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Frequently Asked Questions

1. Who gets Leptospirosis?

It remains largely an occupational disease of farmers, vets, and other who work with animals like pet shop owners, sewage workers. Outbreaks of Leptospirosis have also been associated with flooding.

2. What are leptospirosis symptoms and signs?

Leptospirosis symptoms begin from 7 to14 days after initial direct exposure urine or tissue of an infected animal. But fortunately 90-95%of infection is subclinical or causes only a mild fever.

The illness typically progresses through two phases:

  • The first phase of nonspecific flu-like symptoms includes headaches, muscle aches, anorexia, malaise, eye pain with bright light, followed by chills and fever. Watering and redness of the eyes can be appearing. Hepatosplenomegaly , lymphadenopathy, and skin rashes are sometimes seen.
  • The second phase begins after a few days of feeling well. Fever and aching with stiffness of neck or some patients develop serious inflammation of the nerves to the eyes, brain, spinal cord (meningitis). Right upper abdominal pain.

Leptospirosis associated with liver and kidney disease is called Weil’s

syndrome and characterized by yellowing of eyes and can develop renal failure, cardiac failure, pulmonary haemorrhage or circulatory collapse in serious conditions.

3. How is leptospirosis diagnosed?

Diagnosis usually can be done clinically. Diagnosis can also be done by culture of the bacterial organism Leptospira from infected blood, spinal fluid, or urine .leucocytosis, reduce platelets, elevated creatine phosphokinase.

4. How is the treatment for leptospirosis?

Antibiotic treatment (doxycycline) is most effective when initiated early in the course of the illness. Severely ill patients may need hospitalization for IV fluid and antibiotic treatment. Severe liver and kidney manifestations of the infection may require intensive medical care and sometimes dialysis treatment. liver and kidney function often does return after recovery from the illness.

5. Is it fatel?

Even with full supportive care the mortality is around 10%, rising to 15-20% in elderly.

6. Can leptospirosis be prevented with a vaccine?

A vaccine for leptospirosis is available and used in some countries. It is short acting and must be given every year.

Travelers who are going to an area where leptospirosis is common, con take 200mg of doxycycline per week by mouth starting before and during the time period of potential exposure.

Leptospirosis is a notifiable disease in Sri Lanka.

7. What Is It?

Cholesterol is a fatty substance that occurs naturally in the body. It performs several vital functions. It is needed to make the walls surrounding the body's cells and is the basic material that is converted to certain hormones. Your body makes all the cholesterol you need. You need only a small amount of fat in your diet to make enough cholesterol to stay healthy.

The fat and cholesterol you eat are absorbed in the intestine and transported to the liver. The liver converts fat into cholesterol, and releases cholesterol into the bloodstream. There are two main types of cholesterol: low-density lipoprotein (LDL) cholesterol (the "bad" cholesterol) and high-density lipoprotein (HDL) cholesterol (the "good" cholesterol).

High levels of LDL cholesterol are linked to atherosclerosis, which is the accumulation of cholesterol-rich fatty deposits in arteries. This can cause arteries to narrow or become blocked, slowing or stopping the flow of blood to vital organs, especially the heart and brain. Atherosclerosis affecting the heart is called coronary artery disease, and it can cause a heart attack. When atherosclerosis blocks arteries that supply blood to the brain, it can cause a stroke.

High levels of HDL cholesterol actually protect against heart attacks and strokes by removing cholesterol from the arteries and bringing it back to the liver.

Because high cholesterol levels can cause atherosclerosis, doctors recommend that people keep their cholesterol levels within a specific range. In general, adults older than 20 should try to keep their total cholesterol level below 200 milligrams per deciliter.

For a more precise assessment of the risk of atherosclerosis, your LDL cholesterol should be checked. According to guidelines established by the government-sponsored National Cholesterol Education Program, the desirable level for LDL cholesterol depends on whether or not a person already has a disease caused by atherosclerosis or diabetes or other risk factors for coronary artery disease. In addition to a high LDL cholesterol level and diabetes, risk factors for coronary artery disease include:

  • Being a male older than 45
  • Being a female older than 55
  • Being a female with premature menopause
  • Having a family history of premature coronary artery disease (a father or brother younger than 55 with coronary artery disease or a mother or sister younger than 65 with coronary artery disease)
  • Smoking cigarettes
  • Having high blood pressure
  • Not having enough good cholesterol (high density lipoprotein or HDL)

If you have coronary artery disease, peripheral arterial disease or have had a stroke from atherosclerosis, your LDL cholesterol should be 70 milligrams per deciliter or less.
The more risk factors you have, the lower your target LDL cholesterol should be. In general, an LDL cholesterol level of less than 100 is best, but less than 130 may be acceptable for people with few or no risk factors.

Your level of HDL cholesterol is also very important. People with levels below 40 milligrams per deciliter are more likely to develop atherosclerosis, heart disease and stroke. Levels of HDL cholesterol above 60 milligrams per deciliter are associated with less atherosclerosis and are thought to help protect against heart disease and stroke.

Are there any other reasons that may contribute to the development of hypercholesterolemia?

There are many minor reasons for the occurrence of hypercholesterolemia:

  1. Genetic History.
  2. Anorexia.
  3. Ailment of kidney.
  4. Hypo-Thyroidism.
  5. Particular type of drugs used to treat HIV infection.
  6. Food containing saturated fat in excess amount tends to increase the level of cholesterol in blood stream.
  7. Obesity is also one of the contributory factors towards the development of hypercholesterolemia. Reduction in excess weight will reduce your total cholesterol as well as LDL level on the whole.
  8. Lack of Bodily movement is also regarded as a big factor for various heart related diseases.
8. What are the symptoms?

Most people with high cholesterol don't have any symptoms until cholesterol-related atherosclerosis causes significant narrowing of the arteries leading to their hearts or brains. The result can be heart-related chest pain (angina) or other symptoms of coronary artery disease, as well as symptoms of decreased blood supply to the brain (transient ischemic attacks or stroke).

About 1 out of every 500 people has an inherited disorder called familial hypercholesterolemia, which can cause extremely high cholesterol levels (above 300 milligrams per deciliter). People with this disorder can develop nodules filled with cholesterol (xanthomas) over various tendons, especially the Achilles tendons of the lower leg. Cholesterol deposits also can occur on the eyelids, where they are called xanthelasmas.

9. How is the diagnosis made?

Your doctor will ask if anyone in your family has had coronary artery disease, high cholesterol or diabetes. The doctor will ask about your diet and if you have ever smoked. He or she will check your blood pressure and look for xanthomas and xanthelasmas. Your doctor can confirm a diagnosis of high cholesterol with a simple blood test.

10. How to bring down high cholesterol?

If your cholesterol level is high, you will need to make a long-term effort to bring it down. You can significantly lower your cholesterol levels by sticking with a diet that is low in saturated fats, high in fruits and vegetables, and by substituting "good" fats for "bad" fats. The dietary changes need to be permanent to maintain lower cholesterol levels. Daily exercise also is important. Exercise can raise HDL (good) cholesterol and lower total cholesterol.