Balu Subramanyam, R K (2023) Non Infectious Etiology of Encephalopathy in Patients admitted in IMCU of Tirunelveli Medical College. Masters thesis, Tirunelveli Medical College, Tirunelveli.
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Abstract
BACKGROUND: Encephalopathy is a broad clinicopathological condition, which involves diffuse brain dysfunction. The clinical hallmark of encephalopathy is an altered mental state, which is dependent on the severity of encephalopathy. Encephalopathy is a multifactorial disease that involves reversible and irreversible causes including metabolic, systemic infection, autoimmune, neurological, organ dysfunction, toxin/drug-induced and many others. The underlying etiology and differential diagnosis of encephalopathy can be determined based on the patient’s medical history including the onset of symptoms, progression, total duration, and physical examination with support of laboratory investigations. The study aims to identify the non-infectious causes of encephalopathy to better understand the etiological differences and susceptible high risk groups. Early identification of the disease can help in preventing the progression of the disease and reduce the complication that arises with encephalopathy. AIM AND OBJECTIVES: The study aims to enumerate various non-infectious causes of encephalopathy in patients admitted to IMCU and to identify high-risk groups susceptible to various non-infectious causes of encephalopathy. MATERIALS AND METHODS: This is a single center hospital based cross-sectional study done in the Department of general medicine of Tirunelveli medical college for a time period of 18 months (March 2021 - August 2022). The study included 235 participants who were recruited based on inclusion and exclusion criteria. Detailed history taking, assessment of sensorium using Glasgow Coma Score, routine blood investigations, relevant radiological investigations, body fluid analysis were done and collected data was analyzed using Statistical Package for Social Sciences. RESULTS: The proportion of encephalopathy was seen higher in the age group between 40- 49 years of age (65 participants), followed by the age group of 50-59 years of age (64 participants). Male predominance was noted higher in the current study, with 140 male participants and 95 females. Regarding different etiologies, neurological cause was most common (68 participants), followed by encephalopathy due to systemic disease (62 participants), metabolic disorders (56 participants) and toxin/drug induced (49 participants). Type 2 diabetes was the most common comorbidity seen among the majority of the individuals (65 participants), followed by hypertension (58 participants) although 58 participants presented with encephalopathy with no comorbid condition. In addition, epilepsy, DCLD, CAD, CKD, and COPD were also seen among patients. Out of 235 participants, 134 (57%) of the participants were presented with a GCS score of less than 10, and 101 (43%) participants showed a score above 10. The current study reports a significant difference in the GCS score due to various etiology of encephalopathy (p < 0.0001). The current study reports a significant difference in the etiology of encephalopathy in different age groups. The study found a significant difference between different age groups and the etiology of encephalopathy (p < 0.0001) with the age group of 40-49 and 50-59 years being more prone for encephalopathy with systemic diseases being the predominant cause. The current study did find a significant difference in the comparison of gender and etiology of encephalopathy (p = 0.044). However, the male gender was overall seen in higher numbers among various causes of encephalopathy. CONCLUSION: The present study concludes that encephalopathy is a multifactorial disease with different etiological reasoning for each type of encephalopathy. The severity and morbidity remain high in every type of encephalopathy which increases with advanced age. The most cause of encephalopathy in 40-59 years age group was due to systemic disease, followed by neurological cause, and metabolic. The toxin/drug-induced encephalopathy was seen in the younger age group due to drug abuse or alcohol intoxication. The prognostic role of the GCS score can be beneficial in identifying the severity of the disease. The current study shows that the majority of patients got admitted with GCS < 10 irrespective of the cause of encephalopathy. Hence it is essential to identify the root cause of encephalopathy to prevent morbid complications, reduce the risk of organ damage, and provide optimal therapeutic outcomes.
| Item Type: | Thesis (Masters) |
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| Additional Information: | Reg.No.200120104005 |
| Uncontrolled Keywords: | Non Infectious Etiology, Encephalopathy, Intermediate Medical Care Unit (IMCU), Tirunelveli Medical College |
| Subjects: | MEDICAL > General Medicine > MEDICAL > General Medicine |
| Depositing User: | Subramani R |
| Date Deposited: | 25 Apr 2021 12:55 |
| Last Modified: | 25 Mar 2024 01:33 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/15339 |
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