Clinical Profile of Acute Ischemic Cerebrovascular Stroke.

Introduction: Stroke is the common cause of severe disabilityand death worldwide. Study aimed to evaluate etiological,demographic, clinical course and identification of risk factorsin acute ischemic cerebrovascular stroke.Material and methods: A prospective study of 46 patientsof Ischemic cerebrovascular stroke conducted at MedicalCollege, Vadodara during January 2014 to November 2014.All Patients were subjected to Personal biodata and detailedclinical assessment with written consent. All were sent forroutine blood investigations including Lipid profile, chest xray PA view, Electrocardiography, 2D Echo and CT Scan. AllData were analysed by using Microsoft excel software.Results: In our study, most common age group was 55 to64 yrs (mean age 55.5yrs) with males predominance wasobserved (52%). Among males, 26 (56.53%) patients weresmokers while 18 (39.13%) males were alcoholic. Amongst46 patients, 55% and 35% found to be hypertensive andDiabetic respectively. 24% Patients had positive familyhistory of Hypertension. In our study, 54.3% had normalserum cholesterol level between 150 to 199 mg/dl whileHypertriglyceridemia and low HDL was found in 17.4% and26% respectively. Most common documented risk factors forstroke were age, smoking, hypertension and Diabetes Mellitus.Most of Patients presented with limb/motor weakness (86.9%)followed by speech disturbance and loss of consciousness at41.3% and 34.7% respectively. Hospital outcome was good.Conclusion: Ischemic stroke entails high socioeconomicburden due to increased morbidity and mortality. Age,Smoking, Hypertension and Diabetes are importantatherosclerotic risk factors in our study. Early Identification,treatment and prevention of risk factors can decline theincidence, complications and related mortality. So Physicianhave a important role in stroke prevention by encouraging thereduction in risk factors.

Correlation between reactive oxygen metabolites & atherosclerotic risk factors in patients with type 2 diabetes mellitus.

Background & objectives: Oxidative stress plays important roles in the pathophysiology of type 2 diabetes mellitus (T2DM). The diacron reactive oxygen metabolites (d-ROMs) test has been used in the clinics. The present study was aimed to investigate the correlation of the oxidative stress status, as evaluated by the d-ROMs, with atherosclerotic risk factors in T2DM patients, in comparison to controls. Methods: The study included 200 subjects (100 patients with T2DM and 100 controls; 86 males/114 females; mean age 59.0 yr). Clinical variables including the body mass index, blood pressure (BP), glucose and lipid panels, in addition to the d-ROMs, were measured. Results: Patients with T2DM showed significantly higher d-ROMs levels than controls (322 ± 60 vs. 345 ± 64 U. Carr., P<0.05). A multiple linear regression analysis revealed that systolic BP (β=0.26, P<0.05) and high-density lipoprotein cholesterol (HDL-C: β= -0.30, P<0.05) were independently and significantly correlated with the d-ROMs levels in patients with T2DM, although these correlations were not significant in the controls. The gender-based analysis showed that systolic BP (β = 0.44, P<0.05) and HDL-C (β = -0.36, P<0.05) were independently and significantly correlated with the d-ROMs levels in females with T2DM, while there was a marginally significant correlation between HDL-C and the d-ROMs levels (β = -0.36, P=0.06) in males with T2DM. Interpretation & conclusions: The present findings may reinforce the importance of BP control in female patients with T2DM, as well as the management of HDL-C in male and female patients with T2DM, under the linkage between oxidative stress and atherosclerosis.

The Relationship between Brachial Ankle Pulse Wave Velocity andAtherosclerotic Risk Factors

PURPOSE: Aging and atherosclerotic changes enhance the stiffness of the arterial wall, and the pulse wave travels faster in stiffer vessel. Measurement of the brachial ankle pulse wave velocity (baPWV) is a non-invasive method for evaluating the stiffness of the vessel wall. We investigated the relation between the baPWV and risk factors for atherosclerosis. METHOD: We studied 180 subjects (38 male and 142 female; mean age 46 years, range 24 to 76 years). The instrument used for evaluating the baPWV was a Vasoguard (VIASYS Healthcare, Dublin, Ohio, USA), and measurements were performed in the right arm and in both ankles. Data were analyzed using Pearson correlation, t-test, and multiple regression analysis. Multiple regression analysis was performed for age, sex, smoking, hypertension, height, weight, body mass index (BMI), total cholesterol, LDL, HDL, TG, and HbA1c. RESULT: Right and left baPWVs were significantly increased (P<0.05) in subjects with the following risks: older age, high body weight, high BMI, high total cholesterol, high LDL, high TG, high HbA1c, and low HDL. Right and left baPWVs were also significantly increased (P<0.05) in male subjects with a history of smoking and hypertension. Multiple regression analysis showed that age, sex, and LDL were independent determinants of the right and left baPWVs. CONCLUSION: This study provides evidence that increased age, male gender, and high serum LDL levels are risk factors that contribute to arterial stiffness. Measurement of the baPWV may be a useful method for evaluating vascular status.

An Individualized Teaching Program for Atherosclerotic Risk Factor Reduction in Patients with Myocardial Infarction

This study was conducted to evaluate the effect of a teaching program on patients with myocardial infarction. Forty-five patients were randomly selected 22 were assigned to a teaching group and 23 to a control group. An individualized teaching program was delivered to the teaching group during the hospitalization period. It covered aspects such as: the characteristics of heart disease, the anatomy and physiology of the heart, risk factors of atherosclerosis, medication and diet and exercise therapy. When these subjects were discharged to their homes, they received regular supportive care via telephone or mail for 12 weeks. Atherosclerotic risk factors, including, smoking, exercise, blood lipid profile and BMI were measured before and after the teaching program. Post-testing revealed that the numbers of those who exercised and the number of non-smokers were significantly higher in the teaching group than in the control group. Increased HDL cholesterol (High-Density Lipoprotein cholesterol) was significantly greater in the teaching group than in the control group. The above findings suggest that this individualized teaching program might be helpful at reducing the risk factors of atherosclerosis in myocardial infarction patients.