Deshpande Janhavi Jaywant¹, Kadam Ramesh², Ghanekar Manisha³, Patil Suvrna⁴, Bamane Eknath⁵,

Paranjape Ameya⁶, Nanavare Sagar⁷, V Nandakumar⁸, Kendre Pranam⁹, Itkar Raesh¹⁰, Madkar Chaitanya¹¹,

Thakur Ravising¹², Kulkarni Ujjwala Prabhakar^13*

^1,2,4Professor, ³Professor And Head, ^5,6,7Assistant Professor, ⁸SR, ^9,10,12JR, ¹¹JR-1, Department of General Medicine

B.K.L. Walawalkar Rural Medical College Hospital & Research Centre, Dervan Pin 415606, INDIA.

Email:

RESULT

Table 1: Distribution of the patients as per the age

The average age of Patients of Stroke was 60 ± 4.56 Yrs. and Patients without Stroke was 61 ± 3.76 Yrs. which was comparable with each other (t=1.23,df=399,p>0.05)

Table 2: Distribution of the patients as per the sex

(X²=0.129,df=1,p>0.05)

The male and Female ratio In both the group was comparable with each other 1.25 and 1.35 which was also comparable with each other (X²=0.129,df=1,p>0.05)

Table 3: Distribution of the patients as per the lipid profile

The values were significantly higher in Patients of Stroke like Cholesterol 230± 7.12 and 205 ±5.64 (t=38.96,df=399,p<0.001); TG -169 ± 4.5 and 154± 3.45 (t=42.92,df=399,p<0.0001); LDL- 152 ± 5.76 and 132 ± 4.12 (t=47.45,df=399,p<0.001) and HDL was significantly lower in Patients of Stroke i.e. 43± 3.54 and 58 ± 5.78 (t=29.82,df=399,p<0.001) as compared to patients without stroke respectively.

DISCUSSION

Stroke is an important cause of disability among adults and is one of the leading causes of death worldwide.⁴ A stroke, or cerebrovascular accident, is defined by the abrupt onset of a neurologic deficit that is attributable to a focal vascular cause.⁵ Serum lipid levels have an established effect on short term mortality due to strokes. It is important to evaluate the serum lipid levels in both the types of strokes to guide lipid lowering therapy which can reduce incidence of stroke and related mortality by adapting primary and secondary preventive measures among the stroke patients.^6,7 Stroke is a clinical syndrome characterized by rapidly developing symptoms and/or signs of focal and at times global (for patients in coma) loss of cerebral functions, with symptoms lasting more than 24 hours or leading to death with no apparent cause other than that of vascular origin.⁸ Age is an important risk factor for stroke. The mean age of stroke onset in India (i.e. 63 years).⁹ Cerebral atherosclerosis with atheroma formation is the basic underlying patho-physiologic mechanism in ischemic stroke.¹⁰ In our study we have seen that The average age of Patients of Stroke was 60 ± 4.56 Yrs. and Patients without Stroke was 61 ± 3.76 Yrs. which was comparable with each other (t=1.23,df=399,p>0.05) . The male and Female ratio In both the group was comparable with each other 1.25 and 1.35 which was also comparable with each other (X²=0.129,df=1, p>0.05) The values were significantly higher in Patients of Stroke like Cholesterol 230±7.12 and205±5.64(t=38.96,df=399,p<0.001);TG-169±4.5 and 154± 3.45 (t=42.92,df=399,p<0.0001); LDL- 152 ± 5.76 and 132 ± 4.12 (t=47.45,df=399,p<0.001) and HDL was significantly lower in Patients of Stroke i.e. 43± 3.54 and 58 ± 5.78 (t=29.82,df=399,p<0.001) as compared to patients without stroke respectively. This was similar to study by Onkar Nath Rai et al they found increased total cholesterol was present in 30 patients. Similar prevalence (34%) of hyper cholesteremia was reported by Sreenivasulu et al.¹¹ Total cholesterol was abnormal in 83% of ischemic stroke and 17% of hemorrhagic stroke. This is comparable to study by Sreenivasulu et al, where elevated total cholesterol was seen in 34.5% of patients with Ischemic stroke and 31.2% of patients in Haemorrhagic stroke.¹¹ Qizilbash et al, concluded that there was a significant association between serum lipid profile and prevalence of stroke. ¹² Tanveer et al, proved that hyperlipidemia was present in 16% patients of stroke.¹³ In a study by Siddeswari et al, dyslipidemia in stroke patients was 14%.¹⁴ Most of the patients were having low HDL (which is a risk factor for stroke. The mean TC and LDL-C levels were significantly much higher in the ischemic stroke patients when compared to patients with haemorrhagic stroke by Gnanamoorthy K et al, (183.7±34.5 versus 148.5±30.6 and 118.7±26.7 versus 81.4±22.0).¹⁵ This was similar to the present study results.

