title: Role of Vitamin D in the Outcome of Ischemic Stroke- A Randomized Controlled Trial.
abstract: BACKGROUND
  Vitamin D deficiency has reached epidemic proportions in India with prevalence rates of 70-100% in the general population. Low vitamin D levels are associated with worse outcomes in ischemic strokes. The outcome of stroke after vitamin D replenishment has not been much studied.
  
  
  OBJECTIVE
  To compare the stroke outcome between patients receiving vitamin D supplementation and patients without vitamin D supplementation by Scandinavian Stroke Scale (SSS) and thus, to assess the long term outcome of ischemic stroke patients with low vitamin D level by supplementation of vitamin D.
  
  
  METHODS
  This is a non blinded randomized controlled trial conducted in ischemic stroke patients. The patients were divided into two groups (A and B) where Group A received a single dose of 6 lac IU of Cholecalciferol Intramascular (IM) injection and Group B were not given vitamin D. Finally 30 patients in each group were analyzed. SSS was applied to evaluate the stroke severity at the onset and at the follow up after three months in both groups. The difference in SSS was analyzed using SPSS software. Independent t-test was applied and p-value < 0.05 was taken as significant.
  
  
  RESULTS
  Mean±SD of vitamin D levels in Group A and Group B were 17.98±3.81ng/ml and 18.44±4.69 ng/ml respectively. Mean±SD of SSS at time of admission and after three months for Group A was 32.50±11.61 and 38.89±8.34; and for Group B 35.82±8.56 and 38.32±7.10. The difference in SSS from time of admission and after three months, in Group A (6.39±4.56) and Group B (2.50±2.20) were analyzed statistically and found to be highly significant (p<0.001).
  
  
  CONCLUSIONS
  The results showed that there is a significant improvement in the stroke outcome after three months in those patients who were supplemented with vitamin D. Thus screening for vitamin D deficiency in stroke patients is essential and vitamin D replenishment will improve the stroke outcome.
authors.affiliation: Associate Professor, Department of Physiology, PSG Institute of Medical Sciences and Research , Coimbatore, Tamil Nadu, India .
authors.forename: Shuba
authors.initials: S
authors.lastname: Narasimhan
authors.affiliation: Professor, Department of Neurology, PSG Hospitals , Coimbatore, Tamil Nadu, India .
authors.forename: Prakash
authors.initials: P
authors.lastname: Balasubramanian
keywords: Scandinavian stroke scale; Stroke severity; Vitamin D deficiency; Vitamin D supplementation