Electrocardiographic Abnormalities in Hospitalized acute Cerebrovascular Events

Background: - Physicians are confronted on having ECG in patients with acute stroke as it can mimic that of myocardial infarction or ischaemia. Repolarization and ischemic-like electrocardiographic (ECG) changes observed during acute phase of stroke may cause diagnostic and management dilemmas for the physicians. Aim:- The aim and objective of this study to identify the prevalence of ECG changes in acute stroke patients admitted to medicine units of Dhaka Medical College Hospital. Materials and Method: - This 6-month period observational study was carried out among 100 of acute stroke patients admitted in different medicine wards of Dhaka Medical College Hospital (DMCH). ECG was done in all patients after their admission to hospital within 48 hours of developing their symptoms. Association of various types of ECG changes were identified and observed. Results: - Among 100 patients,55% had ischaemic stroke and 45% had haemorrhagic stroke. 43.63% aged between 61-70 years had ischaemic stroke and 28.28% aged between 61-80 years had haemorrhagic stroke. Female had higher frequency of ischaemic stroke 52.72% and male had higher frequency of haemorrhagic stroke 75.56%. Abnormal ECG found 84.44% in haemorrhagic stroke and 54.54% in ischaemic stroke. Of all abnormal ECG, ST depression is most frequent and 42.22% in haemorrhagic stroke, T inversion is next 20% in ischaemic stroke, AF is present in 18.18% in ischaemic stroke and QT prolongation is found in 17.77% in hemorrhagic stroke. There considerable variation of ECG changes according to CT scan evidence of particular area of brain involvement like ST depression (28.88%) found in gangliothalamic bleed in haemorrhagic stroke, AF is found (16.36%) in insular area involvement in ischaemic stroke, T inversion is more (12.72%) in large MCA territory infarctive stroke and QT prolongation (11.11%) is found in intracerebral haemorrhage including SAH. Predictable early in hospital mortality is associated with AF 37.5% and with QT prolongation 31.25%. Conclusion:- In haemorrhagic stroke the ECG abnormalities were more frequent then in ischaemic stroke. The most common abnormalities were ST depression, T wave inversion, AF and QT prolongation. AF and QT prolongation has association of early in hospital mortality. J Bangladesh Coll Phys Surg 2020; 38(4): 166-171

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Variation of electrolyte status in relation to the type of acute stroke patients

Bangladesh Medical Journal Khulna ◽

10.3329/bmjk.v52i1-2.46142 ◽

2020 ◽

Vol 52 (1-2) ◽

pp. 12-15

Author(s):

Biplob Kumar Das ◽

Abdul Halim Sarder ◽

Tahmida Khanom ◽

Md Shahin Akter Shaikh ◽

Md Shahidul Islam

Keyword(s):

Ischaemic Stroke ◽

Acute Stroke ◽

Haemorrhagic Stroke ◽

Electrolyte Imbalance ◽

Stroke Patients ◽

Biochemical Tests ◽

College Hospital ◽

Baseline Serum ◽

Major Health Problem ◽

Medical College

Background: Stroke is considered as a major health problem and contributes to serious residual disability and death worldwide. Both serum sodium and potassium disturbance influence negatively on the overall outcome of stroke. There is limited data about electrolyte abnormality in acute stroke, especially from developing countries. Objective: The objective of this study was to evaluate the incidence of electrolyte imbalance in relation to aetiological type of acute stroke patients admitted in hospital. Methods: Total fifty three patients of stroke diagnosed clinically and confirmed by CT scan within 24 hours of onset & consecutively selected for the study after fulfillment of inclusion criteria in the inpatient department of Neuromedicine ward, KhuIna Medical College Hospital from January 2018 to July 2018. Baseline serum electrolytes were estimated along with other biochemical tests as needed. Data were collected and analysed. Results: Fifteen (29%) of ischaemic stroke patients and 4 (8%) of haemorrhagic stroke patients had dyselectrolytaemia. Hyponatraemia was found in 15 (29%) of stroke patients. Hyponatraemia was more common in ischaemic stroke patients (22.6%) than haernorrhagic stroke patients (5.6%). In this study hypokalaernia was found in 3 (5.6%) cases of ischaemic stroke patients and 1 (1.88%) cases of haemorrhagic stroke patients. Conclusion: The incidence of electrolyte disturbance was more in ischaemic stroke than in haemorrhagic stroke and most of which were hyponatraemia followed by hypokalaemia. Bang Med J (Khulna) 2019; 52 : 12-15

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Dyselectrolytaemia in Acute Stroke Patients, an Observational Study

Bangladesh Journal of Medicine ◽

10.3329/bjmed.v22i2.13586 ◽

2013 ◽

Vol 22 (2) ◽

pp. 30-34 ◽

Cited By ~ 1

Author(s):

MR Siddiqui ◽

QT Islam ◽

MA Haque ◽

MJ Iqbal ◽

A Hossain ◽

...

