scholarly journals A Prospective Observational Study on Risk Factors and Prescribing Patterns of Drugs used in Stroke Patients at a Tertiary Care Teaching Hospital.

2020 ◽  
Vol 10 (5-s) ◽  
pp. 71-75
Author(s):  
Syed Areefulla Hussainy ◽  
Madiha Habeeb ◽  
Ayesha Jeelani ◽  
Sumaiya Sultana ◽  
Mohammed Mohiuddin Meeran
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Observational Study ◽  
Hemorrhagic Stroke ◽  
Tertiary Care ◽  
Prescribing Patterns ◽  
Care Hospital ◽  
Stroke Patients ◽  
Optimal Care ◽  
Early Management

Objectives: The main aim of the study is to identify the different risk factors, prescribing patterns of medication and rationality of the prescription by observing the management of stroke patients carefully. Methodology: A prospective and observational study was carried out for a period of 6 months in an in-patient department of a tertiary care hospital. Patients above 18 years of age, patients of either sex and patients who previously had stroke were included. Children below 18 years, pregnant women, AIDS patients, patients unable to respond to verbal questions with no caretakers and patients with head injury were excluded. Results: A total of 100 prescriptions were analyzed during the 6 months study period. This was found to be higher in males (79) and females (21). The higher risk with notable occurrence in the age group of 60-79 years (43%). Out of these study populations, (68%) experienced Ischemic stroke and (32%) experienced Hemorrhagic stroke. The major risk factors were Hypertension (62%), alcoholics (41%). Smoking (33%) and Diabetes (24%). Among the 100 prescriptions, Atorvastatin was highly prescribed (96) followed by Pantoprazole (92), Mannitol (64). Out of 100 prescriptions, (67) were rational and (33%) were irrational. Conclusion: The prescribing patterns of drug should be based on specificity and severity of stroke in order to facilitate rational use of drugs providing optimal care. Early management of hypertension and diabetes may reduce risk of stroke. Cessation of smoking and alcohol place a key role in prevention of stroke. Keywords: Ischemic stroke, hemorrhagic stroke, hypertension, diabetes.

scholarly journals An observational study from a new tertiary care hospital in North Odisha: clinical and etiological profile of acute ischemic stroke patients

2019 ◽  
Vol 6 (5) ◽  
pp. 1605
Author(s):  
Bibhu P. Behera ◽  
Partha S. Mohanty
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Observational Study ◽  
Acute Ischemic Stroke ◽  
Hemorrhagic Stroke ◽  
Tertiary Care ◽  
Care Hospital ◽  
Stroke Patients ◽  
Middle Income ◽  
Stroke Subtypes

Background: Worldwide, cerebrovascular accidents (stroke) are the second leading cause of death and the third leading cause of disability. According to WHO estimation, by 2050 nearly 80% of stroke cases may occur in low and middle-income countries like China and India. It is critical that we understand the etiology causing the stroke so that appropriate treatment can be initiated in a timely fashion. Furthermore, understanding the risk factors associated with stroke is important before primary and secondary preventive measures can be prescribed to the patient.Methods: This observational study was carried out amongst 481 acute ischemic stroke patients that fulfils the inclusion and exclusion criteria and admitted in medicine ward of Pandit Raghunath Murmu Medical College and Hospital, Baripada, Dist. Mayurbhanj, Odisha, India from June 2018 to January 2019. Results: In our study, 481(60.43%) patients had ischemic stroke and 315 (39.57%) patients had hemorrhagic stroke. The incidence of stroke is maximum in 51-70 years of age group which comprises of 59.46% of total patients. The average age + SD were 61.4±13.1 in our study. The most common risk factor was hypertension with 69.85% followed by dyslipidemia 51.77%. Most common clinical presentation was hemiplegia (72.35%) followed by speech involvement (59.46%). Most common site of infarct was parietal (22.25%), followed by periventricular (12.68%).Conclusions: Most of the patients had ischemic stroke as compared to hemorrhagic stroke. It was more common in males. The study contributes to understanding of demographic characteristics, risk factors, and stroke subtypes in acute ischemic stroke. The importance of various risk factors among ischemic stroke subtypes should be stressed for prompt preventive strategies and treatment.

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 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 Seroprevalence ofChlamydia PneumoniaeAntibodies in Stroke in Young

2009 ◽  
Vol 36 (6) ◽  
pp. 725-730 ◽  
Author(s):  
V. C. S. Srinivasarao Bandaru ◽  
D. Babu Boddu ◽  
V. Laxmi ◽  
M. Neeraja ◽  
S. Kaul
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Magnetic Resonance ◽  
Acute Ischemic Stroke ◽  
Tertiary Care ◽  
Control Group ◽  
Care Hospital ◽  
Igg Antibodies ◽  
Stroke Patients ◽  
Stroke In Young

