It’s not a stroke of fate, but hypertension and diabetes

Every one in four urban Pakistanis have suffered the symptoms of a stroke because many of the risk factors causing it are present in Pakistani society, said Dr Saad Shafqat, head of neurology at the Aga Khan University Hospital (AKUH).

He was part of the expert panel of neurologists who discussed the symptoms and recovery procedures of strokes to mark the World Stroke Day in the AKUH auditorium on Friday.

No one is safe from strokes, unfortunately, as the disease is common in middle-aged adults – both men and women at equal risk.

Defining the factors, Dr Shafqat said that hypertension is one of the main causes of strokes, affecting one in every three adults (45 years or older).

This is followed by diabetes, which also affects one in every three adults, obesity that affects 28 per cent women and 22 per cent men, while tobacco and depression are also common factors of strokes.

Terming stroke a medical emergency, Dr Ayesha Kamal, an associate professor and the AKUH stroke programme director, said that timely and early response is crucial in strokes. “Those who feel warning signs must immediately go to the hospital,” she urged the audience, highlighting that the symptoms are very sudden and may make it impossible for someone to walk to the phone, talk to an operator or even realise something is amiss.

The trend of strokes in Pakistan is different. “It’s called the Asian trend,” said Dr Kamal, explaining that the incidence of narrowing of head arteries is more than that of the sciatic nerve. About the people’s response system, “it’s good news,” according to her as the disease is recognisable in Pakistan.

Defining another facet of the illness, AKUH consultant neurologist Dr Muhammad Wasay pointed out that people can also have a Transient Ischemic Attack (TIA) that is also referred to as a mini-stroke with symptoms that last less than 24 hours.

He explained that while TIAs do not cause permanent brain damage or disabilities, they should not be ignored as they are a serious warning of a stroke. “Ten per cent of TIA patients will have a stroke in the next month,” he warned.

However, a stroke is not incurable. It can also be prevented by controlling the risk factors, elucidated Dr Bhojo Asumal Khealani, assistant professor and consultant neurologist at the AKUH.

He said that it can be prevented by identifying the risk factors and controlling the levels of cholesterol, high blood pressure, diabetes, smoking habits and hypertension.

There are very good chances of recovery if the patient is given the tissue plasminogen activator (tPA) drug within three hours of the attack, advised Dr Wasay. The drug breaks up or dissolves blood clots, which are the main cause of strokes.

The patients need to get focussed treatment in stroke units, stick to medications and continue routine follow-ups with the doctor, he added.

He said that the recovery rate of strokes is 75 per cent and many are even able to work and go back to their normal routines.

Dr Nabila Soomro from the Institute of Physical Medicine and Rehabilitation discussed the role of physiotherapy for stroke patients and highlighted ways to restore the independence of the patients.

She said the routine physical skills such as eating, walking and working can be learned again and patients can be helped to adjust mentally and emotionally.

Published in The Express Tribune, October 30th, 2010.

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