RESUMEN
To determine the frequency of newly diagnosed diabetes mellitus in acute ischaemic stroke patients. Observational study. Jinnah Postgraduate Medical Centre, Karachi, from June 2007 - June 2008. This study included adult patients [age > 30 years, both genders] with the diagnosis of acute ischaemic stroke. Patients who were known to have diabetes mellitus prior to stroke, had a non-lacunar stroke or were admitted to intensive care units for any reason were excluded. Detailed history and examination, fasting blood sugar, fasting lipid profile, a non-enhanced CT scan brain and electrocardiogram were done on every patient. Data were entered on a preformed proforma. The results were analyzed on SPSS version 10. Chi-square test was applied. P-value <0.05 was considered to be statistically significant. A total of 250 patients were enrolled. The male: female ratio was 1: 0.9. Mean age was observed as 60.9 +/- 10.1 years. In total, 50 new cases of diabetes mellitus were identified [20%]. Average fasting blood sugar in diabetic subjects was 148 +/- 10 mg/dl. The most common risk factors in the newly diagnosed diabetic subjects were hypertension 26 [52%], smoking 18 [36%] and hyperlipidemia 14 [28%]. Atrial fibrillation and myocardial infarction were seen in 12 subjects [24%] and 9 subjects [18%] respectively. Twenty percent patients with acute ischaemic stroke had un-diagnosed diabetes. Therefore, it is advisable to screen acute stroke patients for diabetes to reduce their long-term morbidity and mortality
RESUMEN
To determine the characteristics of post-stroke seizures and compare these in early vs. late post-stroke seizures. Observational study. Department of Neurology, Liaquat National Hospital, Karachi, from March to September 2007. All admitted patients aged over 25 years, with diagnosis of post-stroke seizures were included. Those with known epilepsy, sepsis and eletrolyte imbalance were excluded. Age, co-morbid condition, details of seizures and radiological findings regarding type and location of stroke were collected and entered in a pre-formed proforma. Results were described as frequency and mean. Association of variables was determined through chi-square test with significance at p < 0.05. Out of the 50 patients, there were 28 [56%] males and 22 [44%] females with the mean age of 56.86 +/- 15.26 years. Thirty-one [62%] patients had history of hypertension. Early seizures i.e. within 2 weeks were seen in 29 [58%] patients. Generalized seizures were seen more frequently i.e. in 37 [74%] patients. Thirty-one [62%] subjects experienced more than 2 seizures. Forty [80%] had an ischemic stroke including 36 [72%] arterial infarct and 3 [6%] venous infarcts. Intracerebral hematoma was seen in 10 [20%] of subjects. Comparison between early and late onset seizures revealed significant association between ischemic heart disease [IHD], old stroke, hypertension and late onset seizures [p < 0.05]. Post-stroke seizures were more frequent in males, with history of hypertension, and with cortical ischemic strokes. Early seizures, multiple episodes and generalized seizure type were more common. Venous infarcts were chiefly associated with seizures at presentation. History of old stroke, ischemic heart disease, hypertension and hypercholesterolemia showed a strong relationship with the occurrence of late onset seizures