20 Academia Journal of Medicine ¦ Volume 2 ¦ Issue 2 ¦ July-December 2019 200 Abstract Study of Clinical Correlates of Tubercular Meningitis in a Tertiary Care Centre in Moradabad Vikramjeet Singh Malik 1 , V. K. Singh 2 1 Post Graduate Student, Department of Medicine, TMMC&RC, Moradabad, India, 2 Professor & Head, Department of Medicine, TMMC&RC, Moradabad, India. Background: Tuberculosis continues to remain a leading cause of mortality worldwide with tubercular meningitis being the most common type of central nervous system tuberculosis that is associated with significant morbidity and mortality if not identified and treated promptly. Due to meager amount of published data and lack of evaluation of the western UP population, this study was conducted in order to observe a detailed clinical course of the disease as well as to analyze predictors of morbidity and mortality in patients of TBM admitted at a tertiary care hospital in Moradabad.Subjects and Methods: A total of 120 patients with diagnosis of TBM as per the diagnostic criteria of the study were included and all their information and features recorded and treatment done as per guidelines and a follow-up done at 3 months using Barthel Index.Results: Multivariate logistic regression analysis of various factors revealed age of the patient (p=0.04), duration of symptoms (p=0.002), stage of TBM on presentation (p=0.001), TLC>9000 (p=0.006), low CSF glucose (p=0.01), hyponatremia (p=0.04), hypoalbuminemia (p=0.007) and hydrocephalus (p=0.04) on neuroimaging were significant risk factors of mortality and morbidity in adult patients of TBM.Conclusion: The current study may provide components for the composition of a score to predict outcome using the significant poor prognostic factors that were recognized in this study. This can be utilised for prompt employment of rigorous management remedies in order to reduce patients’ morbidity and mortality. Keywords: Tubercular Meningitis, HIV, CSF. Corresponding Author: V. K. Singh, Professor & Head, Department of Medicine, TMMC&RC, Moradabad, India. Received: December 2019 Accepted: December 2019 Introduction Tuberculosis has continued to persist as a leading disease worldwide and still remains amongst the top 10 causes of death throughout the globe. 2018 hadaround 1.2 million TB patients expiring amongst the HIV negative patientsand 2,51,000 expiring amongst the HIV positive patients. Approximately 10 million new patientsdeveloped TB in 2018. Majority of new cases in 2018 occurred in the WHO South-East Asia Region (44%). Countries with maximum share of the incidental disease burden (2/3rd) in 2018 were India having maximum cases (27%) followed in a descending order by China, Indonesia, Philippines, Pakistan and Bangladesh from Asia and from Africa the nations being Nigeria and South Africa. [1] 5 to 15% cases of extra pulmonary tuberculosis affect nervous system with TBM being the commonest type constituting 70% cases of TB of the neurological system. [2] Tubercular meningitis is a disease that should be ruled out in all patients with fever presenting with altered sensorium.It is a disease that requires early diagnosis and treatment to achieve complete cure rate without sequelae. This study would help create a profile of patients belonging to western UP region in order to help in better and early identification of relatively less common manifestations specific to this population and to reduce morbidity and mortality in such cases. Tuberculous meningitis (TBM)being the most prevalent type of central nervous system tuberculosis is linked with greater incidence of neurologic sequelae as well as mortality if not swiftly managed thus remains a significant threat to the health and wellbeing of patients in developing nations. [3-7] The TBM severity has been ascertained using a TBM grading system that is named after its creators called British Medical Research Council(MRC) grading that is based on the patient’s GCS and the presence of focal neurological deficits. [8] Thorough understanding of the disease’s clinical course and timely evaluation for complications is necessary for prompt treatment, in order to avert complications as well as avert morbidity and high mortality in the TBM cases. Due to meager amount of published data and lack of evaluation of the western UP population, this study was conducted in order to observe a detailed clinical course of the disease as well as to analyze predictors of morbidity and mortality in patients of TBM admitted at a tertiary care hospital in Moradabad. Aim • To study the clinical correlates of tubercular meningitis. ISSN (0): 2663-8290; ISSN (P): 2663-8282 Original Article