scholarly journals Prevalence, Clinical Profile and Outcome of Patients Presenting with Stroke

2021 ◽  
pp. 146-157
Author(s):  
N. Akshaya Thrinetrapriya ◽  
M. Jagadeesan
Keyword(s):  
Risk Factors ◽  
Tertiary Care ◽  
General Medicine ◽  
Lifestyle Changes ◽  
Care Hospital ◽  
Stroke Patients ◽  
Eligibility Criteria ◽  
Medical College ◽  
Awareness Campaigns ◽  
Scale Scores

BACKGROUND: Stroke is a clinical condition that has a greatly increasing prevalence in the recent years owing to our ‘modern’ sedentary lifestyle. The aim of this study is to assess the prevalence, risk factors, clinical presentation and outcome of patients presenting with stroke in a tertiary care hospital. METHODOLOGY: A prospective observational study was conducted in the Department of General Medicine, Saveetha Medical College & Hospital, Thandalam, Chennai for a period of 4 months, i.e., from January 2021 to April 2021.Stroke patients who met the eligibility criteria were included in the study. All sociodemographic and clinical data were recorded by reviewing the patient and his medical records regularly. Scores like NIHSS (National Institute of Health Stroke Scale) score and mRS (modified Rankin scale) scores were calculated and TOAST categorisation was done. Statistical analysis was done using Statistical Package for Social Sciences (SPSS) software. RESULTS: Out of 100 stroke patients, 65% were males and 35% were females. Mean age was 57.95 years. Ischemic strokes were seen in 85% of patients and the rest 15% had hemorrhagic stroke. The most common presentation was facial palsy (67%), followed by hemiparesis (62%) and hemiplegia (38%). The important risk factors were hypertension (70%), diabetes mellitus (48%) and obesity (42%). Based on mRS scores, 59% of the patients had bad outcome. CONCLUSION: Hypertension and diabetes were the most common risk factor in our study population. Preventive measures include creating awareness, lifestyle changes and compliance to medications. National programmes on stroke prevention initiate and coordinate awareness campaigns to reduce the incidence, morbidity and mortality of stroke. Finally, a multidimensional approach involving the patient community, general population, medical fraternity and government authorities is essential to curtail this modern epidemic.

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 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

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 Risk factors, presentation and management of stroke in a tertiary care hospital

2014 ◽  
Vol 2 (1) ◽  
pp. 35-43
Author(s):  
S Sapkota ◽  
H Chhetri ◽  
RP Sharma
Keyword(s):  
Risk Factors ◽  
Lifestyle Modification ◽  
Tertiary Care ◽  
Medical Science ◽  
Developed Countries ◽  
Health Condition ◽  
Care Hospital ◽  
Management Pattern ◽  
Medical College ◽  
The Developed Countries

Background and Objectives: Many studies in recent years have focused attention on identification of risk factors associated with stroke. However, most of these studies have been conducted in the developed countries. Only few studies have been conducted in Nepal. So the present study has been undertaken with the aim of determining the risk factors and management pattern of stroke and makes the people aware of those factors. Material and Methods: It is a descriptive prospective study conducted with 50 consecutive patients who presented in medicine and emergency department at Universal College of Medical Science, Bhairahawa, Nepal from December 2009 to July 2010. Data were collected using a standard questionnaire and encounter form after receiving a verbal consent from the patient. The collected data were coded, tabulated and analyzed using SPSS version- 16. Results: The present study showed that 56% of stroke patients were male. Hemorrhagic stroke (60%) was more than the ischemic stroke (40%).The age was common non modifiable risk factor. The common–modifiable risk factors were hypertension (86%), alcohol consumption (74%) and smoking (56%). Calcium channel blocker (44.18%) and combination of it with Diuretic (18.60%) and ACE inhibitors (20.93%) were the commonly prescribed drugs for lowering blood pressure. Prescribed drugs therapy and lifestyle modification improved the health condition of patients (80%). The non compliance to the drugs was due to multiple dosages (51.52%), side effects (18.18%) and forgetfulness (18.18%). Conclusion: Finding of this study will be helpful for the practitioners as well as researcher in the future. Practitioners can make people aware on the risk factors and preventive measures of the stroke. Researchers will be helped by knowing the commonest risk factors of stroke and its management pattern. DOI: http://dx.doi.org/10.3126/jmcjms.v2i1.11394 Janaki Medical College Journal of Medical Sciences (2014) Vol. 2 (1): 35-43

scholarly journals Etiology and risk factors among young patients presenting with stroke in a tertiary care hospital in South India

2017 ◽  
Vol 5 (3) ◽  
pp. 1027
Author(s):  
Thiagaraj Subburaj ◽  
Subramaniyan Kumarasamy ◽  
Sundaravadivelu Velayudam
Keyword(s):  
Risk Factors ◽  
Clinical Presentation ◽  
Tertiary Care ◽  
Traumatic Injury ◽  
Young Patients ◽  
General Medicine ◽  
Abrupt Onset ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Causes Of Disease

