Disturbance Of Cerebral Function Research Articles

Stroke units in low and middle income countries (LMICs) save lives: application of the western model of stroke care

Stroke is defined as a syndrome of rapidly developing clinical signs of focal or global disturbance of cerebral function with symptoms lasting 24 hours or longer or leading to death with no apparent cause other than of vascular origin. In the current management of stroke in developed countries, stroke units form a vital part of the care pathway. Stroke units save lives, reduce disability, mitigate against complications such as aspiration pneumonitis, facilitate early discharge home with timely interventions by a Multidisciplinary Team. Whilst the burden of stroke has decreased in high income countries, this decrease is lowest in sub-Saharan Africa.

Pathophysiology of parenchymal injury in ischemic stroke

Pathophysiology of parenchymal injury in ischemic stroke

GAMMA GLUTAMYL TRANSFERASE LEVELS IN PATIENTS WITH ACUTE STROKE: AN ANALYTICAL STUDY

Objectives: Stroke is a significant global health issue with a major socioeconomic burden, ranking as the second leading cause of death worldwide. While stroke rates have declined in high-income countries, they have increased in low- to middle-income countries, including India. The World Health Organization defines stroke as a disturbance of cerebral function caused by vascular factors, classified as ischemic or hemorrhagic. Methods: Ischemic stroke is primarily caused by atherosclerosis in the brain’s arteries, including the proximal aorta, leading to embolus formation. Other factors contributing to stroke include arterial stenosis, coexisting thrombosis, artery-to-artery embolism, micro atheroma, lipohyalinosis, and occlusive diseases of small brain arteries. Cardiogenic embolism, often associated with atrial fibrillation, contributes to a significant proportion of ischemic strokes. Gamma-glutamyl transferase (GGT), commonly used as a marker for alcohol consumption and liver diseases, is also linked to oxidative stress, inflammation, and atherosclerosis. Elevated GGT levels are associated with various stroke risk factors. Results: GGT plays a crucial role in cellular intake of glutathione, an important antioxidant. Paradoxically, it can generate reactive oxygen species in the presence of certain metals. Studies have found a correlation between high serum GGT levels and stroke risk, potentially due to oxidative stress and atherosclerosis progression. Conclusion: Despite its primary use as an alcohol consumption marker, GGT has emerged as a potential independent biomarker for vascular diseases, including stroke. However, limited research exists on the association between GGT and acute stroke. This study aims to evaluate GGT levels in patients with acute stroke, exploring potential differences among stroke types to better understand the impact of GGT on acute stroke.

A STUDY OF CLINICAL PROFILE AND RISK FACTORS IN ACUTE ISCHEMIC STROKE

Background: World Health Organisation denes the clinical syndrome of “stroke” as 'rapidly developing clinical signs of focal (or global) disturbance of cerebral function with symptoms lasting 24 hours or longer or leading to death, with no apparent cause other than vascular origin'. After coronary heart disease (CHD) and cancer of all types, stroke is the third commonest cause of death worldwide. Aim: To study the clinical prole and risk factors of stroke in the study population. Objectives: To study the clinical prole & frequency of various risk factors in Ischemic stroke patients at Kamineni Institute of Medical Sciences Narketpally, Nalgonda. Study Design: Cross sectional, observational study. Place Of Study: Department of General Medicine, Kamineni institute of medical sciences, Narketpally. Duration Of Study : November 2020 to December 2022

A CLINICAL STUDY OF STROKE IN INDIVIDUALS AGED 18 TO 45 YEARSIN A TERTIARY CARE HOSPITAL

Ÿ Stroke is dened by the world health organization as clinical syndrome consisting of rapidly developing clinical signs of focal (or global in case of coma) disturbance of cerebral function lasting more than 24 hours or leading to death with no apparent cause other than a vascular origin. Ÿ Stroke is one of the causes for high morbidity and mortality across the world. Ÿ Stroke affecting the young have devastating consequences on the individual, his family and society in general. Ÿ The predisposing factors for stroke in young are smoking, alcohol, hypertension and dyslipidemias. Ÿ The present study was undertaken to study the etiology, risk factors and clinical presentation of young patients with stroke in Sri Venkateswara Ramnarain Ruia Government General Hospital, Tirupati.

