An-Najah Staff

The aim of the study was to investigate and compare clinical characteristics, sex differences and in-hospital mortality between stroke patients with and without diabetes mellitus (DM). All patients admitted to Al- Watani Governmental Hospital for 12 consecutive months and diagnosed with acute stroke were included in the study. Demographic data, clinical characteristics and in-hospital mortality were compared between diabetic and nondiabetic stroke patients. Pearson χ2-test and Student’s t-test were used on univariate analysis. Data were analyzed using SPSS 16. There were 186 stroke patients, mean age 69.09±0.9 years, with positive DM history recorded in 48.9% of male and 45.2% of female patients. Diabetic stroke patients were significantly younger (66.8±10.99 vs. 71±10.52 years; P=0.009) and had a higher proportion of ischemic heart disease (11.9% vs. 3.9%; P=0.04) compared to nondiabetic stroke patients. Inhospital mortality accounted for 39 (21%) patients, including 23 (27.4%) diabetic and 16 (15.7%) nondiabetic stroke patients (P=0.051). Univariate analysis of diabetic stroke patients based on sex showed male patients to have significantly more hemorrhagic strokes (P=0.04), recurrent strokes (P=0.003) and in-hospital mortality (P=0.034) compared to female patients. There was no sex difference in nondiabetic stroke patients. Analysis of diabetic stroke patients based on vital status indicated that in-hospital mortality was significantly associated with sex (P=0.034), type of stroke (P=0.006) and recurrent stroke (P=0.01). None of the variables was significantly associated with mortality in nondiabetic stroke patients. In conclusion, diabetic patients have different clinical characteristics, show sex differences and in-hospital mortality differences compared to nondiabetic patients after acute stroke.

The aim of the study was to investigate and compare clinical characteristics, sex differences and in-hospital mortality between stroke patients with and without diabetes mellitus (DM). All patients admitted to Al- Watani Governmental Hospital for 12 consecutive months and diagnosed with acute stroke were included in the study. Demographic data, clinical characteristics and in-hospital mortality were compared between diabetic and nondiabetic stroke patients. Pearson χ2-test and Student’s t-test were used on univariate analysis. Data were analyzed using SPSS 16. There were 186 stroke patients, mean age 69.09±0.9 years, with positive DM history recorded in 48.9% of male and 45.2% of female patients. Diabetic stroke patients were significantly younger (66.8±10.99 vs. 71±10.52 years; P=0.009) and had a higher proportion of ischemic heart disease (11.9% vs. 3.9%; P=0.04) compared to nondiabetic stroke patients. Inhospital mortality accounted for 39 (21%) patients, including 23 (27.4%) diabetic and 16 (15.7%) nondiabetic stroke patients (P=0.051). Univariate analysis of diabetic stroke patients based on sex showed male patients to have significantly more hemorrhagic strokes (P=0.04), recurrent strokes (P=0.003) and in-hospital mortality (P=0.034) compared to female patients. There was no sex difference in nondiabetic stroke patients. Analysis of diabetic stroke patients based on vital status indicated that in-hospital mortality was significantly associated with sex (P=0.034), type of stroke (P=0.006) and recurrent stroke (P=0.01). None of the variables was significantly associated with mortality in nondiabetic stroke patients. In conclusion, diabetic patients have different clinical characteristics, show sex differences and in-hospital mortality differences compared to nondiabetic patients after acute stroke.

The aim of the study was to investigate and compare clinical characteristics, sex differences and in-hospital mortality between stroke patients with and without diabetes mellitus (DM). All patients admitted to Al- Watani Governmental Hospital for 12 consecutive months and diagnosed with acute stroke were included in the study. Demographic data, clinical characteristics and in-hospital mortality were compared between diabetic and nondiabetic stroke patients. Pearson χ2-test and Student’s t-test were used on univariate analysis. Data were analyzed using SPSS 16. There were 186 stroke patients, mean age 69.09±0.9 years, with positive DM history recorded in 48.9% of male and 45.2% of female patients. Diabetic stroke patients were significantly younger (66.8±10.99 vs. 71±10.52 years; P=0.009) and had a higher proportion of ischemic heart disease (11.9% vs. 3.9%; P=0.04) compared to nondiabetic stroke patients. Inhospital mortality accounted for 39 (21%) patients, including 23 (27.4%) diabetic and 16 (15.7%) nondiabetic stroke patients (P=0.051). Univariate analysis of diabetic stroke patients based on sex showed male patients to have significantly more hemorrhagic strokes (P=0.04), recurrent strokes (P=0.003) and in-hospital mortality (P=0.034) compared to female patients. There was no sex difference in nondiabetic stroke patients. Analysis of diabetic stroke patients based on vital status indicated that in-hospital mortality was significantly associated with sex (P=0.034), type of stroke (P=0.006) and recurrent stroke (P=0.01). None of the variables was significantly associated with mortality in nondiabetic stroke patients. In conclusion, diabetic patients have different clinical characteristics, show sex differences and in-hospital mortality differences compared to nondiabetic patients after acute stroke.

