Clinicoaetiological Evaluation of Afebrile Illness with Altered Consciousness

Altered levels of conscious states are among the most common mental disorders encountered in patients with medical illness, particularly among those who are older. They are associated with many complex underlying medical conditions and can be hard to recognize. Systematic studies and clinical trials are difficult to perform in patients with cognitive impairment. Most recommendations for the assessment and management of delirium are derived from clinical practice and expert opinion. A majority of them suffer from hyponatraemia, uraemia, hepatic failure, respiratory failure, drug overdose, hypoglycaemia, ketoacidosis, hyperosmolar coma, subarachnoid haemorrhage, brainstem infarction/haemorrhage, intracerebral haemorrhage, epilepsy, brain tumour. At present few studies are available in our country regarding clinicoaetiological evaluation of afebrile illness with altered consciousness. So information obtained from this study will be helpful for the physicians and the patients. It will help the doctors to create early diagnosis of these problems and thus in prompt treatment. The crosssectional descriptive type ofobservational study was aimed to find out the causes of the patients of afebrile illness with altered consciousness in a tertiary level hospital. The study was conducted on purposively selected 100 hospitalized patients with afebrile illness with altered consciousness meeting the exclusion and inclusion criteria, who had been admitted in the medicine and neuro-medicine department of Mymensingh Medical College Hospital, Bangladesh during the period of October 2017 to March 2018. Cerebrovascular disease (25%), status epilepticus (5%) intracranial tumour (3%) poisoning (17%) e.g. OPC poisoning (8%), sedative and narcotics (5%), street poisoning (2%), snake bite (l %), acute alcohol intoxication (1%); systemic organ dysfunction (27%) e.g. lung (1 1%), cardiovascular (2%), kidney (5%), liver (9%); metabolic and endocrine (23%) e.g. hyponatremia (8%), hypernatremia (1%), hypoglycemia (1 1%), hyperglycemia (3%) were identified as major causes of afebrile illness with altered consciousness. It can be concluded that proper clinical evaluation and early diagnosis save the valuable lives of many patients. Identification of specific etiology is very much important because successful treatment and prognosis of diseases depend on its correct diagnosis