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By Dr. Abhinav Raina
A stroke can be devastating not only for the person who gets one, but for the entire family. This unfortunate episode can result in premature death and lifelong disability.
In India, the incidence rate of stroke is estimated to be 119 to 145 per 100,000 people and we see 1.44 to 1.64 million cases of strokes annually. Sometimes when we do not heed the warning signs of stroke, we end up becoming victims of this devastating episode. One such sign is the Transient Ischaemic Attack (TIA) or mini-stroke. It has been observed that the risk of stroke in the first three months after a TIA is 2-17 percent. About 33 percent of those with a history of TIA have a major stroke within a year without any treatment.
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When the blood flow to the brain cuts off for a short while (less than 5 minutes) it causes a transient neurological symptom same as is observed in stroke but are rapidly reversible. This is known as TIA. TIA is also referred to as mini-stroke because it is like a miniature version of a full-blown stroke. It causes less damage but it sure needs emergency care without delay.
Difference from stroke
When an artery that is supplying blood to the brain gets blocked due to a blood clot, it causes oxygen starvation resulting in TIA. In a TIA, such a temporary clog is usually pushed along and is broken down. Thus, the normal flow of blood to the brain returns quickly. Symptoms of a TIA usually subside within an hour (typically less than 15 minutes) but may last up to 24 hours in some cases. Quite contrary, in an ischemic stroke, the brain is oxygen-deprived for a longer period. This causes more damage and brings long-lasting effects that can be fatal and cause permanent disability or death.
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Apart from the risks that are not under our control like age and family history, in general women have a higher risk of stroke/TIA than men. Other health conditions such as obesity, carotid artery disease, high BP, high cholesterol, diabetes, and preexisting heart conditions are also found to increase the odds of stroke/TIA. Lifestyle choices like excess smoking, alcohol consumption, eating foods high in cholesterol, and using drugs such as amphetamines, cocaine, and heroin can increase the risk.
Warning signs and symptoms
We must attempt to remember the term "FAST" (which denotes Face, Arms, Speech, Time). These are mainly seen if a person is having a TIA. These include:
The facial droop may be observed where the eyes or mouth may droop to one side. One may also experience trouble smiling.
Problems related to speech such as slurred, garbled, or difficult to understand. Also, one may find it difficult to gather the right words.
Weakness or numbness of limbs may be experienced. There might be trouble lifting or holding up the arms.
Sometimes one may also notice balance and coordination related troubles, blindness or transient blurring of vision, inability to move one side of the body, dizziness, confusion, and difficulties in understanding others.
After knowing about TIA, it is important to make efforts to have a better lifestyle and adopt preventive measures to reduce the risk of experiencing a TIA/stroke. These include:
Quitting smoking and avoiding exposure to second-hand smoke from tobacco.
Eating a healthy and nutritious diet that includes a lot of fresh fruits and vegetables.
Keeping a check on the excessive intake of salt and fats
Keeping away from recreational drugs.
Maintaining ideal body weight.
Following the advised/timely treatment plan for heart disease, diabetes and other health conditions.
Diagnosis and Management
Diagnosis is generally established through thorough physical examination, neurological tests and various imaging techniques (MRI, Angiography, etc). Medications such as blood-thinners, anti-cholesterol medications with or without the use of minimally invasive procedures (carotid angioplasty/stenting) and surgical procedures (Carotid endarterectomy) may be advised depending upon the severity of the TIA.
When the symptoms of a TIA stroke, although it may pass, one should get medical help immediately. It must be remembered that there is a lot of uncertainty about whether the blood flow will restore on its own or not. It is impossible to predict if one is having a TIA or stroke because the symptoms are more or less the same. Furthermore, in the current pandemic situation, the Covid-19 can lead to the development of blood clots in the vessels supplying the brain. This can subsequently progress to TIA and stroke.
When you see the symptoms of a TIA stroke, although it may pass, one should get medical help immediately. It must be remembered that there is a lot of uncertainty about whether the blood flow will restore on its own or not. Unsplash
Keyword : stroke, attack, heart, signs, symptoms, risk factors, lifestyle, diagnosis, management.
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Long Covid symptoms rarely persist beyond 12 weeks in children and adolescents unlike adults, suggests a review. The review, published in the Pediatric Infectious Disease Journal, analysed 14 international studies involving 19,426 children and adolescents who reported persistent symptoms following Covid-19. The findings showed that long covid among children is less common than feared. The mostcommon symptoms reported four to 12 weeks after acute infection were headache, fatigue, sleep disturbance, concentration difficultiesAand abdominal pain.
