Introduction: Stroke is one of the leading causes of adult disability and certainly the most significant single cause of neurological disability. Aim: To examine the quality of life of patients after a stroke by analyzing the physical and mental condition, as well as social skills from the aspect of individual, family, professional and life on the broader community. Methodology: The research is designed as a prospective study. The sample consisted of 20 patients with stroke (experimental group) and patients without stroke (control group), treated at the Clinic for Medical Rehabilitation of the Clinical Center of Vojvodina. The National Institute of Health Stroke Scale (NIHSS), the Modified Bartel Index, the Rankin Scale (mRS) and the Mini-Mental State Exam (MMSE) were used to assess neurological status, functional and cognitive status. In addition, the SF-36 Short Form Health Questionnaire and the Stroke Impact Scale (SIS) were used to assess the quality of life. Results: In all domains of SIS and the overall score, statistically significant differences were found between patients with stroke, compared to those without. The most significant differences were found in handicap, arm, and daily activities. The minor differences, but still statistically significant, were found in communication, memory, and emotions. Conclusion: Patients' quality of life after a stroke is significantly impaired, and physical functioning is most affected.
Introduction: Anosmia and ageusia are one of the most common and characteristic symptoms of SARS-Cov-2 infection, with frequency of almost 50% in patients in Western countries. There are more and more hypotheses of potential central nervous system (CNS) affection by the virus. It is supposed that virus enters via nasal mucosa, and then via cribriform plate enters olfactory bulb, with further dissemination to the CNS. Case report: A 34-year old female patient experienced loss of smell and taste in July 2020, about two months before testing Covid-19 positive. Covid-19 presented with minor pneumonia, and worsening of anosmia and ageusia. After treatment, the patient recovered well, but anosmia and ageusia appeared again, varying in intensity, and since January 2021 became persistent. The case was evaluated by otorinolaryngologist, pulmologist, and finally neurologist. In the meantime, patient was tested Covid-19 negative and received two doses of Sputnik V vaccine. Brain MRI was performed and it clearly shows severe bilateral olfactory bulb atrophy. Thre patient has anosmia and ageusia up to this day, and future MRI follow-up is planned. Conclusion: Loss of smell and taste may be a predictor of further central nervous system dissemination of the virus, and possible neurological complications (which is still a subject of consideration). Olfactory bulb could be a gateway to Covid-19 intrusion into CNS, and its atrophy could be an indicator of that. Further investigation on this topic is required, including wide application of MR imaging in order to come to definite conclusions.
The goal of all medical treatments is a better quality of life for patients. Post-stroke rehabilitation is a long process with uncertain result. The aim of this study was to explore the factors which affect the quality of life of patients recovering from a cerebrovascular disease. This is a prospective study evaluating the quality of life of one hundred patients one month and six months after a stroke, and patients also answered questions retrospectively, of how they felt before the stroke. As assessment tools we used a questionnaire on general and clinical data and Medical Outcomes Study Short Form (SF-36) questionnaire. Physical functioning and Physical role domains of SF-36 show significant differences in both measured periods (p<0.001). Emotional role, Social functioning, Mental health, Vitality and General health domains show a statistically significant change during first six months, while Bodily pain domain did not change (p>0.05). Physical summary score has changed significantly during 6 months (p <0.001). Mental summary score showed no significant difference in both periods (p <0.687; p <0.958). The brain localization is important factor (p<0.0002). Gender, age, education, employment status and previous strokes did not have a statistically significant influence (p> 0.05). Post-stroke physical impairment is not always accompanied by emotional impairment. Emotional functioning impairments generally return to the premorbid level during the period of six months, while physical impairments continue to occur. Further research is needed for better understanding of these relationships.
Background: Being the most austere manifestation of ischaemic heart disease, acute coronary syndrome is one of the most frequent causes of urgent treatment and sudden death in both developed and developing countries as well. Acute stroke is the third cause of death in developed countries, after cardiovascular diseases and tumors, and second worldwide. Besides being a disease with high mortality, it is also a disease with a highest level of disability. Aim: To determine possibilities and modes of rehabilitation of patients with concomitant occurence of acute stroke and acute coronary syndrome. Methods: Retrospective study using hospitalized patients data. 5929 hospitalized patients treated at the Institute for cardiovascular diseases in Sremska Kamenica were analyzed from January 1st 2017 to December 31st 2019, without regarding sex and age. We entered data in created database and analyzed using descriptive statistics and chi-square test. Results: Concomitant stroke and acute coronary syndrome was found in 61 patient (1.0%). There were 32 males and 29 females. Average age was 68.82. Pneumonia occured more frequently in persons with concomitant occurrence of acute stroke and acute coronary syndrome than in persons with acute coronary syndrome without acute stroke. Regarding neurological and/or cardiological condition, only 3 patients (9.0%) were eligible for rehabilitation, and in all others it was delayed or contraindicated. Conclusion: Rehabilitation of patients with concomitant occurrence of acute coronary syndrome and acute stroke was complicated, with high risk, and required multidisciplinary approach to each patient individually.
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