GSC Score Research Articles

2-Propyl-1H-imidazole-4,5-dicarboxylate acid supported cu/ni/fe/co complexes: synthesis, biological and catalytic evaluation

Herein, we report 2-propyl-1H-imidazole-4,5-dicarboxylate complexes of Cu/Co/Fe/Ni metal ions. The complexes have been characterized using powder X-ray diffraction, FTIR, and mass spectrometry. Thermal gravimetric analysis (TGA) established their thermal stability, enduring temperatures of up to 650 °C. The interaction of Bovine Serum Albumin (BSA) and DNA with these complexes was examined, revealing a significant binding affinity up to 70%. Fluorescence quenching experiments also showed the binding of complexes with biomolecules. These interactions were substantiated by molecular docking studies against the proteins 3v03 (BSA) and 1d28 (DNA), shedding light on the essential interactions driving their potential medicinal activity. The Cu complex displayed a notably high GSC score and a substantial area as determined through the Patch Dock server. Free radical interaction with 2,2-diphenylpicrylhydrazyl (DPPH) shows their antioxidant activity where Cu and Fe complexes expressed greater activity as compared to others. The catalytic properties of the compounds were assessed using p-nitrophenol (PNP) where the complexes exhibited reducing activity, leading to a conversion of over 90% of PNP into p-aminophenol. Analysis revealed a pseudo-second-order model closely aligned with experimental values, indicating second-order reduction kinetics.

Correlation Between the Degree of Midline Shift in Computed Tomography Scan of Brain and Level of Consciousness of the Patients with Acute Spontaneous Intracerebral Haemorrhage

Background: Intracerebral hemorrhage (ICH) is the second most common cause of stroke, following ischemic stroke, but accounts for a disproportionate amount of cerebrovascular mortality and morbidity. The extent of midline shift, observed on computed tomography (CT) scans, has been recognized as an important radiological finding associated with the severity of ICH. Objective: To evaluate correlation between the degree of midline shift in computed tomography scan of brain and level of consciousness of the patients with acute spontaneous intracerebral haemorrhage. Material and method: This cross-sectional study was carried out in 100 patients, out of this 50 had spontaneous intracerebral hemorrhage with mass effect and 50 had spontaneous intracerebral hemorrhage without mass effect taken as the control group, the age range from 30-75 years. These patients were purposively collected from the Department of Radiology and Imaging in collaboration with Department of Medicine, Neuromedicine and Neurosurgery of Dhaka Medical College Hospital, Dhaka. All the patients were evaluated by CT findings. On admission Glasgow Coma Scale (GCS) score were recorded from participant’s treatment sheet and reviewed by the senior Neurologist after taking permission of the authority. Results: This study shows there is significant inversely correlation of the GSC score with degree of midline shift measure using septum pellucidum shift (P<0.05). The GCS score of <10 mm of septum pellucidum shift compared to greater than 10 mm of septum pellucidum shift is significantly different (P<0.05). The GCS score of SICH with mass effect compared to the GCS score of SICH without mass effect is significantly different (P<0.05). Conclusion: Radiologist should carefully and elaborately interpret the spontaneous intracerebral hemorrhage with midline shift at CT-scan brain and help clinicians to evaluate the level of consciousness which is significant predictor of outcome of our valuable patients. Sir Salimullah Med Coll J 2023; 31: 94-99

Buchwald coupling promoted benign synthesis of benzoxazine derivatives supported Cu complexes with their multipurpose potential in antimicrobial and catalytical fields

A novel series of benzoxazine derivatives have been synthesized via microwave assistance and used as ligands for the synthesis of their Cu(II) complexes using the same benign method. Synthesized ligands as well as complexes were characterized using NMR, LCMS, and FT-IR analytical tools. The crystalline nature of complexes has been analyzed by powder XRD. These complexes have been tested against six bacterial and three fungal species for their antimicrobial evaluation. Complexes have shown good antimicrobial activity against human pathogens as compared with their ligands, and varied with different pathogens. The molecular docking study against 4GQQ and 5cdp proteins with synthesized complexes was performed to see the necessary interactions responsible for anti-bacterial activity. The docking analysis of the Vid and Via complexes have supported the antibacterial activity exhibiting high GSC score and area obtained through PatchDoc server. The reduction activity shown by the Vib, Vic and Vid complexes inferred about their utility in catalytically process in industries.

