scholarly journals The study of plasma homocysteine level as a risk factor for ischemic strokes in young patients

2017 ◽  
Vol 4 (4) ◽  
pp. 1019
Author(s):  
Prashant T. Gajbhare ◽  
Nazir I. Juvale
Keyword(s):  
Risk Factor ◽  
Ischemic Stroke ◽  
Homocysteine Level ◽  
Tertiary Care ◽  
Young Patients ◽  
Adult Life ◽  
Control Group ◽  
P Value ◽  
Care Hospital ◽  
Serum Homocysteine

Background: According to the WHO, stroke is second leading cause of death for people above the age of 60 years & fifth leading cause in people aged 15 to 59 years old. Each year, nearly six million people worldwide die from stroke. One in six people worldwide will have a stroke in their lifetime. Approximately one-quarter of 45-year-old men will have a stroke before they reach the age of 85. Stroke is also important condition in young people and can occur at any age, including in utero, neonatal period (it is the major cause of cerebral palsy), childhood and young adult life. One-quarter of all strokes occur in people below the age of 65.Methods: This prospective observational case control study was carried on 30 young ischemic stroke patients with 30 control match persons over a period of 20 months, from December 2011 to August 2013 at Tertiary Care Hospital Grant Government Medical College and Sir JJ Group of Hospitals, Mumbai, India.Results: Total plasma fasting homocysteine level in case group was 30.10±14.8 µmol/L and control group was 13±5.3 µmol/L, (p=0.001). Elevated fasting homocysteine level was found in 76.66. 0% of ischemic stroke cases and in 10% of healthy controls (p=0.001). Serum homocysteine levels were higher in subjects having risk factors such as dyslipidemia (p value <0.001), active lifestyle (p value <0.05) and smoking (p value<0.05). Serum homocysteine did not show any significant relation with age, sex, diabetes mellitus, diet pattern and defective coagulation (p value >1).Conclusions: The present study revealed that hyperhomocysteinemia appears to be an important risk factor for young ischemic strokes. It is therefore important to use serum homocysteine level as an important tool to investigate all cases of young ischemic strokes and also in those who are at risk of developing it. Significant correlation has been found between homocysteine concentration and young ischemic strokes.

scholarly journals Study on Homocysteinemia as a Risk Factor of Ischemic Stroke

2021 ◽  
Vol 34 (1) ◽  
pp. 33-39
Author(s):  
Md Amjad Hossain Pramanik ◽  
Achinta Kumar Mallick ◽  
Mukul Kumar Sarkar ◽  
SM Emdadul Haque ◽  
Md Raseul Kabir ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Ischemic Stroke ◽  
Independent Risk Factor ◽  
Homocysteine Level ◽  
Control Group ◽  
Age Group ◽  
Healthy Individuals ◽  
Serum Homocysteine ◽  
And Control

Despite recent advances, only two-third of all strokes can be attributed to known causal risk factors. Homocysteine (tHcy), a sulfur-containing amino acid, is now considered to be an important risk factor for vascular diseases, along with the established risk factors like hyperlipidemia, hypertension, diabetes mellitus, and smoking. Elevated homocysteine levels play a causal role in the pathogenesis of atherosclerosis, thromboembolism and vascular endothelial dysfunction with an increased incidence of ischemic stroke.  This study aimed to find out the association of hyperhomocysteinemia with ischemic stroke. A total of 100 subjects were included in this study, 50 were ischemic stroke patients enrolled as case, and 50 were normal healthy individuals enrolled as control. Serum homocysteine level was measured in both case and control groups. The comparison was made in both groups regarding other common risk factors like diabetes mellitus, hypertension, smoking, dyslipidemia, family history, etc.  Among 100 patients, 50 had ischemic stroke and 50 were healthy individuals. In this study, out of all patients, abnormal serum homocysteine level was found in 32% of cases and 12% of controls. The mean (±SD) serum homocysteine level was found 16.50±13.86 μmole/L in cases and 9.46±3.49 μmole /L in the control group. Significant (p<0.05) difference was found between the case and the control. The incidence of hyperhomocysteinemia is higher in ischemic stroke cases than that in age-sex-matched healthy controls. In our study, serum homocysteine was high in both younger age group patients (16.65±14.55 μmole/L vs. 9.52±3.19 μmole/L) and older age group patients (16.33±9.87 vs. 9.35±3.97 μmole/L,) in case and control group respectively. Significant (p<0.05) difference was found between the case and the control. Multiple logistic regression analysis showed that abnormal serum homocysteine is an independent risk factor of ischemic stroke. So we conclude that hyperhomocysteinemia is an important and independent risk factor for the development of ischemic stroke. Hypertension and smoking are important contributory to elevated serum homocysteine. TAJ 2021; 34: No-1: 33-39

