Wijeramahouse CGPSL
CGPSL
NEWSLETTER OF THE COLLEGE OF GENERAL PRACTITIONERS OF SRI LANKA No.6, “Wijerama House”, Wijerama Mawatha, Colombo 7. APRIL 2017 Tele: 2698894 / 2688775 E-mail: [email protected] / [email protected] Website: www.cgpsl.org
MESSAGE FROM PRESIDENT CGPSL 2016/2017
Dear Members,
It's been 4 months since the last newsletter was released in November 2016. Hope all of you are keeping well and committed to the furtherance of General Practice in Sri Lanka.
The Academic Sessions of the CGPSL held in October 2016, recorded a profit of over 3 million and this has been placed in a Fixed Deposit, thereby enhancing the Assets of CGPSL to help us have a building of our own soon.
Another intake of 28 SLMC registered Doctors interested in General Practice were enrolled into the MCGP 2016 intake (4th intake) in December 2016. This means that College has the task of coordinating these 2 courses with commitment and organising an exam/convocation in 2017 and 2018.
We have had a very successful Convocation ceremony organised for the 18 MCGP Diplomates 2016 and the Awards ceremony for the 15 new Mentors-'Recognition of Mentors of CGPSL' on the 29th January 2017 with Professor Carlo Fonseka, President of Sri Lanka Medical Council as Chief Guest; Prof. Carlo commended the
College on the 'Oath of the General Practitioner'(authored by Prof Leela de A In This Issue Karunaratne) which was a new idea I had gathered Message from the President - P 1,2,3 from attending the RACGP Academic Sessions 'GP Photo Gallery – P 4,5 16' in Perth, Australia in October 2016. He was also CME Online – P 5 very appreciative and full of praise for the Annual General Meeting – P 6 Convocation Book presented on that occasion. The Influenza – P 7,8 event took place at SLMA Auditorium followed by fellowship in the SLMA courtyard. These photos have been uploaded into the website and Facebook.
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– APRIL 2017 Message from the President
I am happy to record that we had a very cordial meeting with Secretary Health, Mr. Anura Jayawickrema, Additional Secretary Health, Dr. Siyambalangoda, Director General Health, Dr. Jayasundera Bandara; Deputy DGHS, Dr. Lakhmi Somatunge, DDG/NCD Dr. Champika Wickremasinghe, & Dr. Collin Fernandopulle, Coordinating Secretary to Hon. Minister of Health, Nutrition & Indigenous Medicine (Hon Minister was unable to be present due to an urgent commitment and had instructed Sec Health to chair it). The team from CGPSL was headed by me as President, PP Dr. Preethi Wijegoonewardene, Immediate PP Prof Antoinette Perera, VP Dr. Jayantha Jayatissa, Secretary Dr. Maithri Rupasinghe and Treasurer Dr. Ruvaiz Haniffa was unable to participate due to an urgent personal commitment. This meeting took place on 24th February 2017 and all topics on the agenda and other important issues which followed from the last meeting with the Hon. Minister of Health, Nurition & Indigenous Medicine on May 2015, was discussed in a very positive and cordial manner. On the topic of Registration of Practices which has been passed as an Act in Parliament, we will have to comply. We have requested a waive off of past payments which were stayed on an agreement with the earlier authorities, besides a reduction in payment of those GP's in the silver age/exemption in those who have given of themselves for almost 50 years, to be considered. We can be rest assured that all this will come to pass very soon. I will keep you updated on these issues soon.
The College outreach Community screening programme on NCD was held at the Pradeshiya Sabha Auditorium at Bulathsinhala, Kalutara District on 26th February 2017; PP Dr. Preethi Wijegoonewardene played a big role and looked into the lunch of the 15 doctors who participated, at his beautiful estate bungalow in Bulathsinhala with no cost to CGPSL. The members of the NCD Committee undertook a big task and the young ones became so competent that they can sort out the next camp very efficiently. We were sponsored by Asiri Group of Hospitals who arranged Asiri transport, breakfast, necessary beds, screens and equipment besides the lunch to the other staff who manned the Medical Camp. Thanks go out to Dr. Harsha Baranage, Medical Director of Asiri Surgical, and his team of PRO's, Laboratory staff, Nutritionists, Nurses and technicians who went out early to help set up and coordinate registrations, lab testing and looking into all logistical arrangements. The Lions Club of Bulathsinhala got involved to coincide with their Centenary Celebrations of Lionism in Sri Lanka, and helped with booking of venue and undertook to follow up and coordinate the referrals. A very big thank you is extended to the DGHS, Dr. Jayasundera Bandara, Dr. Collin Fernandopulle and the RD/Dental Services who had released the fully equipped Ministry mobile dental bus manned by DS Dr. Vindya Hewage who single handedly examined almost 100 patients who were in the habit of chewing betel for early signs of premalignant disease, periodontal disease, & Caries while giving awareness on Oral Cancer. The National Cancer Control Programme, Director, Dr. Sudath Samaraweera and Consultant Community Dental Surgeon Dr. Prassanna Jayasekera shared a DVD presentation of a teledrama on Oral Cancer besides sharing their posters and printed leaflets on oral cancer which was screened for all participants and shared with them. We are thankful for their contributions. I am very thankful to the RDHS Kalutara District, MOH, and MO/NCD and Health Education staff for all the support and corporation. I am very appreciative of the Doctors and other staff for their selfless commitment on a Sunday morning in providing this service to the less fortunate people from the remote areas and estates of this region once again. We hope to follow up this camp next year to analyse the impact we have had on the incidence of NCD's. Photos have been uploaded into website.
