Title: Evaluation of Short Term Neurological Sequelae after Discharge and At One Month in Children Admitted with Non-Tumor Non-Traumatic Intracranial Pathology in A Tertiary Referral Teaching Centre

Authors: Dr Dinesh Mekle, Dr Jeetandra Kumar Sharma, Dr Pawan Ghanghoria

 DOI:  http://dx.doi.org/10.18535/jmscr/v4i10.17

Abstract

Background- Despite appropriate antibiotic therapy and the availability of vaccines, bacterial meningitis in children is associated with a high risk of short term and long-term sequelae. The objectives of the present study were to evaluate the neurological sequelae in non-tumor non-traumatic paediatric patients, to characterize these children from a clinical point of view, and to identify clinical variables with potential to predict neurological sequelae and complications.

Material and Method - This was a observational cross-sectional study, consisting of consecutive 1824 patients admitted in Department of Paediatrics, Neta ji subhash Chandra bose medical college Jabalpur (MP), India.

Result: In our study we found that out of total death 46.15% occurred within 7 days and 30.77% after 15 days while less number of death occurred in more than 15 days of hospital stay. Among those who had sequelae at one month 73.68% cases were of  more than 15 days of hospital stay. So we found that short term outcome [death] was more in cases with short duration of stay.Duration of stay also had significant association with the diagnosis of Tubercular Meningitise And Viral Encephalitise. Out of Tubercular Meningitise 66.67% And Viral Encephalitise  40% cases had hospital stay of more than 15 days duration.

Conclusion- Based on results of the present study, it is possible to conclude that duration of hospital stay variable had correlation with poor outcome.

Key Worlds— Hospital Stay, Paediatric Patients.

References

1.      Aruna Chandran, Hadley Herbert, Derek Misurski,Mathuram Santosham, Long-term Sequelae of Childhood Bacterial Meningitis An Underappreciated Problem ,The Pediatric Infectious Disease Journal • Volume 30, Number 1, January 2011;3-6.

2.      . Baraff LJ, Lee SI, Schriger DL. Outcomes of bacterial meningitis. in children: a meta-analysis. Pediatr Infect Dis J 1993; 12: 389-394.

3.      Koomen I, Grobbee DE, Roord JJ, Donders R, Jennekens-Schinkel A, van Furth AM. Hearing loss at school age in survivors of bacterial meningitis: Assessment, incidence, and prediction. Pediatrics 2003; 112: 1049-1053.

4.      Richardson MP, Reid A, Tarlow MJ, Rudd PT. Hearing loss during bacterial meni-ngitis. Arch Dis Child 1997; 76; 134-138.

5.      Grimwood K, Anderson P, Anderson V, Tan L, Nolan T. Twelve year outcomes following bacterial meningitis: further evidence for persisting effects. Arch Dis Child 2000; 83: 111-116.

6.      Singhi P, Bansal A, Geeta P, Singhi S. Predictors of long term neurological outcome in bacterial meningitis. Indian J Pediatr 2007; 74: 369-374.

7.      George CN, Letha S, Bai SS. A clinical study of chronic morbidity in children following pyogenic meningitis. Indian Pediatr 2002; 39: 663–667.

8.      Wandi F, Kiagi G, Duke T. Long-term outcome for children with bacterial meningitis in rural Papua New Guinea. J Trop Pediatr 2005; 51: 51–53.

9.      Odio CM, Faingezicht I, Paris M, Nassar M, Baltodano A, Rogers J, et al. The beneficial effects of early dexamethasone administration in infants and children with bacterial meningitis. N Engl J Med 1991; 324: 1525-1531.

10.  Lebel MH, Freij BJ, Syrogiannopoulos GA, Chrane DF, Hoyt MJ, Stewart SM, et al. Dexamethasone therapy for bacterial meningitis. Results of two double blind, placebo-controlled trials. N Engl J Med 1988; 319: 964-971.

11.  Schaad UB, Lips U, Gnehm HE, Blumberg A, Heinzer I, Wedgwood J. Dexamethasone therapy for bacterial meningitis in children. Swiss Meningitis Study Group. Lancet 1993; 342: 457-461.

12.  5OGUMEKAN  AO. Et al Non traumatic coma in childhood; etiology, clinical profile,morbidity, prognosis & mortality. J Trop pediatric. 1983;29;230-232.

13.  32 Sesia SS Seshia MMK,Sachdeva RK Coma in childhood, Dev Med & child neurology,1977;19;614-628.

14.  Bansal A, Singhi SC ,Singhi PD, Khandelwal N, Ramesh S, Non traumatic coma. the Indian journal of paediatrics, 2005;72;6;467-473.

Corresponding Author

Dr Jeetandra Kumar Sharma

Postgraduate Medical Officer,

MD (General Medicine) from GMC Bhopal (MP) India