Neuroscience in Acute Stroke Treatment: Current Strategies and Emerging Therapies in Pakistan

Authors

  • Atif Maqsood Department of Neurology, Aziz Fatimah Medical and Dental College, Faisalabad
  • Faizan Aslam Department of Neurology, Aziz Fatimah Hospital, Faisalabad, Pakistan
  • Muhammad Absar Alam Department of Neurology, Aziz Fatimah Hospital, Faisalabad, Pakistan
  • Mubarak Ali Anjum Department of Neurology, Aziz Fatimah Medical and Dental College, Faisalabad
  • Muhammad Umair Saleem Department of Neurology, Aziz Fatimah Hospital, Faisalabad, Pakistan
  • Nadia Zulfiqar Department of Neurology, Aziz Fatimah Medical and Dental College, Faisalabad

DOI:

https://doi.org/10.36552/pjns.v28i3.1001

Keywords:

Acute Stroke Treatment, Strategies, Emerging Therapies

Abstract

Objective:  To discuss the current strategies and emerging therapies in treating acute stroke in Pakistan. Explores how personal beliefs influence health behavior and decision-making.

Materials & Methods:  The present qualitative study of neuroscience in acute stroke treatment was carried out at the Department of Neurology at Aziz Fatimah Medical and Dental College, Faisalabad. The theoretical concepts of the Health Belief Model (HBM) apply to explore how personal beliefs influence health behavior and decision-making in acute stroke treatment, strategies, and emerging therapies. All acute stroke patients of the Department of Neurology from June 2023 to June 2024 were interviewed for thematic analysis. Interviews were transcribed on MS Word, and then they were coded using software called QDA Miner Lite.

Results:  The study found intravenous thrombolysis, mechanical thrombectomy, stroke units, and tele-stroke services, which could gradually be made a part of the healthcare infrastructure. Improvement in stroke management is expected with emerging therapies like neuroprotective agents and stem cell therapy also helpful for acute stroke treatment. The study found major problems in awareness and accessibility of acute stroke treatment, current strategies, and emerging therapies.

Conclusion:  The study revealed that stroke care optimization in Pakistan reduces the burden of disabilities and mortality related to stroke. Although most significant urban centers offer advanced care for stroke patients, accessibility to their services is still not present for those residing in remote and rural areas.

References

Farooq A, Venketasubramanian N, Wasay M. Stroke care in Pakistan. Cerebrovascular Diseases Extra. 2021;11(3):118-21.

Doi: https://doi.org/10.1159/000519554

Grotta JC. Fifty years of acute ischemic stroke treatment: a personal history. Cerebrovascular Diseases. 2021;50(6):666-80.

Doi: 10.1159/000519843

Hafeez A, Dangel WJ, Ostroff SM, Kiani AG, Glenn SD, Abbas J, Afzal MS, Afzal S, Ahmad S, Ahmed A, Ahmed H. The state of health in Pakistan and its provinces and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. The Lancet Global Health. 2023;11(2):e229-43. Doi: https://doi.org/10.1016/S2214-109X(22)00497-1

Zhang S, Wang D, Li L. Recombinant tissue-type plasminogen activator (rt-PA) effectively restores neurological function and improves prognosis in acute ischemic stroke. American Journal of Translational Research. 2023;15(5):3460.

PMID: 37303683

Pandianb KS, Toyodad LL, Uchiyamaf TW, Kurodag S, Hui NC, Changj M, Venketasubramaniank N. Stroke in Asia. mortality. 2024;100:000.

Doi: 10.1159/000538928

Toma C, Bunte MC, Cho KH, Jaber WA, Chambers J, Stegman B, Gondi S, Leung DA, Savin M, Khandhar S, Kado H. Percutaneous mechanical thrombectomy in a real?world pulmonary embolism population: Interim results of the FLASH registry. Catheterization and Cardiovascular Interventions. 2022;99(4):1345-55.

Doi: https://doi.org/10.1002/ccd.30091

Duncan PW, Bushnell C, Sissine M, Coleman S, Lutz BJ, Johnson AM, Radman M, Pvru Bettger J, Zorowitz RD, Stein J. Comprehensive stroke care and outcomes: time for a paradigm shift. Stroke. 2021;52(1):385-93.

Doi: https://doi.org/10.1161/STROKEAHA.120.029678

Ain HQ, Tahir MJ, Ahmed KA, Ahmed F, Ali MM, Elhaj EH, Mustafa GE, Ahsan A, Yousaf Z. Tele-stroke: a strategy to improve acute stroke care in low-and middle-income countries. Annals of Medicine and Surgery. 2024:10-97.

Doi: 10.1097/MS9.0000000000002187

Kandimalla J, Vellipuram AR, Rodriguez G, Maud A, Cruz-Flores S, Khatri R. Role of telemedicine in prehospital stroke care. Current Cardiology Reports. 2021;23(6):71.

Doi: https://doi.org/10.1161/CIR.0000000000000659.

Latchoumane CF, Betancur MI, Simchick GA, Sun MK, Forghani R, Lenear CE, Ahmed A, Mohankumar R, Balaji N, Mason HD, Archer-Hartmann SA. Engineered glycomaterial implants orchestrate large-scale functional repair of brain tissue chronically after severe traumatic brain injury. Science Advances. 2021;7(10):eabe0207.

Doi: 10.1126/Sciadv.Abe0207

Shaheryar ZA, Khan MA, Adnan CS, Zaidi AA, Hänggi D, Muhammad S. Neuroinflammatory triangle presenting novel pharmacological targets for ischemic brain injury. Frontiers in immunology. 2021;12:748663.

Doi: https://doi.org/10.3389/fimmu.2021.748663

Zakria M, Ahmad N, Al Kury LT, Alattar A, Uddin Z, Siraj S, Ullah S, Alshaman R, Khan MI, Shah FA. RETRACTED: Melatonin rescues the mice brain against cisplatin-induced neurodegeneration, an insight into antioxidant and anti-inflammatory effects. 2021; 87:1-10. Doi: https://doi.org/10.3390/cells10092429

Shahid R. The sub-standardized approach to stroke management in low and middle-income countries including Pakistan: limitations and suggested options to overcome some of the shortcomings via teleneurology/telestroke application. Pakistan Journal of Neurological Sciences (PJNS). 2022;17(4): 48-57.

https://doi.org/10.56310/pjns.v17i04.216

Shah FA, Khan MI, Ahmad B, Hussain S. Drug interaction and rational drug therapy in hospitalized patients reported with stroke. Journal of Bashir Institute of Health Sciences. 2020;1(1):15-22.

Doi: https://doi.org/10.53576/bashir.01.01.0017

Syed H. The Interplay of Hegemonic Masculinity and Health Literacy in The Successful Cardiovascular Self-Care Among Pakistani Immigrant Men in Toronto: Ethnographic Case Studies. 2021. (Doctoral dissertation, Toronto Metropolitan University).

Sivertsen M, De Jaegher H, Arntzen EC, Alstadhaug KB, Normann B. Embodiment, tailoring, and trust are important for co?construction of meaning in physiotherapy after stroke: A qualitative study. Physiotherapy Research International. 2022;27(3):e1948.

Doi: https://doi.org/10.1002/pri.1948

Wasay M, Younis S, Malik A, Sherin A. World health organization intersectoral global action plan (WHO-IGAP); implications and impact on neurological care in Pakistan. Pakistan Journal of Neurological Sciences. 2023;18(01).

Doi:https://doi.org/10.56310/pjns.v18i01.249

Downloads

Published

2024-09-01

Issue

Section

Original Articles