Showing 17 results for Stroke
K Ghandehari, A Shuaib,
Volume 18, Issue 4 (11-2005)
Abstract
Silent Brain Infarcts (SBI) are associated with an increased risk of subsequent
stroke. SBI are incidentally revealed by CT or MRI executed in stroke patients.
A prospective study was undertaken involving 200 consecutive patients aged >45
years with brain infarct admitted in University of Alberta Hospital, Canada (100 patients)
and Valie-Asr Hospital, Iran (100 patients) in 2003. Patients were divided in age
groups aged <65 and >65. All of the patients underwent brain CT. A stroke neurologist
with knowledge of stroke history subsequently reviewed the scans and diagnosed SBI.
The relations of race, gender and age groups with SBI were analyzed with chi-square
and Fisher exact tests.
SBr were present in 26.9% of patients aged <65 and 48.6% of patients aged
>65. Canadian patients were significantly more preponderant to SBI in age group> 65
(p= 0.013). The mean age of Canadian patients was significantly higher than Persians
(p<0.001). Within a total of 200 patients the female gender was significantly more
preponderant to SBr (p= 0.02) which was not related to age and race groups. Small
vessel territory infarct was present in 87 % of our patients with SBI.
SBr are cornmon in stroke patients. The frequency of SBI is higher in female
gender and the elderly.
Azizeh Afkham Ebrahimi, A Elahi, H Yousefi, Sh Nohesara, A Aghebati,
Volume 21, Issue 1 (5-2007)
Abstract
Abstract
Background: The purpose of the present study is to determine the frequency and severity of depression in post-stroke patients.
Methods: Based on a cross-sectional research design, 30 recent stroke outpatients were assessed with DSM-IV interview for depression and two self-rating depression scales, CES-D and BDI. Sex differences in depression, the relationship between depression and the location of the brain lesion and other clinical manifestations (sensory, motor and verbal) were also determined.
Results: 68% of the patients reported depression on CES-D, among them 64% suffered from moderate to severe depression according to BDI and interview-based information. Women were more depressed than men (63% and 37% respectively). Differences were found in lesion side, with patients with lesions in right side reporting higher levels of depression than patients with left side lesions. Motor disturbances were the most prevalent clinical features.
Conclusion: There seems to be an increased incidence of depression in stroke patients. The mechanism of pathophysiological processes underlying this association is poorly understood and is an important area for full investigation. Since depression is a significant risk factor for stroke it is important that psychiatric examination of post-stroke patients be conducted.
Maryam Fayazi, Shohreh Noorizadeh Dehkordi, Mehdi Dadgoo, Masoud Salehi,
Volume 26, Issue 1 (2-2012)
Abstract
Background: The Motricity Index was used to measure strength in upper and lower extremities after stroke. The weighted score based on the ordinal 6 point scale of Medical Research Council was used to measure maximal isometric muscle strength. There is dearth of articles dealing with the reliability of this method. Therefore, the aim of this study was to determine the test retest reliability of Motricity Index strength assessments for paretic lower limb in 20 chronic stroke patients with one week interval.
Methods: In a cross sectional study, intrarater reliability of lower extremity Motricity Index strength assessments with one week interval were measured.
Result: The SPSS 18 was used for analysis of data. Two-way random-consistency model of ICC was used for assessment of test-retest reliability. The ICC values showed high reliability of strength measurement of Motricity Index (ICC=0.93).
Conclusion: The Motricity Index can be a reliable instrument for measuring the strength of involved lower extremity when assessment is done by one rater following chronic stroke.
Masoud Mehrpour, Mahbubeh Khuzan, Neda Najimi, Mohamad R. Motamed, Seyed-Mohammad Fereshtehnejad,
Volume 26, Issue 2 (5-2012)
Abstract
Background: The role of uric acid as a risk factor for vascular disease and acute stroke is controversial and there is little information about it. In this study, we determined serum uric acid levels in patients with acute stroke and assessed its relationship with cerebrovascular risk factors.
