Health in Malaysia
Leptospirosis is a water contract disease caused by bacteria of the genus Leptospirabacterial. It is a disease that affects both humans and animals. The number of leptospirosis cases had steadily increased from 2011 (2,268 cases with 55 death) to 2015 (8,291 cases with 78 death) and 5,284 cases with 52 death in 2016. Leptospirosis can have important health impact and is a burden to the nation if not well controlled. Addressing leptospisoris includes maintain a clean environment and by not swimming or wading in water that might be contaminated with animal urine, or eliminating contact with potentially infected animals.
Lupus nephritis
The diagnosis of lupus nephritis depends on blood tests, urinalysis, X-rays, ultrasound scans of the kidneys, and a kidney biopsy. On urinalysis, a nephritic picture is found and red blood cell casts, red blood cells and proteinuria is found. The World Health Organization has divided lupus nephritis into five stages based on the biopsy. This classification was defined in 1982 and revised in 1995.Drug regimens prescribed for lupus nephritis include mycophenolate mofetil (MMF), intravenous cyclophosphamide with corticosteroids, and the immune suppressant azathioprine with corticosteroids. MMF and cyclophosphamide with corticosteroids are equally effective in achieving remission of the disease. MMF is safer than cyclophosphamide with corticosteroids, with less chance of causing ovarian failure, immune problems or hair loss. It also works better than azathioprine with corticosteroids for maintenance therapy. A 2016 network meta-analysis, which included 32 RCTs of lupus nephritis, demonstrated that tacrolimus and MMF followed by azathioprine maintenance were associated with a lower risk of serious infection when compared to other immunosuppressants or glucocorticoids. Individuals with lupus nephritis have a high risk for B-cell lymphoma (which begins in the immune system cells).