Our study has assessed that hypertension followed by diabetes mellitus are the major risk factors for medical complications of hemorrhagic stroke. Female mortality
rate was more when compared to males.
A less-invasive-approach-of-medial-meniscectomy-in-rat-a-model-to-target-earl...science journals
In order for insulin to exert its biological actions on target cells in peripheral tissues like muscle and adipose tissues, Insulin must pass through the endothelial barrier into the interstitium.
BLOOD TRANSFUSIONS ARE ASSOCIATED WITH MORTALITY IN PEDIATRIC PATIENTS WITH S...Texas Children's Hospital
Restrictive thresholds for red blood cell (RBC) transfusion have not been shown to be inferior to liberal transfusion thresholds after cardiac surgery in pediatric or adult patients.1,2
RBC transfusions are associated with readmission due to heart failure (HF) in adults after aortic valve replacements, and with increased risk of right ventricle-pulmonary artery conduit failure in pediatric patients.3,4
Data are limited about RBC transfusions in pediatric patients with HF.
Introduction: Chronic Kidney Disease (CKD) is a worldwide public health problem and it is increasing over time. Cardiovascular disease is a major concern for patients with end stage renal disease, especially those on hemodialysis. It is the leading cause of death among patients with chronic kidney
disease, particularly in dialysis population.
A less-invasive-approach-of-medial-meniscectomy-in-rat-a-model-to-target-earl...science journals
In order for insulin to exert its biological actions on target cells in peripheral tissues like muscle and adipose tissues, Insulin must pass through the endothelial barrier into the interstitium.
BLOOD TRANSFUSIONS ARE ASSOCIATED WITH MORTALITY IN PEDIATRIC PATIENTS WITH S...Texas Children's Hospital
Restrictive thresholds for red blood cell (RBC) transfusion have not been shown to be inferior to liberal transfusion thresholds after cardiac surgery in pediatric or adult patients.1,2
RBC transfusions are associated with readmission due to heart failure (HF) in adults after aortic valve replacements, and with increased risk of right ventricle-pulmonary artery conduit failure in pediatric patients.3,4
Data are limited about RBC transfusions in pediatric patients with HF.
Introduction: Chronic Kidney Disease (CKD) is a worldwide public health problem and it is increasing over time. Cardiovascular disease is a major concern for patients with end stage renal disease, especially those on hemodialysis. It is the leading cause of death among patients with chronic kidney
disease, particularly in dialysis population.
Cardiovascular disease (CVD) reduces the quality of life in patients and remains the leading cause of mortality globally.
Despite a number of preventive strategies for CVD, recommended by multiple scientific societies, there is a clear barrier to their effective implementation.2 In this regard, regular evaluation of the implementation of the CVD prevention guidelines may find the gaps in effective implementation of the guidelines that may help in reducing premature mortality and improving the quality of life in coronary heart patients.
Addressing hypertension to reduce the burden of stroke 19 feb2018 (1)Sudhir Kumar
Hypertension is the commonest risk factor for stroke. Management of hypertension is important in ensuring best outcomes for stroke patients. Adequate control of bP is also important to prevent stroke recurrence. This presentation looks at the role of high BP in stroke occurrence and antihypertensive agents that can be used to achieve target BP.
Journal of Stem Cell Research and Transplantation is an international, open access, peer reviewed, scholarly journal committed to publish articles in diversified fields of transplantations and applications of stem cell research. The aim of the academic journal is to provide a platform for researchers, scientists, physicians, and other health professionals to find latest research information in the areas of stem cell research, transplantations such as stem cell transplantation, transplantation immunology, kidney transplantation and its treatment. It is a wide-ranging Open Access peer reviewed scientific journal that covers multidisciplinary fields.
Journal of Stem Cell Research and Transplantation accepts original research articles, letter to editor, review articles, mini reviews, case reports, editorials, scientific data, technical reports, rapid communication, and short communications, etc. on all the aspects of stem cells. The Journal of Stem Cell Research and Transplantation publishes latest scientific information, and is generously accessible across the world through internet to go halves the innovations of the researchers for intellectual advancement in this field. Austin also brings universally peer reviewed scientific journals under one roof thereby promoting knowledge sharing, collaborative and promotion of multidisciplinary science.
journal club is one of the important academic activity during MD/MS courses. Present PPT is a journal club presented on an article that compare two antihypertensives and the presentation also includes critical analysis of the article.
