Browsing by Author "Deepti Arora"

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Educational and Socioeconomic Correlates of Stroke Risk Behaviors: Findings from the SPRINT INDIA Trial
(Wolters Kluwer Medknow Publications, 2025) Shweta Jain Verma; Gurnoor Kaur; Arya Devi; Deepti Arora; Aneesh Dhasan; Padmavathyamma Narayanapillai Sylaja; Dheeraj Khurana; Vijaya Pamidimukkala; Biman Kanti Ray; Vivek Keshavan Nambiar; Sanjith Aaron; Gaurav Kumar Mittal; Sundarachary Nagarjunakonda; Aparna Ramakrishna Pai; Sankar Prasad Gorthi; Somasundaram Kumaravelu; Yerasu Muralidhar Reddy; Sunil K. Narayan; Nomal Chandra Borah; Rupjyoti Das; Girish Baburao Kulkarni; Vikram Huded; Thomas Mathew; Mv Padma Srivastava; Rohit Bhatia; Pawan Kumar Ojha; Jayanta Roy; Sherly Mary Abraham; Anand Girish Vaishnav; Arvind Kumar Sharma; Sheikh Jabeen; Abhishek Pathak; Sanjeev Kumar Bhoi; Sudhir Sharma; Sulena Sulena; Aralikatte Onkarappa Saroja; Neetu Ramrakhiani; Madhusudhan Byadarahalli Kempegowda; Mahesh Pundlik Kate; Tina K. George; Ivy Anne Sebastian; Meenakshi Sharma; Rupinder Singh Dhaliwal; Rahul Huilgol; Jeyaraj Durai Pandian
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. Methods: Participants were randomly assigned (1:1) to either intervention or control group through computer-based randomization on web. Intervention included stroke prevention Short Message Service messages, short-duration videos, and printed workbooks. Baseline assessments captured demographic and educational data, classifying patients into three categories: no schooling, less than high school, and high school or above. Primary outcome was a composite of recurrent stroke, high-risk TIA, ACS, and mortality at 1 year. Chi-square tests and analysis of variance were used to evaluate educational disparities across various variables. Results: The intervention did not reduce primary outcomes at 1 year among patients with different educational levels. Higher educational group was associated with enhanced medication adherence (94.3% vs 85.4%; P < 0.001), increased physical activity (5497.91 ± 4117.7 vs 6169.91±4828.8; P < 0.001), lower triglyceride levels, and decreased engagement in behavioral risk factors like alcohol intake (5.1% vs 6.8%; P = 0.013) and tobacco use (smoked and chewed) (4% vs 7.9%; P < 0.001 and 5.8% vs 11.6%; P = 0.020). Conclusions: Personalized secondary stroke prevention, tailored to educational levels, is crucial for effective stroke management. © 2025 Annals of Indian Academy of Neurology.
