scholarly journals ELECTROLYTE DISTURBANCE IN HEMORRHAGIC AND NON-HEMORRHAGIC STROKE PATIENTS IN AL-DIWANIYAH TEACHING HOSPITAL

Author(s):  
Aqeel Raheem Hassan ◽  
Zahraa Adel Aryan

Objectives: Although there are many studies on stroke, few studies on electrolyte disturbance have been done in our country, even on the outside. Our aim in this study is to estimate the level of serum potassium and sodium in acute stroke patients with comparison to patients of the control group.Methods: Our study is a comparative cross-sectional study conducted on patients in the neurological center who suffer from stroke and others in medicine department admitted for any disease other than cerebrovascular accidents (CVA) they consider the control group. All were in AL-Diwaniyah Teaching Hospital from April to July 2018. The level of potassium and sodium from all patients is estimated. Patients with ischemic stroke, hemorrhagic stroke, and transient ischemic attack (TIA) were classified into having Glasgow coma scores (GCS) of 3–8, 9–12, and 13–15, respectively.Result: Significant difference was seen in the distribution of patients according to GCS levels (p=0.014). Mean serum sodium was significantly lowest in hemorrhagic stroke, then ischemic stroke, followed by TIA, and the highest sodium level was seen in the control group (p<0.001). Mean serum potassium was significantly lowest in hemorrhagic stroke, then ischemic stroke, followed by TIA, and the highest sodium level was seen in the control group (p<0.001). Mean serum-to-potassium ratio was significantly highest in hemorrhagic stroke, then TIA, followed by ischemic stroke, and finally, by control group (p<0.001).Conclusion: This study reveals that, in hemorrhagic stroke, the incidence of electrolytes imbalance was more than ischemic and which was mostly hyponatremia and hypokalemia.

2020 ◽  
pp. 49-51
Author(s):  
Megha Jha ◽  
Hari Shankar Mishra ◽  
Ajit Kumar Chaudhary ◽  
Debarshi Jana

Background: Hematological parameters are major indicator of ischemic stroke. Hematological parameters and stroke incidence have not been investigated in local population. Objective: The present study was designed to assess whether hematological parameters play an important role in ischemic stroke patients. Methodology: For this purpose a cross-sectional study was done at Department of Pathology,Darbhanga Medical College andHospital, Laheriasarai, Bihar from January 2020 to August 2020. A total of 150subjects were enrolled in Medicine Department and referred to Pathology Department for various hematological test.Patients divided into two groups, control (n=50) and ischemic stroke subjects (n=100). Data regarding risk factors was collected through questionnaire. Their hematological parameters such as WBCs count, RBCs count, haemoglobin concentration, HCT, MCV, MCH and PLT count were assessed by hematology analyzer. Statistical analysis was done by using SPSS (version 13). Result: Mean age of control and ischemic stroke group was 61.40y±1.33 and 63.8y±1.36 respectively with non-significant difference between the groups. Among the ischemic stroke subjects, 73% of the subjects were suffering from hypertension, 53% reported diabetes, 41% had heart disease, 39% had family history of stroke, 32% were smokers and 46% use high cholesterol food. The WBCs count, MCV, MCH and HCT were found significantly higher in ischemic stroke subjects when compared with control group while the significant decrease was observed in RBCs count and hemoglobin concentration. PLT count increased in ischemic stroke subjects as compared to control group. Conclusion: It was concluded that in ischemic stroke patients hematological parameters were greatly altered.


2018 ◽  
Vol 1 (3) ◽  
pp. 163-175
Author(s):  
Panji Harry Priya Nugraha ◽  
Suryo Bantolo ◽  
Annelin Kurniati ◽  
Noor Diah Erlinawati ◽  
Ahmad Azmi Nasution

