scholarly journals Investigation on the current situation of stroke patients in northernern Henan Province of China

Author(s):  
Zhenhua Li ◽  
Qingcheng Yang ◽  
Xiangdong Zhang ◽  
Yanping Guo ◽  
Jiangang Zhang ◽  
...  

Objectives: To analyze the basic situations and clinical characteristics of stroke patients in our hospital from May 2018 to April 2021, lay a foundation for the prevention and reasonable treatment of stroke patients in northern Henan Province. Methods: The basic information of 835 stroke patients in our hospital was collected and classified according to age, gender, bad habits, accompanied diseases and drug use before admission to hospital, and severity of the stroke patients were also evaluated according to mRS scoring standard. Results: A total of 835 stroke patients were collected from May 2018 to April 2021 in our hospital. The age range of stroke patients was 28-95 years old, 96.29% stroke patients was above 40 years old; there were 202 stroke patients with smoking history and 225 stroke patients with drinking history; Among the 835 stroke patients, hypertension, cerebral infarction and diabetes mellitus were the main accompanied diseases. Antihypertensive drugs (506 cases), antiplatelet drugs (208 cases), statins (173 cases) and antidiabetic drugs (143 cases) were the main therapeutic drugs in stroke patients before admission in the northern Henan Province; the results of mRS scoring standard showed that among 835 stroke patients, there were 609 cases with milder symptoms, accounting for 82.84% (there were 330 stroke patients with 1 points, 279 stroke patients with 2 points, and 83 stroke patients with 3 points), and 120 cases with severe symptoms, accounting for 14.37% (55 cases with 4 points, 65 cases with 5 points). Conclusion: The age of stroke patients in northern Henan Province was mainly over 40 years old, most of stroke patients were in the early stage of stroke; smoking, drinking, hypertension and diabetes mellitus were main risk factors of stroke. And there was a sex difference between male stroke patients and female stroke patients in stroke risk factors smoking and hypertension. those data may help us for active prevention and rational drug use for stroke in clinic.

Author(s):  
Made Krisna Adi Jaya ◽  
Dewa Ayu Swastini ◽  
Baiq Leny Nopitasari ◽  
Putu Rika Veryanti

Background: Diabetic Peripheral Neuropathy (DPN) is a microvascular complication that commonly occurs in people with diabetes mellitus. Geriatrics with type 2 diabetes mellitus is one of the populations most vulnerable to this complication. An epidemiological study states that geriatrics has a 32% greater risk of developing this complication compared to other age groups. There have not been many studies conducted to evaluate the risk factors that influence this DPN complication, so it needs to be done an individual evaluation for the elderly population. Objective: This study aims to explore the risk factors that influence the incidence of DPN in elderly patients with type 2 diabetes mellitus. Methods: A case-control study design was carried out on 70 geriatrics with type 2 diabetes mellitus. The outcome determined was the incidence of DPN to track the cause of DPN exposure retrospectively. Influential risk factors are determined by the Odds Ratio (OR) with a 95% confidence interval (CI). All statistical analyzes were two-tailed, and p-values <0.05 were considered as statistically significant. Results: Seven factors influence the incidence of DPN in the elderly consisting of smoking history (OR=13.1), uncontrolled lipid profile (OR=5.1), non-neuroprotector users (OR=5.6), uncontrolled blood glucose (OR=42.7), history of heart disease (OR=9.0), uncontrolled blood pressure (OR=4.3), and BMI above normal (OR=5.1). Conclusion: Strong recommendation for medical personnel to focus attention on seven significant risk factors affected complications of DPN to reduce its progression or prevent upcoming complications.


1970 ◽  
pp. 18-21 ◽  
Author(s):  
Md Badiuzzaman ◽  
Fazle Rabbi Mohammed ◽  
Fazle Rabbi Chowdhury ◽  
Md Shafiqul Bari ◽  
Md Billal Alam ◽  
...  

