Introduction: Blood sampling is a common occurrence in current paediatric practice. Dengue and other febrile illnesses are the main disease entities attributable to admissions. These admissions warrant repeated blood sampling especially with regard to full blood counts. Repeated direct pricking for sampling or having an in-situ cannula for bleeding purposes both have their own disadvantages and undesirable effects.
Objectives: Compare the accuracy of parameters of full blood count of a blood sample taken from a cannula in use against a full blood count from a direct prick.
Method: Nine parameters of the full blood count were compared in 38 paired blood samples from each subject of a cohort of febrile children aged 1-14 years admitted to Professorial Paediatric Unit of Colombo South Teaching Hospital, Kalubowila, Sri Lanka. Samples were taken when medically indicated only.
Results: The mean values of MCV and MCHC from direct venepuncture vs cannula sample were statistically different. Other parameters did not show a statistically significant difference between the samples collected by the two methods.
Conclusion: Blood sampling from a cannula in use for intravenous fluids or medications is favourable for majority of parameters of the full blood count and an advantageous alternative for fresh venepuncture bleeding in febrile children.
{"title":"Assessment of the accuracy of blood drawn from peripheral venous cannula used for infusing intravenous fluids/ drugs versus direct venepuncture to analyse full blood counts in febrile children.","authors":"Ruwanthi Perera, Malithi Guruge, Amila Goonewardena, Piyumaka Peiris","doi":"10.4038/cmj.v66i2.9466","DOIUrl":"https://doi.org/10.4038/cmj.v66i2.9466","url":null,"abstract":"<p><strong>Introduction: </strong>Blood sampling is a common occurrence in current paediatric practice. Dengue and other febrile illnesses are the main disease entities attributable to admissions. These admissions warrant repeated blood sampling especially with regard to full blood counts. Repeated direct pricking for sampling or having an in-situ cannula for bleeding purposes both have their own disadvantages and undesirable effects.</p><p><strong>Objectives: </strong>Compare the accuracy of parameters of full blood count of a blood sample taken from a cannula in use against a full blood count from a direct prick.</p><p><strong>Method: </strong>Nine parameters of the full blood count were compared in 38 paired blood samples from each subject of a cohort of febrile children aged 1-14 years admitted to Professorial Paediatric Unit of Colombo South Teaching Hospital, Kalubowila, Sri Lanka. Samples were taken when medically indicated only.</p><p><strong>Results: </strong>The mean values of MCV and MCHC from direct venepuncture vs cannula sample were statistically different. Other parameters did not show a statistically significant difference between the samples collected by the two methods.</p><p><strong>Conclusion: </strong>Blood sampling from a cannula in use for intravenous fluids or medications is favourable for majority of parameters of the full blood count and an advantageous alternative for fresh venepuncture bleeding in febrile children.</p>","PeriodicalId":9777,"journal":{"name":"Ceylon Medical Journal","volume":"66 2","pages":"73-76"},"PeriodicalIF":0.4,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39789607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction In the medical curriculum, teaching of law is restricted to learning a few elementary aspects of medical jurisprudence which deal with application of scientific and medical knowledge to legal problems such as inquests. In general, medical law deals with medical negligence, consent, pregnancyrelated issues (e.g. abortion), assisted reproduction, organ donation, dying, death etc. This paper will focus on principles of natural justice, which is a key area coming under administrative law, which is distinct from medical law. Administrative law keeps the powers of the government, within their legal bounds [1]. This area of law is vital to medical practitioners in administrative inquiries in different settings. During the course of our professional lives, either as clinicians or as academics, we are called upon to hold administrative positions of varying degrees of responsibility be it as an institution head, department head, ward consultant or postgraduate trainer. These may be in different settings; Hospitals, Department of Health, Universities and the Medical Council. In the course of discharge of these duties, we invariably get involved in the conduct of hearings on disciplinary matters and other purported inappropriate conducts of those serving under our administration. The ‘errant’ medical student, the ‘difficult’ registrar or the ‘troublesome’ junior colleague in the department are experiences many of us have faced. On the other hand, we ourselves may