A brief presentation on the Management of Haemophilia with a focus on bypassing agents. The presentation covers the disease, its available treatment options, intro to bypassing agents, and clinical evidence.
SAM brings the an elite panel of speakers for the Panel Discussion themed
on “The Unfulfilled Dream : Vision behind IITs”.
Panelist -
Dr. D.B. Phatak (Alumni and professor)
Prof. Ali Q Contractor (Moderator)
Satish Joshi (Alumni)
Antariksh Bothale (Young alumni)
Vaibhav pittie (Student Representative)
Date - 7th October | Time - 5pm - 6:30pm | venue - VMCC Main Auditorium
Beyond The Horizons event brings the opportunity to interact with alumni
who prefered unconventional profession and followed their passion in
respective fields such arts, politics, social entrepreneurship,
mountaineering etc.
Alumni Speakers are-
Shazad Wakeel (Founder of Pankhudi NGO and Rang club, IITB)
Derek Monteiro (Painter,musician,poet)
Vasant Limaye (Mountaineer)
Ajit Phadnis (Civic activist)
Ankur Pegu (Health care services)
Sundeep Kapila (studied LLB after IIT)
Date - 6th October | Time - 5pm - 6:30pm | venue - VMCC Main Auditorium
This year, SAM has also expanded to encompass cultural and sports events to
make it a complete festival for students and alumni together. The sports
events are organized on day 1 (4-7PM)in gymkhana and the cultural events
are organized both days at same timing in SAC. In addition to that tech
fair to display the STAB projects is also arranged at VMCC ground floor on
both days from 1 to 5pm.
With events on the lines of placement preparation (Mock Interviews by
Alumni) to open ended fundae session on Power of Innovation, there is a
little something for everyone.
Adding the humor factor, the famous alumni comedian Rivaldo will be
performing in the SAM on Sunday.
Through this blend of versatility this year, SARC wishes to engulf the
entire institute in the various events planned during the course of the
event. We also hope to create strong long lasting bonds between IITians,
both new and old.
Schedule of sessions (open for all):
6th October
Interview fundae Session : 2pm – 3pm
Interactive session on Power of Innovation : 3 30pm - 4 30pm
Beyond The Horizons : 5pm - 6 30pm
7th October
Teach for India session : 2 - 2 45 PM
Performance by Rivaldo : 3 - 4 30 PM
Panel Discussion : 5pm - 6 30pm
Venue: VMCC Main Auditorium
For more details and schedule, please visit http://sam.sarc-iitb.org/
Cardiovascular disease (CVD) reduces the quality of life in patients and remains the leading cause of mortality globally.
Despite a number of preventive strategies for CVD, recommended by multiple scientific societies, there is a clear barrier to their effective implementation.2 In this regard, regular evaluation of the implementation of the CVD prevention guidelines may find the gaps in effective implementation of the guidelines that may help in reducing premature mortality and improving the quality of life in coronary heart patients.
Addressing hypertension to reduce the burden of stroke 19 feb2018 (1)Sudhir Kumar
Hypertension is the commonest risk factor for stroke. Management of hypertension is important in ensuring best outcomes for stroke patients. Adequate control of bP is also important to prevent stroke recurrence. This presentation looks at the role of high BP in stroke occurrence and antihypertensive agents that can be used to achieve target BP.
Journal of Stem Cell Research and Transplantation is an international, open access, peer reviewed, scholarly journal committed to publish articles in diversified fields of transplantations and applications of stem cell research. The aim of the academic journal is to provide a platform for researchers, scientists, physicians, and other health professionals to find latest research information in the areas of stem cell research, transplantations such as stem cell transplantation, transplantation immunology, kidney transplantation and its treatment. It is a wide-ranging Open Access peer reviewed scientific journal that covers multidisciplinary fields.
