BackgroundAlthough mental health literacy has been widely studied in adults, there are still relatively few studies on adolescent populations. In Sri Lanka, adolescents account for about one fifth of the population. Current evidence shows that most mental health problems diagnosed in adulthood begin in adolescence. There is also growing evidence that the trajectories of these disorders can be altered through early recognition and intervention. Although, help-seeking for mental health problems is known to be poor in adolescents, mental health literacy improves help-seeking. It is also known that adolescents may act as agents of change regarding mental health in their wider communities. Thus, mental health literacy in adolescents is an important aspect of community mental health initiatives. The objective of this study was to describe aspects of mental health literacy in terms of ability to recognise problems, helpful interventions, helpful referral options and outcomes in a target adolescent population in Sri Lanka. The association between socio economic variables and recognition of mental health problems was also examined.MethodsThis descriptive cross sectional study used a pretested questionnaire on 1002 adolescents aged between 13 and 16, where mental health literacy was assessed using 4 case vignettes. The vignettes represented depression with suicidal ideation, social phobia, psychosis and diabetes, where the last was for comparison.ResultsThe response rates for recognition as a mental health problem was 82.2% (n = 824) for the vignette depicting depression, 68.7% (n = 689) for the psychosis vignette and 62.3% (n = 623) for the social phobia vignette. “Talking to the person”, was responded to as helpful by 49.9% (n = 500), for the depression vignette followed by 49.8% (n = 499) for social phobia, 39.5% (n = 396) for psychosis and 19.5% (n = 195) for the diabetes vignette. The response rate for exercise being a helpful intervention was 25% (n = 251) for the diabetes vignette, followed by 21% (n = 210) for social phobia, 18.7% (n = 187) for psychosis vignette and 18.4% (n = 184) for the depression vignette. While 70.2% (n = 704) responded that there would be benefit in seeing a doctor for the diabetes vignette, the response rates for psychosis was 48.5% (n = 486), and for both depression and social phobia it was 48.2% (n = 483). The responses for the persons in the vignettes becoming better with treatment was 81.4% (n = 816) for the diabetes, 79.5% (n = 797) for depression, 75.6% (n = 758) for psychosis and 63.4% (n = 636) for the social phobia vignette. A statistically significant association was found between the income level of the family and appropriate recognition as mental health problems, for all the 3 mental health related vignettes.ConclusionsThe ability to recognise mental health problems, helpful interventions and outcomes in this population was comparable to those of adolescent populations in other countries, with some exceptions. The main differences were in relation to the identification and inter...

G lobal incidence of dengue has increased 7-fold, from 8.3 million cases in 1990 to >58.4 million in 2013 (1). Currently, ≈390 million new infections occur annually in 128 dengue-endemic countries (2). Worldwide, ≈14,000-20,000 dengue-related deaths occur each year (1,2). In dengue-endemic countries, Aedes (Stegomyia) aegypti and Ae. (Stegomyia) albopictus mosquito vectors transmit the disease. Sri Lanka, a tropical island in the Indian Ocean (population 21 million) (3), has reported dengue cases since the 1960s; seasonal epidemics predominantly affect areas that have annual rainfall >2,500 mm (4). However, until 1988, the more severe form of dengue virus (DENV) infection, dengue hemorrhagic fever, was reported only sporadically (5,6). During 1991-2008, dengue epidemics occurred once every few years on the background of endemic transmission (6). A disproportionate epidemic occurred in 2009 comprising 35,008 suspected cases (incidence 170 cases/100,000 population) and 346 deaths (case-fatality rate 1%) (7). During 2010-2016, dengue became a major public health problem; cases increased steadily (from 28,473 in 2011 to 55,150 in 2016) throughout the country but disproportionately affected the most populated Western province (7). In 2017, a total of 186,101 suspected cases and 440 dengue-related deaths were reported to the Central Epidemiology Unit of the Ministry of Health, Sri Lanka (7). This number is the highest number of suspected cases reported in a single calendar year in Sri Lanka since dengue was designated a notifiable disease in 1996. We compared the temporal, epidemiologic, virologic, entomologic, and climatic characteristics of the 2017 dengue epidemic with those of the epidemics during the preceding 5 years (2012-2016). Methods Data Sources Epidemiology We obtained epidemiologic data from the integrated national communicable disease surveillance system, which captures symptomatic dengue patients classified according to a standard case definition based on the 1997-2011 World Health Organization classification (8). Etiologic screening was conducted with NS1 antigen testing or dengue antibody assays. However, given the limited diagnostic test availability, especially in remote areas of the country, many cases were clinically diagnosed using the surveillance case

