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Papers by Samantha Ramachandra

Future of Business and Finance, 2021

Dietary Diversity of Pregnant Mothers in a Semi-Urban Setting: Sri Lanka

World Academy of Science, Engineering and Technology, International Journal of Medical and Health Sciences, 2018

International Journal of Dental Medicine, 2018

Introduction: The negative health effects of dental caries are cumulative, tracking from childhoo... more Introduction: The negative health effects of dental caries are cumulative, tracking from childhood to adulthood and most dental caries is now occurring in adults [1-3]. Oral diseases such as dental caries, gingivitis, and periodontal diseases can occur during pregnancy [4-9]. This study was carried out in Medical officer of health (MOH) area, Ambalantota, Sri Lanka. 363 pregnant women in first visit attending antenatal clinic were recruited. Written informed consent was obtained from all subjects who agreed to take part in the study. Ethical approval was taken from faculty of Medicine, University of Ruhuna. Prior to a dental examination, demographic information regarding age, education, occupation, socioeconomic status and residence were obtained from the participants using interviewer administered questionnaire. Findings of dental examination were entered examination table separately. The mean DMFT among antenatal women was 3.8 ± 5.17, with 3.27 (± 2.31) decayed teeth, 1.85 (± 1.87) missing teeth, and 1.4 (± 1.4) filled teeth. Results were shown in table 3 with binary logistic analysis of DMFT for the overall sample of 363 pregnant women. The final model explained 6.3% to 8.4% of DMFT variation (dependant variable) with variation of independent variables (educational level up to Ordinary level, Sinhla over non-sinhala, income over 30,000, knowledge on dental services free by government and ever taken treatment) and the p-value for Hosmer-Lemeshow test of goodness of fit was 0.957, which indicated an acceptable fit of the model. In the final model significant predictors were Sinhala: Non-sinhala (adjusted OR [95% CI]: 5.67 [1.25-25.99], p=0.026) and "ever taken treatment for dental diseases"(Yes vs No: adjusted OR [95% CI]: 0.432 [0.274-0.680], p<0.0001). In this study, pregnant women in Ambalantota MOH area were found to have a significantly higher DMFT value among Sinhala women over Non-Sinhala women and similarly significantly lower DMFT value among pregnant women who sought treatment for their dental diseases against women who did not.

Behavior change through counselling to improve dietary diversity of pregnant mothers: A lesson from Sri Lanka

Sri Lanka as a middle-income country performs outstandingly in health-related indicators on a par... more Sri Lanka as a middle-income country performs outstandingly in health-related indicators on a par with the developed world. Continuous political commitment, together with dedication of health professionals, has still been unable to reach the desired level in nutritional indicators. The possibility of improving maternal nutrition without being an economical burden to the country is worthy of study. The objective of this study was to improve the dietary diversity of pregnant mothers through nutritional counselling in the Kalutara district. The study was a cluster randomized community trial (n= 270 per arm) conducted in two phases. The first phase was a nutritional counselling training to the intervention group PHMM; the second phase was intervening to change the diet of pregnant mother through PHMM. Pregnant mothers were recruited to the study before 12 weeks of gestation and followed up until the delivery to assess the birth outcome. During pregnancy, PHMM intervened with the pregnan...

Cochrane Database of Systematic Reviews, 2020

Trusted evidence. Informed decisions. Better health.

Preparedness of Health System in Providing Continuous Health Care: A Case Study From Sri Lanka

World Academy of Science, Engineering and Technology, International Journal of Medical and Health Sciences, 2018

Stroke, 2020

Review question Does organised inpatient (stroke unit) care improve the recovery of people with ... more Review question
Does organised inpatient (stroke unit) care improve the recovery of people with stroke in hospital compared with conventional care in
general wards?
Background
Organised inpatient (stroke unit) care is a form of care provided in hospital by nurses, doctors, and therapists who specialise in looking
aIer people with stroke. They aim to work as a co-ordinated team to provide the most appropriate care tailored to the needs of individual
people with stroke.
Study characteristics
Organised inpatient (stroke unit) care for stroke: network meta-analysis (Review)
Copyright © 2020 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