be the subject of an inquiry. Some institutions may have procedures for inquiries laid down whilst some others may not have. Whilst complying with institutional and statutorily defined procedures, the person who holds administrative authority is expected to adhere to principles of natural justice. No institution cannot conduct an inquiry in an ad hoc or an arbitrary fashion without following these basic tenets of administrative law. Even when institutional procedures are clearly laid down, if they are at variance with tenets of administrative law and principles of natural justice, the institutional procedures will not be valid if challenged in a court of law by an aggrieved party. Ceylon Medical Journal 2021; 66: 59-62 Principles of natural justice, their relevance and importance to doctors
{"title":"Principles of natural justice, their relevance and importance to doctors.","authors":"Arosha Dissanayake, Satish Goonesinghe","doi":"10.4038/cmj.v66i2.9464","DOIUrl":"https://doi.org/10.4038/cmj.v66i2.9464","url":null,"abstract":"Introduction In the medical curriculum, teaching of law is restricted to learning a few elementary aspects of medical jurisprudence which deal with application of scientific and medical knowledge to legal problems such as inquests. In general, medical law deals with medical negligence, consent, pregnancyrelated issues (e.g. abortion), assisted reproduction, organ donation, dying, death etc. This paper will focus on principles of natural justice, which is a key area coming under administrative law, which is distinct from medical law. Administrative law keeps the powers of the government, within their legal bounds [1]. This area of law is vital to medical practitioners in administrative inquiries in different settings. During the course of our professional lives, either as clinicians or as academics, we are called upon to hold administrative positions of varying degrees of responsibility be it as an institution head, department head, ward consultant or postgraduate trainer. These may be in different settings; Hospitals, Department of Health, Universities and the Medical Council. In the course of discharge of these duties, we invariably get involved in the conduct of hearings on disciplinary matters and other purported inappropriate conducts of those serving under our administration. The ‘errant’ medical student, the ‘difficult’ registrar or the ‘troublesome’ junior colleague in the department are experiences many of us have faced. On the other hand, we ourselves may be the subject of an inquiry. Some institutions may have procedures for inquiries laid down whilst some others may not have. Whilst complying with institutional and statutorily defined procedures, the person who holds administrative authority is expected to adhere to principles of natural justice. No institution cannot conduct an inquiry in an ad hoc or an arbitrary fashion without following these basic tenets of administrative law. Even when institutional procedures are clearly laid down, if they are at variance with tenets of administrative law and principles of natural justice, the institutional procedures will not be valid if challenged in a court of law by an aggrieved party. Ceylon Medical Journal 2021; 66: 59-62 Principles of natural justice, their relevance and importance to doctors","PeriodicalId":9777,"journal":{"name":"Ceylon Medical Journal","volume":"66 2","pages":"59-62"},"PeriodicalIF":0.4,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39666322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: The lack of rapid and sensitive test remains a key issue in diagnosing meningitis and affordability impedes using the molecular techniques. However, conventional PCR is currently becoming more affordable.
Objectives: Optimize and establish a multiplex PCR and to compare the above PCR to Cerebrospinal fluid (CSF) culture and antigen detection in sensitivity and specificity for the detection of bacterial meningitis.
Methods: CSF specimens were collected from patients with suspected acute meningitis admitted to Teaching Hospital, Peradeniya from December 2016 to March 2017. A multiplex PCR was used to detect Neisseria meningitides, Streptococcus pneumonia and Haemophilus influenzae.
Results: Eighty specimens of CSF were collected during the study period. The mean duration to sample collection was 4.78(SD 2.6) from the onset of symptoms. None of the samples given positive CSF culture. CSF antigen detection was performed on 50 specimens and all were negative. Of the total samples, eight yielded positive PCR results. In two of the positives, the full report was normal, one was suggestive of viral aetiology and five were suggestive of bacterial aetiology. Three were positive for S.pneumoniae and five for H.influenzae. positive PCR results were associated with a shorter time gap between hospitalization and sample collection and a larger CSF volume.
