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Prasadi G, Senarathna L, Dharmaratne SD, Mohamed F, Jayasinghe SS, Dawson A. Mothers' ability to determine and measure paracetamol doses for children-a contrived observational study. J Child Health Care 2023; 27:105-115. [PMID: 34719983 DOI: 10.1177/13674935211046101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Caregivers are primarily responsible for the administration of Over The Counter (OTC) medications in children. This study examines the mothers' ability to determine and measure paracetamol doses for children aged between 1 and 5 years. A contrived observational study was conducted for mothers of preschool aged children at two Public Health Midwifery (PHM) areas in Southern province, Sri Lanka. Stratified random sampling was used. Only 26.9% (n = 95, 95% CI = 22.5%-31.7%) of the 353 participants correctly determined and measured the doses of paracetamol. Errors were frequently made in both determining and measuring dose together (n = 113, 32.0%, 95% CI = 27.3%-37.1%), determining only (n = 94, 26.6%, 95% CI = 22.2%-31.5%) and measurement only (n = 51, 14.4%, 95% CI = 11.1%-18.5%). Dose determined errors were not significantly associated with maternal education, number of children in the family, total monthly income and age of the index child. Similarly measuring errors were not significantly associated with mothers' education, income of the family and number of children in the family. However, there was a weak positive correlation between measuring errors and age of the index child. The study suggests that mothers made errors when determining doses and measuring doses of paracetamol. Results emphasize importance of clear, concise guardian information leaflet and healthcare professionals' guidance to minimize dosing errors of child medication.
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Affiliation(s)
- Gam Prasadi
- South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, 54692University of Peradeniya, Peradeniya, Sri Lanka.,Department of Pharmacy, Faculty of Allied Health Sciences, 54687University of Ruhuna, Galle, Sri Lanka
| | - L Senarathna
- South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, 54692University of Peradeniya, Peradeniya, Sri Lanka.,Department of Health Promotion, Faculty of Applied Sciences, 127432Rajarata University, Mihintale, Sri Lanka.,School of Public Health of the University of Sydney, Sydney, NSW, Australia
| | - S D Dharmaratne
- Department of Community Medicine, Faculty of Medicine, 54692University of Peradeniya, Peradeniya, Sri Lanka.,Department of Health Metrics Sciences, Institute for Health Metrics and Evaluation, School of Medicine, University of Washington, USA.,Department of Family and Community Medicine, College of Medicine, University of Kentucky, Lexington, KY, USA
| | - F Mohamed
- South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, 54692University of Peradeniya, Peradeniya, Sri Lanka.,Department of Pharmacy, Faculty of Allied Health Sciences, 54692University of Peradeniya, Peradeniya, Sri Lanka.,Faculty of Medicine and Health, Biomedical informatics and Digital Health, Clinical Pharmacology and Toxicology Research Group, University of Sydney, Sydney, NSW, Australia.,National Poison Centre, 54687Universiti Sains Malaysia, Penang, Malaysia
| | - S S Jayasinghe
- Department of Pharmacology, Faculty of Medicines, 4334University of Ruhuna, Galle, Sri Lanka
| | - A Dawson
- South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, 54692University of Peradeniya, Peradeniya, Sri Lanka.,Central Clinical School, University of Sydney, Sydney, NSW, Australia.,569777New South Wales Poisons Information Centre, Sydney Children's Hospital Network, Sydney, Australia
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De Silva PMCS, Gunasekara TDKSC, Gunarathna SD, Sandamini PMMA, Pinipa RAI, Ekanayake EMDV, Thakshila WAKG, Jayasinghe SS, Chandana EPS, Jayasundara N. Urinary Biomarkers of Renal Injury KIM-1 and NGAL: Reference Intervals for Healthy Pediatric Population in Sri Lanka. Children (Basel) 2021; 8:children8080684. [PMID: 34438575 PMCID: PMC8391325 DOI: 10.3390/children8080684] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 08/02/2021] [Accepted: 08/05/2021] [Indexed: 01/08/2023]
Abstract
Emerging renal biomarkers (e.g., kidney injury molecule-1 (KIM-1) and neutrophil gelatinase-associated lipocalin (NGAL)) are thought to be highly sensitive in diagnosing renal injury. However, global data on reference intervals for emerging biomarkers in younger populations are lacking. Here, we aimed to determine reference intervals for KIM-1 and NGAL across a pediatric population in Sri Lanka; a country significantly impacted by the emergence of chronic kidney disease of unexplained etiology (CKDu). Urine samples were collected from children (10–18 years) with no prior record of renal diseases from the dry climatic zone of Sri Lanka (N = 909). Urinary KIM-1 and NGAL concentrations were determined using the enzyme-linked immunosorbent assay (ELISA) and adjusted to urinary creatinine. Biomarker levels were stratified by age and gender, and reference intervals derived with quantile regression (2.5th, 50th, and 97.5th quantiles) were expressed at 95% CI. The range of median reference intervals for urinary KIM-1 and NGAL in children were 0.081–0.426 ng/mg Cr, 2.966–4.850 ng/mg Cr for males, and 0.0780–0.5076 ng/mg Cr, 2.0850–3.4960 ng/mg Cr for females, respectively. Renal biomarkers showed weak correlations with age, gender, ACR, and BMI. Our findings provide reference intervals to facilitate screening to detect early renal damage, especially in rural communities that are impacted by CKDu.
