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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

Parliament winter session: Government lists 15 bills, including Waqf bill

The session will kick off on November 25 and conclude on December 20.

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The government has listed five new ones and one to amend the contentious Waqf law out of 15 bills for the winter session of Parliament. The session will kick off on November 25 and conclude on December 20.

The government has introduced five new bills, including the Coastal Shipping Bill, 2024, which aims to promote coasting trade and increase the participation of Indian-flagged vessels owned and operated by Indian citizens for both national security and commercial purposes.

Another significant legislation that will be introduced by the government is the Indian Ports Bill, 2024. This bill is designed to implement measures for the conservation of ports, enhance security, and manage pollution, ensuring compliance with India’s international obligations and statutory requirements.

Additionally, the government plans to introduce the Merchant Shipping Bill, 2024, which aims to meet India’s obligations under maritime treaties and support the development of Indian shipping while ensuring the efficient operation of the Indian mercantile marine in a way that serves national interests.

Pending legislation includes the Waqf (Amendment) Bill, which is awaiting consideration and passage after the joint committee of both Houses submits its report to the Lok Sabha. The committee is expected to report by the end of the first week of the winter session.

Currently, there are eight bills, including the Waqf (Amendment) Bill and the Mussalman Wakf (Repeal) Bill, pending in the Lok Sabha, while two additional bills are in the Rajya Sabha.

Furthermore, the government has also listed the Punjab Courts (Amendment) Bill for introduction, consideration, and passage, which seeks to increase the pecuniary appellate jurisdiction of Delhi district courts from Rs 3 lakh to Rs 20 lakh.

The Merchant Shipping Bill, along with the Coastal Shipping Bill and the Indian Ports Bill, is slated for introduction and eventual passage.

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International Criminal Court issues arrest warrant against Israel PM Benjamin Netanyahu over war crimes

The court accused Prime Minister Netanyahu and Defence Minister Gallant of crimes against humanity, including murder, persecution, inhumane acts, and the war crime of starvation as a method of warfare.

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International Criminal Court issues arrest warrant against Israel PM Benjamin Netanyahu over war crimes

The International Criminal Court (ICC) today issued arrest warrants for Israeli Prime Minister Benjamin Netanyahu and former Defence Minister Yoav Gallant over alleged war crimes and crimes against humanity.

The court accused Prime Minister Netanyahu and Defence Minister Gallant of crimes against humanity, including murder, persecution, inhumane acts, and the war crime of starvation as a method of warfare. The leaders allegedly restricted essential supplies such as food, water, and medical aid to civilians in Gaza, resulting in severe humanitarian crises and deaths, including among children.

Last year in October, Israel had launched attacks on Gaza in retaliation for the surprise attack by Hamas. The Israel-Hamas war has led to the death of thousands of civilians, while lakhs have been displaced. The major infrastructures in Gaza, including hospitals and schools, were also destroyed as Israel vowed to wipe out Hamas.

The International Criminal Court stated that it found reasonable grounds to believe the accused intentionally targeted civilians and limited medical supplies, forcing unsafe medical procedures, which caused immense suffering. This ruling was based on the findings from at least October 8, 2023 until at least May 20, 2024.

The court remarked that it has assessed that there are reasonable grounds to believe that PM Netanyahu and Defence Minister Gallant bear criminal responsibility as civilian superiors for the war crime of intentionally directing attacks against the civilian population of Gaza.

Furthermore, it also noted that the lack of food, water, electricity and fuel, and medical supplies created conditions of life calculated to bring about the destruction of part of the civilian population in Gaza, leading to death of civilians, including children due to malnutrition and dehydration.

Additionally, the International Criminal Court dismissed two challenges by Israel against its jurisdiction in the situation in the State of Palestine.

Notably, Israel had contested the ICC’s jurisdiction, claiming it could not be exercised without Israel’s consent. Nonetheless, the Chamber ruled that the Court has jurisdiction based on Palestine’s territorial scope, including Gaza, the West Bank, and East Jerusalem. It further noted that Israel’s objections were premature, as jurisdictional challenges under the Rome Statute can only be made after an arrest warrant is issued.

Reportedly, Israel had also requested a fresh notification regarding the investigation, started in 2021. Denying the request, the court stated that Israel had earlier declined to request a deferral, making additional notifications unnecessary.

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Yogi Adityanath accords tax-free status to Sabarmati Report film in Uttar Pradesh

Earlier, Prime Minister Narendra Modi and Home Minister Amit Shah have also praised this film.

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Uttar Pradesh Chief Minister Yogi Adityanath on Thursday accorded a tax-free status to ‘The Sabarmati Report’ film, based on the train burning incident at Godhra in Gujarat in 2002, in the state.

The announcement was made after Chief Minister Adityanath attended the screening of Vikrant Massey and Raashii Khanna-starrer ‘The Sabarmati Report’ in Lucknow with the film’s cast.  

Speaking to reporters, actor Vikrant Massey thanked the Uttar Pradesh Chief Minister for making ‘The Sabarmati Report’ film tax-free in the state. “I want to thank Yogi Adityanath ji. This is an important film and I appeal to everyone to go and watch this film,” he said.

Chief Minister Adityanath along with many of his cabinet colleagues watched the film ‘The Sabarmati Report’ under a special screening at a cinema hall in the capital, said a spokesperson of the state government.

Several people associated with the film unit were also present on the occasion. Later the chief minister announced to make this film tax-free in UP.

The BJP-ruled states have been praising the makers of The Sabarmati Report, claiming the team has tried to bring out this truth in front of the people of the country through the film.

The saffron party is appealing to people to watch this film and try to get closer to the truth of Godhra.

Uttar Pradesh becomes the sixth BJP-ruled state after Haryana, Rajasthan, Chhattisgarh, Madhya Pradesh and Gujarat to declare lead actors Vikrant Massey and Raashii Khanna’s film tax-free.

Adityanath said along with identifying the faces of those who are conspiring against the country for political gains, there is also a need to expose them. The film team has discharged its responsibilities to expose the truth, he said, adding an attempt has been made to bring the real truth in front of the country in a big way through the film.

The Sabarmati Report is said to be based on the incident of setting fire to a train full of ‘karsevaks’ in Godhra on February 27, 2002, killing 90 devotees. After this incident, communal riots broke out in Gujarat. Earlier, Prime Minister Narendra Modi and Home Minister Amit Shah have also praised this film.

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