Common Type Of Stroke Research Articles

Association between hemoglobin A1c and acute ischemic stroke among patients with type-2 diabetes: a case-control study

At present, stroke is a major health burden and the leading cause of death and long-term disability in the elderly. Ischemic stroke is the most common stroke type in the Thai population. Causes of ischemic stroke are likely to be multifactorial. The purpose of this study was to determine the association between hemoglobin A1c (HbA1c) and acute ischemic stroke (AIS) among Thai patients with type-2 diabetes (PTDs). A hospital-based case-control study was conducted among PTDs attending the Bhuddasothorn hospital with 100 cases and 300 controls from 2013 to 2016. Cases were defined as PTDs who had an AIS and diagnosed by neurologists and computed tomography (CT) scan and controls were PTDs who did not have AIS. Cases and controls were matched by gender, age (± 5 years), residential area, and attending duration. Data were collected using a questionnaire comprising 2 parts: demographic characteristics and medical data. Conditional logistic regression was applied to estimate the effect of HbA1c on acute ischemic stroke among PTDs. Univariable conditional logistic regression showed risk factors for AIS among the PTDs comprised history of dyslipidemia, history of atrial fibrillation, diastolic blood pressure, systolic blood pressure, HbA1c, history of CVD, FPG, creatinine, and microvascular complications (p < 0.05). For multivariable conditional logistic regression, after controlling for potential confounders, it revealed a HbA1c of 8–8.9% and higher increased the risk of AIS by a factor of 7.9 and 10.9 times, respectively (OR = 7.9, 95%CI = 3.0–20.9; OR = 10.9, 95%CI = 4.3–27.9). Ongoing surveillance of HbA1c among PTDs should be conducted alongside knowledge sharing of glycemic control and stroke prevention as an essential measure to prevent developing AIS risk.

Correlation of Smoking and National Institutes of Health Stroke Scale (NIHSS) in Acute Ischemic Stroke Patients

Background: Ischemic stroke is the most common type of stroke with 87.00% prevalence of atherosclerosis as one of the causes of cerebral vascular lumen occlusion. Smoking is known as a modifiable risk factor for stroke. The process of atherosclerosis leads to a neurological deficit resulting in impairment of the patient. One of the scales used to assess impairment is the National Institutes of Health Stroke Scale (NIHSS).Objectives: To know the correlation between smoking status and functional degree of acute ischemic stroke patients as measured by NIHSS.Method: The subjects were 48 patients. The study design was cross-sectional and clinical sampling consecutive admissions and an acute ischemic stroke image imaging. Smoking status data was obtained through anamnesis at the time the patient was hospitalized supported by the testimony of the immediate family. NIHSS values were obtained on the first day of hospitalization. Data analysis used chi-square test and logistic regression.Result: Sex (p = 0.001) and smoking (p = 0.013) were variables that had significant correlations with NIHSS. There was no association between smoking and the functional degree of acute ischemic stroke patients measured by NIHSS, (p = 0.57) with Adjusted Odds Ratio 1.5 (CI 95% 0.35 - 6.9).Conclusion: There was no significant association between smoking with functional degree of acute ischemic stroke patients as measured by NIHSS.

A PROSPECTIVE STUDY ON CLINICAL PROFILE OF STROKE PATIENTS ATTENDING IN A TERTIARY CARE HOSPITAL OF GUWAHATI, ASSAM.

Cerebrovascular disease include most common devastating disorders :ischaemic stroke and haemorrhagic stroke.The incidence of cerebrovascular disease increases with age and the number of strokes is projected to increase as the elderly population grows.A stroke is the second leading cause of death worldwide. Some of the Indian studies have shown a stroke prevalence of 471.58/100000 population. OBJECTIVE:To study the clinical presentation, risk factors,neurological presentation,pattern of brain strokes,areas of brain affected as per CT/MRI Brain scan findings in a newly admitted patients in GNRC Institute of Medical Sciences, North Guwahati,Assam. METHODS:This is a prospective study included all new patients with stroke admitted in ICU and Ward under Neurology Department of GNRC institute of Medical Sciences ,North Guwahati,Assam,from 1st August,2018 to 31st July ,2019. RESULTS: The cerebrovascular strokes are more common in males (64.4%) than females (35.6%). Most common age group was 58-67 years (28.29%).Most common clinical feature was hemiplegia (71.21%).Most common risk factor was Hypertension (89.51%) followed by diabetes mellitus(51.70%) . Most common type of stroke was haemorrhagic (60.24%) followed by ischaemic (39.75%). In stroke infarct most common involved areas were parietal (13.65%). In hemorrhagic stroke most common site was basal ganglia (21.95%) followed by thalamus (10.97%). CONCLUSION: Males were more commonly affected with cerebrovascular accident with hypertension was the most common risk factor among the stroke patients and most common type of stroke was haemorrhagic.