CONCLUSION

it can be concluded from our study that majority of the patients were old and significantly the patients with stroke were having higher values of Cholesterol, LDL, TG and lower values of HDL as compared to the patients without stroke.

REFERENCES

1. Allen CM. Predicting the outcome of acute stroke: A prognostic score. J Neurol Neurosurg Psychiatry 1984; 47: 475-80.
2. Adams GF. Prospects for patients with strokes, with special reference to the hypertensive hemiplegic. Br Med J 1965; 2: 253-9.
3. Adams RD, Victor M. Cerebrovascular diseases. In: Principles of Neurology. 4th ed. New York, NY: McGraw Hill; 1989. p. 617-50.
4. Bonita R, Mendis S, Truelsen T, Bogousslavsky J, Toole J, Yatsu F. The global stroke initiative. Lancet Neurol. 2004; 3: 391-3.
5.  Powers AC. Harrison's Principles of Internal medicine, Cerebrovascular Accident. Maryland. 2012; 338: 2275-304.
6. Kirshner HS. Medical prevention of stroke. South Med J. 2003; 96: 354-8.
7. Bhalla A, Gupta OP, Gupta SB. Predicting mortality in stroke. Neurol India. 2002; 50(3):279-81.
8. Banerjee TK, Das SK. Fifty years of stroke researches in India. Ann Indian Acad Neurol. 2016; 19(1):1-8. 9.
9.  Wasay M, Khatri IA, Kaul S. Stroke in South Asian countries. Nat Rev Neurol. 2014; 10: 135-43.
10. Khan J, Attique-ur-Rehman, Ali SA, Jielani A. Frequency of hypertension in stroke patients presenting at Ayub teaching hospital. J Ayub Med Coll Abbottabad. 2006; 18(1):59-61.
11. Sreenivasulu C, Bai LS, Kumar KN. Study of serum lipid profile in stroke patients, medical science. Indian J Applied Res. 2016;6(2):385-6.
12.  Qizilbash N, Duffy SW, War low C, Mann J. Lipids are risk factors for ischemic stroke: overview and review. Cerebrovascular Disease. 1992; 3(2):127-36.
13. Tanveer A. Localization and management in cerebrovascular accident: a comparison of clinical assessment versus CT scan (dissertation). J Coll Physician Surg Pak. 1996:5-6.
14. Siddeswari R, Sudarsi B, Abhilash T, Rao NS. A study on risk factors and lipid profile pattern in patients of stroke in Osmania general hospital, Hyderabad, India. Int J Res Med Sci. 2015; 3: 3337- 41.
15. Gnanamoorthy K, Suthakaran PK, Rajendran K, Deepak K. Comparison of fasting lipid profile in ischemic and haemorrhagic stroke patients of a tertiary care hospital. Int J Adv Med. 2016;3:755-8
16. Onkar Nath Rai, Amit Kumar. Study of serum lipid profile in stroke patients in Northern India International Journal of Advances in Medicine Rai ON et al. Int J Adv Med. 2017Oct;4(5):1374-1377.