COVID-19 was declared a pandemic by WHO on March 11, 2020, the first non-influenza pandemic, affecting more than 200 countries and areas, with more than 5·9 million cases by May 31, 2020. Countries have developed strategies to deal with the COVID-19 pandemic that fit their epidemiological situations, capacities, and values.This section is intended for clinicians caring for COVID-19 patients during all phases of their disease, at district hospitals.
There is an increasing demand on doctors to be better and more effective communicators. This is in line with the understanding that curing patients requires a holistic approach. It is far more than the correct treatment at correct time. Studies have proved that, an effective doctor-patient communication has a positive relationship with the higher rates of patient recovery, therapy compliance, and lower rates of medical malpractice.
Epidemiology is the study and analysis of the distribution, patterns and determinants of health and disease conditions in defined populations. It is a cornerstone of public health, and shapes policy decisions and evidence-based practice by identifying risk factors for disease and targets for preventive healthcare.
Research methodology is the specific procedures or techniques used to identify, select, process, and analyze information about a topic. In a research paper, the methodology section allows the reader to critically evaluate a study's overall validity and reliability.
Medical writing involves writing scientific documents of different types which include regulatory and research-related documents, disease or drug-related educational and promotional literature, publication articles like journal manuscripts and abstracts, content for healthcare websites, health-related magazines or news articles. The scientific information in these documents needs to be presented to suit the level of understanding of the target audience, namely, patients or general public, physicians or the regulators.
Medical humanities is an interdisciplinary field of medicine which includes the humanities such as philosophy, ethics, history, and religion), social science (psychology, sociology, anthropology) and the arts and their application to medical education and practice. Medical humanities can be instrumental in nurturing qualities of compassionate care, professionalism and ethics in healthcare professionals.
Coronary artery disease (CAD) is the leading cause of death in Sri Lanka. For comparison, CAD accounts for only 17% of deaths in the US and UK. Exponential increase in hospitalization is projected for three diseases: heart disease 29%, diabetes 36%, and high blood pressure 40%. Diabetes and CAD are estimated to be the leading cause of morbidity and mortality in the coming years.The CAD risk factors are increasing.
In CKD, until 50% of the kidney function is lost, the patient might not show any symptom of kidney disease. As such, it is vital that the doctor should suspect and investigate the patients for kidney disease. It has been shown that early detection and treatment of CKD, prevents or delays the progression of the CKD to end-stage renal failure which requires dialysis or a kidney transplant.
Diabetes mellitus, which was once considered a disease of the developed world, has become a worldwide pandemic, with two thirds of the global diabetic population living in the developing countries. Local studies show a definite upward trend in the prevalence of diabetes mellitus. Wider preventive programmes need to be urgently implemented to stem the tide.
Noncommunicable diseases (NCDs), also known as chronic diseases, tend to be of long duration and are the result of a combination of genetic, physiological, environmental and behaviours factors. NCDs including heart disease, stroke, cancer, diabetes and chronic lung disease, are collectively responsible for almost 70% of all deaths worldwide. Almost three quarters of all NCD deaths, and 82% of the 16 million people who died prematurely, or before reaching 70 years of age, occur in low- and middle-income countries.
Dengue is an epidemic disease which has periodic outbreak. For an example, Sri Lanka experienced an outbreak of dengue with the highest number of cases being reported in 2017 with more than 186101 cases and some 440 deaths. As a strategy to combat these epidemics the Ministry of health and WHO decided that a comprehensive training module on dengue control was necessary that would benefit all the government officials and members of the public whose cooperation was necessary for dengue control activities.
- Teacher: Sudath Samaraweera
Sri Lanka is considered as a country with a high incidence of leptospirosis and it is a disease with a relatively high case fatality rate. Therefore it is important to stay up to date on the current management of the disease.
- Teacher: Dr Upeksha Samarakoon
Sri Lanka is among the low TB prevalence countries in the South East Asia region. The estimated prevalence rate of all forms of TB was 103 per 100,000 population. Sri Lanka has reached & sustained the target of 85% treatment success rate among all new TB cases since 2004.
