An Observational Study on Clinical Profile and Outcome of Japanese Encephalitis Patients Admitted in the Department of Medicine of a Tertiary Care Hospital of North Bank of Assam, India

Bhaskar Brahma, Dwijen Das, Arup Choudhury, Rimli Kaushik Barua
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Abstract

 Background: A significant public health issue in India is Japanese encephalitis (JE), which has a high fatality rate and causes residual neurological damage in survivors. The goal of the current study was to examine JE positive among patients who had been admitted with acute encephalitis syndrome (AES) and to analyse the differences in clinical profile, disease severity, neurological consequences, and mortality rate in Tezpur Medical College and Hospital. Methods: This study is a retrospective observational study in a patients who were diagnosed as Japanese encephalitis on the basis of JEV-specific IgM antibodies in blood and cerebrospinal fluid (CSF) samples. The study included 32 Japanese Encephalitis positive patients admitted in Tezpur Medical College and Hospital (who met the clinical case definition of AES) and thus, their clinical profile and outcome were analysed. Result: A total 32 JE cases were enrolled in the study diagnosed with CSF and Serum IgM ELISA antibody test. All of them were Serum IgM ELISA antibody positive, 9(28%) cases were both Serum and CSF IgM antibody positive. Most common age group affected was 12-20 years(31%). 59.37% cases recovered completely, 21.87% had neurological sequelae at the time of discharge and 18.75% died at ward. Conclusion: Japanese Encephalitis is one of the leading cause of AES in India. In our study it has been seen that GCS score on presentation and CSF cell counts has positive association with mortality and disease sequale. Adequate care and treatment should be provided in order to avoid subsequent complications/sequale. Proper vaccination and vector control can prevent or mitigate this disease.
印度阿萨姆邦北岸一家三级医院内科收治的日本脑炎患者的临床概况和预后观察研究
背景:日本脑炎(JE)是印度的一个重大公共卫生问题,其致死率很高,并对幸存者造成残余神经损伤。本研究的目的是检查急性脑炎综合征(AES)住院患者中的 JE 阳性患者,并分析特兹普尔医学院和医院在临床概况、疾病严重程度、神经系统后果和死亡率方面的差异。研究方法本研究是一项回顾性观察研究,研究对象是根据血液和脑脊液(CSF)样本中的 JEV 特异性 IgM 抗体诊断为日本脑炎的患者。该研究包括 32 名在 Tezpur 医学院和医院住院的日本脑炎阳性患者(符合 AES 的临床病例定义),因此分析了他们的临床概况和预后。结果:共有 32 例 JE 病例通过 CSF 和血清 IgM ELISA 抗体检测确诊。所有病例的血清 IgM ELISA 抗体均呈阳性,9 例(28%)病例的血清和脑脊液 IgM 抗体均呈阳性。最常见的患病年龄段为 12-20 岁(31%)。59.37%的病例完全康复,21.87%的病例出院时有神经系统后遗症,18.75%的病例在病房死亡。结论日本脑炎是导致印度 AES 的主要原因之一。在我们的研究中发现,发病时的 GCS 评分和 CSF 细胞计数与死亡率和疾病后遗症呈正相关。应提供适当的护理和治疗,以避免后续并发症/后遗症。适当的疫苗接种和病媒控制可以预防或减轻这种疾病。
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