KARACHI, May 10: Stroke is the number one killer in developing countries and the main reason for causing disabilities among adults. It affects patients frequently in their productive years leading to a huge financial burden to the society. These views were expressed by experts during a continuing medical education programme on “Stroke-Dissolving the clot breading the barrier” organized at the Liaquat National Hospital, Karachi here on Tuesday.
It was observed that new and emerging treatments could potentially reverse the disability caused by stroke. Ischemic stroke was caused by a blockage of blood vessel to a part of brain. But new medication and procedures were now available to re-open the blood vessel to brain that could reverse the disability.
Talking about prevention, Dr Shahid Mustafa said stroke was the most common neurological diseases and atherothombosis was accounting high deaths worldwide.
“It has major impact on quality of life, but it can be prevented by modifying risk factors including smoking, hypertension, diet, dyslipidemia, physical inactivity, obesity and diabetes,” Dr Mustafa told.
He said fruits, vegetables, fibres, fish etc. were beneficial in diet, but one must do 30 minutes brisk walk four to six times a week and moderate intensive exercise.
“Awareness should be created among the masses regarding its prevention, as many people do not know about it,” he stressed.
Dr Farrukh S. Khan talked on “Treating acute strokes-Dissolving the clot, the race to save brain.”
He said once a feeding vessel to a part of the brain was occluded, the cell death could occur rapidly in infarct core.
Dr Khan said the process was slower in ischemic penumbra-cell and death might occur in hours.
“The race is now to save the still viable pneumbra. First of all, starting of stroke symptoms should be determined exactly and then treatment should start accordingly,” he added.
Delivering presentation on “Management of medical complications in acute stroke” Dr Naveed Uddin Ahmed said medical complications of stroke were important to recognize as it added significantly to the patient’s morbidity and mortality.
“Strokes may exacerbate pre-existing medical disorders like ischemic heart disease (IHD), chronic obstructive pulmonary disease (COPD); diabetes mellitus etc. strokes may precipitate medical problems like aspiration pneumonia, cardiac arrhythmias, venous, thromboembolism etc,” he told.
“The various body systems that may be primarily or secondarily affected by stroke include cardiovascular, pulmonary, psychiatric, nutritional, excretory, neuromuscular and integumentary,” Dr Ahmed added.
Dr Ahmed said treating hypertension (HTN) in acute stroke presented several dilemmas and it should not be treated unless to a modest degree of 10-15 per cent reduction.
“Further drop in BP should be avoided as chronically hypertensive patients have their auto regulation of cerebral blood flow set at a higher level than normal mean,” he suggested.
“Needless to say, in the chronic stage beyond the first few weeks following a stroke, hypertension should be aggressively treated to prevent stroke recurrence,” Dr Ahmed emphasized.
He said most stroke patients could resume oral feeding with rehabilitation techniques including diet modification and swallowing exercises. Dr Salman Sharif, Dr Bushra Rehman, Dr Mariam H. Syeda and Ms Brigitte Ikram also spoke.—PPI
