Profile of Stroke in Gizan, Kingdom of Saudi Arabia.

Profile of stroke in Gizan, Kingdom of Saudi Arabia.

Neurosciences (Riyadh). 2003 Oct; 8(4): 229-32
Ayoola AE, Banzal SS, Elamin AK, Gadour MO, Elsammani EW, Al-Hazmi MH

The epidemiological characteristics of stroke at different geographical locations in the Kingdom of Saudi Arabia (KSA) have not been fully investigated. Reports from some areas indicate that stroke is one of the major causes of morbidity and mortality in the population. The present study was carried out to determine the clinical profile of stroke, its subtypes and associated risk factors in Gizan Province, KSA.Data on consecutive patients with stroke admitted to King Fahd Central Hospital, Gizan, KSA over a 2-year period from January 1997 to December 1998, were retrospectively analyzed. Diagnosis was confirmed by computerized tomography of the brain. Etiologic and risk factors were identified by relevant clinical, laboratory and imaging investigations.Two hundred and forty-one patients (146 males and 95 females; mean age 64.5) were hospitalized during the study period. The subtypes of stroke comprised cerebral infarction (65.6%); intracerebral hemorrhage (30.7%) and sub-arachnoid hemorrhage (3.7%). Coma and convulsions were more frequent among patients with hemorrhagic strokes compared to the subgroup with cerebral infarction. Major risk factors included hypertension (45.6%), heart diseases with or without atrial fibrillation (31.1%) and diabetes mellitus (22.8%). In 19 (7.9%) patients, no risk factor was found. In-hospital mortality occurred in 20.3% (49 of 241 patients), with no significant difference in the rates in the different subtypes.The crude incidence (estimated as 15.9 per 100, 000) in Gizan, KSA, a largely rural area is lower than the reported rates in urban areas of KSA. However, intracerebral hemorrhage had a higher relative frequency, suggesting a geographic variation in the subtypes at different areas. The establishment of rehabilitation centers in the province will reduce the heavy burden on health services and relatives. The incidence and prevalence of stroke must be reduced by appropriate strategy with the objectives of preventing or modifying risk factors such as hypertension, diabetes mellitus and smoking. A national stroke registry should be strengthened to provide further information on the epidemiology of stroke in KSA. HubMed – rehab centers


Anatomy of the vestibular system: A review.

NeuroRehabilitation. 2013 Jan 1; 32(3): 437-43
Khan S, Chang R

A sense of proper sensory processing of head motion and the coordination of visual and postural movements to maintain equilibrium is critical to everyday function. The vestibular system is an intricate organization that involves multiple levels of sensory processing to achieve this goal.This chapter provides an overview of the anatomical structures and pathways of the vestibular system.The five major vestibular structures are located in the inner ear and include: the utricle, the saccule, and the lateral, superior, and posterior semicircular canals. Hair cells on the neuroepithelium of the peripheral vestibular organs carry sensory impulses to primary processing centers in the brainstem and the cerebellum. These areas send input via ascending and descending projections to coordinate vital reflexes, such as the vestibuloocular reflex and the vestibulospinal reflex, which allow for the proper orientation of the eyes and body in response to head motion. Specific connections regarding higher level cortical vestibular structures are poorly understood.Vestibular centers in the brainstem, cerebellum, and cerebral cortex function to integrate sensory information from the peripheral vestibular organs, visual system, and proprioceptive system to allow for proper balance and orientation of the body in its environment. HubMed – rehab centers


[Outcome analysis of hearing aids fitting for 2 635 hearing-impaired people].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2013 Jan; 27(1): 13-5
Zhu Z, Zheng Y, Li G

To investigate the reasons that hearing-impaired patients who owned the indication of hearing aid fitting but were not successfully fitted.Analyzing the records of hearing aid fitting for 2 635 hearing-impaired people from 2005 to 2010, especially for the people who were not successfully fitted.In general, there were 1 700 people having proper hearing aids. The success rate of hearing aid fitting is 64.52%, which increased year by year. According to the analysis of records about hearing-impaired people who were not successfully fitting, the primary factor was economic constraints (23.64%), the second was the patients could not accept them (18.61%), and the third was acceptation and satisfaction for the professional centers (10.27%). The another factor also included the dissatisfaction for the hearing aid (8.13%). Meanwhile, it showed the success rate in the auditory specialist clinic was significantly lower than that in the general otolaryngologist clinic (P < 0.05). In addition, the success rate (61.29%) in the group patients' ages were lower than 50 years old was significantly lower than that (66.33%) in the group patients' ages were more than 50 years old (P < 0.05).The research shows that so many factors could lead to the success of hearing aid fitting. So its necessary for us to do some special things to overcome them, including disseminating the knowledge about hearing rehabilitation and improving our abilities. They are the only solutions to improve the patients confidence and make them get the better rehabilitation from the hearing aids. HubMed – rehab centers


The calibrated, unidimensional anxiety item bank for cardiovascular patients provided the basis for anxiety assessment in cardiovascular rehabilitation patients.

J Clin Epidemiol. 2013 May 2;
Abberger B, Haschke A, Krense C, Wirtz M, Bengel J, Baumeister H

OBJECTIVE: Computer adaptive tests (CATs) offer a flexible, test fair, and economic opportunity for accurate measurement of anxiety in patients with cardiovascular diseases (CVDs). The objective of this study was to develop and calibrate an item bank [anxiety item bank for cardiovascular patients (AIB-cardio)] as a prerequisite for an anxiety-CAT in CVD patients. STUDY DESIGN AND SETTING: After pretesting for relevance and comprehension, a pool of 155 anxiety items was answered on a five-point Likert scale. Sample consisted of 715 CVD patients, who were recruited in 14 German cardiac rehabilitation centers. A confirmatory factor analysis (CFA), Mokken analysis, and Rasch analysis were conducted. RESULTS: The results of CFA and Mokken analysis confirmed one factor structure and double monotonicity. In Rasch analysis, merging response categories and removing items with misfit, differential item functioning or local response dependency reduced the AIB-cardio to 37 items. The AIB-cardio fitted to the Rasch model with a nonsignificant item-trait interaction (chi-square, 133.89; degrees of freedom, 111; P = 0.07). Person separation reliability was 0.85, and unidimensionality could be verified. CONCLUSION: The calibrated, unidimensional AIB-cardio provides the basis for a CAT to assess anxiety in rehabilitation patients with CVD with good psychometric properties. Further testing in other cardiovascular patients is needed to increase generalizability. HubMed – rehab centers



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