Risk Factors Associated with Outcomes of Recombinant Tissue Plasminogen Activator Therapy in Patients with Acute Ischemic Stroke

Ischemic stroke is the most common type of stroke, and early interventional treatment is associated with favorable outcomes. In the guidelines, thrombolytic therapy using recombinant tissue-type plasminogen activator (rt-PA) is recommended for eligible patients with acute ischemic stroke. However, the risk of hemorrhagic complications limits the use of rt-PA, and the risk factors for poor treatment outcomes need to be identified. To identify the risk factors associated with in-hospital poor outcomes in patients treated with rt-PA, we analyzed the electronic medical records of patients who were diagnosed with acute ischemic stroke and treated for rt-PA at Chang Gung Memorial Hospitals from 2006 to 2016. In-hospital death, intensive care unit (ICU) stay, or prolonged hospitalization were defined as unfavorable treatment outcomes. Medical history variables and laboratory test results were considered variables of interest to determine risk factors. Among 643 eligible patients, 537 (83.5%) and 106 (16.5%) patients had favorable and poor outcomes, respectively. In the multivariable analysis, risk factors associated with poor outcomes were female gender, higher stroke severity index (SSI), higher serum glucose levels, lower mean corpuscular hemoglobin concentration (MCHC), lower platelet counts, and anemia. The risk factors found in this research could help us study the treatment strategy for ischemic stroke.

Clinical profile of patients with stroke in a tertiary hospital setting in rural Telangana

Background: Stroke is the second leading cause of death and the third leading cause of disability across the world. The understanding of stroke in a clinical setting is what we wanted to achieve as there is a very scarce amount of data present in India when it comes to vascular diseases, especially the rural part of India. Aims and Objectives: The aims of the study were (1) to study the clinical profile of stroke and (2) to study the prescribing pattern of drugs in stroke patients attending a tertiary care hospital in rural Telangana. Materials and Methods: A retrospective case sheet-based study was conducted in a tertiary care institute from January 01, 2015, to July 31, 2016. The approval for the study was obtained from the Institutional Ethics Committee. Results: Of the total 155 stroke case sheets analyzed, the majority had an ischemic stroke (91.61%). The incidence of stroke was more in the 50–70 years age group with male preponderance. The most commonly involved area and presentation were capsuloganglionic region and hemiparesis (75.48%), respectively. About 97.89% of ischemic stroke patients were treated by antiplatelet agents (aspirin – 66.2% and clopidogrel – 31.69%). All the hemorrhagic stroke patients were managed by mannitol. The most commonly prescribed antihypertensives medications were calcium channel blockers (55.45%). Conclusion: Ischemic stroke is the most common type of stroke with increased occurrence in the age group of the 5th–7th decade and male preponderance. Capsuloganglionic infarction or hemorrhage was the most common radiological finding with hemiparesis being the most common presentation. Antiplatelet agents (aspirin and clopidogrel) and mannitol were prescribed in ischemic and hemorrhagic stroke, respectively.

Causes and Secondary Prevention of Acute Ischemic Stroke in Adults.

Stroke still remains a major cause of death and disability worldwide. Ischemic stroke is the most common type of stroke. Causes of ischemic stroke can be classified into large-artery atherosclerosis, cardiogenic embolism, small-vessel disease, stroke of other determined etiology, and stroke of undetermined etiology. Stroke causes in adults are mainly attributable to classical cardiovascular risk factors such as hypertension, diabetes, hypercholesterolemia, and smoking. In neuroimaging, stroke subtypes can be defined according to lesion localization and distribution (territorial infarct, lacunar infarct, hemodynamic infarct), which provide information as to the underlying etiology. Acute stroke management comprises rapid neurological assessment and rapid imaging to initiate effective reperfusion treatment with intravenous thrombolysis and mechanical thrombectomy. Stroke survivors are at increased risk of recurrent stroke. Therefore, diagnosis of the underlying cause and optimal secondary prevention is of importance. Pharmacologic secondary prevention includes antithrombotic therapy with antiplatelet drugs, oral anticoagulation, and treatment of vascular risk factors. Nonpharmacologic measures of secondary prevention comprise surgical or interventional revascularization of symptomatic carotid stenosis and interventional closure of patent foramen ovale.

