Literature review of dysphagia in

stroke
Study : cross sectional
CT SCAN AND MRI findings = individuals pre-diagnosed as stroke 
3 hospitals
6 months
Sample size= 150 patients
Age = any
Gender= both male and female
GCS : mild or moderate
Modified Massey Bedside Swallow Screener =to screen out the patients for
dysphagia
SPSS-19 = for the statistical analysis.
Results:
• sample of 150 individuals with stroke= 53% of patients had dysphagia.
• Females = 38%
• males =62%.
• Older individual more likely to have dysphagia.
• 65% =ischemic stroke
• 35% =haemorrhagic.
• 87% of dysphagic individuals =history of smoking
• 13% were without any.
• These factors demonstrate significant relationship by showing p-value <0.05. While no
significant difference was seen between levels of alertness and risk of dyspagia by
showing p-value 0.2.
Conclusion:
• Dysphagia after stroke occurs frequently
• and factors like type of stroke and history of smoking are significantly
related to this condition.
Cleft palate
• Cleft palate=congenital deformity
• affecting the speech production skills of children born th with it.
• Pakistan =4 largest number of cleft births in the world.
• gender values
• family history
• age greatly (affect the speech nasality in children with cleft palate.)
• Objective: To determine the factors affecting the speech nasality in
children with cleft palate.
Methods:
• Sample size= 120 childrens ,
• ages rang=8 to 12
• by cross sectional purposive sampling method,
• Clapp General Hospital, Lahore.
• Demographic data were collected in terms of age, gender, family history and
cousin marriage,
• Tool: modifying Temple Street Scale.
• SPSS version 21.0 =for data analysis.
• Gold standard for diagnosis : clinical assessment (to assess speech disorders
related to velo-pharyngeal disorders and cleft palate)
Results
• The descriptive analysis of age revealed
• highest frequency of speech nasality =at 9 years (35%).
• The gender distribution indicates increased percentage of speech
nasality (62.5%) in males than females.
• The frequency of children having family histories was 99 (82.5%).
• The frequency of consanguineous marriages was higher (83.3%) than
the non-consanguineous (16.7%).
Conclusions
• It was concluded that gender, age and genetics greatly affect the
speech nasality of individuals with cleft palate.
• So, these points must be considered seriously because prevention is
better than cure.
• a congenital deformity that can affect the speech production 1 skills
of children
• The splits or any separation either in the palate or in upper lip or
sometimes 2 in both of them is referred as 'cleft'.
• The speech disorders related to cleft palate are
• hyper nasality,
• air emission
• compensatory articulation.
• The diagnosis of speech disorders resulting from cleft palate should
be carried out through clinical assessment as it is considered the 'gold
standard' to assess speech disorders related to velo-pharyngeal
disorders and cleft 3 palate.
• The study of demographic variables (family Hx = major genetic factor)
in different populations throughout the world greatly help in
advancing our knowledge of oro-facial clefts
• There is a group of children and young people, born with cleft palate, who
have long-term intractable speech impairment even after the repair of their
cleft.
• Identifying the factors associated with poor speech outcomes i.e. from 8
years to 12 years may help us to design and target interventions and
resources that 11 improve this important outcome.
• There are number of factors which have been identified in the literature that
may have an impact upon speech outcomes in children born with cleft lip
and palate. These include age, gender, genetics, velo-pharyngeal insuficiency.
• The majority of affected children in developing countries receive limited
treatment for this condition due to the lack of resource
• Incidence; increased by Positive family history of clefts, consanguineous marriage
and low infant birth weight
• greater in males than females
• prevalence of oral diseases =descriptive cross-sectional multi-centre study which
showed the higher ratio in males than females and the highest numbers of cases
were reported at the age of 9 year (15%)
• cleft palate demographics in a retrospective study and find out that age and genetics
affect the speech of individuals with 16 cleft
• In this study, the researcher will try to and out the factors involved in the speech
nasality and after identification of these factors through health education, efforts will
be commended to reduce it in a society, if left as it is, it may enhance the gravity of
symptoms.
Discussion
• Racial differences in the incidence of cleft palate have been reported. The
demographic factors are vital for consideration to the assessment of
discourse (speech) results related with congenital fissure and velo-
pharyngeal dysfunction
• The absence of nasality was found high at the age of 9 years and lowest at
12 years.
• Live perceptual judgment of speech nasality revealed higher occurrence of
presence of speech nasality followed by presence of hyper-nasality. In this
study, the ratio of males with cleft palate is higher than females. This study
also confirms that individuals with repaired cleft palate have a higher rate
of speech nasality which is similar to a study