Ischemic Strokes in Pakistan: Observations from the National Acute Ischemic Stroke Database

Khealani, Bhojo A; Khan, Maria; Tariq, Muhammad; Malik, Abdul; Siddiqi, Alam Ibrahim; Awan, Safia; Wasay, Mohammad

doi:10.1016/j.jstrokecerebrovasdis.2014.01.009

Cited by 15 publications

(17 citation statements)

References 17 publications

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“…This may be due to inadequate monitoring of the health service and control of the common modifiable risk factors in developing countries like Nepal, Bangladesh, and India where the poverty line of the population is still on the higher side. In our study we found that dyslipidemia, smoking, carotid artery atherosclerosis, hypertension, atrial fibrillations, diabetes were the most common risk factors which were consistent with the previous study 9,12 .…”

Section: Discussionsupporting

confidence: 93%

“…Age is one of the non-modifiable risk factor of stroke. Mean age of the stroke patients which was around 63 was consistent with the findings from a similar stroke registry in Nepal (61) 8, 9, India (63) 11 , China (60) 12 , Bangladesh (60) 13 . However, in contrast to the western countries (69 years in USA and 71 years in Italy), the mean age of the stroke onset was higher 14 .…”

Section: Discussionsupporting

confidence: 86%

“…Atrial fibrillation was the most common ECG abnormality followed by left ventricular hypertrophy (LVH) which was not similar to the study done in the past which showed ischemic heart disease was common followed by LVH and AF 13 . Similarly another study showed LVH to be the commonest, followed by ischemia and AF, which was also not consistent with our study 12 .…”

Section: Discussioncontrasting

confidence: 76%

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Ischemic stroke: Observations and analysis of stroke patients admitted in a tertiary hospital of Kathmandu

Shakya

Shrestha

Dhungana

et al. 2019

J. Kathmandu Med. Coll.

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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.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 86%

Section: Discussioncontrasting

confidence: 76%

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Ischemic stroke: Observations and analysis of stroke patients admitted in a tertiary hospital of Kathmandu

Shakya

Shrestha

Dhungana

et al. 2019

J. Kathmandu Med. Coll.

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“…25 A multi-center study conducted in Pakistan found that 64% of the population who had suffered a CVA was functionally disabled (mRS≥3). 26 Chandra et al 19 divided the population after a CVA into two groups: under 80 and 80 or older, and found that 74% of elderly people were functionally disabled (mRS≥3).…”

Section: Discussionmentioning

confidence: 99%

Functional disability and associated factors in elderly stroke survivors in Vitória, Brazil

Carmo

Morelato

2016

Rev. bras. geriatr. gerontol.

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Objective: The aim of the present study was to estimate the prevalence of disability and associated factors in elderly stroke survivors. Methods: A cross-sectional study of 230 elderly persons was conducted in the 22 territories of the Estratégia de Saúde da Família (the Family Health Strategy) of Vitória, in the state of Espirito Santo. Patients were assessed using the modified Rankin Scale. Poisson regression with robust variance in crude and adjusted analyses was employed. Results: The majority of subjects were men (52.1%) aged between 60 to 98 years, with a mean age of 75.8 (sd±9.2). The prevalence of disability was 66%. Age ≥80 years, self-perceived limitations in bodily function, considering the physical structure of the street to be a barrier to leaving home and believing street lighting to be insufficient were positively associated with functional disability. Possessing 12 or more years of schooling was inversely associated with the outcome. Conclusions: The high prevalence of disability and associated factors in elderly stroke survivors reinforce the need for a health system that operates continuously and proactively, promoting active aging.

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“…By conducting more sophisticated prospective studies on larger population cohorts, the association between level of HbA1c and risk of ischaemic stroke can be more clearly defined in Pakistani population without diabetes. [19][20][21] CONCLUSIONS Higher HbA1c indicated a significantly increased risk for ischaemic stroke after adjusting for other confounding variables in Pakistani population without diabetes. HbA1c quartile >6% showed eightfold increase in risk of stroke compared to quartile ≤5.3%.…”

Section: Limitationsmentioning

confidence: 93%

High HbA1c is associated with higher risk of ischaemic stroke in Pakistani population without diabetes

et al. 2016

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ContextThe role of glycated haemoglobin (HbA1c) in the prediction of ischaemic stroke in individuals without diabetes is underestimated.AimsWe performed a study to analyse the role of HbA1c in the risk prediction of ischaemic stroke in Pakistani population without diabetes. We further studied the difference between HbA1c values of individuals with diabetes and without diabetes with stroke.Settings and designSingle centre, case–control.Materials and methodsIn phase I, a total of 233 patients without diabetes with ischaemic stroke and 245 as controls were enrolled. Association of HbA1c levels, lipid profiles and blood pressure recordings with ischaemic stroke was analysed. In phase II, comparison was done between diabetics and non-diabetics with stroke.Statistical analysisComparison of the mean variables was performed with Student's t-tests. Logistic regression analysis with ischaemic stroke as the dependent variable was performed for phase I.ResultsIn phase I, the ischaemic stroke group had significantly higher HbA1c levels (5.9±2.9% vs 5.5±1.6%) compared with controls (p<0.05). Triglyceride cholesterol, high-density lipoprotein cholesterol, systolic blood pressure, diastolic blood pressure and HbA1c were the significant determinants of stroke (p<0.05). In phase II, mean HbA1c values were significantly higher in the diabetes group (7.6±2.1 vs 6.1±2.3) (p<0.05) but other parameters were not statistically significantly different (p>0.05).ConclusionsHigher HbA1c indicated a significantly increased risk for ischaemic stroke. An HbA1c value above 5.6% (prediabetic range) predicted future risk of stroke and efforts to maintain glucose level within the normal range (≤5.6%) in individuals with high cardiovascular risk are important.

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Ischemic Strokes in Pakistan: Observations from the National Acute Ischemic Stroke Database

Cited by 15 publications

References 17 publications

Ischemic stroke: Observations and analysis of stroke patients admitted in a tertiary hospital of Kathmandu

Ischemic stroke: Observations and analysis of stroke patients admitted in a tertiary hospital of Kathmandu

Functional disability and associated factors in elderly stroke survivors in Vitória, Brazil

High HbA1c is associated with higher risk of ischaemic stroke in Pakistani population without diabetes

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