Effect of Different Doses and Times of FK506 on Different Areas of the Hippocampus in the Rat Model of Transient Global Cerebral Ischemia-Reperfusion.

Background Stroke is a major worldwide problem that is leading to a high mortality rate in humans. Ischemia, as the most common type of stroke, is characterized by tissue damage that can occur due to insufficient blood flow to the brain even for a brief duration, leading to the release of inflammatory factors, cytokines, and free radicals. In this study, we investigated the effective dose and injection time of FK506 as an immunophilin ligand for providing a suitable effect on cells of CA2, CA3, and dentate gyrus of the hippocampus. Methods In this in vivo study, a total of 48 male Wistar rats were divided into nine groups. The ischemia model was induced by the ligation of bilateral common carotid arteries. The doses of FK506 (3, 6, and 10 mg/kg) were administered intravenously (IV) at the beginning of reperfusion, followed by repeated injections (10 mg/kg) at 6, 24, 48, and 72 hours after ischemia, respectively. Brains were removed and prepared for Nissl staining and the TdT-mediated dUTP Nick End Labeling method. Results Data showed that global ischemia did not decrease the number of viable pyramidal cells in CA2 and CA3 regions, but significant differences were observed in the number of viable granular cells and apoptotic bodies in the dentate gyrus between the control and ischemia groups. Repeated doses of 6 mg/kg of FK506 at an interval of 48 hours were deemed to be the suitable dose and best time of injection. Conclusions It seems that FK506 can ameliorate the extent of apoptosis and may be a good candidate for the treatment of ischemia-induced brain damage.

Management of Acute Ischemic Stroke

AbstractAcute ischemic stroke (AIS) is a time-sensitive neurological emergency and it remains to be the most common type of stroke. Rapid neuroimaging is the cornerstone for initiating time-sensitive interventions in the treatment of AIS. Revascularization therapies that were once considered irreversible, including intravenous thrombolysis (IVT) and endovascular treatment (EVT), administered in a timely fashion have revolutionized the treatment of AIS. The indications for these therapies have expanded over the past few years and a lot of advancements are happening every year. IVT is offered to all eligible patients presenting within 3 hours of symptom onset and up to 4.5 hours with additional criteria. EVT with stent retrievers or aspiration devices, once limited to the first 6 hours of stroke onset, is now being offered up to 24 hours with advanced image-guided patient selection, which includes a computed tomography or magnetic resonance perfusion imaging. A protocol-based approach to the management of stroke, beginning from prehospital care reduces the time delay in the initiation of treatment. Providing access to these therapies by creating systems of care, hospital stroke team, and “stroke codes” improves the outcome of patients with AIS.

Forsythiaside A protects against focal cerebral ischemic injury by mediating the activation of the Nrf2 and endoplasmic reticulum stress pathways.

Ischemic stroke is a common type of stroke with a high mortality and morbidity rate. Preventing and controlling cerebral ischemic injury is particularly important. Forsythiaside A (FA) has been reported to have anti‑inflammatory and antioxidant activities. The aim of the present study was to explore the impact of FA on middle cerebral artery occlusion (MCAO)‑induced cerebral ischemic injury in rats. The results indicated that FA markedly increased the percent survival and decreased the neurological deficit score in rats with cerebral ischemic injury. Furthermore, cell apoptosis was significantly inhibited by FA administration, which was accompanied by decreased caspase‑3 and caspase‑9 expression. A marked increase in the expression levels of nuclear factor‑erythroid 2‑related factor 2 (Nrf2), NAD(P)H quinone dehydrogenase 1 and glutathione‑s‑transferase was detected in FA‑treated rats. In addition, treatment with FA reduced malonaldehyde expression, and enhanced the expression of superoxide dismutase and glutathione. Furthermore, endoplasmic reticulum (ER) stress was vastly alleviated by FA treatment, as evidenced by the increased expression of B‑cell lymphoma 2, apoptosis regulator and the downregulated expression of phosphorylated (phospho)‑protein kinase RNA‑like ER kinase (PERK)/PERK, phospho‑inositol‑requiring enzyme 1 (IRE1α)/IRE1α and CCAAT‑enhancer‑binding proteins homologous protein. Taken together, the present study demonstrated that FA attenuated cerebral ischemic damage via mediation of the activation of Nrf2 and ER stress pathways. These data may provide ideas for novel treatment strategies of cerebral ischemic damage.

