ABSTRACT
Introduction Stroke is a leading cause of death and disability globally, with atrial fibrillation (AF) recognized as a significant risk factor due to its association with increased stroke recurrence and mortality. Timely detection of AF is crucial to prevent recurrent strokes and improve outcomes. This study primarily aimed to evaluate the utility of 24-hour Holter monitoring for AF detection in acute ischemic stroke patients. Methods This retrospective observational study examined data from 207 patients admitted with acute ischemic stroke to a tertiary-care hospital over a two-year period. Patients with pre-existing AF, transient ischemic attacks, unconfirmed diagnoses, and missing Holter reports were excluded. A total of 140 patients were included in the analysis. The study investigated AF detection rates, the relationship between AF and stroke risk factors, other Holter findings, and the time delay in attaching Holter monitors. Results Of the 140 patients evaluated, AF was detected in nine (6.4%), exclusively in those aged ≥65 years. The most prevalent risk factors among the study participants were hypertension (74.3%) and diabetes (61.4%). No significant correlations were observed between AF and the analyzed stroke risk factors. The median delay for Holter device attachment was 3,503 minutes (approximately two days and 10 hours), with longer delays noted in males (4,084 mins (approximately two days and 20 hours) vs. 2,565 mins (approximately one day and 18 hours), p=0.005). Premature atrial complexes (PACs) were notably associated with the absence of AF, suggesting their potential role as markers for undiagnosed AF. Conclusion The study highlights the limited utility of 24-hour Holter monitoring in detecting AF in acute ischemic stroke patients, advocating for extended monitoring durations, especially in older patients. To improve AF detection, potential strategies include using longer monitoring periods and optimizing hospital workflows to reduce delays in attaching Holter devices. These approaches can minimize the risk of underdiagnosing paroxysmal AF, thereby preventing recurrent strokes and improving patient outcomes. Further investigation into PACs as potential predictive markers for AF is warranted.
ABSTRACT
The rheological model for yield stress exhibiting fluid and the basic laws for fluid flow and transport of heat and mass are used for the formulation of problems associated with the enhancement of heat and mass due to dispersion of nanoparticles in Casson. The heat and mass transfer obey non-Fourier's laws and the generalized Fick's law, respectively. Model problems are incorporated by thermal relaxation times for heat and mass. Transfer of heat energy and relaxation time are inversely proportional, and the same is the case for mass transport and concentration relaxation time. A porous medium force is responsible for controlling the momentum thickness. The yield stress parameter and diffusion of momentum in Casson fluid are noticed to be inversely proportional with each other. The concentration gradient enhances the energy transfer, and temperature gradient causes an enhancement diffusion of solute in Casson fluid. FEM provides convergent solutions. The relaxation time phenomenon is responsible for the restoration of thermal and solutal changes. Due to that, the thermal and solutal equilibrium states can be restored. The phenomenon of yield stress is responsible for controlling the momentum boundary layer thickness. A porous medium exerts a retarding force on the flow, and therefore, a deceleration in flow is observed. The thermal efficiency of MoS2-SiO2-Casson fluid is greater than the thermal efficiency of SiO2-Casson fluid.
