Objective To determine the criterion validity of the Sinhala version of the General Health . Methods This was a descriptive cross-sectional study including 374 patients (between the ages 18 to 75 years) attending the outpatient department of the Colombo North Teaching Hospital during the period June 2009 to September 2010. The Sinhala version of the GHQ-12 was completed by the participants. The 'Clinical Examination' was done by the designated psychiatrist (blindly to the GHQ score) by employing the ICD 10 classification of 'Depression/Anxiety and Social Dysfunction' as a reference standard. Cut-off values for the GHQ-12 were determined by applying the Receiver Operation Characteristic (ROC) curves. Results The optimal cut-off level for GHQ-12 was 1/2 with a sensitivity of 74% (95%CI 66%-81.5%), and a specificity of 71% (95%CI: 65.4%-76.6%). Optimal cut-off levels were not changed based on gender, age and educational levels. The area under the ROC curve for GHQ-12 was 0.79 (95% CI: 74%-84%). Despite the above mentioned statistics/measurements, GHQ scores with specific likelihood ratios of >1 were obtained only for the total scores of ≥3. Conclusions The GHQ-12 displays its efficacy when used among the Sinhala speaking Sri Lankan primary care settings for assessing psychiatric disorders.

Background Cervical cancer is the second commonest female cancer in Sri Lanka. Two major drawbacks of the present cervical cancer screening programme are the suboptimal sensitivity of the pap smear and the low coverage. The objective of the study is to determine the feasibility of a new HPV/DNA test among 35 -years -old ever-married women in a district of Sri Lanka. Method A community based descriptive cross-sectional study was conducted from 1stof July 2018 to 30th November 2018 in the public health divisions called Medical Officer of Health (MOH) areas of Kalutara district. The study population is comprised of ever-married women 35 years of age. Three women from each cluster (n = 413) were selected by consecutive sampling. A total of 918 women were recruited. HPV/DNA cervical specimen collection (n = 822) was carried out. Cervical specimens were tested by two cytoscreeners with the cobas 4800 PCR based screening machine. Clients’ perceptions and prevalence were assessed. The follow-up of women with positive HPV/DNA screening results was carried out. The operational and technical feasibility of the screening test were assessed. Data entry was done by using the statistical package IBM SPSS version 20. Results Overall response rate was 91.1% (n = 836). Clients’ perception was highly positive for HPV/DNA screening test procedure (99.9%, n = 821) and 99.6% (n = 819) of clients had mentioned that the HPV/DNA screening test is worthwhile to be incorporated into the National Cervical Cancer Screening program. The prevalence of HPV was 6.2% (95%CI: 6.18–6.22%). The coverage of the HPV/DNA screening was 89.5%(n = 822). Invalid results reported were 0.12% (n = 1). The percentage of HPV/DNA test positive women who underwent pap test within 3 months of the initial screening was 100% (n = 51), while the percentage of women who attempted to get a colposcopy within the 1 month of referral was 86.7% (n = 13). Conclusions HPV/DNA test implementation as a primary cervical cancer screening method is feasible among the 35- year age cohort of ever- married women in Kalutara district. It is necessary to further attempt alternative methods of cobas 4800 HPV/DNA test, which would be much suitable for resource-limited settings.

ObjectiveTo measure the quality of interaction between the Public Health Nursing Sister (PHNS) and the Public Health Midwife (PHM) during supervision. Methods This was a cross-sectional study, using triangulation of data obtained from structured observations and audio tape records of supervisor-supervisee interactions and written records of all supervision activities. Twenty four PHNS participated in the study. This study was undertaken in the district of Kalutara. Results Supervisors spent less time on supervising client care issues than on supervising facility level issues and interacting with clients. The weakest skills among the PHNS were 'seeking client input' and 'discussing the next visit' and the strongest skills were 'giving feedback', 'discussing/interpreting data' and 'developing rapport'. Skills of supervision increased with the service duration of the PHNS but none were able to achieve the cut-off mark for satisfactory overall quality of interaction. Conclusions This study indicates that the overall quality of interaction between the PHNS and the PHM during supervision was poor. PHNS lacked skills in prioritisation of supervision activities and time management. They also lacked other necessary skills that ensure a higher quality of PHNS-PHM interaction.

Objective To describe the secondary preventive measures adopted in the management of patients with Acute Coronary Syndrome (ACS) admitted to the National Hospital of Sri Lanka (NHSL), in comparison with standard guidelines. Methods A hospital based, descriptive cross-sectional study was carried out in the Cardiology Unit and medical wards of the NHSL during September to October 2009. A sample of 345 patients diagnosed with ACS was included in the study. Medical records were used as the source of data regarding secondary preventive measures during the inward period. Results Among ACS recruited, 168 (48.7%) were diagnosed with unstable angina, 92 (26.7%) with NSTEMI and 85 (24.6%) with STEMI. Acetyl Salicylic Acid (ASA) was given within 3 hours and documented in only 175 (53.7%). Although a twelve-lead ECG within 20 minutes of arrival at hospital is recommended in the guidelines, ECG was performed after 20 minutes in 203 (59%). In 85 with STEMI 66 (77.6%) received re-perfusion/streptokinase therapy. The time of commencing streptokinase was noted in only 49 (57.6%) and only 9 (18%) received streptokinase within 30 minutes of arrival in hospital. Left ventricular function was assessed in only 53 (15.4%) patients. Continuity of treatment with ACE inhibitors was seen in 298 (86.4%), beta-blockers in 213 (61.7%) and statins in 326 (94.5%). In 337 (97.7%) a maintenance dose of ASA was given during the hospital stay. Conclusions Some processes in the management of patients with ACS at NHSL did not meet the standard set by local and international guidelines on secondary preventive measures.

Is intermittent use of inhaled corticosteroids as effective as daily use for management of persistent asthma? A common recommendation in the management of persistent asthma is to use daily inhaled corticosteroids (ICS). Practices however may vary. Intermittent 'as needed' prescription or patient initiated use of ICS in acute exacerbations is becoming popular.