The relevance of CVD (Cerebrovascular Diseases), in particular strokes, is due to the high prevalence, disability and mortality.
The degree of medical, social, psychological rehabilitation of patients after Ischemic Stroke depends on the regression of the clinical picture and cerebral disintegration.
Objectives of the study: detection of the entire spectrum of clinical manifestations from examined patients, corresponding to damage to the structures of the brain supplied by the vessels of the Vertebrobasilar basin, the relationship with regression of the primary focus and the subtype of Ischemic Stroke, and determination of the presence of a statistically significant dependence of clinical manifestations on COPD.
To achieve the goal and solve the set tasks, 126 patients, 60 men and 66 women were examined in the recovery period of stroke in the in the vertebro-basillar system, at the age of 50-80. The Blindemark scale was used to assess the neurological status. To assess neuropsychological status, the Montreal Cognitive Assessment Scale, the Hospital Anxiety and Depression Scale, the Rankin scale were used, as well as for objectification of MRI data and Dopplerography.
Results of the study: In patients with Ischemic Stroke in the vertebro-basillar system, paresis and paralysis prevailed in the structure of clinical manifestations, 68 patients had them, which is 54%, 43.7% of patients had dysarthria, coordination disorders were observed in 48.4% of patients, 26.2% had vertigo, 24.6% had sensory impairments and 5.6% had neglect.
In patients with Ischemic Stroke in the vertebro-basillar system, a correlation was found between the scores of Renkin scale. Various pathogenetic subtypes of ischemic stroke in vertebro-basillar system were analyzed. They have a significant correlation between NIHSS scores at the time of hospitalization and at the end of rehabilitation. In patients with AT Ischemic Stroke in the vertebro-basillar system the incidence of oculomotor disorders is significantly lower. Based on the above mentioned, the following conclusions can be drawn:
1. A certain localization of the focus of ischemic stroke in the vertebra-basilar system is more likely to be characteristic of the corresponding stroke subtype.
2. The rate of reduction and reorganization of the focus does not depend on the stroke subtype, localization of the hearth, comorbidphone, rehabilitation methods and is proportional to the initial size of the heart attack site.
3. The degree of severity of COPD has a correlation with the blood flow indices of posterior cerebral arteries and vertebral arteries, as well as the asymmetry coefficient.
The article reviewed frequency of types of stroke among the population of Ferghana valley, at once analyzed structure of background diseases, which played the main role in the progression of stroke. An analysis of the case histories of patients hospitalized with a stroke diagnosis at the Andijan branch of the RSCEM from January 2018 to January 2019 was performed. Among 1243 patients, there were 607 men and 636 women, whose average age is 62.45 ± 2.9 years. Ischemic stroke was detected in 56.1% of cases, hemorrhagic in 12.4%, and transient cerebrovascular accident in 31.5%. The main underlying disease for the progression of stroke were arterial hypertension - in 70,4%, cerebral atherosclerosis - in 14,1 and coronary heart disease - in 7,4% of patients.
Stroke has remained the most important medical and social problem for many years. According to the WHO, of the number of stroke survivors, only half remain functional. Cognitive impairments of varying severity occur in a significant number of patients with acute cerebrovascular accident, and slow down the process of functional recovery, increase the risk of recurrent stroke and death. In the recovery period of a stroke, both regression and a significant increase in cognitive deficit are possible. The prevalence of im -paired cognitive functions in the population associated with vascular diseases of the brain has a significant impact on the state of so - ciety as a whole and is one of the most pressing medical and social problems that cause impaired adaptation in the professional, social and domestic spheres.
According to the stroke registry, in 2019, the frequency of new and repeated cases of brain stroke was more than 63,000 cases. During the pandemic, we identified 36,975 new and repeated cases of stroke, which obliges us to emphasize that the incidence of stroke during the pandemic did not decrease due to a decrease in the true incidence rates, but probably due to the Covid-19 pandemic that occurred , in which a large number of patients who had suffered from ONMC,fearing to become infected with a viral infection , received treatment at home, without official registration in state medical institutions.
Hemorrhagic stroke among acute cerebral circulatory disorders is characterized by severe neurological complications and the need to choose between surgical intervention or therapeutic therapy. According to the World Health Organization (WHO)". Globally, stroke deaths will reach 7.8 million by 2030 unless an aggressive global response to the epidemic is put in place" 1. Subarachnoid haemorrhage, which accounts for half of the non-traumatic intracerebral haemorrhage, affects the most active and able-bodied population. The most important medical and social objectives are to monitor the course of the disease from the first hours after the onset of stroke, to prescribe adequate treatment in a timely manner, and to reduce mortality and disability rates [5,9].