High cerebrospinal fluid lactate concentration at 48 h of hospital admission predicts poor outcomes in patients with tuberculous meningitis: A multicenter retrospective cohort study.

ObjectiveThis study aimed to analyze the cerebrospinal fluid (CSF) parameters affecting the outcomes of patients with tuberculous meningitis (TBM).MethodsThis is a multi-center, retrospective, cohort study involving 81 patients who were diagnosed with TBM and treated in Haihe Clinical College of Tianjin Medical University, Tianjin Medical University General Hospital, and General Hospital of Air Force PLA from January 2016 to December 2019. Baseline data, Glasgow Coma Scale (GCS) score, and clinical presentations of all patients were collected at admission. CSF samples were collected at 48 h, 1, 2, and 3 weeks after admission. CSF lactate, adenosine deaminase, chloride, protein, glucose levels and intracranial pressure were measured. After a follow-up of 16.14 ± 3.03 months, all patients were assessed using the modified Rankin Scale (mRS) and divided into good (mRS scores of 0–2 points) and poor outcome groups (mRS scores of 3–6 points). The differences in patients' baseline data, GCS score, clinical presentations, and levels of CSF parameters detected at 48 h, 1, 2, and 3 weeks after admission between two groups were compared. Statistically significant variables were added to the binary logistic regression model to identify the factors impacting the outcomes of patients with TBM. Receiver operating characteristic (ROC) curve was used to assess the predictive ability of the model.ResultsThe CSF lactate level exhibited a decreasing trend within 3 weeks of admission in the two groups. For the within-group comparison, statistically significant differences in the lactate level was found in both groups between four different time points. A binary logistic regression model revealed that CSF lactate level at 48 h after admission, age, and GSC score on admission were independently associated with the outcomes of patients with TBM. ROC curve analysis showed that the area under the ROC curve (AUC) was 0.786 for the CSF lactate level (48 h), 0.814 for GCS score, and 0.764 for age.ConclusionHigh CSF lactate level at 48 h after admission is one of the important factors for poor outcomes in patients with TBM.

Value of coma scale in prediction of mortality in non-traumatic coma in 1-12 years old children

Background: Acute non-traumatic coma is a common problem in pediatric practice accounting for 10-15% of all hospital admissions and is associated with significant mortality. Assessment of the severity of coma is essential to comment on the likelihood of survival in comatose children. In the last three decades, various scores have been used to assess the severity of coma and to predict its outcome. Glasgow Coma Scale (MGCS) in spite of its various drawbacks has been widely used for assessing pediatric coma, though only few studies are available to support its use in pediatric coma as a whole. Hence the study was undertaken to evaluate the usefulness of coma scale in prediction of mortality in children between 1-12 years old admitted with coma of non-traumatic origin. Methods: A prospective study was conducted at Inpatient services of intensive medical care unit and general medical wards of Institute of child Health and Hospital for children, Egmore, Chennai, between October 2018 to November 2019. A Study Population consisting of children in the age group 1-12 years admitted in intensive care unit and medical wards with alteration in sensorium as one of the predominant complaints and admitted within 7 days of onset of coma were included. Sample size was 148. Chi-square test was used to study the association between the scores at Various times points and outcome. Results: It was observed that when the scores were between 3‐ 5 mortality rate was 67.0%, it was 17% when the minimal observed score was between 6-8. The group in which the minimal score never decreased be1ow 9 had no mortality. As the score increases the proportion of death decreases and the proportion having good recovery increases and vice versa. This type of association has been observed at different time points (Initial, 24 hrs, 48 hrs and 72 hrs). The significance of this association increases with the progression of time since admission. P value for the degree of association at various time points are: At presentation P < 0.00001, 24hrs - P < 0.000001, 48 hrs - P < 0.000001 and 72 hrs P < 0.00000001. Conclusion: There is highly statistically significant association between the GSC score levels and outcome. As the score increases the proportion of death decreases and the proportion having good recovery increases and vice versa.