Conclusion: Findings of the study highlight the usefulness and recommendation of multiplex PCR in the diagnosis of pathogens causing acute bacterial meningitis. Collection of an adequate volume of CSF early in the illness, without delay may improve the diagnosis.
{"title":"Identification of bacterial aetiology in acute meningitis.","authors":"Balachandran Devakanthan, Veranja Liyanapathirana, Nilanthi Dissanayake, Palitha Harasgama, Jeewaka Punchihewa","doi":"10.4038/cmj.v66i2.9465","DOIUrl":"https://doi.org/10.4038/cmj.v66i2.9465","url":null,"abstract":"<p><strong>Background: </strong>The lack of rapid and sensitive test remains a key issue in diagnosing meningitis and affordability impedes using the molecular techniques. However, conventional PCR is currently becoming more affordable.</p><p><strong>Objectives: </strong>Optimize and establish a multiplex PCR and to compare the above PCR to Cerebrospinal fluid (CSF) culture and antigen detection in sensitivity and specificity for the detection of bacterial meningitis.</p><p><strong>Methods: </strong>CSF specimens were collected from patients with suspected acute meningitis admitted to Teaching Hospital, Peradeniya from December 2016 to March 2017. A multiplex PCR was used to detect Neisseria meningitides, Streptococcus pneumonia and Haemophilus influenzae.</p><p><strong>Results: </strong>Eighty specimens of CSF were collected during the study period. The mean duration to sample collection was 4.78(SD 2.6) from the onset of symptoms. None of the samples given positive CSF culture. CSF antigen detection was performed on 50 specimens and all were negative. Of the total samples, eight yielded positive PCR results. In two of the positives, the full report was normal, one was suggestive of viral aetiology and five were suggestive of bacterial aetiology. Three were positive for S.pneumoniae and five for H.influenzae. positive PCR results were associated with a shorter time gap between hospitalization and sample collection and a larger CSF volume.</p><p><strong>Conclusion: </strong>Findings of the study highlight the usefulness and recommendation of multiplex PCR in the diagnosis of pathogens causing acute bacterial meningitis. Collection of an adequate volume of CSF early in the illness, without delay may improve the diagnosis.</p>","PeriodicalId":9777,"journal":{"name":"Ceylon Medical Journal","volume":"66 2","pages":"65-72"},"PeriodicalIF":0.4,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39901942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
What gives an action its moral worth? Kant says what makes an action morally worth is not the consequence or the results that flow from that action. It has to do with the motive of the action. The motive confers the moral worth on the action. According to Kant, the only kind of motive that can confers moral worth on an action is the motive of duty and not the inclinations, one's preferences, likes, desires or impulses.
{"title":"Evidence based medicine : ideology, hegemony, statistical gaze and beyond part two.","authors":"Harindra Karunatilake","doi":"10.4038/cmj.v66i2.9476","DOIUrl":"https://doi.org/10.4038/cmj.v66i2.9476","url":null,"abstract":"What gives an action its moral worth? Kant says what makes an action morally worth is not the consequence or the results that flow from that action. It has to do with the motive of the action. The motive confers the moral worth on the action. According to Kant, the only kind of motive that can confers moral worth on an action is the motive of duty and not the inclinations, one's preferences, likes, desires or impulses.","PeriodicalId":9777,"journal":{"name":"Ceylon Medical Journal","volume":"66 2","pages":"63-64"},"PeriodicalIF":0.4,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39901950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Главные героини германского героического эпоса «Песнь о нибелунгах» — это бургундская принцесса Кримгильда, ставшая женой главного героя Зигфрида, и исландская дева-богатырша Брунгильда, чью руку Зигфрид добывает в жестоком бою, чтобы отдать ее бургундскому королю Гунтеру в обмен на руку Кримгильды. Ревность, спор о социальном статусе, личная неприязнь между обеими героинями выливаются в жестокую ссору у ворот Вормского собора. В этой ключевой сцене одна героиня обвиняет другую в якобы имевшей место добрачной потере девственности и предъявляет сопернице пояс в качестве доказательства. Острый, напряженный конфликт характеров и воль, обрисованный в этой сцене, с давних пор интересовал деятелей искусства. Сцена «ссора королев» послужила сюжетом многочисленных художественных произведений. В настоящей статье рассматриваются особенности визуализации героинь, их тел, одежды, внешнего облика в произведениях литературы, изящного искусства и кинематографа. Статья насыщена иллюстрациями и образными примерами.