Hemorrhagic stroke is less common than ischemic stroke and is heavier and in most cases has an adverse outcome in the form of death of a patient or permanent disability.Recently, there has been a tendency to increase the frequency of GI, which is increasingly found at a younger age. GI is based on a rupture of blood vessels, the development of hemorrhage and as a consequence - the formation of cerebral edema, ischemia of brain tissue, violation of the integrity of GBS, imbalance of the neuroimmune system, as well as violation of the function of other systems and organs.
Stroke is one of the leading causes of death. Every 7th patient with stroke is of a hemorrhagic nature, from which the mortality rate is 35-40%, and disability is 75%, and 10% disabled are bedridden. The disease has social impact, as it is common among working-age population. In the past three decades, neurosurgeons conducted an active search for and introduction of new methods of treatment of primary intracerebral hematomas. That is, patients with extravasations have the most pronounced neurological deficit and require prompt action to eliminate it. Thus, the admission of patients to specialized neurosurgical department, the proper selection of patients for surgery, the use in surgery minimally invasive methods and usage of modern technologies postoperative mortality does not exceed 25%, and the time from diagnosis to the possibility of a complete rehabilitation therapy is 1.5-2 weeks.
Background: The first patient with Crimean-Congo hemorrhagic fever was reported in Iraq for the first time on 3rd of September, 1979, and recurrent outbreaks were recorded thereafter with none more patients observed during the next two years. Little is known about the epidemiological state of the disease in Iraq during the previous years.
Patients and methods: An overview of the cases of Crimean-Congo hemorrhagic fever registered by the Iraqi Ministry of Health from January, 2018 to May, 2022 is provided. An educational review is presented in the "Discussion".
Results: During the year 2018, there were ten cases (including 3 from Diwaniyia province) confirmed by Reverse Transcriptase Polymerase Chain Reaction registered by the Iraqi Ministry of Health, and death occurred in eight of the cases. During the year 2021, the Iraqi Ministry of Health reported the registration of fifteen laboratory confirmed cases of Crimean-Congo hemorrhagic fever during the period from April to November 2021, and 5 deaths occurred. On the 27th of April 2022, the Iraqi Ministry of Health registered 17 cases of laboratory confirmed hemorrhagic fever occurred during the year 2022, and many cases were from ThiQar, and five deaths occurred.
Conclusion: 42 cases of laboratory confirmed cases of Crimean-Congo hemorrhagic fever occurred in Iraq during the period from January, 2018 to May, 2022. The disease is still endemic in Iraq and was associated with a high mortality as 18 of the 42 confirmed cases died. Therefore, we are recommending using the available research evidence suggesting the early use of ribavirin in the treatment of patients, and also using ribavirin post-exposure prophylaxis and early ribavirin treatment for workers at medium-to-high risk.
This research article aims to investigate the prevalence and nature of psychiatric morbidity among stroke outpatients at Kenyatta National Hospital in Kenya. Stroke patients often experience comorbid psychiatric disorders, which can significantly impact their overall well-being and treatment outcomes. However, limited research has been conducted on psychiatric morbidity in stroke outpatients in Kenya. This study utilized standardized psychiatric assessment tools to evaluate the presence and nature of psychiatric disorders, including depression, anxiety, post-traumatic stress disorder, and cognitive impairment. Sociodemographic and clinical data were also collected to explore potential correlations. The findings contribute to a better understanding of psychiatric morbidity in stroke outpatients in Kenya and have implications for patient care and management.
We analyzed the incidence of various types of stroke and studied the epidemiology of ischemic stroke subtypes using the example of one neurological unit. The most common was the atherothrombotic type of ischemic stroke, the least common being the hemodynamic type. The greatest risk of occurrence of ischemic stroke of various types was in persons with hypertensive disease, tobacco users with excessive body weight, the probability of ischemic stroke is higher in autumn and spring.
Statistically, in 1 in 10 adult patients, first-onset epilepsy is associated with a history of stroke, and this aetiology occurs in 1 in 4 patients aged 65 years and older with epilepsy. Incidence rates are higher in patients with intracranial, that is, intracerebral or subarachnoid haemorrhage. Haemorrhage increases the risk of seizures by up to 10- 16%. The risk of subsequent development of epilepsy is highest in patients with remote and sequelae of ischaemic stroke. Classification of seizures in stroke and their frequency Seizures develop in different stages of stroke. Depending on the time of onset, they can be divided into the following types: precursor seizures, early and late seizures. Unfortunately, there is currently no consensus among neurologists about the timing of the onset of these seizures . The most common definitions are that early attacks are those that occurred in the first 24-48 h, the first week, the first 2 weeks, and 1 month from the onset of stroke.
