The incidence, prevalence and trends of Chronic Kidney Disease and Chronic Kidney Disease of uncertain aetiology (CKDu) in the North Central Province of Sri Lanka: an analysis of 30,566 patients.

Background: Chronic Kidney Disease (CKD) of uncertain origin (CKDu) has affected North Central Province (Anuradhapura and Polonnaruwa districts) of Sri Lanka. The cause is still unknown. The objective of this study was to describe the incidence, prevalence and trend of CKD/CKDu in North Central Province of Sri Lanka.

Addressing the information deficit in global health: lessons from a digital acute care platform in Sri Lanka.

Lack of investment in low-income and middle-income countries (LMICs) in systems capturing continuous information regarding care of the acutely unwell patient is hindering global efforts to address inequalities, both at facility and national level. Furthermore, this of lack of data is disempowering frontline staff and those seeking to support them, from progressing setting-relevant research and quality improvement. In contrast to high-income country (HIC) settings, where electronic surveillance has boosted the capability of governments, clinicians and researchers to engage in service-wide healthcare evaluation, healthcare information in resource-limited settings remains almost exclusively paper based.

Evaluation of the feasibility and performance of early warning scores to identify patients at risk of adverse outcomes in a low-middle income country setting.

Objective: This study describes the availability of core parameters for Early Warning Scores (EWS), evaluates the ability of selected EWS to identify patients at risk of death or other adverse outcome and describes the burden of triggering that front-line staff would experience if implemented.

Design: Longitudinal observational cohort study.

Setting: District General Hospital Monaragala.

Inequalities in the prevalence of diabetes mellitus and its risk factors in Sri Lanka: a lower middle income country.

Background: Explorations into quantifying the inequalities for diabetes mellitus (DM) and its risk factors are scarce in low and lower middle income countries (LICs/LMICs). The aims of this study were to assess the inequalities of DM and its risk factors in a suburban district of Sri Lanka.

Methods: A sample of 1300 participants, (aged 35-64 years) randomly selected using a stratified multi-stage cluster sampling method, were studied employing a cross sectional descriptive design.

Experiences of ICU survivors in a low middle income country- a multicenter study.

Background: Stressful patient experiences during the intensive care unit (ICU) stay is associated with reduced satisfaction in High Income Countries (HICs) but has not been explored in Lower and Middle Income Countries (LMICs). This study describes the recalled experiences, stress and satisfaction as perceived by survivors of ICUs in a LMIC.

Methods: This follow-up study was carried out in 32 state ICUs in Sri Lanka between July and December 2015.

Traumatic brain injury (TBI) outcomes in an LMIC tertiary care centre and performance of trauma scores.

Background: This study evaluates post-ICU outcomes of patients admitted with moderate and severe Traumatic Brain Injury (TBI) in a tertiary neurocritical care unit in an low middle income country and the performance of trauma scores: A Severity Characterization of Trauma, Trauma and Injury Severity Score, Injury Severity Score and Revised Trauma Score in this setting.

Methods: Adult patients directly admitted to the neurosurgical intensive care units of the National Hospital of Sri Lanka between 21st July 2014 and 1st October 2014 with moderate or severe TBI were recruited. A telephone administered questionnaire based on the Glasgow Outcome Scale Extended (GOSE) was used to assess functional outcome of patients at 3 and 6 months after injury.

Practices and Perspectives in Cardiopulmonary Resuscitation Attempts and the Use of Do Not Attempt Resuscitation Orders: A Cross-sectional Survey in Sri Lanka.

Objective: The objective of this study is to describe the characteristics of in-hospital cardiopulmonary resuscitation (CPR) attempts, the perspectives of junior doctors involved in those attempts and the use of do not attempt resuscitation (DNAR) orders.

Methods: A cross-sectional telephone survey aimed at intern doctors working in all medical/surgical wards in government hospitals. Interns were interviewed based on the above objective.

Critical Care Junior Doctors' Profile in a Lower Middle-income Country: A National Cross-sectional Survey.

