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July2005 Vol.42 Issue:        2        Table of Contents
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Therapeutic Study of Ischaemic Stroke in Minoufiya Governorate

M. Okda1, M. Allam2, M. Elwan1, W. El-Shekh1, L. Soltan3, R. Alkapany1
Department of Neurology, Minoufiya1, Cairo2, Alexandria3 Universities

ABSTRACT

Stroke is a common disease leading to disabilities of varying degrees and many deaths. At present, there is no agreed beneficial treatment for the acute stroke patients. This work aimed to study the outcome of patients with acute ischaemic stroke in correlation with treatment with either low molecular weight heparin unfractionated heparin or aspirin & treatment with folic acid, vitamin B6 and vitamin B12. The study was carried out on 60 patients suffering from first ever acute ischaemic stroke within 48 hours of onset. The selected patients were divided into three groups that were matched for age, sex and different risk factors. Unfractionated heparin group (group I) composed of 20 patients. They were 13 males and 7 female, their mean age was 53.2±4.6. low molecular weight heparin group (group II) composed of 20 patients, they were 10 males and 10 females with mean age was 53±4.9 years. Aspirin group (group III) composed of 20 patients, they were 11 males and 9 females with mean age 52.6±5.2 years. At the start of treatment there was no significant difference between the three groups in the degree of neurological impairment regarding NIHSSS and SSSS, After 14 days and one month all patients showed improvement in the neurological impairment but the improvement in group I who were treated with unfractionated heparin was better than group II and group III regarding NIHSS and SSS scores and this difference in the mean scores was statistically significant. Addition of vitamins to the treatment did not give any improvement to the patients regarding the NIHSS or SSS scores and the difference between the treated and non-treated groups with vitamins was not statistically significance. Haemorrhagic transformation occurred in one patient/only in group I and another in II. We can conclude that, treatment of patients with acute ischaemic stroke with intravenous unfractionated heparin decreases the severity of disability and improve the outcome of the patients at one month better than low molecular weight heparin or aspirin, addition of vitamins to treatment did not provide more benefit to the patients in improving outcome or decreasing severity of disability.

(Egypt J. Neurol. Psychiat. Neurosurg., 2005, 42(2): 465-473).

 





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