Study of the profile of stroke in a tertiary-care hospital in the sub-Himalayan region in north India Dhiraj Kapoor, Pankaj Gupta, Shyam Sundar, Rupinder Sharma, Ashish Dhiman, Vishnu Agarwal Department of Medicine, RP Govt. Medical College, Tanda, Himachal Pradesh, India. Correspondence to: Dhiraj Kapoor, E-mail: kapoordhiraj65@rediffmail.com Received August 31, 2014. Accepted October 3, 2014 Abstract Background: Rapid urbanization of rural areas is predicted to increase the incidence of risk factors for vascular events such as stroke among the ruralites. A different culture, beliefs, terrain, and climatic conditions of Himachal Pradesh may have an impact on the profile of stroke. Objectives: To study the profile and the various risk factors of stroke in the sub-Himalayan region of north India. Material and Methods: It was an observational cross-sectional study conducted at the Department of Medicine, R.P. Government Medical College, Kangra, Himachal Pradesh, for a duration of 12 months, from June 2012 to May 2013. Consecutive patients presenting to the hospital with signs and symptoms of stroke were included in the study. Detailed history and clinical examination was carried out in all patients. CT scan, routine blood examination, and lipid profile were evaluated in all patients. Results: Total number of patients who presented with stroke in a year was 374. It formed 4.0% of the total hospital admissions in medical wards. The mean age of stroke patients was 66.17 ± 12.9 years. Of the total patients, 254 (67.9%) were males and 120 (32%) were females; 127 patients (33.9%) presented between 6 am and 12 pm. The majority of patients presented in winter months, from November to January. Average delay in the presentation to hospital was 29 h. Only 79 (21.1%) patients presented within 3 h. Among the patients, 342 (91.4%) belonged to rural area, 61.4% had an infarct, and 38.6% had intracerebral bleed. The most common symptoms reported were weakness in 276 (73%) followed by speech abnormality in 53%. Hypertension as a risk factor was found in 174 (46.5%); 155 patients (41.4%) were smokers; and diabetes was present in 61 patients (16.4%). Average cholesterol level was 176 ± 54.99 mg/dl, and average triglyceride level was 339 mg/dl. Conclusions: The major strength in our study was the predominance of rural population. The state has witnessed an increase in the incidence of stroke. Elderly population is predominantly affected. Average delay in presentation was 29 h, which is substantially high. Majority of the events occurred in winter months. KEY WORDS: Stroke, sub-Himalayan, risk, rural hilly Introduction Stroke is one of the leading causes of mortality and morbidity worldwide. Rapid urbanization is predicted to increase the risk factors for vascular diseases such as stroke. Ability to forecast stroke has been challenging, making the detailed study of predisposing factors essential. Prevention still holds the key to reduce the impact of stroke. For planning prevention strategies, reliable information on profile of diseases in defined populations is necessary. Himachal Pradesh is a hilly state situated in the northwest of India. It has different culture, beliefs, climatic conditions, and terrain. The only data regarding incidence and pattern of various risk factors of stroke in Himachal Pradesh available are from a study conducted a decade ago. Since then, the state has witnessed rapid urbanization and lifestyle changes. Dr. Rajendra Prasad Government Medical College (RPGMC) is located in Kangra district of Himachal Pradesh, which caters to approximately 60% of the population of the state. The population served is predominantly rural. The districts and other areas of Himachal Pradesh served by RPGMC are given in Figure 1. The hospital serves inhabited areas ranging from 600–4000 m above sea level. Access this article online Website: http://www.ijmsph.com Quick Response Code: DOI: 10.5455/ijmsph.2015.3108201427 International Journal of Medical Science and Public Health | 2015 | Vol 4 | Issue 1 124 Research Article