Methods: In this cross sectional study, we assessed patients with acute stroke who were admitted in Firoozgar Hospital from September 2010 to March 2011. Clinical records of patients and their serum uric acid level was investigated. Finally, collected data were analyzed using SPSS software Ver.16.
Results: Fifty five patients with acute stroke were evaluated who 25 of these patients (45.5%) were female and 30 of them (54.5%) were male. The mean age of patients was 67±14 years. Mean serum uric acid levels in the patients studied 5.94±1.70 mg/dl, and about half of the patients (47.3%) were hyperuricemic. There was a significant negative correlation between age of patients and their serum uric acid level (p=0.04, R =-0.27). Uric acid level was significantly higher in men than women (p=0.03). Hyperuricemia was associated with increased amounts of triglycerides and Low-density lipoprotein (LDL) cholesterol (p=0.03, p=0.02). In patients with acute stroke, there was no significant association between serum uric acid level and diabetes mellitus, hypertension, history of ischemic heart disease, smoking, prescription rTPA, and type of stroke.
Conclusion: Due to the high prevalence of hyperuricemia in patients with acute stroke, and its accompanying increase in triglyceride and LDL cholesterol levels, it can be considered as a risk factor for acute stroke.
Masoud Mehrpour, Mahboubeh Aghaei, Mohammad Reza Motamed,
Volume 27, Issue 3 (8-2013)
Abstract
Background: Thrombolytic therapy is the only approved treatment for acute cerebral ischemia. The hemorrhagic transformation is the greatest complication of this treatment, which may occur after recanalization of occluded artery. The aim of this study was to determine factors associated with clinical improvement and worsening in patients with acute ischemic stroke treated with intravenous thrombolysis.
Methods: Thirty seven patients who were treated with intravenous thrombolysis between August 2010 and August 2012 who had the inclusion criteria were studied. In this prospective study, all of the admitted patients in stroke unit, monitored for at least 48 hours. We registered all patients’ information in a stroke data registry and followed them for at least 6 months.
Results: Thirty seven patients with acute ischemic stroke who treated with recombinant tissue plasminogen activator (r-TPA) were studied. There were hemorrhagic transformations in 9 (24%) patients. Seven of them (18%) revealed intracerebral hemorrhages (ICH) within the control brain CT after 24 hours without any deterioration of neurologic symptoms (asymptomatic ICH). Although outcomes of patients with symptomatic post r- TPA hemorrhages were worse than non-hemorrhagic post r-TPA patients, there were no significant differences between asymptomatic post r-TPA hemorrhages and non-hemorrhagic post r-TPA patients, according to the National Institutes of Health Stroke Scale (NIHSS) at admission (p = 0.2), after 24 hours (p= 0.07) and after 7 days (p= 0.06) post treatment.
Conclusion: If the r-TPA protocol is followed carefully, the risk of symptomatic hemorrhage is low (about 7%). Taking r-TPA was feasible and safe in our study population thus, it can be applied for other Iranian patients.
Asghar Dalvandi, Hamidreza Khankeh, Saiedeh Bahrampouri, Abbas Ebadi, Hojjat Passandeh, Hassan Nouri Sari, Fardin Faraji, Mehdi Rahgozar,
Volume 28, Issue 1 (1-2014)
Abstract
Background :The studies have shown that stroke morbidity and mortality could be decreased if early diagnosis and treatment is delivered faster for patients. This tool is designed based on all Pre-hospital stroke scales across the world as well as experiences of the emergency medicine specialists and pre-hospital emergency technicians to improve the diagnostic accuracy of the stroke scale in Iran.
Methods : This study used mixed methods and was carried out in two main phases. In the first phase (items generating ), concept elicitation was conducted based on the review of the literature related to stroke diagnosis and usual instruments in pre-hospital emergency stroke centers, and a series of semi- structured individual interviews with 35 neurologists, emergency medicine practitioners, and physicians working in hospitals and emergency technicians in the pre-hospital field participated. In the second phase (items reduction), the face and content validity, and reliability of the procedure were checked.
