Open AccessSTUDY ON THE EFFECTS OF METHYL PREDNISOLONE AS PULSE THERAPY IN PATIENTS WITH TUBERCULOUS MENINGITIS IN RIMS RANCHI, JHARKHAND, INDIA
Author(s) -
Kumari Neelam,
B Chandra,
Rishi Tuhin Guria,
Sanjay Kumar
Publication year - 2021
Publication title -
global journal for research analysis
Language(s) - English
DOI - 10.36106/gjra/7609725
Subject(s) - tuberculous meningitis , medicine , tuberculosis , dexamethasone , meningitis , methylprednisolone , prednisolone , radiological weapon , surgery , meninges , presentation (obstetrics) , pediatrics , pathology
The common presentation of tuberculosis is common but uncommon presentation of tuberculosis is not so uncommon. Mycobacterium tuberculosis can affect any part of the body, at any age and in any form. Tuberculous meningitis (TBM) is a serious form of tuberculosis that affects meninges (coverings of brain and spinal cord) which are responsible for many deaths (1). It is associated with high mortality and morbidity. The steroids appear to reduce mortality in the patients of tuberculous meningitis, regardless of the MRC stage at presentation. Corticosteroids have been used as an adjunct to anti-tuberculous drugs to treat patients with tuberculous meningitis (3,4,5,6). The present study has been undertaken to evaluate the effects of short course, high dose of intravenous methylprednisolone (pulse therapy) versus intravenous dexamethasone (in conventional dose) as an adjunct to anti-tuberculous treatment, on the clinical, biochemical and radiological outcome in patients with tuberculous meningitis.A total of 94 TBM patients were enrolled for this study. 49 TBM patients as a case were given IV infusion of high dose methylprednisolone (1g/day for 5 days) and forty five TBM patients as control were given IV dexamethasone in conventional dose (0.4mg/kg/day divided in 3-4 doses) along with antituberculous therapy. Detailed clinical, biochemical, microbiological and radiological evaluation were performed and findings were evaluated.TBM is considered as a serious extrapulmonary form of TB (Tuberculosis) and should arise suspicion in mind of clinicians based on clinical findings for prompt diagnosis and treatments. In various studies it has been shown that corticosteroids used for longer periods in TBM patients along with antituberculous drugs, were associated with reduced mortality and morbidity but increased adverse effects. In the present study, methylpredisolone used as a pulse therapy showed significant improvement in clinical profile, laboratory findings and radiological outcome.