Factors influencing Outcome of Extradural Hematoma in a Tertiary Care Hospital of Dera Ghazi Khan, Pakistan

Background: The outcome for this neurosurgical problem is still far from set target in many developing countries like Pakistan. Major proportion of cases presenting with EDH in hospital still has poor outcome. This poor outcome of EDH is attributed to many factors including weak health systems of most developing countries. Objective of study was to analyze factors influencing outcome among patients of head injury with an extradural hematoma before surgery admitted in neurosurgery department of Dera Ghazi Khan Medical College, Dera Ghazi Khan.
 Materials and Methods: This cross-sectional analytical study was conducted in neurosurgery department of Dera Ghazi Khan Medical College from January 2019 to December 2019 after ethical approval. All the patients with extradural hematoma of either gender admitted in the department during the study duration in which surgery was performed to evacuate extradural hematoma were included in the study. Data was collected by using preformed, pretested questionnaire. A vital signs and Glasgow coma scale record was maintained at thirty minutes interval. Computerized tomography was done in every patient. The EDH volume was calculated by using Peterson and Epperson equation a x b x c x 0.5. Data was entered and analyzed by using SPSS version 22. Chi square test was applied to observe any statistically significant difference between various strata if existed and p value <0.05 was taken as significant.
 Results: Total 237 patients with Extradural Hematoma (EDH) were admitted in neurosurgery department during the study period were included in study. More than half 136 (57.4%) patients were more or equal to the age of 18 years. Majority of the patients 218 (91.9%) in the study were male. Major cause of extradural hematoma among patients in this study was road traffic accident 154 (64.9%). The outcome of EDH was found to be significantly (p <0.001) associated with age of patients. More than ninety percent of the patients who were directly admitted to tertiary care hospital has good outcome as compared to 109 (60.2%) patients which were referred and difference in outcome was statistically significant (p<0.001). The volume of EDH is not significantly associated with the outcome (p=0.090). The GSC score of the patients at the time of admission is significantly associated with the outcome (p<0.001). Study findings showed that GCS score of the patients at the time of surgery was also found to be significantly associated with outcome of EDH (p<0.001).
 Conclusion: There is a strong association of outcome in extradural hematoma with age, gender and GCS of the patient. In higher GCS the outcome was excellent but in low GCS the outcome was poor.

Factors influencing Outcome of Extradural Hematoma in a Tertiary Care Hospital of Dera Ghazi Khan, Pakistan

