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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]

India News

PM Modi’s Indonesia visit to boost defence, digital and strategic partnership

Prime Minister Narendra Modi’s Indonesia visit is expected to strengthen bilateral ties through new initiatives in defence, digital infrastructure, maritime security, trade and critical minerals.

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PM Narendra Modi

Prime Minister Narendra Modi’s upcoming visit to Indonesia is expected to give fresh momentum to the growing strategic partnership between the two countries, with discussions likely to cover defence cooperation, maritime security, digital connectivity, trade, critical minerals and several other sectors.

India’s Ambassador to Indonesia, Sandeep Chakravorty, said the relationship between New Delhi and Jakarta has entered a stronger phase following Indonesian President Prabowo Subianto’s visit to India as the Chief Guest for the Republic Day celebrations last year. He said the Prime Minister’s visit is expected to further strengthen this trajectory through a series of new understandings and agreements.

Defence and maritime cooperation likely to receive major push

According to the ambassador, defence and maritime security will remain key pillars of the discussions during the visit.

He highlighted Indonesia’s strategic location along the Malacca Strait, describing secure sea lanes as vital for both countries and the wider Indo-Pacific region. He stressed that uninterrupted maritime connectivity remains essential for global trade and regional stability.

Without revealing specific details, Chakravorty indicated that the visit could produce significant outcomes in defence cooperation, saying several important announcements are expected.

‘BrahMos Plus’ hints at broader defence partnership

The ambassador also suggested that defence ties between India and Indonesia are moving beyond discussions centred on the BrahMos supersonic cruise missile.

Responding to a question about future cooperation, he remarked that the next phase would be “BrahMos Plus,” while refraining from providing further details.

He said future collaboration is expected to focus on defence manufacturing, technology partnerships, training and capacity building. India, he noted, has emerged as an important exporter of defence equipment and could support Indonesia’s efforts to strengthen its domestic defence manufacturing capabilities.

Military cooperation is also expanding, with India set to participate with troops for the first time in the multinational Garuda Shield military exercise after previously attending as an observer.

Digital connectivity and UPI integration gain momentum

Digital cooperation is expected to be another major highlight of the visit.

The ambassador said Indonesia is preparing to launch its Open Network for Digital Commerce (ONDC)-inspired platform during Prime Minister Modi’s visit, making it the fastest international adopter of India’s digital public infrastructure model.

The initiative is expected to support nearly 65 million micro, small and medium enterprises (MSMEs) in Indonesia by creating a more open digital commerce ecosystem.

Chakravorty also said discussions on integrating India’s Unified Payments Interface (UPI) with Indonesia’s payment systems have reached an advanced stage.

While technical integration remains complex due to Indonesia’s multiple payment-switch networks, he expressed confidence that progress would continue and the Prime Minister’s visit could accelerate the process.

Critical minerals and investment to feature prominently

Critical minerals are also expected to be a major area of cooperation as both countries look to strengthen supply chains for clean energy technologies and electric vehicle manufacturing.

Indonesia possesses significant reserves of nickel and other strategic minerals, while India is seeking reliable supplies to support its manufacturing ambitions.

The ambassador said India plans to invest in processing critical minerals within Indonesia rather than importing only raw materials. He added that such investments would support industrial development in both countries while contributing to India’s self-reliance goals.

Cultural ties to be highlighted

Apart from strategic and economic cooperation, the visit is also expected to showcase the longstanding cultural relationship between India and Indonesia.

Both countries will launch a 15-month programme commemorating Rabindranath Tagore’s 1927 visit to Indonesia, recognising his influence on the country’s educational and cultural landscape.

Prime Minister Modi is also expected to visit Yogyakarta, a city known for its historic temples, reflecting the deep civilisational links shared by the two nations.

With cooperation expanding across defence, digital infrastructure, trade and critical minerals, the visit is expected to mark another important step in strengthening the India-Indonesia strategic partnership and advancing cooperation in the Indo-Pacific region.

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India News

Ram Mandir Trust accepts Champat Rai’s resignation amid donation theft row

The Shri Ram Janmabhoomi Teerth Kshetra Trust has accepted Champat Rai’s resignation as General Secretary following the donation theft controversy, with Bajrang Bagra emerging as a leading contender for the post.

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Champat Rai

The Shri Ram Janmabhoomi Teerth Kshetra Trust has accepted the resignation of its General Secretary, Champat Rai, following the controversy surrounding the alleged theft of cash donations at the Ram Temple in Ayodhya.

According to sources, Bajrang Bagra has emerged as one of the leading contenders for the post. Bagra currently serves as the International General Secretary of the Vishwa Hindu Parishad (VHP). A chartered accountant by profession and a former head of PSU NALCO, he is considered to have the administrative and financial expertise required as the Trust moves into its next phase.