Background And Aims: Retention of junior doctors in specialties such as critical care is difficult, especially in resource-limited settings. This study describes the profile of junior doctors in adult state intensive care units in Sri Lanka, a lower middle-income country.

Materials And Methods: This was a national cross-sectional survey using an anonymous self-administered electronic questionnaire.

Comparison of Quick Sequential Organ Failure Assessment and Modified Systemic Inflammatory Response Syndrome Criteria in a Lower Middle Income Setting.

Introduction: Quick Sequential Organ Failure Assessment (qSOFA) is potentially feasible tool to identify risk of deteriorating in the context of infection for to use in resource limited settings.

Purpose: To compare the discriminative ability of qSOFA and a simplified systemic inflammatory response syndrome (SIRS) score to detect deterioration in patients admitted with infection.

Methods: Observational study conducted at District General Hospital Monaragala, Sri Lanka, utilising bedside available observations extracted from healthcare records.

Simplified prognostic model for critically ill patients in resource limited settings in South Asia.

Background: Current critical care prognostic models are predominantly developed in high-income countries (HICs) and may not be feasible in intensive care units (ICUs) in lower- and middle-income countries (LMICs). Existing prognostic models cannot be applied without validation in LMICs as the different disease profiles, resource availability, and heterogeneity of the population may limit the transferability of such scores. A major shortcoming in using such models in LMICs is the unavailability of required measurements.

A Retrospective Study of Physiological Observation-reporting Practices and the Recognition, Response, and Outcomes Following Cardiopulmonary Arrest in a Low-to-middle-income Country.

Background And Aims: In Sri Lanka, as in most low-to-middle-income countries (LMICs), early warning systems (EWSs) are not in use. Understanding observation-reporting practices and response to deterioration is a necessary step in evaluating the feasibility of EWS implementation in a LMIC setting. This study describes the practices of observation reporting and the recognition and response to presumed cardiopulmonary arrest in a LMIC.

A survey on socioeconomic determinants of diabetes mellitus management in a lower middle income setting.

Background: Information on socioeconomic determinants in the management of diabetes mellitus is scarce in lower middle income countries. The aim of this study is to describe the socioeconomic determinants of management and complications of diabetes mellitus in a lower middle income setting.

Methods: Cross sectional descriptive study on a stratified random sample of 1300 individuals was conducted by an interviewer administered questionnaire, clinical examinations and blood investigations.

National Profile of Physical Therapists in Critical Care Units of Sri Lanka: Lower Middle-Income Country.

Background: The availability and role of physical therapists in critical care is variable in resource-poor settings, including lower middle-income countries.

Objective: The aim of this study was to determine: (1) the availability of critical care physical therapist services, (2) the equipment and techniques used and needed, and (3) the training and continuous professional development of physical therapists.

Methods: All physical therapists working in critical care units (CCUs) of state hospitals in Sri Lanka were contacted.

Development and Validation of a Measure of Quality of Life for the Young Elderly in Sri Lanka.

Sri Lanka has one of the fastest aging populations in the world. Measurement of quality of life (QoL) in the elderly needs instruments developed that encompass the sociocultural settings. An instrument was developed to measure QoL in the young elderly in Sri Lanka (QLI-YES), using accepted methods to generate and reduce items.

A cross sectional survey on social, cultural and economic determinants of obesity in a low middle income setting.

Introduction: Obesity is an increasing problem in South Asian countries and Sri Lanka is no exception. The socioeconomic determinants of obesity in Sri Lanka, and in neighbouring countries are inadequately described. Aim was to describe social, cultural and economic determinants of obesity in a representative sample from Kalutara District in Sri Lanka.

Social, cultural and economical determinants of diabetes mellitus in Kalutara district, Sri Lanka: a cross sectional descriptive study.

Introduction: Sri Lanka is a country that is expected to face a high burden of diabetes mellitus (DM). There is a paucity of data on social and demographic determinants of DM, especially in the plantation sector.

Aims: To describe social and economic correlates and inequalities of DM in Kalutara District.