Post stroke psychiatric syndrome: a clinical study

Background: Various psychiatric symptoms are seen after strokes which are usually deserted due to poor familiarity about it, hence better knowledge and understanding of various post stroke psychiatric manifestations may help in early identification and management of it. The aim of present research is to study the demographic and clinical profile of various post stroke psychiatric manifestations.Methods: The study was conducted on ninety patients developing psychiatric symptoms after stroke. Detailed socio-demographic characteristics, clinical profile along with psychiatric assessment were recorded in proforma specially designed for the study.Results: Bulk of this post- stroke psychiatric subjects (45%) was in the age range of 61-80 years of which male and female were 29% and 16% respectively.  Most of patients (90%) were residing at rural areas. 47.8 % patients were belonging to lower middle socio-economic status.  Majority of subjects (42.8%) were unemployed followed by farmer and skilled worker (20% each), and most of the patients were right handed (97.8%). On clinical parameters maximum subjects (52.2) developed post stroke major depression followed by depression mixed with anxiety (16.6%). Rest of patients suffered from organic anxiety disorder (8.8%), vascular dementia (10%), amnestic syndrome (5.5%), post stroke psychosis (3.3%), organic manic disorder (2.2%), pathological laughter and crying (1.1%).Conclusions: Huge number of patients (52.9%) developed psychiatric problems of diverse nature among patients with stroke syndrome. depression was most common post stroke psychiatric manifestation, followed by mixed anxiety with depression.  Generally the post stroke psychiatric manifestations are unrecognized and untreated, which has adverse impact on process of stroke rehabilitation. Thus a detailed psychiatric evaluation is mandatory in all patients of stroke syndrome to rule out psychiatric illness

Latent coronary artery disease among smokers and smokeless tobacco users: a cross-sectional study

Background: Tobacco related mortality and morbidity and increase in developing country like India. WHO projected till 2020 India will accounts 15% of tobacco related mortality especially preventable causes of death e.g. cardiovascular disease. Active tobacco smoking is undoubtedly major risk factor for cardiovascular disease, but subjects use smokeless tobacco in dependence pattern is not extensively evaluated for cardiovascular risk factor. In India smokeless tobacco especially Khaini is major form of tobacco consumption. Scarcity of data on effects of smokeless tobacco in cardiovascular disease especially coronary artery disease major limiting factor for undermine the detailed evaluation of cardiovascular effects in smokeless tobacco dependence subjects. The aim of the study was to study the risk of coronary artery disease among smokeless tobacco dependence in comparison to tobacco dependence smokers.Methods: Cross-sectional assessments were done on 36 adults (>18 years), treatment-seeking patients with a ICD 10 diagnosis of Mental and behavioral disorders due to use of tobacco. Data was collected on socio-demographic characteristics, and after detailed clinical evaluation treadmill exercise test was done.Results: Mean age of tobacco dependence smokers 51.5±9.6 years vs 53.6±7.5 years. There were male predominant in study subjects and 38% subjects was treadmill test positive. Smokeless tobacco users had 35% positive treadmill test, and among Smokers 42% subjects was positive for treadmill test.Conclusions: Risk for latent coronary artery disease was similarly higher in smokers and smokeless tobacco dependence subjects

Latent coronary artery disease among smokers and smokeless tobacco users: a cross-sectional study

Background: Tobacco related mortality and morbidity and increase in developing country like India. WHO projected till 2020 India will accounts 15% of tobacco related mortality especially preventable causes of death e.g. cardiovascular disease. Active tobacco smoking is undoubtedly major risk factor for cardiovascular disease, but subjects use smokeless tobacco in dependence pattern is not extensively evaluated for cardiovascular risk factor. In India smokeless tobacco especially Khaini is major form of tobacco consumption. Scarcity of data on effects of smokeless tobacco in cardiovascular disease especially coronary artery disease major limiting factor for undermine the detailed evaluation of cardiovascular effects in smokeless tobacco dependence subjects. The aim of the study was to study the risk of coronary artery disease among smokeless tobacco dependence in comparison to tobacco dependence smokers.Methods: Cross-sectional assessments were done on 36 adults (>18 years), treatment-seeking patients with a ICD 10 diagnosis of Mental and behavioral disorders due to use of tobacco. Data was collected on socio-demographic characteristics, and after detailed clinical evaluation treadmill exercise test was done.Results: Mean age of tobacco dependence smokers 51.5±9.6 years vs 53.6±7.5 years. There were male predominant in study subjects and 38% subjects was treadmill test positive. Smokeless tobacco users had 35% positive treadmill test, and among Smokers 42% subjects was positive for treadmill test.Conclusions: Risk for latent coronary artery disease was similarly higher in smokers and smokeless tobacco dependence subjects