Indian Trial of Tranexamic acid in Spontaneous Intracerebral Hemorrhage study protocol
(SAGE Publications Inc., 2025) Jeyaraj Durai Pandian; Atul Phillips; Shweta Jain Verma; Deepti Arora; Aneesh Dhasan; Pheba Susan Raju; Padmavathyamma Narayanapillai Sylaja; Biman Kanti Ray; Uddalak Chakraborty; Jacob Johnson; Praveen Kumar Sharma; Sanjeev Kumar Bhoi; Menka Jha; Thomas Iype; Chithra P; Dheeraj Khurana; Sucharita Ray; Dwijen Das; Naurima Kalita; Sweekriti Adhikari; Ashish K. Sharma; Jayanta Roy; Rajeshwar Sahonta; Sulena Singh; Vikram Chaudhary; Girish Ramachandran Menon; Sanjith Aaron; Deepti Bal; Rajinder Kumar Dhamija; Monali Chaturvedi; Siddharth Maheshwari; Aralikatte Onkarappa Saroja; Karkal Ravishankar Naik; Neeraj Bhutani; Kailash Dhankhar; Dinesh Sharma; Rohit Bhatia; Sankar Prasad Gorthi; Binod Sarmah; Vijaya Pamidimukkala; Sankaralingam Saravanan; Sunil K. Narayan; Lakshya Jyoti Basumatary; Nagarjunakonda Venkata Sundarachary; Aruna K. Upputuri; Ummer Karadan; Vayyattu Govindankutty Pradeep Kumar; Rajsrinivas Parthasarathy; Darshan Doshi; Satish Wagh; Tirppur C.R. Ramakrishnan; Saleem Akhtar; Soaham Dilip Desai; Nomal Chandra Borah; Rupjyoti Das; Gaurav Kumar Mittal; Agam Jain; Paul J. Alapatt; Girish Baburao Kulkarni; Deepak Menon; Pritam Raja; Inder Puri; Vivek Keshavan Nambiar; Muralidhar Reddy Yerasu; Shyam Krishnakumar Jaiswal; Kapil Gangadhar Zirpe; Sushma Kirtikumar Gurav; Sudheer Sharma; Somasundaram Kumaravelu; M. Bk; Vicky V. Thakkar; Abhishek Pathak; Madhusudhan Byadarahalli Kempegowda; Praveen Chander; Neetu Ramrakhiani; Arya Devi Ks; Prabhakaran Sankara Sarma; Rahul Huilgol; Meenakshi Sharma; Rupinder Singh Dhaliwal
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 4.5 h of symptom onset will reduce early mortality at 30 days. Design: Indian Trial of Tranexamic acid in Spontaneous Intracerebral Haemorrhage (INTRINSIC trial) is a multicenter, randomized, open-label, trial enrolling patients aged more than 18 years presenting with non-traumatic ICH within 4.5 h of symptom onset or when last seen well. Study participants received 2 g of TXA administered within 45 min while control group received standard of care. Intensive blood pressure reduction as per INTERACT 2 protocol is followed is done in both groups. Study plans to recruit 3400 patients. Primary outcome is mortality at day 30. Secondary outcomes are radiological reduction in HV at 24 h from baseline, neurological impairment at day 7 or earlier (if discharged), and assessments of dependency and quality of life at day 90. Summary: If proven to be beneficial, TXA will have a major impact on medical management of ICH. Trial registration: Clinical Trial Registry India (CTRI/2023/03/050224) and Clinical Trials.gov (NCT05836831). © 2025 World Stroke Organization
INSTRuCT: Protocol, Infrastructure, and Governance
(Wolters Kluwer Health, 2021) Jeyaraj Durai Pandian; Shweta Jain Verma; Deepti Arora; Meenakshi Sharma; Rupinder Dhaliwal; Himani Khatter; Rahul Huilgol; P.N. Sylaja; Aneesh Dhasan; Vishnu Renjith; Abhishek Pathak; Aparna Pai; Arvind Sharma; Anand Vaishnav; Biman Ray; Dheeraj Khurana; Gaurav Mittal; Girish Kulkarni; Ivy Sebastian; Jayanta Roy; Somasundaram Kumaravelu; Lydia John; Mahesh Kate; M.V. Srivastava; Madhusudhan Byadarahalli Kempegowda; Nomal Borah; Neetu Ramrakhiani; Nirendra Rai; Pawan Ojha; Rohit Bhatia; Rupjyoti Das; Sachin Sureshbabu; Shaikh Afshan Jabeen; Sanjeev Bhoi; Sanjith Aaron; Prabhakaran Sarma; Aralikatte Onkarappa Saroja; Sherly Abraham; Sudhir Sharma; Sulena Sulena; Sankar Gorthi; Sundarachary Nagarjunakonda; Sunil Narayan; Thomas Mathew; Tina George; Pamidimukkala Vijaya; Vikram Huded; Vivek Nambiar; Y. Muralidhar Reddy
