scholarly journals Hyperhomocysteinaemia among Acute Ischaemic Stroke Patients in a Tertiary Care Centre in Thiruvananthapuram, Kerala – A Cross-Sectional Study

2021 ◽  
Vol 8 (19) ◽  
pp. 1326-1331
Author(s):  
Deepa Gopalakrishna ◽  
Rupa Gopinathan ◽  
Saboora Beegum ◽  
Thomas Iype
Keyword(s):  
Risk Factors ◽  
Ischaemic Stroke ◽  
Acute Ischaemic Stroke ◽  
Homocysteine Level ◽  
Statistical Tests ◽  
Tertiary Care ◽  
Care Hospital ◽  
Stroke Patients ◽  
Cross Sectional ◽  
Total Homocysteine

BACKGROUND Over the last three decades, prevalence of stroke has been high in India, while the Western countries have witnessed a downward slide. Epidemiological studies suggest that hyperhomocysteinaemia might be a potentially modifiable nonlipid risk factor associated with stroke, in addition to the long-recognized factors like hypertension, diabetes mellitus, hyperlipidaemia and smoking. Hyperhomocysteinaemia occurs due to deviation in the metabolic pathway of methionine, attributed by deficiency of vitamins, enzymes and other factors. The present study was undertaken to assess the proportion of hyperhomocysteinaemia in patients with acute ischemic stroke. We also compared the risk factors associated with stroke and serum levels of homocysteine. METHODS This is a cross sectional observational study conducted in a tertiary care hospital. The sample size was 140. Both male and female consecutive patients of age more than 18 years, with first attack of acute ischaemic stroke admitted in the Department of Neurology were selected. Baseline fasting serum samples were obtained for testing serum homocysteine levels. Statistical tests used were proportion, chi square and logistic regression. RESULTS Among 140 acute ischaemic stroke patients, total homocysteine level was raised in 83.6 % cases. The prevalence of moderate hyperhomocysteinaemia in our study was 65.4 % and intermediate hyperhomocysteinaemia was 17.9 % among stroke patients. The mean (± SD) homocysteine level was 22.75 (± 8.19). CONCLUSIONS A strong association was found between hyperhomocysteinaemia and acute ischaemic stroke. We could not find any significant correlation between total homocysteine level and most risk factors of stroke. KEYWORDS Stroke, Homocysteine, Risk Factors, Endothelial Dysfunction, Atherosclerosis, B Vitamins

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 Incidence and Risk Factors of Acute Kidney Injury in Acute Stroke - in a Tertiary Care Hospital

2019 ◽  
Vol 8 (1) ◽  
pp. 12-18
Author(s):  
Nitai Chandra Ray ◽  
Md Ayub Ali Chowdhury ◽  
Md Abdul Muqeet ◽  
Mahmud Javed Hasan ◽  
Ashutosh Saha Roy ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Kidney Disease ◽  
Acute Stroke ◽  
Tertiary Care ◽  
Kidney Injury ◽  
Care Hospital ◽  
Stroke Patients ◽  
College Hospital ◽  
Cross Sectional

Acute kidney injury (AKI) is a common complication after acute stroke. Multiple additional risk factors are also responsible for development of AKI during acute stroke. This cross sectional observational study was conducted with a total of 240 newly detected computed tomography (CT) confirmed acute stroke patients in Mymensingh Medical College Hospital with an aim to find out the incidence and risk factors of AKI in acute stroke. In this study, AKI developed in 15.42% of all types of acute stroke and more commonly in haemorrhagic stroke than in ischaemic stroke (23.44% vs. 12.50%, P<0.05). AKI was found more frequently (54.05%) in old >60 years age group and in male patients(17.93% vs. 11.58% & P>0.05). Again, AKI developed most commonly in chronic kidney disease (CKD) (33.33%, P<0.05) and then in diabetes mellitus (DM) (31.03%, P<0.05), in ischaemic heart disease (IHD) (28.11%, P<0.05), in hypertension (21.14%, P<0.05), in previous stroke (15.22%, P>0.05), in dyslipidaemia (13.33%, P>0.05), and in smoker (9.89%, P>0.05). Family history of (H/O) DM was present in 30.00% (P>0.05) and that of hypertension and kidney disease was present in 24.44% (P>0.05) and 25.00% (P>0.05) of stroke patients, respectively. Among the AKI patients, majority (70.27%) had hypertension and 37.84% had CKD, 29.73% had IHD. DM and smoker were 24.32%of each. Family H/O of hypertension, DM and kidney disease was present in 29.73%, 16.22% & 13.51 % of AKI patients, respectively. So, this study had identified several important risk factors of AKI, in particular age, sex, smoking, hypertension, DM, IHD, CKD and types of stroke. So, the risk score could be easily calculated to predict the risk of AKI in stroke patients. And thus to prevent the development of AKI is of utmost importance to reduce the related morbidity and mortality of acute stroke patients. A multicenter nationwide intensive research is needed to identify the precise mechanism, risk factors, their relation and actual outcome of AKI that develop in patients with acute stroke. CBMJ 2019 January: vol. 08 no. 01 P: 12-18