Journal of Stem Cell Research and Transplantation accepts original research articles, letter to editor, review articles, mini reviews, case reports, editorials, scientific data, technical reports, rapid communication, and short communications, etc. on all the aspects of stem cells. The Journal of Stem Cell Research and Transplantation publishes latest scientific information, and is generously accessible across the world through internet to go halves the innovations of the researchers for intellectual advancement in this field. Austin also brings universally peer reviewed scientific journals under one roof thereby promoting knowledge sharing, collaborative and promotion of multidisciplinary science.
journal club is one of the important academic activity during MD/MS courses. Present PPT is a journal club presented on an article that compare two antihypertensives and the presentation also includes critical analysis of the article.
A brief presentation on the Management of Haemophilia with a focus on bypassing agents. The presentation covers the disease, its available treatment options, intro to bypassing agents, and clinical evidence.
SAM brings the an elite panel of speakers for the Panel Discussion themed
on “The Unfulfilled Dream : Vision behind IITs”.
Panelist -
Dr. D.B. Phatak (Alumni and professor)
Prof. Ali Q Contractor (Moderator)
Satish Joshi (Alumni)
Antariksh Bothale (Young alumni)
Vaibhav pittie (Student Representative)
Date - 7th October | Time - 5pm - 6:30pm | venue - VMCC Main Auditorium
Beyond The Horizons event brings the opportunity to interact with alumni
who prefered unconventional profession and followed their passion in
respective fields such arts, politics, social entrepreneurship,
mountaineering etc.
Alumni Speakers are-
Shazad Wakeel (Founder of Pankhudi NGO and Rang club, IITB)
Derek Monteiro (Painter,musician,poet)
Vasant Limaye (Mountaineer)
Ajit Phadnis (Civic activist)
Ankur Pegu (Health care services)
Sundeep Kapila (studied LLB after IIT)
Date - 6th October | Time - 5pm - 6:30pm | venue - VMCC Main Auditorium
This year, SAM has also expanded to encompass cultural and sports events to
make it a complete festival for students and alumni together. The sports
events are organized on day 1 (4-7PM)in gymkhana and the cultural events
are organized both days at same timing in SAC. In addition to that tech
fair to display the STAB projects is also arranged at VMCC ground floor on
both days from 1 to 5pm.
With events on the lines of placement preparation (Mock Interviews by
Alumni) to open ended fundae session on Power of Innovation, there is a
little something for everyone.
Adding the humor factor, the famous alumni comedian Rivaldo will be
performing in the SAM on Sunday.
Through this blend of versatility this year, SARC wishes to engulf the
entire institute in the various events planned during the course of the
event. We also hope to create strong long lasting bonds between IITians,
both new and old.
Schedule of sessions (open for all):
6th October
Interview fundae Session : 2pm – 3pm
Interactive session on Power of Innovation : 3 30pm - 4 30pm
Beyond The Horizons : 5pm - 6 30pm
7th October
Teach for India session : 2 - 2 45 PM
Performance by Rivaldo : 3 - 4 30 PM
Panel Discussion : 5pm - 6 30pm
Venue: VMCC Main Auditorium
For more details and schedule, please visit http://sam.sarc-iitb.org/
Strongyloidiasis after corticosteroid therapy: A case reportPavan Lomati
Strongyloides hyperinfection requires prompt diagnosis and initiation of antihelmintic therapy. Even with appropriate therapy, the mortality in disseminated Strongyloidiasis is much higher. In light of this, appropriate screening of high risk individual should be carried out prior to the initiation of therapy that is associated with immunosuppression.
Don’t Support the Death of OUR Warm Mineral Springs
By supporting or not understanding the strategy of Local Economic Insiders and current WMS Management you will in effect be supporting the death of Warm Mineral Springs.
By supporting or not opposing the views of the North Port Area Chamber of Commerce, you will help to subvert the real issues.
http://warmmineralsprings2.blogspot.com/
friendsofwarmmineralsprings@gmail.com
Don’t believe the articles in local papers influenced
by the same Economic Insiders whose REAL AGENDA IS NOT THE PROTECTION & PRESERVATION OF THE SPRINGS.
