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CLINICAL FEATURES OF TETANUS PATIENTS IN PEDIATRIC ICU

Dr. Zain-ul-Harmain, Dr. Syed Ammad Saeed, Dr Tariq Mehmood

Objective: Tis research work aimed to examine the demographic & clinical traits, findings, treatment expenses & complications of the tetanus patients who got admission in Pediatric ICU (Intensive Care Unit) in General Hospital Lahore. Methodology: This research work is descriptive study based on observations carried out in General Hospital, Lahore from August 2017 to July 2019. Tetanus patients who got admission in pediatric ICU in the duration of this research work were the participants of this research work. We collected the data from files of the patients and we also included the data about demography, clinical appearance, and severity grade, duration of stay in hospital, outcomes and complications. We also included the treatment expenses. We applied the descriptive statistics for the description of the findings. Results: In the duration of this research work, total twenty three patients of tetanus got admission in pediatric ICU in which 12 patients were male and eleven patients were females. Most of the patients (13) were in the age group of two to six year of age. There were 17 unvaccinated patients and six patients received only OPV & BCG. No patient was present suitable vaccinated for the age. Nine patients were present with tetanus after surgery, among them six patients were males, five patients had otogenic tetanus and nine patients were present with no identifiable portal of entry. Total 11 patients were in the Grade-3 severity of classification of Ablett and six patients were in Grade-4 severity. There was rate of mortality in our patients of 26.0%. We noticed autonomic instability in seventeen patients and there was requirement f ionotropic support in all these patients. The estimated expense of every day tetanus treatment with use of mechanical ventilation was about 31979 rupees and with no mechanical ventilation, it was 20000 rupees. Conclusion: Tetanus is completely preventable complication with high rate of mortality. The therapy of this disease is much expenses in comparison with the vaccination which is free in our country. Proper care of wound and complete vaccination is the best option to decrease the tetanus burden. Keywords: Tetanus, complication, mortality, frequency, therapy.

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