scholarly journals Clinical Profile of Stroke Patients Attended in a Tertiary Care Hospital- Study of 219 cases

2016 ◽  
Vol 32 (1) ◽  
pp. 16-20
Author(s):  
Nayeem Anwar ◽  
Md Rezaul Karim Khan ◽  
Nawreen Binte Anwar ◽  
Shamsun Nahar ◽  
- Md Shahidullah
Keyword(s):  
Risk Factors ◽  
Recurrent Stroke ◽  
Tertiary Care ◽  
The Body ◽  
Clinical Profile ◽  
Care Hospital ◽  
Age Group ◽  
Stroke Patients ◽  
Cross Sectional ◽  
Study Results

Background: Stroke is serious pathology with a immense impact on the functional and vital prognosis. It is the leading cause of death worldwide. The objective of the study was to observe clinical profile of stroke patients and important risk factors. Methods: It was a cross-sectional descriptive study conducted in the department of Neurology, BangabandhuSheikh Mujib Medical Universiy(BSMMU), Shahbag, Dhaka from August 2014 to November2015. All patients above 18 years of age and both sexes attending the above mentioned department meeting all inclusion and exclusion criterias and confirmed CT/MRI scan of Brain were included in this study. Results: A total of 219 patients were studied. Maximum 93(42.5%) patients were in age group of 61-70 years followed by 51(23.3%) and 30(13.7%), in the age group of 51-60 years and 71-80 years respectively. Male 138(63%) were predominant than female 81(63%). 78(35.61%) patients had weakness in both sides of the body, 66(30.1%) had weakness in the left side and 36(16.4%) had weakness in the right side of the body. 190 (87.7) patients had ischemic stroke and 29(12.3%) had hemorrhagic stroke. Among risk factors dyslipidemia was in 185(84.5%) patients, hypertension, smoking habits, diabetes mellitus and ischemic heart disease were present in 165(75.3%), 120(54.8%), 105(47.9%) and 42 (19.2%) patients respectively. H/O recurrent stroke was present in 55(25%) cases. Conclusion: Stroke cases were male predominant where dyslipidaemia was the most common risk factor, most common type of stroke was ischemic, most common presentation was hemiplegia/monoplegia and commonest age of presentation was seventh decade. Bangladesh Journal of Neuroscience 2016; Vol. 32 (1): 16-20

scholarly journals SERUM HOMOCYSTEINE AS A RISK FACTOR FOR STROKE: A PROSPECTIVE STUDY FROM A RURAL TERTIARY CARE CENTRE

2018 ◽  
Vol 11 (11) ◽  
pp. 174
Author(s):  
Nitin Gupta ◽  
Sandeep Joshi ◽  
Udit Narang ◽  
Rosy Bala Gupta ◽  
Ruby Sharma ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cerebrovascular Accident ◽  
Homocysteine Level ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Centre ◽  
Stroke Patients ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Serum Homocysteine

Objective: Stroke is one of the leading causes of mortality and long-term disability in both developed and developing countries. Serum homocysteine level is one of the emerging modifiable risk factors for atherosclerosis which may result into a cerebrovascular accident. This study was designed to study the association of Serum Homocysteine level with the development of acute stroke at a rural tertiary care centre in North India.Methods: The present study was a prospective cross-sectional study conducted in the Department of Medicine, Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Ambala. The study population included 100 patients presenting with Stroke (either ischemic or hemorrhagic) in the indoor and outdoor facilities in the Department of Medicine. 50 age and sex-matched healthy individuals were taken as controls. Serum total Homocysteine level was measured in all the cases and controls.Results: Majority of the patients suffered from ischemic stroke (78%), while only 22% patients had hemorrhagic stroke. The mean Serum Homocysteine level in stroke patients (19.88±8.78 μmol/l) was significantly higher than in controls (10.48±4.39 μmol/l) (p<0.01). In a subgroup analysis, stroke patients with a positive history of smoking had significantly higher homocysteine level as compared to non-smokers (p<0.05).Conclusion: Increased level of Serum Homocysteine is significantly associated with risk of cerebrovascular accident, which is independent of the risk attributed to traditional risk factors. 

