scholarly journals Pharmacotherapy management for hospitalized ischemic stroke patients

2020 ◽  
Vol 3 (8) ◽  
pp. 404-412
Author(s):  
Ahmed Alaa Al-Temimi ◽  
Siew Hua Gan ◽  
Christine Shalin Selvaraj

Background: Worldwide, cerebrovascular accident (stroke) is the second leading cause of death and is the third leading cause of disability. Sadly, stroke prevalence in the low- and middle-income countries remains high (70%) with both stroke-related deaths and disability-adjusted life years reported to be as high as 87%. Aim: The objective of this study is to evaluate the success of pharmacotherapy management strategy for Malaysian stroke patients in a public hospital based on the Clinical Practice Guidelines (CPG), 2012.  Methods: A retrospective, cross-sectional study based on medical records of patients (n=682) with confirmed diagnoses of ischemic stroke admitted to Sungai Buloh Hospital for four years was conducted. Data was collected using self-developed data collection forms consisting of demographic profiles, comorbidity and pharmacotherapy treatment.  Results: The mean age of reported cases was 66.66 years with the majority (58%) being males while only 42% were females. The majority (>72%) adhered to the pharmacotherapy management of Clinical Practice Guideline Malaysia 2012 for ischemic stroke inpatients setting in a public hospital (p=0.001).  Conclusion: Most patients complied to the pharmacotherapy management of ischemic stroke guideline which is important to avoid disability and mortality caused by stroke.

Author(s):  
Betsi Sumanti ◽  
Hexanto Hexanto ◽  
Widiastuti Widiastuti

   ASSOCIATION BETWEEN ALTERED HS-CRP LEVELS AND  COGNITIVE FUNCTION OF ISCHEMIC STROKE PATIENTSABSTRACTIntroduction: The incidence of cognitive impairment in acute ischemic stroke patients is increasing. The mechanism of the inflammatory effect, such as  elevated hs-CRP level, a  non-specific inflammatory marker  sensitive to chronic inflammation due to hypoperfusion as well other vascular risk, is thought to have an effect on cognitive function.Aims: To determine the relationship of cognitive function changes in acute phase of ischemic stroke with hs-CRP level changes on day 3 and day 7 after onset.Methods: This was a cross sectional study of 31 first-timer ischemic stroke patients who met inclusion and exclusion criteria. The level of hs-CRP was checked on the 3rd day and 7th day after onset, while MoCA-Ina was assessed on the 7th day after onset. Cognitive disturbance was considered if MoCA <26. Analyses was done using SPSS 2.0Results: The average onset of day 3 Hs-CRP concentration was 0.66 (0.12-16.67)mg/dl and the onset of day 7 was 5.455 (0.14-17.34)mg/dl. The mean change of hs-CRP level between 3 day and 7 day after onset was -0,16 (-3.32-4.95). There was a significant correlation between elevated hs-CRP levels on day 3 and day 7 after onset with cognitive function of acute ischemic stroke patients.Discussion: There was a significant correlation between elevated hs-CRP levels on day 3 and day 7 after onset with cognitive function of acute ischemic stroke patients.Keyword: Acute ischemic stroke, hs-CRP, MoCA-Ina scoresABSTRAKPendahuluan: Insidens penurunan fungsi kognitif pada pasien stroke iskemik akut semakin meningkat. Hal ini diduga dipengaruhi oleh mekanisme efek inflamasi, meliputi peningkatan kadar high sensitive-C reactive protein (hs-CRP), salah satu penanda inflamasi non-spesifik yang sangat sensitif pada inflamasi kronis, akibat hipoperfusi maupun karena risiko vaskuler lainnya.Tujuan: Mengetahui hubungan perubahan fungsi kognitif pasien stroke iskemik fase akut dengan perubahan kadar hs-CRP hari ke-3 dan hari ke-7 setelah awitan.Metode: Studi potong lintang terhadap penderita stroke iskemik pertama kali yang memenuhi kriteria inklusi dan eksklusi. Dilakukan pemeriksaan kadar hs-CRP hari ke-3 dan hari ke-7 setelah awitan dan MoCA-Ina pada hari ke-7 setelah awitan. Fungsi kognitif dinyatakan terganggu jika MoCA-Ina <26. Analisis data menggunakan program SPSS 22.0.Hasil: Didapatkan rerata kadar Hs-CRP hari ke-3 setelah awitan adalah 0,66 (0,12-16,67)mg/dl dan hari ke-7 setelah awitan adalah 5,455 (0,14-17,34)mg/dl. Dengan rerata perubahan kadar hs-CRP awitan hari ke-3 dan awitan hari ke-7 adalah -0,16 (-3,32-4,95). Didapatkan hubungan yang bermakna antara perubahan kadar hs-CRP hari ke-3 setelah awitan dan hari ke-7 setelah awitan dengan fungsi kognitif pasien stroke iskemik akut.Kesimpulan: Didapatkan hubungan yang bermakna antara peningkatan kadar hs-CRP pada hari ke-7 dan kadar hari ke-3 dengan fungsi kognitif pasien stroke iskemik akut.Kata kunci: hs-CRP, MoCA-Ina, stroke iskemik akut 