{"title":"Ссора королев. Изображения Кримгильды и Брунгильды в искусстве и литературе","authors":"Gunter E. Grimm","doi":"10.46539/CMJ.V2I1.37","DOIUrl":"https://doi.org/10.46539/CMJ.V2I1.37","url":null,"abstract":"Главные героини германского героического эпоса «Песнь о нибелунгах» — это бургундская принцесса Кримгильда, ставшая женой главного героя Зигфрида, и исландская дева-богатырша Брунгильда, чью руку Зигфрид добывает в жестоком бою, чтобы отдать ее бургундскому королю Гунтеру в обмен на руку Кримгильды. Ревность, спор о социальном статусе, личная неприязнь между обеими героинями выливаются в жестокую ссору у ворот Вормского собора. В этой ключевой сцене одна героиня обвиняет другую в якобы имевшей место добрачной потере девственности и предъявляет сопернице пояс в качестве доказательства. Острый, напряженный конфликт характеров и воль, обрисованный в этой сцене, с давних пор интересовал деятелей искусства. Сцена «ссора королев» послужила сюжетом многочисленных художественных произведений. В настоящей статье рассматриваются особенности визуализации героинь, их тел, одежды, внешнего облика в произведениях литературы, изящного искусства и кинематографа. Статья насыщена иллюстрациями и образными примерами.","PeriodicalId":9777,"journal":{"name":"Ceylon Medical Journal","volume":"2 1","pages":"68-122"},"PeriodicalIF":0.4,"publicationDate":"2021-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47290770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Журнал Playboy с самого момента его основания явился одним из ярчайших примеров культурных изменений, происходивших в США во второй половине ХХ в.. Анализируя важность журнала, автор показывает, как, казалось бы, банальная идея журнала с фотографиями обнаженных красавиц превратилась в весьма успешный коммерческий и культурный проект, оказавший огромное влияние на американское общество, да и на многие страны мира. По сути, Playboy превратился в «мягкую силу» способную генерировать новые ценности и транслировать их не только в американское общество, но и в культурный ландшафт других стран. В качестве иллюстрации этого влияния были взяты международные франшизы журнала Playboy, выходящие в других странах. Для наглядности были выбраны две версии журнала: в Бразилии и на Филиппинах. Анализ контента этих франшизных версий показывает, что в них удивительным образом сочетались традиции, заложенные основателем «Плейбоя» Хью Хефнером, и национальные стереотипы. Вместе с тем, в этом симбиозе во многом превалировали именно американские паттерны. Особенно заметно это отразилось на выборе расового типа моделей, их цвета кожи и т.д.. Кроме этого, журнал привносил в эти страны и новые системы гендерных отношений. Все это стало возможным благодаря тому, что редакция журнала создала уникальный продукт, ставший одним из неотъемлемых символов ХХ в.
