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Introduction: Stroke is a global health problem. In this study we evaluated the risk factors, clinical features and their correlation with Magnetic Resonance Imaging (MRI) brain including Magnetic Resonance Angiogram (MRA) and Carotid Verteberal (CV) Doppler findings in patients presenting with acute ischemic stroke. Material and methods: Seventy five patients of the age group 20 to 80 years admitted with acute ischemic stroke were enrolled for the study. A detailed history, clinical examination and blood investigations were done. MRI, MRA and CV Doppler were done in all patients. Serum Homocysteine levels and Anti-nuclear antibody assay (ANA) by Immunofluorescence (IF) were done in selected patients. Statistical analysis was done using SSPS version 16.0 for microsoft windows. Results: In this study, there were more males than females. The mean age was 59 years. Young stroke population (<40 years) was 5%. Anterior circulation was predominantly involved than posterior circulation. Right Middle Cerebral Artery was the most common artery involved. There was positive correlation for clinical presentation and area of infarct and for areas of infarct and the vessels involved. Most common clinical presentations were weakness and slurring of speech. There were 3% intracranial anomalies. 56% had significantly elevated levels of homocysteine. 24% had ANA- IF positivity. Recurrence of stroke was seen in 17%; National Institute of Health Stroke Scale (NIHSS) score was higher in patients with recurrent stroke and right hemisphere infarcts. Conclusion: There was positive correlation for clinical presentation and area of infarct and for areas of infarct and the vessels involved.
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Background: Poorly controlled diabetes mellitus as indicated by elevated glycated haemoglobin (HbA1c) levels is associated with increased cardiovascular risk. C–reactive protein (CRP), an important cardiovascular risk factor, is elevated in diabetics with poor glycaemic control than those with good control. The present study assessed the correlation between HbA1c and CRP levels.Methods: A prospective study was conducted in thirty type 2 diabetic patients irrespective of the disease duration and treatment; those with established target organ damage were excluded. HbA1c and hsCRP levels were measured at baseline; sugars were monitored monthly and medications optimised; at the end of six months HbA1c and hsCRP levels were measured.Results: Mean age of the study subjects was 58.7±8.6 years; At the baseline, all had poor glycaemic control (HbA1c >7%); 15 had hsCRP >3 mg/L. At the end of 6 months, 5 achieved good glycaemic control (HbA1c <7%); 10 had hsCRP >3 mg/L. Baseline median hsCRP was 3.33 mg/L (0.68, 15.9) and at the end of 6 months it was 2.08 mg/L (0.48, 9.12). Mean HbA1c at baseline and end line was 10.6±1.55% and 8.43±1.84% respectively. There was significant reduction in both the mean HbA1c and median hsCRP at the end of 6 months (p <0.001). Positive correlation was observed between HbA1c and CRP at baseline (r=0.32, p=0.10). However, this was not observed at the end of 6 months.Conclusions: There is positive correlation between the level of glycaemic control (HbA1c) and CRP levels; Better glycaemic control results in significant reduction in the hsCRP levels.
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Introduction:: Stroke is a global health problem. Studies haveshown that serum albumin level is an independent predictor ofischemic stroke outcome. In the present study we comparedthe serum albumin and the volume of infarct with the clinicaloutcome.Material and methods: Fifty patients of age more than18 years with clinical and radiological evidence of acuteischemic stroke were included in the study. The severity ofstroke at admission was assessed by National Institute ofHealth stroke scale (NIHSS). Serum albumin levels weremeasured at admission within 36 hours after stroke onset.Functional outcome was measured 1 week post admissionand after 3 months during follow up using modified Rankinscale (mRs). A score of mRs >3 or death was taken as pooroutcome. Statistical analysis and interpretation of the data wasdone. P value of <0.05 was taken as statistically significant.Results: The mean age group of the study population was53 years, male patients had more severe stroke comparedto female patients. Most common risk factors were diabetesmellitus and systemic hypertension. Patients with a goodoutcome had lower NIHSS score, low mRS score, highalbumin and low volume of infarct. Those with worst outcomehad higher NIHSS, high mRS and high volume of infarct.Conclusion: Relatively high serum albumin level in acutestroke patients decreases the risk of poor outcome. It is notonly serum albumin but volume of infarct also does play a rolein the final outcome of the patient
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Background: Dengue infection is a major public health threat; early recognition is crucial to improve the survival in severe dengue. Although there are various biomarkers to predict the severity of dengue, they are not routinely used in clinical practice for prognostication. We analyzed whether serum ferritin can be used to predict the severity at an earlier stage.Methods: A hospital based prospective observational study was done involving 119 dengue cases diagnosed by positive NS1 antigen or dengue specific serology (capture ELISA). Serum ferritin was measured in all at the time of diagnosis. Clinical and platelet count monitoring was done daily; classified as severe and non-severe according to 2009 WHO criteria.Results: Out of 119, 5 developed severe dengue; patients with severe dengue had significantly lower median platelet count (p<0.0001); higher ferritin levels (p=0.03) and hospital stay (p<0.0001) than non-severe group. Age had a significant negative co-relation with platelet count (r= -0.427; p<0.0001); positive correlation with ferritin levels (r=0.16; p=0.08) and hospital stay (r= 0.26; p=0.004) indicating that elderly subjects are at risk of severe disease. Serum ferritin levels negatively correlated with the platelet count (r= -0.51 p<0.001). High ferritin levels in severe cases are noted from day 4 of clinical illness.Conclusions: Elevated serum ferritin levels can be used as a potential early prognostic marker to predict the severity of dengue infection in clinical practice.