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Acute ischemic stroke is a major factor cause of severe morbidity and mortality in general population. Newer modality of treatment like IV thrombolysis has been established to prevent long term complications in this condition within 4.5 hours of symptoms onset. The data regarding IV thrombolysis is limited in rural areas. Various factors like lack of awareness among general population, patients reaching hospital beyond window period, cost of treatment pose difficulty in administration of this treatment. This article presents demographic profile of patients undergoing IV thrombolysis for acute ischemic stroke at a hospital from Kutch, Gujarat. This article also highlights the importance of strong interpersonal communication between physician for better outcomes in patients.The aim of this observational study is to observe demographic profile of patients with acute ischemic stroke receiving intravenous thrombolysis and to estimate the factors which might help in favorable patient outcome.The data was calculated during January 2023 to December 2023. 22 patients were thrombolysed for acute ischemic stroke within 4.5 hours from onset of symptoms. Males were predominant (86.3%), average age of patients was 57.4 years (range 31 – 80 years old). Majority of the strokes were anterior circulation stroke (77.2%). The comorbidities like Diabetes mellitus (36.3%), hypertension (54.5%), dyslipidemia (59%), old coronary artery disease (18%), old cerebro vascular disease (4.5%) were seen. The time from symptom onset to presentation to hospital is approximately 146 minutes. The time from presentation to hospital and IV thrombolysis administration is approximately 49 minutes. 17(77.2%) patients presented to hospital within 3 hours of symptom onset, 13 (59%) underwent IV thrombolysis within 30 minutes of presentation to hospital. Majority of this patients were referred by primary physician to the hospital. Mild stroke (NIHSS < 5) was seen in 1 (4.5%) patient, moderate (NIHSS 5-15) in 11(50%) patients, moderate -severe stroke (NIHSS 15-25)– in 10(45.5%) patients. Large vessel occlusion was seen in 12 (54.5 %), small vessel disease in 4 (18 %), Embolic etiology in 4(18%) and unknown in 2 (9%) of cases. The mean NIHSS at presentation was approximately 16, at 24 hours after IV thrombolysis was approximately 11.3 and after 72 hours of IV thrombolysis is 8.6. Early neurological deficit was seen in 6(27.2%) of cases. 4(18%) of all stroke who underwent thrombolysis required decompression craniotomy. The improving on mRS (grade 0-1) score was found in 16(72.8%) patients at 7 days of thrombolysis. Intravenous thrombolysis with recombinant tissue plasminogen activator is helpful in acute ischemic stroke within 4.5 hours of onset. Early diagnosis and swift evaluation and management helps in prevention of longterm disability.
Acute ischemic stroke is a major factor cause of severe morbidity and mortality in general population. Newer modality of treatment like IV thrombolysis has been established to prevent long term complications in this condition within 4.5 hours of symptoms onset. The data regarding IV thrombolysis is limited in rural areas. Various factors like lack of awareness among general population, patients reaching hospital beyond window period, cost of treatment pose difficulty in administration of this treatment. This article presents demographic profile of patients undergoing IV thrombolysis for acute ischemic stroke at a hospital from Kutch, Gujarat. This article also highlights the importance of strong interpersonal communication between physician for better outcomes in patients.The aim of this observational study is to observe demographic profile of patients with acute ischemic stroke receiving intravenous thrombolysis and to estimate the factors which might help in favorable patient outcome.The data was calculated during January 2023 to December 2023. 22 patients were thrombolysed for acute ischemic stroke within 4.5 hours from onset of symptoms. Males were predominant (86.3%), average age of patients was 57.4 years (range 31 – 80 years old). Majority of the strokes were anterior circulation stroke (77.2%). The comorbidities like Diabetes mellitus (36.3%), hypertension (54.5%), dyslipidemia (59%), old coronary artery disease (18%), old cerebro vascular disease (4.5%) were seen. The time from symptom onset to presentation to hospital is approximately 146 minutes. The time from presentation to hospital and IV thrombolysis administration is approximately 49 minutes. 17(77.2%) patients presented to hospital within 3 hours of symptom onset, 13 (59%) underwent IV thrombolysis within 30 minutes of presentation to hospital. Majority of this patients were referred by primary physician to the hospital. Mild stroke (NIHSS < 5) was seen in 1 (4.5%) patient, moderate (NIHSS 5-15) in 11(50%) patients, moderate -severe stroke (NIHSS 15-25)– in 10(45.5%) patients. Large vessel occlusion was seen in 12 (54.5 %), small vessel disease in 4 (18 %), Embolic etiology in 4(18%) and unknown in 2 (9%) of cases. The mean NIHSS at presentation was approximately 16, at 24 hours after IV thrombolysis was approximately 11.3 and after 72 hours of IV thrombolysis is 8.6. Early neurological deficit was seen in 6(27.2%) of cases. 4(18%) of all stroke who underwent thrombolysis required decompression craniotomy. The improving on mRS (grade 0-1) score was found in 16(72.8%) patients at 7 days of thrombolysis. Intravenous thrombolysis with recombinant tissue plasminogen activator is helpful in acute ischemic stroke within 4.5 hours of onset. Early diagnosis and swift evaluation and management helps in prevention of longterm disability.
India is home to one-fifth of the world’s population and is currently the fastest-growing economy. As the health industry is growing, India needs to develop robust implementation of evidence-based health care addressing the major public health issues. Two of such issues India is grappling with are the establishment of stroke care and the reduction of road accidents. Australia has achieved notable success in implementing stroke care and reducing road accidents. In stroke, Australian initiatives include dedicated stroke units, the development of clinical guidelines, the implementation of acute interventions, the establishment of a national stroke foundation, and the stroke registry. As a result, the combined, primary, and secondary prevention measures, acute treatment, and rehabilitation have reduced the total disease burden of stroke from 2003 to 2023 by 53 per cent, from 7.4 to 3.5 Disability Adjusted Life Years (DALYS) per 1,000 population, which is a 56 per cent decline in fatal burden and 23 per cent decline in non-fatal burden. For road safety, Australia implemented evidence-based practices such as education, legislation including mandatory use of seat belts, and other road safety initiatives. Data show that seat belt use reached 98 per cent in Australia in 2023. Furthermore, about 20 per cent of drivers as well as passengers who were killed in crashes in 2024 did not wear seat belts. The reduction of speed limits in built-up areas, the adoption of monitoring technology, and the clever use of infrastructure are proving to be effective in reducing fatalities and serious injuries. Australia’s implementation research can provide valuable insights into the efforts of mitigating the impact of stroke and enhancing road safety in India.
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