{"title":"“Playboy” как мягкая сила: влияние контента журнала на вестернизацию культуры развивающихся стран","authors":"Serguey N. Yakushenkov","doi":"10.46539/CMJ.V2I1.39","DOIUrl":"https://doi.org/10.46539/CMJ.V2I1.39","url":null,"abstract":"Журнал Playboy с самого момента его основания явился одним из ярчайших примеров культурных изменений, происходивших в США во второй половине ХХ в.. Анализируя важность журнала, автор показывает, как, казалось бы, банальная идея журнала с фотографиями обнаженных красавиц превратилась в весьма успешный коммерческий и культурный проект, оказавший огромное влияние на американское общество, да и на многие страны мира. По сути, Playboy превратился в «мягкую силу» способную генерировать новые ценности и транслировать их не только в американское общество, но и в культурный ландшафт других стран. В качестве иллюстрации этого влияния были взяты международные франшизы журнала Playboy, выходящие в других странах. Для наглядности были выбраны две версии журнала: в Бразилии и на Филиппинах. Анализ контента этих франшизных версий показывает, что в них удивительным образом сочетались традиции, заложенные основателем «Плейбоя» Хью Хефнером, и национальные стереотипы. Вместе с тем, в этом симбиозе во многом превалировали именно американские паттерны. Особенно заметно это отразилось на выборе расового типа моделей, их цвета кожи и т.д.. Кроме этого, журнал привносил в эти страны и новые системы гендерных отношений. Все это стало возможным благодаря тому, что редакция журнала создала уникальный продукт, ставший одним из неотъемлемых символов ХХ в.","PeriodicalId":9777,"journal":{"name":"Ceylon Medical Journal","volume":"2 1","pages":"139-176"},"PeriodicalIF":0.4,"publicationDate":"2021-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41648283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Автор анализирует проблемы изменений представленности тела и метаморфозы телесности в грузинской идентичности. Грузинская идентичность определяется как культурный и интеллектуальный конструкт, вдохновленный и воображенный грузинскими интеллектуалами как часть процессов социальной и политической модернизации. Анализ социальных мутаций и культурных трансформаций визуализации и актуализации грузинского национального / этнического тела и телесности в дискурсе национализма является основой целью статьи. Методологически автор использует положения и идеи, предложенные в междисциплинарных исследованиях национализма. Национальное тело определяется и анализируется как одна из изобретенных традиций грузинского национализма в контекстах модернизации и трансформации интеллектуального дискурса от модерной культуры к массовой культуре общества потребления. Предполагается, что интеллектуалы использовали телесность для актуализации этнической и культурной грузинской идентичности, подчеркивая уникальность грузинской идентичности. Анализируются проблемы сочетания и сосуществования гражданского и этнического национализма в визуализации телесности. Автор изучает, как грузинское «тело» стало политическим фактором, формой визуализации этничности и принципов политического национализма, включая концепты гражданства и лояльности, а также нации как воображаемого политического сообщества граждан с устойчивыми этническими основаниями.
{"title":"Телесность в стране Руставели: злоключения и путешествия грузинского тела между романтическим картвельским национализмом и потреблением массовой культуры","authors":"Maksym W. Kyrchanoff","doi":"10.46539/CMJ.V2I1.36","DOIUrl":"https://doi.org/10.46539/CMJ.V2I1.36","url":null,"abstract":"Автор анализирует проблемы изменений представленности тела и метаморфозы телесности в грузинской идентичности. Грузинская идентичность определяется как культурный и интеллектуальный конструкт, вдохновленный и воображенный грузинскими интеллектуалами как часть процессов социальной и политической модернизации. Анализ социальных мутаций и культурных трансформаций визуализации и актуализации грузинского национального / этнического тела и телесности в дискурсе национализма является основой целью статьи. Методологически автор использует положения и идеи, предложенные в междисциплинарных исследованиях национализма. Национальное тело определяется и анализируется как одна из изобретенных традиций грузинского национализма в контекстах модернизации и трансформации интеллектуального дискурса от модерной культуры к массовой культуре общества потребления. Предполагается, что интеллектуалы использовали телесность для актуализации этнической и культурной грузинской идентичности, подчеркивая