BACKGROUND Leptospirosis is an important cause of mortality and morbidity in India. The present study is conducted to evaluate the association of various blood parameters and urinary parameters with the severity of leptospirosis. MATERIALS AND METHODS Our descriptive study enrolled 84 participants with leptospirosis aged 18 years or above admitted under General Medicine in a period of 2 years. Participants with pre-existing renal, hepatic and respiratory diseases were excluded. Study was approved by Institutional Ethics Committee and written informed consent was obtained from all study participants. All investigations were done in the central laboratory of the institution and results were analysed using R®. Parameters are expressed as categorical variables and association was determined using Chi-square test and Fischer's exact test and p <0.05 was considered statistically significant. RESULTS Among the study participants, 71% were males and 70% had severe leptospirosis. 72% participants had normal leukocyte count, 70% participants had neutrophilia and 32% participants had lymphocytosis. 66% had thrombocytopenia and 2.4% participants had platelet count less than 10,000 cells/μL. 89% participants had elevated erythrocyte sedimentation rate (ESR). 23.8% participants had more than 5 pus cells in urine and 69% had granular cast in urine. Significant association was observed with severity of leptospirosis for platelet count (p<0.001), ESR (p=0.01; OR: 5.9, 95% CI: 1.3-25.9), pyuria (p=0.03; OR: 5, 95% CI 1.1-23.7) and granular cast in urine (p<0.001; OR: 0.6, 95% CI 0.4-0.7). CONCLUSION Early diagnosis, monitoring of clinical and laboratory parameters and prompt intervention in terms supportive care and antibiotic therapy will help in reducing morbidity and mortality.

BACKGROUND Leptospirosis is an important cause of morbidity and mortality in Kerala and severe leptospirosis has been reported in almost 60% of Leptospira infected individuals. Overlapping symptomatology with other diseases makes misdiagnosis very common though adequate hydration and use of appropriate antibiotics reduce morbidity and mortality. This study is conducted to evaluate the association of history, symptoms and clinical examination findings with leptospirosis and its severity. MATERIALS AND METHODS The present descriptive study enrolled 84 participants over 18 years with confirmed leptospirosis. Participants with preexisting renal and hepatic impairment, chronic obstructive pulmonary disease and bronchial asthma were excluded. Institutional ethics committee approved the study and written informed consent was obtained from all participants. Data was collected in separate case record forms and was analysed using R®. All parameters are expressed as categorical variables and tests of significance were Chi-square test, Fischer's exact test. p<0.05 was considered statistically significant. RESULTS 71.4% participants were males. Most common symptoms were fever (98.8%), headache (98.8%) and myalgia (73.8%). 84.5% participants had less than 7 days inpatient stay. Most common examination finding was icterus (23.8%). 70.2% (n=59) of the study participants had severe leptospirosis. Significant association was observed between severity of leptospirosis and age (p=0.02), icterus (p=0.001) and duration of inpatient stay (p=0.04). CONCLUSION Young males were predominantly involved highlighting occupational exposure. Commonest symptoms were fever, headache and myalgia indicating the risk of misdiagnosis. Commonest examination finding was icterus (22%). 70% had severe leptospirosis and significant association was observed between age, icterus, duration of inpatient stay with severity of leptospirosis. Further studies on larger samples are required to assess the exact association of these parameters.

BACKGROUND Leptospirosis is an important cause of mortality and morbidity in Kerala. The present study is conducted to evaluate the association of serum electrolytes, parameters of renal, hepatic and pancreatic function with the severity of leptospirosis. MATERIALS AND METHODS We enrolled 84 participants in our descriptive study with leptospirosis aged 18 years or above with leptospirosis admitted under General Medicine in 2 years. Pre-existing renal, hepatic and respiratory diseases were excluded. The study was approved by Institutional Ethics Committee and written informed consent was obtained from all study participants. Serum electrolytes, liver function tests, renal function tests, serum amylase, serum lipase and creatinine phosphokinase were done in central laboratory and results were analysed using R®. Parameters are expressed as categorical variables and association was determined using Chi-square test and Fischer's exact test and p <0.05 was considered statistically significant. RESULTS Among the participants (n=84), 71% were males, 70% had severe leptospirosis, 72.6% had hyponatremia, 23.8% had hypokalaemia, 40.5% had elevated serum creatinine, 65.5% had elevated blood urea, 56% had elevated serum total bilirubin (T.bil) and 31% had elevated direct bilirubin (D.bil). Aspartate Amino transferase (AST), Alanine Aminotransferase (ALT), Alkaline Phosphatase (ALP) and Creatinine Phosphokinase (CPK) were elevated in 61.9%, 47.6%, 44% and 15.5% participants respectively. 8.3% participants had elevated serum amylase and lipase. Significant association with severity of leptospirosis was observed for serum sodium (p=0.