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Biomedical subjects

S H Siribaddana

Publications and source records attributed to S H Siribaddana.

13 recordsLinked to original sources

Culture-bound syndromes: the story of dhat syndrome.

BACKGROUND: Culture-bound syndrome is a term used to describe the uniqueness of some syndromes in specific cultures. Dhat (semen-loss anxiety) has been considered to be an exotic 'neurosis of the Orient'. AIMS: To ascertain the presence of similar symptoms and syndromes in different cultures and historical settings. METHOD: Electronic and manual literature searches were used to gather information on the existence and description of semen-loss anxiety in different cultures and settings. RESULTS: Most of the empirical studies on dhat syndrome have emerged from Asia, whereas its concepts have been described historically in other cultures, including Britain, the USA and Australia. The different sources indicate the universality of symptoms and global prevalence of this condition, despite its image as a 'neurosis of the Orient'. CONCLUSIONS: It appears that dhat (semen-loss anxiety) is not as culture-bound as previously thought. We propose that the concept of culture-bound syndromes should be modified in line with DSM-IV recommendations.

Anxiety Disorders↗

Feasibility of using different approaches for recruiting younger twins to establish a population based twin register in Sri Lanka.

Identifying twins for a population-based register can be achieved through birth records or community surveys. We studied the feasibility and effectiveness of different methods of identifying and recruiting twins to establish a population based register. To trace twins a population survey was carried out using an interviewer administered questionnaire. We also inspected the birth registration certificates at a divisional secretariat reported from a specified hospital between the years of 1985-1997 and compared it to the birth register of this same hospital. To recruit twins a random sample of 75 twin pairs (150 twins) identified at the Divisional Secretariat were contacted through the post and 25 twin pairs (50 twins) were personally visited. The prevalence of twins was 6.5 twins per 1000 people in the area surveyed. The twinning rate at the hospital was 18.92 twins per 1000 births. A discrepancy of 38 multiples births between the hospital labour room records and those registered at the DS was noted. The response from the postal invitation for recruitment was 59% and the response from the personal invitation was 68%. (Difference 9.4% 95% CI; 7.06-11.73). Community survey and systematic inspection of birth records either at the hospital or the birth registration office was an effective method to trace twins. Once traced, personal contact was more effective than the postal invitation for recruitment of younger twins. A cost-effective approach would be to use a postal coverage followed by personal contact for non-responders. The alternative method, community coverage, would have financial implications.

Birth Certificates↗

Establishing a twin register in Sri Lanka.

Nearly all twin registers are based in developed countries and there is no twin register in the developing world. Our objectives were to initiate the process of establishing a nationwide twin register in Sri Lanka by starting a volunteer register first and working towards a population-based register. Regular newspaper advertisements, feature articles, radio talks, and television programmes were used to publicise a competition for twins, their parents/relatives and friends requesting them to participate by sending in details of twins. The competition ran from 28 March 1997 for a period of 3 months. It offered prizes for three winners selected by drawing lots. Advertisements highlighted the objective of the competition as establishing a twin register for future research and emphasised that informed consent would be obtained for individual research projects. Those who registered comprise 4602 twin pairs (same sex: male--1564, female--1885; different sex--1153), 80 sets of triplets (same sex: male--17, female--31; different sex--42) and two sets of quadruplets (different sex). The oldest twins, triplets, quadruplets are 85, 46, and 5 years old, respectively; 88.0% of twins are less than 30 years old. Although others have previously used media publicity to enrol twins in twin registers, we believe this to be the first time that twins have been enrolled through competition. We have more young twins, and our gender and zygosity proportions after applying Weinburg's rule do not match the proportions expected from a volunteer twin sample. Establishing a twin register for research purposes has proved possible in a developing country.

Adolescent↗

Cross-cultural adaptation and preliminary validation of a zygosity determination questionnaire for twins in Sri Lanka.

