PURPOSE: This study was conducted in the base hospital of Tangalle, Sri Lanka, in order to improve a new emergency operating system. METHODS: Emergency staff and patients were surveyed based on the five point Likert scale. Doctors and nurses were asked to rate their level of satisfaction regarding their relationship with patients. Patients were asked to rate their level of satisfaction with doctors, facilities, and the environment in the hospital. RESULTS: Doctors were overall satisfied with their job, scoring an average of 3.7. They were displeased with limitation of autonomous decision making on medical treatment, which they gave a score of 2.80. Nurses were generally satisfied with emergency services, with a score of 4.53. Nurses feel discomfort in non-specialized training (3.02). They also sense a lack of opportunities in their hospital (3.12). Patients' findings indicate that most patients were satisfied (4.2) and were displeased with wait time (3.429) and the attention that was given to each patient (3.92). When asked if they would recommend their physician to others and were willing to come back to their physician, outcomes were generally positive, receiving scores of 4.1, respectively. CONCLUSION: Findings showed that in order to create a well-structured system in the emergency centers around the Tangalle area, it is crucial to meet the needs of both patients and the emergency staff. Patients must have a sense of rapid treatment as well as privacy. Training should be provided to the staff so that they are better informed in quality care and up to date on recent studies.
Decision Making ; Emergencies* ; Humans ; Privacy ; Sri Lanka*

PURPOSE: This study was done to explore the experiences of young adult males with below-knee amputation at surgical wards and clinics in Teaching Hospital, Kurunegala, Sri Lanka. DESIGN: The study used the phenomenology design of qualitative research. METHODS: Face-to-face interviews were conducted for data collection using a theme list with a saturation point reached at 16 participants. The duration of an interview was 30-45 minutes and was recorded on audiotape and transcribed later. Phases of familiarization with the data, coding, searching for themes, reviewing themes, defining and naming themes, and writing up were conducted accordingly to thematic analysis. FINDINGS: The young adult male below-knee amputees showed changes in lifestyle with dependence on others, supporting aids, and experiencing discomfort. They showed mental distress with dissatisfaction with life and suffering of life. Additionally, they lacked power with identity changes and encounter economic problems in their lives. CONCLUSIONS AND RECOMMENDATIONS: It is essential to give special education to the staff caring for the below-knee amputees to minimize their unpleasant and challenging experiences. Health staff can motivate family members and friends for individuals' mental adjustment to their new life. Additionally, the social attitude of the community should be changed positively regarding amputated patients.
Male ; Sri Lanka ; Disarticulation ; Musculoskeletal System

PURPOSE: This study was performed to evaluate the status of corneal transplantation in Korea over the last 6 years. METHODS: We evaluated the current status of domestic corneal transplantation using the data obtained from Korean Network for Organ Sharing (KONOS). We evaluated imported corneal transplantation by the number of corneal transplantations, the country of origin of imported cornea, the preserved state of corneas, the time from the death to transplantation and the result of corneal transplantation. The imported corneal transplantation data was obtained from the institution registered in KONOS and the institution recognized by the authers. RESULTS: The number of domestic cornea donations has not increased since 2000, but the number of transplantations using imported corneas has increased year by year. The quality of imported corneas was good. There was no difference in operation results when domestic corneas were used compared to the use of imported corneas from the USA, Australia or Sri Lanka. CONCLUSIONS: The increased use of imported corneas results of a deficiency in the number of domestic cornea donations. Social motivation should be used to increase domestic donations of corneas.
Australia ; Cornea ; Corneal Transplantation ; Keratoplasty, Penetrating* ; Korea ; Motivation ; Sri Lanka

PURPOSE: This study was performed to evaluate the status of corneal transplantation in Korea over the last 6 years. METHODS: We evaluated the current status of domestic corneal transplantation using the data obtained from Korean Network for Organ Sharing (KONOS). We evaluated imported corneal transplantation by the number of corneal transplantations, the country of origin of imported cornea, the preserved state of corneas, the time from the death to transplantation and the result of corneal transplantation. The imported corneal transplantation data was obtained from the institution registered in KONOS and the institution recognized by the authers. RESULTS: The number of domestic cornea donations has not increased since 2000, but the number of transplantations using imported corneas has increased year by year. The quality of imported corneas was good. There was no difference in operation results when domestic corneas were used compared to the use of imported corneas from the USA, Australia or Sri Lanka. CONCLUSIONS: The increased use of imported corneas results of a deficiency in the number of domestic cornea donations. Social motivation should be used to increase domestic donations of corneas.
Australia ; Cornea ; Corneal Transplantation ; Keratoplasty, Penetrating* ; Korea ; Motivation ; Sri Lanka

Emergency Medicine and Disaster Medicine are two specialties which are similar in the multidisciplinary involvement during the acute phase of the disaster. Recently, there was an increase in the number of disasters in the world but not many physicians are familiar with the principles for dealing with such situations, the unique organizational demands, coordination and the urgent need for medical assistance and relief. This case report delineates our experiences at a tsunami disaster area and the approach to setting up a medical relief team in the affected area. A medical reconnaissance team comprising of an emergency doctor from Hospital Universiti Sains Malaysia (H.U.S.M) and two MERCY Malaysia members was assembled. The team flew to Colombo on day 5 after the tsunami with medical supplies and related materials. The mission started from December 31st 2004 until January 8th 2005. Our surveillance area covered the Southern and Eastern Province with a total distance of 1700 km along the coast. The strategies employed during this medical reconnaissance included risk analysis, devising a resources matrix, developing lines of communication and rapport with other relief teams, Sri Lankan government agencies, and local and international non-government organizations. As a result, our team was able to set up a medical relief camp and distribute the relief items to the tsunami victims. In conclusion, the Disaster Emergency Medical Assistant Team (DEMAT) from H.U.S.M and MERCY Malaysia were able to set up and provide medical relief with our limited resources to a large scale disaster situation.
Disasters ; legal surveillance ; Sri Lanka ; Malaysia ; After values

