Conference Papers
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This collection contains abstracts of conference papers, presented at local and international conferences by the staff of the Faculty of Medicine
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Item Epidemiology of stroke subtypes and aetiology among Sri Lankan stroke patients(Sage Publishing, 2020) Mettananda, C.; Wettasinghe, L,; Eshani, M.D.P.; Ranawaka, U.BACKGROUND AND AIMS: Prevalence of stroke is on the rise in south Asia and the epidemiology is different to western countries. However, prevalence of stroke subtypes and aetiology is not reported of Sri Lanka. Therefore, we aimed to describe the same of Sri Lanka. METHODS: We analyzed all the acute stroke admissions to a stroke unit of a tertiary care hospital in Sri Lanka over 5 year from October 2013 to 2018. Data were collected prospectively using an interviewer administered questionnaire by interviewing patients and perusing medical records. Ischaemic strokes were classified on OCSP (Oxfordshire Community Stroke Project) and TOAST(Trial of Org 10172 in Acute Stroke Treatment) classifications RESULTS: 891 patients were admitted to stroke unit over 5 years; 765(85.5%) ischaemic strokes, 129 (14.5%) intracerebral haemorrhages (ICH), and 0(0%) sub-arachnoid haemorrhages (SAH). Of the ischemic strokes 16(1.8%) were total anterior circulation, 253(29.0%) partial anterior circulation, 543(62.3%) lacunar, 59(6.8%) posterior circulation infarcts on OCSP classification. 542 of ischaemic stroke patients who had complete investigations for TOAST classification were studied for aetiology of stroke. Atrial fibrillation was reported in only 14(2.7%) and more than 50% carotid stenosis was seen in 22(4.1%) ischaemic stroke patients. 17(3.1%) were of large artery atherosclerosis, 369(68.1%) small vessel occlusion, 11(2.0%) cardioembolic and 145(26.8%) undermined aetiology. CONCLUSIONS: Prevalence of ischaemic strokes, ICH and SAH were not different to western statistics in this Sri Lankan cohort of stroke patients. However, cardio-embolic and large artery strokes were less common compared to west and lacunar strokes were the commonest of ischemic strokes.Item Carotid artery stenosis in patients with ischaemic stroke in a tertiary care centre: Prevalence and associated factors(Ceylon College of Physicians, 2019) Ranawaka, U.K.; Mettananda, K.C.D.; Eshani, M.D.P.; Wettasinghe, L.M.; Somaratne, S.; Premadasa, H.M.S.D.; Sirigampola, C.; Upasena, A.; Sathkorala, W.; Pathmeswaran, A.OBJECTIVES: Data on the prevalence of carotid artery stenosis (CAS) among Sri Lankan stroke patients is limited. We sought to determine the prevalence and associated factors of significant CAS in patients with ischaemic stroke admitted to a Sri Lankan stroke unit. METHODS: We prospectively studied all stroke patients admitted to a stroke unit in a tertiary care hospital over a five-year period. Presence and degree of CAS was evaluated by doppler ultrasonography (US). Degree of CAS was classified as low {<50%), moderate (50-69%), significant (70-99%) or total occlusion (100%) according to NASCET criteria. Factors associated with significant CAS were identified by stepwise multiple logistic regression analysis. RESULTS: Out of 867 stroke patients studied, 704 (81.2%) had ischaemic strokes (59.7% male, mean age 59.0 ± 10.3 years), and 550 (78.1%) of them had carotid doppler data available. 528 (96.0%) had low degree stenosis, 12 (2.2%) had moderate stenosis, 7 (1.3%) had significant stenosis and 3 (0.5%) had total occlusion. Older age was associated with significant CAS (OR 1.14, p=0.011) on stepwise multiple logistic regression analysis. Sex, smoking, BMI, total cholesterol, LDL cholesterol, history of diabetes mellitus, hypertension, hyperlipidemia or ischemic heart disease, and premorbid aspirin or statin use were not associated with significant CAS. CONCLUSIONS: Significant CAS is seen in only 1.8% of Sri Lankan patients with ischaemic stroke at this tertiary care centre. These figures are much lower compared to Western data. Our findings have implications for the use of management approaches such as thrombectomy and carotid endarterectomy in Sri Lankan patients. ACKNOWLEDGEMENTS: EMDP and WLM were supported by a research grant from the National Stroke Association of Sri Lanka.