Stroke is one of the most common causes of disability in the world. Patients with ischemic stroke have different functional improvements from patients with hemorrhagic stroke. The tool is the Functional Independence Measure (FIM) questionnaire. This study aims to determine the difference in FIM scores in hospitalized patients with ischemic stroke and hemorrhagic stroke at hospitals in Bengkulu City. This research is an observational analytic research with cross-sectional design. The study involved stroke patients who hospitalized at RS Bhayangkara Bengkulu City, RSUD Bengkulu City, and RSUD dr. M. Yunus Bengkulu City from January-April 2018 with total sample 22 ischemic stroke patients and 22 hemorrhagic stroke patients who met the inclusion criteria. FIM scores as independent variables, while the type of stroke as dependent variables. The difference between the two variables was analyzed by unpaired t test and Mann-Whitney test. Patients with ischemic stroke had admission FIM score higher than patients with hemorrhagic stroke (26 vs 13,5; p=0.006). There were no differences in discharge FIM score in patients in both types of stroke (1,67 vs 1,58; p=0,081). There was no difference in FIM score gain between patients with ischemic stroke and patients with hemorrhagic stroke (4,12 vs 4,36; p=0,444). Patients with ischemic stroke had higher admission FIM score compared to patients with hemorrhagic stroke, but there was no significant difference in FIM score gain during hospitalization between ischemic stroke and hemorrhagic stroke patients at hospitals in Bengkulu City.


Author(s):  
Saima Sharif

Background: Hematological parameters are major indicator of ischemic stroke. Hematological parameters and stroke incidence have not been investigated in local population. Objective: The present study was designed to assess whether hematological parameters play an important role in ischemic stroke patients. Methodology: For this purpose a cross-sectional study was done at Services hospital, Lahore from January 2013 to August 2013. A total of 150subjects were enrolled and divided into two groups, control (n=50) and ischemic stroke subjects (n=100). Data regarding risk factors was collected through questionnaire. Their hematological parameters such as WBCs count, RBCs count, haemoglobin concentration, HCT, MCV, MCH and PLT count were assessed by hematology analyzer. Statstical analysis was done by using SPSS (version 13). Result: Mean age of control and ischemic stroke group was 61.40y±1.33 and 63.8y±1.36 respectively with non-significant difference between the groups. Among the ischemic stroke subjects, 73% of the subjects were suffering from hypertension, 53% reported diabetes, 41% had heart disease, 39% had family history of stroke, 32% were smokers and 46% use high cholesterol food. The WBCs count, MCV, MCH and HCT were found significantly higher in ischemic stroke subjects when compared with control group while the significant decrease was observed in RBCs count and hemoglobin concentration. PLT count increased in ischemic stroke subjects as compared to control group. Conclusion: It was concluded that in ischemic stroke patients hematological parmeters were greately altered.


2020 ◽  
Vol 1 (2) ◽  
pp. 49
Author(s):  
Hijriyah Putri Tarmizi Hasibuan ◽  
Isra Thristy

Background: Stroke is the second largest cause of death in the world. Stroke is classified based on its etiology as ischemic stroke and hemorrhagic stroke. Most large-scale studies on the risk of total cholesterol and triglyceride levels in stroke are not distinguished between ischemic and hemorrhagic strokes. Purposes: The purpose of this study was to determine the comparison of triglyceride and total cholesterol levels in ischemic stroke patients with hemorrhagic stroke. Method: Descriptive analytic study using medical records of patients at Medan Haji General Hospital in 2018-2019. The number of ischemic stroke patients is 28 patients and hemorrhagic stroke 28 patients with a total sample of 56 patients. Results: In ischemic stroke patients, the average value of triglyceride levels was 144.75 mg/dL and the average value of total cholesterol was 250.93 mg/dL. In hemorrhagic stroke patients, the average value of triglyceride levels is 126.93 mg/dL and the average total cholesterol level is 174.25 mg/dL. Conclusion: From this study we found a significant difference in total cholesterol between ischemic and hemorrhagic strokes. No significant difference was found in triglycerides between ischemic and hemorrhagic strokes.


Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Yoshiaki Shimada

Background: The antiphospholipid syndrome (APS) is a systemic autoimmune disorder characterized by a combination of arterial and/or venous thrombosis and recurrent fetal loss, and can be an independent risk factor for a first-ever ischemic stroke especially in young female patients. Patent foramen ovale (PFO) has been established as a cause of cryptogenic stroke. Atrial septal aneurysm (ASA) is associated with PFO. Until recently, the precise pathophysiology of APS as causing ischemic stroke has been essentially unknown. In the present study, we investigated the relationship between APS and potential embolic sources including PFO and ASA using transesophageal echocardiography (TEE). Methods: This study was a retrospective case series design. From July 2006 to June 2008, 120 patients with ischemic stroke who admitted to Juntendo University Hospital underwent TEE. In this study period, consecutive ischemic stoke patients diagnosed as APS based on the modified Sapporo criteria were enrolled and classified into APS group. Controls were selected among age- and gender-matched stroke patients without APS who also underwent TEE. We assessed clinical characteristics and presence of embolic sources including PFO and atrial septal aneurysm (ASA) between APS and Control groups. Results: Nine of ischemic stroke patients with APS and 41 controls were included. Primary APS was present in one patient (11.1%) of the APS group, and APS with SLE were found in eight patients (88.9%). There is no significant difference in age, risk factors for ischemic stroke, and MRI findings between two groups. The prevalence of PFO and ASA were significantly higher in APS group compared to Control group (89% vs 41%, P=0.027; 67% vs 20%, P=0.015, respectively). C reactive protein was relatively higher in APS group. Multiple logistic regression analysis showed that PFO (OR: 13.71; 95% CI: 1.01 to 185.62; P=0.049) and ASA (OR: 8.06; 95% CI: 1.17 to 55.59; P=0.034) were independently associated with the APS group. Conclusion: Atrial septal abnormalities including PFO and ASA are strongly associated with APS group, and could be potential embolic sources in ischemic stroke patients with APS.


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.


2017 ◽  
Vol 55 (1) ◽  
pp. 19-22
Author(s):  
Hrvoje Budincevic ◽  
Josip Sremec ◽  
Petra Crnac ◽  
Vedran Ostojic ◽  
Edvard Galic ◽  
...  

Abstract Introduction. Stroke is one of the leading causes of morbidity and mortality. Cardiac troponins have been found to be increased in other conditions apart from the cardiac diseases, such as stroke. The aim of the study was to assess the correlation between elevated troponin I levels and stroke outcome. Methods. This retrospective study included 198 acute ischemic stroke patients in whom troponin I levels have been obtained at admission. Exclusion criteria were concomitant acute coronary syndrome, congestive heart failure, pulmonary embolism, renal failure, rhabdomyolysis and septic conditions. Results. There was a statistically significant difference in the proportion of deaths during hospitalization (p = 0.041) and modified Rankin Scale scores (p = 0.016) between the group of patients with elevated troponin I levels and the control group. Prior ischemic strokes were more common in the group with elevated troponin I levels (p = 0.032). No other differences were observed. Conclusions. Our study showed that patients with elevated initial troponin I levels are associated with unfavorable outcome or death. Stroke may be associated with mild elevation of troponin levels, contrary to higher levels which are usually related to other conditions.


2020 ◽  
Vol 3 (1) ◽  
pp. 09-13
Author(s):  
Syarif Indra

Introduction: Stroke is a major health problem in the world, and associated with mortality, disability, and economic burden. Stroke is the second leading cause of death in the world after heart disease and cause of disability in adults. Several recent studies show that levels of Lp-PLA2 contribute to high serum lead to ischemic stroke, whereas some others do not get the association. Aims: studies an association between serum Lp-PLA2 with incident ischemic stroke. Method: This study is a descriptive analytic comparative with cross sectional design in the Neurology ward RS. DR. M. Djamil Padang between October 2013 to April 2014 with total of 88 subjects consisting of 44 subjects ischemic stroke patients and 44 healthy control group who participated in the study. Statistical analysis is used parametric test with unpaired t test, test for normality with the Kolmogorov-Smirnov test, and logistic regression analysis. Result: P value 0.05 was considered statistically significant. The mean age of subjects in the group of ischemic stroke patients was 57.30 ±8.86 years old. Female in patients with ischemic stroke group was 23 people (52,3%). Mean levels of Lp-PLA2 serum in patiens with ischemic stroke group was 103.49±48.00 ng/mL. A significan association between serum levels of Lp-PLA2 with incident ischemic stroke with p<0.05. Conclusion: There was a significant relation in elevation of serum Lp-PLA2 levels with incident of ischemic stroke.


