ASSESSMENT OF SIGNS & SYMPTOMS, RISK FACTORS AND PRESCRIPTION PATTERN IN ISCHEMIC STROKE PATIENTS: AN OBSERVATIONAL & RETROSPECTIVE STUDY IN TERTIARY CARE HOSPITAL

Background: Stroke is a significant health issue that affects people worldwide, with a particular impact on the elderly population. The prescribing patterns of neurologists and physicians can shed light on the choice of medications for stroke management and how they are adjusted after a stroke occurs. The incidence of stroke has been increasing in low- and middle-income countries, including India, over the past few decades. Furthermore, the number of stroke survivors has nearly doubled between 1990 and 2010 and is expected to continue to rise in the coming years. This underscores the importance of effective stroke management and prevention strategies. Objective: Stroke is the second leading cause of death and a major cause of disability worldwide As appropriate and safe drug use is a key factor in achieving quality health and accurate healthcare for hospitalized patients So it is necessary to assess the prescription pattern, percentage of each drug used and to find out the most commonly prescribed drugs along with assessing the warning signs and symptoms, uncontrollable and controllable risk factors of stroke in the hospitalized patient. Method: A retrospective, observational study was conducted, and the data of 120 patients was collected from the medical record department of BAPS Pramukh Swami Hospital. Patients of age 18 and above with ischemic stroke with or without comorbidities will be selected while patients below the age of 18 years and pregnant women will be excluded from the study. The study was conducted for a period of six months and the data collected was analyzed using statistical methods. Result: A total of 120 patients were analyzed during the 6 months study period. The study population consisted of 72 male patients (60%) and 48 female patients (40%) the study found that males have a slightly higher stroke risk compared to females. The highest risk for stroke is in the 60-69 age group (42.5%). The most common signs of stroke patients are arm paresis (55%), leg paresis (53.33%), facial paresis (27.5%), and ataxia (20%) and the most common symptoms of stroke patients are arm weakness (55%), leg weakness (53.33%), speech difficulty (50.83%), general weakness (41.66%), giddiness (39.16%), headache (28.33%), and facial weakness (27.05%). Major controllable risk factors include hypertension(73.33%), diabetes mellitus(45%), dyslipidemia (8.33%), smoking(12%), and alcohol(7%). Among these risk factors, hypertension is more prevalent (73.33%). The current prescribing pattern was the most commonly prescribed thrombolytics drug like alteplase N=5(4.16%), enoxaparin N=84(70%) was the most commonly prescribed anticoagulants drug, a common combination of antiplatelet drugs prescribed in the study was aspirin and clopidogrel, used in N=75(62.05%)of patients aspirin alone was used in N=55(45.83%), atorvastatin was highly prescribed N=108(90%), commonly prescribed class of antihypertensive drugs was CCBs N=49(38%), ARB N=24(18%) and β-blockers N=16(12%). The most commonly prescribed individual drugs were amlodipine n=31(25.83%), telmisartan N=22(18.33%), and nifedipine N=15(12.05%). Among the different classes of anti-diabetic drugs and insulin are prescribed. Insulin-like human act rapid N=26(21.66%) and drug-like glimepiride + metformin N=21(17.5%) were most commonly prescribed. Gabapentin N=9(7.50%) was the most prescribed antiepileptic. Drugs used for Alzheimer’s are memantine N=09(7.05%) other drugs like antibiotics, steroids, nootropics, antidepressants, antipsychotics, thyroid drugs, multivitamins, PPI and H2 blockers, NSAIDS, and analgesics. Conclusion The present study aimed to identify cases with predominant signs and symptoms of stroke, estimate various risk factors and determine the appropriate prescribing pattern of drugs based on stroke severity and associated co-morbid conditions. The study found that arm paresis (55%) and leg paresis (53.33%), were the most common signs of stroke patients. Arm and leg weakness, speech difficulty, general weakness, and giddiness were the most common symptoms reported by patients Recognizing the signs and symptoms of stroke is crucial for minimizing its damage, and seeking immediate medical attention is essential. The study also identified hypertension (73.33%) and diabetes (45%) as the most common risk factors. Managing risk factors such as Hypertension, Diabetes Mellitus, Dyslipidemia, Heart Disease, Smoking, Alcohol, and Obesity for preventing stroke. Additionally, creating awareness among the elderly population about the risk factors associated with stroke can help to reduce the incidence of stroke The study analyzed the prescribing patterns of various drugs for stroke patients. Thrombolytics, such as alteplase, were prescribed in a small number of patients (4.16%), while the most commonly prescribed anticoagulant drug was enoxaparin (70%). Aspirin and clopidogrel were commonly prescribed in combination (62.05%), and aspirin alone was used in (45.83%) of patients. Atorvastatin was highly prescribed (90%) to manage dyslipidemia. Stroke requires a multidisciplinary treatment approach, including medications, rehabilitation, lifestyle modifications, and interventions to prevent future strokes. Prescribing drugs should consider individual patient needs and characteristics Individualized care and adherence to guidelines are essential for stroke management and prevention