Knowledge of stroke among stroke patients and their relatives in Northwest India.

BACKGROUND: The knowledge of warning symptoms and risk factors for stroke has not been studied among patients with stroke in developing countries. AIMS: We aimed to assess the knowledge of stroke among patients with stroke and their relatives. SETTINGS AND DESIGN: Prospective tertiary referral hospital-based study in Northwest India. MATERIALS AND METHODS: Trained nurses and medical interns interviewed patients with stroke and transient ischemic attack and their relatives about their knowledge of stroke symptoms and risk factors. STATISTICAL ANALYSIS: Univariable and multivariable logistic regression were used. RESULTS: Of the 147 subjects interviewed, 102 (69%) were patients and 45 (31%) were relatives. There were 99 (67%) men and 48 (33%) women and the mean age was 59.7+/-14.1 years. Sixty-two percent of respondents recognized paralysis of one side as a warning symptom and 54% recognized hypertension as a risk factor for stroke. In the multivariable logistic regression analysis, higher education was associated with the knowledge of correct organ involvement in stroke (OR 2.6, CI 1.1- 6.1, P =0.02), whereas younger age (OR 2.7, CI 1.1-7.0, P =0.04) and higher education (OR 4.1, CI 1.5-10.9, P =0.005) correlated with a better knowledge regarding warning symptoms of stroke. CONCLUSIONS: In this study cohort, in general, there is lack of awareness of major warning symptoms, risk factors, organ involvement and self-recognition of stroke. However younger age and education status were associated with better knowledge. There is an urgent need for awareness programs about stroke in this study cohort.

Valvular heart disease in end-stage renal failure patients on maintenance hemodialysis.

To determine the presence of, and factors associated with, valvular heart disease in end-stage renal failure patients by M-mode, two-dimensional and Doppler echocardiography. Case series of an unselected group of patients on maintenance haemodialysis. Haemodialysis unit and echocardiography laboratory of the King Fahd Central Hospital, Gizan, Saudi Arabia Sixty patients on haemodialysis for at least 6 months. Main outcome measures: Detection of functional and structural valve abnormalities and their relation to putative aetiological factors. The mean age was 34.4 [SD13.0], range 14-66 years; 31 [51.7%] were men and 29 women. The duratior of dialysis was 37 [SD 29] months with a range of 6-106 months. Mitral regurgitation was found in 20 [33.3%], mitral annular calcification in 3 [5.0%], aortic valve calcification in 5 [8.3%] and tricuspid regurgitation in 8 [13.3%] patients At least one of these lesions was present in 22 [36.7%] patients. No patient had mitral or aortic stenosis. There were significant associations found between left ventricular mass and mitral regurgitation; calcium-phosphate product and aortic valvular calcification; and right ventricular enlargement and tricuspid regurgitation. Mitral and tricuspid regurgitation were common in our dialysis patients. The calcium and phosphate product was found to be an important determinant of aortic valvular calcification. Further studies are needed to determine whether early control of calcium and phosphate levels would prevent the development of this complication