Clinical Profile of Tuberculous Meningitis in Kashmir Valley-The Indian Subcontinent

Wani, Abdul Majid; Hussain, Waleed Mohd; Fatani, Mohd; Shakour, Bothaina Abdul; Akhtar, Mubeena; Ibrahim, Fathaia; Tawakul, Abdullah; Khojah, Amer

doi:10.1097/ipc.0b013e31817e5c16

Cited by 4 publications

(5 citation statements)

References 23 publications

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“…Five patients were deeply comatose on admission with a GCS of <6/15. Similar findings have been reported by Abdul Majid et al [15] wherein about 89.47%of the patients presented with severe disease, that is, stage II (50%) and stage III (39.47%).…”

Section: Discussionsupporting

confidence: 89%

“…Similar findings have been reported by Abdul Majid et al . [ 15 ] wherein about 89.47%of the patients presented with severe disease, that is, stage II (50%) and stage III (39.47%). Our results were also matching with Mishra et al .…”

Section: Discussionmentioning

confidence: 99%

“…Abdul Majid et al . [ 15 ] reported abnormal CT findings in 73.52% patients as basal enhancement in 36%, hydrocephalus in 28%, tuberculomas in 52%, infarcts in 12.0%, cerebral edema in 8.0%, and more than 1 finding in 32.0% of the patients. Normal study was in 26.4%.…”

Section: Discussionmentioning

confidence: 99%

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Impact of clinico-radiological parameters on the outcome of treatment in brain tuberculosis

et al. 2014

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Objectives:The Aim of this study was to evaluate the impact of clinico-radiological parameters on the outcome of the treatment in brain tuberculosis.Materials and Methods:This study was conducted in the Department of Neurosurgery and Neurology Skims Srinagar India for a period of two years from November 2009 to November 2011. A total of 61 patients presenting with brain tuberculosis admitted at skims during these two years were included in the study. Patients having clinical, laboratory and radiological findings suggestive of brain tuberculosis were included in the study. On correlating the CT characteristics-tuberculomas, basal exudates and hydrocephalus with sequelae at 6,12 and 18 months - focal deficit, cognitive impairment, and diplopia.Results:It was seen that basal exudates correlated with all the three neurological sequelae i.e.; with focal deficit (P = 0.001), cognitive impairment (P = 0.011), and diplopia (P = 0.021). Hydrocephalus correlated well with cognitive impairment (P = 0.031) and tuberculoma correlated with none of these clinical characteristics.Conclusion:We concluded that the mortality and neurologic sequelae were directly related to the clinical stage of disease at presentation. Correlating the CT characteristics we concluded that basal exudates correlated with all the three sequelae i.e.; with focal deficit, cognitive impairment, and diplopia. Hydrocephalous correlated well with cognitive impairment and tuberculoma correlated with none of these clinical characteristics.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

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Impact of clinico-radiological parameters on the outcome of treatment in brain tuberculosis

et al. 2014

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“…Moghtaderi et al, in a study reported TLC of 158 cells/mm 3 for TBM and 1000 cells/mm 3 for bacterial meningitis and Wani, et al, reported TLC of 175 cells/mm 3 for TBM. 23,24 Lymphocytic predominance was 81.93% in TBM. However, neutrophilic predominance was 45.38% and lymphocytes were 54.63% in bacterial meningitis, though the TLC was in highest range of 2600 cells/mm 3 , explainable by early rise of lymphocytes reported in 10% of cases.…”

Section: Discussionmentioning

confidence: 96%

“…These results were similar to other studies from India. [22][23][24] The patients of TBM, in CSF revealed highest ADA levels of 10.7±20.24 IU/L followed by 5.84±3.22 IU/L in bacterial meningitis. ADA >6 IU/L in CSF with specificity of 97.5% was found most specific and protein level >45mg/dL with sensitivity of 96.6% was found highly sensitive in predicting the diagnosis of TBM in our study.…”

Section: Discussionmentioning

confidence: 99%

Spectrum of cerebrospinal fluid analysis and nervous system diseases in hospitalised patients: a hospital based prospective study from a hilly state of Himachal Pradesh in North India

et al. 2020

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Background: The cerebrospinal fluid (CSF) analysis is an invaluable diagnostic aid in various nervous system diseases. Many times, alterations in normal CSF parameters with variable and overlapping results are challenging in differential diagnosis and treatment of the diseases. The aim of the study is to know the spectrum of CSF analysis and nervous system diseases with different prevalence in our setup.Methods: Total 150 hospitalised patients with various nervous system diseases and indications were subjected to lumbar puncture and the CSF analysis was done, in a period of one year study.Results: A total of 150 patients with mean age of 50.41±19.54 years had male to female ratio of 1.63:1. CSF analysis revealed most of tuberculous meningitis (TBM) in 30(20%) patients with higher adenosine deaminase (ADA) levels of 10.7±20.24 IU/L and lymphocytic leukocytosis (81.93%). Bacterial meningitis in 8(5.3%) patients revealed highest increase in CSF mean protein levels of 349.63±226.39 mg/dL and in mean cell count of 1039.50±930.23 cells/mm3. There was significant increase in protein levels and decrease in glucose levels of CSF, both in TBM and bacterial meningitis compared to viral, fungal meningitis and other central nervous system (CNS) diseases(p<0.001).Conclusions: Spectrum of CSF analysis and CNS diseases revealed consistent findings of alteration of normal CSF variables and therefore, was found as an invaluable, rapid and cost-effective differentiating diagnostic tool.

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Delirium in a 74-year-old man: correct imaging revealed the truth

Wani

Manjaly²,

Hussain³

et al. 2009

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Delirium is a cognitive disorder. DSM-IV criteria for delirium must include both acute onset and fluctuating symptoms; disturbance of consciousness (including inattention); at least one of the following: disorganised thinking, disorientation, memory impairment or perceptual disturbance; and evidence of a putative causal medical condition. Traditionally, the course has been described as transient in which recovery is likely to be complete if the underlying aetiological factor is promptly corrected or is self-limited. The most common precipitating causes in elderly include sepsis, dehydration and drugs. Work-up for delirium is limited to septic screening, baseline investigations and imaging. Patients with delirium without focal signs and with either evidence for a medical aetiology of delirium or pre-diagnosed dementia are at a very low risk of having focal lesions in their contrast-enhanced CT or MRI. We are presenting an interesting case of delirium with urosepsis whose imaging revealed milliary brain tuberculomas on contrast-enhanced MRI.

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Clinical Profile of Tuberculous Meningitis in Kashmir Valley-The Indian Subcontinent

Cited by 4 publications

References 23 publications

Impact of clinico-radiological parameters on the outcome of treatment in brain tuberculosis

Impact of clinico-radiological parameters on the outcome of treatment in brain tuberculosis

Spectrum of cerebrospinal fluid analysis and nervous system diseases in hospitalised patients: a hospital based prospective study from a hilly state of Himachal Pradesh in North India

Delirium in a 74-year-old man: correct imaging revealed the truth

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