KYAMC Journal ◽  
2019 ◽  
Vol 10 (3) ◽  
pp. 152-155
Author(s):  
Mohammad Iqbal Hossain ◽  
Ahmed Manadir Hossain ◽  
Quazi Shihab Uddin Ibrahimi

Introduction: Stroke is an important cause of disability among adults and is one of the leading causes of death worldwide. The reported prevalence of stroke in Bangladesh is 0.3%. Stroke patients have comorbidity Comorbidity is an important factor in stroke outcomes and burden. Objectives: This study was carried out with a view to find out the common comorbidities prevalent in stroke patients. Materials and Method: This cross sectional study was carried out in Faridpur Medical College Hospital from November 2018 to April 2019 to see the comorbidities and associated factors among admitted stroke patients. A total of 390 stroke patients were included. Data were collected by detailed history from patients or their relatives followed by thorough physical examination; Results: Among total respondents, majority was male (56.4%) and ischemic stroke was the commonest type of stroke (65.6%) diagnosed. The substantial number of patients (85.6%) had one or more comorbidities. Hypertension was the predominant comorbid condition (74.1%) followed by coronary heart disease ((19.5%), diabetes mellitus (17.4%), obesity (6.2%), hyperlipidemia (6.2%), CKD (4.9%), COPD (3.3%), malignancy (0.8%), hypothyroidism (0.5%),CLD (0.5%) and parkinsonism (0.3%). Comorbidities were present in 88.28% of ischemic stroke, 81.81% of intracerebral haemorrhage and 69.23% of subarachnoid hemorrhage cases. Patients with first stroke event have comorbidities in 83.64% cases where as in 95.45% cases of recurrent stroke patients. The relationship between comorbidity and mortality risk is not clear with approximately 16% death in both with or without comorbidity. Conclusion: The results of the study concluded that the prevalence of comorbidities in stroke patients remains high in our settings and the patients with increasing age and those with recurrent stroke events have statistically significant number of comorbid conditions. KYAMC Journal Vol. 10, No.-3, October 2019, Page 152-155


Author(s):  
Meiriani . ◽  
Yuneldi Anwar ◽  
Puji Pinta Omas Sinurat

Background: Diabetes and higher HbA1c level have increased the incidence of stroke. Hemoglobin levels both high and low are associated with poor outcomes. Leukocytes play an important role in the initiation of the atherosclerosis process.Methods: This was a cross-sectional study with a sample size of 62 people selected by non-random sampling method on a consecutive basis, patients with acute stroke were taken blood to measure blood glucose levels, HbA1c, Hb and Leucocytes when entering the hospital room. Outcomes were assessed using NIHSS and MRS. The calculation of NIHSS and MRS scores was performed on the first day of admission and the fourteenth day. To analyze the correlation of blood sugar levels during HbA1c, Hb and leukocytes in acute stroke, this study used Spearman's correlation test. The p value <0.05 was considered statistically significant.Results: The study subjects of 62 acute stroke patients (acute ischemic stroke 31 people and 31 people hemorrhagic stroke). Acute stroke patients were consisted of 38 men (61.3%) and 24 women (38.7%). Of 31 people with hemorrhagic stroke, there were 16 men (51.6%) and 15 women (48.4%), ischemic stroke patients were consisted of 22 people (71, 0%) and women were 9 people. Spearrman repair test showed no symptoms between blood glucose levels, HbA1c, Hemoglobin and leukocytes with outcomes in acute stroke.Conclusions: There was no significant association between blood glucose levels, HbA1c, hemoglobin and leukocytes with outcomes in acute stroke.


