BackgroundDental caries among young children are a global problem. Scant attention is paid towards primary teeth, leading to high prevalence of dental caries. There are only few studies done in Sri Lanka, addressing oral hygiene among preschool children. Scientific evidence is in need to persuade authorities to establish a programme promoting oral hygiene among preschool children.MethodsA descriptive cross sectional study was conducted in Ragama Medical officer of Health area. Consecutive children between 2 – 5 years of age, attending child welfare clinics were recruited for the study. Practices related to dental hygiene and socio-economic characteristics were obtained using an interviewer administered questionnaire. Mouth was examined for evidence of dental caries. Data collection and examination were done by two doctors who were trained for this purpose. The data were analysed using SSPS version 16.ResultsTotal of 410 children were included. None had a routine visits to a dentist. Practices related to tooth brushing were satisfactory. Prevalence of dental caries gradually increased with age to reach 68.8% by 5 years. Mean total decayed-extracted-filled (deft) score for the whole sample was 1.41 and Significant caries index (SIC) was 4.09. Decayed tooth were the main contributor for the deft score and Care index was only 1.55. Girls had a significantly higher prevalence of caries than boys.ConclusionsDental care provided for Sri Lankan preschool children appears to be unsatisfactory as prevalence of dental caries among this cohort of preschool children was very high. There is an urgent need to improve dental care facilities for Sri Lankan preschool children.

AimsTo describe the burden of diabetes mellitus and impaired fasting glucose in middle-aged residents (35–64 years) in an urban area of Sri Lanka.MethodsA cross-sectional survey was conducted in the Ragama Medical Officer of Health area, from which 2986 participants (1349 men and 1637 women) were randomly selected from the electoral registry between January and December 2007. The participants underwent a physical examination and had their height, weight, waist and hip circumferences and blood pressure measured by trained personnel. Fasting blood samples were taken for measurement of glucose, HbA1c and lipids. The prevalence of diabetes (fasting plasma glucose > 7 mmol/l) and impaired fasting glycaemia (fasting plasma glucose 5.6–6.9 mmol/l) and major predictors of diabetes in Sri Lanka were estimated from the population-based data.ResultsAge-adjusted prevalence of diabetes mellitus in this urban population was 20.3% in men and 19.8% in women. Through the present screening, 263 patients with diabetes and 1262 with impaired fasting glucose levels were identified. The prevalence of newly detected diabetes was 35.7% of all patients with diabetes. Among patients with diabetes, only 23.8% were optimally controlled. In the regression models, high BMI, high waist circumference, high blood pressure and hypercholesterolaemia increased the fasting plasma glucose concentration, independent of age, sex and a family history of diabetes.ConclusionsOur data demonstrate the heavy burden of diabetes in this urban population. Short- and long-term control strategies are required, not only for optimal therapy among those affected, but also for nationwide primary prevention of diabetes.

BackgroundChronic abdominal pain is a common worldwide problem and known to be associated with psychological problems. This study evaluated the association between abdominal pain-predominant functional gastrointestinal disorders (AP-FGIDs), psychological maladjustment and personality traits in adolescents.MethodsAdolescents aged 13–18 years were recruited from 5 randomly selected schools in Ampara district of Sri Lanka. AP-FGIDs were diagnosed using Rome III criteria. Translated and validated Rome III questionnaire (Child report form), personality questionnaire (PAQ) and PedsQL (Pediatric Quality of Life) inventory were used in data collection. Written consent was obtained from a parent and assent was obtained from every child recruited. The questionnaire was distributed in an examination setting to ensure confidentiality and privacy. Research assistants were present during data collection to assist on any necessary clarifications.ResultsA total of 1697 subjects were recruited [males 779 (45.9%), mean age 15.1 years, SD 1.6 years]. AP-FGIDs were present in 202 (11.9%). Those with AP-FGIDs had significantly higher mean scores for all personality traits (hostility and aggression, negative self-esteem, emotional unresponsiveness, emotional instability and negative world view), except dependency. Affected children had lower scores for all 4 domains of HRQoL (physical, emotional, social and school functioning), compared to controls (p < 0.05). When the cut off value for Sri Lankan children (89) was used, 66.3% with AP-FGIDs and 48.2% controls had PAQ scores within that of psychological maladjustment (p < 0.001). When the international normative value of 105 was used, these percentages were 27.2% and 14.2% respectively (p < 0.0001). The scores obtained for PAQ negatively correlated with scores obtained for HRQoL (r = − 0.52, p < 0.0001). One hundred and seventeen adolescents with AP-FGIDs (57.9%) had sought healthcare for their symptoms. Healthcare consulters had higher PAQ and lower HRQoL scores (p < 0.05).ConclusionsAdolescents with AP-FGIDs have more psychological maladjustment and abnormal personality traits than healthy controls. Affected adolescents with higher psychological maladjustments have lower HRQoL. Greater psychological maladjustment and lower HRQoL are associated with healthcare seeking behaviour in adolescents with AP-FGIDs.