Background: The outcome for this neurosurgical problem is still far from set target in many developing countries like Pakistan. Major proportion of cases presenting with EDH in hospital still has poor outcome. This poor outcome of EDH is attributed to many factors including weak health systems of most developing countries. Objective of study was to analyze factors influencing outcome among patients of head injury with an extradural hematoma before surgery admitted in neurosurgery department of Dera Ghazi Khan Medical College, Dera Ghazi Khan. Materials and Methods: This cross-sectional analytical study was conducted in neurosurgery department of Dera Ghazi Khan Medical College from January 2019 to December 2019 after ethical approval. All the patients with extradural hematoma of either gender admitted in the department during the study duration in which surgery was performed to evacuate extradural hematoma were included in the study. Data was collected by using preformed, pretested questionnaire. A vital signs and Glasgow coma scale record was maintained at thirty minutes interval. Computerized tomography was done in every patient. The EDH volume was calculated by using Peterson and Epperson equation a x b x c x 0.5. Data was entered and analyzed by using SPSS version 22. Chi square test was applied to observe any statistically significant difference between various strata if existed and p value <0.05 was taken as significant. Results: Total 237 patients with Extradural Hematoma (EDH) were admitted in neurosurgery department during the study period were included in study. More than half 136 (57.4%) patients were more or equal to the age of 18 years. Majority of the patients 218 (91.9%) in the study were male. Major cause of extradural hematoma among patients in this study was road traffic accident 154 (64.9%). The outcome of EDH was found to be significantly (p <0.001) associated with age of patients. More than ninety percent of the patients who were directly admitted to tertiary care hospital has good outcome as compared to 109 (60.2%) patients which were referred and difference in outcome was statistically significant (p<0.001). The volume of EDH is not significantly associated with the outcome (p=0.090). The GSC score of the patients at the time of admission is significantly associated with the outcome (p<0.001). Study findings showed that GCS score of the patients at the time of surgery was also found to be significantly associated with outcome of EDH (p<0.001). Conclusion: There is a strong association of outcome in extradural hematoma with age, gender and GCS of the patient. In higher GCS the outcome was excellent but in low GCS the outcome was poor.

Enteral combined with parenteral nutrition improves clinical outcomes in patients with traumatic brain injury

ABSTRACT Objective: To investigate the effect of nutritional support on nutritional status and clinical outcomes of patients with traumatic brain injury (TBI). Methods: Sixty-one patients with TBI from the intensive care unit and neurosurgery of Xianyang Central Hospital from 2017 to 2019 were retrospectively included. General and clinical data of the study subjects were collected. The control group (n = 28) received parenteral nutrition alone, and the observation group (n = 33) received parenteral nutrition combined with enteral nutrition. The general conditions and biochemical indicators of both groups of patients were divided into two groups of ≤8 and ≥9 for stratified analysis to compare the nutritional support status and infection complications during hospitalization Occurrence, ICU length of stay, total length of stay, total cost of stay, and prognostic indicators of the patients were analyzed and compared. Results: There were no significant differences in biochemical indicators between both groups of patients when they were discharged. Among patients with GCS ≤8 points, the incidence of lung infection in the observer was significantly higher than that in the control group (P < 0.001), but the incidence of intracranial infection, stress ulcers, and diarrhea was not statistically different from that in the control group (P = 0.739). No significant differences were observed in hospitalization time and hospitalization costs between both groups (P = 0.306 and P = 0.079, respectively). The observation group was significantly better than the control group in GSC score and long-term quality of life score (P = 0.042 and P = 0.025, respectively). When GCS was ≥ 9 points, there was no statistical difference in the incidence of lung infections and intracranial infections between both groups of patients (P = 0.800 and P = 0.127, respectively). The observation group was significantly higher than the control group in terms of length of hospital stay, nasal feeding time and hospitalization costs (P < 0.001, P < 0.001 and P = 0.006, respectively). The observation group was significantly better than the control group in GSC score and long-term quality of life score (P = 0.001 and P = 0.015, respectively). There was no significant difference in the incidence of pulmonary infection and intracranial infection between both groups of patients (P = 0.800 and P = 0.127, respectively). Conclusion: Enteral nutrition combined with parenteral nutrition intervention has a positive effect on the clinical prognosis of TBI patients.

Initial Factors Affecting 6-month Outcome of Patients Undergoing Surgery for Acute Post-traumatic Subdural and Epidural Hematoma.

