Post-Stroke Swallowing And Communication Complications: Prevalence And Association With Comorbid Conditions And Risk Factors.

A cross sectional study utilising convenience sampling was conducted to determine the co-morbidities and risk factors in post stroke patients with swallowing and communication complications. The study recruited 150 diagnosed cases of stroke with no gender and age limitation from Combined Military Hospital, Fatima Memorial Hospital, and Mayo Hospital, Lahore, from January to June 2015. Glasgow coma scale, Modified Massey Bedside Swallow Screener, informal clinical assessment by SLP, and medical history sheet were employed for data collection, while the data was analysed using SPSS -23. Results revealed 103 (68.7%) patients with swallowing and 99 (66%) with communication difficulties. Swallowing issues revealed significant association with age (p=.016); history of stroke (p=.017), smoking (p=.004), alcohol intake (p=.035), diabetes mellitus (p=.003), and GCS (p=.009). Communication difficulties had significant association with hypertension (p=.029), GCS (p=.000). Hence, stroke related dysphagia is associated with diabetes mellitus; level of consciousness, previous history of stroke, smoking, alcohol abuse, and age, while communication issues are associated with hypertension and level of consciousness.

Frequency of language and swallowing problems in children with cerebral palsy at a tertiary care hospital Rawalpindi, Pakistan.

Objective: To investigate the occurrence of language and swallowing problem in individuals with cerebral palsy. METHODS: The cross-sectional survey was conducted at the Riphah International University, Rawalpindi, Pakistan, from September 2018 to January 2019 while data was collected from the Armed Forces Institute of Rehabilitation Medicine, Rawalpindi, a tertiary care hospital. The sample comprised individuals with cerebral palsy of either gender aged 5-18 years. Language Sample Checklist was used for language problems and the North western Dysphagia Patient Checklist was used for swallowing problems. Data was analysed using SPSS- Version 21. RESULTS: Of the 55 subjects,62% were males, 38% were females, 76% were from urban areas and 24% were from rural areas. In terms of concepts, processing, and comprehension, 18(33%) persons were able to attempt the tasks, 45(81%) were unable to attempt morphological tasks, 41(74%) were unable to attempt sentence structure tasks, 40(72%) were unable to attempt literacy and narrative skills tasks, 41(74%)could not fulfil pragmatic tasks and 49(89%) had unintelligible speech. The patient checklist showed that 47(85%) children had normal medical history, 41(75%) had normal behavioural variable, 29(52%) had normal gross motor ability,40(73%) completed oral motor test, and 39(71%) had normal swallow trials. Conclusion: Language problems were more prevalent in children with cerebral palsy compared to swallowing difficulties.

Novel therapeutic techniques for post stroke aphasia: A narrative review.

Aphasia, an acquired language disorder, commonly results from a stroke affecting network of cortical and subcortical structures. Aphasia lacks effective standardised treatment. Neuroimaging and behavioural research indicate that some interventions promote neuroplasticity changes in aphasia. Research has suggested that non-invasive brain stimulation may be effective, causing functional reorganisation of language areas between the two hemispheres. This reorganisation evolves from different researches exploring novel procedures, including transcranial magnetic stimulation and intracranial direct current stimulation, which may modulate cortical activity in aphasia. The current narrative review was planned to assess these techniques while examining the casual role of specific regions of brain and the understanding of the underlying mechanism for treatment effects of brain stimulation. Literature was explored on search engines and databases, like Medline, Web of Science and bibliography of published studies. The key words used for the search were 'non-invasive brain stimulation', 'post-stroke aphasia', 'transcranial magnetic stimulation' and 'transcranial direct current stimulation'. Of the 175 publications downloaded, 40(23%) full-text English publications were reviewed.

Frequency of post-stroke dysphagia in Pakistan: a hospital based study.

OBJECTIVE: Purpose of the study is to determine the frequency of dysphagia after stroke and to see the factors associated with it. METHODS: Cross Sectional study design was used by including individuals pre-diagnosed as stroke on the basis of CT scan or MRI findings. Study was conducted in three hospitals of Lahore within six months. Sample size of 150 patients of any age and both gender was taken by using convenient sampling technique. To assess the conscious level, Glasgow coma scale was administered and those who scored mild or moderate on GCS were included in the study. Modified Massey Bedside Swallow Screener was used to screen out the patients for dysphagia. SPSS-19 was used for the statistical analysis. RESULTS: In the sample of 150 individuals with stroke 53% of patients had dysphagia. Females were 38% while males were 62%. Individuals who were older were more likely to have dysphagia. Among dysphagic individuals 65% had ischemic stroke while 35% were with haemorrhagic. There were 87% of dysphagic individuals who presented with history of smoking and 13% were without any. These factors demonstrate significant relationship by showing p-value <0.05. While no significant difference was seen between levels of alertness and risk of dyspagia by showing p-value 0.2. CONCLUSIONS: Dysphagia after stroke occurs frequently that should be actively assessed and factors like type of stroke and history of smoking are significantly related to this condition.