A Prospective Observational Study on Single Vs Dual Antiplatelet Drug Therapy in Patients with Ischemic Stroke in A Tertiary Care Hospital

AIM The main aim of the study is to assess the therapeutic outcomes of single vs. dual antiplatelet therapy by using the NIHS Scale (National Institutes of Health Stroke Scale) among the inclusion criteria in patients with ischemic stroke in a tertiary care hospital. OBJECTIVE To estimate the therapeutic outcomes of single vs. dual antiplatelet drug therapy in patients with ischemic stroke based on the NIHSS scale in a tertiary care hospital. METHOD To determine demographic characters [gender, age], type of stroke occurrence, reoccurrence of stroke, factors causing [smoking, alcohol, hypertension, diabetes, drug incompliance, and genetic history], the severity of the stroke, symptoms, rate of recovery, and outcomes of single vs. dual antiplatelet therapy, both comparatively

At the foramen magnum, the highest cervical segment of the spinal cord is continuous with the lowest level of the medulla of the brain stem. The 12 cranial nerves attached to the brain form the upper part of the peripheral nervous system and record general sensations of pain, temperature, touch, and pressure. In addition, we now find the presence of special senses of smell, vision, hearing, balance, and taste. The blood supply to the brain originates from the first major atrial branches from the heart, ensuring that over 20% of the entire supply of oxygenated blood flows directly into the brain.

BRAIN
The brain is one of the largest organs in the body and coordinates most body activities. It is the centre for thought, memory, judgement, and emotion.The brain is present in the skull, weighs 1300-1400 g, and is made up of a thousand billion neurons; each neuron is surrounded by 10 glial cells. The brain is covered by meninges: the outer dura mater, the middle arachnoid mater, and the inner pie mater. There are certain cavities of the brain called ventricles filled with CSF: ventricles 1 and 2,which are lateral ventricles, lie in two hemispheres of the brain; the third lies between the hypothalamus and thalamus; the fourth lies between the brain stem and cerebellum and is continuous with the spinal cord.

AIMS AND OBJECTIVES AIM
The main aim of the study is to assess the therapeutic outcomes of single vs. dual antiplatelet therapy by using the NIHS Scale (National Institutes of Health Stroke Scale) among the inclusion criteria in patients with ischemic stroke in a tertiary care hospital. Our secondary aim is to evaluate the risk factors that are leading to the occurrence of ischemic stroke.

OBJECTIVES
• Collection and study of patients' clinical profiles. • Study of therapeutic outcome in ischemic stroke patients with single antiplatelet therapy vs. dual antiplatelet therapy using the NIHS Scale To evaluate the risk factors for ischemic stroke.

METHODOLOGY PLACE OF STUDY:
General Medicine Department, inpatient units of Government General Hospital, Kurnool, a 1000-bed teaching hospital

PERIOD OF STUDY:
The study was six months STUDY POPULATION: 80 patients fit the inclusion and exclusion criteria from both female and male general medicine departments.

STUDY DESIGN:
A prospective cross-sectional observational study

RESULTS:
A total of 80 patients were enrolled in the study and presented to the outpatient department of general medicine during a 6-month period. Responses were collected using a patient proforma form, and the data collected from the patients was analyzed.

AGE AND GENDER DISTRIBUTION:
Among 80 patients who were presented to out patient department, the percentage distribution was found to be 50(62.5%) males and 30(37.5%) females were represented

5.DISCUSSION
Ischemic stroke is an emergency condition, which has a persistently long term effect for patients, But it must always be managed as early as possible. In our prospective and observational study of about eighty cases of ischemic stroke in males and females, in particulars with single antiplatelet drug therapy ( SAPT) vs dual antiplatelet drug therapy (DAPT) was carried out for about six months duration in Dr. KVSP drug information centre in Kurnool, it was found to be more of men getting prone to ischemic stroke.
The study was conducted among 80 patients, of which males were 50 ( 62.5%) and females were 30 (37.5%). WhereMales were further classified with single vs dual antiplatelet drug therapy, where 27 are males with SAPT and 23 males are with DAPT. And further of which Females were further classified with single vs dual antiplatelet drug therapy, where 15 are SAPT and 15 are DAPT.
Both males and female patients are taken into the project consideration and involved in this study based on age, gender, distribution of treatment given whether SAPT OR DAPT was prescribed both in males and females, symptoms , factors mostly effecting the patients, risk factors which may occur likely to the present conditions,severity of stroke by using NIHS s ,reoccurrence of stroke in both males and females. Based on age the over all distribution of ischemic stroke in both males and females are from 20-80 years and >80 years mostly the age group of 40-49 (17.5%), 50-59 (22.5%) and 60-69 ( 36.25%) . males and severity Based on symptoms of ischemic stroke in both males and females are observed as weakness of left upper limb and lower limb -13 (18.4%) , weakness of right upper limb and lower limb -45 (25%) , loss of consciousness -15 (9.14%) , slurred speech -25 (15.2%) , vision -5 (3.14%) , deviation of mouth -37 (22.5%) and others -10 (6.09%).