Effects of Mirror Therapy for Improving the Motor Function of Upper and Lower Extremities in Patients with Stroke – A Quasi Experimental Study

Background: Stroke is defined as the rapid onset of focused or generalized disturbance of cerebral functions that lasts more than 24 hours. Speech issues and weakness on one side of the body are typical stroke signs and symptoms. Patients with upper limb disability following a stroke were unable to carry out particular gripping and manipulating tasks. Objective: Determine Effects of Mirror Therapy for Improving the Motor Function of Upper and Lower Extremities in Patients with Stroke Material and Methods: A quasi-experimental study was carried out in which the subjects in between 45-60 years, ischemic and hemorrhagic stroke male and female were recruited. Subjects were divided into two groups. In Group A tasks given, were performed by patients in front of mirror and with the unaffected limb. The mirror therapy was given 5 days a week with 50 min session and Electrical stimulation for 10 minutes. In Group B the patients were given PNF techniques for 6 weeks. The outcome tool used for evaluation of upper and lower limb assessment was Modified Fugl Meyer functional tool. The data was analyzed using SPSS. Results: The pretest and posttest observations for motor assessment of upper, within the mean score of Group A in pre assessment was 31.47±9.67 mid assessment was 34.73±10.47 and post assessment was 238.53±10.72 (0.001) showing significant improvement with intervention of Group A. Motor assessment score in Group B in pre assessment was 36.07±11.25 mid assessment was 43.27±9.83 and post assessment was 49.47±9.48 (0.001) showing significant improvement with intervention of Group A. Motor assessment score in Group B in pre assessment was 15.27±4.56 mid assessment was 21.73±5.23 and post assessment was 28.47±4.56 (0.001) showing significant improvement with intervention of Group A at P value <.05 showing effectiveness of both techniques. Practical Implication: This study will also help peer group in practicing and rehabilitating the stroke patients with new techniques. There is a need to incorporate easy, simple, economic, patient directed and effective treatment techniques to enhance recovery following stroke. There is less data available on comparison between conventional physical therapy and mirror therapy in the up-per limb in the past. Conclusion: We have concluded that both the PNF and MT were effective in improving score motor function but MT were found to have better effect as compared to PNF . Patient can gain muscle control, coordination and know the limitation of movement. It ultimately reduces the muscle atrophy and disability. Keywords: Mirror therapy, Motor function, Patient, Lower Extremity.

To Study the Effects of the PNF Stretching and Stabilization Exercises on the Improvement of Pain and Spastic Shoulder in Hemiplegic Patients: A Comparative Study

Stroke is the leading cause of adult disability and inpatient rehabilitation admissions. The WHO definition of stroke is rapidly developing clinical signs of focal (global) disturbance of cerebral function, with symptoms lasting 24hours or longer or leading to death, with no apparent cause other than of vascular origin: it includes patients presenting clinical signs and symptoms suggestive of subarachnoid haemorrhage, intracerebral haemorrhage or cerebral ischemic necrosis. An estimated 70% of the patients who survive a stroke are unable to use their limbs (Upper Limb/Lower Limb) independently during the first three to four weeks post stroke. Patients who have suffered a stroke experience loss, uncertainty, and social isolation, as stroke represents a sudden, overwhelming, and fundamental change for the survivor. Personal control over progressoptimism, and fears of dependency, as well as markers of independence and interaction with therapists, were identified as important factors influencing recovery. Effective rehabilitation strategies are of utmost concern to different parts of the health care system. Their value resides both in giving people affected by stroke the best possible opportunity for their recovery as individuals and in offering health organizations the best use of limited finances and resources. The objective of the study was to compare the effectiveness of PNF(Proprioceptive Neuromuscular Fascilitation) stretching and stabilizations exercises techniques in the improvement of pain and spastic shoulder.30 post stroke patients (affected for a period of more than 6months), 40-60 years of age were randomly assigned to PNF stretching and stabilization exercises were collected on Day 0, DAY 90. Paired t-test were used for statistical interventions. Assessment of Visual Analogue Scale (VAS) and Modified Ashworth Scale were performed. Analysis of scores showed significant improvement (p<0.02) overtime within the groups and inter group analysis showed statistical significance. The study concluded that PNF Stretching technique is better than Stabilization techniques in improving pain and spastic shoulder in chronic stroke patients.

