Browsing by Author "Sukumaran, S"

Now showing 1 - 12 of 12
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    Antisynthetase syndrome with stroke
    (NEUROLOGY INDIA, 2013) Divya, KP; Sukumaran, S; Sreedharan, SE; Sylaja, PN
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    Changing Patterns of Stroke Awareness among Primary Care Physicians: Results of an Ongoing Study from Kerala, India
    (CEREBROVASCULAR DISEASES, 2016) Sukumaran, S; Maniangat, S; Khan, F; Vt, J; Rajan, R
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    Complications in acute stroke in India (CAST-1): A multicenter study.
    (J Stroke Cerebrovasc Dis, 2012-12) Pandian, JD; Kaur, A; Jyotsna, R; Sylaja, PN; Vijaya, P; Padma, MV; Venkateswarlu, K; Sukumaran, S; Mathew, R; Kaur, P; Singh, YP; Radhakrishnan, K
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    Complications in acute stroke in India (CAST-1): A multicenter study.
    (J Stroke Cerebrovasc Dis, 2012-12) Pandian, JD; Kaur, A; Jyotsna, R; Sylaja, P N; Vijaya, P; Padma, MV; Venkateswarlu, K; Sukumaran, S; Mathew, R; Kaur, P; Singh, YP; Radhakrishnan, K
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    Complications in Acute Stroke in India (CAST-I): A Multicenter Study
    (JOURNAL OF STROKE & CEREBROVASCULAR DISEASES, 2012) Pandian, JD; Kaur, A; Jyotsna, R; Sylaja, PN; Vijaya, P; Padma, MV; Venkateswaralu, K; Sukumaran, S; Mathew, R; Kaur, P; Singh, YP; Radhakrishnan, K
    The prognosis and final outcome in patients who sustain stroke are significantly affected by medical complications occurring during the acute phase of stroke. Only limited information is available from India and other developing countries regarding acute complications of stroke. This study examined the frequency of acute stroke and the factors associated with complications of stroke in India. In this prospective multicenter study, running from March 2008 to September 2009, 6 hospitals collected information on complications of first-ever stroke during admission. Complications were defined in accordance with standard criteria. Outcome at 30 days poststroke was assessed using the modified Rankin Scale. Stroke characteristics, length of hospital stay, and stroke severity (based on the National Institutes of Health Stroke Scale) were documented. Hematologic (ie, hemoglobin) and biochemical (ie, total proteins and albumin) parameters also were obtained. A total of 449 patients out of the recruited 476 completed follow-up. The mean age was 58.1 +/- 13.7 years (range, 16-96 years), and the majority were men (n=282; 62.8%). The mean National Institutes of Stroke Scale score was 10.2 +/- 5.3. Overall, 206 patients (45.9%) experienced complications during admission. In the logistic regression analysis, limb weakness (odds ratio [OR], 0.12; 95% confidence interval [CI], 0.02-0.67; P=.01), anemia (OR, 0.35; 95% CI, 0.15-0.81; P=.01), length of hospital stay (OR, 0.89; 95% CI, 0.85-0.94; P<.0001), and stroke severity (OR, 0.27; 95% CI, 0.10-0.72; P=.01) were the variables associated with complications. Such complications as urinary tract infection (OR, 0.31; 95% CI, 0.13-0.78; P=.01), chest infection (OR, 1.81; 95% CI, 1.12-2.93; P=.02), bedsores (OR, 3.52; 95% CI, 1.02-12.08; P=.05), other pain (OR, 0.21; 95% CI, 0.09-0.49; P<.0001), and depression (OR, 2.22; 95% CI, 1.30-3.80; P<.01) were associated with poor outcome. Our study shows high rates of complication in acute stroke. Limb weakness, stroke severity, length of hospital stay, and anemia were the factors associated with complications. Other complications, such as urinary tract infection, chest infection, bedsores, other pain, and depression, can lead to poor outcome.
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    CORRELATION BETWEEN PRESENCE AND SEVERITY OF LEUKOARAIOSIS WITH CHANGES IN PULSATILITY INDEX (PI) IN TRANSCRANIAL DOPPLER STUDY (TCD)
    (INTERNATIONAL JOURNAL OF STROKE, 2016) Dhing, H; Maniangat, SC; Kumar, S; Sukumaran, S
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    Moyamoya disease: A comparison of long term outcome of conservative and surgical treatment in India
    (JOURNAL OF THE NEUROLOGICAL SCIENCES, 2014) Sundaram, S; Sylaja, PN; Menon, G; Sudhir, J; Jayadevan, ER; Sukumaran, S; Sreedharan, SE; Sarma, S
    Background: Revascularization surgery (RS) is the therapy of choice in moyamoya disease (MMD). Due to rarity of disease and ethical concerns, randomized controlled trials about the treatment options are lacking. Very little information is available on the long-term outcome of conservatively treated moyamoya patients. Aim: We compared the long-term outcome of moyamoya patients treated conservatively to those who underwent RS. Methods: Our study population included all patients with moyamoya disease/syndrome from 2002 to 2012. The demographic, clinical characteristic and imaging details were reviewed. The outcome was obtained prospectively. Results: Of the 36 patients, 26 (72.2%) had MMD and 10 (27.8%) had moyamoya syndrome. The median age at onset of symptoms was 17.5 years (range, 10 months-55 years). Fifteen patients belonged to pediatric group and 21 were adults. All the pediatric patients had ischemic events at onset and 10 (47.6%) of the adults presented with hemorrhage. Twenty (55.6%) patients received conservative treatment and 16 (44.4%) underwent revascularization procedures. The median duration of follow-up was 28 months (range, 3-90 months). Three (18%) of the surgically treated patients had recurrent ischemic events on follow-up, but none of the conservatively treated patients had events. An excellent outcome (Modified Rankin Scale of <= 2) was seen in 12 (75%) surgically treated and 16 (94%) conservatively treated patients (p = 0.17). Conclusion: Compared to East Asians, our patients had a lower stroke recurrence rate and good functional outcome even with conservative treatment. Future studies should focus on clinical and imaging predictors of progression to select moyamoya patients for RS. (C) 2013 Elsevier B.V. All rights reserved.