The emotion, of anger is something we encounter in our dealings with others and as a reaction to certain events. Knowing if how we respond when we are angry is appropriate or if we need to master some anger management techniques can sometimes be difficult to determine, partly because it is human nature to reject the notion that we may have a problem with how we behave. Your first clue may be hearing some of these phrases from those around you: “You need to watch your temper buddy!!” …
http://nuhopecare.com
Deep vein thrombosis prophylaxis in a tertiary care center: An observational ...Apollo Hospitals
Deep vein thrombosis (DVT) is a major health problem with substantial mortality and morbidity in medically ill patients. Prevention of DVT by risk factor stratification and subsequent antithrombotic prophylaxis in moderate- to severe-risk category patients is the most rational means of reducing morbidity and mortality.
Les comparto la publicación del estudio Xatoa
Nosotros en la Clínica de Mérida participamos como investigadores en el reclutamiento y análisis de datos de los pacientes de nuestra consulta diaria quienes han recibido el beneficio de la Terapia de Inhibición de Doble Vía.
Es un gusto enorme contribuir al desarrollo del conocimiento médico global 🌎
Comparison of Infection Episodes in CKD Patients with or without Hemodialysis...ijtsrd
Chronic kidney diseases CKD is a progressive and irreversible deterioration of renal function. Patients with CKD are prone to a variety of infections. Further chronic hemodialysis increases the infections and related morbidity and mortality. The present study was conducted to assess the probability of infection episode in CKD patients in patients with or without haemodialysis. A Cross sectional observational study was conducted with a total 56 patients with CKD. Clinical and biochemical data related to infections were collected from the individual patient records. The results showed that the chills and rigors, increased TLC, and elevated ESR were found to more in CKD patients on chronic haemodialysis. Further, our results suggested that CKD patient population showed increased-risk for the development of lethal sepsis. Hence, identification of the causes of infection and the appropriate treatment based on the severity of symptoms are essential for CKD patients who are on dialysis. Punit Gupta | Swati Sharma | Ashish Deo "Comparison of Infection Episodes in CKD Patients with or without Hemodialysis from Tribal Population" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-3 | Issue-1 , December 2018, URL: http://www.ijtsrd.com/papers/ijtsrd19000.pdf
http://www.ijtsrd.com/medicine/other/19000/comparison-of-infection-episodes-in-ckd-patients-with-or-without-hemodialysis-from-tribal-population/punit-gupta
Unit 8 - Information and Communication Technology (Paper I).pdfThiyagu K
This slides describes the basic concepts of ICT, basics of Email, Emerging Technology and Digital Initiatives in Education. This presentations aligns with the UGC Paper I syllabus.
The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
For more information, visit-www.vavaclasses.com
Welcome to TechSoup New Member Orientation and Q&A (May 2024).pdfTechSoup
In this webinar you will learn how your organization can access TechSoup's wide variety of product discount and donation programs. From hardware to software, we'll give you a tour of the tools available to help your nonprofit with productivity, collaboration, financial management, donor tracking, security, and more.
Instructions for Submissions thorugh G- Classroom.pptxJheel Barad
This presentation provides a briefing on how to upload submissions and documents in Google Classroom. It was prepared as part of an orientation for new Sainik School in-service teacher trainees. As a training officer, my goal is to ensure that you are comfortable and proficient with this essential tool for managing assignments and fostering student engagement.
Read| The latest issue of The Challenger is here! We are thrilled to announce that our school paper has qualified for the NATIONAL SCHOOLS PRESS CONFERENCE (NSPC) 2024. Thank you for your unwavering support and trust. Dive into the stories that made us stand out!
How to Make a Field invisible in Odoo 17Celine George
It is possible to hide or invisible some fields in odoo. Commonly using “invisible” attribute in the field definition to invisible the fields. This slide will show how to make a field invisible in odoo 17.
Palestine last event orientationfvgnh .pptxRaedMohamed3
An EFL lesson about the current events in Palestine. It is intended to be for intermediate students who wish to increase their listening skills through a short lesson in power point.
