Offloading, Diabetic foot ulcer, Mandakini offloading device, Samadhan offloading system
Purpose: Incidence of Cryptococcal meningitis (CM) is increasing as prevalence of HIV, long term steroids use and organ transplant increase. The study was done to analyze demographic, clinical and biochemical parameters and to correlate these parameters with mortality. Materials and Method: 50 patients of CM, diagnosed on the basis of India ink positivity, Cryptococcal antigen or Culture. Patients were followed up till discharge or death. Results: Out of the 50 patients, 45 patients were HIV positive. Headache was the most common symptom (100%), followed by vomiting, fever, and altered sensorium, blindness, seizures, diplopia and psychiatric symptoms. The factors associated with a greater risk for mortality were CD4 ≤ 50 cells/ cu.mm (p=0.012), low GCS ≤ 8 (p=0.000011), blindness (p =0.034), papilledema (p=0.0009) and low CSF sugar (p=0.0005). There was an association between high CSF pressure (>30 cm of H2O) and blindness (p=0.005). Other factors which were associated with a higher trend of mortality but not significant were associated tuberculosis and high CSF pressure. Conclusions: Mortality associated with CM continues to be high in spite of availability of medications. Factors associated with high mortality were low initial CD4, lower GCS at presentation, blindness, papilledema and low CSF sugar.
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