WORLD JOURNAL OF ADVANCE
HEALTHCARE RESEARCH

( An ISO 9001:2015 Certified International Journal )

An International Peer Review Journal for Medical Science and Pharma Professionals
World Journal of Advance Healthcare Research (WJAHR) has indexed with various reputed international bodies like : Google Scholar , Index Copernicus , SOCOLAR, China , Research Bible, Fuchu, Tokyo. JAPAN , Cosmos Impact Factor , Scientific Indexing Services (SIS) , UDLedge Science Citation Index , International Impact Factor Services , International Society for Research Activity (ISRA) Journal Impact Factor (JIF) , IFSIJ Measure of Journal Quality , Scientific Journal Impact Factor (SJIF) , International Scientific Indexing, UAE (ISI) (Under Process) , International Impact Factor Services (IIFS) , Web of Science Group (Under Process) , Directory of Research Journals Indexing , Scholar Article Journal Index (SAJI) , International Scientific Indexing ( ISI ) , 

ISSN 2457-0400

Impact Factor  :  5.464

News & Updation

  • Article Invited for Publication

    Dear Researcher, Article Invited for Publication  in WJAHR coming Issue.

  • Journal web site support Internet Explorer, Google Chrome, Mozilla Firefox, Opera, Saffari for easy download of article without any trouble.

    .

  • 6th International Conference on Human and Soci

    Venue:FCT Education Resource Center, Abuja- Nigeria                                        September 22-24, 2019

  • WJAHR New Impact Factor

    Its our Pleasure to Inform you that WJAHR Impact Factor has been increased from  4.897 to 5.464 due to high quality Publication at International Level

  • .

    6th INTERNATIONAL CONFERENCE ON EDUCATIONAL TECHNOLOGY AND CURRICULUM STUDIES(ICETC2019) 

     

    Venue: FCT Education Resource Center, Abuja-Nigeria

    September 22-24, 2019

  • New Issue Published

    Its Our pleasure to inform you that, WJAHR 1 March 2021 Issue has been Published, Kindly check it on http://www.wjahr.com/home/current_issues

  • WJAHR MARCH ISSUE PUBLISHED

    MARCH 2021 Issue has been successfully launched on 1 March 2021.

Best Paper Awards

World Journal of Advance Healthcare Research (WJAHR)Honored the authors with best paper award, monthly based on the innovation of research work. Best paper will be selected by our expert panel.

Best Article of current issue

Download Article : Click here

Indexing

Abstract

TRANSESOPHAGEAL ECHOCARDIOGRAPHY BE A ROUTINE WORK UP IN ALL YOUNG STROKES? A TERTIARY CARE CENTRE STUDY

Dr. Kannan Balasubramani MD DM*

ABSTRACT

Introduction: Ischemic stroke is one of the major causes of morbidity and mortality in middle and late years of life. 85% CVA caused by ischemia, out of which 20% of is constituted by cardio embolic stroke. Cardio embolic stroke is defined as non-lacunar stroke with presence of potential cardiac source in the absence of cerebrovascular disease. The availability of new diagnostic techniques especially transoesophageal echocardiography (TEE) has allowed clinicians to identify cardiac source of embolism. This study was undertaken to compare the diagnostic yield of transoesophageal echocardiography with transthoracic echocardiography in the detection of a cardiac source of embolism in patient with cerebral ischemia. Materials And Methods: Stroke patients admitted in medical wards for period of one year were selected for this study. Patients with or without cardiac disease below the age 45 years and patient without any known risk factors for thrombotic stroke were included in the study. Age > 45 years, patient with known risk factors for Atherothrombotic stroke and CT suggestive of haemorrhage were excluded. Both transthoracic echocardiography & transoesophageal echocardiography were done for all patients Results: In 30 patients included in the study transthoracic echocardiography revealed a potential cardiac source of embolism in 25% (4 patients) all of whom had clinical evidence of heart diseases and 14% (2 patients) who had no clinical evidence of heart disease. In addition to the yield by transthoracic echocardiography, transoesophageal echocardiography revealed a potential source of embolism in 56% (9 cases). In patients with clinical evidence of heart disease, cardiac abnormalities additionally detected by transoesophageal echocardiography are 2 cases of LA appendage clot, 6 cases of left atrial spontaneous echo contrast and one case of prosthetic valve dysfunction (which is statistically significant). In patients with no clinical evidence of heart disease, transoesophageal echocardiography detected one case of patent foramen ovale with atrial septal aneurysm. Thus transoesophageal echocardiography is more sensitive than transthoracic echocardiography in detection of potential cardiac source of embolism. Conclusion: TEE is of great value in patients with clinical heart disease in comparison with TTE.In patients without clinical evidence heart disease utility value of TEE was less pronounced, still, TTE can be used as a effective screening tool. We suggest TEE may be advised routinely as stroke evaluation tool especially in the young patients.

[Full Text Article]