Synthetic Fiber Construction in lab .pptxPavel ( NSTU)
Synthetic fiber production is a fascinating and complex field that blends chemistry, engineering, and environmental science. By understanding these aspects, students can gain a comprehensive view of synthetic fiber production, its impact on society and the environment, and the potential for future innovations. Synthetic fibers play a crucial role in modern society, impacting various aspects of daily life, industry, and the environment. ynthetic fibers are integral to modern life, offering a range of benefits from cost-effectiveness and versatility to innovative applications and performance characteristics. While they pose environmental challenges, ongoing research and development aim to create more sustainable and eco-friendly alternatives. Understanding the importance of synthetic fibers helps in appreciating their role in the economy, industry, and daily life, while also emphasizing the need for sustainable practices and innovation.
This is a presentation by Dada Robert in a Your Skill Boost masterclass organised by the Excellence Foundation for South Sudan (EFSS) on Saturday, the 25th and Sunday, the 26th of May 2024.
He discussed the concept of quality improvement, emphasizing its applicability to various aspects of life, including personal, project, and program improvements. He defined quality as doing the right thing at the right time in the right way to achieve the best possible results and discussed the concept of the "gap" between what we know and what we do, and how this gap represents the areas we need to improve. He explained the scientific approach to quality improvement, which involves systematic performance analysis, testing and learning, and implementing change ideas. He also highlighted the importance of client focus and a team approach to quality improvement.
Basic phrases for greeting and assisting costumers
Risk factors for medical complications of acute hemorrhagic stroke
1. This article appeared in a journal published by Elsevier. The attached
copy is furnished to the author for internal non-commercial research
and education use, including for instruction at the authors institution
and sharing with colleagues.
Other uses, including reproduction and distribution, or selling or
licensing copies, or posting to personal, institutional or third party
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basis until discharge from the hospital. Eligible patients had seen
and consecutively approached for enrollment, with a target
enrollment of 20 patients from all departments. We excluded
patients with trauma, brain tumor as the cause of hemorrhage
and patient with incomplete follow-ups. Evidence or clinical
suspicions of ischemic stroke patients were also excluded. Each
participating site obtained institutional review board approval
before the study initiation, and each patient provided written
informed consent prior the enrollment. Duration of study
participation for each patient was a single site visit. Enrolled
patients had clinical and laboratory information abstracted from
their medical records by office staff. We utilized a data collec-
tion form to assess risk factors and monitor the incidence of
complications. Information abstracted from the chart included:
sex, age, race, date of recruitment, diabetes, hypertension, hy-
percholesterolemia, elevated triglyceride levels, low density li-
poprotein, current smoker and significant alcohol intake.
Glasgow Coma Scale and modified Rankin scale were also
recorded.
Following the work by Langhorne et al., modified predefined
complications were utilized to monitor the occurrence of com-
plications (Table 2)[3]
. These complications monitored on daily
by the physician. The selected potentially life threatening
complications are as follows: acute congestive aspiration
pneumonia, cardiac arrhythmias, chest infections, deep vein
thrombosis, epileptic seizure, falls, heart failure, pulmonary
embolism and recurrent stroke. The patient's condition,
whether he survived or succumbed to his illness, was noted
upon discharge.
3. Results
Two hundred and eighty eight consecutive patients recruited
from all departments. There were 152 (52.8%) males. Mean age
was (71.0 ± 9.2) years and 218 (75.7%) had their first-ever
stroke. Most of these patients were in the age group of 60–80
years (Figure 1). One hundred and twenty three (42.7%) patients
admitted to a general neurology, 89 (31%) to an emergency
ward and 76 (26.4%) to a general medical ward.
3.1. Risk factors for admission
On admission, the following risk factors were noted among
the subjects: hypertension in 217 (75.35%), diabetes mellitus in
76 (26.39%), alcohol consumption > 30 g/day in 88 (30.56%)
and current cigarette smoking in 92 (31.94%). One hundred and
eighty nine (65.6%) had a Glasgow Coma Scale score 8. A
total of 257 patients (89.23%) experienced at least 1 prespecified
Table 1
Risk factors for stroke.