уникальность грузинской идентичности. Анализируются проблемы сочетания и сосуществования гражданского и этнического национализма в визуализации телесности. Автор изучает, как грузинское «тело» стало политическим фактором, формой визуализации этничности и принципов политического национализма, включая концепты гражданства и лояльности, а также нации как воображаемого политического сообщества граждан с устойчивыми этническими основаниями.","PeriodicalId":9777,"journal":{"name":"Ceylon Medical Journal","volume":"2 1","pages":"14-67"},"PeriodicalIF":0.4,"publicationDate":"2021-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45838167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Автор анализирует визуализацию героев немецкого героического эпоса «Песнь о нибелунгах». То, как иллюстраторы изображают тела персонажей, какие позы им придаются, на фоне какого ландшафта происходит действие, сколько действующих лиц на картине и что именно они делают – все это может стать активным семантическим фактором. Намеренное вторжение в сюжет некоторыми художниками не только создает новый контекст для восприятия, но и придает тексту иное или дополнительное значение. Иногда семантика иллюстраций находится в явном противоречии с событиями сюжета – автор показывает, как и почему это происходит, какие смыслы зашифрованы в иллюстрациях к поэме, как изображения влияют на восприятие текста реципиентами.
{"title":"Визуальная конструкция смыслов – новые правила игры в погибель. Об иллюстрациях к «Песни о нибелунгах»","authors":"Sebastian Karnatz","doi":"10.46539/CMJ.V2I1.38","DOIUrl":"https://doi.org/10.46539/CMJ.V2I1.38","url":null,"abstract":"Автор анализирует визуализацию героев немецкого героического эпоса «Песнь о нибелунгах». То, как иллюстраторы изображают тела персонажей, какие позы им придаются, на фоне какого ландшафта происходит действие, сколько действующих лиц на картине и что именно они делают – все это может стать активным семантическим фактором. Намеренное вторжение в сюжет некоторыми художниками не только создает новый контекст для восприятия, но и придает тексту иное или дополнительное значение. Иногда семантика иллюстраций находится в явном противоречии с событиями сюжета – автор показывает, как и почему это происходит, какие смыслы зашифрованы в иллюстрациях к поэме, как изображения влияют на восприятие текста реципиентами.","PeriodicalId":9777,"journal":{"name":"Ceylon Medical Journal","volume":"2 1","pages":"123-138"},"PeriodicalIF":0.4,"publicationDate":"2021-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42012476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anuradha Baminiwatta, Shamila De Silva, Aruni Hapangama, Kumarini Basnayake, Charani Abayaweera, Dinithi Kulasinghe, Dewmi Kaushalya, Shehan Williams
Introduction Healthcare workers (HCWs) are at risk of mental health problems during a pandemic. Being stationed at the frontline or not may have implications on their mental health. Objectives The aims of this study were to assess depression, anxiety and stress among HCWs, to explore differences between frontline and non-frontline workers, and to investigate associated factors. Methods In this cross-sectional study, frontline and non-frontline HCWs were recruited from a COVID-19 screening hospital in Sri Lanka. Mental health impact was assessed using Depression, Anxiety and Stress Scale (DASS-21). Sociodemographic data and perceptions of social and occupational circumstances were gathered. Categorical variables were analyzed using Chi square and logistic regression. Odds ratios were calculated for the effect of different perceptions on psychological morbidity. Results A total of 467 HCWs participated, comprising 244 (52.2%) frontline and 223 (47.8%) non-frontline workers, with female preponderance (n=341, 77%). Prevalence of depression, anxiety and stress among HCWs were 19.5%, 20.6%, 11.8%, respectively. Non-frontline group showed a higher prevalence of depression (27% vs. 11%, p<0.001), anxiety (27% vs. 14%, p=0.001) and stress (15% vs. 8%, p=0.026). Being married, having children, living with family and higher income were associated with better psychological outcomes. Perceived lack of personal protective equipment, inadequate support from hospital authorities, greater discrimination, and lack of training to cope with the situation predicted poor mental health outcomes, and non-frontline HCWs were more likely to hold such perceptions. Conclusion Addressing factors leading to negative psychological outcomes in HCWs should be a key concern during this pandemic.
