Background: Elevated levels of plasma D-dimer increase the risk of ischemic stroke, stroke severity, and the progression of stroke status, but the association between plasma D-dimer level and functional outcome is unclear. Methods: This observational cohort type of study was done in the Department of Neurology Dhaka Medical College Hospital, Dhaka during August, 2017 to July, 2019. Total 100 patients having acute ischemic stroke were included in this study. Age > 18 year of both male & female patients with first-ever acute ischemic stroke confirmed by CT scan/ MRI who gave informed written consent including consent to give blood sample for plasma D-dimer level measurement were enrolled in this study. Results: Mean D-dimer level was 0.49±0.00 found in MRS 0, 0.57±0.19 in MRS 1, 0.49±0.00 in MRS 2, 0.70±0.33 in MRS 3, 1.46±0.77 in MRS 4, 1.60±0.59 in MRS 5 and 3.17±0.93 in MRS 6. The above findings indicate that MRS score increased with mean D-dimer significantly (p<0.05). Receiver-operator characteristic (ROC) was constructed by using D-dimer level, which gave a cut off value 1.7, with 90.9% sensitivity and 89.4% specificity for prediction of prognosis. Conclusion: Elevated plasma D-dimer level on admission was significantly associated with short-term poor outcome in patients with acute ischemic stroke. Bangladesh Journal of Neuroscience 2018; Vol. 34 (2): 72-78
Background: Guillain Barré Syndrome (GBS) diagnosis is based on a combination of clinical features, Nerve conduction studies (NCS) and analysis of the cerebrospinal fluid (CSF) which eventually assist in monitoring disease progression as well as the efficacy of immunotherapy. The main objective of this study was to determine the relation of CSF protein level and nerve conduction study with short-term prognosis of GBS patients. Methods: This observational study was carried out in the Department of Neurology and Medicine, Dhaka Medical College Hospital, Dhaka during the period August, 2017 to July, 2018. Total 50 patients suffering from GBS were enrolled in this study. Lumber puncture (LP) and NCS were done at day 10 of symptom onset. Results: In this study majority (87.5%) of the patients had GBS Disability score <3 in demyelinating and 16(47.1%) in axonal on day 90. Three fourth (75.0%) patients EGRIS score was ³3 in demyelinating and 34(100.0%) in axonal and mEGOS it was revealed that more than two third (68.8%) patients mEGOS score was ³6 in Demyelinating and 33(97.1%) in axonal. More than three fourth (76.0%) patients ³6 mEGOS score in CSF protein <100 (mg/dl) and 25(100.0%) in CSF protein ³100 (mg/dl). Multiple logistic regression analysis showing a subject with axonal GBS had 1.579 (95.0% C.I 1.717 to 3.475), CSF Protein had 1.013 (95.0% C.I. 1.001 to 1.026) (PÂ0.05%). Conclusion: CSF analysis for protein and NCS examination appeared as the essential short term predictors in evaluating diagnostic accuracy and prognostic determinant of GBS early. Bangladesh Journal of Neuroscience 2018; Vol. 34 (2): 79-84
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