scholarly journals Incidence and outcome of early post stroke seizures in a tertiary care hospital in New Delhi….. a prospective observational study

JMS SKIMS ◽  
2020 ◽  
Vol 23 (3) ◽  
Author(s):  
Maqsood Ahmad Dar ◽  
Vasundhara Aggarwal Saika ◽  
Joy Dev Mukherjee ◽  
Mukesh Kumar ◽  
Khushbu Goel
Keyword(s):  
Risk Factors ◽  
Clinical Outcome ◽  
Acute Stroke ◽  
Tertiary Care ◽  
New Delhi ◽  
Care Hospital ◽  
Exclusion Criteria ◽  
Post Stroke ◽  
Incidence Risk ◽  
Early Seizures

Background: About 11% of all epilepsies and 30% of newly diagnosed seizures in those older than 60 years have been reported to follow cerebrovascular accidents. Acute symptomatic (early) seizures occur in 3-8% of patients, more commonly in those with severe cortical strokes and intra-parenchymal hemorrhages. This study was undertaken to determine the incidence, risk factors and clinical outcome for early seizures after acute stroke.Aims and objectives: To study the incidence, risk factors and clinical outcomes of early seizures in post stroke patients in a tertiary care hospital.Study design: This prospective observational analytical study was conducted from -01-06-2017 to 31-01-2019 in Max Superspeciality Hospital Saket New Delhi. All consecutive patients of acute stroke fulfilling the inclusion and exclusion criteria were included in the study. Inclusion criteria and exclusion criteria: All patients with acute ischemic or hemorrhagic stroke with age above 18 years, either male or female were included in the study. Patients with a history of seizure or epilepsy before admission, patients with SAH, venous infarct and causes other than vascular origin were excluded from the study. Results and observation: Out of two hundred and fifty (n=250) patients of acute stroke included in the study early seizures were diagnosed in 29 patients (11.6%).Conclusions: We concluded that the incidence of post stroke early seizures was 11.6% in our study. We found that Patients with post stroke early seizures had higher NIHSS score, low GCS score and higher modified Rankin score at the time of admission. We recommend that stroke scores like NIHSS, ICH, GCS and mRS should be applied to all the patients of acute stroke to stratify the patients with regard to their risk of developing early seizures and prognosticating the clinical outcome.

scholarly journals Feasibility of laparoscopy in management of ectopic pregnancy: experience from a tertiary care hospital

2018 ◽  
Vol 7 (5) ◽  
pp. 1778
Author(s):  
Jyoti Meena ◽  
Richa Vatsa ◽  
Sunesh Kumar ◽  
Kallol K. Roy ◽  
Anshu Yadav ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ectopic Pregnancy ◽  
Surgical Management ◽  
Tertiary Care ◽  
Primary Objective ◽  
Diagnostic Methods ◽  
New Delhi ◽  
Care Hospital ◽  
Secondary Objective ◽  
A Prospective Study

Background: Ectopic pregnancy is an important cause of maternal morbidity and mortality. For surgical management, laparoscopy is preferred option. In developing world for ruptured ectopic pregnancy laparotomy is done at most of places. In this study we have assessed feasibility of laparoscopic management in both ruptured and unruptured ectopic pregnancy.Methods: A prospective study, conducted over period of 1 year from July 2014 to July 2015 in Department of Obstetrics & Gynecology, All India Institute of Medical Sciences, New Delhi. In 110 patients of ectopic pregnancy parameters studied were age and parity, symptoms, risk factors, diagnostic methods, site of ectopic, management and its outcome. Primary objective was to evaluate management outcome of ectopic pregnancy and to assess feasibility of laparoscopy in ectopic pregnancy. Ruptured ectopic pregnancy with massive hemoperitoneum were analyzed separately. Secondary objective was to study demographic characters and risk factors of ectopic pregnancy.Results: Surgical management was required in 93.6% patients, out of which 86.4% were managed laparoscopically. Unruptured ectopic pregnancy was managed successfully by laparoscopy in 96.6% (29/30) patients. Ectopic was ruptured in 73 (66.3%) cases, laparoscopy was attempted in 91.7% (67/73). In 10.4% (7/67) patients laparoscopy had to be converted to laparotomy and it was successful in 89.5%. Out of 16 patients with massive hemoperitoneum, 12(75%) were managed laparoscopically. There was no mortality.Conclusions: In most of cases laparoscopy is safe and successful. Laparoscopy is feasible in ruptured ectopic cases including selected cases with massive hemoperitoneum thus avoiding unnecessary laparotomy and associated morbidity. Timely diagnosis and management prevents mortality.

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

2013 ◽  
Vol 4 (2) ◽  
pp. 18-22 ◽  
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

scholarly journals Magnitude and determinants of depression in acute stroke patients admitted in a rural tertiary care hospital

2015 ◽  
Vol 6 (02) ◽  
pp. 202-207 ◽  
Author(s):  
Amrish Saxena ◽  
Ajitabh Suman
Keyword(s):  
Acute Stroke ◽  
Rating Scale ◽  
Tertiary Care Hospital ◽  
Economic Status ◽  
Tertiary Care ◽  
Care Hospital ◽  
Stroke Patients ◽  
Post Stroke ◽  
Socio Economic Status ◽  
Post Stroke Depression

