Ayurvedic Treatment in the Rehabilitation of Ischemic Stroke Patients in India: A Randomized Controlled Trial (RESTORE) - Findings from the Process Evaluation.

Introduction: The RESTORE trial was the first randomized controlled trial comparing two systems of medicine in stroke. The trial studied about the safety and efficacy of ayurvedic rehabilitative treatment in comparison with conventional physiotherapy in stroke rehabilitation across North and South India. The results showed that ayurvedic rehabilitative treatment was not superior to conventional physiotherapy for improving sensorimotor recovery in ischemic stroke patients, but it was safe to use.

Ayurvedic treatment in the rehabilitation of ischemic stroke patients in India: A randomized controlled trial (RESTORE).

Background: The effect of Ayurvedic Rehabilitation therapy (ART) in improving the sensorimotor recovery of patients with ischemic stroke is unclear irrespective of the fact that ayurveda is a commonly practiced alternate system of medicine in India and south Asia. The trial hypothesized that ayurvedic treatment is superior to physiotherapy (PT) in recovery of ischemic stroke patients.

Methods: We performed investigator-initiated, multi-center prospective, parallel arm randomized controlled trial (RCT) with blinded outcome assessment across four comprehensive stroke centers in India.

Educational and Socioeconomic Correlates of Stroke Risk Behaviors: Findings from the SPRINT INDIA Trial.

Background And Objectives: Secondary Prevention by Structured Semi-Interactive Stroke Prevention Package in India (SPRINT INDIA) trial was a randomized control trial that enrolled 4298 stroke patients and administered educational interventions at 31 centers across India, with the aim to reduce recurrent stroke through increased stroke knowledge. This SPRINT INDIA trial post hoc study aims to investigate the incidence of recurrent stroke, high-risk transient ischemic attack (TIA), acute coronary syndrome (ACS), death, and lifestyle behavioral factors at 1 year. In addition, it examines the relationship between patients' baseline characteristics and education levels, risk factors, and outcomes and performs subgroup analysis within the intervention and control groups.

SPRINT INDIA: Regional Variations in Primary and Secondary Stroke Outcomes Based on Baseline Characteristics in North and South Indian Sites.

Background And Objectives: Regional differences in stroke prevalence and outcomes in India, driven by demographic and risk factors, are crucial for guiding effective prevention and management strategies. This subanalysis of Secondary prevention with a structured semi-interactive stroke prevention package in INDIA (SPRINT INDIA) randomized controlled trial compared the demographics, risk factors, and clinical outcomes of stroke patients from North and South India to identify regional differences and inform targeted interventions for stroke prevention.

Methods: The study analyzed data of 4298 participants from 31 stroke centers across India, focusing on demographics, stroke types, and risk factors.

Comparing Stroke Profiles and Outcomes between Urban and Rural India: A Secondary Analysis of the SPRINT INDIA Trial.

Introduction: Stroke causes significant death and disability, with urban-rural disparities in healthcare and limited studies in India, despite its rural majority of 70%. The post hoc study aimed to explore differences in stroke profiles, risk factors, and outcomes between urban and rural participants using data from the Secondary Prevention by Structured Semi-Interactive Stroke Prevention Package in India (SPRINT INDIA) trial.

Methods: The SPRINT INDIA trial was a multi-center randomized clinical trial across 31 Indian sites.

Volumetric analysis of maxillary sinus and assessment of various sinonasal anatomic variants on multi-detector computed tomography (MDCT) and their association with chronic rhinosinusitis.

Objectives: The study aimed to evaluate the relationship between maxillary sinus volume and various sinonasal anatomical variants, as detected by multi-detector computed tomography, and their associations with chronic rhinosinusitis (CRS).

Material And Methods: A case-control study was conducted with 103 patients presenting with chronic sinonasal symptoms (cases) and 50 asymptomatic individuals (controls). A 128-slice computed tomography scanner was used to measure maxillary sinus volume and assess anatomical variants, such as a deviated nasal septum (DNS), concha bullosa (CB), and agger nasi cells.

Indian Trial of Tranexamic acid in Spontaneous Intracerebral Hemorrhage study protocol.

Rationale: Early mortality in intracerebral hemorrhage (ICH) is due to hematoma volume (HV) expansion, and there are no effective treatments available other than reduction in blood pressure. Tranexamic acid (TXA) a hemostatic drug that is widely available and safe can be a cost-effective treatment for ICH, if proven efficacious.

Hypothesis: Administration of TXA in ICH patients when given within 4.

RE-OPEN: Randomised trial of biosimilar TNK versus TPA during endovascular therapy for acute ischaemic stroke due to large vessel occlusions.

Rationale: Rapid and timely treatment with intravenous thrombolysis and endovascular treatment (EVT) in patients with acute ischaemic stroke (AIS) and large vessel occlusion (LVO) significantly improves patient outcomes. Bridging therapy is the current standard of care in these patients. However, an incompletely answered question is whether one thrombolytic agent is better than another during bridging therapy.

STENOSIS: Long-term single versus dual antiplatelet therapy in patients with ischaemic stroke due to intracranial atherosclerotic disease - a randomised trial.

