Clinical Study of Coma in Children
Journal Title: Journal of Medical Science And clinical Research - Year 2017, Vol 5, Issue 8
Abstract
Background: Coma is a state of unarousable psychogenic unresponsiveness, in which the subjects lie with eyes closed. It has been an enigma for clinicians for many years and searching for the cause and prognosis is always a huge task. Objective: To study the etiology of coma, find out morbidity and mortality pattern and to determine the outcome of coma in children. Method: 60 children in the age group of 2 months to 12 years for a period of one year from January 2016 to December 2016, admitted with non-traumatic coma in the Department of Paediatrics, Govt, Vellore Medical College, Vellore were included in the study. A detailed history was taken and thorough examination was done according to the proforma. Patients were evaluated daily till discharge as advised or death. Outcome was classified into good recovery, moderate disability, severe disability, persistent vegetative state and death. Results: The incidence of non-traumatic coma was 1.18% among all paediatric admissions. The common cause of non-traumatic coma in the present study was due to Metabolic-Toxic lesions (81.66%) as compared to structural lesions (18.34%). Mortality due to structural causes was high (18.18%) when compared to metabolic-toxic lesions. Low GCS, abnormal pupillary reflex, absent corneal reflex and Doll’s eye movement had significant impact on prognosis. Children with coma duration more than 48 hours had 22.22% mortality (p value 0.02). Conclusion: CNS infections are the commonest cause of non-traumatic coma and it is possible to predict mortality and morbidity due to non-traumatic coma with simple clinical signs.
Authors and Affiliations
Dr Theranirajan E
Apert’s Syndrome - A Case Report and Review of Literature
Apert's syndrome makes up approximately 4% of all cases of craniosynostosis. The incidence is reported to be 1/160,000 live births [1]. Radiology has an important role in the evaluation, management and follow up of Apert...
Miraculous response to sequential therapy in a case of squamous cell lung carcinoma
Lung cancer has been the most common cancer in the world for several decades. As majority of the patients of non-small cell lung cancer present in locally advanced stage along with poor general condition, therefore they...
Histopathology of Endometrial Biopsies in Cases of Abnormal Uterine Bleeding- A Four Year Study
Background: Abnormal uterine bleeding (AUB) is the bleeding pattern that differs in frequency, duration and amount from a pattern observed during a normal menstrual cycle or after menopause and is caused by a variety of...
Detection of large number of NS1+ Dengue Virus (DENV) cases at Lucknow, India during the years 2016 and 2017
Large number of cases with dengue fever (n = 833) were reported in our lab from 30th June 2016 to 26th November 2016. Later, in subsequent year 173 patients with dengue fever were recorded. Diagnosis of dengue virus infe...
Vestibular Reflexes: Evaluation and Relevance in Microgravity
Maintaining postural equilibrium, sensing movement, and maintaining an awareness of the relative location of our body parts requires the precise integration of several of the body's sensory and response systems including...