Medicine and Health Sciences Commons^™

Characteristics Of Tia And Its Management In A Tertiary Care Hospital In Pakistan, Ayeesha Kamal, Farhad Khimani, Rushna Raza, Sahar Zafar, Salman Bandeali, Sayeedullah Jan

Section of Neurology

Background:Transient ischemic attack (TIA) is described as a brief episode of neurological dysfunction caused by focal brain ischemia, with clinical symptoms typically lasting less than an hour, and without evidence of acute infarction. Recent studies depict TIA as a particularly unstable condition. Risk of stroke is greater than 10% in the first 90 days after an index TIA. The presentation, prognosis and intervention for TIA have not been reported in South-Asians in a developing country. Method: A retrospective chart review was done for 158 Patients who were admitted with the diagnosis of TIA, as defined by ICD 9 code …

Diagnostic Yield Of Transthoracic Echocardiography For Stroke Patients In A Developing Country, Muhib Alam Khan, Bhojo A Khealani, Bilal Hameed, Ayeesha Kamal, Mohammad Wasay, Nadir Ali Syed

Section of Neurology

OBJECTIVE: To assess the utility and cost effectiveness of transthoracic echocardiography (TTE) as part of stroke workup in a developing country.

METHODS: All patients over the age of 14 years with acute stroke were prospectively enrolled in Aga Khan University stroke databank from August 1999 to May 2001 (22 month period). All patients were evaluated by a consultant neurologist and underwent standard stroke work up such as neuroimaging, TTE, carotid doppler sonography and blood tests e.g. serum glucose, lipid profile, blood urea nitrogen and serum creatinine. For the purpose of this study, patients with ischemic stroke were identified and their …

Post-Infarct Cerebellar Cognitive Affective Syndrome: A Case Report, Ali Jawaid, Muhammad Ameen Rauf, Uzma Usman, Bhojo A Khealani

Section of Neurology

Post Infarct cerebellar cognitive affective syndrome is a rare disorder, characterized by cognitive impairment in the domains of memory, language, visuo-spatial functioning and affect after cerebellar stroke. We report a case of young female who developed mood alteration and cognitive disturbance following isolated cerebellar infarct. We, therefore, advocate a potential role of cerebellum in regulation of cognition and behaviour in humans.

Brain Death: Concepts And Knowledge Amongst Health Professionals In Province Of Sindh, Pakistan, Mughis Sheerani, Mian Zainul Sajadeen Urfy, Bhojo A Khealani, Junaid Patel, Qamarunnisa, Suresh Rath

Section of Neurology

OBJECTIVE: Last few decades have seen improved resuscitative measures and use of life saving machines like ventilators. Due to these dramatic interventions, end of life decisions, including brain death and organ transplantation, have become more complex and a major problem in our clinical practice. This study was done to find the opinion and awareness of physicians regarding issues surrounding brain death in this region.

METHODS: A total of 259 questionnaires were analyzed that encompassed physicians at different level of training and students in the final year of their training, from five major tertiary care centres, located at Karachi and Hyderabad …

Hypotension At Presentation Is An Indicator Of Poor Prognosis In Acute Intracerebral Haemorrhage, Mohammad Wasay, Bhojo A Khealani, Saad Shafqat, Ayesha Kamal, Nadir Ali Syed

Section of Neurology

OBJECTIVE: To identify frequency of hypotension in a large cohort of patients with intracerebral haemorrhage and its prognostic significance.

METHODS: We retrospectively reviewed medical records of 920 patients with spontaneous intracerebral haemorrhage (ICH). Patients were divided in three groups based on Diastolic blood pressure (DBP); hypotensive group (DBP < 70 mmHg), normotensive group (DBP; 71-90 mmHg) and hypertensive group (DBP > 90 mmHg).

RESULTS: Of the total patients with ICH, 7% (64) presented with hypotension, 13% (120) were normotensive and 80% (736) were hypertensive. In the hypotensive group, 37% (24) patients died as compared to 25%(30) in normotensive group and 25% (182) in hypertensive group (p = 0.03). Hypotension at presentation, thalamic and …

Stroke In Pakistan, Bhojo A Khealani, Bilal Hameed, Uzma U Mapari

Section of Neurology

Stroke is the most common cause of disability and a leading cause of mortality world wide. Though the incidence is falling in West but probably is rising in Asia. The burden of stroke risk factors in Pakistan is enormous e.g. by 2020 Pakistan will be 4th most populous country in terms of diabetic patients. Similarly every 3rd person above age of 45 years has hypertension. Ironically a great majority of these patients are unaware of their diagnosis. This is further complicated by the fact that most of diagnosed patients have uncontrolled hypertension, as a result of poor compliance on patients …

Post Stroke Seizures: Descriptive Study From A Tertiary Care Centre In Pakistan, Bhojo A Khealani, Sajjad Ali, Shahid M Baig

Section of Neurology

OBJECTIVE: To determine the frequency, mode of onset and outcome of post stroke seizures in a local setting.

METHODS: The retrospective (Aug 1999 to July 2001) and prospective (August 2001 to July 2002) data of patients aged 14 years and above, with post stroke seizures was collected from a tertiary care centre in a metropolitan city. The demographic, clinical, radiological, laboratory, neurophysiologic and outcome data was recorded and analyzed.

RESULTS: During the three year period 1548 patients with stroke were admitted to the hospital. Four hundred thirty one (28%) had intracerebral haemorrhage (ICH) and 1117 (72%) had ischaemic stroke. One …

Helicobacter Pylori Gastritis And Risk Of Ischaemic Stroke, Mohammad Wasay, Wasim Jafri, Bhojo Khealani, Iqbal Azam, Akber Hussaini

Section of Neurology

OBJECTIVE: To identify the association between H. Pylori gastritis and stroke.

METHOD: Patients with biopsy proven H. Pylori gastritis and non H. Pylori gastritis were enrolled. Patients were followed for a period of two years.

RESULTS: A total of 326 patients were included in the study. 162 patients were with H. Pylori gastritis. There was no significance difference in age, sex and duration of symptoms in the two groups. Three patients in H. Pylori group had stroke or TIA as compared to one in non H. Pylori group. Patients with H. Pylori gastritis were more likely to die or have …