Muhammad Saleh Khakheli, Bashir Ahmed Khuhro, Abdul Hakeem Jamali.
Tetanus: still a killer in adults.
Anesth Pain Intens Care Jan ;17(2):149-53.

Objective: To determine the socio-demographic characteristics, clinical profile and outcome of the tetanus patients. Study Design: Case Series Place and duration of Study: SICU of Peoples University of Medical and Health sciences (PUMHS) Nawabshah, from January 2010 to December 2012. Methodology: The information obtained from the attendants of patients who presented with clinical features of tetanus and classified into generalized and cephalic types and; severity was classified into mild, moderate severe and very severe. Treatment was started immediately with protocol of supportive care; neutralization of circulating toxin and eradication of the source of tetanospasmin. Details of socio-demographic data, clinical features, complications and outcome were recorded and entered in a questionnaire before analysis. Results: twenty two cases of tetanus were studied included males were 16 and females were 6. Six of 22 (27.3%) patients had prior tetanus immunization while the other sixteen (72.7%) patients were not vaccinated or did not know their tetanus immunization status. Lower limbs were most common of portal of entry 15 (68.2%). Most of patients (95.5%) have generalized tetanus and 5 (22.7%) patients had very severe disease. Body stiffness/spasm (100%), trismus (100%) and dysphagia (68.2%) were the three commonest presenting complaints. Complications of tetanus were documented in 16 (72.7%) patients. Overall mortality was 68.2 %. Conclusion: Tetanus prevalence is still high in interior Sind and is associated with high morbidity and mortality rate

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