Medical students' knowledge and perceptions of e-health: results of a study in Sri Lanka.

The present study investigates the knowledge, perceptions and attitudes of medical students in Sri Lanka in regard to e-health. We also examined the barriers which impede them to develop knowledge and skills in e-health within their medical curriculum. A questionnaire focusing on the knowledge, attitudes and expectations of medical students towards e-health was distributed to all final year students (n=136) at the Faculty of Medical Sciences, Sri Jayewardenepura University, Sri Lanka. Response rate was 74%. 43% of respondents stated that they were familiar with the term e-health. 51% rated their knowledge of e-health applications as minimal. 88% admitted that they had no e-health education or training of any kind. Over 80% of all respondents thought that e-health had an important role to play in the current and future health sector, particularly in developing countries. Our survey revealed that respondents had very poor access to computers and Internet use was rare. 77% of respondents admitted that they were not provided with systematic knowledge and skills in e-health through their medical curriculum and identified the absence of formal education in e-health as a serious shortcoming.

Seroprevalence of varicella zoster virus infections in Colombo district, Sri Lanka.

BACKGROUND: Although Varicella Zoster virus (VZV) infections occur worldwide, the epidemiology is remarkably different in tropical and temperate climates. VZV infections result in significant morbidity and mortality among adults in Sri Lanka. AIMS: For future VZV vaccination strategies, we set to determine the age-specific seroprevalence rate of VZV infections in Colombo, Sri Lanka. MATERIALS AND METHODS: The study was carried out from 1999 to 2000. Multi-stage cluster sampling technique was used to collect 913 blood samples, which were tested for the presence of VZV-specific IgG antibodies. RESULTS: VZV seroprevalence rates were markedly lower in all age groups when compared to temperate climates. The seroprevalence rates increased with age in both the rural and urban populations. Of those aged 60 years, only 50% in the rural population and 78.9% in the urban population were immune to VZV. Seroprevalence rates of VZV infections were significantly different between the urban and rural populations (P< 0.001), with VZV-specific IgG antibodies detected in 47.5% in the urban population and 27.9% in the rural population. It was found that 56.2% (131) of females of childbearing age were nonimmune to VZV. CONCLUSIONS: These findings highlight the need for a VZV vaccination program, which is likely to have a huge impact on the incidence of chickenpox and its associated morbidity and mortality.

Using the DREEM questionnaire to gather baseline information on an evolving medical school in Sri Lanka.

The recent introduction of the Dundee Ready Education Environment Measure (DREEM) has fulfilled a long-felt need for a test instrument specifically meant to evaluate health professions education institutions. It was intended in this study to ascertain the overall DREEM score for the newly established Faculty of Medical Sciences of University of Sri Jayewardenepura (FMS/USJ), Sri Lanka and to compare the DREEM score of the students in the pre-, para- and clinical phases of the traditional curriculum practiced in this school. A total of 339 students belonging to the pre- (n = 147), para- (n = 116) and clinical (n = 76) phases of the medical course participated in this study. The DREEM questionnaire was administered face-to-face after one of their routine lectures to each group of students. The age of the students ranged from 20 to 28 years and the gender distribution was almost equal. The overall DREEM score was 108 (54%) for the pooled data for all three phases. There was no significant difference on the overall DREEM score obtained by each phase of students. The overall DREEM scores of pooled data and also for each domain indicated that the position of the FMS/USJ qualifies to be placed just on the third grade (one below the best) within the overall DREEM scale. However, on analysis of the responses for each domain, Students' Perception of Teachers (SPT), Students' Academic Self-Perceptions (SAP) and Students' Social Self-Perceptions (SSP) showed significant difference between the pre-, para- and clinical phases. Similarly, 22 out of the 50 items showed significant differences between the pre- and clinical phases. Overall, the DREEM demonstrated compatibility of its scores along with the gradual development that took place at this medical school over the last 10 years. Thus, the DREEM could be utilized in a variety of situations.

Multiprofessional and continuing education of health professionals.

The provision of appropriate education and training for health care workers is essential to ensure effective and efficient utilization of their services. Organising multiprofessional learning, providing opportunities for continuing education and utilising of new trends in medical education facilitates achievement of the desired outcome in health care. The delivery of health care is a team effort. Thus, it is beneficial that the members of the health care team are trained together. Such training would provide opportunity to recognise the capabilities and job functions of the fellow health care professionals by the trainees. Similarly, by organising continuing education programmes for health care workers already in service it would strengthen their confidence and also improve the quality of their services. For these purposes, new trends in medical education could be utilised.

Glycaemic indices of different varieties of rice grown in Sri Lanka.

OBJECTIVE: Varieties of red raw rice are widely believed to have a better nutritional quality. The physiological effects of consuming different varieties of rice may not be so. The glycaemic index has been developed as an indicator of the physiological effect of foods. It is the glycaemic response of a 50 g carbohydrate portion of food expressed as a percentage of that of a standard. The objective of this study was to determine the glycaemic indices of different varieties of rice grown in Sri Lanka. DESIGN: Digestible carbohydrate content of 11 varieties of rice flour and bread were determined. Fasting blood samples followed by half-hourly samples for two hours were drawn after giving portions of either cooked rice or bread containing 50 g carbohydrate each. SETTING: Fibre mill in Gampaha district. SUBJECTS: Twenty-two fibre mill workers aged between 25 and 50 years. MEASUREMENTS: The area under the blood glucose curve (AUC) for varieties of rice for a subject was calculated. Average AUC of 3 values for bread were calculated. Glycaemic index of each variety of rice was determined from the above variables. RESULTS: Glycaemic indices of varieties of rice differ. The glycaemic indices of varieties of red raw rice varied between 56 and 73 and the variety Bg 350 had the lowest glycaemic index. There was no significant difference between mean glycaemic index of varieties of white raw and some varieties of red raw rice (p = 0.2). Parboiled varieties of red raw rice had a significantly lower glycaemic index than white raw rice (p = 0.04) and some of the red raw rice (p = 0.005). CONCLUSIONS: The glycaemic index cannot be predicted from the colour of the rice grain. Red parboiled varieties of rice and Bg 350 can be recommended for patients with diabetes.

