Clinical presentations and predictors of mortality for leptospirosis - A study from suburban area in Malaysia

@#Introduction: Malaysia is endemic for leptospirosis with increasing incidence recorded over the years. Perak has recorded one of the highest incidence and mortality of leptospirosis since 2004. Methods: This is a retrospective study of confirmed leptospirosis cases in Larut, Matang and Selama (LMS) district in Perak reported in 2016. The demographic, clinical presentation, laboratory result and clinical outcomes data were analysed and presented. Results: Forty-two patients with confirmed diagnosis of leptospirosis were included into the study. Majority of patients were males and Malays. The case fatality rate was 14.3%. Patients with leptospirosis present with variable clinical presentations and are commonly seen with coinfection. Patients 70-year-old and older, have clinical presentations suggestive of organ dysfunction and require intensive care are associated with higher mortality. Conclusion: Leptospirosis is endemic in LMS district of Perak with high incidence and case fatality rate. The clinical presentation of leptospirosis is variable. Co-infection of leptospirosis with other acute febrile illness is common. Patients presenting with symptoms and signs of organ dysfunctions or require intensive care are associated with an increased odds of death.

Prevalence of Obesity and Screening for Diabetes Among Secondary School Students

Introduction:There is an increasing trend of obesity in children and adolescent globally. The objectives of this study were to identify the prevalence of overweight and obesity among students from secondary schools and to determine the mean random blood sugar (RBS) for the overweight and obese students.Methods:This was a cross sectional study. Two secondary schools that were scheduled for visit by the School Health Team, Taiping in July 2016 were included. A standardized data collection sheet was used to collect the data. Overweight and obesity were defined based on WHO 2007 reference for BMI-for-age criteria. Random blood glucose was checked for overweight and obese students.Results:A total of 184 school students consented and participated. 128 (69.6%) were female and 90 (48.9%) were Malays. The mean weight and height were 56.21 kg and 1.61 m respectively with BMI of 21.49 kg/m2. Overall, the prevalence of obese and overweight were 12.5% and 10.9% respectively. Among the 4 BMI groups, there were no significant difference found in sex (p=0.849) and races (p=0.536). However, there was significant difference (p=0.042) in mean RBS for obese and overweight students between races. RBS readings among overweight and obese students were within normal range with mean of 5.95 (0.67) mmol/l (range between 4.60 – 7.70 mmol/l).Conclusions:The overall prevalence of overweight and obesity were comparable with other studies done in Malaysia. Nevertheless, there was no prevalence of Type II diabetes mellitus among them.