scholarly journals Lipoprotein (a) Levels in Childhood Arterial Ischemic Stroke

2009 ◽  
Vol 16 (2) ◽  
pp. 214-217 ◽  
Author(s):  
Serap Teber ◽  
Gülhis Deda ◽  
Nejat Akar ◽  
Kazım Soylu
Keyword(s):  
Risk Factor ◽  
Ischemic Stroke ◽  
Young Patients ◽  
Control Group ◽  
Healthy Children ◽  
Case Control Studies ◽  
Arterial Ischemic Stroke ◽  
Lipoprotein A ◽  
Screening Programs ◽  
Stroke In Young Adults

Lipoprotein (a) is a cholesterol-rich plasma lipoprotein with a lipid composition similar to that of low-density lipoproteins (LDL). Many prospective and case-control studies identified elevated levels of lipoprotein (a) as a risk factor for premature myocardial infarction and stroke. Elevated lipoprotein (a) has been identified as a genetically determined risk factor for stroke in young adults, but only preliminary data are available on its role as a risk factor for ischemic stroke in infants and children. Fifty two children with arterial ischemic stroke and 78 age- and sex-matched healthy children were studied. Data of this study indicate that 26.9% of children with arterial ischemic stroke had high lipoprotein (a) levels in comparison with the age matched healthy control group. Measurement of lipoprotein (a) should be included in screening programs performed in young patients suffering not only from venous thromboembolism but also arterial ischemic stroke, in addition to other thrombophilic factors.

scholarly journals Elevated anticardiolipin titer as a stroke factor in young patients in kirkuk city

2019 ◽  
Vol 10 (3) ◽  
pp. 1932-1935
Author(s):  
Raad Hassan Najim ◽  
Bilal Jamal kamal
Keyword(s):  
Atrial Fibrillation ◽  
Heart Disease ◽  
Ischemic Stroke ◽  
Valvular Heart Disease ◽  
Young Patients ◽  
Control Group ◽  
P Value ◽  
Diabetic Patients ◽  
Hemorrhagic Disease ◽  
Coronary Arterial Disease

Background: Stroke is a common cause of morbidity and mortality worldwide, and it is the third leading cause of medical death in developed countries. Stroke can be classified into ischemic disease (80%) and hemorrhagic disease (20). Subject and methods: A case-control study done in the period extending from November 2013 to April 2014 in neuro medicine department in Azadi teaching hospital in Kirkuk city in Iraq. This study involving 2 study groups, each one of them, including 50 patients. The first group (cases) included 50 patients diagnosed as having an ischemic stroke by neurologist their ages were less than 45 years .in  another group (control), 50 patients involved admitted to the same hospital with no history of prior ischemic stroke. Results: Fifty patients with stroke of ischemic orgin and 50 controls included in the study. Table 1 summarize demographic and clinical characteristics of patients and control groups, control was older than ischemic stroke patient with no significant correlation (P-value=0.33). Gender distribution showing a significant correlation in regarding female sex in both groups (P-value=0.001). Ischemic stroke according to our findings is more prevalent in those patients with Hypertension with 66% of patients in comparison to 42% of control patients with P-value of 0.0001, diabetic patients with double percentage (72%) to those in control group (36%) with P-value of 0.0001,coronary arterial disease ,valvular heart disease and rhythm disease such as atrial fibrillation seen to be more popular  in those patients with ischemic stroke with no significant value in regarding to patients having coronary and valvular heart disease (P-value=0.11,0.21) and strongly associated with those patient presented with atrial fibrillation (P-value=0.0001). Conclusion: Elevated anticardiolipin antibodies are seen to be as an independent risk factor for ischemic stroke.

scholarly journals A STUDY TO ASSESS THE CONTRAST SENSITIVITY OF THE HUMAN VISUAL SYSTEM IN PATIENTS WITH OR WITHOUT DIABETES IN A TERTIARY CARE HOSPITAL