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Affiliation(s)
- P. Mangala C. S. De Silva
- Department of Zoology, Faculty of Science, University of Ruhuna, Matara 81000, Sri Lanka; (P.M.C.S.D.S.); (T.D.K.S.C.G.); (S.D.G.); (P.M.M.A.S.); (R.A.I.P.); (E.M.D.V.E.); (W.A.K.G.T.)
| | - T. D. K. S. C. Gunasekara
- Department of Zoology, Faculty of Science, University of Ruhuna, Matara 81000, Sri Lanka; (P.M.C.S.D.S.); (T.D.K.S.C.G.); (S.D.G.); (P.M.M.A.S.); (R.A.I.P.); (E.M.D.V.E.); (W.A.K.G.T.)
| | - S. D. Gunarathna
- Department of Zoology, Faculty of Science, University of Ruhuna, Matara 81000, Sri Lanka; (P.M.C.S.D.S.); (T.D.K.S.C.G.); (S.D.G.); (P.M.M.A.S.); (R.A.I.P.); (E.M.D.V.E.); (W.A.K.G.T.)
| | - P. M. M. A. Sandamini
- Department of Zoology, Faculty of Science, University of Ruhuna, Matara 81000, Sri Lanka; (P.M.C.S.D.S.); (T.D.K.S.C.G.); (S.D.G.); (P.M.M.A.S.); (R.A.I.P.); (E.M.D.V.E.); (W.A.K.G.T.)
| | - R. A. I. Pinipa
- Department of Zoology, Faculty of Science, University of Ruhuna, Matara 81000, Sri Lanka; (P.M.C.S.D.S.); (T.D.K.S.C.G.); (S.D.G.); (P.M.M.A.S.); (R.A.I.P.); (E.M.D.V.E.); (W.A.K.G.T.)
| | - E. M. D. V. Ekanayake
- Department of Zoology, Faculty of Science, University of Ruhuna, Matara 81000, Sri Lanka; (P.M.C.S.D.S.); (T.D.K.S.C.G.); (S.D.G.); (P.M.M.A.S.); (R.A.I.P.); (E.M.D.V.E.); (W.A.K.G.T.)
- Department of Biomedical Sciences, School of Medicine and Health Sciences, University of North Dakota, Grand Forks, ND 58203, USA
| | - W. A. K. G. Thakshila
- Department of Zoology, Faculty of Science, University of Ruhuna, Matara 81000, Sri Lanka; (P.M.C.S.D.S.); (T.D.K.S.C.G.); (S.D.G.); (P.M.M.A.S.); (R.A.I.P.); (E.M.D.V.E.); (W.A.K.G.T.)
| | - S. S. Jayasinghe
- Department of Pharmacology, Faculty of Medicine, University of Ruhuna, Galle 80000, Sri Lanka;
| | - E. P. S. Chandana
- Department of Biosystems Technology, Faculty of Technology, University of Ruhuna, Matara 81000, Sri Lanka;
| | - Nishad Jayasundara
- The Nicholas School of the Environment, Duke University, Durham, NC 27708, USA
- Correspondence:
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Hettihewa LM, Jayasinghe SS, Imendra KG, Weerarathna TP. Correlation between changes of blood pressure with insulin resistance in type 2 diabetes mellitus with 4 weeks of pioglitazone therapy. Int J Diabetes Dev Ctries 2011; 28:26-30. [PMID: 19902036 PMCID: PMC2772002 DOI: 10.4103/0973-3930.41983] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVE: To examine effects of pioglitazone (PIO) on systolic, diastolic, pulse and mean blood pressures (SBP, DBP, PP and MP, respectively) in type 2 diabetes mellitus (T2DM). MATERIALS AND METHODS: One hundred and six normotensive patients with T2DM with mean fasting blood glucose (FBS; 183 ± 6 mg/dl) were randomly divided into two groups. Test group was treated with 15 mg of PIO in addition to metformin 500 mg three times per day in both groups. SBP, DBP, PP and MP and fasting insulin, FBS and lipid profiles were measured before and after PIO therapy. RESULTS: There was a significant reduction in SBP (123 ± 2 vs. 118 ± 2 mmHg, P < 0.05), PP (41 ± 1 vs. 37 ± 1 mmHg, P < 0.05), and MP (95 ± 1 vs. 91 ± 1, P < 0.05). Clinical reduction in DBP was observed but not significant (82 ± 2 vs. 81 ± 1 mmHg, P > 0.05). There was a significant correlation between decline in SBP and DBP with respective baseline values (r = 0.76, P < 0.001 and r = 0.62, P < 0.001, respectively). Changes in PP and MP strongly correlated with baseline values (r = 0.51, P < 0.05 and r = 0.56, P < 0.05, respectively). There was a parallel reduction of FBS (183 ± 2 vs. 121 ± 3, P < 0.001) but reduction in IR or lipid profiles was not significant in test group. Changes in BP were not significant in control group ( P > 0.05). CONCLUSION: PIO treatment of T2DM showed early reduction of SBP and MP within first 4 weeks. Results suggest that pharmacodynamic effects of PIO mainly affect the systolic component. We hereby suggest that reduction of BP by PIO is independent from mechanisms of changes in IR and dyslipidaemia in normotensive diabetic patients.
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