Factors associated with hospital arrival time of acute stroke patients in rural India

Abstract Funding Acknowledgements Type of funding sources: None. Background Delays in the treatment of acute stroke leads to unfavorable prognosis. Shortening the delay time in the health care of these patients is essential in order to reduce the morbidity and mortality rates of this disease. Eligibility for acute stroke interventions depends on the time from symptom onset to hospital arrival. The socio-cultural profile in rural India is different from that in urban India. Lot of people in rural India prefer living in joint families, general level of education and awareness is low and they opt for alternative modalities of treatment for stoke. There is lack of adequate and fast transport facilities that worsen the scenario. Delay in arrival of acute stroke cases may be caused by organizational, educational, socioeconomic and demographic factors. Purpose This study was conducted to understand the factors associated with hospital arrival time of acute stroke patients in Rural India. Materials and Methods Hospital data of 27 acute stroke patients admitted to our clinic from January 2019 to December 2019 was retrospectively studied. Stroke was defined, according to the WHO definition, as 'rapidly developing clinical sign of focal (or global) disturbance of cerebral function, lasting more than 24 hours or leading to death with no apparent cause other than of vascular origin'. Chi square test and Mann Whitney U tests were used to analyze the data. Results Only 8 (29.62%) patients arrived within 3 hours of stroke onset whereas 3 (11.11%) patients arrived after 12 hours. Mean and standard deviation of hospital arrival time in minutes for patients < 50 years was 125±116, for 51-60 years was 279±127, for 61-70 years was 379±191 and for >70 years was 1127±716.Younger patients reported significantly earlier than older ones (p <0.001). Males reported earlier than females (p: 0.032). Patients with stroke onset in the night time arrived significantly late compared to stroke onset in the day time (p:0.001). Prior ayurvedic treatment delayed hospital arrival (p <0.001). Conclusions A nationwide public awareness campaign is needed to improve the public awareness of stroke and importance of timely treatment when acute stroke symptoms are suspected. Lot of patients in rural India still delay emergency treatment of acute stroke due to preference to ayurvedic remedies which should be strongly discouraged. Gender and age bias need to be further studied and strategies to reduce the bias should be considered. This study shows that there is substantial room for reducing the time from symptom onset to hospital arrival in acute stroke. Strategies to improve stroke awareness and referral protocols together with the use of tele-medicine and mobile stroke unit should be considered to reduce the hospital arrival time.

Acute stroke and transient ischaemic attack

The World Health Organization defines a stroke as ‘rapidly developing clinical signs of focal (or global) disturbance of cerebral function, with symptoms lasting 24 hours or longer or leading to death, with no apparent cause other than vascular origin’. If the symptoms last less than 24 hours, typically less than 2 hours, then this is classified as a transient ischaemic attack. ‘Brain attack’ is a term that is increasingly used, as the rapid nature of treatment means the differentiating criterion of symptoms lasting at least 24 hours, is often not met before initiation of treatment.

Effectiveness of Bilateral Task-Oriented Exercises and Mirror Therapy to Improve Hand Function in Hemiparetic Stroke

Background and Objectives: Stroke is a clinical syndrome consisting of rapidly developing clinical signs of focal disturbance of cerebral function lasting more than 24 hours or leading to death with no apparent cause other than a vascular origin.” Some evidence-based studies proved that bilateral task-oriented exercise and Mirror therapy are effective in improving the hand function in hemiparetic stroke patient. But there is no comparative study of these two protocols. Hence the purpose of this study is to compare the effectiveness of bilateral task-oriented exercises and Mirror therapy in improving hand function in hemiparetic stroke patient. Methods: A total of 67 subjects met selection criteria for the study among them 7 members are dropouts from group A and B and were divided into 2 groups, 30 members in group A (bilateral task-oriented exercises), 30 members in group B (Mirror therapy). Both groups performed intervention for 5 days per week, for 4 weeks. The outcomes were Fugl Meyer and Motor Activity Log for measuring functional disabilities. Results: Paired “T” test was used to access the statistical significance within the groups. Statistical analysis between two groups using independent “t” test revealed that there is no significant difference between Bilateral task-oriented exercises and Mirror therapy groups. Conclusion: In this study, 4 weeks of bilateral task-oriented exercises and Mirror therapy showed that both approaches are equally effective in improving hand function in hemi paretic stroke. Keywords: Hemiparetic stroke, Bilateral task-oriented exercises, Mirror therapy, Motor activity log, Fugl Meyer.