2020 ◽  
pp. 24-26
Author(s):  
NIKITA RAJGADIA ◽  
BINDU BHASKARAN ◽  
N. DIVYA ◽  
V. PANIMALAR A. VEERAMANI ◽  
SYEDA SADIYA IKRAM
Keyword(s):  
Visual Acuity ◽  
Visual Impairment ◽  
Contrast Sensitivity ◽  
Tertiary Care ◽  
Dependent Diabetes Mellitus ◽  
Control Group ◽  
P Value ◽  
Care Hospital ◽  
Type Ii ◽  
Department Of Ophthalmology

Objective: The objective of our study was to assess the variations in contrast sensitivity values of normoglycemic subjects and that of type II diabetic subjects of the same age group. It was also aimed at finding the visual acuities and study the associations of it with contrast sensitivity if any. Methods: It was a hospital-based comparative cross-sectional descriptive study conducted in the out-patient department of the Department of Ophthalmology, Saveetha Medical College, Hospital, Chennai. Visual Acuity and Contrast Sensitivity of 50 Type II Diabetic individuals and 50 age-equivalent control group subjects were measured using the Snellen’s chart and Pelli-Robson chart, respectively, during the months of January to March 2020. Results: Contrast Sensitivity measurements from 50 subjects with Non-Insulin dependent Diabetes Mellitus (NIDDM) were obtained. The subjects were the ones who had minimal or no diabetic retinopathy. It was observed that there is a significant association between reduced contrast sensitivity and Diabetes (P value<.00008). We also noted that CS may be reduced without corresponding loss of Visual Acuity. Hence, both visual acuity and contrast sensitivity measurements are helpful in the assessment of visual impairment due to diabetic eye disease. Conclusion: The contrast sensitivity can be seen as an early marker for visual impairment in diabetic eye care.

scholarly journals Effect of Taping of Thoracic and Abdominal Muscles on Pelvic Alignment and Forward Reach Distance Among Stroke Subjects: A Randomized Controlled Trial

2019 ◽  
Vol 26 (3-4) ◽  
pp. 10-16
Author(s):  
Megha Mehta ◽  
Abraham M. Joshua ◽  
Suruliraj Karthikbabu ◽  
Zulkifli Misri ◽  
Bhaskaran Unnikrishnan ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Control Group ◽  
P Value ◽  
Abdominal Muscles ◽  
Care Hospital ◽  
Physiotherapy Treatment ◽  
Short Term ◽  
Randomized Controlled ◽  
Conventional Physiotherapy ◽  
Experimental Group

Introduction: The objective of this study was to find the immediate as well as short-term effect on pelvic alignment and forward arm reach distance in sitting among stroke patients following thoracic spine and abdominal muscles taping along with conventional therapy. Methods: Thirty subjects with stroke attending the physiotherapy programme at Department of Physiotherapy at a tertiary care hospital underwent this randomized controlled experimental study. Subjects in the experimental group received taping, along with conventional physiotherapy treatment, for restricting thoracic kyphosis and facilitating abdominal muscles. Subjects in the control group received only conventional physiotherapy treatment. To assess the change in pelvic alignment and forward arm reach distance while sitting, Palpation MeterTM (PALMTM) and sit and reach test were used, respectively. Results: In the experimental group, pelvic obliquity was corrected (4.1 ± 0.94) and anterior pelvic tilt revealed improvement (4.9 ± 2.1, p value < 0.001). In the control group, no improvement in pelvic alignment was recorded. Improvement in forward arm reach distance was similar in both groups ( p value = 0.804). Conclusion: Taping as an adjunctive treatment method to physiotherapy can cause immediate as well as short-term improvement of pelvic alignment in sitting, following stroke. It also, immediately improves the sit and reach distance in the same population.

scholarly journals Study On Stroke In Young Patient Due To Cardiac Disease in Tertiary Care Hospital in Dhaka City

2016 ◽  
Vol 17 (2) ◽  
pp. 95-99
Author(s):  
Sanjoy Kumar Saha ◽  
Prodip Kumar Biswas ◽  
Meherunessa Mukta ◽  
Mohammed Shahadat Hossain ◽  
Mimal Kumar Basu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Ischemic Stroke ◽  
Cardiac Disease ◽  
Heart Diseases ◽  
Tertiary Care ◽  
Care Hospital ◽  
Stroke Patients ◽  
Female Ratio ◽  
Valvular Heart Diseases

