Jena Subhransu Sekhar, Kabi Shobhitendu, Panda Baikuntha Nath, Kameswari B C, Behera Ishwar Chandra, Tripathy Subrat Kumar, Mahanta Seemanchana
Associate Professor, Department of Neurology, IMS & SUM Hospital , Sector-8, Kalinga Nagar, Bhubaneswar, Odisha, India .
Associate Professor, Department of Medicine, IMS & SUM Hospital , Sector-8, Kalinga Nagar, Bhubaneswar, Odisha, India .
J Clin Diagn Res. 2016 Oct;10(10):OC40-OC43. doi: 10.7860/JCDR/2016/21763.8756. Epub 2016 Oct 1.
Among the modifiable risk factors for stroke, tobacco smoking is well recognized. In some studies the use of Smokeless Tobacco (ST) has also been contributed as a risk factor for ischemic stroke. Use of ST is very common in South-East Asia. The form of ST varies according to the geographical and cultural variation.
To study the various clinical symptoms and radiological findings of stroke due to different types of ST.
This was a prospective hospital based study carried out over a period of 2 years. All the cases within age group of 16 - 60 years and with a clinical and radiological diagnosis of acute stroke were included in the study. The Fagerström Test for Nicotine Dependence for ST of more than 6 was taken as the inclusion criteria. Patients having other addictions like smoked tobacco, alcohol, etc., and with important risk factors like hypertension, diabetes, dyslipidemia were excluded. The cases were extensively investigated and followed up for at least 6 months. Analysis was done using the Statistical Package for Social Sciences (SPSS- version 16.0). Descriptive statistics like percentage, mean were used wherever appropriate.
During a period of 2 years, a total of 54 patients were studied. Forty two (77.7%) were males and 12(22.3%) were females. The mean age at presentation was 42.72(± 8.6) years and among all 96.3% patients were diagnosed as ischemic stroke. Among ST, pan was most commonly used in 21(38.9%) patients with an average of 14.6(±3.27) years of addiction. Hemiplegia was the predominant symptom on presentation (46, 85.2%). According to Oxfordshire Stroke Classification, partial anterior circulation infarct was most common in 20(38.4%). The mean Modified Rankin scale after 5 days of hospital stay was 3.83(±1.03) and after 6 months of follow-up was 2.1(±0.8). Patients were counseled for deaddiction and after 6 months follow-up 48(88.8%) patients had quit ST.
ST is an important etiological factor for young ischemic stroke. This is the first study depicting clinical symptomatology of ST addicted ischemic stroke patients from India. Considering the increasing prevalence of ST use in south-east Asia, further long term studies are needed from this region.
在可改变的中风危险因素中，吸烟是广为人知的。在一些研究中，无烟烟草（ST）的使用也被认为是缺血性中风的一个危险因素。ST在东南亚地区非常普遍。ST的形式因地域和文化差异而有所不同。
研究不同类型ST导致中风的各种临床症状和影像学表现。
这是一项基于医院的前瞻性研究，为期2年。所有年龄在16 - 60岁之间、临床和影像学诊断为急性中风的病例均纳入研究。将ST的尼古丁依赖Fagerström测试得分超过6分作为纳入标准。排除有其他成瘾行为（如吸烟、饮酒等）以及有高血压、糖尿病、血脂异常等重要危险因素的患者。对病例进行了广泛的调查，并至少随访6个月。使用社会科学统计软件包（SPSS - 16.0版）进行分析。在适当的情况下使用百分比、均值等描述性统计方法。
在2年期间，共研究了54例患者。其中42例（77.7%）为男性，12例（22.3%）为女性。就诊时的平均年龄为42.72（±8.6）岁，所有患者中96.3%被诊断为缺血性中风。在ST使用者中，嚼烟是最常用的，21例（38.9%）患者平均成瘾14.6（±3.27）年。偏瘫是就诊时的主要症状（46例，85.2%）。根据牛津郡中风分类，部分前循环梗死最为常见，有20例（38.4%）。住院5天后改良Rankin量表的平均得分是3.83（±1.03），随访6个月后的平均得分是2.1（±0.8）。对患者进行了戒毒咨询，随访6个月后，48例（88.8%）患者已戒除ST。
ST是年轻缺血性中风的一个重要病因。这是第一项描述来自印度的ST成瘾缺血性中风患者临床症状学的研究。鉴于东南亚地区ST使用的患病率不断上升，该地区需要进一步开展长期研究。
