A Study on the Correlation between the Levels of Serum Uric Acid and the Prognosis of Acute Ischemic Stroke

Prabhakar, A (2010) A Study on the Correlation between the Levels of Serum Uric Acid and the Prognosis of Acute Ischemic Stroke. Masters thesis, Madurai Medical College, Madurai.


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INTRODUCTION: Stroke is a major public health problem all over the world. It plays an important role in the morbidity and mortality in late middle age and in the elderly. Stroke is the third most common cause of death in the world after coronary artery disease and cancer. It is the single most important case of severe disability and also the most common life threatening neurological disease. The burden of stroke is likely to increase substantially in the future because of the aging population. Apart from implementing effective stroke prevention programs, identification of factors associated with more severe stroke may help to ease the burden of this coming epidemic. Stroke is a heterogenous disease. Ischaemic and haemorrhagic strokes are the 2 main types of stroke, with very different pathogenesis and outcome. For India, community surveys have shown, a crude prevalence rate for hemiplegia is in the range of 200 per 1,00,000 persons, nearly 1.5% of all urban hospital admission, 4.5% of all medical and around 20% of neurological cases. AIMS AND OBJECTIVES: 1. To identify the role of serum uric acid in influencing the prognosis of acute ischaemic stroke. 2. To identify whether any association exists between age, sex, hypertension, diabetes, dyslipidemia, renal parameters and BMI and serum uric acid level. MATERIALS AND METHODS: Setting: The study on “the correlation between the levels of serum uric acid and the prognosis of acute ischemic stroke” was carried out in the Department of Medicine, Madurai Medical College and Government Rajaji Hospital, Madurai. Collaborative Departments: Department of Biochemistry, Neurology, Radiology, Madurai Medical College, Madurai. Study Design: prospective study of consecutive patients with acute stroke admitted to Government Rajaji Hospital, Madurai. Period of Study: October 2008 To September 2009. Sample Size: Patients were classified into ischemic stroke or primary haemorrhage. CT scan of brain was required for the diagnosis of ischemic stroke. Patients without neuroimaging were classified as having as uncertain stroke type were excluded in statistical analysis. 50 Patients were included in this study. Inclusion Criteria: 1. All acute ischemic stroke within 24 hours of onset. Exclusion Criteria: 1. Haemorrhagic stroke, 2. Ischaemic stroke >24 hours from onset, 3. CNS tumours, 4. Vasculitic stroke, 5. CNS infections, 6. Patients who did not do CT-SCAN, 7. Subdural hematoma. METHODS: After obtaining the verbal consent either from the patient or the relatives, all patients were evaluated by complete medical history, full neurological examination, standardized blood tests imaging studies and data was recorded in a standardized sheet. Clinical history was obtained from the patient, his/her relatives or past records. History regarding diabetic status, hypertension, TIA, smoking, alcoholism, chronic kidney diseases. Clinical examination was done to assess the side of the stroke, glasgow coma scale on admission, presence of gaze palsy, papillary abnormality, plantar reflex facial palsy, speech difficulty, admission blood pressure. Electrocardiography, blood sugar, urea, creatinine, lipid profile, serum uric acid and CT-brain were done after admission. CONCLUSION: The following conclusions were derived from the study. 1. The serum Uric acid was independent of age, sex, BMI, hypertension, diabetes, smoking, dyslipidemia and renal parameters. 2. Outcome in patients with acute ischemic stroke was better in patients with high serum uric acid level in terms of higher function recovery, motor activity, self – care, small size infart etc. 3. Every 1mg increase in Uric acid above 4.2mg /dl was associated with better outcome. 4. The antioxidant capacity of serum Uric acid is a favourable independent factor that improves the clinical prognosis of patients with acute ischemic stroke. 5. This study opens up the possibility of therapeutic administration of Intravenous infusion of uric acid along with rtPA to improve the immediate prognosis of acute ischemic stroke. SUMMARY: This study “CORRELATION BETWEEN SERUM URIC ACID LEVEL AND THE PROGNOSIS OF ACUTE ISCHEMIC STROKE” was carried out in Govt.Rajaji Hospital, Madurai Medical College, Madurai from October 2008 to September 2009. 50 cases of acute ischemic stroke within 24 hours of onset were admitted in this period. Male out numbered stroke. Males - 66%, females- 34%. The risk factors in this study group were increasing age, hypertension, smoking, diabetes, dyslipidemia. Raised serum uric acid associated with small size infarct and good functional outcome at the time of discharge.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Acute Ischemic Stroke ; Levels of Serum Uric Acid ; Prognosis.
Subjects: MEDICAL > General Medicine
Depositing User: Subramani R
Date Deposited: 16 Mar 2018 01:42
Last Modified: 16 Mar 2018 01:42
URI: http://repository-tnmgrmu.ac.in/id/eprint/6281

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