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

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.

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

Journal of Medicine ◽

10.3329/jom.v10i3.2011 ◽

1970 ◽

pp. 18-21 ◽

Cited By ~ 2

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. Â doi:10.3329/jom.v10i3.2011 Â J Medicine 2009; 10 (Supplement 1): 18-21

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Abstract #803815: Prevalence of Gestational Diabetes Mellitus in Women with High Risk Factors at a Tertiary Care Hospital in North India

Endocrine Practice ◽

10.1016/s1530-891x(20)39556-2 ◽

2020 ◽

Vol 26 ◽

pp. 109-110

Author(s):

Smiti Nanda

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

High Risk ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

North India ◽

Care Hospital ◽

High Risk Factors

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Pattern of Congenital Heart Diseases and Associated Risk Factors among Children at a Tertiary Care Hospital

10.53350/pjmhs211592451 ◽

2021 ◽

Vol 15 (9) ◽

pp. 2451-2453

Author(s):

Shahid Iqbal ◽

Muhammad Fareed Khan ◽

Raja Imtiaz Ahmed ◽

Shahab Saidullah ◽

Nisar Ahmed ◽

...

Keyword(s):

Risk Factors ◽

Folic Acid ◽

Congenital Heart ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Febrile Illness ◽

Care Hospital ◽

Younger Age ◽

History Of ◽

Associated Risk Factors

Objective: To find out the pattern of CHD and associated risk factors among children presenting at a tertiary care hospital. Study Design: A case-control study. Place and Duration of the Study: The Department of Pediatrics and Department of Cardiology, Sheikh Khalifa Bin Zayed Al Nahyan Hospital, Rawlakot from July 2020 to June 2021. Material and Methods: A total of 207 children of both genders, screened by ECG along with chest x-ray and further confirmed with the diagnosis of CHD through echocardiography were enrolled as cases. Same number of healthy controls (n=207) were recruited from immunization center of the study institution. Among cases, types of CHD were noted. For cases and controls, demographic, antenatal and maternal risk factors including maternal age, gender of the child, history of consanguinity, history of febrile illness in pregnancy, use or multi-vitamin or folic acid in pregnancy, bad obstetrical history and maternal diabetes mellitus were noted. Results: In a total of 414 children (207 cases and 207 controls), there were 219 (53.8%) male. In terms of CHD types among cases, VSD was the most noted in 62 (30.0%), ASD 35 (16.9%), TOF 33 (15.9%) and PDA in 30 (14.5%). Cases were found to have significant association with younger age (78.3% cases below 1 year of age vs. 64.7% in controls, p=0.0085), bad obstetrical history (p=0.0002), history of febrile illness in 1st trimester of pregnancy (p=0.0229) and lack of multivitamins and folic acid in the 1st trimester of pregnancy (p=0.0147). Conclusion: Majority of the children with CHDs were male and aged below 1 year. VSD, ASD, TOF and PDA were the most frequent types of CHD. Younger age, bad obstetrical history, history of febrile illness in 1st trimester of pregnancy and lack of multivitamins and folic acid in the 1st trimester of pregnancy were found to have significant association with CHDs among children. Keywords: Congenital heart disease, echocardiography, ventricular septal defect.

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Prevalence and the risk factors for the carriage of beta-haemolytic streptococci among women visiting a tertiary care hospital in South India

Indian Journal of Microbiology Research ◽

10.18231/j.ijmr.2021.062 ◽

2021 ◽

Vol 8 (4) ◽

pp. 308-312

Author(s):

Pendru Raghunath ◽

LN Rao Sadanand

Keyword(s):

Risk Factors ◽

Teaching Hospital ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Latex Agglutination ◽

Research Centre ◽

Care Hospital ◽

Microbiological Techniques ◽

History Of ◽

Group B

Streptococci are gram positive cocci arranged in chains and are part of normal flora of humans and animals. The present study is carried out to determine the prevalence and risk factors for the carriage of beta-haemolytic streptococci (BHS) among women visiting Dr. VRK Women’s Teaching Hospital & Research Centre, Hyderabad. Vaginal swabs were collected from 250 patients attending outpatient department (OPD) of Dr. VRK Women’s Teaching hospital. Swabs were inoculated onto 5% sheep blood agar plates and incubated for 24 h at 37°C in a candle jar. BHS isolates were phenotypically identified by standard microbiological techniques, all the isolates presumptively identified as BHS were tested for Bacitracin susceptibility. Sensitive isolates were presumptively identified as GAS and resistant isolates were identified as non-group A BHS (NGABHS). Presumptively identified GAS & NGABHS isolates were serogrouped by Lancefield grouping using a commercially available latex agglutination test. BHS were isolated from 12.4% of samples. As many as 12 BHS isolates were identified as GAS and 19 were identified as NGABHS. Ten of nineteen were identified as group B (GBS), 4 (12.9%) were identified as group C (GCS) and 5 (16.12%) were identified as group G (GGS). Among six clinical groups, the prevalence of GAS is highest i.e. 7.5% in female patients visiting Gynaecology OPD with history of white discharge. Prevalence of NGABHS was more among post insertion (18%) IUCD group compared to pre insertion (8%) IUCD group. GBS were isolated from 7% of samples from IUCD group and 4% of samples from prostitutes.This study reports the prevalence of BHS among women visiting a tertiary care hospital in Hyderabad. This study also identified certain risk factors such as IUCD usage and working as a FSW are associated with the increased prevalence of NGABHS especially GBS.