{"title":"Impact of COVID-19 on the mental health of frontline and non-frontline healthcare workers in Sri Lanka.","authors":"Anuradha Baminiwatta, Shamila De Silva, Aruni Hapangama, Kumarini Basnayake, Charani Abayaweera, Dinithi Kulasinghe, Dewmi Kaushalya, Shehan Williams","doi":"10.4038/cmj.v66i1.9351","DOIUrl":"https://doi.org/10.4038/cmj.v66i1.9351","url":null,"abstract":"Introduction\u0000Healthcare workers (HCWs) are at risk of mental health problems during a pandemic. Being stationed at the frontline or not may have implications on their mental health.\u0000\u0000\u0000Objectives\u0000The aims of this study were to assess depression, anxiety and stress among HCWs, to explore differences between frontline and non-frontline workers, and to investigate associated factors.\u0000\u0000\u0000Methods\u0000In this cross-sectional study, frontline and non-frontline HCWs were recruited from a COVID-19 screening hospital in Sri Lanka. Mental health impact was assessed using Depression, Anxiety and Stress Scale (DASS-21). Sociodemographic data and perceptions of social and occupational circumstances were gathered. Categorical variables were analyzed using Chi square and logistic regression. Odds ratios were calculated for the effect of different perceptions on psychological morbidity.\u0000\u0000\u0000Results\u0000A total of 467 HCWs participated, comprising 244 (52.2%) frontline and 223 (47.8%) non-frontline workers, with female preponderance (n=341, 77%). Prevalence of depression, anxiety and stress among HCWs were 19.5%, 20.6%, 11.8%, respectively. Non-frontline group showed a higher prevalence of depression (27% vs. 11%, p<0.001), anxiety (27% vs. 14%, p=0.001) and stress (15% vs. 8%, p=0.026). Being married, having children, living with family and higher income were associated with better psychological outcomes. Perceived lack of personal protective equipment, inadequate support from hospital authorities, greater discrimination, and lack of training to cope with the situation predicted poor mental health outcomes, and non-frontline HCWs were more likely to hold such perceptions.\u0000\u0000\u0000Conclusion\u0000Addressing factors leading to negative psychological outcomes in HCWs should be a key concern during this pandemic.","PeriodicalId":9777,"journal":{"name":"Ceylon Medical Journal","volume":"66 1","pages":"16-31"},"PeriodicalIF":0.4,"publicationDate":"2021-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39784644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Retroperitoneal fibrosis (RPF) is a disease that develops following inflammation and fibrosis of the retroperitoneum and other abdominal organs, which manifests with various local and systemic symptoms. It has several entities, namely the idiopathic RPF (IRPF), secondary RPF and Immunoglobulin G4-related disease (IgG4-RD). The role of a gynaecologist in the management of retroperitoneal fibrosis is highlighted in this case of a parametrial tumour causing retroperitoneal fibrosis and hence leading to hydronephrosis and hydroureter as a consequence. A 49-year-old woman presenting with a symptom cluster suggestive of acute pyelonephritis was found to have reduced eGFR. Elevated levels of inflammatory markers indicated an inflammatory nature of the disease, in addition to a normochromic anaemia that could be due to chronic inflammation itself. CECT Neck, Chest, Abdomen and Pelvis revealed mild hydronephrosis with a distal narrowing and a retroperitoneal confluent mass. Investigations led to suspect an invasive left ovarian malignancy or an endometriotic nodule with ureteric compression, which was later thought to be unlikely with a normal CA-125 level. To obtain a better understanding, a cysto-ureteroscopy was performed where she was found to have an obstruction. Although stent placement is a reasonable temporary mode of symptom relief, this was proven unsuccessful. Surgical management was opted for considering the severity of her symptoms and the course of time it would take for medical management to take effect. In addition, laparoscopy would aid in the exclusion of other pelvic pathologies under direct vision and treat any if found concurrently. Consequently, a laparoscopic hysterectomy, bilateral salpingo-oophorectomy, left sided ureterolysis with careful resection of the densely adhered tumour surrounding the left cysto-ureteric junction was performed, followed by retrograde ureteric stenting. Histology revealed retro-peritoneal fibrosis, and further immunohistochemistry pointed towards a diagnosis of IgG4 related sclerosing disease. This was also supported by elevated levels of IgG, especially the IgG4 component. Disseminated RPF was subsequently excluded by CECT. Following surgery, she was started on high dose corticosteroids and the stent was left in place for six weeks. She is being kept on a maintenance dose of low dose corticosteroids without disease relapse. Regular follow-up with inflammatory markers, serum IgG4 levels and imaging demonstrate adequate response to corticosteroid therapy.
