Search

IntroductionA properly documented medical record is a vital component in good clinical care. A medical record lies as a core of health information system in the hospital. Medical document is a record pertaining to clinical assessment, medical care, professional judgment and critical thinking by a health professional in relation to providing patient care. There is a paucity of studies in Sri Lankan literature to assess attitudes and competencies among pre-intern doctors on medical documentation. AimTo describe the Attitude and perception towards medical documentation among pre-intern doctors in Sri Lanka Methods A descriptive cross-sectional study was carried out among 641 pre-interns who were eligible for medical internship in 2020. A pre-tested self-administered questionnaire was used to collect data. The objective of the study was to determine attitude and perception towards medical documentation among pre-intern doctors. Pre-interns who joined for the Good Intern Programme, in year 2020 were invited to participate for the study. Descriptive statistical analyses were done. Results Mean age of the participants was 27.6 (SD 1.4) years and majority of them were females (66.5%). Majority (92.20%) of pre- interns perceived that if a patient leaves against medical advice, it is a duty of the doctor to issue a diagnosis card to the patient. Majority (91.73%) believed that they have to give a diagnosis card even for the simple viral fever. Around 69.42% of pre- interns have got a chance to participate for any training on writing diagnosis cards within last 3 years while majority (74.26%) of them perceived that they have received an adequate training in diagnosis card writing so far. Fifty-eight percent of them specified as they learnt to write diagnosis card by observing it during ward work. Majority (52.26%) of the participants perceived that they have satisfactory level of competency in writing a diagnosis card. Meanwhile majority (88.3%) of participants perceived that they need a training on proper way of writing a diagnosis card prior to the internship.ConclusionThis study highlights the importance of adding training components on medical documentation to undergraduate medical curricula and having refresher trainings prior to the commencement of medical internship.

Background: Medical Officers are one of the key staff categories in the healthcare service. Globally there is high demand for medical officers and the government as well as private organizations have major task in retaining the services of highly trained and competent medical staff. Preventive health sector plays a vital role in the healthcare system. Medical Officers of Health (MOH) are the Medical Officers providing preventive health services in Sri Lanka. This study was carried out to explore the factors affecting retention of Medical Officers of Health in the preventive health sector in Sri Lanka. Methods: A descriptive cross-sectional study was carried out among Medical Officers of Health in the Colombo district which has 18 MOH Offices with 64 Medical Officers. A pre-tested self-administered questionnaire was used as the study instrument. Data were analyzed using descriptive analysis, correlation and regression analysis. Results: Of the 74 Medical Officers 64 responded with a response rate of response rate of 86.5%. Regression analysis showed that all four variables; recognition, work schedule, remuneration and responsibility are positively and significantly correlated with retention of Medical Officers of Health in the preventive health sector. The variable ‘work schedule’ showed the highest impact to the retention of Medical Officers of Health. Conclusions: In order to retain trained Medical Officers of Health in the Sri Lankan preventive health sector, health authorities should address the factors that influence retention. If policy makers fail to address these factors the preventive health services will be negative impact due to shortage of key service providers.&nbsp

Background:Ischemic Heart Disease(IHD) characterized by atheroma formation, is a leading contributor for the rising disease burden of chronic non-communicable diseases in Sri Lanka. Even though excessive salt-consumption has been attributed with hypertension, documented literature is scarce on exploring its direct association with atheroma formation with primary data. Coronary-Artery- Bypass-Grafting(CABG) is done as a tertiary preventive measure for IHDs. The aim was to estimate the sodium-intake and to describe the association of salt consumption and atheroma formation among preoperative patients undergoing CABG at Sri Jayewardenepura General Hospital, Sri Lanka.MethodsA descriptive cross-sectional study was done on a calculated sample size of 213 participants who were awaiting CABG at SJGH. An interviewer-administered Additional file 1 was used, and dietary intake of sodium was calculated with food-frequency tables and web-based tools. A data extraction form was used and details regarding Coronary arterial segments with atheroma formation were obtained from angiogram reports. After exploring the normality, Spearman-correlation-coefficient and Mann-Whitney-U tests were used to explore associations of atheroma formation. Independent association of sodium-intake and Coronary arterial segments affected with atheroma was explored with multiple-logistic regression. ResultsThe sample was with a male preponderance(male to female ratio=3:1). Comorbidities were observed in a notable proportion: diabetes(47%), dyslipidemia(40%), hypertension(56%). The median(IQR) of BMI and waist circumference were 25.00(23.00-27.00)kg/m2 and 87.00(82.00-91.00)cm. The median(IQR) sodium-intake was 5875.50(4905.25-7091.25)mg. All participants (n=210) had a sodium intake of more than 2000mg/day. Sodium intake(rs=0.599,p0.05). Sodium intake was found to be an independent predictor of affecting “5 or more segments” when multiple logistic regression was applied(OR= 2.25,CI=1.41 to 3.61).Conclusions and RecommendationsThe daily intake of sodium by a regular person is more than the dietary recommendations in the study sample. Salt intake reflected by sodium intake seemingly increase the risk of atheroma formation in more coronary segments irrespective of age, sex as well as several known disease conditions and risk factors. More research must be promoted with analytical approaches in proving this hypothesis.

Introduction One of the core indicators of monitoring universal access to safe, affordable surgical care is access to timely, essential surgery. Analysing the waiting time for elective operations is one way to determine access to surgical services in a country. Aims of this study were to determine the access to surgical services in a urology unit of Sri Lanka by analysing waiting time for elective surgical operations and to determine whether waiting time is related to income categories and social classes. Methodology All patients undergoing surgery (excluding emergency and elective minor surgery) at a urology unit between 01.01.2016 to 30.04.2017 were included in the study. The income groups were categorised according to the household income and receipt of Samurdhi benefit. Waiting time was the period between the day the decision was taken for surgery and the day of surgery. Results A total of 1079 patients had complete data and 845 (78.3%) were men. Median waiting time for surgery was 40 days. Eighty nine (8.2%) were Samurdhi beneficiaries and their median waiting time was 48 days. Two hundred and nineteen (20.3%) operations were done for malignancies and the median waiting time was 20 days. Median waiting time for TURP and renal stone surgery were 55 and 125 days respectively. One hundred and seventy (15.8%) patients had their operations postponed at least once. Survival analysis showed that there is no statistically significant difference between the waiting time with income levels (p=0.38) and recipient status of Samurdhi (p=0.29). Conclusion Waiting time for elective urological surgery is too long though waiting time for malignancies is satisfactory in the unit. Socioeconomic status of the patient has no statistically significant influence on the waiting time indicating equity in the unit policy.