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http://archive.cmb.ac.lk:8080/xmlui/handle/70130/16
2024-02-24T23:29:38ZPsychological impact on parents of children with congenital adrenal hyperplasia: a study from Sri Lanka
http://archive.cmb.ac.lk:8080/xmlui/handle/70130/7119
Title: Psychological impact on parents of children with congenital adrenal hyperplasia: a study from Sri Lanka
Authors: de Silva, K.S.H.; de Zoysa, Piyanjali; Dilanka, W.M.S.; Dissanayake, B.S.
Abstract: Introduction: Congenital adrenal hyperplasia (CAH) is a group of autosomal recessively inherited disorders with significant morbidity. The long-term implications result in immense psychological stress to the parents. This study assessing the psychological impact on the parents is a first in Sri Lanka and one of the few worldwide.
Objective: Document the presence of depressive symptoms in parents of children with CAH.
Design: Study participants were 37 parents of children diagnosed with CAH who were attending an endocrinology clinic of the largest children’s hospital in Sri Lanka. Centre for Epidemiological Studies-Depression scale (CES-D), a psychometrically sound scale for assessing depressive symptomatology, was used.
Results: The study classified 59% of the parents as being affected, and the psychological impact on them did not reduce with time.
Conclusion: Parents of children with CAH demonstrated symptoms of depression that did not abate with the passage of time.
Keywords: congenital adrenal hyperplasia; depression; parents; Sri Lanka2014-01-01T00:00:00ZEffect of long term inhaled corticosteroid therapy on adrenal suppression, growth and bone health in children with asthma
http://archive.cmb.ac.lk:8080/xmlui/handle/70130/7112
Title: Effect of long term inhaled corticosteroid therapy on adrenal suppression, growth and bone health in children with asthma
Authors: Anuradha, KWDA; Prematilake, GLDC; Batuwita, BAU; Kannangoda, KASR; Hewagamage, US; Wijeratne, S; Lankatilake, Kantha; de Silva, KSH
Abstract: Background: Inhaled corticosteroids (ICS) are the most effective treatment for children with persistent asthma.
However adverse effects of ICS on Hypothalamo Pituitary Adrenal (HPA) axis, growth and bone metabolism are a
concern. Hence the primary objective of this study was to describe the effects of long term inhaled corticosteroid
therapy (ICS) on adrenal function, growth and bone health in children with asthma in comparison to an age and
sex matched group of children with asthma who were not on long term ICS. Describing the association between
the dose of ICS and duration of therapy on the above parameters were secondary objectives.
Method: Seventy children with asthma on ICS and 70 controls were studied. Diagnosis of asthma in selected
patients was reviewed according to the criteria laid down by GINA 2018 guidelines. The estimated adult heights
were interpreted relative to their Mid Parental Height (MPH) range. Serum calcium, alkaline phosphatase and
vitamin D levels were analyzed in both groups and cortisol value at 30 min following a low dose short synacthen
test was obtained from the study group. The average daily dose of ICS (Beclamethasone) was categorized as low,
medium and high (100–200, 200–400, > 400 μg /day) respectively according to published literature.
Results: Heights of all children were within the MPH range. There was no statistically significant difference in the
bone profiles and vitamin D levels between the two groups (Ca: p = 0.554, vitamin D: p = 0.187) but vitamin D levels
were insufficient (< 50 nmol/l) in 34% of cases and 41% of controls. Suppressed cortisol levels were seen in 24%.
Doses of ICS were low, medium and high in 56, 32 and 12% of children respectively. The association between
adrenal suppression with longer duration of therapy (p < 0.01) and with increasing dose of ICS (p < 0.001) were
statistically significant.
Conclusion: ICS had no impact on the growth and bone profiles but its dose and duration were significantly
associated with adrenal suppression.
Keywords: Asthma, Inhaled corticosteroids, Growth, Adrenal suppression, Bone metabolism, Vitamin D2019-01-01T00:00:00ZSeroprevalence of hepatitis A antibodies in relation to social factors — a preliminary study
http://archive.cmb.ac.lk:8080/xmlui/handle/70130/7111
Title: Seroprevalence of hepatitis A antibodies in relation to social factors — a preliminary study
Authors: de Silva, K.S.H.; Weerasuriya, D.C.; Peelawattage, Mallika; Fernando, Sirimali
Abstract: Introduction Hepatitis A is a benign illness in children
with the rare possibility of fatal complications. Although
an endemic disease, very few studies have been done
in children regarding the seroprevalence of hepatitis A
antibodies in Sri Lanka.
Objectives (i) To document the seropositivity for hepatitis
A in a group of children admitted to a paediatric ward.
(ii) To determine the relationship of hepatitis A viral
infection to social factors in these children.
Method A prospective, descriptive, cross-sectional study
was carried out in a ward at the Lady Ridgeway Hospital
for 7 months from September 2001. Children admitted
on predetermined days, needing venepuncture for their
presenting illness, were studied while those who were
seriously ill were excluded. Written consent was obtained
and a questionnaire with details of socio-economic
conditions, personal hygiene practices of the mother,
access to water and sanitation and health related
behaviour was administered. Total antibodies to hepatitis
A were detected by ELISA on a sample of blood taken
from each patient.
Results Two hundred and eighty eight samples of blood
were analysed. None of the children were immunised
against hepatitis A. There were 158 boys (54.9%). Thirty
one (10.8%) of the 288 patients had antibodies against
hepatitis A. The seroprevalence was 11.6% in children
under 10 years of age.
Majority (78%) were from families with a monthly
income of less than Rs 10,000/-. Fifteen (48.4%) of the
31 seropositive children were from families earning less
than Rs 5000/- per month. Belonging to social classes IV
and V and having mothers with only primary education
were factors significantly associated with seropositivity.
No significant difference in the presence of antibodies
was observed regarding the personal hygiene practices
analysed and access to basic amenities.
Health related behaviour practices analysed were
significantly associated with the presence of hepatitis A
antibodies.
Conclusions Seroprevalence of 10.8% was observed in
a selected group of children. Factors such as poor socioeconomic background and having mothers with only
primary education were associated with hepatitis A virus (HAV) antibodies as were certain health related behaviour
practices of children.2014-01-01T00:00:00ZMetabolic consequences of childhood obesity-a preliminary report
http://archive.cmb.ac.lk:8080/xmlui/handle/70130/7109
Title: Metabolic consequences of childhood obesity-a preliminary report
Authors: de Silva, K.S.H.; Wickramasinghe, V.P.; Goonaratne, I.N.A.2006-01-01T00:00:00Z