Background: Acute febrile encephalopathy (AFE) is defined as fever associated with acute alteration of consciousness, with or without seizure, motor and/ or sensory deficit and total duration of illness one week or less. It is associated with significant morbidity and mortality in children. Various etiologies have been implicated in its causation and differ as per geographical. Efforts to promptly identify the underlying etiology and institute appropriate treatment early and adequately should be our goal so as to avoid any long-term sequelae and death. Aims and Objectives: To evaluate the clinical profile and aetiology of children presenting with fever and altered sensorium and to assess the predictors of morbidity & mortality related to Acute Febrile Encephalopathy. Materials and Methods: In this prospective, hospital-based study, a total of 282 children, between 1month to 12 years, presenting to the department of Pediatric Medicine, Calcutta National Medical College, Kolkata, West Bengal, India with fever and altered sensorium were clinically evaluated and investigated. Each patient was examined for vital signs, detailed systemic examination with focus on neurological examination. The etiology of AFE was evaluated based on detailed history, a meticulous clinical examination and relevant investigations. Results: The incidence of AFE was 5% of the total hospital admissions. Demographic profile showed 166 (58.8%) males, 116 (41.2%) females and 48% of the study population less than 5 years of age. The most important presenting complaints apart from fever and altered sensorium, were convulsion and vomiting. Raised Intracranial tension (58%), low GCS (58%) and shock (48%) were commonest presenting signs. CNS infections were the most common cause of AFE encountered. Low GCS, refractory seizures, multi-organ failure respiratory failure were significantly associated with death (p<0.005). Conclusions: CNS infections are the leading cause of febrile encephalopathy. Toxic- metabolic and unknown etiologies contributed maximum to the mortality. Low GCS, shock, refractory seizures, multi-organ failure and respiratory failure are associated with higher risk of mortality. Most of the morbidities were observed in auto-immune encephalitis and ADEM and as most of them were curable, early institution of appropriate treatment will decrease morbidity.

No abstract

Introduction: Medical education is considered to be one of the most academically and emotionally demanding training programmes out of any profession. Stress causes a negative effect on the students’ psychosocial well-being. Students having anxiety can experience intense feeling of fear or panic and also impairs concentration and working memory. Aim: To estimate the examination related anxiety levels among medical students. Also, to find out its association with different lifestyle and behavioural factors. Materials and Methods: This institution-based cross-sectional descriptive study was conducted among 365 medical students of Calcutta National Medical College, Kolkata, West Bengal, India, from February 2022 to March 2022. The study used predesigned, pretested, and semi-structured questionnaire. To assess anxiety level, the 10-item Westside Test Anxiety Scale was used. The scale consists of 10 questions which are answered based on a 5-point scale. Data was analysed done in Statistical Package for Social Sciences (SPSS) version 16.0. Results: Out of 365, 108 (29.6%) students suffered from moderately-high test anxiety during exams in both 1st and 2nd professional MBBS year. Only 8.2% students had comfortably-low test anxiety, whereas, 11.2% had extremelyhigh test anxiety. Among the first year students 37.5% male and 19.5% female had moderately high to extremely high level of test anxiety. In second year students 34.6% male and 20.6% female had moderately high to extremely high level of test anxiety. Male gender, addiction to smoking, addiction to alcohol, virtual gaming habit, coming from a nuclear family, and staying at home during exams had greater odds of having high anxiety than their counterparts. Addiction to smoking had adjusted odds of 1.52 and was found to be statistically significant. Students who resided in their homes had 2.34 times more chances of having high test anxiety and this association was found to be statistically significant. The practice of yoga was found to be protective with adjusted odds of 0.31 and this was also statistically significant. Conclusion: Male gender, addiction to smoking and alcohol, virtual gaming habit, coming from a nuclear family and staying at home during examination time had greater impact on anxiety level than their counterparts. The practice of yoga was found to be protective. Involving students in different extra-curricular activities like outdoor games, yoga, playing music may be helpful in alleviating anxiety level.