Background Stroke is the second leading cause of death in the world and a major cause of disability, with ischemic stroke contributing to 87% of all strokes. Platelets are central in the formation of thrombus, and in the process, they enlarge in size, become active, and secrete prothrombotic factors. This is supported by the presence of large platelets in ischemic stroke, where they may be implicated in the pathogenesis of vessel occlusion, leading to stroke. The mean platelet volume (MPV) is an important laboratory marker of platelet function and activation.
Materials and Methods The present study was conducted to assess the role of MPV in the pathogenesis, severity, and outcome of ischemic stroke. It was an observational study in 100 acute ischemic stroke (AIS) patients (excluding cardioembolic stroke) admitted to the Medicine wards, Department of Medicine, Jawaharlal Nehru Medical College, a tertiary care hospital at Aligarh. The MPV was correlated with the conventional risk factors of ischemic stroke and outcome (using modified Rankin scale [mRS]). The study revealed statistically significant correlation between MPV and hypertension, type 2 diabetes mellitus, and carotid intima media thickness (CIMT). Also, the MPV at presentation positively correlated with mRS (correlation coefficient 0.818); thus, high MPV was associated with more severe disability.
Conclusion The MPV at the time of presentation of ischemic stroke may be useful in predicting the severity of stroke and neurological recovery. However, a larger study including diverse population is required to endorse its predictive value in AIS.
In December 2019, a novel coronavirus (now named COVID-19) was identified as a causative agent for a cluster of pneumonia cases in Wuhan, China.1 Till March 2020, India was one among 50 countries which identified patients tested positive for COVID-19.2 One day curfew was imposed in the country on March 22, 2020 to forewarn the people about the danger the country was going to face. The government of India announced a nationwide lockdown for 21 days from March 25, 2020 with subsequent second, third and fourth lockdowns. This was done to reduce the transmission of disease and flatten the curve. The preparations to manage COVID-19 pandemic crisis began in Jawaharlal Nehru Medical College Hospital Aligarh, a tertiary care centre in western Uttar Pradesh by 15th of March 2020. In April 2020, it was declared as Level 2 COVID care hospital to deal with complicated and critical cases. The establishment of flu clinic, exclusive COVID-19 isolation ward, teleconsultation and widespread screening of patients by Reverse transcriptase polymerase chain reaction (RT PCR) were some measures undertaken to deal with the crisis. The increased burden of patients presenting with bronchopneumonia necessitated augmentation of the existent infrastructure and better utilization of resources. Emergency and trauma centre, JNMCH, AMU Aligarh was also no exception and reorganising emergency trauma ICU as COVID-19 suspect ICU made the functioning of the entire hospital a lot smoother during this unsustainable crisis situation. However, there were several challenges to overcome while designating an emergency and trauma ICU as COVID-19 suspect ICU. There is ample amount of literature available discussing the strategies for preparing a dedicated COVID ICU, however there is relative scarcity of literature on the challenges in managing an emergency and trauma ICU (ETC – ICU) during the pandemic. In this review, we discuss the strategies and planning for converting an emergency and trauma ICU into a COVID suspect ICU in a tertiary care centre in western Uttar Pradesh (India) during the pandemic and the challenges faced.
Bangladesh Journal of Medical Science Vol.20(5) 2021 p.26-31
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