2018 ◽  
Vol 21 (04) ◽  
pp. 739-744
Author(s):  
Heena Rais ◽  
Fehmina Arif ◽  
Sangeeta Santosh

Objective: To determine the knowledge and practice of parents of children withAsthma. Introduction: Asthma is a disease characterized by recurrent attacks of breathlessnessand wheezing typically begins in early childhood with an earlier onset in males than females. Lifetime prevalence of asthma is 13.5% and current asthma prevalence of 9.3% among children <18years. According to WHO 15 million disability adjusted life years (DALY) are lost annually due toAsthma. Prevalence of asthma in Pakistani children is 19%. Due to rapid industrialization andurbanization prevalence of Asthma has increased from 9 t0 20% during the last decade. Thisstudy was conducted to assess the extent of knowledge and practice which are associated withthe control of Asthma. Methodology: It was descriptive cross sectional study conducted in ED,Pediatric unit CHK. Sampling was convenience and the study duration six months. One hundredand twenty parents of asthmatic children from 4-13 years of age were selected. Results: Averageage of the children was 7.69±2.58 years (95% CI: 7.23 to 8.16) and average duration of illnesswas 3.08±2.0 years (95% CI: 2.69 to 3.45). Minimum duration was two years and maximum tenyears. One hundred and four mothers (86.7%) and 16 fathers(13.3%) participated in the study.Over all asthma knowledge and practice of parents was adequate in 20(16.7%), inadequate in46(39.3%) and average in 54(45%). Conclusions: Asthma knowledge especially about themanagement is inadequate and practices are also inappropriate in the urban population ofKarachi.


2020 ◽  
Author(s):  
Xiaohua Yang ◽  
Huijuan Chen ◽  
Wanling Yang ◽  
Bin Deng ◽  
Jialing Zheng ◽  
...  

Abstract Background: Stroke-associated pneumonia (SAP) is a major complication after stroke, oral microorganisms are important contributors to SAP. Here, we aimed to investigate whether the oral hygiene was associated with SAP and related risk factors of them in patients with acute ischemic stroke. Methods: We performed a cross-sectional study that recruited 331 patients with acute ischemic stroke from two medical centers. A series of assessments were performed to evaluate the neurological status and habits of oral hygiene. According to whether the oral hygiene was abnormal and SAP occurred, univariate analyses were performed in cohort 1 (normal / abnormal oral hygiene groups) and cohort 2 (SAP / non-SAP groups). Multiple logistic regression analyses were conducted to confirm risk factors of oral cleanliness and SAP in stroke patients. Results: A total of 12 and 8 independent variables were included in the model 1 and 2 analysis. After adjusting for confounders, multivariable logistic regression analysis showed that oral cleanliness was not only closely related to SAP (OR=2.219, P=0.026), dental caries (OR=1.292, P=0.005) and age (OR=1.030, P=0.006) in model 1, but also an independent risk factor for predicting SAP (OR=1.678, P=0.001) in model 2. Barthel index was a protective factor for oral cleanliness (OR=0.986, P=0.019) and SAP (OR=0.977, P=0.002) in ischemic stroke patients. Conclusions: Mutually primary risk roles of abnormal oral cleanliness and SAP exist in patients with acute ischemic stroke. Dental caries and aging are important risk factors for oral health disorders. Improving the activities of daily living would have protective effects on both oral hygiene and SAP prevention in stroke patients.


PeerJ ◽  
2016 ◽  
Vol 4 ◽  
pp. e2577 ◽  
Author(s):  
Irma Elizabeth Huayanay-Espinoza ◽  
Felix Guerra-Castañon ◽  
María Lazo-Porras ◽  
Ana Castaneda-Guarderas ◽  
Nimmy Josephine Thomas ◽  
...  

ObjectiveThe objective of this study was to assess patients’ achievement of ADA (American Diabetes Association) guideline recommendations for glycosylated hemoglobin, lipid profile, and blood pressure in a type 2 diabetes mellitus (T2DM) outpatient clinic in a low-middle income country (LMIC) setting.MethodsThis is a descriptive cross-sectional study with 123 ambulatory T2DM patients who are being treated at a public hospital in Lima, Peru. Data was gathered via standardized interviews, clinical surveys, and anthropomorphic measurements for each patient. Blood samples were drawn in fasting state for measures of glucose, glycosylated hemoglobin (HbA1c), and lipid profile. Laboratory parameters and blood pressure were evaluated according to ADA recommendations.ResultsOf the 123 patients, 81 were women and the mean age was 61.8 years. Glycemic control was abnormal in 82 (68.33%) participants, and 45 (37.50%) were unable to control their blood pressure. Lipid profile was abnormal in 73 (60.83%) participants. Only nine (7.50%) participants fulfilled ADA recommendations for glycemic, blood pressure, and lipid control.ConclusionsAmongst individuals with type 2 diabetes, there was poor attainment of the ADA recommendations (HbA1c, blood pressure and LDL-cholesterol) for ambulatory T2DM patients. Interventions are urgently needed in order to prevent long-term diabetic complications.


2016 ◽  
Vol 59 ◽  
pp. e77 ◽  
Author(s):  
Sana Salah ◽  
Mariem Rekik ◽  
Soumaya Boudokhane ◽  
Houda Migaou ◽  
Anis Jellad ◽  
...  

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