Keyword(s):

Ischaemic Stroke ◽

Acute Stroke ◽

Stroke Patient ◽

Haemorrhagic Stroke ◽

Age Group ◽

Acute Stroke Patient ◽

Stroke Patients ◽

College Hospital ◽

Medical College ◽

Associated Conditions

Background: There are many studies on stroke, its associated conditions and their effect on stroke patients outcome, but a few studies on dyselectrolytaemia in stroke patients has been done in our country, even outside. Method: a total number of 100 randomly selected, clinically and CT proven acute stroke patients were studied at medicine units of Dhaka Medical College Hospital. Association of electrolytes imbalance among acute stroke patient were identified and correlated. Result: Out of 100 patients 29% were in between 51-60 years age group & 72% were male and 28% were female patients. Majority 53% patients had Ischaemic stroke, 45% Intracerebral haemorrhage (ICH) and only 2% had Subarachnoid haemorrhage (SAH). 53% of total acute stroke patient had dyselectrolytaemia. Among 100 acute stroke patients 62.22% of haemorrhagic stroke (p<0.05) & 43.39% of ischaemic stroke (p>0.05) patients had dyselectrolytaemia. Total 36% of all stroke patients had serum sodium imbalance & 31% had serum potassium imbalance. In haemorrhagic stroke & ischaemic stroke patients, hyponatraemia (17% & 13%), hypernatraemia (1% & 3%), hypokalaemia (19% & 11%), hyperkalaemia (0% & 1%), hypochloraemia (9% & 6%) respectively with found. Conclusion: In haemorrhagic stroke, the incidence of dyselectrolytaemia was more than ischaemic stroke and which were mostly hyponatraemia and hypokalaemia. DOI: http://dx.doi.org/10.3329/bjmed.v22i2.13586 Bangladesh J Medicine 2011; 22: 30-34

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Electrolytes Status in Different Type of Acute Stroke Patients and Their Correlation with Some Common Clinical Presentation

Journal of Medicine ◽

10.3329/jom.v13i2.12740 ◽

2012 ◽

Vol 13 (2) ◽

pp. 133-137 ◽

Cited By ~ 1

Author(s):

Mahmudur Rahman Siddiqui ◽

Quazi Tarikul Islam ◽

Md Azharul Haque ◽

Md Jabed Iqbal ◽

Ahmed Hossain ◽

...

Keyword(s):

Ischaemic Stroke ◽

Acute Stroke ◽

Stroke Patient ◽

Clinical Presentation ◽

Haemorrhagic Stroke ◽

Acute Stroke Patient ◽

Stroke Patients ◽

College Hospital ◽

Medical College ◽

Common Clinical Presentation

Background: In our country, there are many studies on stroke, its associated conditions and their effect on stroke patients outcome, but a few studies on electrolytes status in stroke patients have been done in our country, even outside. Method: A total number of 100 randomly selected, clinically and CT proven acute stroke patients were studied at medicine units of Dhaka Medical College Hospital. Electrolytes status in different type of acute stroke patients and their association with some common clinical presentation were identified and correlated. Result: Out of 100 patients, 29% were in between 51-60 years age group & 72% were male and 28% were female patients. Majority 53% patients had Ischaemic stroke, 45% Intracerebral haemorrhage (ICH) and only 2% had Subarachnoid haemorrhage (SAH). 53% of total acute stroke patient had dyselectrolytaemia. Among 100 acute stroke patients, 66.66% haemorrhagic stroke and 28.30% ischaemic stroke patients had headache (p<0.05). 70.66% haemorrhagic and 30.23% ischaemic stroke patients had vomiting (p<0.05). 53% of total acute stroke patient had dyselectrolytaemia. Among 100 acute stroke patient 49 (49%) presented with vomiting from which 73.46% had dyselectrolytaemia (p<0.01). 54 (54%) presented with headache from which 74.07% had dyselectrolytaemia (p<0.001). 62.22% of haemorrhagic stroke (p<0.05) & 43.39% of ischaemic stroke (p>0.05) patients had dyselectrolytaemia. Total 36% of all stroke patients had serum sodium imbalance & 31% had serum potassium imbalance. In haemorrhagic stroke & ischaemic stroke patients, hyponatraemia (17% & 13%), hypernatraemia (1% & 3%), hypokalaemia (19% & 11%), hyperkalaemia (0% & 1%), hypochloraemia (9% & 6%) respectively. Conclusion: In haemorrhagic stroke, the incidence of electrolytes imbalance was more than ischaemic stroke and which were mostly hyponatraemia and hypokalaemia. DOI: http://dx.doi.org/10.3329/jom.v13i2.12740 J Medicine 2012; 13 : 133-137

