Attitudes of the 1984 medical graduates of Sri Lanka to anaesthesia

A total of 196 intern medical officers who had graduated from the four medical schools in Sri Lanka in 1984 indicated their attitudes towards anaesthesia as a medical specialty in response to a postal questionnaire. Eighty per cent of the graduates considered anaesthesia to be an established specialty in Sri Lanka, while 17% felt that the specialty had limited clinical application. A total of 62% of the graduates were not aware, prior to their entry to medical school, that anaesthesia was related to medical practice. All the graduates indicated that the intra-operative role of the anaesthetist was on a par with that of the surgeon, but 40% felt that the pre- and post-operative roles were of a secondary nature. Overall, 42% considered that an anaesthetist acts as an assistant to the surgeon. The graduates were of the opinion that only 35% of the patients undergoing surgery were appreciative of the services rendered by an anaesthetist. Fifty per cent of the graduates considered exposure to the specialty in the undergraduate curriculum as inadequate. Anaesthesia was chosen as the first career preference by 1.5%. The dominant reasons for not selecting anaesthesia as a career specialty were: minimal patient contact and patient recognition (62%), and lack of recognition of the specialty by society (54%). Anaesthetists in Sri Lanka are challenged to alter the perceptions associated with the specialty, which are probably a result of chronic staff shortages restricting practice to the confines of operating theatres.     

Two Sri Lankan cases of identified sea snake bites, without envenoming.

Sea snakes are among the most venomous creatures encountered around coasts and reefs, in estuaries, rivers and at sea. Their venoms are more toxic than those of land snakes. However, they are rarely aggressive or menacing. Bites have become unusual with the advent of modern fishing methods but the two encounters we report, in the Indian Ocean off the shores of Sri Lanka, emphasise that sea snake bites may not result in envenoming.     

Association between underweight and taste sensitivity in middle‐ to old‐aged nursing home residents in Sri Lanka: a cross‐sectional study

Low taste sensitivity may be one factor related to undernutrition, which is a major problem in developing countries. The purpose of this cross‐sectional study was to examine the association between underweight, one indicator of undernutrition, and taste sensitivity in middle‐ to old‐aged Sri Lankan nursing home residents. Participants were 946 residents with BMI of <25·0 from 25 nursing homes. Data were obtained on height, weight, taste sensitivity, subjective taste ability, sex, age, ethnicity, number of years in nursing homes, activities of daily living (ADL), frequency of exercise, bowel movements, smoking status, drinking status, current number of chronic diseases, number and kinds of medications used, self‐reporting questionnaire 20 (SRQ20), subjective smell ability, number of teeth present, Eichner index and flow rate of saliva. Low sensitivity to bitter taste, being male, old age, low ADL, smoking experience, drinking experience, fewer medications used and no use of medication for hypertension and diabetes were each associated with underweight (P < 0·05). In a multilevel Poisson regression model adjusted for sex, age, ADL, smoking status, drinking status, number of medications used, use of medication for hypertension and diabetes and flow rate of saliva, subjects with low sensitivity (>0·003% quinine hydrochloride dihydrate) to bitter taste had a significant 1·70 times higher prevalence ratio (95% confident interval 1·04–2·80) for underweight compared with those with high sensitivity (0·0001% quinine hydrochloride dihydrate). These results suggest that low taste sensitivity to bitter taste may be one factor related to underweight.     

Menstrual Problems and Health Seeking in Sri Lanka

Menstruation is associated with some morbidity, although it is a normal physiological event. In this article, we draw on qualitative research conducted in Sri Lanka in 2006–2007, which included eight key informant interviews with healthcare providers, six focus group discussions with eight women in each, and five case studies. We describe and analyze women's perceptions of menstruation and menstrual problems, their help-seeking behaviors to reduce these health problems, and the consequences of them on their lives. The majority of women perceived menstruation as a physiological process and related problems to changes in hormone levels, pathological conditions of the uterus, and the side effects of contraceptive methods. Menstrual problems significantly affected their daily activities, mental well-being, social life, and sexual life, but few sought medical advice to resolve these problems. Implications of the findings included the need for health care providers and educators to provide accurate information on menstruation to girls and women to enable them to identify normal variation of menstruation and to take appropriate action regarding health care.     

A Bayesian approach to infer geographical origins of migrants through surnames

Background: Surnames are an easy tool to analyse human genetic structure, mobility and evolution. Few studies use surnames to estimate human migration at different geographical level.

Primary objective: Here we propose the application of a Bayesian method to estimate the probability of geographical origin (pgo) of migrants in a given area using surnames.

Method: This method can be applied with data recordings when they are available for at least two successive periods and in the areas which are the potential sources of emigration. The principle is that the new surnames which are arriving during the second period in the area under investigation can provide information on their geographical origins. The probability of the origin of migrants can easily be estimated iteratively from the frequency of surnames by using the Bayes' theorem.

Results: This method is exemplified using civil birth registers at different geographical scales. The pgo of migrants, estimated between two periods (1891-1915 and 1916-1940), (i) from French departments to Paris (ii), from these departments to Tarbes, and (iii) from counties surrounding Tarbes to Tarbes, are mapped and discussed.