PREVALENCE OF RISK FACTORS ASSOCIATED WITH STROKE

Objective: To assess the most common type of stroke and to determine the rateof different risk factors of stroke. Methodology: This cross sectional study was conducted at Armed ForcesInstitute of Rehabilitation Medicine, Rawalpindi, from 1st July to 31st December2016. The study included patients with acute or chronic stroke of either type i.einfarct or hemorrhagic stroke. Pre planned questionnaire including severalvariables like age, gender, type of stroke, area involved, side of hemiplegia andknown risk factors of stroke like hypertension, diabetes mellitus, cardiacdiseases, smoking, stress, sedentary life style and family history was recorded.Sampling was done by consecutive non-probability technique. The data wascollected and analyzed using SPSS-20. Results: Among 100 stroke patients 65% were males. The mean age was 20 to60 years. About 75% had ischemic stroke while 25% had hemorrhagic stroke.Among all stroke patients 64% had sedentary life style. 34% patients had familyhistory of stroke, 71% had hypertension, 52% had diabetes mellitus and 35%males had habit of smoking. Of all 68% patients had MCA lesion, 7% had PCAlesion and 25% had ACA lesion, 33% had cardiac problems and stress wasamong 31% patients. Conclusion: Our study explored that risk factors for stroke are advanced age,sedentary life style and associated diseases like hypertension and diabetesmellitus. Key Words: Prevalence, Stroke, Risk factors

Malignant Cerebral Venous Infarction: Decompressive Craniectomy versus Medical Treatment

Cerebral venous thrombosis (CVT) is a common type of stroke in young adults and associated with 8% mortality. High intracranial pressure (ICP) and brain herniation are the most common causes of death in these patients. In contrast with malignant arterial middle cerebral infarction, there are few studies reporting the efficacy of decompressive craniectomy (DC) for treatment of high ICP in patients with CVT. In this study, we assess the clinical outcome of patients with CVT with impending brain herniation treated with DC versus medical management. In this retrospective study, medical records of all patients with CVT admitted to our hospital were reviewed. Patients with the following inclusion criteria were entered into the study: 1) CVT proven by contrast-enhanced magnetic resonance venogram and/or computed tomography venogram, 2) malignant CVT (impending brain herniation according to imaging and clinical finding), and 3) age between 16 and 80 years. Patients with deep venous system thrombosis, Glasgow Coma Scale (GCS) score of 3, and bilateral nonreactive midposition pupils or mydriasis on admission were excluded. Patients were classified into 2 groups: surgical group (DC group) including patients who received medical treatment and DC and medical group (MG) including patients who received only medical treatment. Outcomes and complications were assessed and compared between the 2 groups. Of 357 patients with CVT hospitalized in our center, 48 patients entered into the study. Twenty-three patients were managed medically, and 25 patients were managed surgically. There was no significant difference between the groups concerning age, sex, presenting symptoms, transient and permanent risk factors of CVT, GCS score on admission, and pupils' reactivity on admission. All patients in the MG died during hospitalization in comparison with 8 patients in the DC group (100% vs. 32%, P< 0.001). Favorable outcome (modified Rankin scale score 0-2) was achieved in 52% of the DC group and 0% of the MG group (P < 0.001). The results of our study confirmed that in contrast with DC, medical treatment could not prevent transtentorial herniation. DC is not only lifesaving for patients with CVT with impending brain herniation but also results in favorable outcome in most patients.

