BackgroundLeptospirosis is endemic in both urban and rural areas of Sri Lanka and there had been many out breaks in the recent past. This study was aimed at validating the leptospirosis surveillance case definition, using the Microscopic Agglutination Test (MAT).MethodsThe study population consisted of patients with undiagnosed acute febrile illness who were admitted to the medical wards of the Teaching Hospital Kandy, from 1st July 2007 to 31st July 2008. The subjects were screened to diagnose leptospirosis according to the leptospirosis case definition. MAT was performed on blood samples taken from each patient on the 7th day of fever. Leptospirosis case definition was evaluated in regard to sensitivity, specificity and predictive values, using a MAT titre ≥ 1:800 for confirming leptospirosis.ResultsA total of 123 patients were initially recruited of which 73 had clinical features compatible with the surveillance case definition. Out of the 73 only 57 had a positive MAT result (true positives) leaving 16 as false positives. Out of the 50 who didn't have clinical features compatible with the case definition 45 had a negative MAT as well (true negatives), therefore 5 were false negatives. Total number of MAT positives was 62 out of 123. According to these results the test sensitivity was 91.94%, specificity 73.77%, positive predictive value and negative predictive values were 78.08% and 90% respectively. Diagnostic accuracy of the test was 82.93%.ConclusionThis study confirms that the surveillance case definition has a very high sensitivity and negative predictive value with an average specificity in diagnosing leptospirosis, based on a MAT titre of ≥ 1: 800.

White adipose tissue (WAT) and brown adipose tissue (BAT) are involved in whole-body energy homeostasis and metabolic regulation. Changes to mass and function of these tissues impact glucose homeostasis and whole-body energy balance during development of obesity, weight loss, and subsequent weight regain. Omega-3 polyunsaturated fatty acids (ω-3 PUFAs), which have known hypotriglyceridemic and cardioprotective effects, can also impact WAT and BAT function. In rodent models, these fatty acids alleviate obesity-associated WAT inflammation, improve energy metabolism, and increase thermogenic markers in BAT. Emerging evidence suggests that ω-3 PUFAs can also modulate gut microbiota impacting WAT function and adiposity. This review discusses molecular mechanisms, implications of these findings, translation to humans, and future work, especially with reference to the potential of these fatty acids in weight loss maintenance. Please see http://www.annualreviews.org/page/journal/pubdates for expected final online publication date for the Annual Review of Nutrition, Volume 40. 2020

Introduction Adolescents have high vulnerability for body image distortions which may result in many psychological and physical problems.Objectives This study aimed to determine body image perception and dissatisfaction among rural schooling adolescents in Sri Lanka.Methods Adolescents (aged 13-16 years) were selected using probability-based sampling framework. Selfadministered figure rating scale was used to assess perceived current (PCBS) and ideal (IBS) body size and body discrepancy score (BDS = PCBS -IBS). Pubertal stage was assessed with pubertal development scale. Anthropometry was done according to WHO guidelines.Conclusions Body dissatisfaction is evident even among rural adolescents, affecting boys more than girls. Many students show a desire to have a larger body size than their current. This study also provides valid and reliable tools to assess body dissatisfaction and pubertal development in Sinhala speaking adolescents.

Visceral obesity may be a driving factor in nonalcoholic fatty liver disease (NAFLD) development. Previous studies have shown that the omega-3 polyunsaturated fatty acid, eicosapentaenoic acid (EPA), ameliorates obesity in high-fat (HF) fed male, C57Bl/6 mice at thermoneutral conditions, independent of uncoupling protein 1 (UCP1). Our goals herein were to investigate sex-dependent mechanisms of EPA in the livers of wild type (WT) and UCP1 knockout (KO) male and female mice fed a HF diet (45% kcal fat; WT-HF, KO-HF) with or without supplementation of 36 g/kg EPA (WT-EPA, KO-EPA). KO significantly increased body weight in males, with no significant reductions with EPA in the WT or KO groups. In females, there were no significant differences in body weight among KO groups and no effects of EPA. In males, liver TGs were significantly higher in the KO-HF group and reduced with EPA, which was not observed in females. Accordingly, gene and protein markers of mitochondrial oxidation, peroxisomal biogenesis and oxidation, as well as metabolic futile cycles were sex-dependently impacted by KO and EPA supplementation. These findings suggest a genotypic difference in response to dietary EPA supplementation on the livers of male and female mice with diet-induced obesity and housed at thermoneutrality.

In Sri Lanka, the double burden of nutrition is often neglected, and increase of adolescent obesity is not well investigated. This study determines the double burden of malnutrition among adolescents in Anuradhapura district exploring the differences of prevalence based on different definitions. Students aged 13 to 16 years were selected from 74 schools using probability proportionate to size sampling. Anthropometry was done according to WHO guidelines. Obesity was defined according to body mass index (BMI) based definitions of WHO, International Obesity Task Force and Indian growth references. Central obesity was defined using Indian and British waist circumference cut-offs. Prevalence estimates from different definitions were compared using McNemar’s test. Socio-demographic determinants of nutritional issues were assessed using Chi-square test for independence. A total of 3105 students (47.7% boys) were studied (mean age 14.8 + 0.8 years). According to WHO definitions, 73 (2.4%, 95% CI; 1.9–2.9) were obese, 222 (7.2%, 95% CI; 6.3–8.1) were overweight, 673 (21.7%, 95% CI; 20.2–23.1,) were thin and 396 (12.8%, 95% CI; 11.6–14.0) were stunted. More boys (3.1%) than girls (1.7%) were obese as well as thin (29.0% compared to 15.0%). Prevalence of overweight/obesity was higher among students in larger, urban schools, and belonging to high social class and more educated parents. Prevalence of overweight/obesity estimated using IOTF-Asian and Indian thresholds were significantly higher than that from WHO and IOTF-international thresholds. Double burden of malnutrition is affecting the adolescents in rural Sri Lanka. Prevalence estimates of obesity largely depend on the definition used.