Dr. Karuna Hazarika
(drkaruna97@gmail.com.)
World stroke day is "observed worldwide on 29th October every year to create awareness for the prevention and treatment of stroke and to ensure better care and support of stroke survivors. Various organizations organize different types of events to educate, testing and take initiatives for preventing damages and effects of stroke worldwide. This annual event was started in the year 2006 by World Stroke Organization (WSO) and it was declared as a public health emergency in 2010. WSO provides a platform globally for stroke awareness and drives action on stroke worldwide. This and the coming year will focus on the campaign on awareness of the signs of stroke and the need for timely access to proper treatment. There are various themes for campaigns like stroke is treatable, Little stroke big trouble, Stroke-what can I do? etc. are in bygone years. This year theme is # Precious Time and is aimed at the response time of stroke patients to celebrate recovery or prevention. Stroke is the single largest cause of disability and the second largest cause of death globally.
There is a lifetime risk of stroke 1 in 4. About 70% of stroke occurs in low and middle-income countries and occurs 15 years earlier than in higher-income countries. Up to 84% of stroke in low and middle-income countries die as early as three years of stroke as compared with 16% in high-income countries. In India, 4500 people are affected by stroke in a day and 41% of patients do not survive. One stroke happens every 40 sec and one death every 4 minutes. So, every second counts after a brain stroke."Stroke is a disease of the blood vessels of the brain that affects the supply of blood to the brain tissue. A stroke occurs when the blood supply is reduced or interrupted in a part of the brain thereby brain tissue is deprived of oxygen and other nutrients. This results in the death of brain tissue in a minute. Stroke is a medical emergency and prompt treatment is very crucial, and early action may reduce the brain damage and thereby other complications following a stroke. The Sooner a person receives stroke treatment there is less damage of the brain tissue. Three types of stroke affect the blood vessels. They are ischemic stroke, hemorrhagic stroke and transient ischemic stroke. In an ischemic stroke, the supply of blood is disrupted due to clots or narrowing of blood vessels that results in the reduction of blood flow to the brain tissue. Two main types of ischemic stroke are thrombotic that happens when a blood clot forms in one of the arteries that supply the brain and embolic when a blood clot may pass from different parts of the body and may lodge in the brain and result in occlusion of the blood vessel and causes a stroke.
A hemorrhagic stroke results from leaking blood from the vessel and results in a rise of intracranial pressure and damage to the brain cells. There may be a disease of blood vessels like an aneurysm (bulging) or an abnormal connection of vein and arteries (AVM) that can lead to bleeding in the brain. The other transient ischemic attack (TIA) occurs when the blood flow of the brain is temporarily blocked. The symptoms are almost similar but in TIA the symptoms disappear after a few minutes. This may serve as a warning sign of a future stroke."The campaign-related to stroke is focused on the acronym FAST: F is facial weakness or face dropping, A is for Arm weakness or numbness, S for Speech difficulty means unable to speak, and T for Time that is very important as time loss is brain loss. When you feel someone is having a stroke don't waste time and call an ambulance. Additional signs of stroke could be a sudden weakness, numbness of arm or leg especially one side of the body, confusion, sudden loss of vision Loss of balance, difficulty in walking, dizziness loss of coordination and may there be a sudden severe headache without a known cause and there may be nausea and vomiting also. It can be dangerous if not prevented and unattended. A slight delay may lead to catastrophic changes in life which could impact their families as well. The stroke may leave you crippled for the rest of your life so it's considered that time is very precious. One should focus on a healthy life with good habits like avoiding alcohol, smoking a high fatty diet, and one should eat and drink healthy and go for regular exercise. Apart from these regular checkups like blood pressure, cholesterol and blood sugar and monitoring closely will help to prevent stroke. There are five key facts about stroke: Stroke kills brain cells, three types of stroke, one in four is at risk, prevention is key and F.A.S.T i.e. is time lost is brain loss."There happened to be many activities in the field of stroke control programmed in India with the collaboration of ICMR and other organizations and NGOs for education, prevention and treatment plans of stroke patients. As a part of it Tezpur Medical College and Assam Medical College have developed special stroke units in collaboration with ICMR along with partner hospital, Baptist Hospital for Tezpur and the project MSU(Mobile Stroke Unit) is supported by ICMR for infrastructure and maintenance.
A high-tech ambulance within built CT scan machine is provided one each in both centres by ICMR. The ambulance moves to the spot following the phone call and an immediate CT scan is done and the images are been reported with teleradiology or by the help of AI( artificial intelligence) then the next steps start for treatment of the stroke patient even right in the ambulance, if needed. The results are very encouraging. The Tezpur unit was inaugurated by then Union Health Minister, Dr Harsha Vardhan, virtually on 28 September 2020. Since then there are many initiatives for the training of health care workers for rapid action on patients and other preventive procedures with the help of international NGOs like Angels. There are many awareness programmes on the block levels for the general people and Asha workers. A similar type of ambulance was inducted in Assam Medical College in March 2021, and it is functioning well. In the stroke unit, at Tezpur Medical College, we have treated many patients with stroke and come out successful to achieve our goals. Some of the patients were treated immediately within the golden hour of stroke i.e. 4.5 hours and could give a second life with complete recovery from stroke. NHM, Assam also offers their supportive hand in supplying costly thrombolytic medicine free of cost to the patient and it's a commendable step taken towards the treatment of stroke patients.
Hard work and commitment will change the landscape of management of acute stroke cases in future in our region."Now, it is time to educate people about the possible cause, effects and sequel of stroke in the rest of the life of the patient. The awareness campaign launched on this day of World Stroke Day by the World Stroke Organization (WSO) is encouraging this dreaded disease treatment, management and prevention as well.