Background Post-Traumatic Stress Disorder (PTSD) usually follows a catastrophic event. However, the experience of child birth can be severe enough to cause PTSD in some women. The aim of this study is to highlight the prevalence of Post Traumatic Stress Disorder among a cohort of postpartum mothers. Methods A cross-sectional study was conducted in field clinics of a semi-urban area in Sri Lanka. A pre-tested interviewer administered checklist was used to collect socio-demographic and pregnancy related data. Pre-existing self-administered, validated Sinhalese versions of the Edinburgh Postnatal Depression Scale (EPDS) and PTSD Symptom Scale-Self Report (PSS-SR) were used to assess the presence of Post-Partum Depression (PPD) and PTSD, respectively. Each participant was assessed for PTSD and PPD after one, two and six months following delivery. Scores of PPD > 9 and PSS-SR > 13 were taken as screening positive for the two conditions, respectively. Results Two hundred and twenty-five mothers at the end of postpartum one month were recruited for the study. The response rate at their follow-up visits at the second and sixth months were 95 % (n = 214) and 93 % (n = 211). The prevalence of postpartum PTSD was 2.7 % (n = 6), 0.9 % (n = 2) and 0.5 % (n = 1) after one, two and sixth months respectively. Prevalence of postpartum PTSD was 3.6 % over 6 months. Verbal abuse during labour (p = 0.04) and the presence of postpartum depression (P ≤ 0.001) were significantly associated with postpartum PTSD. There were no significant associations between PTSD and gestational age at delivery, index pregnancy being a planned pregnancy, a history of subfertility, family history of psychiatric disorders, intimate partner violence, receiving antenatal counseling, type and mode of delivery, duration of labour, presence of a labour companion, post-partum hemorrhage, manual removal of placenta, negative birth experience, low APGAR score of the baby at delivery, receiving neonatal and maternal intensive care, birth defects, problems with breast feeding or opportunity to discuss with a health care worker. Conclusions Prevalence of postpartum PTSD in this community-based study is 3.6 %; which is comparable with the overall global prevalence. PTSD was significantly associated with verbal abuse during labour and postpartum depression.

Background: Surgery-related anxiety is universal, leading to complications. The objective of this study was to assess the prevalence of pre-operative anxiety levels among a group of patients. Methods: A descriptive cross-sectional study of 64 women was conducted in a tertiary care hospital, Sri Lanka. Patients who underwent emergency surgeries, those with mental illnesses or those aged <18 years were excluded. Pre-operative assessment was done one day prior to the surgery using a self-administered Sinhala validated Amsterdam-Preoperative-Anxiety-and-Information-Scale (APAIS), Hospital Anxiety and Depression Scale (HADS) and Visual-Analogue-Scale (VAS). The APAIS consists of six questions which assess three anxiety components: anesthesia-related-anxiety (Sum A), surgery-related-anxiety (Sum S) and information-desire-component (Sum IDC). The combined score (Sum C) is given by the total of Sum A and Sum S. A Sum C of ≥11 indicates significant anxiety. Results: The mean age of participants was 38.03 years (SD=13.53 years). The mean total score of APAIS was 10.36 (4.06), of HADS was 5.734 (4.487) and of VAS was 3.156 (2.773). All scores were higher in participants <50 years. There were negative correlations between age and anxiety levels in VAS and APAIS scales; the Sum IDC in APAIS (r=-0.416, p=0.001) and VAS scores (r=-246, p=0.050) showed significant negative correlations. Excepting Sum IDC all APAIS, HADS and VAS scores were higher among the group without insurance; despite free healthcare. However only Sum S (t=-3.716, p=0.000) and Sum C (t=-2.281, p=0.026) in APAIS, HADS (t=-3.412, p=0.001) and VAS (t=-2.135, p=0.037) had statistically higher values. Anxiety scores were higher in the group that underwent minor surgeries but where not significantly related to education level, marital status, income, employment or living status. Conclusions: Pre-operative anxiety is common. Age <50 years, lacking insurance cover and undergoing minor surgeries are associated with increased pre-operative anxiety levels. Screening and appropriate interventions would be beneficial.

Introduction: Early childhood nutrition plays an important role in growth and development of children. However, due to false beliefs of parents, undue prominence has been given to milk in the child's diet. Objective: To assess the knowledge, attitudes, practices and factors related to milk powder usage among mothers of 1-5 year old children. Method: A cross sectional study was carried out among 187 mothers of 1-5 year old children in five randomly selected weighing centres in Pitakotte MOH area using an interviewer administered questionnaire. Scores were given to knowledge, attitudes and practice. Results: The mean age of the children was 32 (SD 16.3) months. Mothers' knowledge on milk/milk powder and their usage was good in 20% and level of attitudes was good in 55%. Parents received information regarding milk powder from doctors (42.4%) and TV advertisements (36.5%). The commonest factor mothers considered when selecting a milk powder was the brand name (69.7%). Mean age of initiating cow's milk was 13.5 (SD 9.2) months. Forty seven percent selected a single brand to start feeding their children. At the time of conducting the survey, 47% were using one particular brand of full cream. While 52.8% gave concentrated milk, 33.7% gave diluted milk. One hundred and one (62%) used a cup while 44 (27%) used a bottle to give milk. Sixty (36.8%) mothers were giving the correct volume of milk, while 95 (58.3%) gave more than recommended. There was a statistically significant association between social class and level of practice (χ 2 =5.19;p<0.05;df=1). Practice was not significantly associated with mother's level of attitudes, knowledge, age, education, parity or the sex of the child.

To evaluate distance education via the web facilitates teaching through problem-based learning and incorporating scientific evidence in the context of practical application to medical undergraduates.Methods: Web-based distance teaching program based on the Zoom video conferencing software was developed and introduced into a selected group of medical students. Current knowledge about handling web-based resources, evaluation of learning activities, and self-evaluation of their involvement and participation of medical students were evaluated. Results:The provision of lectures and relevant notes through the internet was emphasized during this study. A satisfactory response was observed regarding obtaining factual knowledge. This method was considered relatively ineffective with relevance to the application of knowledge, development of clinical skills, and improvement of professional attitudes. Students believed that it helped to improve the ability of critical thinking, refine reasoning skills, and enhance the capacity of mediating subject matter. Students had a general idea regarding using this method as a supplementary education strategy. The majority of the participants demonstrated considerable satisfaction towards this method, and most of them were prepared to recommend this method for another person. The students had disclosed that lectures showed significantly higher skills while teaching through this method, especially they believed that this distant learning method provided an additional benefit for face to face clinical teaching procedures. Conclusion:When generally considered, a satisfactory response was received regarding the learning outcomes of using this method, and the quality of participation of students was extremely positive.

This study focuses on the importance of a safety checklist for gynecological laparoscopic surgeries. There is no dedicated safety check list for gynecological laparoscopy although several general safety checklists are used in practice. (e.g. WHO safety check list). The aim was to introduce a safety check list dedicated to gynecological laparoscopy. This check list is based on our experience in performing gynecological laparoscopy in a tertiary care centre with a high workload.  This check list is introduced after studying the complications occurring in areas covered by the check list. Present data from 776 cases performed over 4 years at professorial unit in obstetrics and gynecology, university of Sri Jayewardenepura, Colombo South teaching hospital, Kalubowila, Sri Lanka. Mean surgical time and complications associated with patient positioning were assessed. Complications associated with the areas assessed were found to be low. However, it is belief that these can be further reduced by the introduction of a check list specifically designed for gynecological laparoscopy.