Dengue fever is an acute febrile disease that is caused by a mosquito-borne flavivirus. It has become a major infectious disease threat in tropical and subtropical areas. In Korea, travel-associated dengue fever is increasing. Thirty-five Koreans went to Sri Lanka to do volunteer activities. Eight of the volunteers developed fever, myalgia, and rash; they were diagnosed with dengue fever. Two patients had macular hemorrhages and edema with no ophthalmic symptoms. The maculopathy caused by the dengue fever improved without specific treatment.
Communicable Diseases ; Dengue* ; Edema ; Exanthema ; Eye Manifestations ; Fever ; Flavivirus ; Hemorrhage ; Humans ; Korea ; Myalgia ; Sri Lanka* ; Volunteers*

Between 2008 and 2009, We found 9 new cases and 3 relapse cases, diagnosis by the clinical finding, skin smear, skin biopsy, lepromin test, ELISA for PGL-I antibody, and DNA-PCR. The obtained results were summarized as follows: 1. In 9 new cases, the mean age was 56.2 in 5 Koreans and 28.2 in 4 foreigners(Nepal, Thailand, Sri Lanka, Philippines), the types of Hansen's disease were 5 lepromatous(2 Koreans and 3 foreigners), 1 borderline(1 foreigner) and 2 tuberculoid(2 Koreans), mean BI was 3.4+, mean O.D. of PGL-I antibody was 0.445, numbers of TTC repeat are 16(2 Korean and 2 foreigners), 11(2 Koreans), 12(1 Koreans) and 13(1 Koreans), and of GACATC repeats are 4(4 Koreans) and 3(1 Korean and 4 foreigners). Among 9 new cases, 1 case has the mutation offolP1 gene. 2. All new cases had no mutation of & rpoB gene. 3. In 3 relapse cases, the mean age was 63.7, the types of Hansen's disease were 3 lepromatous(3 Koreans), mean BI was 4.0+,and mean O.D. of PGL-I antibody was 0.846, and numbers of TTC repeat were 12(2 cases), 11(1 case), and of GACATC repeats are 4(all 3 Koreans). Among 3 relapse cases, 1 case has the mutation ofrpoB gene.
Biopsy ; Enzyme-Linked Immunosorbent Assay ; Lepromin ; Leprosy ; Recurrence ; Skin ; Sri Lanka ; Thailand

INTRODUCTIONThe Faculty of Medicine, University of Colombo, Sri Lanka provided voluntary healthcare services during the aftermath of the 2004 tsunami. At that time the faculty recognised the need to prepare the healthcare system for future disasters by enhancing the capability of healthcare workers. The development and implementation of a disaster management course for healthcare workers was identified as a priority.

METHODAn outcome-based approach was used to develop the curriculum. Qualitative and quantitative methods were used to identify the core competencies and outcomes that healthcare workers need to achieve at the end of the course. The content, teaching learning methods and assessments were aligned with the course outcomes. The course consists of 9 core modules and an elective research module. Formative and summative assessment methods were included.

CONCLUSIONTraining is an important component of disaster management. The outcome-based approach provides a useful framework for developing such training programmes and ensures that needs are addressed.

INTRODUCTIONStudents adapt their learning strategies, orientations and conceptions to differences in the learning environment. The new curriculum of the Faculty of Medicine, University of Peradeniya, Sri Lanka, which commenced in 2005, puts greater emphasis on student-centred learning. The aim of this study was to compare the learning strategies, orientations and conceptions measured by means of a validated Sri Lankan version of the Inventory of Learning Styles (ILS) at the end of the first academic year for a traditional curriculum student group and a new curriculum student group.

MATERIALS AND METHODSThe Adyayana Rata Prakasha Malawa (ARPM) 130-item Sinhala version of the ILS was administered to students of the traditional curriculum and the new curriculum at the end of their first academic year respectively. Mean scale scores of the 2 groups were compared using independent sample t-test.

RESULTSStudents of the new curriculum reported the use of critical processing, concrete processing and memorising and rehearsing strategies significantly more than those in the traditional curriculum group. With respect to learning orientations, personal interest scores were significantly higher for the new curriculum students while reporting of ambiguity was significantly lower among them.

CONCLUSIONThe results favour the assumption that changes made to the organisation of subject content and instructional and assessment methods have a positive impact on students' use of learning strategies and motivation.

Midgut malrotation includes a range of developmental abnormalities that occur during fetal intestinal rotation. Manifestations of intestinal malrotation are generally seen in the paediatric population and are uncommon in adults. Symptomatic patients may present with either acute abdominal pain due to midgut volvulus, or chronic abdominal pain due to proximal midgut partial obstruction in the presence of congenital bands. A limited number of paediatric cases of duodenal occlusion due to duodenal malrotation has been previously reported in the medical literature. We herein report the case of a 57-year-old woman who presented with duodenal obstruction due to organoaxial partial rotation of the distal duodenum associated with midgut malrotation. This is probably the first of such a case diagnosed in adulthood reported in the medical literature. Our patient underwent Roux-en-Y duodenojejunostomy and had symptomatic relief following the successful surgery.
Duodenal Obstruction ; congenital ; diagnosis ; surgery ; Duodenostomy ; Duodenum ; abnormalities ; Female ; Humans ; Middle Aged ; Sri Lanka ; Treatment Outcome