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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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Manipur CM Biren Singh says state needs immediate peace, understanding between two communities

He claimed that the administration is responding quickly to the displaced people’s needs in areas such as education and agriculture.

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Manipur Chief Minister N Biren Singh on Wednesday emphasised the urgent need for peace in the state, which has faced ethnic violence since May of last year, and called on two communities to reach a mutual understanding.

Speaking at the Good Governance Day event held at the state BJP headquarters, Singh expressed confidence that the BJP could restore stability to the northeastern state, highlighting the party’s commitment to coexisting harmoniously.

“What is happening in Manipur today has multiple causes. Those who seek to divide the state are now questioning the government’s actions… they are driven by a desire for power,” Singh remarked.

He mentioned several initiatives, such as ‘Meeyamgi Numit’ (People’s Day), designed to foster closer relationships between officials and the public. “We do not oppose any specific community. The BJP’s position is clear: we advocate for the idea of living together and have initiated efforts to strengthen ties between the police and the community,” he stated.

Singh added that the state government is diligently addressing the needs of internally displaced persons by establishing committees throughout the administrative framework. He claimed that the administration is responding quickly to the displaced people’s needs in areas such as education and agriculture.

“We have not made any mistakes. Our goal is to ensure the well-being of future generations. It is essential for both communities to remain calm. Rather than dwelling on the past, we should concentrate on the upcoming NRC process, capturing biometrics, and using 1961 as the foundation year for the Inner Line Permit,” Singh said.

He also highlighted the government’s commitment to acting within a democratic and constitutional framework, noting that achieving these goals will take time. “What we require now is immediate peace and a resolution of misunderstandings between the two communities,” he concluded.

The ongoing violence has resulted in the deaths of over 250 individuals and left thousands homeless due to clashes between the Meitei community and Kuki-Zo groups since last May.

“Only the BJP can save Manipur. BJP leaders possess strong values of nationalism and social justice, practicing reality-based politics in the nation’s interest. If I am not nominated for a ticket by the BJP, I will remain loyal to the party,” Mr. Singh added.

He also highlighted several unity-focused projects initiated by the BJP government, mentioning that a Unity Mall featuring stalls from all ethnic groups in the state will be constructed with an investment exceeding ₹140 crores.

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Pushpa 2 makers, Allu Arjun announce Rs 2 crore aid to stampede victim’s family

After consulting with the doctors, Allu Aravind expressed relief upon learning that the boy is recovering and is now able to breathe independently.

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Pushpa 2 makers, Allu Arjun announce Rs 2 crore aid to stampede victim’s family

Film producer Allu Aravind, also father of Pushpa 2 actor Allu Arjun, on Wednesday announced financial support totalling Rs 2 crores for the eight-year-old boy injured in the December 4 Sandhya Theatre stampede.

The unfortunate incident, which occurred during Allu Arjun’s visit to the theatre for a Pushpa 2 premiere, claimed the life of the boy’s 35-year-old mother. Allu Arjun is now facing charges in the case, and was questioned by police on Tuesday regarding his involvement.

Reportedly, the veteran producer along with Dil Raju and others, visited the private hospital where the boy injured in the stampede is being treated. After consulting with the doctors, Allu Aravind expressed relief upon learning that the boy is recovering and is now able to breathe independently.

Speaking to the media, Allu Aravind said that the boy, Sri Teja, is recovering, and is not on a ventilator. He added that to support the family, they should support him with Rs2 crore: Rs 1 crore by Allu Arjun, Rs 50 lakh by Mythri Movie Makers, and Rs 50 lakh by director Sukumar. He further mentioned that they will give this money through Telangana Film Development Corporation Chairman Dil Raju.

When questioned if he had visited the boy’s family, Aravind explained that he cannot interact with the family due to the legal problems. With the police permission, once, 10 days back, he visited him. He was then recovering, he continued.

Meanwhile, producer and Telangana Film Development Corporation (FDC) chairman Dil Raju also addressed the media, stating that there is a meeting planned tomorrow with Chief Minister Revanth Reddy, and they have taken an appointment. He added that they have invited most of the prominent members of the industry.

Earlier on Tuesday, the father of the eight-year-old boy injured in the December 4 stampede during the screening of Pushpa 2 said that the boy has shown improvement and is now off oxygen and ventilator support. He added that while the boy’s condition has improved, full recovery will take time, according to doctors.

He further shared that he received a Rs 10 lakh cheque from Pushpa star Allu Arjun, along with additional assistance from the film’s production team and Telangana Cinematography Minister Komatireddy Venkat Reddy.

Speaking about his willingness to withdraw the complaint, he clarified that he received support from Allu Arjun’s team the day after the incident and emphasized that there was no pressure on him to drop the case.

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Man sets himself on fire near Parliament building, rushed to hospital: Delhi Police

The exact reason will be unearthed only after the investigation.

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A man on Wednesday set himself afire near the Parliament in Delhi. He was immediately rushed to the RML hospital after he sustained severe injuries. The police have started an investigation into the matter.

The area where the man attempted to set himself on fire has been cordoned off. A forensic team is also present at the spot to investigate which substance he doused on himself before setting himself on fire.

Delhi Police stated that the man has been identified as Jitendra from Uttar Pradesh’s Bagpat. They said the reason behind the suicide attempt seems to be related to personal enmity in Bagpat. The exact reason will be unearthed only after the investigation.

“Today one person probably Jitendra of Uttar Pradesh’s Bagpat set himself on fire in roundabout rail Bhavan. The local police and railway police along with some civil persons immediately extinguished the fire and the person was sent to hospital. The issue as we can decipher is probably related and personal enmity in Bagpat. Further investigation is on,” Delhi Police said.

“The local police, railway police, and some civilians quickly managed to extinguish the flames, and the man was sent to the hospital. Preliminary findings suggest the incident may be linked to personal enmity in Bagpat. Further investigations are ongoing,” the police statement said.

In another similar incident, a man from Rohini set himself on fire outside the Transport Bhawan near the Parliament in April, 2023. The man was reportedly raising slogans against Prime Minister Narendra Modi and in support of Congress leader Rahul Gandhi.

He had lost his job during the lockdown imposed during the pandemic. He doused himself with an inflammable liquid as he shouted slogans and set himself afire. He was rescued immediately by police personnel in the area and taken to a nearby hospital. The man had sustained 50 per cent burns in the incident, according to reports.

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