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Home care for stroke patients ineffective, reveals new study

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Home care

[vc_row][vc_column][vc_column_text]~By Dinesh C Sharma

New Delhi, June 28 (India Science Wire): For years, doctors in Indian hospitals have been recommending home-based care for rehabilitation of stroke patients. But a new study – largest of its kind – has revealed that this does not work.

Stroke patients require continuous care including physiotherapy to recover and minimize life-long disability. In the absence of adequate professional and affordable rehabilitation facilities, doctors often recommend care at home by family members supplemented by physiotherapist visits. Hospital-based care is also offered in various centres but is costly.

In order to study if home-based care results in desired outcomes, a study was done at 14 public, private and district hospitals across the country. A total of 1250 stroke patients were followed up over six months. The study participants were divided in two groups – one received standard package of care given by respective hospital while the other group was given home-based care which included training to family members and weekly visits by physiotherapists for two months. The results revealed that there was no reduction in disability for patients who got care at home, compared to those who received the standard package.

The findings, published in medical journal The Lancet on Tuesday, have surprised medical community because earlier studies carried out in developed countries had indicated that community-based rehabilitation played significant role in recovery of stroke patients. The World Health Organisation (WHO) too recommends such an approach.

“We found that despite extensive training in hospital and during follow up visits in the home, there was no difference in the degree of recovery or quality of life of people who received this extra treatment,” explained Professor Richard Lindley of the George Institute for Global Health and the University of Sydney, who led the study.

The study, supported by the National Health and Medical Research Council (NMHRC) of Australia, was coordinated by Christian Medical College, Ludhiana. Patients in the intervention group had access to physiotherapists who taught the family techniques such as mobility training and communication practice.

“Professional help like training and visits by physiotherapists was provided for first two months only because the intervention needed to be cost effective and sustainable. If family members required more training, then the aspiration of routinely providing rehabilitation through family caregivers might not be feasible,” pointed out Jeyaraj Pandian, neurologist from Christian Medical College, Ludhiana who led the trial. “Our training programme might not have been sufficient (in time and content) to deliver effective family rehabilitation, as we observed only about 30 minutes of daily activities in the intervention group. Conventional western rehabilitation is usually associated with greater daily therapy time.” Accredited Social Health Activist (ASHA) might have been a more effective strategy, but probably more expensive.

Dr Vijaya Nath Mishra, a neurologist at the Sir Sunderlal Hospital at BHU, Varanasi, said the results of the study are surprising. “We will have to carefully examine the evidence because we have so far believed and also observed that caregivers and family members have a major role in outcome of stroke.” Dr Mishra was not associated with the study.

It is estimated that around 1.6 million people have a stroke in India each year, yet the vast majority receive no formal rehabilitation. The whole country has just 35 stroke units, and most are in the cities, despite stroke being the third commonest cause of death in the adult population.

Professor G V S Murthy of the Indian Institute of Public Health, the Co-Chair of the study, commented, “Task shifting is increasingly seen as a solution to targeting chronic diseases in many countries in the world. But our results show it may be ineffective for some conditions and waste already limited resources. We need more rigorous examinations of such family and community led programs before they become commonplace.”

The participating hospitals included Christian Medical College, Ludhiana; Apollo Gleneagles Hospitals, Kolkata; All India Institute of Medical Sciences, New Delhi; Baptist Christian Hospital, Tezpur; Christian Medical College and Hospital, Vellore;  GNRC Hospitals, Dispur; Lalitha Super Specialty Hospital, Guntur; Nizam Institute for Medical Sciences, Hyderabad; Postgraduate Institute for Medical Sciences and Research, Chandigarh; Sree Chitra Tirunal Institute for Medical Sciences and Technology; Global Hospitals, Chennai; BGS Global Hospitals, Bangalore; Amrita Institute of Medical Sciences, Kochi and St Stephen’s Hospital, New Delhi. (India Science Wire) [/vc_column_text][/vc_column][/vc_row]

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3 dead, 9 hospitalised after gas leak at fertiliser plant in Maharashtra

According to police, the explosion released toxic chemical fumes.

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Three individuals, including two women, lost their lives and nine others were hospitalised following a gas leak caused by an explosion in a reactor at a fertiliser plant in Maharashtra’s Sangli district, an official said on Friday.

The incident occurred at approximately 6:30 PM on Thursday at the Myanmar Chemical Company, located in Shalgaon MIDC within Kadegaon tehsil.

Sangli Superintendent of Police Sandip Ghuge stated that the gas is suspected to be ammonia.

According to police, the explosion released toxic chemical fumes. “Approximately 12 people in the facility were affected and subsequently taken to the hospital. Tragically, two female workers and a security guard have died, while nine others are currently receiving treatment,” stated Sangram Shewale, Senior Inspector at Kadegaon police station.