Results: According to results from the first phase of this study (items generation), three domains were introduced as the most important factors influence to detection of early signs and symptoms of stroke. In the second phase (items reduction), the face validity of this tool was based on the comments received from participants (the experts and EMS technicians), and changes were made for clarity of items. The content validity based on Lawshe index was identified. The S-CVI/Ave for Iranian Pre-Hospital stroke scale was calculated (89%). To determine the criterion validity of the instrument, he Iranian pre-hospital stroke scale scores were compared with the final diagnosis based on Brain CT scan result in hospital.
Conclusion : This study made an Iranian pre hospital stroke scale for emergency technicians in pre-hospital field which is dichotomous items, simple and very easy to use. For future this tool could be recommended and employed by emergency dispatch units as well as using it in the triage procedure in the hospital.
Akram Azad, Afsoon Hassani Mehraban, Masoud Mehrpour, Babak Mohammadi,
Volume 28, Issue 1 (1-2014)
Abstract
Background :Fear of falling may be related to falling during stroke onset. The Fall Efficacy Scale-International (FES-I) with excellent psychometric properties, is an instrument developed to assess patients’ concerns about fallings. The aim of this study was to determine validation of this scale in Iranian patients with stroke.
Methods : The “forward-backward” procedure was applied to translate the FES-I from English to Persian. One hundred-twenty patients who had suffered stroke, aged 40 to 80 years (55% male) completed the Persian FES-I, Geriatric Depression Scale-15 (GDS-15), General Health Questionnaire-28 (GHQ-28), Berg Balance Scale (BBS) and Timed up and Go (TUG) questionnaires. The interval time for the test-retest of the Persian scale was 7-14 days.
Results : The test-retest and inter-rater reliabilities of the Persian FES-I were excellent (ICC2,1=0.98, p<0.001) and the internal consistency was high (Cronbach’s alpha=0.78). Factor analysis of the 16 items in the Persian scale showed only one significant factor. The total Persian FES-I score had a significantly negative correlation (p<0.001) with the BBS, but it had significantly positive correlation with the TUG, GHQ-28, and GDS-15. The difference in responsiveness scores across fallers and non-fallers yielded a large effect size (0.46), which indicated a good discriminating validity.
Conclusion : The Persian FES-I proved to be an effective and valuable measurement tool to assess stroke patients’ fear of falling in practice and research setting.
Mohammad Amin Toodeji, Sadegh Izadi, Abdolhamid Shariat, Mohamad Hosin Nikoo,
Volume 29, Issue 1 (1-2015)
Abstract
Background: Embolus is one of the causes of ischemic stroke that can be due to cardiac sources such as valvular heart diseases and atrial fibrillation and atheroma of the aorta. Transesophageal echocardiography (TEE) is superior in identifying potential cardiac sources of emboli. Due to insufficient data on TEE findings in ischemic stroke in Iran, the present study was done to evaluate TEE in detecting cardiac sources of emboli. The main aim of this study was to describe the cardiogenic sources of emboli using TEE in the ischemic stroke patients.
Methods : This is a cross-sectional study conducted during a 13-month period from January 2012 to February 2013 in Shiraz Nemazee teaching hospital. Patients admitted with stroke diagnosis were included but hemorrhagic stroke cases were excluded. 229 patients with ischemic stroke diagnosis were included and underwent TEE.
Results : Causes of cardiac emboli were detected in 65 cases (40.7%) and categorized to high-risk (29.7%) and potential risk (11%). High risk cardiac sources included atrial fibrillation (8.7%), mitral valve disease (MS or MI) 11 cases (4.75%), aortic valve disease (AS or AI) 8 (3.5%), prosthetic valve 3 (1.35%), dilated cardiomyopathy 45 (19.65%) and congestive heart failure with ejection fraction < 30% in 8 cases (3.5%). Potential cardiac sources of emboli comprised 7 cases (3.05%) of septal aneurysm, 4 (1.75%) left ventricular hypokinesia, 13 (5.7%) mitral annular calcification and 9 cases (3.95%) complex atheroma in the ascending aorta or proximal arch.
