Fifty years of stroke researches in India

Banerjee, Tapas Kumar; Das, Shyamal Kumar

doi:10.4103/0972-2327.168631

Cited by 97 publications

(46 citation statements)

References 68 publications

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“…This is because they not only affect the victim but also their caregiver, relatives, family, and society. [ 1 2 ] The impact of ischemic and hemorrhagic CVA in a developing country like India is still a subject of scrutiny. [ 3 4 ]…”

Section: Introductionmentioning

confidence: 99%

Factors delaying management of acute stroke: An Indian scenario

Abraham

Krishnan

Thaha

et al. 2017

Int J Crit Illn Inj Sci

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Background and Purpose:The purpose of this study was to assess factors causing delay in treatment of acute stroke in a tertiary care institute in South India.Methods:All clinically suspected cases of acute stroke presenting to the emergency department over a period of 1 year were prospectively followed up and data collected as per a preset pro forma. The various time intervals from stroke onset to definitive management and other pertinent data were collected. The time delays have been evaluated in the decision tree model: Chi-squared Automatic Interaction Detection. Significance was assessed at 5% level of significance (P < 0.05).Results:The mean prehospital time delay for all clinically suspected stroke (n = 361) in our institute was 716 min and the median time 190 min. The mean total in-hospital delay was 94.17 ± 54.5 min and median time being 82 min. The onset of symptoms to first medical contact was the main interval that influenced the prehospital delay. Computed tomographic (CT) diagnosis to stroke unit admission influenced the in-hospital delay the most.Conclusions:Lack of awareness regarding stroke leads to delayed seeking of treatment for the same. The factors that contribute to the in-hospital delay included patient admission procedure delay, lack of staff to transport the patient, and the distance between the stroke unit and CT room. Educating the community with regard to “stroke” and implementation of a better pre- and in-hospital stroke care system is a need of the hour in the country.

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Section: Introductionmentioning

confidence: 99%

Factors delaying management of acute stroke: An Indian scenario

Abraham

Krishnan

Thaha

et al. 2017

Int J Crit Illn Inj Sci

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“…[ 18 ] A review performed by Banerjee and Das showed that poor availability of transport in rural areas and congestion in urban areas were considered constraints or barriers to immediate hospitalization and treatment initiation. [ 19 ]…”

Section: Discussionmentioning

confidence: 99%

Factors affecting the effective management of acute stroke: A prospective observational study

Nagendra

Kumar

Bohra

et al. 2018

Indian Journal of Critical Care Medicine

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Background:Stroke, characterized by sudden loss of cerebral function, is among one of the leading cause of death and disability world over. The newer treatment modalities have changed the landscape of stroke treatment but are very much time bound.Aim:To characterize pre-hospital and in-hospital factors affecting acute stroke management thus defining lacunae in stroke management.Subjects and Methods:A prospective observational study, conducted at the emergency department of a tertiary care center in southern India from August 2015 to July 2016. All stroke patients presenting within first 24 hours of onset were included. A pre -defined Knowledge-Attitude-Practice (KAP) questionnaire was used.Results:Total of 133 patients were eligible out of which 28 were excluded for various reasons. Majority were >60 years age and male (61%). About 60% arrived within window. Distance from the hospital was one of the major factors for arrival within the window period. When compared by KAP questionnaire, bystanders of those arriving within window period had better awareness of stroke symptoms.Conclusions:Improving awareness of stroke symptoms and increasing availability of EMS is likely increase chances of stroke patients receiving appropriate acute management.

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“…There are limited published studies from India which have shown marked variation in the incidence of ICH complications of thrombolysis. [ 6 7 ]…”

Section: Introductionmentioning

confidence: 99%

Predictors of intracerebral hemorrhage in acute stroke patients receiving intravenous recombinant tissue plasminogen activator

Chenna

Kaul

Tandra

et al. 2018

Ann Indian Acad Neurol

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Background:Symptomatic Intracerebral hemorrhage (sICH) is a serious complication of recombinant tissue-plasminogen activator (rt-PA) therapy for acute ischemic stroke (AIS).Objective:To estimate the prevalence and predictors of sICH in patients after receiving IV rt-PA for AIS.Material and Methods:Consecutive patients of AIS thrombolysed between January 2010 and June 2016 in a University hospital in Hyderabad (India) were studied prospectively for sICH and it's various variables compared with the control group without sICH to determine any sigificantant difference.Results:Out of 113 patients , sICH was detected in 12 (10.61%) whose mean age(58±12.0 years) and gender ratio ( 2:1 ) was not statistically significant from controls. In s ICH group mean NIHSS score was 16.53± 5.81 vs 10.19± 5.06 in controls (p<0.001), gap between stroke onset and thrombolysis was 227.50±46.15 min vs 178.50± 69.20 min in controls(p=0.018). At presentation mean blood sugar was 208.75±90.97 mg/dl in sICH group vs 146.83±70.21 mg/dl in controls (p=0.002). Prior diabetes was in 7(53.30%) vs 23 (22.8%) in controls (p= 0.014)and hypertension in 11 (91.7%) vs (56(55.4%) in controls (p= 0.026) The mortality in sICH was 7 (58.30%)vs 4 (4.94%) in controls (p<.0.001). At 3 months mean mRS ofsICH patients was 5.57± 0.54 vs 2.17± 1.69 in controls (p<.05).Conclusion:High NIHSS score, increased stroke onset to thrombolysis time , high blood sugar at presentation ,prior diabetes and hypertension increase the chances of sICH. None of these contraindicate thrombolysing strokes but should caution the physician.

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Fifty years of stroke researches in India

Cited by 97 publications

References 68 publications

Factors delaying management of acute stroke: An Indian scenario

Factors delaying management of acute stroke: An Indian scenario

Factors affecting the effective management of acute stroke: A prospective observational study

Predictors of intracerebral hemorrhage in acute stroke patients receiving intravenous recombinant tissue plasminogen activator

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