English

BACKGROUND World Health Organization (WHO) defines stroke as “rapidly developing clinical signs of focal (or global) disturbance of cerebral function, lasting more than 24 hours or leading to death, with no apparent cause other than that of vascular origin.” Low serum 25 hydroxy vitamin D is associated with large infarct volume, which worsens the outcome in ischemic stroke patients. In this study, we wanted to evaluate serum vitamin D levels in acute ischaemic stroke (AIS) patients and correlate the severity of stroke with lipid profile & central nervous system (CNS). METHODS It was a cross sectional comparative study, conducted in Department of Medicine in SGRDIMSR, Sri Amritsar from December 2018 to June 2020. A total of 100 subjects, 50 cases of AIS, diagnosed by history, clinical examination and supported by magnetic resonance imaging (MRI) of brain and 50 age and sex matched healthy controls were enrolled for the present study to estimate serum vitamin D level in AIS. Detailed clinical history and clinical examination were done on all participating subjects and relevant investigations were done. Diagnosis was confirmed by MRI brain in acute ischemic stroke cases. The severity of neurological impairment was evaluated as per Canadian neurological stroke scale within 24 hours of admission of the cases. RESULTS Mean age of cases was 62.06 ± 10.52 years and mean age of control was 59.14 ± 11.36 with maximum number of subjects were in age group of 61 - 70 years. The mean value of vitamin D in study group was 19.31 ± 9.24 while in control group, mean value was 36.42 ± 8.33, showing more serum vitamin D deficiency in cases having AIS than controls. (P value 0.021). CONCLUSIONS The present study suggests that the low serum vitamin D levels in the body is associated with more severe neurological deficit. KEYWORDS Stroke, Serum Vitamin D, Acute Ischemic Stroke, Canadian Neurological Scale

English

BACKGROUND World Health Organisation (WHO) defined stroke as rapidly developing clinical signs of focal disturbance of cerebral function, lasting more than 24 hours or leading to death, with no apparent cause other than vascular origin. Prognostic factors for predicting functional outcome and mortality play a major role in determining the treatment outcome. We intended to study the clinical charecteristics and outcome of patients with intracerebral bleeding coming to emergency room. METHODS Patients more than 18 years of age who were diagnosed to have intracerebral haemorrhage (ICH) on CT brain plain scan were included in the study. Age < 18 years, patients not willing to participate in the study were excluded from the study. Type of clinical presentation, imaging findings, ICH score, and Glasgow coma scale (GCS) score, were calculated for each patient at the time of admission. The condition of the patient, whether death / discharge (alive) was documented in all study population at the time of discharge. RESULTS Hypertension was the most common risk factor present in 68 % of study population. Most of the patients were between 41 - 70 years of age with a male preponderance. High ICH score, low GCS score at the time of admission, presence of intraventricular haemorrhage, and midline shift (P - value 0.000) were significantly associated with poor clinical outcome. Mortality was high in patients with infratentorial bleed and volume > 40 c.c. CONCLUSION Males in their sixth decade were the most affected in our study on ICH. Cerebellar and brainstem haemorrhages had higher mortality, though putamen is the commonest site of haemorrhage, low Glasgow Coma Scores and high ICH scores were associated with increased mortality. KEY WORDS Stroke, Haemorrhage, Intracerebral, Prognosis, Bleed

