Minor stroke needs quick medical attention, too

Agencies
July 4, 2018

Jul 4: Minor strokes and “mini-strokes,” or transient ischemic attacks (TIAs), need early medical attention, just like major strokes, but a public education campaign in the UK had little success convincing the public to act fast after these events.

“Although the campaign worked well for behavior after more major stroke, patients were still slow to act on, or ignored completely, the symptoms of minor events,” said Dr. Peter M. Rothwell from John Radcliffe Hospital, University of Oxford.

“It was almost as though the messages from the campaign about major stroke had falsely reassured them that the more minor event that they had experienced was probably nothing to worry about,” said Rothwell, senior author of a study on the campaign´s impact.

“If you have a minor ‘warning’ event, the risk of a more major stroke over the next week is about 10 percent if you are not treated,” he said in an email. “However, that risk is reduced by 80 percent if simple medical treatments are started urgently.”

If you have sudden, temporary neurological symptoms that you haven’t had before, he advises, “Don’t delay. . . get checked.”

Also, he said, “The most important immediate thing that you can do yourself if you have a ‘TIA’ is to take an aspirin (same as is advised after a suspected heart attack). Take an aspirin and seek medical attention.”

Rothwell’s team looked at the impact of the Face, Arm, Speech, Time (FAST) public education campaign on the likelihood that patients would seek medical attention within three hours of their symptoms.

The campaign warned, “When stroke strikes, act FAST. Face: has it fallen on one side? Arms: can they raise them? Speech: is it slurred? Time: if you notice any of these signs, it’s time to call (for an ambulance).”

Facial weakness, arm symptoms and speech disturbance were less common among people with minor stroke or TIA than among those with major stroke, and only about 35 percent of patients with TIAs who didn’t seek medical attention had any of these signs.

Before the campaign, about 68 percent of people with major stroke obtained medical attention within three hours; after the FAST campaign this increased to 81 percent, according to the report in JAMA Neurology.

In contrast, only about 40 percent of patients with TIA and minor stroke obtained medical attention within three hours both before and after the FAST campaign.

Surprisingly, fewer patients correctly attributed their symptoms to TIA or minor stroke after the FAST campaign (28 percent) than before it (37 percent), and 5 percent of patients did not even report their symptoms until the next routine appointment with their doctor.

“Campaigns rightly stress the need to seek emergency medical attention if you have signs of a major stroke,” Rothwell said. “The symptoms of TIA and minor stroke are very similar - but just less severe and more transient (often lasting only minutes). Current campaigns would really only need to add that message at the end of the TV advertisement or poster – ‘and don’t ignore symptoms that might be a small ‘warning stroke’ either - that is an emergency, too.’”

“For any of the stroke symptoms, major, minor, or transitory, time remains of the essence,” said Dr. Victor Loh from National University Health System, Singapore, who recently detailed the outpatient management of TIA, but was not involved in the study.

“Perhaps after the primary message of needing to head to hospital within the time window for patients with major stroke, the secondary message needs to be emphasized: that even if symptoms are mild or transitory, early review and intervention can drastically reduce the risk of a major stroke,” he said by email.

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Agencies
April 15,2020

Dear parents, if you want your children to have proper sleep, read this carefully. Joining a growing list of studies that tell parents to shun devices at bed-time, researchers say that children who use devices and decide what time they go to sleep, achieve less sleep and feel more sleepier the following day than their peers.

The study of children in this age-group (aged 11 to 13 years), published in the New Zealand Medical Journal, found most (72 per cent) of the 163 students interviewed by University of Otago researchers achieved recommended guidelines of an average 9 to 11 hours sleep nightly over one week.

"But that also means that almost one in four students did not achieve sleep within these guidelines, which highlights an area for improvement," said study researcher Kate Ford.

However, consistent with previous research in 15 to 17-year-old New Zealanders, the study results show less sleep on the nights where devices are used in the hour before bed.

According to the researchers, students who used devices before going to sleep were also more likely to report that they felt sleepy the following morning. Watching television before bed had no significant effect on sleep length.

There were also some interesting observations over the weekends where students went to bed later but woke later achieving similar sleep length to the school days, the researchers said.

A small group of students (six per cent) who reported less than seven hours of sleep, including a small number reporting not sleeping at all, according to the study,

Therefore, while the average across the week of 72 per cent of students reporting adequate sleep is reassuring, it is far from the goal of every child achieving sleep within the recommended guidelines," Ford said.

Dr Paul Kelly, head of the Sleep Health Service at Canterbury District Health Board, supervised the study and explained that the foundations for good health are based on proper nutrition, regular exercise and good sleep quality.

Sleep quality is often overlooked as a contributory factor to poor health.

