scholarly journals Clinical Profile of Stroke Patients Presenting to the Emergency Department of a Major Stroke Centre in Oman

2021 ◽  
Author(s):  
Hasina A. Al Harthi ◽  
Ammar Al Kashmiri ◽  
Lubna M. Zakaryia ◽  
Jawad A. Al-Lawati ◽  
Omar M. Najem ◽  
...  
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Heart Diseases ◽  
Tertiary Care ◽  
Public Health Problem ◽  
Large Artery ◽  
Care Hospital ◽  
Stroke Patients ◽  
Vessel Occlusion ◽  
Number Of Patients

Objectives: Stroke is a significant public health problem and one of the important preventable non-communicable diseases. Preventive stroke programs are yet to be properly established in Oman, with a better focus on increasing awareness among those who are currently at risk. This study was conducted to describe the characteristics of stroke presenting to a tertiary care hospital in Oman. Methods: This was a cross-sectional hospital-based study. Included 193 stroke cases which were prospectively recruited from the Emergency Department of a tertiary-level hospital. Data was collected from November 2017 to April 2018. Results: The total number of patients was 193. 82.9% of strokes were ischemic strokes. 58% were male. The mean age of stroke patients was 61.05 years. Risk factors included hypertension (72.5%) and diabetes mellitus (54.4%). Dyslipidemia, atrial fibrillation and ischemic heart diseases were not particularly prevalent in our population. 24.4% of ischemic strokes had large artery atherosclerosis and 21.9% had small vessel occlusion. Significantly more patients had lower Glasgow Coma Scale (GCS), required ICU admission and had in-hospital deaths in hemorrhagic stroke compared to ischemic stroke. Conclusions: This study provides essential stroke characteristics data specific to Oman’s population. Most of the information obtained conforms with that described internationally and similar preventive strategies can be implemented. The information can be utilized by health administrators in planning resource allocation. Further research is needed to explore rehabilitation aspects and long-term outcomes. Keywords: Stroke; Ischemic; Hemorrhagic; Young Stroke; Risk Factors; Thrombolysis; Epidemiology; Oman.

scholarly journals Prevalence of Modifiable Risk Factors among Stroke Patients in a Tertiary Care Hospital in Dhaka

1970 ◽  
pp. 18-21 ◽  
Author(s):  
Md Badiuzzaman ◽  
Fazle Rabbi Mohammed ◽  
Fazle Rabbi Chowdhury ◽  
Md Shafiqul Bari ◽  
Md Billal Alam ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Heart Diseases ◽  
Tertiary Care ◽  
Modifiable Risk Factors ◽  
Care Hospital ◽  
Stroke Patients ◽  
Female Ratio ◽  
History Of ◽  
Arachnoid Hemorrhage

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

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 Etiology of ischemic stroke among young adults of Serbia

2008 ◽  
Vol 65 (11) ◽  
pp. 803-809 ◽  
Author(s):  
Dejana Jovanovic ◽  
Ljiljana Beslac-Bumbasirevic ◽  
Ranko Raicevic ◽  
Jasna Zidverc-Trajkovic ◽  
Marko Ercegovac
Keyword(s):  
Risk Factors ◽  
Young Adults ◽  
Ischemic Stroke ◽  
Heart Diseases ◽  
Developed Countries ◽  
Large Artery ◽  
Stroke Treatment ◽  
Prosthetic Valves ◽  
Number Of Patients ◽  
Coagulation Inhibitors

Background/Aim. Etiology of ischemic stroke (IS) among young adults varies among countries. The aim of the study was to investigate the causes and risk factors of IS in the young adults of Serbia. Methods. A total of 865 patients with IS, aged 15 to 45 years, were treated throughout the period 1989-2005. Etiologic diagnostic tests were performed on the patient by the patient basis and according to their availability at the time of investigation. The most likely cause of stroke was categorized according to the TOAST (Trial of ORG 10172 in Acute Stroke Treatment) criteria. Results. There were 486 men and 379 women, with 19% of the patients ? 30 years old. Large artery arteriosclerosis and small artery disease were confirmed in 14% of the patients, and embolism and other determined causes in 20%. Undetermined causes made up 32% of the patients, mostly those (26%) with incomplete investigations. Smoking (37%), hypertension (35%) and hyperlipidemia (35%) were the most common risk factors. Rheumatic heart diseases and prosthetic valves were the most common causes of IS. Arterial dissections and coagulation inhibitors deficiency were detected in a small number of patients. Conclusion. Etiology of IS among Serbian young adults shares characteristics of those in both western and less developed countries.

scholarly journals Ischemic stroke: Observations and analysis of stroke patients admitted in a tertiary hospital of Kathmandu