English

A seizure is a brief disturbance of cerebral function, lasting from seconds to a few minutes, caused by an abnormal electrical discharge. Epilepsy is the tendency to have seizures on a chronic, recurrent basis, not resulting from a temporary condition. The term, epilepsy, does not presuppose a cause; there are many causes. Essentially, anything that disturbs the normal functioning of the cerebral cortex can cause seizures, and if this abnormality is enduring, it can result in epilepsy.1 Epilepsy is a common neurological condition with a global prevalence of 1.2 %. Most women with epilepsy who become pregnant or are planning to conceive are recommended to continue taking antiepileptic drugs (AEDs) to minimise seizure recurrence during pregnancy, adverse effects to the fetus, and unintended ill consequences during labour and / or delivery.2,3 The seizure pattern during pregnancy may be influenced by variations in ovarian hormones, blood levels of antiepileptic drugs, and metabolic changes.4 Status epilepticus occurs in only 1 – 2 % of pregnancies,5 and if treated appropriately and aggressively carries a fairly low risk of morbidity and mortality. Structural and metabolic changes may precipitate new-onset seizures during pregnancy. The structural causes include intracranial haemorrhage of multiple types, cerebral venous sinus thrombosis, and ischemic stroke. Metabolic causes include hyperemesis gravidarum; acute hepatitis (due to fatty liver of pregnancy or viral hepatitis); metabolic diseases, such as acute intermittent porphyria; infections, such as malaria; and eclampsia.5 Evaluation and management should be performed in a stepwise fashion and may require a multidisciplinary approach with other specialties such as neurology.6 The threat of seizures during pregnancy and the consequences that they might have on the developing foetus are fundamental reasons for the prescription of daily antiepileptic medication to a pregnant woman with epilepsy (WWE).7 We present an original case of 3 episodes of seizures, of 22-year-old female who was 16 weeks pregnant. This study was approved by Sree Uthradom Thirunal Hospital, Pattom, Trivandrum, Kerala (ethics committee).

Effects of mirror therapy vs modified constraint induced movement therapy on upper extremity in subacute stroke patients

Objective: To compare and to examine the effectiveness of mirror therapy and modified constraint induced movement therapy (mCIMT) on upper extremity in subacute stroke patients.
 Background: Stroke or cerebral vascular accident is sudden dead of the brain cells due to inadequate blood flow. The WHO defines stroke as rapidly developing clinical signs of focal disturbance of cerebral function, with symptoms lasting for 24hrs or longer or leading to death, with no apparent cause other than of vascular origin. The most common consequence of stroke is loss of upper limb function. The protocol planned for improving the function of upper limb are mirror therapy and modified constraint induced movement therapy (mCIMT). Mirror therapy is a simple and inexpensive treatment which uses the visual information activating the premotor and motor cortex of the brain. This is explained by activation of so called mirrorneuron system. Whereas mCIMT utilises the redundant pathway in brain through neuro plasticity.
 Methodology: A total of 30 participants with subacute stroke were selected. The inclusion criteria are both gender of age 55-70 years and duration of 2-12 months of post stroke. Participants with mini mental state examination score<24, uncontrolled systemic hypertension, severe shoulder subluxation, previous stroke and severe cardiac failure were excluded. The outcome measures were measured using Upper Extremity Functional Index (UEFI) and Fugl Meyer Upper Extremity Scale.
 Procedure: All 30 participants with sub-acute stroke were divided into two groups. Both the group individuals were assessed for pre test using Fugl Meyer Upper Extremity Scale and Upper Extremity Functional Index Scale. Group A (15) was assigned to mirror therapy for 5 days a week, for 4 weeks and rest intervals was given. Similarly group B (15) was assigned to modified constraint induced movement therapy for 5 days a week, for 4 weeks. Both the groups were given conventional therapy for 20 mins. At the end of study subjects were assessed for post test using UEFI and Fugl Meyer upper extremity scale.
 Results: The Modified Constraint Induced Movement (mCIMT) is more effective than Mirror Therapy in improving the hemiparetic upper extremity in subacute stroke patients.
 Bangladesh Journal of Medical Science Vol.20(2) 2021 p.323-329

