The methodology - Book Report/Review Example

As per the article the patients were eligible for inclusion if they fulfilled the following conditions: "(1) they were between the age of 18 and 80 years, (2) there was a hemiparesis, with the affected outstretched arm unable to hold a 90 position for 10 seconds, (3) they were conscious, (4) symptoms had started within 24 hours before admission, and (5) they were ineligible for intravenous thrombolysis according to the NINDS (National Institute of Neuro-logical Disorders and Stroke rt-PA Stroke Study Group).

" Patients considered for inclusion range between 18 and 80 years is a very wide range, common understanding is that the recovery rate in an 18 year old could be very less as compared to that in an 80 year old; hence the age range should not be so wide. Similarly in accordance to the second criteria an 18 year old may be able to hold an outstretched arm at 90 position for 10 seconds or more, due to a good muscular build but may be severely effected, then will the patient be ineligible for study OvConsciousness cannot be and should not be considered for eligibility of inclusion criteria.

Overall it appears that people who were affected by stroke only for the first time were considered as eligible for inclusion. Thus the results cannot hold good or useful for people effected second time and those having any other disorder interfering with neurological or life threatening concurrent illness. Patients were assigned to SCMU or SU randomly rather than on complexity of case. In the endpoints it is stated that the Barthel Index (BI) is a 100 point scale that assess activities of daily living, poor outcome is defined when the BI < 60 it implies that when a person has a BI of 50 he is stated to have a good outcome or is fit, then does that mean to say that a person having BI=10 or 20 is totally fit or has a very good outcomeIn table 3 out of total seven deaths reported therein the causes for two sudden deaths are not known and Initial stroke severity NHSS is 10 and 17, causes for death of Patient 1(SU) and patient 6 is stated as Respiratory insufficiency and aspiration pneumonia and Initial stroke severity NHSS is 26 and 21 respectively, though the Initial stroke severity NHSS for Patient 1 (SU) and Patient 6 is same i.e., 26 the mRS at discharge is 6 and 5 respectively.

It is clear from above that Initial stroke severity NHSS and mRS cannot be correlated. As it is stated that Hypoxia was observed in higher proportion in SCMU and it is also stated that "Hypoxia further depletes the energy stores and can influence ischemic progression." A question naturally arises then what could be the reason for higher proportion of Hypoxia in SCMU and how can this be minimised to retard ischemic progression Similarly cases of higher proportion