BACKGROUND:  Although stroke is one of the leading causes of morbidity and mortality worldwide, no studies on stroke were reported from Palestine. The objective of this study was to identify the risk factors and incidence rates of stroke in a well-defined area in north Palestine (i.e., the district of Nablus) with 362,159 native Palestinian inhabitants.
METHODS:  All patients admitted to Al-Watani governmental hospital from September 2006 to August 2007 and given the diagnosis of acute stroke were included in the study. Diagnosis of stroke was confirmed by computerized tomography scan. Demographic characteristics and clinical data pertaining to the patients were obtained from their medical files.
RESULTS:  A total of 186 patients with stroke (95 female and 91 male) were identified during the study. The average age of the patients was 69.09 +/- 10.9 years. Among the total patients, 112 had a first-ever stroke (FES) and 74 had recurrent stroke (RS). Hypertension, diabetes mellitus, and renal dysfunction were the most common risk factors with comparable prevalence in both FES and RS. The majority of patients (153; 82.3%) had ischemic stroke subtype whereas 33 (17.7%) had hemorrhagic stroke subtype. The overall (FES + RS) annual crude incidence rate of stroke was 51.4 per 100,000 persons whereas the annual crude incidence rate of FES was 31 per 100,000 persons. The age-adjusted incidence rates were 54.5 (FES) and 89.8 (FES and RS). The overall inhospital mortality was 21% and was higher in patients with RS than in those with FES.
CONCLUSION:  Modifiable risk factors were common among patients with stroke. Better control of these risk factors might decrease incidence of stroke and all consequences thereafter. Incidence rate and inhospital mortality of stroke reported in this study were within the range reported from other Arab countries.

BACKGROUND:  The aim of this study was to analyze the types and cost of medications prescribed at discharge for ischemic stroke survivors.
METHODS:  This is a descriptive study of medications prescribed for ischemic stroke survivors admitted to Al-watani hospital during a 6-month period.
RESULTS:  A total of 95 consecutive stroke patients were included in the study period; 78 (82.1%) survivors were having ischemic stroke subtype and were designated the study group. The average age of the survivors was 66.9 +/- 12.7 years. Survivors had prevalent risk factors such as diabetes mellitus (70%), hypertension (68%), and ischemic heart disease (34.6%). On average, survivors experienced a minimum of 0.73 complications (range 0-3) with the most common being infections (n = 35, 44.8%). Forty-two per cent of the ischemic stroke survivors were taking antiplatelet drugs prior to the current attack. At discharge, ischemic stroke survivors were prescribed an average of 4.9 medications from 4.3 different drug classes. All ischemic stroke survivors were prescribed antiplatelet therapy at discharge. Aspirin monotherapy was prescribed for 61 survivors while the combination of aspirin/clopidogrel antiplatelet therapy was prescribed for 17 survivors. The average monthly cost for prophylactic therapy and for medications used to treat post-stroke complication was approximately 52 USD per survivor.
CONCLUSION:  Most of the patients in the study group were having the traditional risk factors for ischemic stroke and were suffering form typical post-stroke complications. Lack of medical insurance will impose a heavy financial burden on stroke survivors in Palestine.

Although stroke is one of the leading causes of morbidity and mortality worldwide, no studies on stroke were reported from Palestine. The objective of this study was to identify the risk factors and incidence rates of stroke in a well-defined area in north Palestine (i.e., the district of Nablus) with 362,159 native Palestinian inhabitants.Methods: All patients admitted to Al-Watani governmental hospital from September 2006 to August 2007 and given the diagnosis of acute stroke were included in the study. Diagnosis of stroke was confirmed by computerized tomography scan. Demographic characteristics and clinical data pertaining to the patients were obtained from their medical files. Results: A total of 186 patients with stroke (95 female and 91 male) were identified during the study. The average age of the patients was 69.09 6 10.9 years. Among the total patients, 112 had a first-ever stroke (FES) and 74 had recurrent stroke (RS). Hypertension, diabetes mellitus, and renal dysfunction were the most common risk factors with comparable prevalence in both FES and RS. The majority of patients (153; 82.3%) had ischemic stroke subtype whereas 33 (17.7%) had hemorrhagic stroke subtype. The overall (FES 1 RS) annual crude incidence rate of stroke was 51.4 per 100,000 persons whereas the annual crude incidence rate of FES was 31 per 100,000 persons. The age-adjusted incidence rates were 54.5 (FES) and 89.8 (FES and RS). The overall inhospital mortality was 21% and was higher in patients with RS than in those with FES. Conclusion: Modifiable risk factors were common among patients with stroke. Better control of these risk factors might decrease incidence of stroke and all consequences thereafter. Incidence rate and inhospital mortality of stroke reported in this study were within the range reported from other Arab countries. Key Words: Stroke—incidence rate—Palestine.