Background The global epidemic of type 2 diabetes mellitus (T2DM) renders its prevention a major public health priority. A key risk factor of diabetes is obesity and poor diets. Food environments have been found to influence people’s diets and obesity, positing they may play a role in the prevalence of diabetes. Yet, there is scant evidence on the role they may play in the context of low- and middle-income countries (LMICs). We examined the associations of food environments on T2DM among adults and its heterogeneity by income and sex. Methods and findings We linked individual health outcome data of 12,167 individuals from a network of health surveillance sites (the South Asia Biobank) to the density and proximity of food outlets geolocated around their homes from environment mapping survey data collected between 2018 and 2020 in Bangladesh and Sri Lanka. Density was defined as share of food outlets within 300 m from study participant’s home, and proximity was defined as having at least 1 outlet within 100 m from home. The outcome variables include fasting blood glucose level, high blood glucose, and self-reported diagnosed diabetes. Control variables included demographics, socioeconomic status (SES), health status, healthcare utilization, and physical activities. Data were analyzed in ArcMap 10.3 and STATA 15.1. A higher share of fast-food restaurants (FFR) was associated with a 9.21 mg/dl blood glucose increase (95% CI: 0.17, 18.24; p < 0.05). Having at least 1 FFR in the proximity was associated with 2.14 mg/dl blood glucose increase (CI: 0.55, 3.72; p < 0.01). A 1% increase in the share of FFR near an individual’s home was associated with 8% increase in the probability of being clinically diagnosed as a diabetic (average marginal effects (AMEs): 0.08; CI: 0.02, 0.14; p < 0.05). Having at least 1 FFR near home was associated with 16% (odds ratio [OR]: 1.16; CI: 1.01, 1.33; p < 0.05) and 19% (OR: 1.19; CI: 1.03, 1.38; p < 0.05) increases in the odds of higher blood glucose levels and diagnosed diabetes, respectively. The positive association between FFR density and blood glucose level was stronger among women than men, but the association between FFR proximity and blood glucose level was stronger among men as well as among those with higher incomes. One of the study’s key limitations is that we measured exposure to food environments around residency geolocation; however, participants may source their meals elsewhere. Conclusions Our results suggest that the exposure to fast-food outlets may have a detrimental impact on the risk of T2DM, especially among females and higher-income earners. Policies should target changes in the food environments to promote better diets and prevent T2DM.

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Bti might have a moderate impact on adult vector populations mediated via transient reductions in larval populations. However, this effect is not sustained probably due to rapid re-infestation. Bti spray, if implemented, can only play a supplementary role to other vector control methods.

Introduction Evaluation of the external genitalia is important in the routine neonatal examination, since abnormalities of the genitalia give clues to underlying endocrine disorders or structural malformations.Objectives The objectives of the study were to document the stretched penile length (SPL) of healthy term neonates born following an uncomplicated delivery at a tertiary care hospital in Sri Lanka, and to establish the normative data for the SPL for Sri Lankan neonates.Method This was a cross sectional observational study, carried out at post natal wards of the Castle Street Hospital for Women, Sri Lanka. The study was done on 369 stable newborns delivered at the gestational age of 37 to 42 weeks. A complete neonatal examination was performed by the principal investigator and the measurements of the weight, length, head circumference and stretched penile length were obtained. Mean penile length and statistically significant difference of penile length (SD) values were calculated. The correlation of mean penile length, period of gestation, birth weight and length were analysed. ResultsThe SPL positively correlated with the length of the baby. There is no statistically significant correlation of birth weight, head circumference and gestational age with the SPL. The mean SPL for term Sri Lankan newborns was 3.03cm ± 0.37cm and the -2SD value was 2.29cm. ConclusionSince the -2SD of SPL was 2.29cm, measurements less than this should be considered as micropenis.This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Primary school teachers should be able to identify struggling learners who may have dyslexia type learning difficulties, in order to facilitate early intervention. Considering this importance, a nationwide survey was conducted in Sri Lanka with 705 primary school teachers among randomly selected schools in order to investigate teacher readiness to identify learners with dyslexia. Teacher readiness was measured based on three variables (a) teachers' selfreported basic knowledge of dyslexia, (b) their self-reported awareness of local tools and processes used to identify dyslexia and (c) their self-reported attitudes towards engaging in identifying dyslexia. Data were gathered through a structured questionnaire. Logistic regression analyses revealed that the participants had minimal readiness to engage in identifying learners with dyslexia. However, most of them showed positive attitudes towards actively engaging in identifying dyslexia.

The main objective of this study was to assess the prevalence of stress, anxiety and depression, among nurses working in a tertiary hospital dedicated to the COVID-19 patients in Sri Lanka. A cross-sectional study was carried out among nurses working at Colombo East Base Hospital. The data was collected using a self-administered questionnaire and DASS-21, a set of three self-report scales designed to measure the negative emotional states of depression, anxiety, and stress over three months from October 2020. Data were analysed applying descriptive statistics and inferential statistical methods. There was a total of 131 study participants (response rate 83 %), and most of them were working in general wards (56%), while 42% were in critical care units. The proportion of anxiety and stress is associated with nurses working in critical care units were significantly higher than those in general wards (p<0.001). There were no associations between sex, marital status, having children, experience, qualifications, and medical or psychiatric conditions (p>0.05). The system of reporting mental health issues was unfortunately not in place. Staff felt that reporting stress/burnout or anxiety might seem like a negative attribute. Considering the above factors, one would expect more prevalence than we have seen in this study; therefore, we can infer that if mental health is not prioritised in healthcare institutions, then definitely lack of awareness/openness and under-reporting by staff will result in a long-term systemic problem (Suffering in the name of Resilience). doi: https://doi.org/10.12669/pjms.38.4.5508 How to cite this:Pathiraja PDM, Srikanthi WS, Jayamanne BDW, DeSilva HS. Depression, Anxiety and Stress among nursing officers in a dedicated hospital for COVID patients in Sri Lanka: A Single Institute Experience. Pak J Med Sci. 2022;38(4):---------.  doi: https://doi.org/10.12669/pjms.38.4.5508 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.