Objectives: Study of the risk factors associated with stoke due to cardiac disease in age group between 18 to 45 years of age,evaluate the risk factor of hospitalized stroke patients & to search for cardiac disease associated with stroke also appropriate preventive measure applicable for our country.Materials & Methods: Non randomized prospective observational study was carried out in the department of Neurology, Medicine & Cardiology unit of Dhaka Medical College Hospital between the periods of July 2009 to December 2009. Fifty (50) consecutive indoor patients more than 18 years of both sex admitted with suspicion of stroke. Diagnosis of stroke will be made from details clinical history clinical examination and confirmed by CT scan or MRI.Result: Fifty patients were randomly chosen for this study, of which 26 (52%) patients were male, 24 (48%) patients were female & male: female ratio was 1.08:1. Highest incidence of stroke was in between 3rd & 4th decade. The incidence of ischemic stroke 46 (92%) & hemorrhagic stroke 4(8%).Cardio embolism is the major (92%) risk factor for ischemic stroke. Among the cardiac risk factors, valvular disease (64%), MI (16%), &IHD (10%), Atrial fibrillation 8%, Patent foramen ovale 2%.Among the patients 33.33% of women with cerebral infarction were using OCP. Majority of the patients in this study were sedentary worker (45%). Among the stroke patients 8% & 10% had previous H/O stroke & TIA respectively.Conclusion: In this study a number of modifiable risk factors were identified, of which valvular heart disease & HTN are important risk factor next are DM & IHD smoking. Most of the valvular heart diseases are rheumatic in origin, which can be prevented through primary & secondary prevention of rheumatic fever.J MEDICINE July 2016; 17 (2) : 95-99

scholarly journals Comparative study of serum urea, creatinine and C-reactive protein level in chronic kidney disease patients with healthy subjects

2017 ◽  
Vol 5 (4) ◽  
pp. 1480 ◽  
Author(s):  
Dileep Singh Nirwan ◽  
R. K. Vyas ◽  
Sunil Jain
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Tertiary Care ◽  
Age Groups ◽  
Control Group ◽  
P Value ◽  
Care Hospital ◽  
Serum Urea ◽  
C Reactive Protein ◽  
Reactive Protein

Background: Chronic diseases are a leading cause of morbidity and mortality in India. Globally, chronic kidney disease is the 12th cause of death and the 17th cause of disability, respectively. CKD is defined as kidney damage or glomerular filtration rate (GFR) <60 mL/min/1.73 m2 for 3 months or more, irrespective of cause. The present study aimed to find out correlation between serum urea, creatinine and C-reactive protein (CRP) level among patients suffering from chronic kidney disease in an urban based tertiary care hospital in Bikaner, western Rajasthan, India.Methods: This study was conducted at Sardar Patel Medical College and Associated Hospitals at Bikaner, Rajasthan from August 2015 to December 2016. There were 50 cases and 50 controls in the age groups from 10 to 60 yearrs. We took fresh samples and performed required tests following standard protocol. CRP has been done by Antigen Antibody reaction (latex method). RFT has been performed on semi-automatic analyzer.Results: Levels of serum urea and creatinine were significantly raised in CKD patients (p-value<0.005) and CRP level was raised in 52% cases. While 48% cases having normal level %), which requires further study.  Renal function tests were significantly higher in cases than controls.Conclusions: Serum creatinine and urea level were significantly higher in cases as compared to control group.

scholarly journals Sex differences in clinical presentation in acute MI

2017 ◽  
Vol 4 (4) ◽  
pp. 940
Author(s):  
Ashwin Kodliwadmath ◽  
Naren V. Nimbal
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Chest Pain ◽  
Clinical Presentation ◽  
Tertiary Care ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Control Group ◽  
Care Hospital ◽  
Acute Mi

Background: Acute myocardial infarction differs in women and men with respect to risk factors and clinical presentation. There are studies carried out worldwide on this issue but few from India. This study was done to study the sex based differences in the risk factors and clinical features of acute MI in patients with Indian ethnicity.Methods: Comparative prospective study consisting of 100 women as study group and 100 men as control group with acute MI, who were admitted in a tertiary care hospital, from December 2016 to June 2017.Results: Chest pain was the main complaint in majority of the women (82%) and men (88%). Radiation of chest pain (87%) and sweating (90%) were significantly present in men compared to women (65% and 62% respectively), while breathlessness was significantly present in women (78%) compared to men (64%) and fatigue in women (76%) significantly more than men (55%). Smoking was a significant risk factor in men (69%) compared to women (5%), while diabetes mellitus was a significant risk factor in women (62%) compared to men (39%).Conclusions: Women with acute MI had more atypical presentation of symptoms, similar risk factors, compared to men except for smoking which was more significant in men and diabetes more common in women.

