Annals of Indian Academy of Neurology
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LETTER TO EDITOR
Year : 2009  |  Volume : 12  |  Issue : 1  |  Page : 71-72
 

Minimising disability in stroke survivors


Research Centre, C/o Lilavati Hospital, A-791, Bandra Reclamation, Lilavati Hospital & L.K.M.M. Trust Research Centre, A-791, Bandra Reclamation, Mumbai - 400 050, India

Correspondence Address:
P M Dalal
Research Centre, C/o Lilavati Hospital, A-791, Bandra Reclamation, Lilavati Hospital & L.K.M.M. Trust Research Centre, A-791, Bandra Reclamation, Mumbai - 400 050
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0972-2327.48871

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How to cite this article:
Dalal P M, Bhattacharjee M. Minimising disability in stroke survivors. Ann Indian Acad Neurol 2009;12:71-2

How to cite this URL:
Dalal P M, Bhattacharjee M. Minimising disability in stroke survivors. Ann Indian Acad Neurol [serial online] 2009 [cited 2020 Jun 4];12:71-2. Available from: http://www.annalsofian.org/text.asp?2009/12/1/71/48871


Sir,

The Editorial on "Little strokes, big trouble and more" is thought provoking. [1] Stroke prevention by risk factor intervention would be a practical way but we do not have population based national data to plan prevention strategies. To estimate the magnitude of problem, we urgently need population based regional surveys using standard terminologies and methodologies. [2]

On the other hand, Quality of Life in stroke survivors is an immediate problem. For example, in Mumbai Stroke Registry [3] among other factors (e.g. age, stroke subtype and associated risk factors), the neurological deficit (by NIHSS score) at onset correlated with outcome status (by Barthel Index or Modified Rankin Scale) at 28 days. Mild deficit at onset was associated with good recovery whereas; moderate to severe neurological deficit had poor outcome. Therefore, the aim of immediate treatment will be to restrict the extent of brain damage and minimize post-stroke disability.

Unfortunately, lack of public awareness on warning symptoms, transportation difficulties and paucity of acute care beds are major handicaps. With limited number of neurologists in our country, one will have to depend on expertise of local medical practitioners to initiate emergency intensive management (not tPA) until patient is shifted to acute care unit. Thus, training of local physicians in acute stroke care is most urgently needed. In other words, our emphasis on sophisticated advanced technologies requires rethinking and our concern for improving quality of life in stroke survivors needs greater emphasis.

 
   References Top

1.Thomas SV. Little strokes, big trouble and more Ann Indian Acad Neurol 2008;11:201-2.  Back to cited text no. 1    
2.Dalal PM, Bhattacharjee M, Vairale J, Bhat P. Mumbai stroke registry (2005-2006) - surveillance using WHO steps stroke instrument - challenges and opportunities. J Assoc Physicians India 2008;56:675-80.  Back to cited text no. 2  [PUBMED]  
3.Dalal PM, Malik S, Bhattacharjee M, Trivedi ND, Vairale J, Bhat P, et al. Population-based stroke survey in Mumbai, India: Incidence and 28-day case fatality. Neuroepidemiology 2008;31:254-61.  Back to cited text no. 3  [PUBMED]  [FULLTEXT]



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1 Authoręs reply
Thomas, S.V.
Annals of Indian Academy of Neurology. 2009; 12(1): 72
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