Hintergrund: Familiennamen sind ein einfaches Hilfsmittel zur Analyse von genetischen Strukturen, von Mobilität und Evolution des Menschen. Wenige Studien nutzen Familiennamen, um menschliche Migration bezüglich unterschiedlicher geographischer Niveaus einzuschätzen. Ziel: Hier wird die Anwendung einer Bayes'schen Methode empfohlen, um die Wahrscheinlichkeit des geographischen Ursprungs (pgo) von Einwanderern in ein vorgegebenes Gebiet mittels Familiennamen zu schätzen. Methode: Diese Methode kann für Datenaufzeichnungen angewendet werden, wenn diese für mindestens zwei aufeinanderfolgende Perioden und die Gebiete vorhanden sind, die potentielle Emigrationsquellen sind. Die Grundannahme ist, dass die neuen Familiennamen, die während der zweiten Untersuchungsperiode in diesem Gebiet auftreten, Informationen über deren geographischen Ursprung liefern können. Die Wahrscheinlichkeit der Herkunft der Einwanderer kann leicht anhand der Wiederholungsfrequenz der Familiennamen geschätzt werden, indem man das Bayes'sche Theorem verwendet. Ergebnisse: Diese Methode wird anhand von Zivilgeburtsregistern unterschiedlicher geographischer Herkunft illustriert. Die Wahrscheinlichkeit des geographischen Ursprungs (pgo) der Einwanderer, geschätzt in zwei Perioden (1891-1915 und 1916-1940), (i) von französischen Departements nach Paris (ii), von diesen Departements nach Tarbes und (iii) von den Gebieten, die Tarbes umgeben nach Tarbes, werden aufgezeigt und diskutiert.

Contexte: Les patronymes sont un outil propice à l'étude de la mobilité et de l'évolution de la structure génétique humaine, cependant peu d'études les utilisent dans une perspective de migration géographique. Objectif: On propose d'employer la méthode bayésienne appliquée aux patronymes, afin d'estimer la probabilité d'origine géographique (pog) des migrants d'une zone donnée. Méthode: cette méthode peut être appliquée à des données enregistrées sur au moins deux périodes successives, dans les régions qui sont les sources potentielles de migrants. Le principe réside en ceci que les nouveaux patronymes qui arrivent au cours de la seconde période dans la région étudiée, peuvent fournir une information sur leurs origines géographiques. La probabilité d'origine des migrants pouvant être aisément estimée itérativement par le théorème de Bayes, d'après la fréquence des noms de famille. Résultats: cette méthode est appliquée à différentes échelles géographiques, aux enregistrements des naissances contenus dans les registres d'état civil. Les pog des migrants sont estimées, discutées et représentées graphiquement entre les périodes 1891-1915 et 1916-1940 (i) des départements vers Paris (ii) de ces départements vers Tarbes et (iii) des cantons entourant Tarbes vers Tarbes.     

Patterns of abuse amongst Sri Lankan women returning home after working as domestic maids in the Middle East: An exploratory study of medico-legal referrals

ObjectiveMigrant worker abuse is well recognised, but poorly characterised within the scientific literature. This study aimed to explore patterns of abuse amongst Sri Lankan women returning home after working as domestic maids.MethodsSri Lanka has over 2 million of its citizens employed overseas as international labor migrants. A cross-sectional study was conducted on Sri Lankan female domestic maids returning from the Middle East region who were referred for medico-legal opinion.ResultsA total of 20 women were included in the study. Average length of their employment overseas was 14 months. Complaints of physical violence directed mainly through their employers were made by 60% of women. Upon physical examination, two-thirds had evidence of injuries, with a third being subjected to repetitive/systematic violence. Eighty percent suffered some form of psychological trauma. Personal identity papers and travel documents had been confiscated by the employer in 85% of cases, with two thirds indicating they were prevented and/or restricted from leaving their place of work/residence.ConclusionsOur study demonstrates that female domestic maid abuse manifests through multiple pathways. Violence against such workers span the full spectrum of physical, financial, verbal, emotional abuse and neglect, as defined by the World Health Organization. Findings from this exploratory study cannot be generalized to the large volume of migrant worker outflows. Further research is needed to determine incidence and define patterns in other migrant worker categories such as low-skilled male workers.     

Reemergence and Autochthonous Transmission of Dengue Virus,Eastern China, 2014

In 2014, 20 dengue cases were reported in the cities of Wenzhou (5 cases) and Wuhan (15 cases), China, where dengue has rarely been reported. Dengue virus 1 was detected in 4 patients. Although most of these cases were likely imported, epidemiologic analysis provided evidence for autochthonous transmission.     

Characteristics and sputum conversion of tuberculosis (TB) patients in Kalutara,Sri Lanka

Background

Tuberculosis (TB) is an infectious bacterial disease; remains as one of the important public health problem affecting every part of the world. Substantial number of TB cases are reported from Sri Lanka every year irrespective of its strong preventive health system. The aim of this analysis is to describe the characteristics of TB patients and to assess the factors associated with sputum conversion. This analysis was based on the data from the District Chest Clinic of Kalutara district, Sri Lanka.