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Introduction: Many patients are transferred to Teaching hospital, Kandy (THK) from peripheral hospitals for investigation and specialized management. Objectives: To study the pattern of transfers from peripheral hospitals to a paediatric unit in THK and the outcome of management of these transfers. Method: A prospective observational study based on questionnaires was carried out from May to July 2007on children transferred from peripheral hospitals to a paediatric unit in THK. Questionnaires were completed by one of the investigators on admission and on discharge. Results: The study population comprised 146 transferred children, 84% from district and rural hospitals and 16% from base and general hospitals. Forty five percent were admitted outside working hours and 75% were preschoolers. Eighty six percent of transfers were for further management. Fifty nine percent were transferred on the first day of admission. Thirty one percent had respiratory tract infections, 14% febrile convulsions and 10% gastroenteritis. Seventy percent needed basic medical treatment on admission. Only 3% needed intensive care. Fifteen percent had basic investigation results on admission. Sixty five percent were discharged during first two days. Forty eight percent had respiratory tract infections as the final diagnosis. Forty one percent of the transfer forms were well completed with necessary information. In 19% the designation of the transferring officer was not mentioned. Conclusions: Most transfers were from rural and district hospitals and the main reason for transfer was investigation and further management of respiratory tract infection. Transferring officers need to pay more attention to essential information when filling the forms.
RESUMO
Objective To identify the socio-demographic and psychological aspects of thalassaemia Method An observational descriptive study was carried out on 50 thalassaemic children, admitted for monthly blood transfusion to paediatric units of Teaching Hospital Kandy. Information was gathered using questionnaires. Results Eighty four percent of the respondents were mothers. Age groups of children were: 1-4years (14%), 5-9years (34%), 10-14years (36%), and 15-20years (16%). Sixty two percent were girls and 74% from the Central Province. Forty two percent were on subcutaneous desferrioxamine chelation, 8% on oral deferiprone and 50% on combined therapy. Thirty eight percent of children over ten years of age could self administer subcutaneous desferrioxamine. Eighty eight percent of parents had adequate knowledge about thalassaemia. In 88% father was the breadwinner. All said that they could not afford the expenses on travelling and investigations. Seventy five percent had satisfactory relationships with siblings and peers. In 74% teachers were happy about the school performance. Eighty six percent had family support but none had adequate social support. Conclusions Eighty six percent had family support but none had adequate social support. Seventy five percent had satisfactory relationships with siblings and peers.
RESUMO
OBJECTIVE: To test the efficacy of exfoliative cytology in the detection of oral premalignant and malignant lesions. DESIGN: Cytological diagnosis of lesions of the buccal mucosa assessed using histopathological diagnosis of the same lesions as the gold standard. SUBJECTS: Patients with buccal lesions clinically diagnosed as leukoplakia (n = 91) and squamous cell carcinoma (SCC, n = 59), and healthy subjects (n = 40) in whom buccal mucosa appeared clinically normal. SETTING: Oral and Maxillo-facial Unit, General Hospital, Kandy and Department of Pathology, Faculty of Medicine, University of Peradeniya. RESULTS: A sensitivity of 77%, specificity of 100% and accuracy of 92% were obtained for leukoplakia. SCC gave a sensitivity of 94%, specificity of 100% and an accuracy of 95%. CONCLUSIONS: Oral exfoliative cytology is a useful method for detecting oral premalignant and malignant lesions. Anucleated squames in a smear is non-diagnostic.