Rehabilitation efforts for Sri Lankan SCI patients should be sensitive to psychosocial concerns in addition to physical concerns in order to help patients re-integrate into their family lives and community. Furthermore, religious practices should be respected as possible aids to rehabilitation. Implications for Rehabilitation Rehabilitative efforts should be conscientious of patients' psychosocial well-being in addition to their physical well-being. Hospital-based rehabilitative efforts for traumatic spinal cord injury patients should promote functional independence and community re-integration. Spiritual and/or religious practices should be respected as ways by which traumatic spinal cord injury patients may confront personal challenges that arise following injury.

Perceived functional impairment in work, social and family domains predicted depressive symptomatology among SCI inpatients in Sri Lanka, while perceived benefit through S/R protected against depression. The findings emphasize the need for rehabilitative programming to support patients' S/R activities and mental wellbeing, promoting reintegration into their community roles.

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Background Betel consumption has been traditionally associated with cultural practices in South Asian, South East Asian and Asian Pacific regions (1,2). Betel is chewed either alone or more often as a quid with additives such as areca nut, slaked lime, tobacco, cloves, or cardamom. The ingredients and preparation of the betel quid may vary from region to region. In Sri Lanka betel leaf (Piper betle) is usually consumed in a quid of varied combinations with ingredients such as slaked lime, tobacco, areca nut (Areca catechu) (3). Areca nut is the primary ingredient in the quid and chewing tobacco may or may not be added according to preference.