Conclusion : Our study showed that high risk cardiac sources of emboli can be detected using TEE in a considerable percentage of ischemic stroke patients. The most common high risk cardiac etiologies were dilated cardiomyopathy and valvular heart diseases.
Alireza Akbarzadeh Baghban, Somayeh Ahmadi Gooraji, Amir Kavousi, Navid Mirzakhani Araghi,
Volume 29, Issue 1 (1-2015)
Abstract
Background: Stroke is a prevalent cause of disability in adults. The fall is the most common balance
and motor impairments, which affects the quality of life in stroke patients. This study aims to
employ random effects hurdle model for evaluating the balance improvement in stroke patients under
the occupational therapy.
Methods: In this longitudinal study with repeated measurement during one year between 2013 and
2014, the data was collected using non-random sampling method from three occupational therapy
clinics. For a total of 38 stroke patients, the number of falls was recorded every two weeks. The random
effects hurdle model and random effects zero inflated Poisson (ZIP) model were fitted to the
data and were compared together. Data analysis was carried out using SAS Software version 9.2.
Results: The results of random effects ZIP model showed that the covariates of sex and age and
affected side of stroke and follow up duration had statistically significant effect on balance improvement
(p< 0.05). The occupational therapy has been effective on balance improvement more
than 40% during one year.
Conclusion: The ZIP model with random effects can capture zero inflation and correlation structure
in longitudinal count data simultaneously. Older patients, women and patients with left-side impairments
were more at risk of fall and balance impairment, so they need more care and therapy.
Masoud Mehrpour, Mohammad Mehrpour,
Volume 30, Issue 1 (1-2016)
Abstract
Background: Hemorrhagic Transformation (HT) of Ischemic Stroke (IS) is a detrimental complication. This study investigated the association between serum ferritin level and HT in patients with massive IS of middle cerebral artery.
Methods: Thirty patients with massive IS of middle cerebral artery were enrolled in this prospective cohort study. They were divided into two groups based on the serum ferritin level, lower or greater than 164.1ng/ml at the first 24 hours after admission. To investigate the incidence of HT in the two groups, we observed them for two weeks.
Results: During the two- week observation, the incidence of HT was two persons (13.3%) in the group with the serum ferritin level of lower than 164.1ng/ml, and eight persons (53.3%) in the other group. This difference was statistically significant between the two groups (p=0.02). The relative risk of HT was 4 (95% CI: 1.012-15.8) in the patients with massive IS of middle cerebral artery and the serum ferritin level greater than 164.1ng/ml.
Conclusion: This study revealed that the serum ferritin level greater than 164.1ng/ml in the first 24 hours after admission is a reasonably important predictor for HT of IS. Conducting studies on factors affecting the serum ferritin level are suggested.
Malek Amini, Aryan Shamili, Bijan Frough, Marzieh Pashmdarfard, Abolghasem Fallahzadeh Abarghouei,
Volume 30, Issue 1 (1-2016)
Abstract
Background: Spasticity is one of the problems after a stroke. Due to this increase in muscle tone, patients are confronted with problems in motor control and difficulties in activities of daily living and complications such as shortness and contracture. The aim of this study was to examine the effects of the simultaneous use of both splint and botulinum toxin-A (BTX-A) injection on spasticity, range of motion and upper extremity function in a 3-month period.
Methods: In this study a comparison was done between three groups of interventions, conducted in rehabilitation clinics in Tehran. Sixty people with chronic stroke were recruited. Based on the inclusion criteria, a total of 39 stroke patients after completing the consent forms were entered to intervention groups; splint or botulinum toxin injection or combined splint/botulinum toxin injection. They were followed up about three months and the evaluations were done monthly. Goniometry was the method to measure the range of motion, and Modified Ashworth Scale was used to examine the spasticity and the upper extremity function was scored based on Fugl-Meyer Assessment. Statistical analysis was done using SPSS 17. And ANOVAs was used for comparison between groups and times. Significance was set at 0.05.