Background: Stroke is one of the leading causes of disease and death throughout the world with the incidence rising steeply with age. The occurrence of stroke in young is rare but once it occurs the outcome is severe. Limited studies have been performed in the Indian population to describe the clinical presentation and etiology of young adults with stroke. The objective of present study is to assess the etiology, risk factors and clinical presentation among patients who visit a tertiary care centre with a clinical diagnosis of stroke in individuals less than 45 years of age.Methods: Consecutive patients visiting the Dept of General Medicine & Neurology, SRM Hospital aged between 15-45 years with abrupt onset of focal or global neurological deficit attributable to vascular cause and persisting for more than 24 hours were included into the study. Patients with traumatic injury and transient ischemic attack were excluded. The clinical features, laboratory and radiological investigations were obtained from the patient’s records.Results: The mean age of the study group was 36.42±6.92 years. The most common risk factor amongst study subjects was smoking (36%). Hemiplegia was more commonly seen in males (38 vs. 14 %, p= 0.26) than in females. Seizures were more commonly seen among subjects with hemorrhagic stroke and cortical venous thrombosis (p= 0.001). Among   subjects with ischemic stroke, the most common etiology was hypercoagulation. The most common arterial territory involved was Middle cerebral artery territory 84.84% with the  Left MCA (53.5%) being  more common than right MCA (46.4%).Conclusions: The clinical presentation and etiology among young patients with stroke appear to remain consistent with that reported earlier in the literature. The paucity of rare presentations of stroke in our study could be attributable to the limited sample size of our study. 

scholarly journals Immediate outcome and risk factors determining the outcome of status epilepticus in children attending tertiary care centre

2017 ◽  
Vol 4 (4) ◽  
pp. 1289
Author(s):  
Murali Thandavarayan ◽  
Sureshkumar Ramaswamy ◽  
Priyadarsini Bose ◽  
Sivaraman Thirumalaikumarasamy
Keyword(s):  
Risk Factors ◽  
Status Epilepticus ◽  
Tertiary Care ◽  
Medical Emergency ◽  
Time Of Arrival ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
College Hospital ◽  
Medical College

Background: Status epilepticus (SE) is a paediatric and neurological medical emergency, continuous seizure lasting more than 30 min, or two or more seizures without full recovery of consciousness between any of them. Determination of immediate outcome of SE in children in a tertiary care hospital and to identify the risk factors influencing the outcome was the objectives of the present study.Methods: A study was conducted in Dept of Pediatrics, Tirunelveli Medical College Hospital among the children from 1 month to12 years of age, who had admitted for SE in hospital’s pediatric causality from October 2009 to October 2010 were selected for the study.Results: Out of 92 patients, total 87 patients completed the study and out of those 74 have recovered and 13 have died. The risk factors significantly affecting the outcome were hypoxia at the time of arrival, decompensated shock, respiratory failure requiring intubation and acidosis.Conclusions: Proper prehospital therapy, early referral, proper care while transporting, anticipitating risk factors involved, and protocol based approach uniformly at all hospital can reduce the mortality due to status epilepticus in children. 

Evaluation of Pattern of Use of Prescribed Oral Hypoglycaemic Drugs in Newly Diagnosed Diabetic Nephropathy Patients Visiting a Tertiary Care Hospital of Southern Bihar

2020 ◽  
Vol 7 (43) ◽  
pp. 2492-2496
Author(s):  
Rajan Goyal ◽  
Himanshu Jindal ◽  
Abhilasha Singh ◽  
Abhishek Kamendu
Keyword(s):  
Renal Function ◽  
Diabetic Nephropathy ◽  
Tertiary Care ◽  
General Medicine ◽  
Care Hospital ◽  
Newly Diagnosed ◽  
Oral Hypoglycaemic Agents ◽  
Total Study Population ◽  
Medical College ◽  
Oral Hypoglycaemic Drugs

BACKGROUND Diabetes is the most important risk factor for chronic kidney disease. Because of this, clearance of many oral hypoglycaemic drugs from our body is hampered and time of exposure to these drugs increases. Therefore, patients of diabetes need to be assessed frequently for the development of diabetic nephropathy and the dosage of oral hypoglycaemic drugs should also be modified accordingly. So, the purpose of this study was to evaluate the doses of prescribed OHAs in newly diagnosed diabetic nephropathy patients. METHODS A hospital based observational study was conducted at Narayan Medical College and Hospital, Sasaram, Bihar, India. A total of 600 diagnosed patients of diabetic nephropathy of age more than 18 years visiting for the 1 st time in OPD of general medicine / nephrology department were included in the study after obtaining an informed consent. The results were expressed as a percentage of the assessed population. RESULTS Only about 38% of the total study population was taking doses of Oral Hypoglycaemic Agents (OHAs) according to their GFR status. 62% were taking wrong doses of OHAs with their respective renal function. CONCLUSIONS Treatment of diabetes in a CKD patient is more difficult than in non-CKD patient. GFR status should be monitored on regular basis in patients of diabetes with CKD. A significant number of these patients are still treated with wrong dosage of OHAs for their respective renal function. KEYWORDS Wrong Dose of OHA, Diabetic Nephropathy, Oral Hypoglycaemic Drugs