scholarly journals Study of perception and behaviour in patients with coronary heart disease about risk factors and life style modification in tertiary care hospital, Bhavnagar

2019 ◽  
Vol 6 (4) ◽  
pp. 1549
Author(s):  
Pooja A. Chauhan ◽  
Atul Trivedi
Keyword(s):  
Risk Factors ◽  
Behaviour Change ◽  
Lifestyle Modification ◽  
Tertiary Care Hospital ◽  
Disease Risk ◽  
Statistical Tests ◽  
Tertiary Care ◽  
Personal Data ◽  
Care Hospital ◽  
Cross Sectional

Background: Non-communicable diseases are now the major cause of death in India, with cardiovascular diseases being the dominant cause. Very few studies had been done regarding patients perception of risk factors, behaviour change and counselling. So this study is based on patient perspective and role of health education for patients. The objective of the study was to identify the risk factors of CHD, to assess behaviour changes whether lifestyle and habits modified by patients of CHD, to assess perception, to assess effectiveness of counselling.Methods: A cross-sectional study was conducted in 174 patients attending follow up Out Patient Department in Tertiary Care Hospital, Bhavnagar using questionnaire which includes personal data, BMI, history of risk factors, behaviour change and medical counselling. Data was analyzed by epi info and appropriate statistical tests were applied.Results: Total 73 patients were addicted to tobacco; smoking or alcohol. Mean duration of addiction was 22.43 years. Counselling was given by doctors at the time of illness to 94% patients. Counselling regarding disease, risk factors, lifestyle modification has got positive effect in 96% patients and only 4% patients were in need of further future counselling.Conclusions: More and more emphasis should be given to preventive aspect and population should be given counselling before actual illness.

scholarly journals Incidence and Risk Factors for Severe Dehydration in Hospitalized Children in Ujjain, India

2020 ◽  
Author(s):  
Abhishek Sharma ◽  
Aditya Mathur ◽  
Cecilia Stålsby Lundborg ◽  
Ashish Pathak
Keyword(s):  
Risk Factors ◽  
Tertiary Care ◽  
World Health ◽  
Respiratory Pattern ◽  
Care Hospital ◽  
Severe Dehydration ◽  
Cross Sectional ◽  
Oral Rehydration ◽  
History Of ◽  
Independent Risk Factors

Diarrhoea contributes significantly in the under-five childhood morality and mortality worldwide. This cross-sectional study was carried out in a tertiary care hospital in Ujjain, India from July 2015 to June 2016. Consecutive children aged 1 month to 12 years having &ldquo;some dehydration&rdquo; and &ldquo;dehydration&rdquo; according to World Health Organization classification were eligible to be included in the study. Other signs and symptoms used to assess severe dehydration were capillary refill time, urine output, and abnormal respiratory pattern. A questionnaire was administered to identify risk factors for severe dehydration, which was the primary outcome. Multivariate logistic regression modeling was used to detect independent risk factors for severe dehydration. The study included 332 children, with mean &plusmn; standard deviation age of 25.62 &plusmn; 31.85 months; out of which, 70%(95% confidence interval [CI] 65 to 75) were diagnosed to have severe dehydration. The independent risk factors for severe dehydration were: child not exclusive breast fed in the first six months of life (AOR 5.67, 95%CI 2.51 to 12.78; p&lt;0.001), history of not receiving oral rehydration solution before hospitalization (AOR 1.34, 95%CI 1.01 to 1.78; p=0.038), history of not receiving oral zinc before hospitalization (AOR 2.66, 95%CI 1.68 to 4.21; p&lt;0.001) and living in overcrowded conditions (AOR 5.52, 95%CI 2.19 to 13.93; p&lt;0.001). The study identified many risk factors associated with severe childhood dehydration; many of them are modifiable though known and effective public health interventions.