- Teacher: Dr Upeksha Samarakoon
Throughout the history, influenza pandemics have occurred approximately every 10‐50 years
often causing catastrophic loss of life and significant economic and social impact. In the 20th
century, there were three pandemics; in 1918 (H1N1), 1957 (H2N2), and 1968 (H3N2). Avian influenza caused by H5N1 virus has been widely reported across South East Asia since
December 2003 and it is now well established in the region’s poultry populations. H5N1 virus
which is highly pathogenic has expanded its geographical spread across the globe.
- Teacher: Dr Upeksha Samarakoon
Risk of Dengue exists
throughout the country and transmission occurs year-round. There are two peak
seasons for Dengue transmission in Sri Lanka: from October to December and from
May to July. The most affected areas include Colombo, Galle, Kalutara, Kandy,
Ratnapura, and Gampaha
- Teacher: Anuruddhika Rathnayake
WHO capacity building course on Trauma Care System Planning and Management.
WHO capacity building course on Trauma care quality improvement.
WHO capacity building course on Child Injury Prevention.
Trauma sustained through various mechanisms is a leading cause of death and injury around the world. Most of the injuries are preventable and it is essential that health care professionals are competent in both prevention and treatment of these injuries to minimize the impact and maximize the recovery process.
- Teacher: Anuruddhika Rathnayake
Hematology, also spelled haematology, is the branch of medicine concerned with the study of the cause, prognosis, treatment, and prevention of diseases related to blood. It involves treating diseases that affect the production of blood and its components, such as blood cells, haemoglobin, blood proteins, bone marrow, platelets, blood vessels, spleen, and the mechanism of coagulation.
- Teacher: Saroj Jayasinghe
Medical ethics is a system of moral principles that apply values to the practice of clinical medicine and in scientific research. These values include the respect for autonomy, non-maleficence, beneficence, and justice. Field of medical ethics continues to develop and change throughout history and the respected codes of conduct spans from the Hippocratic Oath which dates back to the fifth century BCE to the more recent ones such as the Declaration of Helsinki (1964) and The Nuremberg Code (1947).
According to the British Medical Journal, "Clinical governance" is defined as “A framework through which NHS organisations are accountable for continuously improving the quality of their services and safe-guarding high standards of care by creating an environment in which excellence in clinical care will flourish.” The seven pillars of Clinical Governance are clinical effectiveness, risk management, patient experience and involvement, communication, resource effectiveness, strategic effectiveness, and learning effectiveness.
- Teacher: Rasnayake Mudiyanse
High hospital performance relies on medical administrators to efficiently and effectively manage healthcare services and this requires competent teams covering a wide skillset. A good hospital administrator needs to develop skills in a wide range of domains including leadership, communication and relationship management, professional and social responsibility, health and healthcare environment and business.
In Sri Lanka the number new clinic attendees in STD clinics for suspected STDs for the year 2018 was 26245. This was according to the National STD/AIDS control programme in Sri Lanka. Therefore it is important to be educated about the preventive aspects as well as the management of STDs.
WHO capacity building course on Intimate Partner Violence.
Maternal and child health services in Sri Lanka has a very long history, which dates back to the early 20th century. Sri Lanka has been able to achieve significant progress during the past few decades with marked reductions in maternal and infant mortality rates.
Psychoactive substance use and substance use disorders (SUDs) continue to be major problems around the world, taking a toll on global health and on social and economic functioning. The United Nations Office on Drugs and Crime (UNODC) reports that, in 2014, some 247 million people between ages 15 and 64 had used illicit substances1 at least once in the previous year.
Having overcome a three decade long terrorist conflict, Sri Lanka has begun its “transformation towards a sustainable and resilient society”. UN has recognized Sri Lanka among “high human development” achieved countries. Yet many challenges are to be encountered and many areas need to be progressed.