Background: An event of stroke can be ignited by a number of risk factors, some of which are nonmodifiable and some are modifiable. Hypertension, diabetes mellitus, different heart diseases, hyperlipidemia and smoking belong to the latter group and their prevalence shows immense diversity worldwide. In this study we tried to identify the most prevalent risk factor for stroke. Categorization of various types of stroke and history of noncompliance in medication has also been evaluated. Methods: This direct observational study was carried out on 400 patients of stroke admitted in different medicine units of Dhaka Medical College Hospital from July to December, 2007. Only patients having clinical diagnosis of stroke, confirmed by CT scan or MRI, were recruited. Patients were grouped into ischemic or hemorrhagic stroke or sub arachnoid hemorrhage. Results: The male, female ratio was found 1.2:1. In the study cerebral infraction, intra cerebral hemorrhages (ICH) and sub arachnoid hemorrhage (SAH) were found in 56.25%, 38.25% and 5.5% patients respectively. In case of Ischemic stroke and ICH males were predominantly affected but in case of SAH females were predominant. Among patients, hypertension was found in 58.62% followed by smoking (53.79%), lipid disorder (48.01%), heart diseases (25.75%), diabetes mellitus (20.01%), and previous history of stroke (10.61%). 40% patients were on irregular use of antihypertensive drug and it was 17.5% in case of anti diabetic drugs. Major groups (42.44%) of patients have two modifiable risk factors. Conclusion: Stroke is better to prevent than to cure. Identification of risk factors is the only way to achieve this goal. Implementation of screening programme in community to identify risk factors and educate people about primary prevention should be initiated in this regard. This way, we can reduce morbidity and mortality among stroke patients and alleviate the burden of stroke.   doi:10.3329/jom.v10i3.2011   J Medicine 2009; 10 (Supplement 1): 18-21


2018 ◽  
Vol 24 (8) ◽  
pp. 6225-6231
Author(s):  
S Rachmayanti ◽  
W Kusumaningsih

Hypertension and diabetes mellitus are the most common risk factors of stroke.The study aimed to determine the relationship between stroke risk factors, hypertension and diabetes mellitus, with dependency of chronic stroke patients in Department of Medical Rehabilitation RSCM. The study is conducted by using the analytical observational cross-sectional study. The samples used in this study were 44 respondents selected by quota sampling method. The relationship between variabels was analyzed by bivariate test Chi-Square and multivariate analysis: Logistic Regression. Based on Chi-Square test, relationship between MSBI scoring with hypertension and diabetes mellitus as stroke risk factors, sequentiallly p = 0,122 and p = 0,002. Furthermore, Logistic Regression test suggested that hypertension and diabetes mellitus as stroke risk factors related to MSBI scoring, respectively; hypertension p = 0,076 (OR 4,076; CI95 0,861–19,297) and diabetes mellitus p = 0,007 (OR 22,690; CI95 2,332–220,722). Discussion: Diabetes mellitus is the most prominent risk factor in severe dependecy of chronic stroke patients.


2014 ◽  
Vol 37 (3) ◽  
pp. E3
Author(s):  
Richard Dalyai ◽  
Robert M. Starke ◽  
Nohra Chalouhi ◽  
Thana Theofanis ◽  
Christopher Busack ◽  
...  

Object Cigarette smoking has been well established as a risk factor in vascular pathology, such as cerebral aneurysms. However, tobacco’s implications for patients with cerebral arteriovenous malformations (AVMs) are controversial. The object of this study was to identify predictors of AVM obliteration and risk factors for complications. Methods The authors conducted a retrospective analysis of a prospectively maintained database for all patients with AVMs treated using surgical excision, staged endovascular embolization (with N-butyl-cyanoacrylate or Onyx), stereotactic radiosurgery (Gamma Knife or Linear Accelerator), or a combination thereof between 1994 and 2010. Medical risk factors, such as smoking, abuse of alcohol or intravenous recreational drugs, hypercholesterolemia, diabetes mellitus, hypertension, and coronary artery disease, were documented. A multivariate logistic regression analysis was conducted to detect predictors of periprocedural complications, obliteration, and posttreatment hemorrhage. Results Of 774 patients treated at a single tertiary care cerebrovascular center, 35% initially presented with symptomatic hemorrhage and 57.6% achieved complete obliteration according to digital subtraction angiography (DSA) or MRI. In a multivariate analysis a negative smoking history (OR 1.9, p = 0.006) was a strong independent predictor of AVM obliteration. Of the patients with obliterated AVMs, 31.9% were smokers, whereas 45% were not (p = 0.05). Multivariate analysis of obliteration, after controlling for AVM size and location (eloquent vs noneloquent tissue), revealed that nonsmokers were more likely (0.082) to have obliterated AVMs through radiosurgery. Smoking was not predictive of treatment complications or posttreatment hemorrhage. Abuse of alcohol or intravenous recreational drugs, hypercholesterolemia, diabetes mellitus, and coronary artery disease had no discernible effect on AVM obliteration, periprocedural complications, or posttreatment hemorrhage. Conclusions Cerebral AVM patients with a history of smoking are significantly less likely than those without a smoking history to have complete AVM obliteration on follow-up DSA or MRI. Therefore, patients with AVMs should be strongly advised to quit smoking.