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Plasma D-Dimer Level in Different Types of Acute Ischaemic Stroke Patients: Experience at a Tertiary Hospital in Dhaka City

Journal of National Institute of Neurosciences Bangladesh ◽

10.3329/jninb.v5i1.42162 ◽

2019 ◽

Vol 5 (1) ◽

pp. 13-17

Author(s):

Paritosh Kumar Sarkar ◽

Anwar Israil ◽

Mohammad Sayeed Hassan ◽

Abu Nayeem ◽

Md Azharul Hoque ◽

...

Keyword(s):

Internal Medicine ◽

Ischemic Stroke ◽

Ischaemic Stroke ◽

Clinical Diagnosis ◽

Acute Ischaemic Stroke ◽

Stroke Patients ◽

College Hospital ◽

Medical College ◽

Different Types ◽

D Dimer

Background: Plasma D-Dimer is a biomarker of thrombo-embolism. Objective: The purpose of the present study was to see the plasma D-dimer level in different types of acute ischaemic stroke patients. Methodology: This cross-sectional study was conducted in the Department of Neurology & Department of Internal Medicine at Dhaka Medical College Hospital, Dhaka, Bangladesh from July 2010 to June 2012 for a period of two (02) years. Patients with ischemic stroke with history within 7 days attending in the stroke clinic of Department of Neurology or admitted in the Department of Neurology and Internal Medicine through the outpatient and emergency Department of Dhaka Medical College Hospital (DMCH) were selected as study population for this study. Analysis of plasma D-Dimer was done in the Department of Hematology of DMCH.b Result: A total of 50 cases were recruited for this study. There were 24.0% lacunar infarcts, 40.0% atherothrombotic and 36.0% embolic infarcts in the study group. Highest level of plasma D-Dimer was observed in embolic (1700±964 ηg/ml) followed by atherothrombotic group (536±234 ηg/ml). The plasma D-Dimer was lowest (100±0 ηg/ml) in lacunar group. Concentration of Plasma D-Dimer showed significant correlation with clinical diagnosis in different subtypes of ischemic stroke (r=0.902; p=0.001) and also with risk factors, example, diabetes (r=0.319; p=0.012) and valvular heart disease (r=0.281; p=0.024), but no significant correlation with age, hypertension, hyperlipidaemia and smoking. Conclusion: In conclusion plasma D-Dimer is an important bio-marker in the clinical diagnosis and subtypes of ischemic stroke patients. Journal of National Institute of Neurosciences Bangladesh, 2019;5(1): 13-17

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Evaluation of Electrolyte Imbalance in Acute Stroke

Pakistan Journal Of Neurological Surgery ◽

10.36552/pjns.v24i4.501 ◽

2020 ◽

Vol 24 (4) ◽

pp. 363-368

Author(s):

Mukhtiar Ahmed ◽

Aziz Ur Rehman ◽

Safdar Ali Pervez ◽

Farrukh Imtaiz ◽

Abdul Razaque ◽

...

Keyword(s):

Acute Stroke ◽

Hemorrhagic Stroke ◽

Brain Infarction ◽

Morbidity And Mortality ◽

Electrolyte Imbalance ◽

Stroke Patients ◽

Serum Electrolyte ◽

College Hospital ◽

Severe Morbidity ◽

Medical College

Objective: Electrolyte imbalance is common in acute stroke; it may cause severe morbidity and mortality, so timely management of electrolyte imbalance may improve morbidity and mortality in cerebro-vascular accident. The purpose of this study was to evaluate electrolyte imbalance in acute stroke and its effect on the outcome of patients. Material and Methods: This study was prospective descriptive in nature and it is comprised of 106 patients of acute stroke after clinically diagnosis confirmed by CT scan brain plain admitted in Khairpur Medical College Hospital. Serum electrolyte along with the other baseline investigation was performed. Results: Hyponatremia was comparatively more common in brain infraction than spontaneous ICH. Hypokalemia is also more common in brain infarction as compared to the hemorrhagic stroke patients of this study. Conclusion: Incidence of Hyponatremia was more common than hypokalemia in patients with acute stroke. Keywords: Hemorrhage, Infraction, Hyponatremia, Hypokalemia.

