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Rare presentation of a prostatic carcinoma as pyrexia of unknown origin: A case report

Thu, 01 Jan 2026 00:00:00 GMT

Title: Rare presentation of a prostatic carcinoma as pyrexia of unknown origin: A case report Authors: Navakumaran, M.; Suganthan, N.; Kumanan, T.; Sujanitha, V.

Adherence, Knowledge to Epilepsy Medication and their Associated Factors Among Caregivers of Epileptic Children Followed up at the Paediatric Clinic at TH, Jaffna

Thu, 01 Jan 2026 00:00:00 GMT

Title: Adherence, Knowledge to Epilepsy Medication and their Associated Factors Among Caregivers of Epileptic Children Followed up at the Paediatric Clinic at TH, Jaffna Authors: Thenuka, K.; Kalki, P.; Nilukshika, U.; Saranja, N.; Sanchayan, K. Abstract: Epilepsy affects both adults and children and requires long-term medication control, with antiepileptic drugs as the first-line therapy. Good adherence to anti-epileptic medication (AEM) is essential for optimal treatment outcomes, particularly in children who may not require lifelong treatment. Caregiver awareness and knowledge play a critical role, as non-adherence to AEM has become a significant concern. This hospital-based descriptive cross-sectional study aimed to assess caregiver knowledge and medication adherence among caregivers of children with epilepsy attending the Paediatric Clinic at Teaching Hospital Jaffna. A total of 127 caregivers aged over 18 years, caring for children under 14 years with epilepsy, participated in the study, with a response rate of 97%. Data were collected using a knowledge questionnaire (score range: 0–13), numerical, and the MARS-5 (Parent Version) adherence scale (score range: 6–30), categorized into good and poor adherence. Statistical analysis included Chisquare or Fisher’s exact tests, Mann–Whitney U, and Kruskal–Wallis tests, with significance set at p ≤ 0.05. Most caregivers were parents (96%). The mean caregiver knowledge score was moderate (8.43/13). Good adherence was significantly associated with higher knowledge scores, regular clinic attendance, fewer seizure episodes, family history of epilepsy, parental factors, and awareness of medication side effects. Higher knowledge levels were associated with being married, having a middle household income, a better understanding of epilepsy, and awareness of AEM side effects. The findings highlight the need for ongoing caregiver education and consistent support from healthcare professionals to ensure effective epilepsy management in children.

Visual Outcomes of Cataract Surgery at a Tertiary Care Hospital in Northern Sri Lanka

Thu, 01 Jan 2026 00:00:00 GMT

Title: Visual Outcomes of Cataract Surgery at a Tertiary Care Hospital in Northern Sri Lanka Authors: Kumanan, T.; Malaravan, M.; Kumaran, S.; Arulijenani, K.; Powsiga, U.; Thurga, J. Abstract: Background: Cataract is the leading cause of blindness and visual impairment. Cataract surgery is the most common procedure for restoring vision in individuals with cataracts. It is important to assess the surgical outcomes of cataract surgery to ensure the highest standard of vision restoration, improved patient quality of life, and service delivery. Therefore, the present study aimed to evaluate the visual outcomes of cataract surgery among patients attending the Eye Unit of Teaching Hospital Jaffna, Northern Sri Lanka, at the fourth week follow-up postoperatively. Methods: An institution-based, retrospective analytical study design was conducted among 1,133 patients who underwent cataract surgery using phacoemulsification with intraocular lens implantation. The study participants were selected using a systematic random sampling technique. Data were obtained through a structured data extraction form derived from patients’ medical records and an interviewer-administered questionnaire, and were subsequently analysed using IBM SPSS Statistics for Windows, Version 25 (Released 2017; IBM Corp., Armonk, New York, United States). Proportions, summary statistics, and tables were used to present the findings. Multivariable linear regression was performed to identify associations among the variables. A p‑value of <0.05 was considered indicative of statistical significance. Results: Among 1,133 patients who underwent phacoemulsification with intraocular lens implantation, 1,027 (90.6%) achieved good postoperative visual outcomes of 6/12 or better. The majority, 699 (61.7%), were female, and 800 (70.6%) were aged 60 years and above. The most common systemic comorbidities were hypertension with 386 (34.1%) patients and diabetes mellitus with 350 (30.9%), while 24 (2.1%) of them had pre-existing ocular comorbidities. Patients aged 60 years and above demonstrated significantly less improvement in visual acuity than those aged <60 years (p < 0.001). Diabetes mellitus was independently associated with reduced postoperative visual improvement (p = 0.014), whereas sex and pre-existing ocular comorbidities were not. Conclusion: The visual outcome following cataract surgery exceeds WHO recommendations. In this study, age and diabetes mellitus were associated with postoperative visual outcomes, whereas the presence of other ocular comorbidities and sex were not. Furthermore, this study demonstrates that good postoperative visual outcomes can be achieved with cataract surgery even in resource-constrained settings.

Patient perceptions of inhaled asthma medications: a qualitative study in Northern Sri Lanka

Thu, 01 Jan 2026 00:00:00 GMT

Title: Patient perceptions of inhaled asthma medications: a qualitative study in Northern Sri Lanka Authors: Guruparan, Y.; Thiyahiny, S.N.; Kumar, R.; Gowry, S.; Shalini, S.R. Abstract: Objectives This study explores perceptions of inhaled medications among patients with asthma at an outpatient tertiary care setting in Northern Sri Lanka. Design A descriptive qualitative research design was used to gather data through focus group discussions (FGDs) that were transcribed, translated, manually coded and thematically analysed using Braun and Clarke’s six-step approach. Setting The study was conducted at an outpatient medical clinic at a tertiary care centre in Northern Sri Lanka. Participants Six FGDs were carried out among adult patients with asthma who had been on inhaled medications for at least 3 months. Participants were selected by maximum variation sampling, with each FGD consisting of 6–10 participants. Results 51 participants between the ages of 20 and 71 years were recruited; 36 (70.6%) were female, and about a fourth had primary education or less. Seven subthemes were drawn out and organised into three overarching themes: (1) inhaler hesitancy; (2) fear-driven adherence and (3) conviction at last. Most participants were initially reluctant to use inhalers, primarily due to concerns about dependency and side effects, often influenced by opinions of family members. They delayed use until they experienced severe symptoms, with some describing nebulisation, hospitalisation and fear of death as turning points. Symptom alleviation and improved quality of life led to better adherence. Conclusions Delays in inhaler use could lead to poor asthma control and outcomes. As many patients reported using their inhalers more consistently after an exacerbation or hospitalisation, asthma education programmes, involving both patients and family members, could address context-specific beliefs and misconceptions to promote early and sustained adherence to inhaled medications.