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    Moyamoya Syndrome Comparison of Long Term Outcome of Conservative and Surgical treatment in India.
    (STROKE, 2013) Sylaja, PN; Sundaram, S; Menon, G; Jayadevan, ER; Sukumaran, S; Sreedharan, S
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    Physiotherapy Practice in Stroke Rehabilitation: A Cross-Sectional Survey of Physiotherapists in the State of Kerala, India
    (TOPICS IN STROKE REHABILITATION, 2012) Khan, FR; Vijesh, PV; Rahool, S; Radha, AA; Sukumaran, S; Kurupath, R
    Background: Physiotherapy, a major component of rehabilitation for stroke patients, has been shown to have a positive effect on outcome. However, there is debate over efficacy of different interventions related to stroke rehabilitation. Purpose: The purpose of this study was to compare knowledge and attitudes of physiotherapists working with stroke patients in Kerala, India, with emphasis on demographics, approach to treatment, and beliefs about stroke rehabilitation. Methods: Two hundred one physiotherapists in Kerala were surveyed using questionnaires, which were sent by post. Questionnaires consisted of items related to stroke rehabilitation such as approaches to physiotherapy, use of walking aids, and discharge issues. Data analysis was done using percentage-wise comparisons. Results: Examination of results showed variation in the beliefs held by physiotherapists about treatment of stroke patients. Of the 201 respondents, 153 (76.1%) used a conventional treatment approach. There was a strong disparity among physiotherapists regarding use of walking aids by stroke patients: 119 (59.2%) agreed that tripods or quadripods should be given to patients, but 55 (27.4%) disagreed and 27 (13.4%) were unsure. In response to questions about discharge issues, 30 (14.9%) of the 118 respondents agreed that they were actively involved in discharge planning for stroke patients, and 158(78.6%) agreed that skill of the physiotherapist influences outcomes. Conclusion: A great deal of variation among physiotherapists in treatment approaches and beliefs was revealed in this study, which indicates the need for development and implementation of a standardized protocol for stroke rehabilitation in Kerala.
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    Premorbid nutrition and short term outcome of stroke: a multicentre study from India
    (JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY, 2011) Pandian, JD; Jyotsna, R; Singh, R; Sylaja, PN; Vijaya, P; Padma, MV; Venkateswaralu, K; Sukumaran, S; Radhakrishnan, K; Sarma, PS; Mathew, R; Singh, Y
    Background Little is known about the impact of premorbid undernutrition on stroke outcome in developing countries. Aim To study the impact of premorbid undernutrition status, measured by the Subjective Global Assessment (SGA) tool, on short term stroke outcome. Methods First ever stroke patients admitted to six major hospitals in North and South India participated in this study from 1 March 2008 to 30 September 2009. The SGA tool was administered within 48 h of stroke onset, and 6 months premorbid nutritional status was rated as well nourished (A rating) and undernourished (B and C ratings) using this tool. Stroke outcome was assessed after 30 days using the modified Rankin scale (mRs), and a mRs score >3 was defined as a poor outcome. Statistical analyses were performed using SPSS Statistics V.17.0. Results Of 477 patients enrolled, 448 patients were included in the analyses. Mean age was 58.1 +/- 13.7 years (range 16-96) and 281 (62.7%) patients were men. At admission, premorbid undernutrition was found in 121 (27.2%) patients. Older age (OR 4.99, CI 1.26 to 19.64, p=0.021), hypertension (OR 1.99, CI 1.04 to 3.79, p=0.037) and patients from Andhra Pradesh State (OR 1.87, CI 1.05 to 3.32, p=0.032) were predictors of undernutrition in multiple logistic regression analysis. Premorbid undernutrition (OR 1.99, CI 1.20 to 3.31, p=0.007) and length of hospital stay (OR 3.41, CI 1.91 to 6.06, p<0.0001) were the independent predictors of poor outcome in the multiple logistic regression model. Conclusions High rates of premorbid undernutrition in stroke patients were found. Age, hypertension and patients from Andhra Pradesh State were predictors of premorbid undernutrition. Premorbid undernutrition was associated with poor stroke outcome. The results provide opportunities for primary prevention and improving stroke outcome.
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    Successful mechanical thrombectomy of acute middle cerebral artery occlusion due to vegetation from infective endocarditis
    (NEUROLOGY INDIA, 2012) Sukumaran, S; Jayadevan, ER; Mandilya, A; Sreedharan, SE; Harikrishnan, S; Radhakrishnan, N; Sylaja, PN