Seven of the injured individuals have been admitted to Sahyadri Hospital in Karad, with five of them in critical condition in the ICU.

The deceased women have been identified as Suchita Uthale (50) from Yetgaon in Sangli district and Neelam Rethrekar (26) from Masur in Satara district, PTI reported.

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Ahead of Delhi Elections, Arvind Kejriwal launches Revdi Par Charcha campaign to seek feedback on freebies

Arvind Kejriwal said 65,000 meetings will be held across Delhi at micro levels by the AAP leaders and workers.

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Ahead of Delhi Elections, Arvind Kejriwal launches Revdi Par Charcha campaign to seek feedback on freebies

The Aam Aadmi Party (AAP) on Friday launched a campaign with a tagline Revdi Par Charcha to seek public feedback on freebies. The campaign comes ahead of the assembly elections, which is scheduled to be held in February.

Former Chief Minister and AAP national convenor Arvind Kejriwal launched the campaign with his colleagues at the party office, saying while the opposition calls freebies as revdi, the party calls it services. This campaign will start on November 25 and will continue for 15 days until December 10, discussing the issues with common man.

Notably, the opposition has been targeting the AAP for providing free electricity, water and free public buses for women among other facilities. However, AAP feels freebies help citizens live a life of dignity.

Gopal Rai, AAP’s Delhi unit chief, said that so far, politicians used to enjoy the facilities, while citizens paid taxes. He continued that Arvind Kejriwal’s government decided that the people should also get the facilities like the politicians, adding the BJP called their attempt revdis. He said that AAP is launching the ‘Revdi Par Charcha’ campaign to discuss with the people in the city if the government should provide the facilities or not.

Launching the campaign, Arvind Kejriwal said 65,000 meetings will be held across Delhi at micro levels by the AAP leaders and workers. He said that AAP has six revdis for the people of Delhi. Mentioning that the Prime Minister and BJP have said several times that Kejriwal is providing freebies to the people that should be stopped, the former Chief Minister said that now people will now tell them if they want these six freebies.  He further concluded that if the BJP is elected here, they will stop these services immediately.

While listing the six services, the AAP national convenor said that Delhi is getting free electricity round the clock. He added that there was a time when Delhi used to see power cuts for 8-10 hours, but AAP ensured that the situation changed. He also noted that his party is providing free water, free pilgrimage to senior citizens, free bus rides to women, free world-class education and free medicine and treatments. Additionally, the pamphlet launched by Arvind Kejriwal also listed that soon the women in Delhi will get Rs 1,000 per month as well, later termed as the seventh revdi by the former Chief Minister.

Reports said that the paper will be circulated across the national capital. The paper also reads that if the reader feels they are getting huge water bills, they should not pay it. It mentioned that AAP will waive all water bills once Arvind Kejriwal is re-elected.

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Rahul Gandhi says air pollution in North India a national emergency, tourism declining, global reputation crumbling

“We need a collective national response, not political blame games,” the Congress leader said on his X handle.

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Leader of Opposition in the Lok Sabha Rahul Gandhi on Friday said the air pollution in North India is a national emergency that needs a collective national response and not a political blame game. The Congress leader added that due to air pollution tourism is declining and “our global reputation is crumbling”.

It is a public health crisis that is stealing children’s future and suffocating the elderly, Gandhi said, adding an environmental and economic disaster that is ruining countless lives.

“As Parliament meets in a few days, MPs will all be reminded of the crisis by our irritated eyes and sore throats. It is our responsibility to come together and discuss how India can end this crisis once and for all,” the Leader of the Opposition in Lok Sabha said.

The former Congress chief said the poorest “among us suffer the most”, unable to escape the toxic air surrounding them. Families are gasping for clean air, children are falling sick, and millions of lives are being cut short, he added.

The Rae Bareli MP noted that the pollution cloud covers hundreds of kilometres. He said cleaning it up will require major changes and decisive action from governments, companies, experts, and citizens.

“We need a collective national response, not political blame games,” the Congress leader said on his X handle.

Gandhi also shared a video on a social media platform where he discussed the capital’s air pollution with environmentalist expert Vimalendu Jha. In the video, the Congress leader said he has been facing eye-burning and breathing issues and how the last week in Delhi has been terrible.

He said, “I tell my mother to leave town this month.” Jha explains to Gandhi that the sources of air pollution in Delhi are episodic and perennial. Episodic sources are firecrackers and stubble burning, which affect the month of November. “Vehicular contributes 50 per cent of Delhi’s pollution and construction-related roadside dust is another 30 per cent,” Jha said.

The Air Quality Index in Delhi has been severe since November 16, making it five consecutive days till Wednesday. On November 15, the average AQI was 396 (very poor).

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