Dipping temperatures, increasing pollution levels are surging stroke cases by 40 per cent in the national capital region, doctors said on Wednesday. In addition to dense fog conditions, the Indian Meterriolgical Department on Wednesday predicted the minimum temperatures in the range of 7 degrees Celsius -10 degrees Celsius over most parts of plains of Northwest India.

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"We are seeing around 40 per cent rise in brain stroke currently as in today's date. We are admitting almost double the number of strokes, as we were doing in October or September. This is a clear-cut impact of cold weather combined with pollution," Dr. Praveen Gupta, Principal Director of Department of Neurology at Fortis Memorial Research Institute, told IANS.

"Cold weather combined with air pollution is like double edged sword that can do more damage then expected.. we are seeing 20 per cent increase in number of stroke cases in our ICU's," added Dr. Prof Vinay Goyal, Chairman Neurology, Medanta, Gurugram.

The Central Pollution Control Board (CPCB) on Wednesday reported 'very poor' air quality in the national capital, with the overall AQI at 381.

"Stroke risk is more during winters because blood pressure fluctuates and patients who do not control hypertension during this time their stroke chances increases and when combined with high pollution the risk multiplies," Dr. Sumit Singh, Director -- Neurology at Artemis Hospitals told IANS.

Dr. Gupta explained that pollution leads to an increase in particulate matter which leads to increased generation of oxidative reactive species. This further leads to pro-inflammatory cytokines which leads to inflammation in the body and increased endothelial dysfunction.

Increased endothelial dysfunction with inflammation combined with vasoconstriction and greater aggregability with raised blood pressure leads to a significant increase in brain strokes, the doctor said.

"We are seeing increase in number of patients admitted in our ICU due to stroke, as winter season is already known to increase the stroke risk when it is combined with pollution, the number of cases multiply," Dr. Singh told IANS.

"This requires need of control of modifiable risk factors like hypertension, diabetes, stop smoking along with do everything to reduce pollution. Stay away from polluted environment," Dr. Goyal said.

The doctors also recommended using air purifiers indoors, wearing face mask when going out in polluted areas, especially during walks early in the morning.

"Avoid eating lot of nuts during winters as it can increase blood cholestrol, don't stop physical activities and prefer doing during afternoon when weather is warm and follow up with doctor is necessary if someone has cardiac or BP issue," Dr. Singh said.