scholarly journals Clinical profile and serum homocysteine level in young patients with stroke: a prospective, observational study

2019 ◽  
Vol 6 (4) ◽  
pp. 1134
Author(s):  
Manoharan S. ◽  
Sathyasagar K. ◽  
Natesh Prabhu M.
Keyword(s):  
Homocysteine Level ◽  
Elevated Serum ◽  
Young Patients ◽  
Individual Risk ◽  
P Value ◽  
Serum Homocysteine ◽  
Cortical Vein Thrombosis ◽  
Number Of Patients ◽  
Significant Difference ◽  
Stroke In Young

Background: According to the WHO, stroke is the second most important cause of death in elderly people with age >60 years and fifth leading cause in the age group of 15 to 59 years. Hyperhomocysteinemia has been linked to increased incidence of ischemic strokes. Thus, the aim of the present study was to assess serum homocysteine levels as an individual risk factor of stroke in young patients.Methods: This was a prospective, cross-sectional, single center study performed in 50 patients admitted in the Department of Medicine, Thanjavur Medical College and Hospital, Thanjavur, over a period of 7 months (i.e., from December 2013 to June 2014). Young patients, aged 1545 years, and diagnosed with stroke were included in the study. Serum homocysteine was measured by fluorescein polarization immunoassay (FPIA). Significant difference between the patients with normal and elevated mean serum homocysteine levels was identified by using unpaired t-test. P value ≤0.05 was considered as statistically significant.Results: Majority of the stroke patients were male (78%). Similarly, male patients dominated the total number of patients with elevated serum homocysteine levels (75%). Thirty-two (64%) patients had an elevated serum homocysteine level. There was a significant difference between the patients with increased homocysteine levels as compared to patients with normal homocysteine levels (p value <0.05). Out of 32 patients with hyperhomocysteinemia, 27 (84.38%) patients had ischemic stroke, 4 (12.50%) had cortical vein thrombosis and 1 (3.12%) had hemorrhagic stroke.Conclusions: Findings of the present study confirm that hyperhomocysteinemia is associated with an increased incidence of stroke in young patients. As healthcare providers, we must stress on prevention of stroke, especially by identifying treatable risk factors.

scholarly journals Profile of tuberculous pneumothorax and comparison with pulmonary tuberculosis without pneumothorax

2019 ◽  
Vol 7 (3) ◽  
pp. 658
Author(s):  
Gayatri D. Yellapu ◽  
Surya K. Vipparthi ◽  
Rohini K. Vangara
Keyword(s):  
Pulmonary Tuberculosis ◽  
Hospital Stay ◽  
Past History ◽  
Financial Burden ◽  
Tertiary Care ◽  
Control Group ◽  
P Value ◽  
Care Hospital ◽  
Common Cause ◽  
The Mean

Background: Tuberculosis is the most common cause of secondary spontaneous pneumothorax (SSP) in India. The prevalence of SSP in patients with pulmonary tuberculosis (PTB) is between 1- 3%. There were only few studies in the literature that specifically analyze tuberculous PNTX. In a study from this hospital, author found PTB was the most common cause of SSP. Now, author aimed at studying the clinical profile of tuberculosis associated PNTX cases and compared with pulmonary tuberculosis cases without PNTX.Methods: This was a single centre prospective observational case control study done at a tertiary care hospital. Fifty patients of tuberculous pneumothorax as cases, and 100 patients of pulmonary tuberculosis without pneumothorax were taken as control. The demographic data, clinical presentation, and radiologic presentation, outcomes after treatment were recorded in both the groups. The data was analyzed using statistical software (SPSS) using appropriate statistical tools.Results: The mean age of patients in the PNTX group was 38.18±14.132, where as in the control group it was 45.29±14.89 (p-value of 0.0052). Past history of tuberculosis was present in 27 (54%) cases of PNTX group and in 41 (41%) cases in the control group (p-value of 0.091). The mean duration of length of hospital stay in PNTX group was 16.5±11.865 days and in non-pneumothorax group was 6.2±2.54 days (p-value was 0.0001).Conclusions: Tuberculous pneumothorax was more common between 30-40 yrs age group. Gender and smoking have no association with PNTX. Tuberculous pneumothorax was more common in previously treated cases of TB. Patients with tuberculous PNTX have prolonged hospital stay and complications resulting in increased morbidity, financial burden and mortality.

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