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Publication Setting up a centralised DKA registry : a leap towards coordinating DKA management in the UK(Royal College of Physicians, 2022-07-09) Rengarajan, Lakshmi Narayanan; Cooper, Catherine; Birchenough, Amy; Hebbar, Meghnaa; Pan, Carina Synn Cuen; Sheikh, Haaziq; De, Parijat; Narendran, Parth; University Hospitals Birmingham NHS Foundation Trust; Walsall Healthcare NHS Trust; Sandwell and West Birmingham NHS Trust; Haberdashers' Adams Grammar School; Queen Elizabeth Hospital; Sandwell and West Birmingham NHS Trust; Elderly Care; Internal Medicine; Medical and Dental; Birchenough, Amy; De, Parijat; Cooper, Catherine; Rengarajan, Lakshmi NarayananBackground: Diabetes-related ketoacidosis (DKA) is a common and potentially life-threatening complication in people with diabetes.1 Despite national and international guidelines, interhospital guideline variation and mismanagement during admission are important contributory factors to increased DKA duration and length of stay. Aim: To establish a common DKA registry to identify gaps in management, assess outcomes and share best practises across centres.Publication Analysis of recent trends in aetiology of diabetes-related ketoacidosis(Royal College of Physicians of London, 2022-07) Rajendran, Dineshwaran; Cooper, Catherine; Yip, Wai Nga Alice; Ponniah, Gobeka; Anilkumar, Anjitha; Zhou, Dengyi; Soghal, Shamanth; De, Parijat; Sheikh, Haaziq; Good Hope Hospital; Walsall Healthcare NHS Trust; University of Birmingham; Queen Elizabeth Hospital Birmingham; Sandwell and West Birmingham Hospitals NHS Trust; Haberdashers' Adams Grammar School; Cardiology; Elderly Care; Medical and Dental; Soghal, Shamanth; De, Parijat; Cooper, CatherineNo abstract availablePublication Atrial fibrillation in UK South Asian hospitalized ischemic stroke patients : the BRAINS study(Public Library of Science, 2023-02-07) Aurelius, Taylor; Ken-Dror, Gie; Sharma, Sapna D; Amlani, Sageet; Gunathilagan, Gunaratnam; Cohen, David L; Rajkumar, Chakravarthi; Maguire, Stuart; Ispoglou, Sissi; Balogun, Ibrahim; Parry, Anthea; Sekaran, Lakshmanan; Syed, Hafiz; Lawrence, Enas; Singh, Ravneeta; Hassan, Ahamad; Wharton, Chris; Javaid, Khalid; Goorah, Neetish; Carr, Peter; Abdus Sami, Eman; Sharma, Pankaj; University of London; Royal London Hospital; Queen Elizabeth the Queen Mother Hospital; Northwick Park Hospital; Brighton and Sussex University Hospitals NHS Trust & University of Sussex; Bradford Teaching Hospital; City Hospital Birmingham; William Harvey Hospital; Hillingdon Hospital; Luton and Dunstable Hospital; Newham University Hospital; Croydon University Hospital; West Middlesex University; Leeds General Infirmary; New Cross Hospital; Walsall Healthcare NHS Trust; Queen's Park Hospital Royal; Birmingham Heartlands Hospital; Airedale General Hospital; Ashford & St Peter's NHS Foundation Trust; Imperial College Healthcare NHS Trust; Stroke; Elderly Care; Nursing and Midwifery Registered; Medical and Dental; Carr, Peter; Javaid, KhalidIntroduction: South Asian diaspora comprise one of the largest ethnic minority groups in the world yet data about atrial fibrillation (AF) in this demographic is understudied. Our aim is to identify differences in AF prevalence and treatment between South Asians and white British stroke patients. Method: The UK arm of a prospective ongoing large international repository on stroke was analysed. Ethnic differences in AF prevalence and management in those with ischemic stroke were analysed. Results: Of the 3515 individuals recruited with ischemic stroke, 1482 (men: 972, women: 510) were South Asian and 2033 (men:1141, women:892) of white British ethnicity. AF was present in 462 white British and 193 South Asians stroke patients, with South Asians displaying a lower prevalence of AF (South Asians: 13.0% vs white British 22.7%, P<0.001). Despite adjustment for traditional AF risk factors, South Asians had a significantly lower OR of AF compared to white British stroke patients (OR: 0.40, 95%CI: 0.33:0.49, P<0.001). Among confirmed