{"title":"Parametrial tumour causing hydronephrosis and hydroureter due to IgG4 mediated retroperitoneal fibrosis; A laparoscopic resection.","authors":"Dhammike Silva, Prabath Randombage, Wedisha Gankanda, Rukshani Edirisinghe, Janani Mathanamohan, Chandu De Silva","doi":"10.4038/cmj.v66i1.9360","DOIUrl":"https://doi.org/10.4038/cmj.v66i1.9360","url":null,"abstract":"Retroperitoneal fibrosis (RPF) is a disease that develops following inflammation and fibrosis of the retroperitoneum and other abdominal organs, which manifests with various local and systemic symptoms. It has several entities, namely the idiopathic RPF (IRPF), secondary RPF and Immunoglobulin G4-related disease (IgG4-RD). The role of a gynaecologist in the management of retroperitoneal fibrosis is highlighted in this case of a parametrial tumour causing retroperitoneal fibrosis and hence leading to hydronephrosis and hydroureter as a consequence. A 49-year-old woman presenting with a symptom cluster suggestive of acute pyelonephritis was found to have reduced eGFR. Elevated levels of inflammatory markers indicated an inflammatory nature of the disease, in addition to a normochromic anaemia that could be due to chronic inflammation itself. CECT Neck, Chest, Abdomen and Pelvis revealed mild hydronephrosis with a distal narrowing and a retroperitoneal confluent mass. Investigations led to suspect an invasive left ovarian malignancy or an endometriotic nodule with ureteric compression, which was later thought to be unlikely with a normal CA-125 level. To obtain a better understanding, a cysto-ureteroscopy was performed where she was found to have an obstruction. Although stent placement is a reasonable temporary mode of symptom relief, this was proven unsuccessful. Surgical management was opted for considering the severity of her symptoms and the course of time it would take for medical management to take effect. In addition, laparoscopy would aid in the exclusion of other pelvic pathologies under direct vision and treat any if found concurrently. Consequently, a laparoscopic hysterectomy, bilateral salpingo-oophorectomy, left sided ureterolysis with careful resection of the densely adhered tumour surrounding the left cysto-ureteric junction was performed, followed by retrograde ureteric stenting. Histology revealed retro-peritoneal fibrosis, and further immunohistochemistry pointed towards a diagnosis of IgG4 related sclerosing disease. This was also supported by elevated levels of IgG, especially the IgG4 component. Disseminated RPF was subsequently excluded by CECT. Following surgery, she was started on high dose corticosteroids and the stent was left in place for six weeks. She is being kept on a maintenance dose of low dose corticosteroids without disease relapse. Regular follow-up with inflammatory markers, serum IgG4 levels and imaging demonstrate adequate response to corticosteroid therapy.","PeriodicalId":9777,"journal":{"name":"Ceylon Medical Journal","volume":"66 1","pages":"55-58"},"PeriodicalIF":0.4,"publicationDate":"2021-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39786217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号