Classification Factors
Sociodemographic Age
Sex: slightly higher risk in men
Ethnicity: higher risk in African
Caribbean and South Asian
populations
Socio-economicstatus: increasing
deprivation is associated with
increased risk
Biological Raised blood pressure: doubling in
risk of death from stroke for every
10 mmHg increase in diastolic blood
pressure or 20 mmHg increase in
systolic blood pressure
Hyper cholesterolaemia
Hyper homocysteinaemia
Lifestyle Smoking: 50% increase in risk
Excessive alcohol consumption:
50%–100% increase in risk
Physical inactivity: 2.5-fold increase
in risk
Diet: obesity; low potassium; high
salt; low fruit and vegetable intake
Other conditions Diabetes mellitus: doubling of risk
Atrial fibrillation: 5-fold increase in
risk
Ischemic heart disease: doubling in
risk
Cardiac sources of thrombo-
embolism
Hematological disorders: sickle cell
disease; raised packed cell volume;
hypercoagulability
Carotid artery stenosis
Migraine
Other factors Oral contraception: doubling of risk
Hormone replacement therapy:
doubling of risk
Major life events
Influenza and other intercurrent
infections
Table 2
Modified predefined complications.
Complications Follow-up in hospital
Neurological Recurrent stroke Clinical features lasting more than 24 h consistent with World Health
Organization definition of stroke.
Epileptic seizure Clinical diagnosis of focal and/or generalized seizure in a previously
nonepileptic patient.
Infection Urinary tract infection Clinical symptoms of urinary tract invention or positive urine culture.
Chest infection Auscultatory respiratory crackles and fever or radiographic evidence, or new
purulent sputum.
Other infection Any pyrexial illness lasting more than 24 h.
Immobility Falls Any documented falls regardless of cause.
Pressure sore/skin break Any skin break or necrosis resulting form either pressure or trivial trauma.
Psychological Depression Low mood considered to interfere with daily activities or require
pharmacological or psychiatric intervention.
Miscellaneous Any documented complication resulting in a specific medical or surgical
intervention (e.g. Gastrointestinal hemorrhage, constipation, episodes of
cardiac failure, cardiac arrhythmias and arthritis).
Jangala Mohan Sidhartha et al./Journal of Acute Disease 2015; 4(3): 222–225 223
4. Author's personal copy
risk factor for their admission in hospital. The main risk factors
showed in Table 3. Among these hypertension is a major risk
factor for causing stroke, the proportion of hypertension in HS
patients showed in Table 4 (along with summary results from
previous retrospective of HS patients).
3.2. Complications in hospital
A total of 216 (75%) complications were seen in this cohort
of patients. Among the neurological complications, 36
(12.50%) patients developed recurrent stroke and 24 (8.33%)
had epileptic seizure. Among the non-neurologic complica-
tions, the most commonly encountered were diabetes, con-
stipation, and chest infections with a rate of 11%, 7.63%, and
6.25% respectively.
Recurrent stroke and seizure were more frequent during the
first week. Chest infection was the most common complication
during the entire two weeks of observation, with a peak inci-
dence during the first week. The main complications of our
study showed in Table 5.
3.3. Mortality
One hundred and fifty two (52.78%) were discharged alive
and 136 (47.2%) died during confinement. Most of these deaths
occurred during the first week from admission. Among 87 (64%)
were females in the age group of 50–80 years shown in Figure 2.
4. Discussion
This study conducted among the patients attending in RIMS,
Kadapa to ascertain the risk factors for causing complications of
HS in adults. Out of 288 patients male ratio was slightly
increased when compared to women, similarly in a cohort study
showed 57% male ratio[4]
. Most people fall in the age group of
60–80 years.
4.1. Risk factors
Hypertension is a major risk factor common to both coro-
nary heart disease and stroke, in our study the rate was 75.34%.
There is prolific evidence, both from cohort studies and case–
control studies, shows that hypertension is the single most
important risk factor for intracerebral hemorrhage[9,10]
. Out of
217 hypertension patient shows 203 patients were having
blood pressure 160/90 shows almost 7 fold increased risk
for HS when compared to normotensives. Similarly a meta-
analysis showed that self-reported hypertension or a
measured blood pressure of 160/90 increased the risk of ICH
more than nine fold[9]
. The proportion of hypertension in our
study was more in women but in a study the rate was very
similar in men[11]
.
