hypocalcemia can be utilized as a prognostic indicator and to evaluate effectiveness of calcium therapy in prevention of dengue complications.
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The number of people with diabetes is increasing worldwide, especially in developing South Asian countries. Therefore, preventing diabetes at the early stages has become an important issue. Recent ...clinical trials, systematic reviews, and meta-analysis have shown that zinc has beneficial effects on glycemic and metabolic control in those with diabetes. The present study is designed to evaluate the effects of zinc supplementation on glycemic control and other metabolic parameters in those with pre-diabetes.
The study will be conducted as a randomized, double-blind, placebo-controlled clinical trial for a period of 12 months at the Faculty of Medicine, University of Colombo, Sri Lanka. The study has been approved by the Ethics Review Committee of Faculty of Medicine, University of Colombo (EC/11/189). A total of 200 adults (age 18-60 years) with pre-diabetes will be recruited for the study. They will be stratified according to age, gender, and body mass index and randomly assigned into the test and placebo groups on a 1:1 ratio. The zinc capsules, each weighing 456 mg, will contain the following ingredients:zinc sulfate monohydrate 55.096 mg (elemental zinc 20 mg), lactose monohydrate 399.504 mg, and stearic acid 1.400 mg. The placebo capsule with the same weight will be comprised of lactose monohydrate 454.600 mg and stearic acid 1.400 mg. The subjects will receive either zinc 20 mg capsules or placebo daily for a period of 12 months. The study drugs will be double blinded to both investigators and subjects. The visits and the evaluations will be done as follows: screening (visit 0), 1 month (visit 1), 3 month (visit 2), 6 month (visit 3), and 12 month (visit 4). The following primary outcome measures will be evaluated:fasting plasma glucose (FPG), post oral glucose tolerance test (OGTT), serum insulin, HbA1c, total/low-density lipoprotein (LDL)/high-density lipoprotein (HDL) cholesterol, triglycerides, serum zinc, and appetite using a visual analog scale. Secondary outcome measures include: blood pressure, anthropometry, and dietary assessment using a validated food frequency questionnaire. Data will be analyzed using SPSS v16.
The present protocol will aim to establish the beneficial effects of zinc supplementation on disease progression in those with pre-diabetes and also establish its effectiveness in the prevention of diabetes mellitus.
Sri Lanka Clinical Trial Registry: SLCTR/2012/010.
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Objectives: This study aimed to determine the prevalence and underlying sociodemographic correlates of smoking among Sri Lankans. Methods: A cross-sectional sample (N = 5000, age >18 years) was ...selected using a multistage random cluster sampling. Data were collected using an interviewer-administered questionnaire. Results: Response rate was 91% (n = 4532); males 40%; mean age 46.1 years (±15.1). Overall, urban and rural prevalence of current smoking (smoking) was 18.3%, 17.2%, and 18.5%, respectively (P = nonsignificant, urban vs rural). Smoking was much higher in males than in females (38.0% vs 0.1 %, P < .0001). Ex-smokers comprised 10.0% (males 20.7%, females 0.1%, P < .0001). Among the smokers 87.0% smoked <10 cigarettes per day.The male age groups <20 and 20 to 29 years had the lowest (15.6%) and the highest (44.6%) prevalence of smoking, respectively. In males, smoking was highest in the least educated (odds ratio = 1.96, P = .001). Conclusions: Smoking is common among Sri Lankan males and is associated with lower education, income, and middle age.
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BFBNIB, NMLJ, NUK, OILJ, PNG, SAZU, UKNU, UL, UM, UPUK
16.
Cardiac involvement in dengue infection Shivanthan, Mitrakrishnan C; Navinan, Mitrakrishnan R; Constantine, Godwin Roger ...
Journal of infection in developing countries,
2015-Apr-15, Volume:
9, Issue:
4
Journal Article
Peer reviewed
Open access
Dengue is endemic in the tropics, and complications involving organ systems are seen with varying incidence.
We performed a systematic review. MEDLINE, EMBASE, Scopus SciVerse, Google Scholar, and ...LILACS were searched for papers providing information on cardiac involvement in dengue.