Nuevo adiestramiento para nuevas funciones / New training for new roles

En Sri Lanka, los practicantes médicos auxiliares se manifiestan con razón descontentos de su formación, que debería modificarse para capacitarles mejor y permitirles actuar con más eficacia en las comunidades del país, predominantemente rurales. Además, para motivar en la mayor medida posible a esos profesionales de la salud, habría que ofrecerles una estructura profesional atractiva

New training for new roles

Assistant medical practitioners in Sri Lanka are justifiably dissatisfied with their training, which should be modified so that they are enabled to function more effectively in the country's predominantly rural communities. Furthermore, in order to motivate these health professionals to the greatest possible extent, they should be offered an attractive career structure

The coefficient of swallowable composition of masticated hard-baked soya beans.

In addition to the graphical representation of swallowable composition (SC) of masticated food, an index--the coefficient of swallowable composition (CSC)--has been proposed in this study. This index was tested using hard-baked soya beans on various types of dentitions. The value of CSC ranged from +24 to -14 in full dentition and full denture wearers respectively.

A rationale for selecting suitable physiology topics for the basic sciences curriculum in dentistry.

The suitability of physiology topics taught in the first-year dental curriculum needs to be investigated in the light of the view of the present generation of clinical and preclinical teachers, and students. This was studied in the University of Malaya in order to propose a rational physiology curriculum with proper identification of priority topics. Oral physiology, blood and the cardiovascular system were found to be the most relevant for dental students. Among the systems, high and low priority topics were identified and their relative importance is discussed.

Diuretic effect of Aerua lanata with water, normal saline and coriander as controls.

The extract (200 ml of 50 g/L) of common garden herb (in Sri Lanka) Aerua lanata (S. Polpala, T. Thengapookeerai) induced diuresis, consistent ovet four repetitions in 70% of the subjects. The rest of the subjects needed higher concentration of the solution (100 g/L), to induce diuresis. The urine output observed with the fresh plant extract was significantly elevated (P less than 0.001) when compared with controls who received the same quantities of water, 0.9% saline of extracts of the seeds of another medicinal plant, Corlandrum sativum. Raw flowers of Aerua lanata were found to be the most effective in inducing diuresis when compared to the other parts of the raw plant and its dried form.

Development of the swallowable composition of food in normal dentate subjects.

This study aimed to find out the changes which occur in the frequency distribution of the size of particles produced during mastication of a convenient mouthful of hard-baked soya beans to its swallowable composition (SC), and to identify the particles which undergo rapid pulverization. In this group the total number of masticatory strokes utilized to prepare food for the SC varied between forty and eighty masticatory strokes. All the subjects produced a similar pattern of the frequency distribution of particles produced at the end of mastication and when mastication was interrupted at a particular phase. Particles larger than 1180 micrometers were pulverized to form particles smaller than 1180 micrometers. Most rapid pulverization was seen in particles of 2400 micrometers whereas particles of average size 655 micrometers, formed rapidly.

Variations in the particles produced at the end of mastication in subjects with different types of dentition.

The final composition of the size of particles of food or the swallowable composition (SC) has been investigated in subjects with different types of dentition. A convenient mouthful of hard-baked soya beans was masticated and thereafter the bolus was dried, sieved and weighed. Full denture wearers prepared a SC with a mode value around 4000 microns whereas subjects with mixed dentition prepared a SC with a mode value around 2000 microns. Subjects with partial dentition produced wide variations in the SC. To produce a SC which is usually swallowed by a particular subject the quantity of masticated food should bear an optimum ratio to the area of the healthy oral tissues.

Analysis of particles produced at the end of mastication in subjects with normal dentition.

A study was made to establish a norm for the frequency distribution of the size of particles produced by masticating a certain food item to its swallowable composition by normal dentate subjects. Only about 80% of the initial weight of food taken into the mouth could be recovered after mastication for particle size analysis. The particles ranged from 53 micrometers to 4750 micrometers, showing a positively skewed distribution with a mode value between 600 micrometers and 1200 micrometers.

Effects of prostaglandins F2 alpha and E2 on the contractility of non-pregnant human fallopian tube in vitro.

The effects of PGF2 alpha and PGE2 on the distal part of the isolated non-pregnant human fallopian tubes obtained from known menstrual phases has been investigated. Both PGF2 alpha and PGE2 produced an increased contractility of fallopian tube. However, PGF2 alpha was found to be more potent than PGE2 and also the contractions produced by the former compound showed wave forms of relatively high amplitude and low in frequency than that produced by the latter compound. These two compounds did not show a priming effect on each other. There was no discernible effect of phase of the menstrual cycle upon the contractile response to PG.

Effects of neuromuscular blocking agents on arterial blood pressure in the rat.

Gallamine triethiodide pancuronium bromide or d-tubocurarine was infused intravenously at different rates in urethane anaesthetized rats. When given in neuromuscular blocking doses gallamine triethiodide produced significant hypotension if the rate of infusion exceeded 2 mg/min whereas neither pancuronium bromide nor d-tubocurarine produced a marked change in blood pressure in neuromuscular blocking doses.