1970 ◽  
Vol 9 (1) ◽  
pp. 37-41
Author(s):  
Ahmedul Kabir ◽  
MM Sadeka ◽  
MJ Ahmed ◽  
E Kabir ◽  
MA Kahhar

Background: Metabolic syndrome is a cluster of cardiovascular risk factor and is strongly associated with CVD. This study had been carried out at Mitford Hospital with a view to get a profile of the stroke patients and to obtain the proportion of the patients having metabolic syndrome. Patients & methods: In the observational study a total of fifty patients of stroke (confirmed by CT Scan) were studied at medical unit of Mitford hospital from December, 2005 to April, 2006. Results: Among the fifty stroke patients, about half (48%) were diagnosed as metabolic syndrome and there was slight female preponderance among them. Majority of the patients (79%) were from middle socio-economic class. Investigations regarding hypertension, diabetes mellitus and dyslipidaemia revealed the percentages of these risk factors along with gender distributions among the patients with stroke. Conclusion: Stage two hypertension and diabetes were the major risk factors causing stroke. This study would provide baseline line information for the future researcher in the relevant field.   DOI = 10.3329/jom.v9i1.1424 J MEDICINE 2008; 9 : 37-41


2020 ◽  
Vol 11 (3) ◽  
pp. 131-140
Author(s):  
Hacer Dinçoğlu

Diabetes mellitus (DM); is a metabolic progressive di-sease with a rapidly increasing prevalence. The most important factors in the treatment of DM is the education of individuals with diabetes and rational drug use. Multiple insulin therapy is started with the diagnosis in type 1 DM (T1DM), oral antidiabetic drugs (OAD) and insulin treatments are initiated together according to the glycemic status in Type 2 DM (T2DM). Problems causing irrational drug use related to OAD in DM; advanced age, multidrug use, complex drug intake program, lack of knowledge, drug-related side effects, and patient disbelief. Problems causing irrational drug use related to insulin; hypoglycemia, lipodystrophy, incorrect injection technique, insufficient and high dose administration. This situation appears as macrovascular and microvascular diseases with not reaching target HbA1c values by causing glycemic dysregulation in DM. The success of the holding of treatment in optimal status with prevention for glycemia and metabolic condition raises the quality of life in patients, prolong the patient’s life expectancy and reduces costs. Doctors and insulin educators raising awareness of rational drug use in the diabetic population ensures that correct the irrational behaviors performed in the diabetic population and adopt appropriate behaviors as a lifestyle. Thus it will improve the educational content given to people with diabetes, help to improve diabetes management and behavioral change, thereby achieving appropriate glycemic goals and increasing secondary rational gains from drugs with treatment.


2021 ◽  
Author(s):  
Roshan Kumar Jha ◽  
Anil Shrestha ◽  
Basant Tamang ◽  
Indu K.C. ◽  
Shiv Kumar Sah

Objective: We aimed to determine the prevalence of the severity of COVID-19 illness and its associated predisposing factors in Nepal. Design: Cross-sectional, observational study Setting: Single-centered hospital-based study, conducted at Nepal armed police force (APF) hospital, Kathmandu, Nepal. Participants: All individuals aged greater than or equal to 18 years with laboratory-confirmed SARS-Cov-2 (the SARS-CoV-2 specific real-time- RT- PCR result positive), regardless the severity of their disease. Measurements: Disease severity was evaluated as a primary outcome and age, sex, BMI, smoking history, alcohol history, Hypertension, diabetes mellitus were evaluated as predictors in the analysis. Results: Mean ages of the patients were 40.79 plus or minus 16.04 years, and about two-thirds of the patients were male 146 (73.7%). More than half 57.1% (95%CI: 52.42-61.51) of the population had a mild infection, whereas 16.7% (95%CI: 7.4-24.6%) had severe/critical illness. In univariate analysis, each 1- year increase in age (OR: 1.05; 95% CI:1.030-1.081; P<0.001), each 1 unit increase in BMI (OR:1.12; 95% CI:1.02-1.25; P=0.033), comorbid illness (OR: 5.79; 95%CI: 2.51-13.33; P<0.001), hypertension (OR:5.95; 95%CI:2.66-13.30: P<0.001), diabetes mellitus (OR:3.26; 95%CI:1.30-8.15: P<0.005), and fever (OR:34.64; 95% CI:7.98-150.38; P<0.001) were independently associated with severity of the disease, whereas age (OR: 1.049; 95% CI: 1.019-1.080; P=0.02), hypertension (OR: 4.77; 95%CI: 1.62-14.04; P=0.004), and fever (OR: 51.02; 95%CI: 9.56-272.51; P<0.001) remained a significant predictive factors in multivariate analysis. Conclusion: The majority of the patients with COVID-19 had a mild illness, with 16.7% severe illness. Age, BMI, hypertension, diabetes mellitus, comorbidity, and temperature were associated the severity of the illness. Age, hypertension, and fever emerged as an independent predictive factor in multivariate analysis, and thus, these vulnerable groups should be given special protection to the infection and proactive intervention should be initiated at an early stage of the infection to diminish the severity of the illness and improve the clinical outcome of the disease. Keywords: COVID-19, disease severity, risk factors, SARS-CoV-19