2022 ◽  
Vol 8 (1) ◽  
pp. 30-34
Author(s):  
Fildza Intan Rizkia ◽  
Chandra Calista ◽  
Suryani Gunadharma ◽  
Asep Nugraha Hermawan ◽  
Lisda Amalia ◽  
...  

Background: Cognitive impairment is a common condition that may affect up to 50% of stroke patients. Post stroke cognitive impairment is associated with reduced quality of life, which may increase the number of dependency. Recurrent stroke may happen in approximately 25% patients and they have higher rates of cognitive impairment. Objective: The aim of this study is to examine the comparison of cognitive function between first ischemic stroke and recurrent ischemic stroke patients in Hasan Sadikin Hospital, Bandung. Methods: This study is a retrospective, cross-sectional study using the data recruited between the year 2012 - 2016 at the Department of Neurology at the Hasan Sadikin Hospital Bandung. The data collected in this study were demographic data, including age, level of education, and residence, and the clinical data as well. Cognitive function was assessed using Mini-Mental State Examination (MMSE). The comparison between the cognitive function between both groups were analyzed using the Mann-Whitney U test. Results: There were 428 subjects eligible for this study, with 207 subjects categorized as first ischemic stroke group and 221 subjects categorized as recurrent ischemic stroke group. There was a statistically significant difference in MMSE scores between the first ischemic stroke patients (24.90 ± 4.64) and recurrent ischemic stroke patients (22.85 ± 4.64 ) with a p value of 0.002. Conclusion: Recurrent ischemic stroke patients had lower MMSE scores than the first ischemic stroke patients. Clinicians should be more aware in detecting early cognitive impairment in stroke patients and in preventing the incidence of recurrent stroke.


2021 ◽  
Vol 9 (2) ◽  
pp. 184-197
Author(s):  
Diah Retno Wahyuningrum ◽  
Retnaningsih Retnaningsih ◽  
Martha Irene Kartasurya

Background: The occurrence of ischemia causes a loss of energy to switch to anaerobic processes resulting in acidosis due to reduced Adenosina Triphosphate (ATP). This condition makes neuron cells apoptotic. Apoptotic of several biochemical substrates in the brain, such as Glial Fibrillary Acidic Protein (GFAP) exit into the circulatory system which is associated with dysbiosis through immunological pathways.Objectives: To determine the effect of giving enteral formula containing protein, phosphatidylcholine, phosphatidylserine, and inulin on GFAP levels in patients with acute ischemic stroke Dr. Kariadi Hospital.Materials and Methods: This study was done in a single-blind RCT. Eighteen ischemic stroke patients were randomly divided into intervention (9 subjects) and control groups (9 subjects). The intervention group received 69 g of the powdered enteral formula three times a day for seven days. The formula contained protein (15 g), phosphatidylcholine (128 mg),  phosphatidylserine (32 mg), and inulin (3 g). The subject who had diabetes mellitus received for 14 days at a dose of 34.5 g per day (7.5 g protein with additions 64mg phosphatidylcholine, 16mg phosphatidylserine, 1.5 g inulin). The control group received the standard enteral formula from the hospital, which contains (11.8 g protein without additions protein, phosphatidylcholine, phosphatidylserine, and inulin). GFAP levels by ELISA method (Enzyme-linked immunosorbent Assay) at pre and post-intervention.Results: There was a trend of decreasing GFAP levels before and after in the intervention group towards a better direction from 8.37±4.25 to 8.30±4.9 compared with the control group which experienced an increasing trend from 5.4±1.8 to 7.5±4. There was no significant difference in GFAP levels after intervention between groups (p = 0.7).Conclusions: The addition of protein, phosphatidylcholine, phosphatidylserine, and inulin had no significant effect on GFAP levels.


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