Breast cancer is the commonest cancer reported in Sri Lanka and it accounted for 24% of all new cancer cases in females in year 2018 according to the WHO. Therefore it is essential for the doctors in the country to stay up to date on the prevention, early detection and management of the disease.
Cervical cancer is the second most frequent cancer in the women of Sri Lanka. It is estimated that every year 643 women die from the disease in the country. Several strategies are in place in the health care sector for the prevention, early detection and the management of the condition. These include the recently started HPV vaccination programme and the Pap smear test which has been available through the well women clinics for years.
The emergency health care providers in the country should be competent in managing unscheduled patients of all ages presenting with any medical condition requiring immediate medical attention. They should be efficient in triaging, resuscitation and stabilization of the patients to allow for the definite management. The emergency patient care is a rapidly developing sector in Sri Lanka with the intention of providing the best possible care to the patients.
Dermatology is the branch of medicine dealing with the skin and its diseases,a unique specialty with both medical and surgical aspects. A dermatologist takes care of diseases,in the widest sense, and some cosmetic problems of the skin, scalp, hair, and nails
- Teacher: Dr Indira Kahawita
This course provides readers with a firm foundation in
neuroscience concepts to make timely diagnostic,
treatment, and referral decisions about common symptoms, including
chronic pain, headache, seizures, numbness, and dizziness.
- Teacher: Padma Gunaratne
Gastroenterology covers a wide area of diseases from the common ones such as gastro-oesophageal reflux disease to rare diseases requiring specialist care. The management of gastroenterological diseases have developed rapidly during recent times.
Alcoholic liver disease causes a high disease burden to the Sri Lankan health care services. There is also an increasing incidence of Non-alcoholic fatty liver disease (NAFLD). Viral hepatitis is another important disease spectrum encountered in hospitals.
Psychiatry is the branch of medicine focused on the diagnosis, treatment and prevention of mental, emotional and behavioral disorders. People seek psychiatric help for many reasons. Psychiatrists provide psychological treatment, prescribe medications and do procedures such as electroconvulsive therapy.
The reported suicide rate in Sri Lanka by the world population review for 2018 was at 14.6 per 100,000 population. This ranks Sri Lanka 29th among 157 countries. The doctors of the country should be the forerunners in working for the prevention of suicides by debunking the myths in the society about suicide, identifying features of depression, maximizing the support available for those in need and effectively treating mental health disorders.
The surgical specialty of plastic surgery can be divided in to two main areas. Which are reconstructive surgeries and the cosmetic surgeries. While reconstructive surgery aims to reconstruct a part of the body or improve its functioning the cosmetic (or aesthetic) surgery aims at improving the appearance of it. The recent development of cosmetic surgeries in the country have unlocked a new set opportunities to the public.
- Teacher: Dr Yasas Abeywickrama
Family medicine, formerly family practice, is a medical specialty devoted to comprehensive health care for people of all ages. The specialist is named a family physician or family doctor. In Europe, the discipline is often referred to as general practice and a practitioner as a general practice doctor or GP.
Nephrotic syndrome which presents with the triad of generalized oedema, low serum albumin level and hyperlipidemia is the commonest childhood glomerular disorder.
Diseases related to respiratory system are one of the most commonly encountered problems, both in general practice and in the hospital setting. Therefore it is important to be aware of the latest guild lines and the new developments in the field of pulmonology.
The field of ophthalmology deals with a wide range of disease conditions spanning from refractory errors to glaucoma. At the same time many systemic diseases may also manifest as ophthalmological conditions. There are a wide range of management options available to ophthalmologists as well, including surgery, laser treatment and other medication.
A wide range of diseases that affect the joints, muscles and bones are dealt with in rheumatology. These include many types of arthritis which are regularly encountered and the rarer autoimmune disease conditions such as SLE and systemic sclerosis. The field is also closely linked with the processes of rehabilitation through occupational therapy and physiotherapy.
- Teacher: Chiranthi Liyanage