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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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Election Commission responds after Kejriwal questions BJP’s involvement in home voting process

Upon approval, a polling team, comprising election officials and security personnel, will visit the voter’s residence prior to election day to facilitate the voting process.

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The Election Commission of India (ECI) issued a detailed clarification regarding the home voting facility for the upcoming Delhi Assembly elections scheduled for February 5, 2025. This initiative, designed to enhance accessibility for senior citizens (over 85 years old) and persons with disabilities (PwD), requires eligible voters to submit Form 12D to apply.

Upon approval, a polling team, comprising election officials and security personnel, will visit the voter’s residence prior to election day to facilitate the voting process.

Crucially, the ECI clarified that candidates or their authorized representatives will be permitted to accompany the polling team during these home visits. This provision addresses concerns raised by Aam Aadmi Party (AAP) leader Arvind Kejriwal, who had previously highlighted a video showing BJP representatives present during a home voting event.

While the ECI statement did not directly mention Kejriwal or any specific political party, the inclusion of candidate representatives aims to ensure transparency and alleviate concerns about potential irregularities. The commission’s statement emphasizes that the presence of representatives is permissible to uphold fairness and prevent any accusations of undue influence.

The ECI has received a significant number of applications for this facility: 6,447 from senior citizens and 1,058 from PwD voters. To date, 1,271 senior citizens and 120 PwD voters have already cast their ballots through this home voting system. The process itself involves the polling team providing the voter with a ballot paper, overseeing the casting of the vote, and ensuring strict adherence to ECI guidelines regarding confidentiality. To maintain transparency and accountability, the entire process is recorded on video.

The ECI unequivocally stated that participation in the home voting option is entirely voluntary. Voters choosing this method will not be allowed to cast their vote at a regular polling station on election day.

The commission reiterated its commitment to conducting free and fair elections and underscored the importance of this initiative in promoting inclusive participation in the democratic process. Voters facing any difficulties are urged to contact their local Returning Officer (RO) or district Election Officer (DEO), or utilize the central helpline at 1950.

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76th Republic Day: US sends warm wishes to India, says defining relationship of the 21st century

The meeting with his Quad counterparts—External Affairs Minister S Jaishankar of India, Takeshi Iwaya of Japan, and Penny Wong of Australia—focused on enhancing economic opportunities and ensuring peace and security in the Indo-Pacific. It served as a practical demonstration of the commitment to the strategic vision articulated in his Republic Day statement.

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The United States marked India’s 76th Republic Day with effusive praise, highlighting the enduring strength of the world’s largest democracy and the burgeoning partnership between the two nations. Secretary of State Marco Rubio, in a statement released on the occasion, extended warm congratulations to the people of India, emphasizing the significance of the Indian Constitution as the bedrock of this vibrant democracy. He went beyond simple well-wishes, however, painting a picture of a rapidly strengthening bilateral relationship destined for even greater heights.

Rubio’s statement explicitly described the US-India partnership as “the defining relationship of the 21st century,” a bold assertion reflecting the growing strategic alignment and mutual economic interests between the two nations. This statement was not merely ceremonial; it underscored the deepening cooperation across various sectors, from space research to joint efforts within the Quadrilateral Security Dialogue (Quad).

The Quad, comprising the US, India, Japan, and Australia, received significant attention in Rubio’s remarks. He emphasized the alliance’s crucial role in promoting a “free, open, and prosperous” Indo-Pacific region, a clear signal of the shared commitment to counterbalancing China’s influence in the region.

This emphasis was reinforced by Rubio’s actions earlier in the week, hosting a crucial meeting of Quad foreign ministers at the US Department of State. This meeting, his first official engagement as Secretary of State, underscored the immediate priority given to strengthening the Quad alliance and its collaborative efforts.

The meeting with his Quad counterparts—External Affairs Minister S Jaishankar of India, Takeshi Iwaya of Japan, and Penny Wong of Australia—focused on enhancing economic opportunities and ensuring peace and security in the Indo-Pacific. It served as a practical demonstration of the commitment to the strategic vision articulated in his Republic Day statement.

Furthermore, Secretary Rubio’s bilateral meeting with External Affairs Minister Jaishankar in Washington D.C. further cemented the strengthening ties between the two countries. The discussions covered a broad range of topics, including regional issues and avenues for further deepening the US-India relationship.

A notable point of discussion, as highlighted in an official press release, included a shared commitment to addressing concerns related to irregular migration, an area of mutual interest requiring collaborative solutions. This commitment, alongside the focus on economic ties, demonstrated the multifaceted nature of the burgeoning partnership, extending beyond strategic security concerns.

India’s own Republic Day celebrations showcased the nation’s unique blend of cultural diversity, unity, and military strength. The grand parade on Kartavya Path served as a vivid display of national pride and the successful integration of diverse elements into a cohesive and powerful nation. The presence of Indonesian President Prabowo Subianto as the Chief Guest further underscored India’s growing global influence and its capacity to foster strong relationships with key international partners.

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Ratan Tata featured in Jharkhand’s Republic Day tableau, pic surfaces

By celebrating both its industrial achievements and its vibrant cultural traditions, the tableau offered a nuanced and multifaceted portrayal of Jharkhand, highlighting its progress while deeply respecting its heritage.

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Jharkhand’s Republic Day tableau, a vibrant spectacle of colour and movement, presented a compelling narrative of the state’s journey from its rich heritage to its remarkable progress. The tableau, aptly titled “Swarnim Jharkhand: A Tradition of Heritage and Progress,” served as a powerful visual testament to the state’s multifaceted identity. Central to this narrative was the pivotal role played by the late industrialist, Ratan Tata, whose visionary leadership laid the groundwork for much of Jharkhand’s subsequent development.

The tableau’s design was meticulously crafted to showcase this multifaceted narrative. At its heart was Jamshedpur, India’s first planned industrial city, a legacy of Tata’s pioneering efforts. This iconic city, depicted in vivid detail, served as a powerful symbol of industrial growth and modernization. However, the tableau astutely avoided portraying a solely industrial narrative. It carefully integrated elements celebrating Jharkhand’s cultural richness and its commitment to social progress.

A striking image of two young girls engaged with laptop computers underscored Jharkhand’s significant strides in education. This symbolized the state’s dedication to expanding educational access, particularly for tribal children in both urban and rural areas, representing a crucial investment in the future.

The tableau cleverly juxtaposed this modern image with vibrant representations of traditional art forms. Sohrai and Khobar paintings, meticulously crafted by tribal artists, were displayed prominently, showcasing the enduring legacy of Jharkhand’s artistic heritage. Adding to the spectacle, performers enacted the energetic Chhau dance of Seraikela, a captivating dance form deeply rooted in the state’s cultural identity.

The tableau also subtly highlighted the contributions of women in Jharkhand’s economic landscape, acknowledging their significant role in generating employment and driving economic growth. This balanced depiction of industrial progress and cultural preservation made the tableau a truly comprehensive representation of Jharkhand’s identity.

By celebrating both its industrial achievements and its vibrant cultural traditions, the tableau offered a nuanced and multifaceted portrayal of Jharkhand, highlighting its progress while deeply respecting its heritage.

The inclusion of the Jaduguda uranium plant subtly acknowledged the state’s contribution to India’s nuclear energy program. In essence, the tableau was a powerful and memorable celebration of Jharkhand’s journey, skillfully weaving together its past, present, and future.

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