Diabetes mellitus, smoking and alcohol were showing similar
risk for HS. Smoking studies have consistently shown tobacco
Figure 1. Patient distribution based on age group.
Table 3
Risk factors in HS patients.
Risk factor Number Percentage (%)
Hypertension 217 75.35
Diabetes mellitus 76 26.39
Smoker 92 31.94
Alcohol 88 30.56
Obese 16 5.55
Table 4
Proportion of hypertension among HS.
Hypertension
in current
study [n (%)]
Hypertension from
pervious retrospective
study (%)
(Syed Zulfiquar AS et al.)
Men (n = 152) 105 (69.07) 62.1
Women (n = 136) 112 (82.70) 64.7
Table 5
Complications after admission in hospital.
Complication Number Percentage
Recurrent stroke 36 12.50
Epileptic seizure 24 8.33
Fall 65 22.57
Pain 12 4.17
Depression 8 2.78
Loss of muscle control/paralysis 112 38.89
Speech problems 103 35.76
Swallowing problems 63 21.88
Deaths 136 47.22
Diabetes mellitus 32 11.11
Hypertension 11 3.82
Constipation 22 7.63
Urinary tract infection 13 4.51
Chest infection 18 6.25
22
24
32
56
29
0
10
20
30
40
50
60
50 -60 60-70 70-80
Male Female
Figure 2. Distribution of HS mortality.
Jangala Mohan Sidhartha et al./Journal of Acute Disease 2015; 4(3): 222–225224
5. Author's personal copy
use as a risk factor for ICH, though the effect size is not as large
as for hypertension[12,13]
. There is compelling evidence relating
high alcohol intake with a higher risk of ICH[10,12]
.
4.2. Complications
In our study the complications after occurrence of stroke was
75%, similarly earlier studies have demonstrated that compli-
cations after the occurrence of stroke showed range from 40% to
96%[5,8]
. Among these death (47.2%), loss of muscle control
(38.9%) and speech problem (35.7%) were the major
complications following occurrence of stroke. Our findings
that approximately 8.33% of patients were shows seizures
after admission in hospital, similarly some studies reported
range from 1.4% to 17%[14]
. Hypertension and diabetes
mellitus were the major comorbid conditions in our study.
4.3. Mortality
Patients with HS are generally at high risk for mortality[15,16]
.
In our study the mortality rate was 47.2%. The mortality rate
was high in our study, when compared to other studies the
ranges from 7.6% to 30%[17]
. Hematoma expansions, edema
formation, and intra-ventricular hemorrhage leading to
increased intracranial pressure are likely contributors to the
acute excess mortality[18–20]
.
In adults hypertension followed by diabetes mellitus are the
major risk factors for medical complications of HS. Female
mortality rate was more in hemorrhagic stroke compared to men.
Females are more prone to hemorrhagic stroke because of high
risk of hypertension.
Conflict of interest statement
The authors report no conflict of interest.
Acknowledgements
The authors are grateful to staffs of Rajiv Gandhi Institute of
Medical Sciences for their contribution and help.
References
[1] Gorelick PB, Testai F, Hankey G, Wardlaw JM. Hankey's clinical
neurology. 2nd ed. Boca Raton: CRC Press; 2014.
[2] Ganti L, Jain A, Yerragondu N, Jain M, Bellolio MF, Gilmore RM,
et al. Female gender remains an independent risk factor for poor
outcome after acute nontraumatic intracerebral hemorrhage. Neurol
Res Int 2013; http://dx.doi.org/10.1155/2013/219097.
[3] Mant J, Walker MF, editors. ABC of stroke. Hoboken: John Wiley
Sons, Ltd. Publication; 2011, p. 1-25.
[4] Navarro JC, Bitanga E, Suwanwela N, Chang HM, Ryu SJ,
Huang YN, et al. Complication of acute stroke: a study in ten Asian
countries. Neurol Asia 2008; 13: 33-9.