"It is reassuring that there was little evidence that symptoms persisted longer than 12 weeks suggesting long Covid might be less of a concern in children and adolescents than in adults," Nigel Curtis, Professor at the Murdoch Children's Research Institute (MCRI) in Melbourne, Australia. A recent study, led by University College London and Public Health England researchers, showed that up to one in seven children and young people who caught SARS-CoV-2 may have symptoms linked to the virus about three months later.
Most children with Covid recover within a week, only a small percentage had long-term symptoms. | Photo by Kelly Sikkema on Unsplash
Another study published in the journal Lancet Child and Adolescent Health in August, noted that most children with Covid recover within a week, only a small percentage had long-term symptoms. The study, by researchers at King's College London, showed that less than one in 20 children with symptomatic Covid-19 experienced symptoms lasting longer than four weeks, and almost all children have fully recovered by eight weeks.
However, the existing studies on long Covid in children have not pointed to long lasting symptoms unlike adults. The most common symptoms reported in children have been headaches, tiredness (fatigue), a sore throat, and loss of smell (anosmia). Reassuringly, there have been no reports of serious neurological symptoms such as fits or seizures, impaired concentration or attention, or anxiety.
Yet more studies are required to investigate the risk and impact of long Covid in young people to help guide vaccine policy decisions, said Curtis. "The low risk posed by acute disease means that one of the key benefits of Covid vaccination of children and adolescents might be to protect them from long Covid," he said. "An accurate determination of the risk of long Covid in this age group is therefore crucial in the debate about the risks and benefits of vaccination." Many countries, including the US, Canada, Denmark, Spain, France have rolled out Covid vaccinations for children aged 12 and above. (IANS/ MBI)
Keywords: covid, symptoms, survey, report, 12 weeks, risks, children
Researchers have shown that a combination of deep brain stimulation (DBS) and exercise has potential benefits for treating ataxia. Ataxia is a rare genetic neurodegenerative disease characterized by progressive irreversible problems with movement. Working with a mouse model of the human condition, the researchers discovered that combining DBS targeted to the cerebellum, a major motor center in the brain, and exercise rescued limb coordination and stepping.
“People with ataxia usually have progressive problems with movement, including impaired balance and coordination that affect the person’s ability to walk, talk and use fine motor skills,” said researcher Lauren Miterko from the Baylor College of Medicine in the US. “There are limited treatment options for this condition, and patients typically survive 15 to 20 years after symptoms first appear,” the researcher added.
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In addition, the study, published in the journal Nature Communications, showed that stimulating mice with early-stage ataxia showed the most dramatic improvements. DBS currently is used to relieve motor dysfunction in Parkinson’s disease and other movement conditions, but its value in treating ataxia has not been extensively explored.
For the study, the researchers worked with Car8, a mouse model of hereditary ataxia to investigate whether adjusting the parameters of DBS and the stimulation target location would help increase the treatment’s efficacy for the condition. “We first targeted the cerebellum, because it’s a primary motor center in the brain and this target location for DBS has seen encouraging success for treating motor problems that are associated with other conditions, such as a stroke,” Miterko said.
“We systematically targeted the cerebellum with different frequencies of DBS and determined whether there was an optimal frequency that would boost the efficacy of the treatment. When we used a particular frequency, 13 Hz, that was when motor function improved in our Car8 mice,” the researcher added. (IANS/SP)
Asthma may not increase the risk of severe illness or death from Covid-19, a new study suggests. The review of studies on 587,000 people showed that people with asthma had a 14 percent lower risk of getting Covid-19 and were significantly less likely to be hospitalized with the virus.
“While we showed that people with asthma do not seem to have a higher risk of infection with Covid-19 compared to those without asthma and have similar outcomes, we need further research to better understand how the virus affects those with asthma,” said lead author Anthony Sunjaya from the University of New South Wales in Australia.
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For the study, published in the peer-reviewed Journal of Asthma, the team analyzed data from 57 studies with an overall sample size of 587,280. Almost 350,000 people in the pool had been infected with Covid-19 from Asia, Europe, and North and South America and found they had similar proportions of asthma to the general population.
The results showed that just over seven in every 100 people who tested positive for Covid-19 also had asthma, compared to just over eight in 100 in the general population having the condition. Previous findings have shown that people with chronic respiratory conditions like asthma were reported to be at greater risk during the Middle East Respiratory Syndrome (MERS) outbreak, caused by a virus with a similar structure.
“Respiratory infections like those caused by coronaviruses can exacerbate asthma symptoms and corticosteroid treatment may increase susceptibility to Covid-19 infection and its severity,” Sunjaya said.
However this study using the best evidence available on the risk of infection, severe illness — requiring admission to ICU and/or ventilator use — and death from Covid-19 in people with asthma find “no significant difference” of people with asthma being at higher risk, the team said. (IANS)