Results: All outcome measures were improved within each group but the differences between splint group and BTX-A group and the BTX-A-splint group was not significant in most outcomes during the 3 periods (first evaluation until end of the first month, the end of first month until the end of second month, the end of second month until the end of the third month) (p>0.05). The results also showed that the changes in elbow`s spasticity (p=0.05) and wrist`s spasticity (p=0.007) and upper extremity function (p=0.04) were obvious between the three groups over the 3-months and the difference in the group of combined use of botulinum toxin, and the splint was more than other groups.
Conclusion: In this study, the effects of botulinum toxin injection and Volar-Dorsal Wrist/Hand Immobilization splint and the combined use of botulinum injection and splint were obvious in all groups but was not significantly different between the interventions in a 3-month follow-up.
Masoud Mehrpour, Salameh Taghipour, Sahar Abdollahi, Fatemeh Oliaee, Azin Goran, Mohamadreza Motamed, Rezan Ashayeri,
Volume 30, Issue 1 (1-2016)
Abstract
Background: Firoozgar Comprehensive Stroke Center started up as the first organized care unit in the country in 2014; this study was performed to investigate quality indicators such as reduction in mortality, morbidity and hospital stay.
Methods: Two groups of ischemic stroke patients were compared. The first group had been admitted in general neurology ward (non-stroke unit patients) and the second one received specialized stroke care in the stroke unit within a period of two years (stroke unit patients). Non-stroke unit patients were selected from a pool of patients admitted two years before establishment of stroke unit. Variables compared were factors such as modified Rankin Scale (mRS), confinement days in stroke unit or Intensive Care Unit, total days of hospitalization, history of prior stroke, receiving recombinant tissue plasminogen activator (rtPA) and the stroke category indicating anterior or posterior circulation infarct. Quantitative testing was conducted using independent t-test as well as “Mann-Whitney U Test”; Chi-squared test was used for qualitative testing.
Results: A total number of 129 patients enrolled in the study (66 cases of non-stroke unit patients and 63 cases of stroke unit patients). The average total days of hospitalization were 17.32 (95% CI: 0.15-36.1) in non-stroke unit patients and 21.19 (95% CI: 4.99 - 38.1) in stroke unit patients (p=0.2). Results for stroke unit patients showed a lower mRS score (OR=1.48, p=0.01).
Conclusion: It was concluded that stroke unit patients tend to have a better outcome and a lower mRS score at discharge. No significant difference in hospitalization period was noted between the two groups.
Akram Azad, Tayyebe Mohammadinezhad, Ghorban Taghizadeh, Laleh Lajevardi,
Volume 31, Issue 1 (1-2017)
Abstract
Background: Katz Index is a well-known index for assessing basic activities of daily living. The aim was to determine validity and reliability of the Katz Index in Iranian patients with acute stroke.
Methods: Eighty-seven patients (56 male, 31 female) with acute stroke (1-30 days post-stroke) participated in this psychometric properties study. Interval time for retest was 14 days. All participants were Iranian with Persian as native language, had no other major diseases (e.g. cancer, Alzheimer) and no psychiatric disorder. Cognitive mental score of all participants was above 18 (according to Mini-Mental State Examination). If they had another stroke during the following-up period, they were excluded from the study. Intraclass Correlation Coefficient (ICC), Standard Error of Measurement (SEM) and Minimum Detectable Change (MDC) were calculated to investigate the reliability of the KI. Criterion validity of the KI was assessed by Spearman’s Correlation Coefficient (ρ). Moreover, Confirmatory Factor Analysis (CFA) and Exploratory Factor Analysis (EFA) were performed to investigate the construct validity of the KI.
Results: Inter-rater and intra-rater reliability of Persian Katz Index were reasonable (ICC2,1=0.93, ICC2,1=0.83; respectively). Internal consistency of this index was high (cronbach’s alpha=0.79). The high to excellent correlation was found between Katz Index and the motion (ρ=0.88), self-care (ρ=0.98), and total scores (ρ=0.92) of Barthel Index. Factor analysis of the Persian Katz Index indicated two factors including motion (bathing, toileting, and transferring) and self-care (dressing, bowel & bladder control, and feeding).