2019 ◽  
Vol 8 (2) ◽  
pp. 66-71
Author(s):  
Dipesh Shakya ◽  
Rabindra Shrestha ◽  
Krishna Dhungana ◽  
Raisha Kafle ◽  
Sabnam Bhatta
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Carotid Artery ◽  
Public Awareness ◽  
Tertiary Care ◽  
Care Hospital ◽  
Stroke Patients ◽  
Cross Sectional ◽  
Carotid Artery Atherosclerosis ◽  
Common Risk Factors

Background: Stroke is a disabling condition that has physical and mental impact on a patient’s life. Stroke is an important morbidity for low and middle income countries like Nepal. Hypertension, diabetes, smoking, and dyslipidemia are common risk factors in this regard and are inadequately controlled; mainly because of poor public awareness, inadequate infrastructure, lack of service and qualified manpower.Objectives: This study aims to provide insight into the epidemiology and risk factors in ischemic stroke patients.Methodology: A descriptive cross sectional study was conducted in 92 ischemic stroke patients at a tertiary care hospital Kathmandu Medical College and Teaching Hospital (KMCTH), Sinamangal, Nepal from December 2017 to June 2018. Consecutive sampling technique was used and data was collected from ischemic stroke patients above 14 years of age who were admitted in the Department of Neurology. Information regarding pre-morbid and morbid conditions, imaging findings as well as results was obtained from biochemical analysis of blood after taking consent from the patient or patient’s relative. Statistical Package for the Social Sciences Version 20 was used as a tool for statistical analysis.Results: Their mean age was 63.25 years with standard deviation of 16.45. Dyslipidemia was the most commonly found risk factor which was present in 77.2% of the subjects, followed by smoking (59.8%), presence of carotid artery atherosclerosis (59.8%), hypertension (50%), atrial fibrillation (26.1%) and diabetes mellitus(15.2%). Smoking was significant in males and heart disease was mostly seen in females.Conclusion: Dyslipidemia and smoking were the most common risk factors followed by carotid artery atherosclerosis. Patients with hypertension and dyslipidemia had higher incidence of stroke in both young and elderly group.

scholarly journals Recurrent Emergency Department Users: Two Categories with Different Risk Profiles

2019 ◽  
Vol 8 (3) ◽  
pp. 333 ◽  
Author(s):  
Ksenija Slankamenac ◽  
Meret Zehnder ◽  
Tim Langner ◽  
Kathrin Krähenmann ◽  
Dagmar Keller
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Emergency Services ◽  
Hospital Admissions ◽  
Tertiary Care ◽  
Chronic Obstructive ◽  
Care Hospital ◽  
Co Morbidity ◽  
Ed Visits ◽  
Morbidity Index

Recurrent emergency department (ED) visits are responsible for an increasing proportion of overcrowding. Therefore, our aim was to investigate the characteristics and prevalence of recurrent ED visitors as well as to determine risk factors associated with multiple ED visits. ED patients visiting the ED of a tertiary care hospital at least four times consecutively in 2015 were enrolled. Of 33,335 primary ED visits, 1921 ED visits (5.8%) were performed by 372 ED patients who presented in the ED at least four times within the one-year period. Two different categories of recurrent ED patients were identified: repeated ED users presenting always with the same symptoms and frequent ED visitors who were suffering from different symptoms on each ED visit. Repeated ED users had more ED visits (p < 0.001) and needed more hospital admissions (p < 0.010) compared to frequent ED users. Repeated ED users visited the ED more likely due to symptoms from chronic obstructive pulmonary diseases (p < 0.001) and mental disorders (p < 0.001). In contrast, frequent ED patients showed to be at risk for multiple ED visits when being disabled (p = 0.001), had an increased Charlson co-morbidity index (p = 0.004) or suffering from rheumatic diseases (p < 0.001). A small number of recurrent ED visitors determines a relevant number of ED visits with a relevance for and impact on patient centred care and emergency services. There are two categories of recurrent ED users with different risk factors for multiple ED visits: repeated and frequent. Therefore, multi-professional follow-up care models for recurrent ED patients are needed to improve patients’ needs, quality of life as well as emergency services.

scholarly journals Risk Factors of Candida parapsilosis Catheter-Related Bloodstream Infection

2021 ◽  
Vol 9 ◽  
Author(s):  
Dina Hussein Yamin ◽  
Azlan Husin ◽  
Azian Harun
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Bloodstream Infection ◽  
Candida Parapsilosis ◽  
Heart Diseases ◽  
Tertiary Care ◽  
Solid Organ ◽  
Care Hospital ◽  
Icu Admission ◽  
Catheter Related Bloodstream Infection