ISCHEMIC STROKE REGISTRY IN EGYPT: HOSPITAL BASED STUDY

Background: Stroke is defined by the World Health Organization(WHO) as ‘a clinical syndrome consisting of rapidly developing clinical signs of focal (or sometimes global) disturbance of cerebral function lasting more than 24 hours or leading to death with no apparent cause other than a vascular origin. Objective: To study the pattern of ischemic stroke subtypes in a sample Egyptian patients, common risk factor profiles and management methods. Patients: A retrospective study was conducted on 321 patients who were admitted to Al-Azhar University Hospitals and Nasser Institute with a main primary diagnosis of acute ischemic stroke during the period from January 2017 until December 2018. Results: Small vessel strokes were the most common accounting for 51.1% of all patients, followed by large vessel getting affected 24% of the cases. Cardio embolic stroke was present in 20.8%of the cases, Hypertension was the most prevalent risk factor among patients accounting for 61.1%, diabetes (49.5%), obesity (38.6%), and smoking (32.1%). A significant difference in stroke severity among stroke patients regarding smoking status was found in univariate analysis and obesity. Multivariate analysis using multiple linear regressions showed that the relationship with obesity was significant. Conclusion: In spite of the high prevalence of stroke risk factors among the study patients, the power wasn’t enough to show any association with stroke severity except for smoking and obesity, where smokers and obese patients are more likely to have higher stroke severity.

ISCHEMIC STROKE REGISTRY IN EGYPT: HOSPITAL BASED STUDY

Background: Stroke is defined by the World Health Organization(WHO) as ‘a clinical syndrome consisting of rapidly developing clinical signs of focal (or sometimes global) disturbance of cerebral function lasting more than 24 hours or leading to death with no apparent cause other than a vascular origin. Objective: To study the pattern of ischemic stroke subtypes in a sample Egyptian patients, common risk factor profiles and management methods. Patients: A retrospective study was conducted on 321 patients who were admitted to Al-Azhar University Hospitals and Nasser Institute with a main primary diagnosis of acute ischemic stroke during the period from January 2017 until December 2018. Results: Small vessel strokes were the most common accounting for 51.1% of all patients, followed by large vessel getting affected 24% of the cases. Cardio embolic stroke was present in 20.8%of the cases, Hypertension was the most prevalent risk factor among patients accounting for 61.1%, diabetes (49.5%), obesity (38.6%), and smoking (32.1%). A significant difference in stroke severity among stroke patients regarding smoking status was found in univariate analysis and obesity. Multivariate analysis using multiple linear regressions showed that the relationship with obesity was significant. Conclusion: In spite of the high prevalence of stroke risk factors among the study patients, the power wasn’t enough to show any association with stroke severity except for smoking and obesity, where smokers and obese patients are more likely to have higher stroke severity.

Comparative Study of Lipid Profile among Stroke Patients with Gender Variations: A Study in Mymensingh Medical College Hospital, Mymensingh, Bangladesh

Introduction: Stroke is defined according to WHO as rapidly developing clinical signs of focal disturbance of cerebral functions with symptoms lasting for 24hrs or longer or leading to death, with no apparent cause other than vascular origin. More than 2400 years ago the father of modern medicine Hippocrates recognized and described stroke as sudden onset of paralysis. In Bangladesh day by day increase in stoke patients. Objective: This study was aimed to find out the association of one common risk factor of cardiovascular complication risk factor namely lipids level in stroke patient. And the main course of the study is to find the lipid level variations among both genders of stroke population. Materials and Methods: The stroke patients admitted in the Department of Neurology, Mymensingh Medical College Hospital, Mymensingh, Bangladeshduring the period of January 2019 to June 2019 included in this study. Patients with diagnosis of stroke comprising 50 consecutive patients of both the genders of age group around 21-60yrs were included in the study while patients on lipid lowering therapy were excluded from study. A serum sample after 12 hours of overnight fasting was taken on the both groups of patients. Results: Total serum cholesterol was high in female stroke patient’s 210±32.92 mg/dl when compared to male stroke patient’s 190±25.82 mg/dl which is statistically significant. Total triglycerides were increased in females stroke patients because of high body mass index when compared to male stroke patients was around 213±23.92, 197±58.43 mg/which is statistically significant. HDL-cholesterol level were very low in female stroke patients when compared to male stroke patients this is statistically more significant. The values were around 23.72±12.06, 37.43±7.18 mg/dl. LDL cholesterol is the direct marker of large vessel obstruction. LDL cholesterol level was found to be more in female stroke patients when compared to male stroke patients. The values are 141.81±31.89, 123.92±33.73 mg/dl. VLDL-cholesterol was high in female stroke patients when compared to male stroke patients which are statistically significant the values are 44.93±8.75, 37.83±9.33 mg/dl. Conclusion: Different environmental factors, genetic influences, and aging are playing a wide role in the prevalence of stroke among the old age group. Dyslipidaemia is a major risk factor for coronary heart disease, and atherosclerosis. In our study female patients had an increase in lipid level when compared to males.

