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Low-cost alternatives for the management of acute ischemic stroke in low and middle-income countries
Ann Med Surg (Lond). 2021 Oct 21;72:102969. doi: 10.1016/j.amsu.2021.102969. eCollection 2021 Dec.ABSTRACTAcute ischemic stroke (AIS) patients arriving within a suitable time frame are treated with recanalization therapy i.e. intravenous thrombolysis (IVT) with alteplase and/or mechanical thrombectomy (MT). IVT with alteplase is indicated in AIS patients presenting within 4.5 hours of onset regardless of vascular territory involved. MT is indicated in AIS patients presenting within 24 hours of onset with large vessel occlusion in the anterior circulation. However, MT is ludicrously expensive and requires exorbitant setup, ...
Source: Annals of Medicine - January 7, 2022 Category: Internal Medicine Authors: Gaurav Nepal Jayant Kumar Yadav Siddhartha Bhandari Jeevan Gautam Bikram Prasad Gajurel Source Type: research

Role of female community health volunteers in ischemic stroke prevention, identification, referral and rehabilitation in Nepal
Ann Med Surg (Lond). 2021 Oct 8;72:102893. doi: 10.1016/j.amsu.2021.102893. eCollection 2021 Dec.ABSTRACTFor the past three decades, female community health volunteers (FCHVs) have been at the forefront of Nepal's health map and have contributed significantly to its improving health indicators such as maternal mortality rate and infant mortality rate. Given the changing epidemiology of Nepal and the shift of burden from communicable to non-communicable diseases (NCDs), it is important to revitalize their role with the changing times. The prevalence of ischemic stroke in Nepal is on the rise. However, very few people make i...
Source: Annals of Medicine - January 7, 2022 Category: Internal Medicine Authors: Babin Basnet Jayant Kumar Yadav Bikram Prasad Gajurel Yow Ka Shing Bipin Kandel Gaurav Nepal Source Type: research

An opportunity to improve Acute Ischemic Stroke care in the South Asian region through telestroke services
Ann Med Surg (Lond). 2021 Nov 25;72:103115. doi: 10.1016/j.amsu.2021.103115. eCollection 2021 Dec.ABSTRACTThe South Asian region accounts for more than 40% of the stroke burden of the developing world and is the highest contributor to global stroke mortality. Despite proven treatment guidelines, the limited number of neurologists, the number of dedicated stroke centers and the fact that most of these facilities are urban-centric renders poor access to thrombolysis in this region, especially in the rural areas. Studies have shown that thrombolysis using telestroke services are comparable to face-to-face thrombolysis. Telest...
Source: Annals of Medicine - December 10, 2021 Category: Internal Medicine Authors: Jayant Kumar Yadav Gaurav Nepal Yow Ka Shing Rohit Raman Banerji Bikram Prasad Gajurel Source Type: research