Early recurrent ischemic stroke complicating intravenous thrombolysis for stroke: incidence and association with atrial fibrillation

<p><b>Background and Purpose:</b> Mechanisms of early neurologic deterioration after treatment with intravenous, recombinant, tissue-type plasminogen activator (IV rt-PA) include symptomatic intracerebral hemorrhage (SICH) and early recurrent ischemic stroke. We observed a number of cases of acute deterioration due to recurrent ischemic events.</p> <p><b>Methods:</b> We undertook a single-center, retrospective analysis of consecutive acute stroke patients treated with IV rt-PA between January 2006 and December 2008 to define the incidence of early neurologic deterioration (>= 4-point drop on the National Institutes of Health Stroke Scale within 72 hours) and its mechanism. Deterioration was attributed to SICH when associated with a PH1 or PH2 hemorrhage on postdeterioration computed tomography scans, to recurrent ischemic stroke when there was clinical and radiologic evidence of a new territorial infarction or new vessel occlusion, and otherwise to evolution of the incident stroke.</p> <p><b>Results:</b> Of 228 consecutive IV rt-PA-treated patients, 34 (15%) developed early neurologic deterioration, 18 (8%) secondary to incident strokes 10 (4.4%) due to SICH, and 6 (2.6%) due to early recurrent ischemic events, which were significantly associated with atrial fibrillation (present in 5 of 6 patients; 4 paroxysmal, 1 permanent). In 4 patients, sudden clinical deterioration developed during or shortly after IV rt-PA infusion, and in 2, deterioration developed 3 days later. All died 2 days to 2 weeks later. The single case without atrial fibrillation had a recurrent, contralateral, middle cerebral artery stroke during IV rt-PA infusion and multiple high-signal emboli detected by transcranial Doppler. Early recurrent ischemic stroke accounted for 5 of 12 (42%) cases of early neurologic deterioration in patients with atrial fibrillation.</p> <p><b>Conclusion:</b> In this single-center series, the incidence of early recurrent ischemic stroke after IV rt-PA was 2.6% and was associated with previous atrial fibrillation.</p&gt

Shiite buildings of Awadh : characteristics and nomenclature

The region of Awadh (also known in older British sources as Oudh or Oude), located in northern India and now constituting a part of the state of Uttar Pradesh, for several centuries has remained one of the largest and most significant Shiite centres in the Subcontinent. A particularly important role in shaping its cultural tradition was played by the Shiite dynasty of Nishapuri nawabs, which ruled the Awadh between 1722 and 1858. The cultural and religious heritage of the Shiites manifests itself, among other things, in the architecture of the region, abounding especially in buildings erected in connection with the mourning celebrations of the month of Muharram, commemorating the martyrdom and death of Imam Al-Husayn. Imambaras (assembly halls) and rauzas (mausoleums), dozens of which we find in Lucknow, the capital of historical Awadh, and in other localities of the region and thanks to which this part of the Subcontinent enjoys a unique character and colour, are characterized not only by specific Indo-Muslim architectural syncretism, but also by multi-source nomenclature. The names of the structures derive freely both from the indigenous languages, like Hindi and Urdu, and from the linguistic adstratum – mostly Persian and to some extent Arabic. The article aims at description and categorization of the main types of religious Shiite structures found in Awadh, as well as at characterization of their names

Between Qasbas and Cities: Language Shifts and Literary Continuities in North India in the Long Eighteenth Century

The cultural memory of Awadh is almost exclusively identified with Urdu poetry and courtesan culture, and already in the colonial period it came to stand as the epitome of the “last phase of Oriental culture” (‘Abdul Halim Sharar). But if instead of taking a retrospective, nostalgic view we approach literary culture in Awadh prospectively and multilingually and broaden our lens to consider not just the capitals, Faizabad and Lucknow, but also the qasbas (small towns), the small rural courts, the nearby growing city of Banaras, and the colonial capital of Calcutta, a different set of literary dynamics and shifts comes into view. The prevalent image of Awadh as identified with Urdu and Lucknow is not wrong, of course, but it does obscure the other stories, trajectories, and languages. This essay considers some of them. A multilingual and prospective approach helps us consider the circulation of literary tastes across the colonial divide and recognize the production of forgetfulness and ignorance that accompanied modern narratives of languages and literary histories, both colonial and Indian, and that made a host of texts “homeless” (Mohamad Tavakoli-Targhi)

Adolescent pregnancies and health issues in Uttar Pradesh: Some policy implications

In the globalization era, adolescent pregnancies have become an important health issue. Teenage mothers have bigger disadvantage in terms of socio-economic factors. In Uttar Pradesh teenage mothers are found in the poorer households with less education. The logistic regression shows that odd ratio for the teenage mothers are more in rural area. The odd is higher for scheduled caste, tribe and other backward caste as compare to other caste households. The adolescent mothers of low standard of living index has higher odd ratio as compare to the adolescent mothers of higher standard of living index. Teenage mothers do not use the family planning methods and prenatal care. They do not deliver the baby in the health care facility and breastfeed their baby immediately after the delivery. The odd ratio is higher for no breastfeeding after child birth. In order to reduce the teenage pregnancy, government of Uttar Pradesh must generate more self employment opportunities to women and girls. The vocational training will improve the employment possibilities among adolescent girls. Government must provide the health care facilities to the poorer households. Such policies will reduce the adolescent pregnancies in the state.Pregnancies, fertility, employment