HIV infection does not influence stroke outcomes in HIV-infected patients: A prospective study

BackgroundHuman immunodeficiency virus (HIV) infection, opportunistic infections and antiretroviral therapy contribute to the pathogenesis of stroke, yet, little is known about the influence of HIV infection on outcome in stroke patients. The aim of this study was to compare the outcome of stroke in HIV-infected patients with that of HIV-negative patients at the Douala General Hospital (DGH). Patients and methodsA prospective cohort study was carried out at the Neurology unit and the Intensive Care Unit of the DGH from January 2010 to December 2015. All patients aged 15 years and above, admitted for stroke confirmed by brain imaging were included. HIV testing was systematically prescribed for all stroke patients. HIV-infected patients were then compared with HIV-uninfected patients. Quantitative variables were expressed as means while qualitative variables were expressed as frequencies, and were compared with the Chi2 test or the Fisher test and the Student test respectively. Stroke outcome was evaluated by the mortality, in-hospital stay and functional outcome at 6 months post-stroke. Kaplan–Meyer method was used to determine survival. ResultsForty of the 608 patients with stroke were HIV-positive, giving an in-hospital HIV prevalence of 6.6%. Mean age of the HIV-infected stroke patients was 51.3±10.4 years as against 59.6±13.53 in the HIV-uninfected group (P=0.001). The proportion of dyslipidemia in HIV-infected stroke patients with was greater than that in HIV-uninfected stroke patients (57.5% vs 8.9%, P<0.001). The most common type of stroke was ischemic in two-thirds of the patients in both groups. HIV-infected stroke patients had a mean hospital stay longer than that of HIV-uninfected patients (10.3±8.1 days vs 8.1±6.3 days, P=0.042). Post-stroke infections were more frequent in HIV-infected patients (17.5% vs 6.9%, P=0.014). The cumulative mortality rates at 6 months were 37.5% and 34.5% for the HIV-infected and the HIV-uninfected groups respectively (P=0.471). The functional outcome was similar in both groups at the 6th month post-stroke (Rankin score>2: 38.5%vs 38.8%, P=0.973). There was no difference in survival between the two groups. ConclusionHIV infection does not affect in-hospital mortality and functional outcome in stroke patients a part the length of hospital stay.

Clinical Profile of Stroke Patients with Vertigo in Hasan Sadikin General Hospital Bandung Neurology Ward

Vertigo often occurs from the ages of 18 to 79 years with a prevalence of 7.4%. Central vertigo is less common than peripheral vertigo, but it can worsen disability in stroke patients. This study aims to determine the profile of stroke patients with vertigo in Hasan Sadikin General Hospital Bandung Neurology Ward. This is a retrospective descriptive study, using medical record data from 2013 to 2017, and collected 173 medical record data. The results showed that most stroke patients with vertigo were women (59%), the most age group was 55-64 years (34.1%), the most common type of stroke was ischemic stroke (75.7%), the most disturbance regarding the vertebrobasilar system was (72.8%), the most patients got the first stroke was (52.6%), 60.7% of patients suffered from hypertension, 23.1% of patients suffered from hyperlipidemia 40 (23.1%), and 22% of patients suffered from diabetes mellitus type 2. This study concludes that stroke patients who experience vertigo are more common in women, and in the 55-64 year age group. The most common stroke is ischemic in the vertebrobasilar system. Most symptoms in stroke patients with vertigo are dizziness not affected by position, vomiting and nystagmus. Hypertension, hyperlipidemia and diabetes mellitus play an important role in the incidence of stroke in patients.&#x0D; &#x0D; Keywords: vertigo, risk factor, stroke, vertebrobasilar

Epidemiology of neonatal stroke: A population-based study.

The goal of this study was to obtain population-based data on the incidence, clinical presentation, management, imaging features, and long-term outcomes of patients with all types of neonatal stroke (NS). Full-term neonates with NS born between January 2007 and December 2013 were identified through the Nova Scotia Provincial Perinatal Follow-up Program Database. Perinatal data and neonatal course were reviewed. Neurodevelopmental outcomes were assessed at 18 and 36 months of age using standardized testing. Twenty-nine neonates with NS were identified during the study period, giving an incidence of 47 per 100,000 live births in Nova Scotia. Arterial ischemic stroke was the most common stroke type (76%), followed by neonatal hemorrhagic stroke (17%), then cerebral sinovenous thrombosis (7%). The majority of neonates presented with seizures (86%) on the first day of life (76%). At 36 months of age, 23 (79%) of the children had a normal outcome, while 3 (10%) were diagnosed with cerebral palsy (2 with neonatal arterial stroke and one with neonatal hemorrhagic stroke) and 3 (10%) had recurrent seizures (1 patient from each stroke subtype group). The incidence of NS in Nova Scotia is higher than what has been reported internationally in the literature. However, the neurodevelopmental outcomes at 3 years of age are better. Further studies are required to better understand the reasons for these findings.