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Socio-demographic Status & Associated Risk Factors of the Stroke Patient's in a Tertiary Care Hospital of Bangladesh

Anwer Khan Modern Medical College Journal ◽

10.3329/akmmcj.v4i2.16920 ◽

2013 ◽

Vol 4 (2) ◽

pp. 18-22 ◽

Cited By ~ 1

Author(s):

Mahmudur Rahman Siddiqui ◽

Quazi Tarikul Islam ◽

Md. Jabed Iqbal ◽

Sumaiya Sultana Binte-Mosharraf

Keyword(s):

Risk Factors ◽

Acute Stroke ◽

Low Income ◽

Demographic Data ◽

Tertiary Care ◽

Income Group ◽

Care Hospital ◽

Stroke Patients ◽

College Hospital ◽

Medical College

Stroke is the most common neurological emergency. A total number of 100 randomly selected, clinically and CT proven acute stroke patients were studied at medicine units of Dhaka Medical College Hospital. Socio-demographic data and major risk factors or co-morbid conditions among acute stroke patient were identified and correlated. Out of 100 patients 29% were in between 51- 60 years age group & 72% were male and 28% were female patients. In this series 24% were illiterate. Of the literate group 39% went to primary school, 20% completed SSC, 8% completed HSC, 5% completed graduation and only 4% completed post-graduation. Majority of the patients were unemployed (22%). Other was businessman (20%), housewife (19%) and cultivator (16%). 63% percentage of the patients from low income group, which was followed by middle income group (33%). Majority 53% patients had Ischaemic stroke, 45% Intracerebral haemorrhage (ICH) and only 2% had Subarachnoid haemorrhage (SAH). 77% of patient had history of hypertension, 22% Diabetes mellitus, 20% Dyslipidaemia, 13% Previous Stroke, 27% Ischaemic heart disease. Out of 77 hypertensive stroke patients 37(48.05%) had haemorrhagic stroke & 40(51.94%) had ischemic stroke. Anwer Khan Modern Medical College Journal Vol. 4, No. 2: July 2013, Pages 18-22 DOI: http://dx.doi.org/10.3329/akmmcj.v4i2.16920

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Acute kidney injury is a common complication after acute stroke in Mymensingh Medical College Hospital

Bangladesh Medical Journal ◽

10.3329/bmj.v44i2.27243 ◽

2016 ◽

Vol 44 (2) ◽

pp. 82-86

Author(s):

Nitai Chandra Ray ◽

Md Ayub Ali Chowdhury ◽

Ashutosh Saha Roy ◽

Md Abdul Muqueet ◽

Binoy Paul ◽

...

Keyword(s):

Acute Kidney Injury ◽

Acute Stroke ◽

Kidney Injury ◽

Developed Countries ◽

Common Complication ◽

Stroke Patients ◽

College Hospital ◽

Cross Sectional ◽

Medical College ◽

Significant Burden

Stroke represents a continuously evolving medical and social problem, being the third leading cause of death after heart disease and cancer in developed countries. Acute kidney injury (AKI) may develop as a possible complication after acute stroke. Insufficient care of acute stroke patients is an important factor behind it. It may be associated with a significant burden of morbidity and mortality. This cross sectional observational study was conducted in Mymensingh Medical College & Hospital, Mymensingh from July 2012 to June 2014. A total of 240 patients with newly detected acute stroke confirmed by CT scan of brain were included in this study. According to this study, 15.42% of acute stroke patients developed AKI. Majority (54.05%) of the AKI patients were in >60 years age group. 17.93 % of male patients developed AKI and 11.58% of female patients developed AKI. So, AKI was a common complication after acute stroke. Early diagnosis and management of AKI may be an important part of management of these stroke patients.Bangladesh Med J. 2015 May; 44 (2): 82-86

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Clinical Presentation and Risk Factors of Stroke-A Study of 100 Hospitalized Stroke Patients in Bangladesh

Faridpur Medical College Journal ◽

10.3329/fmcj.v11i1.30875 ◽

2016 ◽

Vol 11 (1) ◽

pp. 23-25 ◽

Cited By ~ 1

Author(s):

Radheshyam Saha ◽

MM Shahin Ul Islam ◽

Ahmed Manadir Hossain ◽

Mohammad Rafiqul Kabir ◽

Abdullah Al Mamun ◽

...