Conclusion: The results of this study suggest that Persian version of Katz Index in patients with acute stroke can be considered as an acceptable clinical instrument in practice and research.
Fatemeh Gholami, Malihe Khoramdad, Ebrahim Shakiba, Yousef Alimohamadi, Jabbar Shafiei, Alireza Firouzi,
Volume 31, Issue 1 (1-2017)
Abstract
Background: There is no global consensus about the relationship between dairy consumption and cardiovascular diseases (CVD). This study aimed at integrating the results of several studies to predict the dairy effects on CVD, e.g. stroke and CHD.
Methods: In the present study, some major databases such as Scopus, Science Direct, and PubMed were searched up to September 2014. All prospective cohort studies dealing with dairy products consumption and CVD were surveyed regardless of their publication date or language. This reference population includes all individuals without any delimitation with regard to age, gender, or race. The quality of the study was evaluated using STROBE Checklist. Study selection and data extraction were done by 2 independent researchers separately. The indices in this study were RR and HR. The random model was used to combine the results.
Results: Out of 6234 articles, 11 were included in the meta-analysis. No relationship was found between stroke and consumption of milk, cream, and butter, and the results are as follow: RR = 0.91 (95%CI: 0.81-1.01) for milk, RR = 0.97 (95%CI: 0.88-1.06) for cream, and RR = 0.95 (95%CI: 0.85-1.07) for butter. However, cheese was found to decrease stroke risk: RR = 0.93 (95%CI: 0.88-0.99).
The relationship of CHD with consumption of milk, cheese, cream, and butter are as follows, respectively: RR = 1.05 (95% CI: 0.96-1.15), RR = 0.90 (95%CI: 0.81-1.01), RR = 0.96 (95% CI: 0.87-1.06), and RR = 0.99 (95%CI: 0.89-1.11). In other words, no relationship existed between dairy products and CHD.
Conclusion: No relationship was found between consumption of various dairy products and CHD or stroke, except for cheese that decreased stroke risk by 7%. Considering the small number of studies, the result of the present study is not generalizable and more studies need to be conducted.
Aryan Shamili, Afsoon Hassani Mehraban, Akram Azad, Gholam Reza Raissi, Mohsen Shati, Ata Farajzadeh,
Volume 35, Issue 1 (1-2021)
Abstract
Background: Action Observation Therapy (AOT) is a top-down approach that has been recently introduced in the rehabilitation of neurological disorders mainly after stroke. The main goal of this study was to investigate the effects and feasibility of a new technique in AOT procedure (called self-AOT) following periods of no treatment and routine AOT intervention on upper limb motor function, occupational performance and neurophysiological changes in a stroke patient.
Methods: A single-subject A-B-A-C design was used and a 58-year-old woman with a 3-year history of left hemiplegia poststroke participated in this study. In the baseline (A1, A2) phases, the patient received no treatment. In the first intervention (B phase), she received a 4-week AOT, and in the second intervention (C phase), a 4 week of Self-AOT was practiced. In all phases, upper limb motor recovery as a target outcome was evaluated on 4 occasions using the Fugl-Meyer assessment. Upper limb function, dexterity and spasticity were assessed using Action Research Arm Test, Box-Block Test and Modified Modified Ashworth Scale respectively. Occupational Performance/Satisfaction was assessed with Canadian Occupational Performance Measure and to assess neuroplasticity, Motor Evoked Potential was recorded by Transcranial Magnetic Stimulation. Visual analysis, slope, and percentage of non-overlapping data were used for assessing the changes between phases.
Results: Percentage of non-overlapping data and slopes indicated that motor recovery had clinically relevant improvements after both interventions compared to baselines. Other outcomes also showed improvements except for spasticity of wrist/elbow flexors and Motor Evoked Potential of opponens indicis.