Clinical Features and Diagnosis of Spontaneous Intracerebral Hemorrhage

Intracerebral hemorrhage (ICH) is the second most common type of stroke, trailing only ischemic stroke in frequency. There are many underlying pathological conditions associated with ICH; hypertension, amyloid angiopathy, ruptured saccular aneurysm, and vascular malformation account for the majority of cases. Initial goals of treatment include preventing hemorrhage extension, as well as the prevention and management of elevated intracranial pressure along with other neurologic and medical complications.

A New Paradigm Shift in Acute Ischemic Stroke, Large Vessel Occlusions, and Endovascular Therapy.

In the past threeyears, there have been several major studies published on the use of endovascular therapy (EVT) in large vessel occlusion (LVO) acute ischemic stroke. With multiple publications in such a short amount of time, it is difficult to keep up with the evolving landscape of ischemic stroke therapy. This narrative review discusses recent randomized controlled trials evaluating EVT and its effects on acute ischemic stroke management. Ischemic stroke is the most common type of stroke overall, and recanalization is the predominant focus in stroke therapy to improve outcomes. Treatment first focused on systemic thrombolysis for ischemic stroke, followed by studies evaluating the use of thrombolysis with EVT. Early research did not find a benefit to EVT; however, recent studies using current devices and with narrow selection criteria demonstrate significant benefit to EVT in LVOs. In patients with LVOs and perfusion mismatches, reperfusion rates are higher with EVT compared with systemic thrombolysis alone. Recognition of patients with small infarct cores and large areas of ischemic but salvageable brain tissue up to 24h after symptom onset stresses the need for advanced imaging to recognize the target group. EVT technology for acute ischemic stroke has now become more efficient, minimizing complications and improving the efficacy of EVT. Several viable interventions for a small subgroup of patients with ischemic stroke up to 24h after symptoms onset can significantly improve patient outcomes.

Microembolic signal detection by transcranial Doppler: Old method with a new indication

Transcranial Doppler (TCD) is useful for investigation of intracranial arterial blood flow and can be used to detect a real-time embolic signal. Unfortunately, artefacts can mimic the embolic signal, complicating interpretation and necessitating expert-level opinion to distinguish the two. Resolving this situation is critical to achieve improved accuracy and utility of TCD for patients with disrupted intracranial arterial blood flow, such as stroke victims. A common type of stroke encountered in the clinic is cryptogenic stroke (or stroke with undetermined etiology), and patent foramen ovale (PFO) has been associated with the condition. An early clinical trial of PFO closure effect on secondary stroke prevention failed to demonstrate any benefit for the therapy, and research into the PFO therapy generally diminished. However, the recent publication of large randomized control trials with demonstrated benefit of PFO closure for recurrent stroke prevention has rekindled the interest in PFO in patients with cryptogenic stroke. To confirm that emboli across the PFO can reach the brain, TCD should be applied to detect the air embolic signal after injection of agitated saline bubbles at the antecubital vein. In addition, the automated embolic signal detection method should further facilitate use of TCD for air embolic signal detection after the agitated saline bubbles injection in patients with cryptogenic stroke and PFO.

Treatment Outcomes and Associated Factors among Hospitalized Stroke Patients at Shashemene Referral Hospital, Ethiopia.

