ABSTRACT
Background: Thrombolysis with intravenous recombinant tissue plasminogen activator (IvrtPA) for acute ischaemic stroke is the only approved standard protocol since 1995 done within window period studies as to fate of non thrombolysed patients were few and anecdotal especially from our part of the country. As the usage a drug increase in time and numbers, it’s problems and pitfalls begin to emerge. Hence this study was undertaken to have a fresh look at the scenario at 20 years. Aims & Objectives: The main aim of study was to evaluate the profile of patients who were not thrombolysed with intravenous recombinant tissue plasminogen activator (i v r-tpa) versus thrombolysed patients in acute ischaemic stroke using NIHSS scoring. Objective is to compare the efficacy of thrombolytic therapy in males versus females. Study Population and Setting: All patients presenting to NEURO ICU of Jubilee Mission Medical College And Research Institute with acute stroke from 1 OCTOBER 2014 to 1 APRIL 2016 over 18 month period were included in study. To compare the neurological profile of patients not undergoing thrombolysis to those thrombolysed using serial NIHSS scoring at baseline (0 hours,12 hours,24 hours, 7 days and 90 days post thrombolysis. To compare the efficacy of thrombolytic therapy in males versus females . Methodology: All suspected stroke patients were sent for a non contrast computed tomographic (CT) imaging of brain and admitted in NEURO STROKE UNIT. Initial assessment including GRBS, ECG, a baseline National Institute of Health Stroke Scale (NIHSS) and Glasgow Coma Scale (GCS) scoring as per institutional protocol. Results: 60% (36/60) thrombolysed patients whereas in the non thrombolysed individuals 50% improved (74/148). 63% (14/22) of Female patients improved whereas in the male thrombolysed individuals 57% improved (22/38). Conclusion: In this study the neurological profile of patient assessed with NIH stroke scale, Barthel score showed a statically significant 90 day improvement in the thrombolysed group of individuals.
KEYWORDS:Thrombolytic therapy, Stroke, IvrtPA, Gender