Rationale: Intracranial atherosclerotic disease (ICAD) is a pathological process that causes progressive stenosis and cerebral hypoperfusion, leading to stroke occurrence and recurrence around the world. The exact duration of dual antiplatelet therapy (DAPT) for ICAD is unclear in view of long-term risk of bleeding complications.

Aim: The current study aims to study the efficacy and safety of long-term DAPT (up to 12 months) in patients with ICAD.

Secondary prevention by structured semi-interactive stroke prevention package in INDIA (SPRINT INDIA): Findings from the process evaluation of a randomized controlled trial.

Introduction: Secondary Prevention by Structured Semi-Interactive Stroke Prevention Package in INDIA Trial delivered secondary stroke awareness intervention to sub-acute stroke patients in form of workbook, videos and SMS across 31 centres in 12 languages. Trial was stopped for futility due to fewer vascular outcomes than anticipated. Trial results indicated that trial intervention, did not lead to reduction in vascular events.

Ayurvedic Treatment in the Rehabilitation of Ischemic Stroke Patients in India: A Randomized Controlled Trial Study Protocol.

In patients with ischemic stroke, motor and sensory impairments are common and are associated with functional disability. Conventional physiotherapy (CP) is the primary modality of rehabilitation for post-stroke sensorimotor dysfunction. Ayurveda is a commonly practiced alternative system of medicine that offers unique rehabilitative measures for post-stroke recovery.

Impact of Pre-Stroke Antiplatelet Use on 3-Month Outcome After Ischemic Stroke.

Background: Pre-stroke anti-platelet (PAP) therapy can potentially influence the severity and outcome after ischemic stroke.

Methods: We analyzed data from the prospective multicenter Indo-US collaborative stroke project for the impact of PAP therapy. Outcome measures included the admission National Institute of Health Stroke Scale (NIHSS) score, 3-month modified Rankin scale (mRS) score, and rates of in-hospital mortality and post-ischemic intracerebral hemorrhage.

INSTRuCT: Protocol, Infrastructure, and Governance.

Background And Purpose: Very few large scale multicentric stroke clinical trials have been done in India. The Indian Council of Medical Research funded INSTRuCT (Indian Stroke Clinical Trial Network) as a task force project with the objectives to establish a state-of-the-art stroke clinical trial network and to conduct pharmacological and nonpharmacological stroke clinical trials relevant to the nation and globally. The purpose of the article is to enumerate the structure of multicentric stroke network, with emphasis on its scope, challenges and expectations in India.

Impact of revascularization therapies on outcome of posterior circulation ischemic stroke: The Indo-US stroke project.

Introduction: Posterior circulation strokes (PCS) have been less extensively studied than anterior circulation strokes (ACS), especially regarding revascularization therapies. We analyzed the differences in baseline stroke characteristics, revascularization therapy and 3-month outcomes between PCS and ACS in a large prospective multicentre Indian stroke registry.

Methods: Patients with acute ischemic stroke recruited in the Indo-US collaborative stroke project from January 2012 to August 2014 were classified into PCS and ACS based on imaging-confirmed infarct location.

Secondary Prevention by Structured Semi-Interactive Stroke Prevention Package in India (SPRINT INDIA) study protocol.

Rationale: Recurrent stroke, cardiovascular morbidity, and mortality are important causes of poor outcome in patients with index stroke. Despite the availability of best medical management recurrent stroke occur in up to 15-20% of patients with stroke in India. Education for stroke prevention could be a strategy to prevent recurrent strokes.

Regional differences in ischemic stroke in India (north vs. south).

Background: India is a large country with geographically diverse populations and varying risk factors. Identification of regional differences can improve healthcare policy decisions.

Aim: To study regional differences in stroke between North and South India.

Quality of care for ischemic stroke in China vs India: Findings from national clinical registries.

Objective: To understand stroke risk factors, status of stroke care, and opportunities for improvement as China and India develop national strategies to address their disproportionate and growing burden of stroke.

Methods: We compared stroke risk factors, acute management, adherence to quality performance measures, and clinical outcomes among hospitalized ischemic stroke patients using data from the Indo-US Collaborative Stroke Project (IUCSP) and China National Stroke Registry-II (CNSR-II). The IUCSP included 5 academic stroke centers from different geographic regions (n = 2,066).

Determining the feasibility and preliminary efficacy of a stroke instructional and educational DVD in a multinational context: a randomized controlled pilot study.

Objective: To assess the feasibility of conducting a randomized controlled trial of an instructional and educational stroke DVD and determine the feasibility and preliminary efficacy of this intervention in a multinational context.

Design: Non-funded, pilot randomized controlled trial of intervention versus usual care.

Setting: International, multicentre, community-based.

Ischemic Stroke Profile, Risk Factors, and Outcomes in India: The Indo-US Collaborative Stroke Project.

Background And Purpose: The Indo-US Collaborative Stroke Project was designed to characterize ischemic stroke across 5 high-volume academic tertiary hospitals in India.

Methods: From January 2012 to August 2014, research coordinators and physician coinvestigators prospectively collected data on 2066 patients with ischemic stroke admitted <2 weeks after onset. Investigator training and supervision and data monitoring were conducted by the US site (Massachusetts General Hospital, Boston).