scholarly journals Cross-sectional Study on MyocardialInfarction in Young Adults in an EmergencyDepartment of a Rural Tertiary Care Hospital, Davanagere,Karnataka, India

2021 ◽  
Author(s):  
CH Karthik Reddy ◽  
Mahesh Krishnamurthy ◽  
Ashray Vasanthapuram ◽  
Girish Narayan ◽  
SS Narendra
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Young Adults ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
Vessel Disease

Introduction: The incidence of Acute Coronary Syndrome (ACS) in the young has been increasing globally. Research in this population has been limited in developed countries or urban areas in developing countries. Identifying the various epidemiologic features in this age group is crucial to understand the disease. Aim: To describe the clinical characteristics of young adults presenting with ACS in a rural tertiary care hospital. Materials and Methods: This cross-sectional study included 50 patients diagnosed with ACS. Data were collected from consecutive patients between the ages of 18 to 45 years diagnosed with ACS between January 2014 to January 2015 in the Emergency Medicine Department of a tertiary care hospital in Davanagere, India. Data were collected on demographic characteristics, risk factors, laboratory tests, and angiographic findings. Range, mean and percentages were calculated for continuous and categorical variables, respectively. A 95% confidence intervals were calculated for all variables. Results: The mean age was 38.1±5.8 years with male preponderance 46 (92%). Risk factors were smoking 36 (72%), diabetes 17 (34%), hypertension 6 (12%) and Body Mass Index (BMI) >23 kg/m2, 36 (72%). Anterior Wall Myocardial Infarction (AWMI) was observed in 35 (70%) of subjects with angiography revealing Single Vessel Disease (SVD) 28 (56%), Double Vessel Disease (DVD) 5 (10%), Triple Vessel Disease (TVD) 3 (6%) and Myocardial Infarction with Non-Obstructive Coronary Artery Disease (MINOCA) 11 (22%). Three patients died during their course of treatment before initiating an interventional procedure. Conclusion: Smoking, diabetes mellitus and elevated BMI are associated with ACS among young patients. Interventions targeting these risk factors among younger individuals should be developed.

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 A Clinical Study of Secondary Glaucoma with Special Reference to Its Proportion, Causes and Its Risk Factors in a Tertiary Care Hospital - A Cross Sectional Study

2021 ◽  
Vol 8 (01) ◽  
pp. 23-27
Author(s):  
Partha Chakma ◽  
Debal Kisor Pal ◽  
Amar Kanti Chakma
Keyword(s):  
Risk Factors ◽  
Special Reference ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Secondary Glaucoma ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
Common Cause

BACKGROUND Secondary glaucoma is an anatomically identifiable abnormality which in turn is an underlying cause of the events that lead to aqueous outflow obstruction and rise in the intraocular pressure. This prospective study mainly highlights the secondary glaucoma with special reference to its proportion, causes and its risk factors in a tertiary care hospital. METHODS This study was a cross sectional study. Patients, who attended the Department of Ophthalmology after fulfilling the inclusion and exclusion criteria diagnosed with secondary glaucoma, were included in the study. The study period was from February 2018 to June 2020. A standard form was filled up for each patient documenting parameters and findings of various examinations and was evaluated as per protocol. RESULTS Secondary glaucoma was seen in 0.2 % patients who visited during the study period. Out of 106 patients, males were 50, females were 56, with a male: female ratio of 1:1.1. The most common cause of secondary glaucoma was lens induced glaucoma seen in 44.34 % followed by uveitic glaucoma in 20.8 % cases, traumatic 17.9 %, neovascular 10.4 %, pseudoexfoliation glaucoma 2.8 %, pigmentary glaucoma 1.9 %, silicon oil induced 0.9 %, and uveitis-glaucomahyphema syndrome in 0.9 % cases. Around thirty five percent (34.9 %) cases presented with sudden onset of painful diminution of vision with nausea and vomiting. CONCLUSIONS Secondary glaucoma is still one of the prevalent diseases in this part of country. Lens induced glaucoma is still the most common cause of secondary glaucoma. Hypermature cataract, uveitis, trauma and neovascularisation are the different risk factors. KEYWORDS Secondary Glaucoma, Lens Induced Glaucoma, Phacomorphic Glaucoma, Uveitic Glaucoma

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