Introduction Cardiovascular disease (CVD) prevention guidelines recommend lifetime risk stratification for primary prevention of CVD, but no such risk stratification has been performed in India to date. Methods We estimated short-term and lifetime predicted CVD risk among 10 054 disease free, adult Indians in the age group of 20-69 years who participated in a nationwide risk factor surveillance study. The study population was then stratified into high shortterm ($10% 10-year risk or diabetes), low short-term (<10%)/high lifetime and low short-term/low lifetime CVD risk groups. Results The mean age (SD) of the study population (men¼63%) was 40.8+10.9 years. High short-term risk for coronary heart disease was prevalent in more than one fifth of the population (23.5%, 95% CI 22.7 to 24.4). Nearly half of individuals with low short-term predicted risk (48.2%, 95% CI 47.1 to 49.3) had a high predicted lifetime risk for CVD. While the proportion of individuals with all optimal risk factors was 15.3% (95% CI 14.6 to 16.0), it was 20.6% (95% CI 18.7 to 22.6) and 8.8% (95% CI 7.7 to 10.5) in the highest and lowest educational groups, respectively. Conclusion Approximately 1 in 2 men and 3 in 4 women in India had low short-term predicted risks for CVD in this national study, based on aggregate risk factor burden. However, 2 in 3 men and 1 in 2 women had high lifetime predicted risks for CVD, highlighting a key limitation of short-term risk stratification. Background Women who have higher systolic blood pressure (SBP) and diastolic blood pressure (DBP) in early pregnancy are more prone to develop pregnancy complications such as hypertension, preeclampsia and eclampsia. These complications contribute significantly to morbidity, stillbirth and neonatal mortality. Objective To evaluate the effect of pre-pregnancy body mass index (BMI) on first trimester SBP, DBP and mean arterial pressure (MAP). Methods 118 pregnant women between 20 and 40 years of age, up to 13 weeks and free from chronic or infectious diseases were investigated. SBP and DBP were obtained with automatic arm sphygmomanometer (Omron) and MAP was calculated as (SBP +DBP32)/3. Statistical analysis was performed using ANOVA, correlation and multivariate linear regression. Adjustments were made for age, skin colour, parity and smoking. Results Women were 26.364.9 years of age, had 8.762.7 years of schooling, per-capita income (US$) of 291.26166.4 and pre-pregnancy BMI of 25.665.1 kg/m 2 . There was a moderate positive correlation between pre-pregnancy BMI and SBP (r¼0.52; p<0.001), DBP (r¼0.33; p<0.001) and MAP (r¼0.44; p<0.001). Mean MAP (mm Hg) increased with BMI categories (underweight¼76.5; normal weight¼77.4; overweight¼82.9 and obesity¼88.7, p<0.001) as did SBP (underweight¼100.3; normal weight¼105.8; overweight¼112.4 and obesity¼121.2, p<0.001) and DBP (underweight¼64.8; normal weight¼63.5; overweight¼68.3 and obesity¼72.6, p<0.001). Multivariate linear regression showed that an increase of 1.0 kg/m 2 in pre-pregnancy BMI raised SBP in 1.24 mm Hg (p<0.001) ...

Growth parameters of new-born babies deviated significantly from the values of the MGRS data. Growth characteristics of one population may not be applicable to another population due to variations in maternal, genetic and socio-economic factors. Using growth charts not applicable to a population will result in wrong interpretations.