AF cases, 31.8% of South Asians and 41.4% of white British were untreated at admission (P = 0.02). Antiplatelet treatment was significantly higher among South Asians at both admission (South Asian: 47.4% vs. white British: 29.9%, P<0.001) and discharge (South Asian: 49.5% vs. white British: 34.7%, P = 0.001), although anticoagulation treatment was similar across both ethnic groups at admission (South Asian: 28.5% vs white British: 28.1%, P = 0.93), and discharge (South Asian: 45.1% vs white British: 43.1%, P = 0.64). Conclusion: Stroke patients of South Asian descent are at significantly lower risk of AF but more likely to be on antiplatelet treatment compared to their white British counterparts.Publication Ischaemic stroke in South Asians : the BRAINS study(Wiley, 2022-11-05) Aurelius, Taylor; Maheshwari, Ankita; Ken-Dror, Gie; Sharma, Sapna D; Amlani, Sageet; Gunathilagan, Gunaratnam; Cohen, David L; Rajkumar, Chakravarthi; Maguire, Stuart; Ispoglou, Sissi; Balogun, Ibrahim; Parry, Anthea; Sekaran, Lakshmanan; Syed, Hafiz; Lawrence, Enas; Singh, Ravneeta; Hassan, Ahamad; Wharton, Chris; Javaid, Khalid; Goorah, Neetish; Carr, Peter; Sami, Eman Abdus; Sharma, Shri Ram; Sylaja, Padmavathy N; Prasad, Kameshwar; Sharma, Pankaj; University of London; New Delhi & Rajendra Institute of Medical Sciences; Royal London Hospital; Queen Elizabeth the Queen Mother Hospital; Northwick Park Hospital, London; Brighton and Sussex University Hospitals NHS Trust & Brighton and University of Sussex; Bradford Teaching Hospital; Sandwell and West Birmingham NHS Trust; William Harvey Hospital; Hillingdon Hospital; Luton and Dunstable Hospital; Newham University Hospital; Croydon University Hospital; West Middlesex University; Leeds General Infirmary; The Royal Wolverhampton NHS Foundation Trust; Walsall Healthcare NHS Trust; Queen's Park Hospital Royal Blackburn; University Hospitals Birmingham NHS Foundation Trust; Airedale General Hospital; North Eastern Indira Gandhi Regional Institute for Health and Medical Sciences; Sree Chitra Tirunal Institute for Medical Sciences and Technology; Ashford & St Peter's NHS Foundation Trust; Imperial College Healthcare NHS Trust; Neurology; Elderly Care; Medical and Dental; Ispoglu, Sissi; Javaid, KhalidBackground and purpose: Studies on stroke in South Asian populations are sparse. The aim of this study was to compare differences in age of onset of ischaemic stroke in South Asian patients living in the United Kingdom and South Asian patients living in India versus White British stroke patients. Methods: We studied the UK and Indian arms of the ongoing BRAINS study, an international prospective hospital-based study of South Asian stroke patients. The BRAINS study includes 4038 South Asian and White British patients with first-ever ischaemic stroke, recruited from sites in the United Kingdom and India. Results: Of the included patients, 1126 were South Asians living in India (ISA), while 1176 were British South Asian (BSA) and 1736 were White British (WB) UK residents. Patients in the ISA and BSA groups experienced stroke 19.5 years and 7.2 years earlier than their WB counterparts, respectively (mean [interquartile range] age: BSA 64.3 [22] years vs. ISA 52.0 [18] years vs. WB 71.5 [19] years; p < 0.001). Patients in the BSA group had higher rates of hypertension, diabetes mellitus and hypercholesterolaemia than those in the ISA and WB groups. After adjustment for traditional stroke risk factors, an earlier age of stroke onset of 18.9 years (p < 0.001) and 8.9 years (p < 0.001) was still observed in the ISA and BSA groups, respectively. In multivariable stepwise linear regression analysis, ethnicity accounted for 24.7% of the variance in early age onset. Conclusion: Patients in the BSA and ISA groups experienced ischaemic stroke approximately 9 and 19 years earlier, respectively, than their WB counterparts. Ethnicity is an independent predictor of early age of stroke onset. Our study has considerable implications for public health policymakers in countries with sizable South Asian populations.