Background The 2013 Global Burden of Disease report indicated that 80% of stroke deaths occur in low- and middle-income regions. Although stroke has been consistently reported as one of the three leading causes of morbidity and mortality in the past years in Ethiopia, there is a paucity of data regarding treatment outcomes of stroke if sufficient. Hence, the present study aimed to assess patterns of treatment outcomes and associated factors among hospitalized stroke patients at Shashemene Referral Hospital. Methods A retrospective cross-sectional study was conducted at the medical ward of Shashemene Referral Hospital. A total of 73 hospitalized stroke patients during the period 2012–2017 were included in the study. Demographic characteristics, risk factors, and stroke types and their hospital outcomes were reviewed from the medical records of the patients. The data were entered and analyzed using SPSS version 16.0. Descriptive statistics such as percent and frequency were used to summarize patients' characteristics. Binary logistic regression was used to investigate the potential predictors of treatment outcome. A p-value ≤0.05 was considered statistically significant. ResultIschemic stroke was the most common type of stroke (65.8%) diagnosed in our setting. Hypertension (52.05%) was the common comorbid condition. More than half (54.79%) of the stroke patients improved on treatment. Dyslipidemics were prescribed to 68.49% of patients and the most popular antiplatelet was aspirin, which was prescribed to 61.64% of the study participants. Age, sex, type of stroke, and type of comorbidity were not significant factors of stroke treatment outcome. Conclusion Ischemic stroke was the most common type of stroke diagnosed among the study participants while aspirin and statins were the most frequently used drugs in the management of stroke. Approximately 50% of hospitalized stroke patients had good treatment outcome and none of the investigated variables were significantly associated with the treatment outcomes.

Evaluation of ischemic stroke patients with systemic cancer.

In cancer patients, an ischemic stroke can be seen as both a direct effect of cancer and a complication of treatment. This condition can negatively affect the follow-up and treatment of these patients. For this research, we aimed to evaluate the clinical features, stroke types and etiological features of ischemic stroke patients with histories of cancer or found to have cancer during the aetiological investigation. We retrospectively evaluated 100 patients (57 males, 43 females) who were hospitalized with acute stroke and determined to have the presence of cancer or a cancer history during the aetiological investigation between 2011 and 2016. All the demographic features, stroke types and localizations, National Institutes of Health Stroke Scale (NIHSS) scores, Rankin Scale scores, durations of cancer and cancer treatments were recorded. The mean age of the patients was 67.07 ± 10.9 years old, the median NIHSS score was 5, and the median Rankin Scale score was 4. While 79% of patients had ischemic stroke risk factors, 21% did not. Atherosclerotic stroke was the most common stroke type (49%, n=49) and cryptogenic strokes were detected in 21% (n=21). In addition, 63% of the patients had chronic cancer (later than 6 months), 31% of the patients had recent cancer histories (less than 6 months), and 29% of the patients had metastases. Among all the malignancies, lung cancer (n=23), gastrointestinal cancer (n=20) and gynaecological-breast cancer (n=16) were the three most common. Moreover, 37% of the patients underwent chemotherapy, 29% underwent radiotherapy, and 88% of the patients had Carotid/Vertebral Doppler USG abnormalities. Similar to what is stated in the literature, an atherosclerotic stroke was the most common type of stroke in the cancer patients. Stroke risk factors were not detected in 21% of the patients, and in the majority of the patients, atherosclerotic changes in the carotid artery were observed in the Doppler examinations. In the aetiology and prognosis of ischemic stroke, it is important to keep in mind the existence of cancer in addition to the classical stroke risk factors.

KORELASI RASIO LINGKAR PINGGANG-PANGGUL TERHADAP PROBABILITAS STROKE ISKEMIK

Background. Stroke is the third cause of death worldwide. Ischemic stroke is the most common type of stroke with high prevalence. Obesity is one of ischemic stroke risk factor, but its correlation with higher ischemic stroke risk remains unclear. Studies about correlation of waist hip ratio (WHR) and ischemic stroke risk is still contradictive. Objective. This study was aimed to explore the correlation between WHR and ischemic stroke probability. Methods. This was a descriptive analytic study using cross sectional design. The population of this study was resident in Sekarbela Mataram aged 55-84 years old. This study was conducted 63 participants. They were interviewed and received a measurement of WHR and ischemic stroke probability. The ischemic stroke probability was assessed by using assessment of Framingham stroke risk score. Data were analyzed by using Pearson correlation. Results. Among 63 participants, 51 (81%) were abdominal obesity and 12 (19%) were normal based on WHR measurement. Pearson correlation analysis showed that there was no correlation between WHR and ischemic stroke probability (p = 0,11). Conclusion. There was no correlation between WHR and ischemic stroke probability of population in Sekarbela Mataram