The most frequent consequences of a traumatic brain injury are acute subdural (SDH) and epidural hematoma (EDH), which usually require a surgical treatment. Most of the factors affecting the prognosis have been analyzed on a wide group of traumatic brain injuries. Nonetheless, there are few studies analyzing factors influencing the prognosis regarding patients with EDH and SDH. The aim of the study is to identify factors which have prognostic value in relation to 6-month outcome of patients undergoing surgery for acute hematoma. The study included a group of 128 patients with isolated craniocerebral injuries. The patients were divided into two groups, namely a group of 28 patients operated on due to epidural hematoma and a group of 100 patients operated on due to acute subdural hematoma. All patients were operated and treated in the Department of Neurosurgery at the Medical University in Lublin from 1.10.2014 to 31.08.2017. The following factors from the groups were analyzed: demographic data, physiological factors, laboratory factors, computed tomography scan characteristics, and time between the trauma and the surgery. All the factors were correlated with six-month outcome in Glasgow outcome scale. The univariate analysis has confirmed the influence of many factors affecting the outcomes. It is interesting that the factors such as GSC score, saturation, respiratory rate, and systolic blood pressure were associated with outcome with highly statistically significant differences in both group. These are factors that, with an appropriate treatment, could be normalized at the place of the accident.

The initial factors affecting in-hospital mortality rate of patients undergoing surgery for post-traumatic extra-axial hematomas.

Traumatic brain injury (TBI) is one of the most important causes of disability and death among young adults and referred to as "silent" epidemic. The most frequent consequences of a TBI are extra-axial hematomas, comprising of acute subdural (SDH) and epidural hematoma (EDH). Most of the factors affecting the mortality have been analyzed in a wide group of TBI. The aim of this study is to identify factors affecting in-hospital mortality in patients undergoing surgery for acute traumatic subdural and epidural hematoma. The study included 128 patients operated on due to extra-axial hematomas. Twenty-eight patients were operated on for EDH and 100 on for SDH. Patients were treated at the Department of Neurosurgery Medical University in Lublin, during almost three years. The following factors were analyzed: demographic data, physiological factors, laboratory factors, computed tomography scan characteristics and time between the trauma and the surgery. All the factors were correlated with in-hospital mortality rate. The univariate analysis has confirmed the influence of many factors affecting the in-hospital mortality. It is interesting that factors such as GSC score, systolic blood pressure, respiratory rate and glycemia were associated with in-hospital mortality rate with highly statistically significant differences (Tab. 3, Fig. 2, Ref. 40).

Comparison of Traumatic Brain Injury Patients by Age Group in Emergency Department

Introduction:Traumatic brain injury (TBI) is an important public health concern because of the high mortality rate of young people and a high proportion among the trauma. According to studies, patients visiting the emergency department (ED) with TBI comprise 1.4% of all ED patients.Aim:The authors think that the characteristics of patients with TBI will vary according to the age group. Therefore, the purpose of this study is to investigate the clinical and social characteristics of patients with TBI visiting the ED by age group.Methods:Trauma patients who conducted brain CT at the ED of Korean University Hospital (three hospitals) for 3 years from March 2013 to February 2016 were enrolled. Medical records were investigated retrospectively. The GCS scores were estimated at initial ED arrival. The primary outcome was to determine the characteristics of each age groups with gender, severity (by GSC score), trauma mechanism, and admission rate.Results:A total of 15,567 TBI patients received brain CT evaluation during the investigation period. Based on age, patients in their 50s were the most common (16.5%). Regarding the severity, the ratio of mild was higher in under patients under 9 (99.3%); the ratio of severe was higher for patients in their 20s (4.6%). In almost every age group, the male ratio of TBI was higher, except for females aged 70 or older. Under 19 years of age, the ambulance utilization rate was lower than any other age group. The most common injury mechanism was a collision, the next was a traffic accident, and in under 9, a fall was the most common. 70.1% of patients returned home after treatments.Discussion:Identifying the characteristics of patients with TBI visiting ED is fundamental. Therefore, it is necessary to continuously collect basic data on TBI among patients visiting the ED.