Conclusion: Self-AOT may be as effective as other procedures of AOT for improving upper limb motor function, occupational performance/satisfaction, and cortical excitability post-stroke.
Guljakhan Abilova, Vitaly Kamkhen, Zhanna Kalmatayeva,
Volume 37, Issue 1 (2-2023)
Abstract
Background: Acute cerebrovascular accident is known to be one of the main causes of morbidity, mortality, long-term disability, and disability in society.
To investigate the quality of life of patients who have suffered from acute cerebrovascular accident (hereinafter ACVA) in stratified groups by age, gender, diagnosis, type (primary or secondary), and severity of a stroke, as well as undergoing rehabilitation.
Methods: This research is a cross-sectional descriptive-analytical study. The main research method is a survey. Data collection was carried out in 2020 in Almaty of the Republic of Kazakhstan by inpatient doctors (City Clinical Hospital No. 5 of the Public Health Department of Almaty), engaged in the rehabilitation treatment of patients with acute cerebrovascular accident. The standardized questionnaire EQ-5D-5L was used to assess the quality of life due to health conditions. Data on the state of "mobility", "self-care", "daily activities", "pain", "anxiety", as well as data on self-assessment of health status (according to the EQ VAS scale) were analyzed using the Level Sum Scores (hereinafter LSS).
Results: The study involved 258 respondents who had a stroke. The survey was conducted 2 months after the respondents were discharged from the hospital. The average LSS index of patients who underwent ACVA was 10.2 (9.7±10.7). Significant differences in LSS levels (P ≤ 0.001) were revealed by the severity of stroke and by the fact of rehabilitation. Differences in LSS levels by age, gender, diagnosis, and type of ACVA are insignificant (P > 0.05).
The difference in health indicators of patients with primary and repeated strokes indicates the fact of deterioration in the quality of life with each subsequent stroke. The quality of life of patients with ACVA is associated with the fact of rehabilitation: low values of EQ VAS in the group of patients who did not undergo rehabilitation and high values of EQ VAS in those who underwent rehabilitation.
Conclusion: After a stroke, the majority of patients tend to have a negative quality of life, mostly due to violations of the component "daily activities". The identified significant disparities in LSS and EQ VAS indicators further show that the quality of life varies among stratified groups. The kind (primary or secondary) and severity of the stroke, as well as the existence of rehabilitation, are indicators that impact the quality of life of patients who have had ACVA.
Rouzbeh Kazemi, Alireza Amirbeigloo, Ali Ghotbi, Mahsa Nazifi, Fahimeh Soheilipour,
Volume 38, Issue 1 (1-2024)
Abstract
Background: Hyperglycemia is common in the early acute stroke phase especially in patients with diabetes. To the best of our knowledge, no study has evaluated the course of hyperglycemia in patients with diabetes during the post-stroke recovery phase.
Methods: It was an observational study conducted in Tabassom Rehabilitation Center for Stroke Patients, Tehran, Iran, 2018-2021. Forty-seven consecutive patients with diabetes and stroke were enrolled and included if at least 3 months had passed from their stroke . Any change in glycemic control before and after stroke was controlled by monitoring drugs used for diabetes treatment and laboratory results. To assess categorical variables, the Pearson chi-squared test was used. Quantitative variables before and after the stroke were analyzed by the paired sample t-test.
Results: The mean age was 63.6 ± 6.9 years, and 22 patients were women. The median time from occurrence of stroke to the first visit was 5 months and 6 days. Glycemic control improved among patients with diabetes during the post-stroke recovery phase. There was a significant decrease of 0.7 ± 1.3 % in HbA1c (P = 0.001). The number and the dose of drugs needed for diabetes treatment decreased. No significant correlation could be found between changes in HbA1c and weight.
Conclusion: Despite the initial increase in glycemia in patients with diabetes in the acute phase of stroke, glycemic control improves after stroke, and often, it is necessary to decrease diabetes drugs to prevent hypoglycemia. This topic is important and should be addressed by guidelines and institutions involved in the care of patients with diabetes and stroke.