We report the process of adaptation into Sinhala of a questionnaire given to mothers of twins to determine zygosity. Adaptation and validation was carried out in three stages. Firstly, we used a nominal group to translate the English version and to assess the extent of agreement (consensus measurement) on the appropriateness of the translation and resolve disagreement (consensus development). Secondly we used a qualitative interview with 25 mothers of twins. The three main stems of the translated questionnaire were used as a semi-structured interview, and the responses noted verbatim. These were categorised and analysed, and the translated full questionnaire was then presented as closed questions with fixed choice responses. The categorised responses generated during the qualitative interview were compared with the responses to the fixed choices in the full questionnaire. The third stage was the appraisal of the questionnaire by 17 bilingual parents of twins. The source and translated version of the questionnaire were given to them at least 3 days apart. The responses were rated and the total scores were computed to determine the zygosity. This step was carried out to measure the validity and reliability of the Sinhala version. A perfect correlation between the original and adapted version was obtained, with a kappa of 1. The results suggest that the Sinhala version of the questionnaire is conceptually equivalent to the original questionnaire. Comparison of the zygosity determination by using this adapted questionnaire with results from analysis of genetic markers on Sri Lankan twins is needed for final validation of the translated questionnaire.

Cross-Cultural Comparison↗

Toluene diisocyanate exposure in a glove manufacturing plant.

CASE REPORT: An accidental exposure due to reuse of containers of toluene diisocyanate to transport nontoxic substances and subsequent occupational toxic exposure caused illness among forty workers in a glove manufacturing plant. Examination and investigation of the patients and factory site inspection were carried out. Toluene diisocyanate-contaminated latex was examined by the infrared spectroscopy. Thirty-two of forty patients had muscle pain and seven had elevated creatine phosphokinase activity. These features have not been reported previously as components of toluene diisocyanate toxicity and their underlying causation remains speculative.

Adolescent↗

The prevalence of gestational diabetes in a Sri Lankan antenatal clinic.

INTRODUCTION: Early diagnosis of gestational diabetes mellitus (GDM) is a prerequisite to reducing fetal and neonatal complications of GDM. OBJECTIVES: (a) To ascertain the prevalence of GDM in a Sri Lankan pregnant population. Using the 75 g oral glucose tolerance test (GTT) and WHO criteria. (b) To establish the predictive value of a 50 g glucose challenge test (GCT) compared to the GTT (c) To compare the outcome of pregnancy in GDM with 'non-diabetic pregnancy' (NDP) STUDY DESIGN: Prospective study on a cohort of pregnant women attending antenatal clinics. SETTING: Sri Jayawardenepura General Hospital (SJGH) RESULTS: Of the 721 patients, 131 (18%) had a positive GCT. 40 (5.5%) patients had GDM. If a one-hour GCT of 7.8 mmol/l was considered suspicious of GDM the sensitivity of the glucose challenge test was 63% and the specificity 84%. Statistically significant differences in the prevalence was found when the women were > 35 years [Relative risk (RR) = 3.87 (95% CI-2.06 to 7.27)] or the body mass index > or = 25. (RR = 2.45 (95 CI-1.30 to 4.61) Presence or absence of high parity, family history of diabetes or recurrent abortions had no significant impact on the prevalence of GDM. Mean birth weight was higher (p < 0.05) in GDM (3615 SD 103) than in NDP (2898 SD 143.6). The likelihood of having a caesarean section was higher (p < 0.01, Relative risk (RR) 2.50, 95% CI 1.56-3.95) in GDM when compared to NDP. A higher incidence of hydramnios (p < 0.01 RR 3.41 95% CI 1.44-8.05) was recorded in GDM when compared to NDP. CONCLUSION: The prevalence of GDM in the antenatal clinics at SJGH is 5.5%. Traditional risk factors did not predict GDM. GDM is associated with a higher risk of caesarean section, hydramnios and macrosomia. Hence screening for GDM should be performed in all pregnant women at 24 to 28 weeks of pregnancy using a GCT.

Adult↗