2

Cochrane
Library

Trusted evidence.
Informed decisions.
Better health. Cochrane Database of Systematic Reviews
We identified 29 trials involving 5902 participants (search completed 2 April 2019). Participants who were recruited had had a recent stroke
and required admission to hospital. Organised inpatient (stroke unit) care was provided in a variety of ways including stroke ward (care
provided in a discrete stroke ward), mixed rehabilitation ward (setting seeking to improve care for people with stroke within a mixed
rehabilitation ward), and mobile stroke team (peripatetic team looking aIer people with stroke across a range of wards).
Key results
At an average of 12 months aIer their stroke, people who received organised inpatient (stroke unit) care were more likely to be alive (an
extra two people surviving for every 100 receiving stroke unit care; moderate-quality evidence) and living at home (an extra six patients for
every 100 receiving stroke unit care; moderate-quality evidence). They also were more likely to be independent in daily activities (an extra
six patients for every 100 receiving stroke unit care; moderate-quality evidence). The apparent benefits were seen in men and women,
older and younger patients, and people with diEerent types of stroke and diEerent stroke severity. Benefits were most obvious when the
stroke unit was based in a discrete stroke ward.
Quality of the evidence
We downgraded the quality of evidence to 'moderate' for the main outcomes because it was impossible to hide the treating service from
participants or healthcare workers. These conclusions were not dependent on trials judged to be of lower quality because of poor design

or missing data. More information was missing for some of the other outcome measures and analyses, which we have downgraded to low-
quality evidence.

Conclusion
People with stroke who receive organised inpatient(stroke unit) care are more likely to be alive, living at home, and independentin looking
aIerthemselves one year aIertheir stroke. Apparent benefits were seen across a broad range of people with stroke. Various types of stroke
units have been developed. The best results appear to come from stroke units based in a dedicated stroke ward.

Expert Review of Molecular Diagnostics, 2021

ABSTRACT Introduction Oral squamous cell carcinoma (OSCC) and oral potentially malignant disorder... more ABSTRACT Introduction Oral squamous cell carcinoma (OSCC) and oral potentially malignant disorders (OPMD) are a significant health burden globally. Smoking, alcohol, and betel quid are the main risk factors. Lack of screening methods has been highlighted as a significant challenge in management. Salivary biomarkers are proposed as noninvasive diagnostic tools. The aim of this systematic review was to study salivary biomarkers reported in OSCC and OPMD. Specific objectives were to select a salivary biomarker panel suitable for early detection of OSCC and OPMD and to assess relationships between salivary biomarkers and risk factors. Methods Electronic literature search was conducted in academic databases (Scopus, Medline, Embase and Web of Science) without any restrictions. Following calibration, two blinded reviewers screened the studies and extracted data. A risk of bias assessment was conducted using Newcastle Ottawa scale. 295 studies were included with descriptive data analysis. Expert opinion A salivary biomarker panel including Interleukin (IL) 1β, IL6, and IL8 was selected for OSCC and OPMD. Reported relationships between salivary biomarkers and risk factors are discussed and research gaps are highlighted. Future research should be directed to assess potential salivary biomarkers and their relationships to risk factors in order to understand the biomarker’s role in disease initiation.

Introduction: Brachial plexus birth injuries (NBPI) are occurs during difficult labour mostly in ... more Introduction: Brachial plexus birth injuries (NBPI) are occurs during difficult labour mostly in large babies. Many children with brachial plexus birth injury develop shoulder problems with subsequent joint deformities of upper limb without treatment. Occupational Therapist assess, plan and intervene the therapeutic management to prevent contractures and deformities and improve the active range of motion to promote the clients activities of daily living and instrumental activities of daily living.
Objectives:To assess the effectiveness of occupational therapy for shoulder joint after neonatal brachial plexus injury
Methodology:This study is a pre and post assessment of function of shoulder joint. Study was carried out in Occupational Therapy Unit, Plastic and Reconstructive Unit, National Hospital of Sri Lanka. 36 patients regularly attend to the unit over 2 years were assessed using “Mallet Scale”. A self administrative questionnaire also was administrated to mothers of above children to identify selected factors contribute for continuation of treatment.
Results: Children were coming from all over the country and over 95° parents are satisfied with the improvements gained. Parents spend average of Rs.2000/= for one visit and many children are brought to the hospital once a week for exercises. Over 75% mothers are educated over grade 10 and capable of continuing exercises at home. Mean birth weight of affected children was 3617.5 g only 03% of caesarean deliveries are affected. Shoulder abduction. External rotation, hand to nape, hand to back, hand to pocket and hand to mouth all had highly significant improvements when analysed using paired t –test.(p<0.000 in each).
Conclusion and/or Recommendations: Occupational therapy is an effective mode of treatment mode. We recommend expanding the services to all teaching and general hospital where an occupational therapist available as the out of pocket expenses are high in attending National Hospital from all over the country and need long term treatment.
Keywords: Brachial Plexus, Birth injury, Mallet Scale

