Background: Epidemiological studies reveal that over 50% of adults with obsessive compulsive disorder (OCD) report that their symptoms started during childhood or adolescence, with a mean age of onset around 9 years. Lack of diagnostic tools for screening of OCD among children and adolescents in their native language, adds to the burden of already limited child and adolescence mental health services (CAMHS) in Sri Lanka. Methods: The Brief Obsessive Compulsive Scale (BOCS) was translated into Sinhala, and cultural and semantic adaptation was conducted. Criterion validity was measured for the symptom checklist and severity scale, by administration of the translated tool to a sample of children and adolescents – the cases consisted of 50 children and adolescents aged 8-18 years, diagnosed to have OCD, who attended the CAMHS at Lady Ridgeway Hospital, Sri Lanka. Age and sex matched controls consisting of 50 healthy children and adolescents were selected from the general population. Results: Criterion validity scores were obtained via the receiver operator curve for the severity scale, with a cut off of 0.92, which had a sensitivity and specificity of 100% and 92% respectively. The reliability measured by Cronbach’s alpha were 0.78 and 0.94 for the symptom checklist and severity scale respectively. Conclusions: The locally validated BOCS has a high criterion validity, with an excellent reliability for diagnosing OCD in children and adolescents in Sri Lanka.
Introduction:Per rectal suppository administration of diclofenac sodium is commonly used for post-operative pain relief. This audit was conducted to assess whether, patients were informed of administration of diclofenac sodium suppository and to find out whether they were questioned about contraindications and cautions for its use. Method:Audit conducted during five consecutive days in general surgical wards (n=16) in National Hospital Sri Lanka, among 150 patients on post-operative day one or two. Data extracted from bed head tickets and an interviewer-administered questionnaire. Results:Mean age of the population was 48.15yrs (SD=15.91), 51.3% being males and 70.7% had received diclofenac sodium suppository post-operatively. Of them 92.5% were not informed prior to administration of the suppository. Majority were not questioned about peptic ulcers (50.9%), bleeding disorders (72.6%), allergy for non steroidal anti-inflammatory drugs -NSAIDs -(50.0%) and renal impairment (62.2%), which are contraindications for the drug. Among those given diclofenac, 12.3% had asthma, 2.8% coagulation defects, 17% ischaemic heart disease, 11.3% peptic ulcer, 31.1% hypertension, 1.9% allergy to NSAIDs, 0.9% heart failure, 5.75% renal impairment which are contraindications for use of NSAIDs and 12.3% were elderly. Conclusion:Majority of patients are administered diclofenac suppository without prior consent and a considerable proportion of them have contraindications to the drug Recommendation:There is need for a guideline for prescription of diclofenac sodium suppositories in the post operative period.
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