Catheter-related bloodstream infection (CRBSI) is an important healthcare-associated infection caused by various nosocomial pathogens. Candida parapsilosis has emerged as a crucial causative agent for the CRBSI in the last two decades. Many factors have been associated with the development of CRBSI including, demography, pre-maturity, comorbidities (diabetes mellitus, hypertension, heart diseases, neuropathy, respiratory diseases, renal dysfunction, hematological and solid organ malignancies, and intestinal dysfunction), intensive care unit (ICU) admission, mechanical ventilation (MV), total parenteral nutrition (TPN), prior antibiotic and/or antifungal therapy, neutropenia, prior surgery, immunosuppressant, and type, site, number, and duration of catheters. This study aims to determine C. parapsilosis CRBSI risk factors. A retrospective study has been performed in an 853-bedded tertiary-care hospital in north-eastern Malaysia. All inpatients with C. parapsilosis positive blood cultures from January 2006 to December 2018 were included, and their medical records were reviewed using a standardized checklist. Out of 208 candidemia episodes, 177 had at least one catheter during admission, and 31 cases had not been catheterized and were excluded. Among the 177 cases, 30 CRBSI cases were compared to 147 non-CRBSI cases [81 bloodstream infections (BSIs), 66 catheter colonizers]. The significance of different risk factors was calculated using multivariate analysis. Multivariate analysis of potential risk factors shows that ICU admission was significantly associated with non-CRBSI as compared to CRBSI [OR, 0.242; 95% CI (0.080–0.734); p = 0.012], and TPN was significantly positively associated with CRBSI than non-CRBSI [OR, 3.079; 95%CI (1.125–8.429); p = 0.029], while other risk factors were not associated significantly. Patients admitted in ICU were less likely to develop C. parapsilosis CRBSI while patients receiving TPN were more likely to have C. parapsilosis CRBSI when compared to the non-CRBSI group.

scholarly journals A Hospital based cross sectional study to find out factors associated with disease severity and length of hospital stay in COVID-19 patients in Tertiary Care Hospital of Ahmedabad city

2021 ◽  
Vol 33 (2) ◽  
pp. 256-259
Author(s):  
Arpit Chelabhai Prajapati ◽  
Mansi Maulik Patel ◽  
Hardika Jamanadas Khanpara ◽  
Rujul Pankajbhai Shukla ◽  
Donald Shailendra Christian ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hospital Stay ◽  
Disease Severity ◽  
Tertiary Care Hospital ◽  
Heart Diseases ◽  
Tertiary Care ◽  
Length Of Hospital Stay ◽  
Care Hospital ◽  
Factors Associated ◽  
High Dependency

Background: Tertiary hospital care may vary from isolation bed ward care to high dependency units (HDUs) with oxygen support to intensive care unit (ICU) where patients may be intubated for mechanical ventilation The major risk factors for severe disease are age more than 60 years and underlying diseases like diabetes, hypertension. COVID-19 patients present at varying levels of severity. Understanding how long patients hospitalized with COVID-19 remain in hospital is critical for planning. Objectives: 1. To determine risk factors associated with disease severity 2. To determine risk factors associated with length of hospital stay in COVID-19 patients 3. To study the disease outcome Material & Methods: This was retrospective record-based study of inpatients with COVID-19 at Tertiary Care Hospital of Ahmedabad City. All patients admitted at tertiary care hospital diagnosed with COVID-19 between April 2020 to June, 2020, were included in present study. Inclusion criteria were all COVID-19 patients admitted at tertiary care hospital during the duration of April 2020 to June 2020. Results: A total of 916 COVID-19 patients were included in the study. Out of 916 total admitted patients 526 (57.4%) were male. 174 (19%) patients having one or more comorbidities like diabetes, hypertension, tuberculosis, heart diseases etc. Total 769 discharged (83.9%), 115 deaths (12.6%) and 32 transferred to other COVID-19 hospital (3.5%) out of total 916 patients admitted during study period. Conclusion: Severity of disease and deaths were associated with age and comorbidities. COVID-19 patients with comorbidities have more deteriorating outcomes compared with patients without.

scholarly journals Acute Poisoning among Patients Presenting to the Emergency Department of a Tertiary Care Center: A Descriptive Cross-sectional Study

2020 ◽  
Vol 58 (227) ◽  
Author(s):  
Sameer Thapa ◽  
Bishwa Raj Dawadi ◽  
Anup Raj Upreti
Keyword(s):  
Emergency Department ◽  
Binary Data ◽  
Tertiary Care ◽  
Public Health Problem ◽  
Cross Sectional Study ◽  
Acute Poisoning ◽  
Point Estimate ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional

Introduction: Acute poisoning is a major global public health problem contributing to one of theleading causes for a visit to an emergency department. This study aims to analyse the demographicand psychosocial characteristics of patients with acute poisoning presented to the emergencydepartment. Methods: This was a descriptive cross-sectional study conducted in a tertiary care hospital fromJune to December 2019 after obtaining ethical approval from Institutional review board (referencenumber. 041-075/0760). A convenient sampling method was applied. Epidemiological factors, typesof poison consumed, reason, motive, and place to take poison, time elapse in the presentation to thehospital were studied. Statistical analysis was done using statistical package for the social sciencesversion 20. Point estimate at 95% Confidence Interval was calculated along with frequency andproportion for binary data. Results: Out of 76 cases of acute poisoning, the organophosphorus poisoning was 18 (23.7%) followedby unknown 12 (15.8). Of total, 28 (36.8%) had quarrel before taking poison and 41 (53.9 %) hadintention to commit suicide. Sixty-seven (88.2%) took a poison at home. The average elapsed time tothe visit of the emergency department was 110±80 minutes.   Conclusions: The most common poisoning was organophosphorus with a suicide being the mostcommon intention. Quarrel was the most frequent reason to take poison and the home was the mostcommon place to take poison.

scholarly journals Risk Factors Associated With Sino-Nasal Polyposis And Its Relationship With The Occupational Inhalants

2019 ◽  
Vol 09 (04) ◽  
pp. 290-293
Author(s):  
Qaisar Sajad ◽  
Ayub Musani ◽  
Faheem Ahmed Khan
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Nasal Polyposis ◽  
Local Population ◽  
Tertiary Care ◽  
Nasal Allergy ◽  
Care Hospital ◽  
Common Risk Factor ◽  
Factors Associated ◽  
Number Of Patients

Objective: To determine the risk factors associated with sino-nasal polyposis and its relationship with the exposure of occupational inhalants in patients presenting in a tertiary care hospital of Karachi. Study design and Settings: Cross-sectional study conducted at department of otorhino-laryngology Karachi Medical & Dental College and Abbasi Shaheed Hospital Karachi for a period of two and a half years from October 2015 to April 2018. Methodology: Total number of patients included for this study were 221 patients with diagnosis of bilateral and multiple nasal polyposis with age greater than 10 years. Specifically, designed proforma was used for data collection specially in relation with occupation and exposure to different occupational inhalants and entered in SPSS version 23 for analysis. Results: There were 133 male and 88 female patient with a mean age was 36.16 ± 12.33 years. Mostly patients belonged to poor socio-economic status i.e. 133 (60.70%). Allergic rhinitis or nasal allergy was the most common risk factor present in 114 patients (51.6%) while aspirin hypersensitivity was the least common risk factor present in only 19 patients (8.5%). Most of the patients (76 or 34.4%) were related with one or the other form of agriculture and were exposed to different occupational inhalants like mud, pollens, animals and plants. Conclusions: Nasal allergy is the most common risk factor and occupational inhalant specially related with agriculture, poultry and pets are the common agents responsible for nasal polyposis in our local population.

scholarly journals Subtypes, Risk Factors and Site of Stenosis of Ischaemic Stroke in a University Hospital in Bangladesh

2021 ◽  
pp. 11
Author(s):  
Mohammad Shahidullah ◽  
Nahid Sultana ◽  
Subash Kanti Dey ◽  
Anis Ahmed
Keyword(s):  
Risk Factors ◽  
Magnetic Resonance ◽  
Ischaemic Stroke ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Large Artery ◽  
Stroke Patients ◽  
Vessel Occlusion ◽  
Cross Sectional ◽  
Common Cause

Stoke is the second most common cause of death and the most common cause of adult disability. To plan an efficient evaluation and treatment of an individual patient with ischaemic stroke, the clinician should be familiar with the subtyping of ischaemic stroke patients and the risk factors analysis of different aetiology. Eight hundred seventy-seven (877) patients have been selected for this cross-sectional study conducted in a university hospital of Bangladesh from 2014 to 2018, to whom brain imaging [Computed Tomography (CT)/ Magnetic Resonance Imaging (MRI)], vascular imaging [Magnetic Resonance Angiogram (MRA), Digital Subtraction Angiogram (DSA)], ECG and echocardiography have been done. We did subtyping according to TOAST criteria. The mean age of patients was 60.5 ± 11 years. Most patients (29.33%) belonged to the age group 51 – 60, where 70.47% of subjects were male and 29.53% were female. In this study, 43.87% of patients were in the large artery atherosclerosis group, 23.83.% in the small vessel occlusion group, 8.46% in the cardiac embolism group, 19.30% in the undetermined aetiology group and 4.54% in other determined aetiology. Among risk factors hypertension, diabetes mellitus, dyslipidaemia was present in 58.15%, 38.42%, and 38.88% of patients, respectively. In ischaemic stroke patients, large artery atherosclerosis was the most common subtype and hypertension was significant in this group. Extracranial stenosis was more common in ischaemic stroke.

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