Background: The aim of this study was to analyze the types and cost of medications prescribed at discharge for ischemic stroke survivors.
Methods: This is a descriptive study of medications prescribed for ischemic stroke survivors admitted to Al-watani hospital during a 6-month period.
Results: A total of 95 consecutive stroke patients were included in the study period; 78 (82.1%) survivors were having ischemic stroke subtype and were designated the study group. The average age of the survivors was 66.9 6 12.7 years. Survivors had prevalent risk factors such as diabetes mellitus (70%), hypertension (68%), and ischemic heart disease (34.6%). On average, survivors experienced a minimum of 0.73 complications (range 0-3) with the most common being infections (n 5 35, 44.8%). Forty-two per cent of the ischemic stroke survivors were taking antiplatelet drugs prior to the current attack. At discharge, ischemic stroke survivors were prescribed an average of 4.9 medications from 4.3 different drug classes. All ischemic stroke survivors were prescribed antiplatelet therapy at discharge. Aspirin monotherapy was prescribed for 61 survivors while the combination of aspirin/clopidogrel antiplatelet therapy was prescribed for 17 survivors. The average monthly cost for prophylactic therapy and for medications used to treat post-stroke complication was approximately 52 USD per survivor.
Conclusion: Most of the patients in the study group were having the traditional risk factors for ischemic stroke and were suffering form typical post-stroke complications. Lack of medical insurance will impose a heavy financial burden on stroke survivors in Palestine.

The objective of this study was to examine and evaluate the frequency of bleeding and serious drug interactions among patients with atrial fibrillation (AF) treated with oral anticoagulant [Warfarin]. A random sample of 59 patients from Al-Watni government hospital in Nablus with a principal or secondary discharge diagnosis of AF was identified. All drug and clinical data were abstracted from the patient's files. We excluded patients who were less than 65 years of age, or left the hospital against medical advice, and those whose AF was transient or could not be confirmed. Of the original 59 AF patients, 19 were cliagnosed who were discharged on Warfarin. The mean age for these patients was 71.7 years. Among the patients discharged on Warfarin, 94.7 % had one or more drug – drug interactions that could lead to increase risk of bleeding. Many patients discharged on Warfarin were having multiple interacting drugs. Patient counseling and follow-up monitoring are essential and should be carried out to minimize the risk of bleeding and other complications.

Although stroke is one of the leading causes of morbidity and mortality worldwide, no studies on stroke were reported from Palestine. The objective of this study was to identify the risk factors and incidence rates of stroke in a well-defined area in north Palestine (i.e., the district of Nablus) with 362,159 native Palestinian inhabitants. Methods: All patients admitted to Al-Watani governmental hospital from September 2006 to August 2007 and given the diagnosis of acute stroke were included in the study. Diagnosis of stroke was confirmed by computerized tomography scan. Demographic characteristics and clinical data pertaining to the patients were obtained from their medical files. Results: A total of 186 patients with stroke (95 female and 91 male) were identified during the study. The average age of the patients was 69.09 6 10.9 years. Among the total patients, 112 had a first-ever stroke (FES) and 74 had recurrent stroke (RS). Hypertension, diabetes mellitus, and renal dysfunction were the most common risk factors with comparable prevalence in both FES and RS. The majority of patients (153; 82.3%) had ischemic stroke subtype whereas 33 (17.7%) had hemorrhagic stroke subtype. The overall (FES 1 RS) annual crude incidence rate of stroke was 51.4 per 100,000 persons whereas the annual crude incidence rate of FES was 31 per 100,000 persons. The age-adjusted incidence rates were 54.5 (FES) and 89.8 (FES and RS). The overall inhospital mortality was 21% and was higher in patients with RS than in those with FES. Conclusion: Modifiable risk factors were common among patients with stroke. Better control of these risk factors might decrease incidence of stroke and all consequences thereafter. Incidence rate and inhospital mortality of stroke reported in this study were within the range reported from other Arab countries.