Effectiveness of Chest Physiotherapy in Cerebrovascular Accident Patients With Aspiration Pneumonia

Introduction: According to WHO, a stroke refers to rapidly developing clinical signs of focal (or global) disturbance of cerebral functions, with symptoms lasting 24 hours or longer or leading to death. The damage caused by a stroke can interrupt your normal swallowing and food or fluid is entered into your airways and lungs. Dysphagia can damage the lungs, which can trigger a lung infection (pneumonia). To assess the efficacy of chest physiotherapy in the prevention of aspiration pneumonia in stroke patients.Materials and Methods: A quasi-experimental study was conducted with a sample size of 35 participants from C1 ward Agha Khan Hospital in Karachi City, Pakistan. The participants were selected via random sampling method. The inclusion criteria include patients of the C1 ward with a cerebrovascular accident, both male and female gender, with the age ranges from 45 to 63 years. All statistical analysis was done by using SPSS v. 19. The paired t test was used to evaluate the effectiveness of chest physiotherapy in a patient with aspiration pneumonia. The chest physiotherapy includes turning, postural drainage, percussion, vibration, deep breathing exercises, coughing, and suctioning were performed on a patient with aspiration pneumonia.Results: The results of this study show pre-treatment and post-treatment chest congestion, heart rate, and respiratory rate show that the P value is highly significant.Conclusion: This study concludes that chest physiotherapy seems to be effective in treating aspiration pneumonia in cerebrovascular accident patients.

Lama Hari Rawat Pasien Stroke

Background: Stroke has remained the leading cause of death globally in the last 15 years. Stroke is rapidly developing clinical signs of focal or global disturbance of cerebral function. Hospitalization is a treatment process which including patient to stay at the hospital. Length of stay is influenced by the type of stroke. This study aimed to know classification of stroke and length of stay of stroke patients. Methods: The study was a descriptive study with restrospective design. Data collected from medical record from May until December 2020 in RS PKU Muhammadiyah Yogyakarta. There were 207 patients with stroke. Descriptive data is then processed. Results: The results showed the highest percentage stroke patients male (50,24%), non hemorrhagic stroke (57,49%), length of stay hemorrhagic stroke 8 days. Conclusion: The result of this study may provide nursing research in patients with stroke.

Cerebro-renal interaction and stroke.

Stroke is an event causing a disturbance in cerebral function leading to death and disability worldwide. Both acute kidney injury and chronic kidney disease (CKD) are associated with an increased risk of stroke and cerebrovascular events. The underlying mechanistic approach between impaired renal function and stroke is limitedly explored and has attracted researchers to learn more for developing therapeutic intervention. Common risk factors such as hypertension, hyperphosphatemia, atrial fibrillation, arteriosclerosis, hyperhomocysteinemia, blood-brain barrier disruption, inflammation, etc. are observed in the general population, but are high in renal failure patients. Also, risk factors like bone mineral metabolism, uremic toxins, and anemia, along with the process of dialysis in CKD patients, eventually increases the risk of stroke. Therefore, early detection of risks associated with stroke in CKD is imperative, which may decrease the mortality associated with it. This review highlights mechanisms by which kidney dysfunction can lead to cerebrovascular events and increase the risk of stroke in renal impairment.