Background:Younger patients, aged below 45 years, usually lack the conventional risk factors of stroke whereas infections, especially in developing countries, may play a role. There have been many reports in the last decade about the association ofChlamydia pneumoniae(C.pneumoniae) and atherosclerosis involving cerebral vessels.Objective:To investigate the seroprevalence ofC.pneumoniaeIgG and IgA antibodies in patients aged below 45 years with acute ischemic stroke.Methods:This study was done at a tertiary care hospital in South India between January 2004 and December 2006 where we recruited consecutive patients aged less than 45years with acute ischemic stroke. Age and sex matched controls were recruited from the outpatient department with non stroke diagnosis. All stroke patients underwent CT (Computerized Tomography), MRI (Magnetic Resonance Image), MRA (Magnetic Resonance Angiography), Transthoracic Echocardiography and Carotid Doppler for stroke sub group diagnosis. We measuredC.pneumoniaeantibodies IgG and IgA by microimmunofluorescence technique in all patients and controls.Results:A total of 120 patients and 120 controls were studied over a period of two years. We foundC.pneumoniaeantibodies in 29.1% (35/120) stroke patients and in 12.5% (15/120) control subjects (p=0.002).C.pneumoniaeIgG antibodies were found in 27.5 % (33/120) of stroke patients and 12.5% (15/120) of controls (p=0.006). IgAantibodies were observed in 5 % (6/120) of strokes and none in control group (p=0.03). After adjustment of all risk factorsC.pneumoniaeIgG seropositivity showed odds ratio of 2.6; 95% Confidence Interval 1.2-5.6.Conclusions:C.pneumoniaeIgG antibodies were found to be associated with ischemic stroke in young.

scholarly journals Socio-demographic characteristics of ischemic stroke patients in a tertiary care hospital of Nepal

2020 ◽  
Vol 1 (1) ◽  
pp. 16-19
Author(s):  
Ritesh Luitel ◽  
Sujan Dhital ◽  
Subodh Sharma Paudel ◽  
Suman Bhattarai
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Ischemic Stroke ◽  
Alcohol Consumption ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Demographic Characteristics ◽  
Care Hospital ◽  
Stroke Patients ◽  
History Of

Introduction: Incidence of stroke patients is increasing in low income countries like Nepal where management of these patients is challenging due to poor healthcare resources. Ischemic stroke is related to risk factors like age, male population, hypertension, diabetes mellitus, smoking and alcohol. Identification of these risk factors in the vulnerable population is important for prevention of ischemic stroke. The purpose of this study is to find out the social and demographic characteristics of patients with acute ischemic stroke treated at Upendra Devkota Memorial National Institute of Neurological and Allied Sciences, a tertiary care hospital of Nepal. Methods: Data was collected from all acute ischemic stroke patients presenting to the hospital over a period of one year. The age, sex, medical history of hypertension and diabetes and history of smoking and alcohol consumption were recorded. Statistical analysis of data was performed using Microsoft EXCEL 2019. Result: Total 310 patients were studied, out of which two-thirds were male. The highest number of patients were within the age group of 60-80 years with the mean age being 60 years. Hypertension and diabetes were present in 67.42% and 28.53% of patients respectively. 43.93% of the patients smoked while 33.87% of the patients consumed alcohol. Conclusion: Identification of association between risk factors like age, sex, hypertension, diabetes mellitus, smoking and alcohol consumption must be the emphasis for targeted preventive action to decrease the increasing burden of ischemic stroke among developing countries.

scholarly journals DRUG-RELATED PROBLEMS AND ITS PRESCRIBING INDICATORS IN STROKE PATIENTS: A PROSPECTIVE OBSERVATIONAL STUDY

2021 ◽  
pp. 141-144
Author(s):  
DURGA PRASAD THAMMISETTY ◽  
DIVITI RANGANAYAKULU ◽  
DEVANNA NAYAKANTI
Keyword(s):  
Observational Study ◽  
Drug Interactions ◽  
Hospital Stay ◽  
Prospective Observational Study ◽  
Tertiary Care ◽  
World Health ◽  
Care Hospital ◽  
Drug Related Problems ◽  
Stroke Patients ◽  
Prescribing Indicators

Objective: The objective of the study was to assess the drug-related problems (DRPs) and the World Health Organization (WHO) core prescribing indicators among stroke patients. Methods: A prospective observational study was conducted among stroke inpatients of Acute Medical Care and General Medicine Department of a tertiary care hospital located in Tirupati, Andhra Pradesh, India. A suitable data collection form was used to collect the data about demographics, clinical characteristics, WHO prescribing indicators, and DRPs. Descriptive statistics were used to represent the demographics, distribution of DRPs, and prescribing indicators in the study. Chi-square test was employed to test the significant association between the demographics and the occurrence of DRPs. Results: Among 174 patients included in the study, 89 had one or more DRPs. A total of 122 DRPs were identified in the study population. Drug interactions (48.4%) and adverse drug reactions (ADRs) (17.2%) were commonly observed DRPs. A significant direct association was observed between the occurrence of DRPs and number of comorbidities (p<0.001), polypharmacy (p<0.001), and hospital stay (p<0.05). The average number of drugs per prescription was 7.2. Of drugs prescribed, 67.6% were in their generic names. The percentage of encounters in which an antibiotic, injection was prescribed was 65.5% and 89.6% respectively. The percentage of drugs prescribed from an essential drug list was 91.2%. Conclusion: The rate of drug interactions and ADRs was high in treatment of stroke patients. Patients suffering from comorbidities, polypharmacy, and long hospital stay were positively associated with occurrence of DRPs in stroke. Regular monitoring and screening for drug interactions and ADRs were advised to reduce the burden DRPs in stroke patients admitted in a critical care unit.

