BACKGROUND: Immune dysfunction is increasingly recognized to be contributing to stroke associated infections.
OBJECTIVE: The present study was aimed to study the magnitude of the stroke associated infection in a mixed population of hemorrhagic and ischemic strokes and its predisposing f actors.
MATERIAL &METHODS: The study population consisted of 173 consecutive stroke admissions at SKIMS Srinagar, a tertiary core hospital. The patients developing fever at admission or in hospital were included and underwent neuroimaging and workup for the source of infection. The follow up was done upto death or discharg e of the patient. A univariate and binary logistic regression analysis was done to find the patient characteristics associated with infection.
RESULTS: The stroke subtypes in the study were 60.1% hemorrhagic and 39.9% ischemic strokes. The majority of hemorrhagic strokes (65A%) were located in putamina while as anterior circulation territory contributed about 80% of the ischemic strokes. Fifty eight (33.5%) patients developed stroke associated infection. Chest was the source of infection in 58.6% of the cases. The culture positivity rate was poor (18.9%) in the patient study. The presence of a comorbid illness {OR 3.4), volume of hematoma (OR 4,7). and ventricular extension of the hemorrhoge (OR 4.9) significantly increased the odds ratio of stroke associated infection.
CONCLUSIONS: The frequency of post stroke infection is around 33%, chest being the commonest source. Presence of a comorbid illness, volume of hemorrhage a nd ventricular extension increase the risk of infection . JMS 2012; 15(1):22-27
Background and Aim:
The World Health Organization estimated that 15 million people throughout the world suffer stroke every year. Only 5%–10% of all acute ischemic stroke (AIS) patients presenting to emergency departments (EDs) are eligible for and receive thrombolytic therapy. This study was conducted to assess and compare the efficacy and safety profile of thrombolysis with tenecteplase (TNK) with that of alteplase among patients with AIS who were eligible for thrombolysis.
Materials and Methods:
This was a hospital-based prospective observational study. All the patients who presented with AIS within the time window period of ≤4.5 h to ED of Sher-i-Kashmir Institute of Medical Sciences, Soura, from September 2018 to March 2021, were screened for eligibility of thrombolysis by TNK. A total of 76 patients were enrolled; among which 42 were thrombolysed with TNK and 34 patients were thrombolysed with alteplase. These data were compared with departmental data of patients thrombolysed by alteplase during July 2015–July 2017. Inclusion and exclusion criteria used in the study were as per the American Heart Association/American Stroke Association guidelines for thrombolysis. Efficacy and safety were assessed and compared of the two drugs.
Results:
After 24 h of thrombolysis, early neurological improvement occurred in 62% of TNK patients compared to only 35% of patients from alteplase group, which was significant statistically (P < 0.05). An excellent functional outcome, defined as the Modified Rankin Scale (mRS) of 0–1 at 3 months of discharge, was seen in 67.6% of TNK and 48.5% of alteplase group. A poor recovery, defined as the mRS of 4–6 at 3 months of follow-up, was seen in 16% and 21% in TNK and alteplase group patients, respectively.
Conclusion:
TNK appears to be characterized by a better safety and efficacy profile than alteplase; however, further multicenter studies and randomized controlled trials are required to confirm our preliminary findings.
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