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Acute ischemic stroke is a major factor cause of severe morbidity and mortality in general population. Newer modality of treatment like IV thrombolysis has been established to prevent long term complications in this condition within 4.5 hours of symptoms onset. The data regarding IV thrombolysis is limited in rural areas. Various factors like lack of awareness among general population, patients reaching hospital beyond window period, cost of treatment pose difficulty in administration of this treatment. This article presents demographic profile of patients undergoing IV thrombolysis for acute ischemic stroke at a hospital from Kutch, Gujarat. This article also highlights the importance of strong interpersonal communication between physician for better outcomes in patients. The aim of this observational study is to observe demographic profile of patients with acute ischemic stroke receiving intravenous thrombolysis and to estimate the factors which might help in favorable patient outcome. The data was calculated during January 2023 to December 2023. 22 patients were thrombolysed for acute ischemic stroke within 4.5 hours from onset of symptoms. Males were predominant (86.3%), average age of patients was 57.4 years (range 31 – 80 years old). Majority of the strokes were anterior circulation stroke (77.2%). The comorbidities like Diabetes mellitus (36.3%), hypertension (54.5%), dyslipidemia (59%), old coronary artery disease (18%), old cerebro vascular disease (4.5%) were seen. The time from symptom onset to presentation to hospital is approximately 146 minutes. The time from presentation to hospital and IV thrombolysis administration is approximately 49 minutes. 17(77.2%) patients presented to hospital within 3 hours of symptom onset, 13 (59%) underwent IV thrombolysis within 30 minutes of presentation to hospital. Majority of this patients were referred by primary physician to the hospital. Mild stroke (NIHSS 5) was seen in 1 (4.5%) patient, moderate (NIHSS 5-15) in 11(50%) patients, moderate -severe stroke (NIHSS 15-25)– in 10(45.5%) patients. Large vessel occlusion was seen in 12 (54.5 %), small vessel disease in 4 (18 %), Embolic etiology in 4(18%) and unknown in 2 (9%) of cases. The mean NIHSS at presentation was approximately 16, at 24 hours after IV thrombolysis was approximately 11.3 and after 72 hours of IV thrombolysis is 8.6. Early neurological deficit was seen in 6(27.2%) of cases. 4(18%) of all stroke who underwent thrombolysis required decompression craniotomy. The improving on mRS (grade 0-1) score was found in 16(72.8%) patients at 7 days of thrombolysis. Intravenous thrombolysis with recombinant tissue plasminogen activator is helpful in acute ischemic stroke within 4.5 hours of onset. Early diagnosis and swift evaluation and management helps in prevention of longterm disability.
Shah et al. (Thu,) studied this question.