Abstract W MP70: Characteristics of Patients With Microemboli Detected With Transcranial Doppler Monitoring

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Lauren Koffman ◽  
Zubair Ahmed ◽  
Rebecca Michael ◽  
Leasa Baus ◽  
Larry Raber ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Care Center ◽  
Cerebral Arteries ◽  
Tertiary Care ◽  
Cryptogenic Stroke ◽  
Final Analysis ◽  
Stroke Patients ◽  
Artery Disease ◽  
Wbc Count

Introduction: TCD emboli monitoring (TCDe) is a non-invasive tool used to detect the presence of ongoing microembolic signals (MES) in the intracranial arterial vessels. The clinical utility of this test in the evaluation of acute stroke patients has been debated. Our goal was to evaluate clinical factors associated with MES in ischemic stroke patients who underwent TCDe to determine which patient population may benefit from TCDe. Methods: Retrospective cohort study of adult patients admitted to our tertiary care center for TIA or ischemic stroke from 2011 to 2012 who underwent TCDe. Monitoring was performed for 20 minutes using a standardized protocol. Inclusion criteria included insonatation of both middle cerebral arteries and completion of TCD bubble study (TCB). Repeat TCDe performed on the same patient were excluded from the analysis. Demographic, clinical and objective data were collected using our EMR system. Results: Of the 113 patients included in the final analysis, mean age was 57.9 years and 46.9% were female. MES occurred in 33.6% patients. Mean # of MES was 9.3 (SD 60.6). Patients with MES were significantly younger (51.8 years vs 61.0, p.006) and had fewer vascular risk factors: diabetes (10.5% vs 33.3%, p 0.006), hyperlipidemia (23.7% vs 49.3%, p 0.007), hypertension (47.4% vs 17.33%, p 0.067), atrial fibrillation (7.9% vs 17.33 %, p 0.16), congestive heart failure (5.3% vs 10.7%, p 0.32) and coronary artery disease (18.4 % vs 29.3%, p 0.2). Cryptogenic stroke and the presence of right to left shunt (RLS) was more frequent in patients with MES than those without. Mean WBC count and usCRP were both nonsignificantly higher in patients with MES. Conclusions: Clinical characteristics of patients with MES on TCDe differed from those without MES, which may have diagnostic and clinical implications. Patients with MES were younger and had fewer stroke risk factors. MES were seen more often in patients with RLS and in those with cryptogenic stroke, which raises the possibility of an association between these two factors. Interestingly, patients with MES also had higher usCRP and WBC values, suggesting a possible inflammatory component to the occurrence of MES. More research is needed with a larger sample size to better define the significance of the above findings.

Characteristics of Pediatric Stroke and Association of Delayed Diagnosis with Mortality in a Mexican Tertiary Care Hospital

2021 ◽  
Author(s):  
Gerardo Garza-Alatorre ◽  
Ana Luisa Carrion-Garcia ◽  
Alfredo Falcon-Delgado ◽  
Elda Carolina Garza-Davila ◽  
Angel R Martinez-Ponce de Leon ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Hemorrhagic Stroke ◽  
Early Recognition ◽  
Tertiary Care ◽  
Delayed Diagnosis ◽  
University Hospital ◽  
Pediatric Stroke ◽  
Care Hospital ◽  
Continuous Increase ◽  
Common Risk Factors

Abstract Background and objectives Pediatric cerebrovascular disease carries significant morbidity and mortality. Early recognition of a pediatric stroke as well and its most common risk factors are important, but that diagnosis is often delayed. It is believed that the incidence in our center is higher than it appears. This study aims to assess the incidence and characteristics of the pediatric stroke in our university hospital. Likewise, this study seeks to evaluate if a longer symptoms-to-diagnosis time is associated with mortality in patients with ischemic stroke. Methods A retrospective study including children with stroke admitted to the UANL University Hospital from January 2013 to December 2016. Results A total of 41 patients and 46 stroke episodes were admitted. About 45.7% had an ischemic stroke and 54.3% had a hemorrhagic stroke. A mortality of 24.4% and a morbidity of 60.9% were recorded. Regarding ischemic and hemorrhagic stroke, an increased symptoms-to-diagnosis time and a higher mortality were obtained with a relative risk of 2.667 (95% confidence interval [CI]: 1.09–6.524, p = 0.013) and 8.0 (95% CI: 2.18–29.24, p = < 0.0001), respectively. A continuous increase in the incidence rate, ranging from 4.57 to 13.21 per 1,000 admissions comparing the first period (2013) versus the last period (2016), p = 0.02, was found in our center. Conclusions Pediatric stroke is a rare disease; however, its incidence shows a continuous increase. More awareness toward pediatric stroke is needed.

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

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