Pesticide poisoning: a major health problem in Sri Lanka

Acute pesticide poisoning is a major public health problem in Sri Lanka. In several agricultural districts, it precedes all other causes of death in government hospitals. Most of the acute poisoning cases are intentional (suicide) and occur among young adults, mainly males. Poisoning due to occupational exposure is also common, but less well documented. In an irrigation area in Sri Lanka a very high incidence of serious pesticide poisoning was observed, with 68% due to intentional ingestion of liquid pesticides. It is argued that the easy availability and widespread use of highly hazardous pesticides is the most important reason for this high number of poisoning cases. The frequent application of highly hazardous pesticides in high concentrations was often irrational and posed serious health and financial risks to the farmers. Sales promotion activities and credit facilities promoted this excessive pesticide use, which was not counteracted by an agricultural extension service. Hazardous practices when spraying pesticides were due to the impossibility of applying recommended protective measures under the local conditions, rather than to lack of knowledge. Current emphasis on programs that promote the safe use of pesticides through education and training of farmers will be ineffective in Sri Lanka because knowledge is already high and most poisoning cases are intentional. Instead, enforcement of legislation to restrict availability of the most hazardous pesticides would result in an immediate health benefit. Improved agricultural extension services to promote alternative non-chemical methods of pest control is the most important strategy, in the long term, to prevent acute pesticide poisoning.     

Fertility trends in Sri Lanka and future prospects

Effects of reciprocal forebrain transplantation on the embryonic motility and the hatching behavior in the chick and the duck embryos were studied. The forebrains were transplanted before the establishment of circulation. The grafted tissue formed the telencephalon, diencephalon, eyes, upper beak and part of the cranium. Data indicate that the size of the forebrain has no significant influence on the early embryonic motility (Type I and II) in the chick and the duck embryos. The initiation and maintenance of the pre-hatching behavior (Type III motility) does not reside in the forebrain. The final stage of hatching (climax) on the other hand may be controlled by the forebrain.     

Injuries due to antipersonnel land mines in Sri Lanka

This series comprises 191 victims injured by antipersonnel land mines in the North-east of Sri Lanka. The pattern of mine injuries is described and the injuries to the lower limb are classified according to the level of injury. Injuries to the lower limb were the commonest and over 73% required a below knee amputation. Recommendations are made for the improved care of these victims. The socio-economic effects of mines experienced by other countries affected by internal conflicts are described. The preventive measures that could be taken to avert such a situation in Sri Lanka are stressed.     

Sri Lanka. Political violence and ethnic conflict

In recent years, Sri Lanka has experienced 2 violent rebellions in which youths have played a prominent role, 1 in the majority Sinhala community and 1 in the minority Tamil community. The former was crushed, but the latter remains ongoing, with the Liberation Tigers of Tamil Eelam, who claim to represent the Tamil minority, battling the Sinhala-dominated government. Prospects for peace in the short- and medium term appear poor. These events have generated an impressive body of interdisciplinary interpretation, but several important topics have received relatively little attention. Most ongoing research is being carried out by anthropologists, historians, and political scientists, but psychological insights would offer important complementary perspectives.     

Ethics of resource allocation in developing countries: the case of Sri Lanka

The issues of prioritization of health care services and allocation of resources have recently received increasing attention and discussion. Several reports have been published by governments in different countries and the issues are discussed in many recent books and papers. In this paper the focus is on the problems faced by a developing country when allocation of health care resources is considered. We consider these issues under three headings and exemplify the situation in a developing country by taking Sri Lanka as an example. Firstly the evidence to formulate an ethical basis for the existing health care system in Sri Lanka is discussed, in particular the problem of defining a minimum quality of health care for the population. Secondly, we consider the issues which arise when we want to formulate the ethical basis for health sector reform. In particular, we examine current World Bank proposals. We shall argue that there are a number of important conceptual and ethical issues that have not been properly addressed in the various policy documents. Finally, we introduce our own alternative ethical framework for policy reform.     

Reproductive change in Sri Lanka: analysis of intermediate variables, 1982 and 1987

This study examines the intermediate determinants of fertility in Sri Lanka by making use of the data collected in the 1982 Sri Lanka Contraceptive Prevalence Survey and the 1987 Sri Lanka Demographic and Health Survey. The analysis shows that the most important inhibitor of potential fertility is deliberate control. The marital structure of the population is also an important fertility-inhibitor, but lactational infecundability is increasingly becoming an unimportant contributor. The findings show the success of the family planning program in Sri Lanka, which propelled fertility to a substantial lower level. Achievement of the replacement level fertility by the turn of the century, set by the Sri Lankan government, would largely depend on the efforts to increase the quality and quantity of contraceptive use and the duration of breastfeeding.     