Cardiac involvement is not uncommon in dengue infection and is often transient, but may be associated with significant morbidity and even mortality. Direct viral invasion, immune mechanisms, electrolyte imbalance, derangement of intracellular calcium ion storage, lactic acidosis, and ischemia due to hypotension all play a role in myocardial dysfunction. The manifestations of cardiac involvement include clinical, electrocardiographic, echocardiographic, cardiac enzyme, and histopathologic abnormalities. Echocardiography appears to be a useful tool for detecting myocardial involvement and should be performed in patients with electrocardiographic abnormalities or hemodynamic instability. Treatment is largely supportive, though there are some anecdotal reports of improvements with specific agents.
Knowledge on cardiac manifestations in dengue is limited, and further studies are needed to establish the exact pathophysiology and role of specific agents in the prevention and treatment of cardiac complications in dengue.
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Patterns and correlates of adult height in Sri Lanka Ranasinghe, Priyanga; Jayawardana, M.A. Naveen A.A.D.; Constantine, Godwin R. ...
Economics and human biology,
2011, 2011-Jan, 2011-1-00, 20110101, Volume:
9, Issue:
1
Journal Article
Peer reviewed
▶ The present study examines patterns and socioeconomic and demographic correlates of height among Sri Lankan adults. ▶ Mean height showed a significant negative correlation with age. ▶ A distinct ...secular trend in height was observed and highest mean height in females and males were observed in the youngest age group. ▶ In multivariate analysis, year of birth, level of education and household income were significantly associated with height. ▶ Height demonstrated a significant negative correlation with systolic blood pressure, presence of diabetes, total cholesterol, HDL cholesterol and LDL cholesterol.
The present study examines patterns and socioeconomic and demographic correlates of adult height among Sri Lankan adults. Data were available for height and socio-demographic factors from a nationally representative cross-sectional sample of 4477 subjects above 18 years. Recruitment was between 2005 and 2006. Mean age of all subjects was 46.1
±
15.1 years. Mean height of males and females were 163.6
±
6.9
cm and 151.4
±
6.4
cm respectively. Mean height showed a significant negative correlation with age (
p
<
0.001,
r
=
−0.207). Highest mean height in females 154.0
±
5.9
cm and males 165.6
±
6.9
cm were observed in those born after 1977. Rural females (151.4
±
6.2
cm) were significantly taller than the urban (151.3
±
7.2
cm). However, this was not observed in males. In multivariate analysis, year of birth, level of education and household income were significantly associated with height. Height demonstrated a significant negative correlation with systolic blood pressure (
r
=
−0.032), presence of diabetes (
r
=
−0.069), total cholesterol (
r
=
−0.106), HDL cholesterol (
r
=
−0.142) and LDL cholesterol (
r
=
−0.104). Height was associated with household income and level of education in Sri Lanka and demonstrated a distinct increasing trend over successive generations.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
Diabetes mellitus is becoming a serious public health problem in Sri Lanka and many other developing countries in the region. It is well known that effective management of diabetes reduces the ...incidence and progression of many diabetes related complications, thus it is important that General Practitioners (GPs) have sound knowledge and positive attitudes towards all aspects of its management. This study aims to assess knowledge, awareness and practices relating to management of Diabetes Mellitus among Sri Lankan GPs.
A cross-sectional study was conducted among all 246 GPs registered with the Ceylon College of General Practitioners using a pre-validated self-administered questionnaire.
205 responded to the questionnaire(response rate 83.3%). Their mean duration of practice was 28.7 ± 11.2 years. On average, each GP had 27 ± 25 diabetic-patient consultations per-week. 96% managed diabetic patients and 24% invariably sought specialist opinion. 99.2% used blood glucose to diagnose diabetes but correct diagnostic cut-off values were known by only 48.8%. Appropriate use of HbA1c and urine microalbumin was known by 15.2% and 39.2% respectively. 84% used HbA1c to monitor glyceamic control, while 90.4% relied on fasting blood glucose to monitor glyceamic control. Knowledge on target control levels was poor.Nearly 90% correctly selected the oral hypoglyceamic treatment for obese as well as thin type 2 diabetic patients. Knowledge on the management of diabetes in pregnancy was poor. Only 23.2% knew the correct threshold for starting lipid-lowering therapy. The concept of strict glycaemic control in preference to symptom control was appreciated only by 68%. The skills for comprehensive care in subjects with multiple risk factors were unsatisfactory.
