Background: Stroke is a serious life-threatening health condition. Prevention, treatment, and rehabilitation for stroke rely heavily on stroke health literacy, which refers to health literacy regarding stroke and stroke literacy. Objectives: The objectives of this review were to investigate stroke health literacy and summarize into 3 main topics: 1) assessment tools for stroke health literacy; 2) stroke health literacy levels in various populations; and 3) strategies to improve stroke health literacy. Materials and methods: A comprehensive search of the English literatures published between 2011-2021 was conducted using PubMed and Scopus databases. All studies relevant to stroke health literacy regardless the study types were included. Results: Total of fourteen studies complied with the criteria were included in a review. As a results, nine assessment tools for stroke health literacy were found (four for health literacy and five for stroke literacy). Stroke health literacy was insufficient in the general population, the population at high risk for stroke, and patients with stroke. Some strategies to improve stroke health literacy were revealed, consisted of two stroke educational programs for patients with stroke and one educational program for the general population. Conclusion: To conclude, there is very limited knowledge about stroke health literacy in terms of assessment tool, and improvement strategy. Further research is needed in order to expand knowledge and increase comprehension regarding stroke health literacy, and thus improve preventive, curative, and rehabilitative outcomes.
Background: Severe sepsis and septic shock are among the leading causes of morbidity and mortality in intensive care units worldwide despite rapid advances in treatment protocols. Even with all advances, determining the prognosis of sepsis continues to remain tricky. Objectives: This study was planned to assess early onset coagulopathy as a predictor of outcome and mortality in septicemic patients and to study the underlying risk factors associated with mortality in septicemic patients with underlying coagulopathy. Materials and methods: 240 patients fulfilling the criteria of SIRS and sepsis were included in the study. Coagulation parameters including platelet count, prothrombin time – international normalized ratio (PT-INR), activated partial thromboplastin time (aPTT) were evaluated within 48 hours of admission and 28-day mortality was evaluated. Independent predictors of 28-day mortality were evaluated using logistic regression model. Results:Twenty-eight-day mortality rate was 77.77% (98/126) in patients with coagulopathy and a meagre 1.7% (2/114) in patients without coagulopathy which was statistically significant (p<0.05). Log Odd’s ratio calculated using chi-square test was found to be 5.2781, 95% CI (1.633-17.321), which was highly significant. Univariate logistic regression for mortality showed PT-INR, aPTT and APACHE II scores to be independent variables. Multivariate logistic regression revealed severe increase in PT-INR [adjusted OR=1.622 (0.841, 3.092)], moderate increase in aPTT [adjusted OR=4.537 (0.989, 7.326)], and severe increases in aPTT [adjusted OR=3.851 (2.438, 4.996)], and APACHE II scores [adjusted OR=5.381 (1.925, 11.01)], were independently associated with 28-day mortality whereas age, sex, any severity of thrombocytopenia, mild to moderate increase in PT-INR, and mild increase in aPTT were not. Conclusion: Early onset coagulopathy was found to be significantly associated with increased mortality risk in septicemic patients. Septicemic patients should be screened for coagulopathy within 24-48 hours of admission in appropriate clinical scenario to predict mortality outcome and take necessary action at the earliest.
Prevalence of infection is generally higher in the patients with diabetes mellitus (DM) and the bacteriological profile varies in the myriad complications that are generally associated with it. Some infections are more common in diabetes probably due to dysregulation of immune function. As communityacquired and hospital-acquired infections galore in diabetes, strict glycemic control is indispensable in curbing the extremely high morbidity and mortality associated with the disease. Our study highlights the usual bacteriological profile in various diabetic infections in eastern India and reinforces upon strict glycemic control which profoundly affects the morbidity, hospital stay and mortality. Older age, longer duration of diabetes and poor glycemic control were associated with increased risk for infections in diabetic patients.
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