Promoting interdisciplinary collaboration in health research in developing countries: lessons from the Triangle Programme in Sri Lanka

The Triangle Programme (1989-1992) aimed at strengthening the institutional capacity for health social science research and intervention in Sri Lanka through the promotion of appropriate international and national partnerships. First, it involved an international partnership (Triangle 1) among two universities in the developed world, i.c. University of Antwerp in Belgium and the University of Connecticut in the USA, and one university in the developing world, i.c. the University of Peradeniya, Sri Lanka. This partnership facilitated the transfer of knowledge, experience, skills across national boundaries and the North/South divide. Second, it developed a national/local partnership (Triangle 2) among the Faculties of Arts, Agriculture and Medicine at the University of Peradeniya by involving them in a joint programme of health social science research and training covering the entire range of activities from proposal development to dissemination of research results. Focusing on the latter aspect (Triangle 2) this paper reviews the results of the programme from the angle of cross-fertilization of disciplines through their collaboration in applied health research in a developing country setting.     

Population dynamics of anophelines in a malathion treated village in the intermediate zone of Sri Lanka

As part of research programme on malaria transmission in Sri Lanka, a study was made of man-biting anophelines at Nikawehera, a village on the border of the intermediate and dry rainfall zones. Weekly mosquito collections by night human bait (NHB) were performed inside and outside four fixed stations from October 1992 till March 1993. Houses in the village were treated with malathion by the Anti-Malaria Campaign in October and at the end of January 1993. An. culicifacies and An. tesselatus were the most abundant species. An. culicifacies was probably the only species responsible for malaria transmission. An. culicifacies densities varied between stations and reflected differences in availability of breeding places. An. culicifacies aggressivity is closely related to the rainfall pattern, increasing after the first monsoon rains in November and reaching a peak in late December--early January. Vectorial capacity, however, decreased during the first weeks of the rainy season. The maximum vectorial capacity was found in January. The night biting cycle of An. culicifacies showed a peak between 20.00 and 23.00 h. Since the introduction of electricity in the village, people go to bed later. This might reduce the impact of impregnated bednets on malaria transmission. The results show that malathion spraying as performed now is not very effective. The timing of the spray rounds should be improved. In order to limit malaria transmission, we suggest to advance the malathion spraying campaign of January with one month.     

Seroepidemiology of rinderpest in bovids in Sri Lanka using the enzyme linked immunosorbent assay (ELISA) technique

Approximately 0.2% (n = 4397) of the bovids (cattle and buffalo) in Sri Lanka were sampled, from June 1992 using a multi-stage sampling procedure. Serum antibodies for the rinderpest virus were detected using the competitive enzyme-linked immunosorbent assay. The age, the agroclimatic zone, the management system practiced in the farms, and the vaccination history of the sampled bovids were studied as potential risk factors for being seropositive. The prevalence of rinderpest antibodies in non-vaccinated bovids was 3.5% (n = 4101). The prevalence was higher in the dry zone (9%; where the outbreak emerged in 1987), compared to bovids in the other zones (1%). Seropositive bovids over three years of age were approximately at fourfold higher chances of being seropositive compared to those that were < or = 3 years old. The higher prevalence in older animals is probably due to exposure to the virus during the 1987 epidemic. Bovids from the dry zone (annual rainfall 20 to 35 inches) were at higher odds of being seropositive even after controlling for the possible effects of age, agroclimatic zone, management system and vaccination. The fact that 62% of bovids from the dry zone in this study were reared under extensive management system (free grazing) which allow unrestricted contact between animals, may be the reason for the above finding. A relatively poor response to vaccination observed in vaccinated bovids (seroprevalence = 12%; n = 296) could be attributed to difficulties in maintaining the vaccine at recommended temperatures in the field. This is the first island-wide study on seroprevalence of rinderpest in Sri Lanka.     

