Browsing by Author "Thirumavalavan, K."

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    Differences in ischaemic and haemorrhagic strokes in Sri Lanka: 7-year data from the Ragama Stroke Registry
    (American Academy of Neurology & Lippincott Williams & Wilkins, 2015) Ranawaka, U.; Peiris, A.; Thirumavalavan, K.; Premawansa, G.; Kasturiratne, A.
    OBJECTIVE:We sought to describe the differences in stroke characteristics of patients with ischaemic and haemorrhagic stroke attending a Sri Lankan tertiary care hospital. BACKGROUND:The burden of stroke in South Asia is high, but epidemiological data are limited from the region. DESIGN/METHODS:The Ragama Stroke Registry is the first comprehensive stroke registry in Sri Lanka capturing data of all stroke patients admitted to an entire hospital. We collected data from all consenting patients with stroke admitted to the Colombo North Teaching Hospital over a seven-year period. We compared data from ischaemic stroke patients (IS group) with intracerebral haemorrhage patients (ICH group) regarding demographic characteristics, clinical features, risk factors, stroke severity and early disability. RESULTS:A total of 2690 patients were studied [mean age (SD) 64.4 (12.3) years; 58.6[percnt] males]; IS group- 2185 patients (81.3[percnt]); ICH group- 411 patients (15.3[percnt]). No differences were noted in age & sex distribution between ICH and IS groups. ICH patients presented to hospital earlier (<6 hours- ICH 74.5[percnt], IS 54.0[percnt], p<0.05). Altered consciousness, dysphasia, dysphagia, gaze palsy and bladder involvement were commoner among ICH patients (p<0.05). Previous history of stroke/ TIA, diabetes, heart disease, obesity/overweight and smoking were commoner in IS group. ICH patients presented with more severe strokes (NIHSS score >7 in ICH 67.6[percnt] vs. IS 43.8[percnt], p<0.05), and had more severe initial disability according to Barthel index and modified Rankin scale (p<0.05). CONCLUSIONS:Clinical and risk factor profiles were different between ICH and IS patients. Stroke severity and functional disability were higher among ICH patients. Study Supported by:Ragama Stroke Registry has been partly supported by research grants from the University of Kelaniya and Research Institute, International Medical Centre of Japan. Disclosure: Dr. Ranawaka has nothing to disclose. Dr. Peiris has nothing to disclose. Dr. Thirumavalavan has nothing to disclose. Dr. Premawansa has nothing to disclose. Dr. Kasthuriratne has nothing to disclose.
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    Recurrent vs. first presentation with acute coronary syndrome in a tertiary care hospital
    (Sri Lanka Medical Association, 2012) Thirumavalavan, K.; Premawansa, G.; Bandara, G.M.T.R.; Fonseka, V.N.R.M.; Danansuriya, D.S.T.; Premawansa, G.; Samarakoon, S.M.S.B.; de Silva, A.P.; de Silva, S.T.; Ranawaka, U.K.
    INTRODUCTION: Profile of recurrent acute coronary events may differ from first-ever events, but no data is available from South Asia where morbidity and mortality are high. AIMS: To describe characteristics of patients with recurrent acute coronary syndrome (ACS) admitted to a tertiary care hospital. METHODS: Data was prospectively collected from all patients admitted with ACS to the Colombo North Teaching Hospital over 18 months. Differences in demographic data, presentation, risk factors, management and early outcome between those with first and recurrent ACS were analysed. Results: Of 765 patients admitted with ACS, 501 (65.5%) presented with the first episode, while 264 (34.5%) presented with a second or subsequent episode. Those with recurrent ACS were more likely to:- present with unstable angina (61.4% vs 39.5%, p<0.001), present directly to hospital instead of a primary care provider (84.1% vs 71.3%, p<0.001), have hypertension (74.1% vs 50.1%, p<0.001) and hyperlipidaemia (51.5% vs 34.3%, p<0.001), and be ex-smokers (28% vs 19.3%, p<0.001). Those with the first episode were more likely to be current smokers (23.8% vs 11%, p<0.001). No differences were noted between the two groups in:- age and sex distribution, presenting symptoms, presence of diabetes, family history of coronary artery disease, alcohol use, in-hospital management, duration of hospital stay and early outcome. CONCLUSIONS: Patients with recurrent ACS were more likely to have unstable angina than myocardial infarction. They were more likely to present directly to hospital, and to have stopped smoking. Hypertension and hyperlipidaemia were commoner among them, highlighting the need for better secondary preventive measures.