The study was done among experienced members of the only professional college dedicated to the specialty. However, we found that there is room for improvement in their knowledge and practices related to diabetes. We recommend continuing medical education and training programs to update GP's knowledge in order to improve health outcomes in this group of patients.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Abstract
Background
This study evaluated the effects of zinc supplementation on glycemic control, other cardiometabolic and anthropometric parameters, and disease progression in prediabetes.
Methods
...A randomized double‐blind placebo‐controlled Phase 2 clinical trial was conducted over a 12‐month period in 200 subjects (43% male; mean ± SD age 51.8 ± 7.3 years), randomly assigned (1: 1) to the treatment or control group. The treatment group received zinc (20 mg daily). Subjects were evaluated at baseline and at 1, 3, 6, and 12 months. The primary outcome was the change in glycemic control from baseline. Multiple regression analyses were performed, with change in outcome variables after intervention from baseline used as continuous dependent variables.
Results
In both groups, mean serum zinc concentrations prior to the trial were below normal (15.29–21.41 μmol/L). During the 12‐month follow‐up, a significantly higher percentage of participants developed type 2 diabetes in the control compared with zinc‐treated group (25.0% vs 11.0% respectively;
P =
0.016). Fasting plasma glucose (FPG), 2‐h glucose levels in the oral glucose tolerance test (OGTT), homeostasis model assessment of insulin resistance (HOMA‐IR), total cholesterol (TC), and low‐density lipoprotein cholesterol (LDL‐C) were significantly lower in the treated group, with significant improvement in β‐cell function. In all four regression models, the best predictor of the dependent variables (i.e. change in FPG, 2‐h glucose in the OGTT, HOMA‐IR, and homeostatic model assessment of β‐cell function) was zinc treatment.
Conclusions
Zinc supplementation reduced blood glucose and insulin resistance while improving β‐cell function. Furthermore, supplementation reduced disease progression to diabetes and had beneficial effects on TC and LDL‐C.
摘要
背景
这项研究评估了补充锌治疗对糖尿病前期患者的血糖控制、其他心脏代谢与人体测量学指标以及疾病进展的影响。
方法
这是一项为期12个月的随机双盲安慰剂对照的2期临床试验, 纳入了200名受试者(43%为男性;平均± SD年龄为51.8 ± 7.3岁), 将他们随机(按照1:1比例)分配到治疗组或者对照组。治疗组接受补充锌治疗(每日20 mg)。在基线以及第1、3、6、12个月时对受试者进行了评估。主要结果为血糖控制从基线以来的变化情况。进行多元回归分析, 评估干预后从基线以来的结果变量(视为连续性因变量)变化情况。
结果
两组受试者在试验前的平均血清锌浓度都低于正常值(15.29‐21.41 µmol/L)。在为期12个月的随访期间, 对照组与补充锌治疗组相比明显有更高比例的参与者发生了2型糖尿病(分别为25.0%与11.0%;
P
= 0.016)。治疗组中的空腹血糖(FPG)、口服葡萄糖耐量试验(OGTT)的2小时血糖水平、稳态模型评估的胰岛素抵抗(HOMA‐IR)、总胆固醇(TC)以及低密度脂蛋白胆固醇(LDL‐C)都显著更低, 并且β细胞功能也有显著的改善。在所有的4种回归模型中, 因变量(亦即FPG、OGTT的2小时血糖、HOMA‐IR以及稳态模型评估的β细胞功能变化)的最佳预测因子为补充锌治疗。
结论
补充锌治疗可以降低血糖与胰岛素抵抗, 同时改善β细胞的功能。此外, 补充锌治疗还可以延缓患者进展为糖尿病, 并且对TC与LDL‐C也具有有益的影响
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FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, UL, UM, UPUK
Procedures: measuring blood pressure; measuring jugular venous pressure; venepuncture; venous cannulation; central venous catheterization; and arterial punctureInvestigations: echocardiogram and ...electrocardiogramEmergencies: cardiopulmonary resuscitation; hypertensive emergency; acute left ventricular failure; acute myocardial infarction; and cardiac arrhythmiasCardiovascular long cases: hypertension; heart failure; ischaemic heart disease; and infective endocarditisApproaching a cardiovascular short case. ...portfolio-based learning represents a model of educational development and review that is consistent with current adult learning theory. ...development of a portfolio is not without its challenges. Since introduction into medical education in the early 1990s, portfolios have been the subject of educational research.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
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