2020 ◽  
Author(s):  
Lin-Lin Ye ◽  
Wen-Bei Peng ◽  
Xiao-Shan Wei ◽  
Xu Wang ◽  
Zi-Hao Wang ◽  
...  

Abstract BAckground Severe COVID-19 patients account for most of the mortality of this disease. Early detection of severe cases of the disease remains a major challenge. Here, we performed clinical and laboratory profiling of COVID-19 to explore the early warning indicators of severe cases. Methods An analysis of the evolution during the hospitalization of clinical and laboratory findings from 78 confirmed COVID-19 patients and the associated risk factors. Results Of the 78 patients who were classified as un-severe at admission, 60 patients(stable group) were stable as mild cases until discharge, and the remaining 18 patients progressed to severe cases(exacerbated group) during hospitalization. Compared with stable patients, exacerbated patients exhibited older, higher BMI values and higher proportion of smokers. In the exacerbated patients, the median time from onset to deterioration was 7.5 days. Before the time point(days 0–7 from onset), we observed higher-levels of White blood cells(WBC), neutrophil, Neutrophi-Lymphocyte-Ratio(NLR), Lactose-dehydrogenase(LDH), D-dimer, and lower-levels of albumin in the exacerbated group, compared with the stable group. In the second week after the time point, the exacerbated patients displayed lower numbers of lymphocytes, CD3+, and CD8+T-cells, and higher-levels of C-reactive protein(CRP), erythrocyte-sedimentation-rate(ESR), Alanine-aminotransferase(ALT),Aspartate-aminotransferase(AST), and Interleukin-6. In the third week, the highest temperature and the proportion of febrile patients declined. All of the laboratory indicators gradually improved. Conclusions Advanced age and smoking history could be risk factors for COVID-19 progression. In the early stage, high-levels of WBC and neutrophils, with noticeably increased LDH and D-dimer, could be early indicators of the disease’s conversion from mild to severe, followed by elevated inflammatory markers, liver enzymes, and decreased T-lymphocytes in the next week.


2022 ◽  
pp. 174749302110649
Author(s):  
Laura Ohlmeier ◽  
Stefania Nannoni ◽  
Claudia Pallucca ◽  
Robin B Brown ◽  
Laurence Loubiere ◽  
...  

Background: Small vessel disease (SVD) is associated with vascular cognitive impairment (VCI) but why VCI occurs in some, but not other patients, is uncertain. We determined the prevalence of, and risk factors for, VCI in a large cohort of patients with lacunar stroke. Methods: Participants with magnetic resonance imaging (MRI)-confirmed lacunar stroke were recruited in the multicenter DNA Lacunar 2 study and compared with healthy controls. A logistic regression model was used to determine which vascular risk factors and MRI parameters were independent predictors of VCI, assessed using the Brief Memory and Executive Test (BMET). Results: A total of 912 lacunar stroke patients and 425 controls were included, with mean ( SD) age of 64.6 (12.26) and 64.7 (12.29) years, respectively. VCI was detected in 38.8% lacunar patients and 13.4% controls. In a logistic regression model, diabetes mellitus (odds ratio (OR) = 1.98 (95% confidence interval (CI) = 1.40–2.80), p < 0.001) and higher body mass index (BMI) (OR = 1.03 (95% CI = 1.00–1.05), p = 0.029) were independently associated with increased risk of VCI, and years of full-time education with lower risk (OR = 0.92 (95% CI = 0.86–0.99), p = 0.018). When entering both lacune count and white matter hyperintensity (WMH) in the same logistic regression model, only WMH grade was significantly associated with VCI (OR = 1.46 (95% CI = 1.24–1.72), p < 0.001). Conclusion: VCI is common in lacunar stroke patients, affecting almost 40%. This prevalence suggests that it should be routinely screened for in clinical practice. Risk factors for VCI in patients with lacunar stroke include diabetes mellitus, depressive symptoms, higher BMI, and WMH severity, while education is protective.


Sign in / Sign up

Export Citation Format

Share Document