Ischemic stroke is a serious medical and social issue due to deep and prolonged disability, as well as social maladjustment of patients. In this regard, the aim of the research was to study the influence of pathogenetic subtypes of ischemic stroke on the rehabilitation possibilities.
Based on the presence of COPD (Chronic Obstructive Pulmonary Disease) we divided all patients into 2 groups
Patients with IS in VI (Vertebrobasilar Insufficiency) and COPD - 62 people (group I) - 29 men and 33 women aged 50 to 74 (59.8 ± 5.8). Patients with IS in VI - 64 people (group II). Of these, 31 are men and 33 are women aged 51 to 80 (62.4 ± 5.4). All patients received traditional treatment in the most acute and severe periods of IS, patients with COPD received and treatment for COPD simultaneously with traditional IS therapy. The Barthel index was used to assess the patient's self-care capabilities. The degree of disability after IS was studied using the Rankin scale. In patients of subgroup II b, by the end of the ED (Eating Disorders), the indicators of the Lindmark B scale for the patient's general mobility differed significantly from the baseline at the beginning of the ED (p = 0.44). At that time, in the II a subgroup, only the indicators of the B. Lindmark scale were reliable.
In patients of subgroup II b, the difference in indicators at the beginning and at the end of ED was significant according to the Barthel index. Recovery in ED depends on many factors, including the subtype of IS, so the IS CE is the most severe, which is reflected in the Rankin scale. The timing and extent of patient recovery depends on the localization of the process, the subtype of IS, the presence of COPD, and the method of rehabilitation. Patients with the lacunar subtype, a single small or medium focus in the cerebellar hemispheres and midbrain recover most fully after complex rehabilitation.
This article describes a study of 64 patients with various forms of cerebrovascular pathology. We studied the prognostic aspects of cognitive impairment in the development of ischemic stroke in patients with TIA on the background of chronic ischemia of the brain. Particular importance is given to the prediction and development of stroke. The data of instrumental and non-instrumental research methods in 64 patients were analyzed. Although we analyzed the most important risk factors for the development of ischemic stroke besides previously known factors.
The study of the course of non-traumatic intracerebral hematomas, including in the age aspect, is one of the significant areas of modern stroke, since it allows to choose the optimal treatment tactics for each group of patients. We have studied and presented in this article the clinical manifestations and features of the course of hemorrhagic stroke in 98 patients, divided into age groups - young, middle, elderly and senile. The study revealed some differences in the course of pathology in patients of different ages.
Based on the results of clinical and neurological studies, the use of mavix in the complex treatment of elderly patients with ischemic stroke is justified. The obtained data on the differentiation of the therapeutic response contribute to the optimization of therapy for acute ischemic stroke in order to stop or slow down its progression and maintain the quality of life of both the patients themselves and their families.
Cardiovascular pathology and acute cerebrovascular accident (ACV) are in first and second place, respectively, as the causes of mortality in the structure of general mortality of the population. In this regard, interest in the issues of cerebral blood flow disorders does not weaken all over the world, more and more new aspects of this problem are being considered. CVA is a widespread pathology in the world and according to the WHO “... about 17.5 million people die every year from cerebrovascular diseases in the world, which is 30% of mortality from all diseases ...”. The most severe form of vascular pathology of the brain is a stroke. In European countries, mortality from stroke varies from 63.5 to 273.4 people per 100,000 population per year. About 85-88% of cerebral strokes are ischemic in nature. Ischemic stroke in developed countries ranks first as a cause of permanent disability. Movement disorders of varying severity are the most common and severe consequences of strokes.
At present, the cerebral circulation disorder is caused by various factors. According to the Ministry of Health of the Republic of Uzbekistan, 62876 cases of strokes were registered in Uzbekistan in 2019. 15% acquired lethal outcome, 10-15% returned to their previous state, 55 - 70% became disabled. Stroke is translated from the Latin language as a "stroke" which means an acute cerebral circulation disorder. Regardless of the cause of cerebral circulation disorder, the result is always the same - the death of brain neurons. The most common cause is atherosclerosis on the inner walls of blood vessels that supply the brain. They narrow the blood vessels and make them less flexible. In this case, the probability of clogging the blood vessels with blood clots increases, as a result, the blood vessels cannot supply blood to the brain.