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The Evolving Pattern and Outcome of Stroke at Moderate Altitude

Journal of Neurosciences in Rural Practice ◽

10.4103/jnrp.jnrp_207_17 ◽

2018 ◽

Vol 09 (01) ◽

pp. 068-072

Author(s):

Deepika Dhiman ◽

Sanjay K. Mahajan ◽

Sudhir Sharma ◽

Rajiv Raina

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Coronary Artery Disease ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Moderate Altitude ◽

Care Hospital ◽

Altered Sensorium ◽

Poor Outcome ◽

Artery Disease

ABSTRACT Background: The people residing in hills of this Sub-Himalayan region traditionally have a distinct lifestyle involving high level of physical activity. However, increased urbanization in the last two decades has led to changes in lifestyle of people. The present study was an endeavor to document changes in the pattern of stroke in people residing at moderate altitude. Aim: This study was aimed to study the evolving trends in clinical profile, risk factors, and outcome at 3 months in hospitalized patients of stroke in a Tertiary Care Hospital situated at moderate altitude. Setting and Design: This prospective, observational study was carried out in a Tertiary Care Hospital, situated at 2000 m mean sea level, from July 2014 to June 2015 in Sub-Himalayan region of India. Methods: The clinical features and risk factors profile of 235 patients of stroke consecutively admitted in hospital were analyzed, and findings were expressed in percentage. The profile was compared with a study conducted at this institute 15 years back. The outcome of patients at 3 months in terms of modified Rankin Scale >3 (mRS) and Barthel Index <60 (BI) was also studied. Results: The occurrence of stroke as a cause of hospitalization was decreasing. Ischemic stroke was noted in 74%, and 26% had hemorrhagic stroke (HS). There was male predominance (58%), but affliction of females with stroke increased from 34% to 42%. The altered sensorium (P = 0.00) and neurological weakness (P = 0.024) were significantly associated with poor outcome in stroke. The occurrence of hypertension, diabetes mellitus, and coronary artery disease increased but smoking decreased among indoor patients of stroke in the last 15 years. Poor outcome of 203 patients at 3 months follow-up in terms of mRS >3 was 79 (IS-47, HS-32) but in term of BI, 63 (IS-32, HS-31) had poor outcome. Overall HS had poorer outcome. Age >70 years, female sex, altered sensorium, hypertension, and diabetes mellitus, were observed as poor prognostic factors, but the association was significant with advanced age, headache, and altered sensorium. Conclusion: The occurrence of stroke decreased among hospitalized patients. Hypertension, diabetes mellitus, and coronary artery disease increased but smoking decreased among patients of stroke.

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

Journal of Kathmandu Medical College ◽

10.3126/jkmc.v8i2.28166 ◽

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.

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A study on risk factors, maternal and foetal outcome in cases of preeclampsia and eclampsia at a tertiary care hospital of South India

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20175859 ◽

2017 ◽

Vol 7 (1) ◽

pp. 266

Author(s):

Bandaru Sailaja ◽

Vijayalakshmi Cooly ◽

Bhuvaneswari Sailcheemala ◽

Surayapalem Sailaja

Keyword(s):

Risk Factors ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Previous History ◽

Developed Countries ◽

Reproductive Technologies ◽

Care Hospital ◽

History Of ◽

Foetal Outcome ◽

In Pregnancy

Background: Hypertension in pregnancy remains still a major health issue for women and their descendants throughout the world but remains a major issue in developing countries rather than developed countries. Eclampsia accounts for 24% of maternal deaths during pregnancy in India according to FOGSI study in India. Changing trends in pregnancy globally with increased maternal age of conception, assisted reproductive technologies has contributed a significant impact in the risk factors for PE and eclampsia. The present study was aimed to investigate and determine the related risk factors in cases of PE and eclampsia. The maternal and foetal outcomes with major complications of the women with PE and eclampsia were also studied.Methods: A prospective cross sectional study for a period of two years was conducted at a tertiary care hospital among antenatal cases and all cases of PIH were recorded and studied. Cases were managed as per the existing obstetric protocol after clinical examination and investigations. Detailed socio demographic data and history of risk factors were collected and entered into Microsoft excel sheet and analyzed. Maternal and foetal outcome were noted in the cases of the study.Results: The incidence of PE and eclampsia in the study was 43.3% and 10.8%, 25-35 years age group being the most common. PE and eclampsia was associated with BMI>30, parous women with previous history of PE, diabetes mellitus and more in unregistered cases. PE and eclampsia were more in Illiterates and socio economic class 2 &3. The incidence of maternal complications was 32.99% with premature labour being the common and in case of foetal complications prematurity was the commonest with 16 cases. The maternal mortality was very less with only 4.64% in the study.Conclusions: Pregnancy induced hypertension with PE and eclampsia still remains a major problem in developed countries. Good antenatal care with increased awareness and increased antenatal visits may help in reducing the incidence and maternal and foetal complications. Increased incidence among illiterates and low socio economic status group provides the target group to be directed against any medical measures and national health programmes.

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