Stroke incidence, mortality, subtypes in rural and urban populations in five geographic areas of India (2018-2019): results from the National Stroke Registry Programme

Background

Increasing stroke burden in India demands a long-term stroke surveillance framework. Earlier studies in India were urban-based, short term and provided limited data on stroke incidence and its outcomes. This gap is addressed by the establishment of five population-based stroke registries (PBSRs) of the National Stroke Registry Programme, India. This paper describes stroke incidence, mortality and age, sex, and subtypes distribution in the five PBSRs with urban and rural populations.

Methods

First-ever incident stroke patients in age group ≥18 years, resident for at least one year in the defined geographic area, identified from health facilities were registered. Death records with stroke as the cause of death from the Civil Registration System (CRS) were included. Transient ischemic attack (TIA) was excluded. Three PBSRs (Cuttack, Tirunelveli, Cachar) included urban and rural populations. PBSRs in Kota and Varanasi were urban areas. The crude and age-standardized incidence rate (ASR) by age, sex, and residence (urban and rural), rate ratios of ASR, case fatality proportions and rates at day 28 after onset of stroke were calculated for years 2018-2019.

Findings

A total of 13,820 registered first-ever stroke cases that included 985 death certificate-only cases (DCOs) were analysed. The pooled crude incidence rate was 138.1 per 100,000 population with an age-standardized incidence rate (ASR) of 103.4 (both sexes), 125.7 (males) and 80.8 (females). The risk of stroke among rural residents was one in seven (Cuttack), one in nine (Tirunelveli), and one in 15 (Cachar). Ischemic stroke was the most common type in all PBSRs. Age-standardized case fatality rates (ASCFR) per 100,000 population for pooled PBSRs was 30.0 (males) and 18.8 (females), and the rate ratio (M/F) ranged from 1.2 (Cuttack) to 2.0 (Cachar).

Interpretation

Population-based registries have provided a comprehensive stroke surveillance platform to measure stroke burden and outcomes by age, sex, residence and subtype across India. The rural-urban pattern of stroke incidence and mortality shall guide health policy and programme planning to strengthen stroke prevention and treatment measures in India.

Funding

The National Stroke Registry Programme is funded through the intramural funding of the Indian Council of Medical Research, Department of Health Research, Ministry of Health and Family Welfare, India.

Modelling and optimization of factors influencing adsorptive performance of agrowaste-derived Nanocellulose Iron Oxide Nanobiocomposites during remediation of Arsenic contaminated groundwater

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Iron oxide Permeated Mesoporous rice-husk nanobiochar (IPMN) mediated removal of dissolved arsenic (As): Chemometric modelling and adsorption dynamics

Adsorption based technologies are most widely used to mitigate the global predominance of heavy-metal groundwater contaminants like Arsenic (As), owing to their high efficiency and economic operation. The current study involves the optimization of Iron oxide Permeated Mesoporous rice-husk nanobiochars (IPMN) for As removal, which were synthesized through a chemically amended pyrolytic approach. The IPMN variants were screened based on preliminary OVAT (one-variable-at-a-time) studies for As removal. Chemometric investigations employing a central composite design matrix of Response surface methodology was further used to understand the influence of the process parameters on the adsorption of As on the most efficient IPMN variant. A Multi-Layered-Perceptron based artificial neural network was further used to confirm the veracity of the experimental and predictive conditions, to derive the optimal condition for the best adsorption efficiency. In addition, the dynamics of As adsorption by the optimal IPMN variant was modelled using pseudo-first-order (Lagergren) and pseudo-second-order (Ho) rate kinetic equations followed by isotherm studies using non-linear regression of Langmuir, Freundlich and Sips adsorption isotherms. The IPMNs have an appreciably higher uptake capacity (>90%) for dissolved As, as compared to the native milled rice husk (∼20%), alongside a substantial recyclability, thereby establishing their potential as a highly efficient, economical and sustainable nanobiochar for As removal.

Biosecurity and Circulation of Influenza A (H5N1) Virus in Live-Bird Markets in Bangladesh, 2012

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Successful management of ventral abdominal hernia in goat: a case report

The study was conducted a four month old Jamunapari doe weighing 15kg that was brought to the SAQ teaching veterinary Hospital, CVASU, Chittagong with the history of unknown cause, loss of appetite and gradual swelling in the pelvic region since one month. Based on clinical examination the case was subjected as a ventral abdominal hernia and corrected by surgical intervention. The case was recovered unevenfully at 10th postoperative day. DOI: http://dx.doi.org/10.3329/ijns.v2i2.11387 International Journal of Natural Sciences (2012), 2(2):60-62

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172 semen samples were collected from a cross section of the infertile population of North-East India, consisting mainly of tribal people and were analysed and evaluated for different parameters. Significant negative correlations were found between sperm count and motility, sperm count and morphology and between motility and abnormal morphology in this series. The percentage of abnormal morphology was very high and prospective study on the aetiology of this factor in these tribal people is warranted.