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 Incidence and risk factors for post caesarean delivery surgical site infection in a tertiary care hospital

2021 ◽  
Vol 10 (6) ◽  
pp. 2316
Author(s):  
Smita S. Naik ◽  
Ajit Nagarsenkar
Keyword(s):  
Risk Factors ◽  
Surgical Site Infection ◽  
Incidence Rate ◽  
Tertiary Care ◽  
Prophylactic Antibiotic ◽  
Public Health Care ◽  
Care Hospital ◽  
Site Infection ◽  
Medical College ◽  
Modifiable Factors

Background: Post-operative surgical site infection (SSI) is the most commonly reported nosocomial infection which constitutes a major public health care problem worldwide. SSI are the one of the most common complication after caesarean section (C-sec) and results in maternal morbidity and mortality, increased length of the hospital stays and economic burden. The aim of the study is to determine the incidence and risk factors of SSI in women undergoing C-sec.Methods: The prospective observational study carried out in department of Obstetrics and Gynaecology in Goa medical college, Bambolim Goa from 1st November 2017 to 30th May 2019. Collection of data was carried using predesigned and pretested proforma. SSI was examined for association of different risk factors and its distribution.Results: During this study period, 2106 patients underwent C-sec, out of which 103 patients developed post-operative SSI with the incidence rate being 4.89%. The incidence rate was found higher in emergency cases (6.55%) as compared to that of elective (1.21%) and median time to SSI was the 6th post- operative day. Majority of SSI, i.e., 102 out of 103 (99.08%) were superficial SSI, 1 (0.98%) were deep SSI and no organ/space SSI. The highest rate of SSI was found in 21-34 years of age group (84.47%). The common risk factors associated are anaemia, diabetes, hypertension and obesity.Conclusions: SSI results from multiple risk factors which include modifiable and non- modifiable factors and thorough analysis of these factors can help prevent SSI. The medical staff should focus on some of the modifiable risk factors can be eliminated by strict antisepsis, timely prophylactic antibiotic and maintaining normothermia as well as optimal glucose level.

scholarly journals Clinical and investigational study for the aetiological evaluation of patients in nontraumatic altered sensorium and its outcome

2019 ◽  
Vol 7 (4) ◽  
pp. 1113
Author(s):  
Siba Narayan Jali ◽  
Sachida Nanda Nayak ◽  
Biju K. Alexander ◽  
Diptimayee Tripathy ◽  
Bijaya K. Behera
Keyword(s):  
Tertiary Care ◽  
General Medicine ◽  
Diagnostic Methods ◽  
P Value ◽  
Care Hospital ◽  
College Hospital ◽  
Metabolic Encephalopathy ◽  
Altered Sensorium ◽  
Medical College ◽  
Gcs Score

Background: Apart from head injury many patients present to the tertiary care hospital in unconscious state, the etiology of which is obscure in most of the cases. The present study was conducted with on objective to provide insight into the clinical features and diagnostic methods to know the aetiology of patients with non-traumatic cases of altered sensorium and to study the outcome of these patients.Methods: This is an observational study on 100 patients of altered sensorium of non-traumatic origin during the period from October 2012 to September 2014 conducted in the Department of General Medicine, MKCG Medical College Hospital, Berhampur, Odisha, India. All patients were selected for the study based on the inclusion exclusion criteria. Detailed history, clinical evaluation, laboratory investigations like neuroimaging studies etc. were carried out. Statistical data analysis was done using Graph pad Prism 6 and Microsoft Excel. P value <0.0001 was considered statistically extremely significant.Results: Out of 100 patients of altered sensorium, 64 were males and 36 were females. All patients were in the age group of 19 to 89 years. Cerebrovascular accident was the most common aetiology of altered sensorium followed by metabolic encephalopathy and infection. Altered sensorium in patients with CVA carries a high mortality. Metabolic causes and younger age indicated a better prognosis, patients with low (Glasgow Coma Score) GCS score of 3 to 4 had poorer prognosis.Conclusions: The results suggest that clinical assessments yield accurate predictive information about the potential for recovery in cases of altered sensorium. So, this study concludes that empirically based estimates of prognosis in the neurologically severely ill provides great reassurance to those involved in a decision-making process, including patients’ families and physicians.

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