Molecular docking of anti-inflammatory drug diclofenac with metabolic targets: Potential applications in cancer therapeutics

Diclofenac is a potent NSAID of clinical choice, which is widely used for containing inflammation. Moreover, recent experimental evidences overwhelmingly substantiate its antineoplastic potential. However, the precise molecular mechanisms of diclofenac's anticancer activity remain poorly understood. Neoplastic cells display reprogrammed metabolic features, which are manifested and regulated by a complex networking of molecular pathways. However, the effect of diclofenac on tumor cell metabolism are not yet clearly deciphered. Hence, the present investigation was carried out to identify and characterize key diclofenac targets of tumor metabolism, cell survival and chemoresistance. The interactions of diclofenac with such targets was analysed by PatchDock and YASARA (Yet Another Scientific Artificial Reality Application). The docking ability of diclofenac with its targets was based on analysis of dissociation constant (Kd), geometric shape complementarity score (GSC score), approximate interface area (AI area) and binding energy. The findings of this investigation reveal that diclofenac is capable of interacting with all of the selected molecular targets. Prominent interactions were observed with GLUT1, MCT4, LDH A, COX1, COX2, BCRP/ABCG2, HDM2/MDM2 and MRP1 compared to other targets. Interactions were of noncovalent nature involving ionic, hydrophobic interactions, Van der Waals forces and H-bonds, which varied depending on targets. This study for the first time, characterizes the nature of molecular interactions of diclofenac with selected targets involved in cancer cell metabolism, pH homeostasis, chemosensitivity, cell signalling and inflammation. Hence, these findings will be highly beneficial in optimizing the utility of diclofenac in development of novel cancer therapeutics.

Antithrombotic agents intake prior to injury does not affect outcome after a traumatic brain injury in hospitalized elderly patients

Background: The purpose of this study is to investigate the effect of risk factors including International Normalized Ratio (INR) as well as the Partial Thromboplastin Time (PTT) scores on several outcomes, including hospital length of stay (LOS) and The Extended Glasgow Outcome Scale (GOSE) following TBI in the elderly population. Methods: Data were retrospectively collected on patients (n=982) aged 65 and above who were admitted post TBI to the McGill University Health Centre-Montreal General Hospital from 2000 to 2011. Age, Injury Severity Score (ISS), Glasgow Coma Scale score (GCS), type of trauma (isolated TBI vs polytrauma including TBI), initial CT scan results according to the Marshall Classification and the INR and PTT scores and prescriptions of antiplatelet or anticoagulant agents (AP/AC) were collected. Results: Results also indicated that age, ISS and GSC score have an effect on the GOSE score. We also found that taking AC/AP has an effect on GOSE outcome, but that this effects depends on PTT, with lower odds of a worse outcome for those taking AC/AP agents as the PTT value goes up. However, this effect only becomes significant as the PTT value reaches 60 and above. Conclusion: Age and injury severity rather than antithrombotic agent intake are associated with adverse acute outcome such as GOSE in hospitalized elderly TBI patients.

Predictors for outcome after surgery for traumatic acute subdural hematoma

Abstract Introduction: Acute traumatic subdural hematoma (ASDH) is one of the most frequent conditions in neurosurgery demanding emergency surgery. The aim of the study was to identify factors influencing outcome in patients who had surgery for evacuation of ASDH. Methods: From 2005 to 2012 eighty-five patients at age above 18 years had surgery for evacuation of ASDH. Outcome was measured according GOS at discharge and was dichotomized as “favorable outcome” (GOS 4 to 5) and “unfavorable outcome” (GOS 1 to 3). These factors were evaluated with univariate and logistic regression analysis for significance with outcome. Results: The mean age of the 85 patients was 62.7 years (SD±18.5). 45.9% patients were with favorable outcome and 54.1% had unfavorable outcome. Patients with GCS score 3-8 (54.1%) had 80.4% unfavorable outcome whereas 78.6% of patients with GCS score 13-15 (32.9%) had favorable outcome. All patients with nonreactive pupils (bilaterally or unilaterally - 31.8%) had unfavorable outcome whereas patients (36.5%) with both reactive pupils (36.5%) had in 80.6% favorable outcome. All patients (40%) with Rotterdam CT scores 5 and 6 had unfavorable outcome. The factors determining outcome were admission GSC score, Rotterdam CT scores, and prothrombin time. Conclusion: Patients who have GSC score of 3, unresponsive pupil(s) or have Rotterdam CT scores 5 and 6 have little chance of survival. Patients with coagulopathy have two times more unfavorable outcome. The patients with ASDH should have surgery as soon as possible after correction of vital parameters in order to avoid deterioration which can be very rapid and irreversible.