Characteristics of mutations in the p53 gene of oral squamous-cell carcinomas associated with betel-quid chewing in Sri Lanka

The PCR copy of the ribR gene of Bacillus subtilis was subcloned in Escherichia coli cells under the control of the phage T7 inducible promoter. The polypeptide of 26 kDa corresponding to the 690-bp gene is the product of the ribR gene. The protein encoded by the ribR gene is flavokinase, and the riboflavin-reduced form is the substrate for it.     

Price elasticities of demand for curative health care with control for sample selectivity on endogenous illness: an analysis for Sri Lanka

Estimation of demand for health care with samples of only the ill may bias estimates. Additionally, the lack of exogenous information, especially distance, about the alternative care providers causes omitted variable problems. This paper alleviates both problems through geographic mapping of facility information to individuals, combined with joint estimation of illness (health production) and health care demand. The joint estimation full sample demand results are compared to those from one equation estimation for only the ill sample. The results indicate that the selectivity problem is significant, but that for this sample the magnitude of the bias on the price coefficient is small.     

四川省壤塘县斯约武锂、铌钽矿床地质特征及成因研究

本矿床位于斯约武与纳合花岗岩体外接触带。矿化伟晶岩墙大多受NE向纵向节理控制,并位于幕阜山岩体的边缘。矿区内已发现4条主要矿体,它们通常呈脉状,延深约数百米。矿石为花岗伟晶结构和条带状构造。含铌、钽的矿物主要包括铌铁矿、钽铁矿、黑钨矿、锂辉石、石英和绿柱石等,它们主要分布于分异晚期的块体带中。经研究表明,该矿床为一岩浆-交代伟晶岩型矿床,成因上与斯约武和纳合花岗岩体有关。     

Growth and carcass characteristics of cattle and buffalo breeds reared on a dry zone pasture in Sri Lanka (Ceylon)

Growth and carcass characteristics were measured on calves from three cattle breeds-the Sinhala, Red Sindhi and Friesian-and two buffalo breeds-the local buffalo and Murrah. The growth study was carried out on Brachiaria brizantha pasture over a period of 48 weeks. The two buffalo breeds grew fastest followed by the two Bos indicus breeds. The Friesian cattle grew at the slowest rate. The Sinhala and local buffalo had normal haematocrit values while the values for all other breeds were lower. The Sinhala and local buffalo had the highest carcass dressing percentages and the highest muscle; bone ratios. Tenderness measured by Warner-Bratzler shear force values and palatability scores by a taste panel were similar for meat from cattle and buffalo.     

EEG findings in frontal lobe epilepsies

As a group, epilepsies of frontal lobe origin are thought to be poorly localized using surface EEG recordings. This finding may depend on the specific areas of frontal lobe from which the seizures originate or the pathologic substrate. We reviewed the presurgical surface EEGs of patients with frontal lobe epilepsy who underwent epilepsy surgery. The specific area of the frontal lobe where seizures originated was determined by 1) intracranial ictal EEG recordings, or 2) the presence of a structural lesion, identified by imaging studies in patients who achieved complete seizure control following surgery. We differentiated patients whose seizures began in the dorsolateral frontal convexity from those whose seizures began in the medial frontal region, and we correlated EEG findings in the interictal, postictal, and ictal states with seizure semiology, pathologic substrate, and surgical outcome. Four of nine patients had seizures originating in the dorsolateral frontal convexity and five had medial frontal onset seizures. Patients whose seizures originated from the dorsolateral convexity had focal interictal epileptiform abnormalities that localized to the region of seizure onset. Patients whose seizures began in the medial frontal region had either no interictal epileptiform abnormality or had multifocal epileptiform discharges. Patients whose seizures began in the dorsolateral convexity showed focal electrographic seizure activity that was localizing. This rhythmic fast activity did not appear to be substrate-specific. Patients whose seizure onset localized to the medial frontal region did not show focal electrographic seizure at clinical onset. We conclude that the scalp EEG recordings of frontal lobe epilepsies contain features that enable differentiation of seizures originating from two different regions of the frontal lobe.     

Reflex sympathetic dystrophy in childhood: a case report

A case report is presented of a 15-year-old girl with reflex sympathetic dystrophy (RSD). She was referred to hospital because of left upper limb pain. Her left upper limb was cold, edematous and blue with a limited active range of movement. The serum concentration of noradrenaline was lower on the painful side than on the healthy side, and neurotropin, which has an antinociceptive effect to hyperalgesia, was clearly effective. Early diagnosis and management is essential in the treatment of RSD and administration of neurotropin is a useful and non-invasive treatment without severe adverse effects.