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– APRIL 2017 Message from the President
Our next CSR project would be in May 2017 coinciding with World Family Doctor day 19th May. This would be coordinated by PP Dr. Chandrasekher at Mattakkuliya/Kotahena.
Now it is time to collect our thoughts and audit all what has been done within these 9 months.
You have received and followed up very closely all activities of the College and the North Western Chapter given in the Mid Term Report.
We have had very close links with representation at all activities of the different Colleges, Academia and National Bodies and National Advisory Committees. We are partners in Updating the Guidelines in the Management of Breast, Thyroid, & Colorectal Cancers. We have a partnership with the Sri Lanka College of Endocrinologists to update all GP's in the Provinces. We have been entrusted a Precongress session at the SLMA Sessions on 13th July 2017 and a Provincial Meeting with SLMA and NWC of CGPSL in November 2017 together with the Dr. Desmond Fernando Lecture to be held in Negombo.
We are in the process of forging very close links with RACGP to help update our standards of care in General Practice besides linking up internationally through WONCA, RCGP and RACGP to get a global perspective to General Practice in Sri Lanka. We will also strengthen our pool of Trainers and examiners with RCGP and RACGP input.
Our very own member PP Dr. Preethi needs our good wishes for all the commendments he has received for his role in bringing Sri Lanka to be the leader in the South Asian region.
We have fixed the AGM and general Body meeting to 28th May 2017.
Thank you for the support extended throughout the year.
Dr. Carmel Fernandopulle President
Editor : Dr. Maithri Rupasinghe Editorial Board: Dr. Preethi Wijegoonewardene, Dr. Thivanka Munasinghe, Dr. Sankha Randenikumara, Dr. Dushyanthi Weerasekera Type setting, page setting & formatting: Dimuthu C Weerasekera
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– APRIL 2017 Photo Gallery
MCGP Diploma - 2016 Convocation and Award Ceremony 29th January 2017 @ Lionel Memorial Auditorium
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– APRIL 2017 Photo Gallery
NCD Screening Health Camp 19th of February 2016 @ Pradeshiya Sabha Auditorium Bulathsinhala, Kalutara District
CME Online
Past President of the CGPSL, Professor Nandani de Silva Gives Leadership to Develop Online Courses
Professor Nandani de Silva, was the Chairperson of a Special Task Force Committee appointed by the University Grants Commission to develop and deliver online courses in English and IT to university entrants. This followed a national policy decision to give laptops to university entrants at 0% interest to encourage online learning. Professor Nandani with her experience in design and delivery of CME online courses while being Vice Chancellor of the Open University of Sri Lanka gave leadership to the academics who developed the online English and IT courses for university entrants. The notice about the Online English and IT courses launched on 27th March 2017 can be viewed on the UGC website at ugc.ac.lk with a link to the two courses and a message from Prof. Nandani de Silva for the IT course at www.itue.lk
We look forward to CME online for the membership in the future through the College with Professor Nandani’s expert guidance.