Neuropsychological and behavioral disorders and their correlations with the severity of the traumatic brain injury

The goal of this study was to evaluate the different neuropsychological and behavioral disorders of patients with traumatic brain injury (TBI) and to study their correlations with the epidemiological and neurotraumatic characteristics. It was a cross-sectional study including 30 patients with TBI conducted in the physical medicine and rehabilitation department. The analysis of memory impairment was performed by the (MMS) and the (GOAT) tests. The psychological profile was evaluated by the HAD scale. Behavioral disorders were tested by the agitated behavior scale. Otherwise, the executive functions were evaluated by the DEX scale. The global social-functional evolution was measured by the GOS scale. The mean age was 32.19 ± 12.37 years with a sex-ratio of 3,5. The mean follow-up period was 3,9 ± 2.24 years. Fifteen patients (55.6%) had severe TBI. Memory disorders were observed in 9 patients (36%) when evaluated by the MMS scale and in 5 patients (18.5%) by the GOAT scale. Depressive symptoms were found in 17 patients (70.4%); Moreover, anxiety was noted in 15 patients (55.6%). Behavioral troubles, such as aggressiveness and agitation were noted respectively in 17 (63%) and 6 patients (22.2%). Severe agitation level was found in one patient (3.7%). Abnormal executive functions were noted in 17 patients (76.7%) with an average. Dex score of 23.68 ± 22.8. The most affected dimensions were intentionality and negative affect. Dex score of 23.68 ± 22.8. The most affected dimensions were intentionality and negative affect. We have found correlations between cognitive impairment and the education level ( P < 0.01), between aggression and male sex ( P < 0.01) and between abnormal executive functions and the initial GSC score ( P = 0.04, r = –0.43). The lack of overall improvement (GOS scale) was correlated to the degree of abnormal executive function ( P = 0.02). The executive function disorders, depressed mood and the memory disorders seemed to be the most frequent among neuropsychological disorders in TBI. We noted that it is so important to evaluate neuropsychological disorders in TBI because they were underestimated. We have started this experience despite the lack of means in our department. The evaluation of the executive function in addition to the classic neurospsychological assessment is essential to propose efficient means of rehabilitation.

English

BACKGROUND: Acute non-traumatic coma is a common problem in pediatric practice accounting for 10-15% of all hospital admission and is associated with significant morality. Assessment of the severity of coma is essential to comment on the likelihood of survival in comatose children. OBJECTIVES: To assess outcome in pediatric non-traumatic coma with role of Glasgow Coma Scale and Modified Glasgow Coma Scale. METHODS:30 cases of non-traumatic coma between 2 months to 12 years, coma severity were assessed by using Glasgow Coma Scale and Modified Glasgow Coma Scale. A score of less than 8 and more than 8 were used for analysis of outcome. RESULTS: Out of 30 Cases, 5 cases expired (16.66%), 2 cases were discharged against medical advice (6.67%, 23 cases improved and discharged, among these, 3 cases were discharged with complication (76.67%). Overall mortality was (16.66%) (5/30), males outnumbered females in frequency with ratio of 1.41:1. CNS infection accounted for almost about 75%. CONCLUSION: Children with GCS and MGCS scores of less than 8 have poor prognosis and very high probability of death. Those with GSC score of more than 8 have good prognosis. Identification of these cases at the outset can help prepare of outcome to the family.