ABSTRACT
Background: Stroke is one of the common causes of mortality and disability. By introducing r-TPA into the global drug market and its effect on the patients’ prognosis, using this drug is recommended in all patients with ischemic stroke who visited less than 4.5 hours after stroke and do not have contraindications. The aim of this study was to investigate the frequency of stroke patients qualified for recombinant tissue plasminogen activator (r-TPA) and its limtations.Methods: In this descriptive cross-sectional study, 244 patients examined with stroke admitted to the Neurology Department of Zahedan city hospital in 2016. Information form were completed with demographic data, transmission method, referral time, CT scan preparation time, and the response of the patients' trials, and finally the data were inserted in SPSS.16 software and analysed by statistical methods.Results: Out of all patients with ischemic stroke, 28 (11.5%) patients had contraindication to receive drug. Of 216 remain patients, 201 patients (93.1%) had no possibility to receive r-TPA due to the loss of golden time and only 15 patients (6.9%) had possibility to receive drug because of visited 4.5 hours before the beginning of symptoms. Of them, 3 (20%) patients due to delay in CT scan and test results, had no possibility to receive r-TPA. In summary, of all patients with inclusion criteria, only 12 (5.5%) patients could use the r-TPA in this study.Conclusions: The most important barrier to using r-TPA has been the loss of golden time and training to raise awareness of the society can lead to early referral from the onset of stroke symptoms.
ABSTRACT
Introduction: Cerebral venous-sinus thrombosis [CVST] is a life threatening condition that needs rapid diagnosis and treatment. It appears comparatively more common in Middle East and South Asia
Objectives: To determine the demographic, clinical patterns, etiologies and prognostic factors of CVST in the North East of Iran
Materials and Methods: All adult patients admitted with a documented diagnosis of CVST from January 2011 to March 2012 in an academic hospital in the North East of Iran, entered this prospective descriptive study. The patients' demographic characteristics, clinical presentations, laboratory and brain imaging findings, treatment options were also studied. Follow-up visits were performed at month 1, 6, and then at month 12 using modified Rankin Scale [mRS]. Findings were analyzed using descriptive tests and Chi square test in SPSS software version 21
Results: Sixty patients [13.3% men, 86.7% women] with mean age of 38.11+/-11.30 years were identified. Fifty one cases [85%] had a clinical picture of increased intracranial pressure. Causes included positive antiphospholipid antibodies in 3.3%, protein C, S and anti thrombin III deficiency in 5%, 1.7% and 3.3%, polycythemia in 1.7%, infections in 1.7%, postpartum in 9.6% of women, and using Oral Contraceptive Pills [OCPs] in 65.38%. We found 10% mortality rate on discharge and 11.9% within 30 days and 42.7% rate of death or dependency at month 12
Conclusion: The findings of the study indicate that the use of OCPs was a main factor associated with CVST especially in association with inherited hypercoagulable state