Keyword(s):

Risk Factors ◽

Heart Disease ◽

Haemorrhagic Stroke ◽

Medical Emergency ◽

Stroke Patients ◽

College Hospital ◽

Female Ratio ◽

Medical College ◽

Male Female Ratio ◽

History Of

Stroke is one of the most common medical emergency. A total number of 100 randomly selected clinically and CT proven acute stroke patients were studied at medicine and neurology ward of Faridpur Medical College Hospital (FMCH), Faridpur from January to July, 2014 with a view to study the clinical features and risk factors of Stroke. Among 100 patients, stroke was found most commonly in 59-70 years age group. Ischaemic stroke was 56%, haemorrhagic stroke was 39% and haemorrhagic infarct was 5%. Most of the patients were male with male-female ratio was 1.6:1. The commonest risk factor was hypertension found in 60%, diabetes mellitus found in 17%, smoking was present in 54% patients and dyslipidaemia was present in 22% cases. History of heart disease (Myocardial infarction was present in 2% patients, valvular heart disease was present in 4% patients) was present in 6% patients. The commonest presentation in both ischaemic and haemorrhagic stroke was hemiplegia (61%). Headache (14%) and vomiting (10%) were found to be more common accompaniment in haemorrhagic stroke. Loss of consciousness was present in 34% patients. Alcohol intake was not found in any patient.Faridpur Med. Coll. J. Jan 2016;11(1): 23-25

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Assessment of Initial Stroke Severity by National Institute Health Stroke Scale (NIHSS) Score at Admission

Journal of Dhaka Medical College ◽

10.3329/jdmc.v26i2.38765 ◽

2018 ◽

Vol 26 (2) ◽

pp. 90-93

Author(s):

Swapon Kumar Ghose ◽

Kazi Gias Uddin Ahmed ◽

Ahmed Hossian Chowdhury ◽

ATM Hasibul Hasan ◽

Kanol Saha ◽

...

Keyword(s):

Risk Factors ◽

Acute Stroke ◽

Physical Inactivity ◽

Tertiary Care ◽

Stroke Severity ◽

Low Oxygen ◽

Stroke Patients ◽

College Hospital ◽

Nihss Score ◽

Medical College

Background: The National Institutes of Health Stroke Scale or NIH Stroke Scale (NIHSS) is a widely used tool for assessing stroke severity. We conducted this study to determine the severity of stroke patients admitted in a tertiary care hospital.Methods: This is a cross sectional study conducted in Department of Neurology, Dhaka Medical College Hospital from April 2016 to October 2016 involving 91 acute stroke patients.Result: About half (44%) of the patients were older than 60 years of age and mean age of the patients was 60.34(±16.1) years at onset and there is a slight female predominance (51.6%). Majority had hypertension (75.8%) followed by physical inactivity (67%), diabetes (37.4%), smoking (33%), obesity (23.1%), family H/O stroke (20.9%) and dyslipideamia (15.4%). Many patients were found to have hyperglycemia (14.3%) followed by hyperthermia (13.2%), hypotension (4.4%) and low oxygen saturation (3.3%) at the time of admission. Most of them had ischemic stroke (60%), followed by intracerebral hemorrhage (35%) and subarachnoid hemorrhage (5%). After leveling with NIHSS score more than half of the patients (51%) were found to be moderate grade on admission. Although, there was no association between risk factors of stroke and admission NIHSS score level, significant association was found between hypoxia and admission NIHSS score severity.Conclusion: Acute stroke patients, mostly have moderate grade of NIHSS score on admission. Hypertension, physical inactivity, diabetes, smoking, obesity, family H/O stroke and dyslipideamia are common risk factors observed among the patients which have no significant association with admission stroke severity determined by NIHSS score. There is significant association between hypoxia and admission NIHSS score severity.J Dhaka Medical College, Vol. 26, No.2, October, 2017, Page 90-93

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