Future of Business and Finance, 2021

Dietary Diversity of Pregnant Mothers in a Semi-Urban Setting: Sri Lanka

World Academy of Science, Engineering and Technology, International Journal of Medical and Health Sciences, 2018

International Journal of Dental Medicine, 2018

Introduction: The negative health effects of dental caries are cumulative, tracking from childhoo... more Introduction: The negative health effects of dental caries are cumulative, tracking from childhood to adulthood and most dental caries is now occurring in adults [1-3]. Oral diseases such as dental caries, gingivitis, and periodontal diseases can occur during pregnancy [4-9]. This study was carried out in Medical officer of health (MOH) area, Ambalantota, Sri Lanka. 363 pregnant women in first visit attending antenatal clinic were recruited. Written informed consent was obtained from all subjects who agreed to take part in the study. Ethical approval was taken from faculty of Medicine, University of Ruhuna. Prior to a dental examination, demographic information regarding age, education, occupation, socioeconomic status and residence were obtained from the participants using interviewer administered questionnaire. Findings of dental examination were entered examination table separately. The mean DMFT among antenatal women was 3.8 ± 5.17, with 3.27 (± 2.31) decayed teeth, 1.85 (± 1.87) missing teeth, and 1.4 (± 1.4) filled teeth. Results were shown in table 3 with binary logistic analysis of DMFT for the overall sample of 363 pregnant women. The final model explained 6.3% to 8.4% of DMFT variation (dependant variable) with variation of independent variables (educational level up to Ordinary level, Sinhla over non-sinhala, income over 30,000, knowledge on dental services free by government and ever taken treatment) and the p-value for Hosmer-Lemeshow test of goodness of fit was 0.957, which indicated an acceptable fit of the model. In the final model significant predictors were Sinhala: Non-sinhala (adjusted OR [95% CI]: 5.67 [1.25-25.99], p=0.026) and "ever taken treatment for dental diseases"(Yes vs No: adjusted OR [95% CI]: 0.432 [0.274-0.680], p<0.0001). In this study, pregnant women in Ambalantota MOH area were found to have a significantly higher DMFT value among Sinhala women over Non-Sinhala women and similarly significantly lower DMFT value among pregnant women who sought treatment for their dental diseases against women who did not.

Behavior change through counselling to improve dietary diversity of pregnant mothers: A lesson from Sri Lanka

Sri Lanka as a middle-income country performs outstandingly in health-related indicators on a par... more Sri Lanka as a middle-income country performs outstandingly in health-related indicators on a par with the developed world. Continuous political commitment, together with dedication of health professionals, has still been unable to reach the desired level in nutritional indicators. The possibility of improving maternal nutrition without being an economical burden to the country is worthy of study. The objective of this study was to improve the dietary diversity of pregnant mothers through nutritional counselling in the Kalutara district. The study was a cluster randomized community trial (n= 270 per arm) conducted in two phases. The first phase was a nutritional counselling training to the intervention group PHMM; the second phase was intervening to change the diet of pregnant mother through PHMM. Pregnant mothers were recruited to the study before 12 weeks of gestation and followed up until the delivery to assess the birth outcome. During pregnancy, PHMM intervened with the pregnan...

Cochrane Database of Systematic Reviews, 2020

Trusted evidence. Informed decisions. Better health.

Preparedness of Health System in Providing Continuous Health Care: A Case Study From Sri Lanka

World Academy of Science, Engineering and Technology, International Journal of Medical and Health Sciences, 2018

Stroke, 2020

Review question Does organised inpatient (stroke unit) care improve the recovery of people with ... more Review question
Does organised inpatient (stroke unit) care improve the recovery of people with stroke in hospital compared with conventional care in
general wards?
Background
Organised inpatient (stroke unit) care is a form of care provided in hospital by nurses, doctors, and therapists who specialise in looking
aIer people with stroke. They aim to work as a co-ordinated team to provide the most appropriate care tailored to the needs of individual
people with stroke.
Study characteristics
Organised inpatient (stroke unit) care for stroke: network meta-analysis (Review)
Copyright © 2020 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