"The study findings suggest the need for parental guidance around bedtimings and moderation of the use and availability of electronic devices before bed," Kelly said.

"Respect and protect your sleep, as good daytime functioning is reliant on adequate sleep," Kelly added.

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Agencies
June 20,2020

The World Health Organisation has warned that the COVID-19 pandemic is entering a "new and dangerous" phase. Thursday saw the most cases in a single day reported to the WHO.

Tedros Adhanom Ghebreyesus said the day had seen 150,000 new cases with half of those coming from the Americas and large numbers also from the Middle East and South Asia, the BBC reported.

He said the virus was still spreading fast and the pandemic accelerating.

He acknowledged people might be fed up with self-isolating and countries were eager to open their economies but he said that now was a time for extreme vigilance.

Maria van Kerkhove, technical lead of the WHO's COVID-19 response, told a press conference the pandemic is "accelerating in many parts of the world".

"While we have seen countries have some success in suppressing transmission and bringing transition down to a low level, every country must remain ready," she said.

Mike Ryan, the head of the WHO's Health Emergencies Programme, said that some countries had managed to flatten the peak of infections without bringing them down to a very low level.

"You can see a situation in some countries where they could get a second peak now, because the disease has not been brought under control," he said.

"The disease will then go away and reduce to a low level, and they could then get a second wave again in the autumn or later in the year."

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Agencies
June 20,2020

At a time when the country is yet to recover from the shock of losing 20 Indian soldiers in a violent clash with the Chinese People's Liberation Army (PLA) troops in Ladakh's Galwan Valley, another shocker has come to light with news coming of a malware hitting the Indian Railways network and snooping its data for foreign countries, including train movements, sources in the intelligence agencies said on Friday.

Meanwhile, Railways Board Chairman V K Yadav said that the national transporter keeps on receiving malware security threats and the engineers in the railways keep on taking all precautions and keeps on updating the firewalls to prevent data theft.

The news comes a day after the Dedicated Freight Corridor Corporation Limited (DFCCIL) decided to terminate the 417-km signalling project worth Rs 471 crore with Chinese firm Beijing National Railway Research and Design Institute of Signal and Communication Group Company Limited (BNRRDISC) due to non-performance.

According to intelligence agency sources, the system of the Railways has been hit by the APT 36 Malware campaign. The source said that the intel agencies have also alerted the Railway Board to instantly disconnect the system with the Internet and change the password immediately.

The source said the APT 36 Malware is connected to Pakistan, which is a close ally of China. The source further said that following the red flag from the intel agencies, the system of a senior Principal Executive Director of the Railways, working in its vigilance department, has been taken for cleaning the malware threat.

As per the source, through the APT 36 Malware campaign, data stored in the Indian Railways systems were being stolen and stored in foreign locations, including the movement of the trains.

He further claimed that the APT 36 Malware also tried to take defence movement data. 

The source said the APT 36 Malware effect was reported from at least four systems of the Indian Railways.

Responding to queries, the Railways Board Chairman said: "Whether it is our systems or the IRCTC, we continuously update it with firewalls, and it is an ongoing process as we get the updates." 

Yadav said that our system is updated time to time. "We get malware threat on a regular basis. And we look at it continuously," he said. 

When pressed further about the malware threat in four railways systems, he said: "It has not come to our notice that some information has been leaked. Our systems are secure and our engineers keep on working on it."

According to intel sources, besides Railways, there was also malware threat in the defence, central police organisations, education and healthcare sectors, the source said.

In view of the threat, the intel agencies have asked the departments concerned to change the passwords of emails and online services from secure computers, format the hard-disk of the affected computers after taking back-up and re-install the operating systems and other softwares.

Sources in the Railways had said on Thursday that DFFCIL, which is looking after the work of the Dedicated Freight Corridor Project, has decided to terminate the tender with BNRRDISC.

A source in the Railway Ministry said that it has informed the Railway Board and the World Bank to take the final decision in the matter.

The source said the project was awarded to the Chinese firm in 2016 for signalling and telecommunication work on the 417-km Kanpur-Deen Dayal Upadhyaya section of the Eastern Dedicated Freight Corridor (EDFC). 

The source disclosed that the contract was awarded to the Beijing National Railway Research and Design Institute in June 2016. The source further said that even after four years, the progress in the project was only 20%. The issues that led to the termination of the project are reluctance by the company to furnish technical documents, as per the contract agreement, such as logic design of electronic interlocking.

The source further said that other issues like non-availability of their engineers and authorised personnel on site were a serious constraint. Even physical work could not progress as they have no tie-up with local agencies. 

The 3,373-km DFC, a flagship project of the Railways, aims to augment rail transport capacity to meet the growing requirement of movement of goods by segregating freight from passenger traffic.

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