Severity of illness was assessed by PIM2 score16. For PIM2, the values of various variables at time of admission to Pediatric ward/PICU were recorded. PIM 2-based mortality index was evaluated based on the regression equation as published in the literature.The children with impaired consciousness and reduced mental state were classified as obtunded, stuporous or comatose based on classification given by Taylor et al.17 The etiology was determined based on review of the clinical, laboratory and imaging data by the Pediatric Neurologist.