Dr. Maithri Rupasinghe Editor 5
– APRIL 2017 Annual General Meeting
42nd ANNUAL GENERAL MEETING OF THE COLLEGE OF GENERAL PRACTITIONERS OF SRI LANKA
SUNDAY, 28TH MAY 2017 AT 5.00 P.M. AT THE LIONEL MEMORIAL AUDITORIUM, NO.6, WIJERAMA MAWATHA, COLOMBO 7
AGENDA
1. READING OF THE NOTICE CONVENING THE ANNUAL GENERAL MEETING
2. VOTES OF CONDOLENCE
3. THE MINUTES OF THE 41st ANNUAL GENERAL MEETING HELD ON 08th May 2016
4. MATTERS ARISING OUT OF THE MINUTES
5. HONY. SECRETARY’S REPORT FOR 2016/2017
6. HONY. TREASURER’S REPORT AND THE STATEMENT OF ACCOUNTS OF THE COLLEGE OF GENERAL PRACTITIONERS OF SRI LANKA FOR THE YEAR ENDED 31ST DECEMBER 2016
7. CHAPTER REPORTS
8. PRESIDENT’S ADDRES
9. ELECTION OF OFFICE BEARERS AND THE COUNCIL
10. ADDRESS BY THE PRESIDENT
11. ELECTION OF AUDITORS
12. APPOINTMENT OF HONY. LEGAL ADVISOR
Hony. Secretary The College of General Practitioners of Sri Lanka 6, Wijerama Mawatha Colombo 07
07th April 2017
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– APRIL 2017 Influenza
SEASONAL INFLUENZA IN SRI LANKA
Seasonal influenza viruses circulate and cause disease in humans every year. In Sri Lanka, for the last few years, it has been generally observed during April to June and again in November to January. It spreads from person-to- person through sneezing, coughing, or touching contaminated surfaces. Seasonal influenza viruses can cause mild to severe illness and even death, particularly in some high-risk individuals. Persons at increased risk for severe disease includes pregnant women, the very young and very old, immune-compromised people, and people with chronic underlying medical conditions such as cancer, diabetes mellitus and heart diseases. Seasonal influenza viruses evolve continuously, which means that people can get infected multiple times throughout their lives. Therefore the components of seasonal influenza vaccines are generally reviewed biannually and updated periodically to ensure continued effectiveness of the vaccines. Recently, the National Drug Regulatory Authority of Sri Lanka has given license for the use of seasonal influenza (flu) vaccine.
There are three large groupings or types of seasonal influenza viruses, labeled A, B, and C. Type A influenza viruses are further divided into subtypes according to the specific variety and combinations of two proteins that occur on the surface of the virus, the hemagglutinin or “H” protein and the neuraminidase or “N” protein. Currently, influenza A (H1N1) is the commonly circulating seasonal influenza A virus subtype in Sri Lanka. During the current season, it has been observed to generally cause severe disease. This seasonal A (H1N1) virus is the same virus that caused the influenza pandemic and it first appeared in Sri Lanka in two waves during 2009/ 10 period.
In addition, there are two type B viruses that are also circulating as seasonal influenza viruses, which are named after the areas where they were first identified, Victoria lineage and Yamagata lineage. Type C influenza causes milder infections and is associated with sporadic cases and minor localized outbreaks. As influenza C poses much less of a disease burden than influenza A and B, only the latter two are included in seasonal influenza vaccines.
The main goals of treatment at the patient level are reduction in severity and duration of symptoms and prevention of complications. At a public health level, the aim is to prevent or control outbreaks of influenza to avoid an epidemic or pandemic situation.
Uncomplicated influenza infection is an acute respiratory infection caused by A or B viruses that is usually self- limiting in the general population. Treatment is aimed at supportive care of the symptoms associated with the respiratory tract infection. These treatments usually include antipyretics/analgesics for fever, and increased fluid intake to counter dehydration. The symptoms typically resolve in approximately 1 week; however, cough and fatigue may persist for longer.
Antiviral treatment is typically reserved for patients with complicated infection and patients at high risk of complications and should ideally be given within the first 48 hours of suspected or laboratory-confirmed influenza.
Treatment is recommended for people at high risk of developing complications of influenza and therapy can be started within 48 hours of onset of symptoms. Treatment can be considered for people diagnosed with influenza 48 hours after onset of symptoms, who have continued symptoms.
All patients hospitalised for influenza require antiviral treatment.
People not at high risk of complications may be given antiviral treatment if influenza is highly suspected or confirmed, it is within 48 hours of symptom onset, and they wish to shorten the duration of their illness.
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– APRIL 2017 Influenza
Complications may occur in any patient, but a variety of high-risk subgroups are more susceptible. At-risk groups include:
Patients with chronic pulmonary (including asthma) or cardiac conditions Patients with diabetes mellitus, renal disease, liver disease, chronic neurological conditions, or immunosuppression Patients in nursing homes or chronic-care facilities Infants aged 6 to 59 months Adults >65 years of age Pregnant women Healthcare workers or carers to members of a high-risk population.
Antiviral drugs have been shown to be effective as prophylaxis against infection when given early after exposure to an infected individual.
Secondary bacterial pneumonia is an important complication of seasonal influenza and contributes to 25% of all seasonal influenza deaths. The most common bacteria associated with pneumonia in the context of influenza co- infection are Streptococcus pneumoniae, Staphylococcus aureus, and Haemophilus influenza. Antibiotics should target these organisms.
Dr. Maithri Rupasinghe
Reference 1) World Health Organization. Seasonal Influenza in Sri Lanka [Online] Available at: http://www.searo.who.int/srilanka/documents/seasonal_influenza_in_sri_lanka/en/ (Accessed on 20 March 2017) 2) BMJ Best Practice. Influenza Infection, [Online] Available at: http://bestpractice.bmj.com/best-practice/monograph/6.html (Accessed on 20 March 2017)
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