Sources indicated that the Trust is looking to appoint someone with strong experience in governance, finance and institutional administration to strengthen its functioning.

Although Champat Rai has stepped down as General Secretary, sources said he is expected to continue as a trustee unless he decides otherwise.

Decision on successor may come after VHP executive meeting

The appointment of the next General Secretary is unlikely to be announced immediately. The VHP’s biannual national executive meeting is scheduled to take place in Delhi on July 19 and 20, where several organisational decisions, including transfers and appointments, are expected to be discussed.

Champat Rai and trustee Anil Mishra had submitted their resignations after Uttar Pradesh Chief Minister Yogi Adityanath reportedly took a firm stand on the alleged donation theft. Their resignations came after the Special Investigating Team (SIT) submitted its preliminary findings into the case.

Donation theft investigation

According to the preliminary investigation, temple staff responsible for counting cash donations allegedly siphoned off money despite CCTV cameras being installed at the counting centre. The report stated that the footage was not monitored regularly, allowing the alleged theft to continue. Reports suggest that around Rs 7 crore to Rs 7.5 crore may be missing.

So far, eight people have been arrested in connection with the case. Among them is Ram Shankar Yadav, also known as Tinnu Yadav, who worked as Champat Rai’s driver.

Sources said Champat Rai has told his close associates that Tinnu Yadav played the central role in the alleged fraud and misused the trust placed in him. According to the sources, Rai also claimed that when Yadav feared he would be caught, he leaked information to a Samajwadi Party leader.

The other accused arrested in the case are Avinash Shukla, Anukalp Mishra, Lav Kush Mishra, Manish Kumar Yadav, Karunesh Pandey, Ramashankar Mishra and Subhash Srivastava.

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WhatsApp gets more time to respond on username feature, rollout in India put on hold

WhatsApp has been granted more time to respond to the government’s concerns over its username feature and has assured that it will not launch the feature in India until discussions are completed.

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WhatsApp

Meta assures the government that the feature will not be introduced in India until ongoing consultations are completed.

Meta-owned WhatsApp has been granted an extension to submit its response to the Centre regarding its proposed username feature, while assuring the government that it will not roll out the feature in India until discussions on the matter are concluded.

According to sources, the government has allowed WhatsApp three additional days to file its response after the company sought more time. The original deadline for the reply was Friday.

The proposed username feature would allow users to connect with others without revealing their phone numbers, a move that has raised concerns within the government over its potential impact on cyber safety.

Last week, the Centre issued a notice to Meta questioning the feature, expressing concerns that it could increase online fraud, phishing attempts, impersonation, and so-called “digital arrest” scams. The government also directed the company to pause the rollout until consultations are completed to its satisfaction.

Sources said representatives from Meta met officials from the Ministry of Electronics and Information Technology (MeitY) on Friday following the issuance of the notice. During the discussions, WhatsApp reportedly assured authorities that the feature would not be introduced in India before the consultation process is completed.

The government has also asked Meta to explain why action should not be initiated under the Information Technology Act and the relevant rules if the proposed feature is found to compromise user safety. It reminded the company that WhatsApp, as a significant social media intermediary, must comply with due diligence obligations under Indian law.

A WhatsApp spokesperson had earlier clarified that the username feature is not yet live and is expected to be introduced gradually later this year.

The company said it has built several safeguards into the feature to prevent impersonation. According to WhatsApp, usernames of public figures, government entities, celebrities, and verified Meta accounts have been reserved so that they can only be claimed by their legitimate owners. It also said lookalike variations of such usernames are being restricted.

WhatsApp also clarified that users will still need a phone number to create and use a WhatsApp account. The username feature is intended only as an alternative way for people to connect.

The company added that users would need to know another person’s exact username before initiating contact. It also plans to limit how many new users an account can message, prevent repeated attempts to guess usernames, and use automated systems to detect impersonation and abusive behaviour.

To help users identify unfamiliar contacts, WhatsApp said it will display contextual information whenever someone sends a message through a username for the first time. Users will be informed whether the sender is a new account, an existing contact, someone who shares a mutual group, or a person located in another country before deciding whether to respond.

Following its notice to WhatsApp, the IT Ministry also issued notices to Telegram and Signal, seeking details on how their existing username-based systems address concerns related to fraud and impersonation. While WhatsApp has around 500 million users in India, Telegram has a significantly smaller user base.

In recent days, Meta and Telegram have also come under regulatory scrutiny on separate issues. The government recently issued a notice to Meta regarding child sexual abuse material appearing in Instagram advertisements, while Telegram was directed to strengthen action against the circulation of pirated films, OTT content, and other copyrighted audio-visual material on its platform.

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