[5] Indredavik B, Rohweder G, Naalsund E, Lydersen S. Medical
complications in a comprehensive stroke unit and an early sup-
ported discharge service. Stroke 2008; 39: 414-20.
[6] Ji R, Wang D, Shen H, Pan Y, Liu G, Wang P, et al. Interrela-
tionship among common medical complications after acute stroke
pneumonia plays an important role. Stroke 2013; 44: 3436-44.
[7] Rocco A, Pasquini M, Cecconi E, Sirimarco G, Ricciardi MC,
Vicenzini E, et al. Monitoring after the acute stage of stroke: a
prospective study. Stroke 2007; 38: 1225-8.
[8] Ingeman A, Andersen G, Hundborg HH, Svendsen ML,
Johnsen SP. Processes of care and medical complications in pa-
tients with stroke. Stroke 2011; 42: 167-72.
[9] O'Donnell MJ, Xavier D, Liu L, Zhang H, Chin SL, Rao-
Melacini P, et al. Risk factors for ischaemic and intracerebral
haemorrhagic stroke in 22 countries (the Inter-Stroke study): a
case–control study. Lancet 2010; 376(9735): 112-23.
[10] Zhang YD, Bayoumy IE, Zhang YH, Yang HJ, Liu J. Risk factors
and predictors of early mortality after acute stroke: hospital based
study. Glo Adv Res J Med Med Sci 2014; 3(6): 111-6.
[11] Shahab F, Irfan MS, Shuaib A, Syed ZAS. Hemorrhagic stroke;
frequency of hypertension, diabetes and smoking in patients. Prof
Med J 2014; 21(6): 1204-8.
[12] Zhang Y, Tuomilehto J, Jousilahti P, Wang Y, Antikainen R,
Hu G. Lifestyle factors on the risks of ischemic and hemorrhagic
stroke. Arch Intern Med 2011; 171(20): 1811-8.
[13] Andersen KK, Olsen TS, Dehlendorff C, Kammersgaard LP.
Hemorrhagic and ischemic strokes compared: stroke severity,
mortality, and risk factors. Stroke 2009; 40(6): 2068-72.
[14] Yang TM, Lin WC, Chang WN, Ho JT, Wang HC, Tsai NW, et al.
Predictors and outcome of seizures after spontaneous intracerebral
hemorrhage. Clinical article. J Neurosurg 2009; 111: 87-93.
[15] Connolly ES Jr, Rabinstein AA, Carhuapoma JR, Derdeyn CP,
Dion J, Higashida RT, et al. Guidelines for the management of
aneurysmal subarachnoid hemorrhage: a guideline for healthcare
professionals from the American Heart Association/American
Stroke Association. Stroke 2012; 43: 1711-37.
[16] Morgenstern LB, Hemphill JC III, Anderson C, Becker K,
Broderick JP, Connolly ES, et al. Guidelines for the management
of spontaneous intracerebral hemorrhage: a guideline for healthcare
professionals from the American Heart Association/American
Stroke Association. Stroke 2010; 41: 2108-29.
[17] Khan SN, Vohra EA. Risk factors for stroke: a hospital based
study. Pak J Med Sci 2007; 23(1): 17-22.
[18] Broderick J, Connolly S, Feldmann E, Hanley D, Kase C,
Krieger D, et al. Guidelines for the management of spontaneous
intracerebral hemorrhage in adults 2007 update: a guideline from
the American Heart Association/American Stroke Association
Stroke Council, High Blood Pressure Research Council, and the
Quality of Care and Outcomes in Research Interdisciplinary
Working Group. Stroke 2007; 38: 2001-23.
[19] Ferro JM. Update on cerebral haemorrhage. J Neurol 2006; 253:
985-99.
[20] H¨anggi D, Steiger HJ. Spontaneous intracerebral haemorrhage in
adults: a literature overview. Acta Neurochir (Wien) 2008; 150(4):
371-9.
Jangala Mohan Sidhartha et al./Journal of Acute Disease 2015; 4(3): 222–225 225