2

Cochrane
Library

Trusted evidence.
Informed decisions.
Better health. Cochrane Database of Systematic Reviews
We identified 29 trials involving 5902 participants (search completed 2 April 2019). Participants who were recruited had had a recent stroke
and required admission to hospital. Organised inpatient (stroke unit) care was provided in a variety of ways including stroke ward (care
provided in a discrete stroke ward), mixed rehabilitation ward (setting seeking to improve care for people with stroke within a mixed
rehabilitation ward), and mobile stroke team (peripatetic team looking aIer people with stroke across a range of wards).
Key results
At an average of 12 months aIer their stroke, people who received organised inpatient (stroke unit) care were more likely to be alive (an
extra two people surviving for every 100 receiving stroke unit care; moderate-quality evidence) and living at home (an extra six patients for
every 100 receiving stroke unit care; moderate-quality evidence). They also were more likely to be independent in daily activities (an extra
six patients for every 100 receiving stroke unit care; moderate-quality evidence). The apparent benefits were seen in men and women,
older and younger patients, and people with diEerent types of stroke and diEerent stroke severity. Benefits were most obvious when the
stroke unit was based in a discrete stroke ward.
Quality of the evidence
We downgraded the quality of evidence to 'moderate' for the main outcomes because it was impossible to hide the treating service from
participants or healthcare workers. These conclusions were not dependent on trials judged to be of lower quality because of poor design

or missing data. More information was missing for some of the other outcome measures and analyses, which we have downgraded to low-
quality evidence.

Conclusion
People with stroke who receive organised inpatient(stroke unit) care are more likely to be alive, living at home, and independentin looking
aIerthemselves one year aIertheir stroke. Apparent benefits were seen across a broad range of people with stroke. Various types of stroke
units have been developed. The best results appear to come from stroke units based in a dedicated stroke ward.

Expert Review of Molecular Diagnostics, 2021

ABSTRACT Introduction Oral squamous cell carcinoma (OSCC) and oral potentially malignant disorder... more ABSTRACT Introduction Oral squamous cell carcinoma (OSCC) and oral potentially malignant disorders (OPMD) are a significant health burden globally. Smoking, alcohol, and betel quid are the main risk factors. Lack of screening methods has been highlighted as a significant challenge in management. Salivary biomarkers are proposed as noninvasive diagnostic tools. The aim of this systematic review was to study salivary biomarkers reported in OSCC and OPMD. Specific objectives were to select a salivary biomarker panel suitable for early detection of OSCC and OPMD and to assess relationships between salivary biomarkers and risk factors. Methods Electronic literature search was conducted in academic databases (Scopus, Medline, Embase and Web of Science) without any restrictions. Following calibration, two blinded reviewers screened the studies and extracted data. A risk of bias assessment was conducted using Newcastle Ottawa scale. 295 studies were included with descriptive data analysis. Expert opinion A salivary biomarker panel including Interleukin (IL) 1β, IL6, and IL8 was selected for OSCC and OPMD. Reported relationships between salivary biomarkers and risk factors are discussed and research gaps are highlighted. Future research should be directed to assess potential salivary biomarkers and their relationships to risk factors in order to understand the biomarker’s role in disease initiation.

Introduction: Brachial plexus birth injuries (NBPI) are occurs during difficult labour mostly in ... more Introduction: Brachial plexus birth injuries (NBPI) are occurs during difficult labour mostly in large babies. Many children with brachial plexus birth injury develop shoulder problems with subsequent joint deformities of upper limb without treatment. Occupational Therapist assess, plan and intervene the therapeutic management to prevent contractures and deformities and improve the active range of motion to promote the clients activities of daily living and instrumental activities of daily living.
Objectives:To assess the effectiveness of occupational therapy for shoulder joint after neonatal brachial plexus injury
Methodology:This study is a pre and post assessment of function of shoulder joint. Study was carried out in Occupational Therapy Unit, Plastic and Reconstructive Unit, National Hospital of Sri Lanka. 36 patients regularly attend to the unit over 2 years were assessed using “Mallet Scale”. A self administrative questionnaire also was administrated to mothers of above children to identify selected factors contribute for continuation of treatment.
Results: Children were coming from all over the country and over 95° parents are satisfied with the improvements gained. Parents spend average of Rs.2000/= for one visit and many children are brought to the hospital once a week for exercises. Over 75% mothers are educated over grade 10 and capable of continuing exercises at home. Mean birth weight of affected children was 3617.5 g only 03% of caesarean deliveries are affected. Shoulder abduction. External rotation, hand to nape, hand to back, hand to pocket and hand to mouth all had highly significant improvements when analysed using paired t –test.(p<0.000 in each).
Conclusion and/or Recommendations: Occupational therapy is an effective mode of treatment mode. We recommend expanding the services to all teaching and general hospital where an occupational therapist available as the out of pocket expenses are high in attending National Hospital from all over the country and need long term treatment.
Keywords: Brachial Plexus, Birth injury, Mallet Scale