ABSTRACT Objectives: Depression is one of the most frequent neuropsychiatric disturbances after a cerebrovascular stroke. The frequency of depression in stroke patients has varied widely in different populations. Post stroke depression is an important factor limiting recovery and rehabilitation in acute stroke patients. Settings and Design: A cross-sectional hospital-based study was performed in acute stroke patients admitted in the department of Medicine of a rural teaching tertiary care hospital in central India. Materials and Methods: In all consecutive acute stroke inpatients, the intensity of depression was assessed by a trained person through a questionnaire, Montgomery-Asberg Depression Rating Scale (MADRS), who is blind of the diagnosis and investigations of the patient. Another study person collected the data including demographics, co-morbid diseases or risk factors. Radiological imaging data was noted from the CT/MRI head reports of stroke patients. Results: Of the total 107 stroke patients, 60 (56%) were males and 47 (44%) were females. Sixty-one (57%) of the 107 stroke patients had depression. Of the 107 stroke patients, 35 (33%) had mild depression, 22 (20%) had moderate depression and 4 (4%) had severe depression. The age, gender, education status and co-morbidities of the stroke patient were not associated with depression. The association of socio-economic status and left-sided lesions with depression was found to be statistically significant (P < 0.05). Type and location of the lesion were not associated with depression. Conclusion: Post-stroke depression was present in more than half of the stroke patients and was related to socio-economic status and left-sided hemisphere lesions.

Risk Factors, Etiology, and Clinical Outcome of Ischemic Stroke in Young Adults Admitted in a Tertiary Care Hospital in India

2019 ◽  
Vol 2 (1) ◽  
pp. 32-39
Author(s):  
Madhavi Karri ◽  
Balakrishnan Ramasamy
Keyword(s):  
Risk Factors ◽  
Young Adults ◽  
Ischemic Stroke ◽  
Clinical Outcome ◽  
Tertiary Care ◽  
Care Hospital ◽  
Diagnostic Challenge ◽  
Stroke Treatment ◽  
Stroke In Young Adults ◽  
Stroke In Young

Background: Ischemic stroke in young adults is becoming a rising concern with the increase in vulnerability to traditional risk factors and changing lifestyles. Aim: An overview of risk factors, classification, and clinical outcome of ischemic stroke in young adults (19 to 45 years) has been presented. Methods: Data fulfilling the study criteria from the stroke registry between June 2014 and June 2017 were collected, and a detailed proforma was taken that included history, clinical examination, and routine investigations. Selective investigations such as prothrombotic workup and 24-hour Holter monitoring were performed. Stroke was subclassified using the Trial of Org 10172 in Acute Stroke Treatment criteria. National Institute of Health Stroke Scale (NIHSS) scores at baseline and the modified Rankin score (mRS) scoring after 3 months of patients’ admission were calculated. Results: Out of 223 identified cases of ischemic stroke in young adults, 186 (83.4%) were taken for analysis, constituting 7.3% of the total stroke population of 3,059. Among the cases taken for analysis, 137 were males and 49 were females. A total of 150 patients were among the age group of 36 to 45 years. Dyslipidemia, smoking, and alcohol consumption were prevalent in the study group. Atherosclerotic strokes were predominant in the study population. NIHSS scores at admission had a significant impact on mRS scores after 3 months. In this study, only 4% reported the recurrence of stroke, whereas mortality was about 0.02%. Conclusions: Workup required for ischemic stroke in young adults has always been a diagnostic challenge for physicians who treat the stroke patients, and this must be optimized in all health care centers. Despite extensive workup, 23.66% participants were found to be cryptogenic in this study. The clinical outcome was good in this study with less mortality observed.

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 A comparative study to assess knowledge, health beliefs and preventive practices among women with cervical cancer and general population at tertiary care hospital, New Delhi

2017 ◽  
Vol 4 (8) ◽  
pp. 2989
Author(s):  
Navreet Kaur Saini ◽  
Kamlesh Kumari Sharma ◽  
Shashi Mawar ◽  
Lalit Kumar ◽  
Sunesh Kumar
Keyword(s):  
Risk Factors ◽  
Cervical Cancer ◽  
General Population ◽  
Comparative Study ◽  
Health Beliefs ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
New Delhi ◽  
Care Hospital ◽  
Preventive Practices

Background: Awareness regarding cervical cancer, its risk factors and preventive practices is very low among Indian women. The objectives of the study was to compare knowledge, health beliefs and preventive practices regarding cervical cancer among women with cervical cancer and general population at tertiary care hospital, New Delhi; to study the correlation among knowledge, health beliefs and preventive practices of women with cervical cancer and general population and their selected demographic variables.Methods: A comparative study was conducted using descriptive, cross sectional survey among conveniently sampled 100 women with cervical cancer (cases) taking treatment from cancer department of tertiary care hospital and 100 women relatives of patients with non-malignant diseases admitted in different medical, surgical, pediatrics wards of tertiary care hospital (controls). Self-developed, pretested, structured questionnaires validated by experts were used for data collection.Results: Majority of subjects had poor knowledge (78% cases and 90% controls) and positive health beliefs (83% cases and 67% controls). Majority of cases (93%) had fair preventive practices while most of controls (62%) had poor preventive practices regarding cervical cancer. There was positive correlation of knowledge with health beliefs (p=0.0001) and health beliefs with preventive practices (p=0.0469) among controls; but in cases none of these correlations were found.Conclusions: Substantial gaps in knowledge and preventive practices regarding cervical cancer were present in both groups. So there is a need to raise public awareness regarding risk factors and prevention of cervical cancer by modifying the risk factors.

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