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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]

2024 Lok Sabha Elections

Priyanka Gandhi accuses BJP of planning to change the Constitution, criticises PM Modi for inflation

Priyanka Gandhi was speaking at an election rally at Dharampur village of tribal dominated Valsad district held in support of Congress candidate for ST-reserved Valsad Lok Sabha seat, Anant Patel.

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Congress leader Priyanka Gandhi on Saturday said the BJP may be denying it now, but the party will change the Constitution if it returns to power. She targeted Prime Minister Narendra Modi over inflation and called him the mehengai man.

Gandhi said the BJP leaders and candidates are saying that they will change the Constitution. She said PM Modi is denying it and this is BJP’s tactic. Priyanka Gandhi was speaking at an election rally at Dharampur village of tribal dominated Valsad district, Gujarat held in support of Congress candidate for ST-reserved Valsad Lok Sabha seat, Anant Patel.

Gandhi said first the BJP will deny what they want to do. But after coming to power they will implement it. She further added the BJP wants to change the constitution to weaken the common people and deprive them of their rights given in the Constitution. She said the BJP leaders project the Prime Minister as powerful and say that chutki bajake ladai rukwa dete hai (he can stop the Russia- Ukraine war with the snap of his fingers). She asked why is Prime Minister unable to remove poverty just like that?

Priyanka Gandhi claimed the tribal population in Gujarat which is Modi’s home state and the whole country is suffering from issues like rising inflation, unemployment, low remumberation, loss of land, violence against women and other atrocities. She highlighted the Congress manifesto and said it addresses issues faced by the tribal population.

She assured the people that the Congress will bring schemes like MGNREGA for urban areas where families will get 100 days of guaranteed work. She said the Congress is committed to filing about 30 lakh vacancies in government jobs, providing subsidised diesel to fishermen and take the minimum wage to Rs 400. Gandhi said the Congress is going to work out sub plans for Scheduled Tribes and scheduled castes.

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2024 Lok Sabha Elections

Smriti Irani takes a swipe at Rahul Gandhi for calling Amethi his home but contesting Lok Sabha elections from Wayanad

Smriti Irani criticised the Rahul Gandhi for changing his families and said they have seen people changing colours, but for the first time changing families is being witnessed.

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Union Minister Smriti Irani took a swipe at Rahul Gandhi on Saturday during a rally in Uttar Pradesh’s Amethi. While addressing the public rally, Irani said Rahul Gandhi spoke about his relations in Amethi and then he went to Wayanad where he declared the Kerala seat as his home as he filed for his nomination for the Lok Sabha elections.

Smriti Irani, who will be contesting her Amethi seat yet again, criticised the Rahul Gandhi for changing his families and said they have seen people changing colours, but for the first time changing families is being witnessed. The Union minister urged the people of Amethi to cast their votes on May 20, the day when Amethi goes for elections. She talked about the benefits of voting for BJP and said, the poor will get free ration for five years, farmers will get Rs 6,000 every month, and will get Rs 5 lakh every year under the Ayushman Bharat scheme.

Irani further added that Congress on the other hand has declared that it will calculate the wealth of the people if voted to power. She took a swipe over Congress candidates and said the grand old party is yet to announce its candidates for two key constituencies in Uttar Pradesh – Amethi and Raebareli, which have historically been the Congress’s stronghold.  The BJP leader said that now that the polling in Wayanad has concluded, the Congress candidate will arrive in Amethi, but will first visit the Ram Temple.

She slammed Congress for rejecting the invitation to the Ram Temple Pran Pratishtha and said they rejected the invitation to the Ram temple Pran Pratishtha, now they will go to the Ram temple as they believe that this will get them votes in the ongoing Lok Sabha elections which means now they will go to the extent of betraying god as well.

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2024 Lok Sabha Elections

Lok Sabha election 2024: Nearly 50% voter turnout recorded in second phase till 3 pm

The constituencies going to polls today include all 20 Lok Sabha seats in Kerala, 14 in Karnataka, 13 in Rajasthan, and others spread across different states.

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In the second phase of Lok Sabha elections 2024, over 50% of voters were registered in 13 states and the UTs till 3 p.m. 65% of voters participated in the first round of the Lok Sabha elections.

The 18th Lok Sabha elections are currently in their second phase, with voting for 88 seats taking place across 13 states and union territories. There are more than 1,200 people running for office, four of them are from outside Manipur.

Union minister Rajeev Chandrasekhar, BJP members Tejasvi Surya, Hema Malini, and Arun Govil, Rahul Gandhi and Congress leader Shashi Tharoor, DK Suresh, the brother of Karnataka Deputy Chief Minister DK Shivakumar, and former chief minister HD Kumaraswamy are among the notable contenders for the second phase.

In 2019, the NDA had won 56 of the 89 seats and the UPA 24. Six of these seats have been redrawn as part of the delimitation exercise.

The first phase of the seven stages of the elections took place on Friday, including 102 seats spread across 21 states and Union territories. Voter turnout was about 65.5% in the first phase, according to the reports.

In biggest festival of democracy, people from all walks of sector took part in it. A video went viral where former India captain and current Indian team head coach Rahul Dravid and former India player and head coach Anil Kumble were seen standing in line  to cast their vote.

Meanwhile, voting started at 7 a.m. and will end at 6 p.m. The Election Commission has extended voting hours for those who are in line by an hour. According to Election Commission figures, the first two hours saw a 9.3% voter turnout throughout the 88 constituencies. By 9 am, Kerala had recorded 8.52%, Karnataka 9.21%, and Madhya Pradesh 13.82%.

In this phase, there were about 15.88 crore eligible voters, comprising 5.929 third-gender electors, 8.08 crore males, and 7.8 crore women. 3.28 crore young voters, aged 20 to 29, are among them; 34.8 lakh of them are first-time voters.

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