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. Methods: Multiple expert group meetings were conducted by Indian Council of Medical Research to understand the scope of network to perform stroke clinical trials in the country. Established stroke centers with annual volume of 200 patients with stroke with prior experience of conducting clinical trials were included. Central coordinating center, standard operating procedures, data and safety monitoring board were formed. Discussion: In first phase, 2 trials were initiated namely, SPRINT (Secondary Prevention by Structured Semi-Interactive Stroke Prevention Package in India) and Ayurveda treatment in the rehabilitation of patients with ischemic stroke in India (RESTORE [Rehabilitation of Ischemic stroke Patients in India: A Randomized controlled trial]). In second phase, 4 trials have been approved. SPRINT trial was the first to be initiated. SPRINT trial randomized first patient on April 28, 2018; recruited 3048 patients with an average of 128.5 per month so far. The first follow-up was completed on May 27, 2019. RESTORE trial randomized first patient on May 22, 2019; recruited 49 patients with an average of 3.7 per month so far. The first follow-up was completed on August 30, 2019. Conclusions: In next 5 years, INSTRuCT will be able to complete high-quality large scale stroke trials which are relevant globally. © 2021 American Heart Association, Inc.
SPRINT INDIA: Regional Variations in Primary and Secondary Stroke Outcomes Based on Baseline Characteristics in North and South Indian Sites
(Wolters Kluwer Medknow Publications, 2025) Somasundaram Kumaravelu; Shweta Jain Verma; Rimpi Arora; Deepti Arora; K. S. Arya Devi; Aneesh Dhasan; Padmavathyamma Narayanapillai Sylaja; Dheeraj Khurana; Pamidimukkala Vijaya; Biman Kanti Ray; Vivek Keshavan Nambiar; Sanjith Aaron; Gaurav Kumar Mittal; Sundarachary Nagarjunakonda; Aparna Ramakrishna Pai; Yerasu Muralidhar Reddy; Sunil K. Narayan; Nomal Chandra Borah; Rupjyoti Das; Girish Baburao Kulkarni; Vikram Huded; Thomas Mathew; Madakasira Vasantha Padma Srivastava; Rohit Bhatia; Pawan T. Ojha; Jayanta Roy; Sherly Mary Abraham; Anand Girish Vaishnav; Arvind Kumar Sharma; Shaikh Afshan Jabeen; Abhishek Pathak; Sanjeev Kumar Bhoi; Sudhir Sharma; Sulena Sulena; Aralikatte Onkarappa Saroja; Neetu Ramrakhiani; Madhusudhan Byadarahalli Kempegowda; Sankar Prasad Gorthi; Mahesh Pundlik Kate; Tina K. George; Ivy Anne Sebastian; Meenakshi Sharma; Rupinder Singh Dhaliwal; Rahul Huilgol; Jeyaraj Durai Pandian
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. In this study, Mumbai, located at 19.07°N in western India, serves as the dividing line between North and South India. One-year follow-up data from 3038 patients were utilized to examine regional disparities between North and South India. Results: South Indian stroke patients were predominantly rural (60.1%) and less educated (58.2%), while North Indian patients were mostly urban (64.2%). South Indian patients had higher incidence of ischemic stroke (91.1% vs. 73.5%, P = 0.001) and higher rates of large artery atherosclerosis (33.6% vs. 19.7%, P = 0.001), hypertension, type 2 diabetes, smoking, and alcohol consumption, but better medication adherence. In contrast, North Indian patients had higher high-density lipoprotein, drug use, and tobacco use. At 1-year follow-up, North Indian patients had more high-risk transient ischemic attacks and poorer lifestyle-related outcomes, despite South Indians having higher systolic blood pressure and fasting glucose levels. Conclusion: Region-specific strategies are crucial. Block randomization may help. South India needs better lifestyle modification programs, while North India requires improved health education and medication adherence strategies. © 2025 Annals of Indian Academy of Neurology.