High prevalence of hypertension and habit of smoking in adults is major cause of Stroke


 16th International Neurology Update 2016,

High prevalence of hypertension and habit
of smoking in adults is major cause of Stroke

By Mubarak Ali

KARACHI: Pakistanis are having stroke at least 10 years earlier than people of rest of the world due to high prevalence of hypertension and habit of smoking in its adults. Government should spend more on primary healthcare and awareness to prevent deaths and disability from preventable diseases. By controlling hypertension and smoking, 50 percent stroke cases can be prevented in Pakistan. This was stated by Prof. Dr. Ismail. A. Khatri, a Pakistani neurologist associated with King Saud bin Abdul Aziz University for Health Sciences, Riyadh. He was speaking at the 16th International Neurology Update 2016 held in Karachi recently. The Neurology moot was inaugurated by Prof. Ikuyu Nonaka, Director of the National Center of Neurology and Psychiatry, Tokyo Japan while neurologists, health experts and researchers from United States, Britain, Canada, Saudi Arabia, Qatar, Singapore and several other countries of the World besides all over the country attended the conference.

Continuing Prof. Ismail Khatri said that magnitude of stroke and its burden on the healthcare system in Pakistan was so huge that Pakistan would have to spend billions of rupees on the treatment and rehabilitation of stroke patients every year as thousands of Pakistanis, many in their early 40s and 50s, were having stroke due to their poor lifestyle. By spending just Rs. 400 to 500 million initially on prevention and awareness, Pakistan can save over 21 billion rupees which it would have to spend annually on the treatment and rehabilitation of stroke patients every year. He urged authorities to spend more money on lifestyle diseases and awareness to lower burden of diseases on their healthcare system. High cholesterol and diabetes are also two important risk factors for stroke but if we manage to control the hypertension and smoking, stroke can be prevented among 50 percent people, he added.

Prof. Nonaka addressing the conference offered to train Pakistani neurologists at National Center of Neurology and Psychiatry at Tokyo, Japan. We have state of the art equipment and facilities which could be offered to young Pakistani scientists and experts to learn from their experiences and apply the knowledge and training in Pakistan for the benefit of local people.

Pirzada Qasim Raza Siddiqui, Amjad Islam Amjad, Anwar Shaoor, Prof. Mohammad Wasay,
Dr. Aziz B Sonawalla, Dr. Athar Javed, Dr. Abdul Malik and others photographed at Gala dinner 
during the 16th International Neurology Update 2016 held in Karachi from December 22-25, 2016.

Chairman of the Neurology Update Prof. Muhammad Wasey while speaking at the opening session said that Pakistan Society of Neurology and its allied bodies were striving hard for the training of young neurologists, general physicians and paramedics regarding the management and treatment of neurological disorders. Pakistan he stated was facing a shortfall of trained and qualified neurologists while number of patients with nerve and muscle diseases were on the rise due to poor lifestyle and lack of awareness among the masses. No reliable data on the number of patients with neurological disorders, their prevalence and incidence in the country was available. He announced that a proposal to launch a population based survey to ascertain the magnitude of the problem was being prepared so that a comprehensive strategy could be prepared in this regard. He urged both the federal and provincial governments to spend more money on prevention of neurological disorders, which could be avoided with awareness and offered full support of the Pakistan Society of Neurologists and allied bodies in launching preventive measures and programs for the control of neurological disorders.

National Guidelines for Epilepsy

National Guidelines for Epilepsy for the General Practitioners and Family Physicians were launched during the concluding session of 16th International Neurology Update 2016. These guidelines have been prepared to help young doctors and physicians to diagnose epileptic seizures and fits in patients and prescribe them inexpensive but effective drugs available in Pakistan.

Dr. Fauzia Siddiqui, lead author of the guidelines speaking at the occasion said that Guidelines have been designed to assist primary-care physicians in diagnosing epilepsy and providing its treatment. They would also help them in prescribing first, second and third generation Anti-Epileptic Drugs (AEDs) to patients which are not only available in Pakistan but are also very inexpensive but highly effective in treatment of epilepsy. She claimed that general physicians could not only identify and diagnose 70 percent of the patients with epileptic seizures but also provide them treatment with medicines which were readily available in the local market. These guidelines are aimed at minimizing inappropriate or inadequate treatment methods, identify preventable etiologies, make individualized selections for women and children with epilepsy, advice about pregnancy and contraception. Guidelines for selecting AEDs in elderly are also provided with common drug interactions, she added.

Dedicating the epilepsy guidelines to her detained sister in United States Dr. Afia Siddiqui, Dr. Fauzia deplored that there were hardly 200 trained neurologists for over two million epileptics in Pakistan, majority of whom could not get proper treatment of their neurological condition although their disease was treatable with affordable and effective drugs available in Pakistan.

Speaking on identification and treatment of headaches, Consultant Neurologist from United Kingdom Dr. Fayyaz Ahmed Shaikh said that migraines, especially Cluster Headaches in men, there could be thousands of patients with the miserable condition in Pakistan but due to unfamiliarity with the neurological condition, most of the general physicians could not diagnose and properly treat the condition. Cluster headache is a form of headache, found mostly among smokers, who wake up in the second half of the night with pain in one side of their head and tears tolling down from their eyes. This pain is so severe that it sometimes compels a person to commit suicide because most of the doctors are unable to diagnose and properly treat it, Dr. Fayyaz Ahmed Shaikh added.

He was of the view that consultant neurologists take up to two and half years even in the Britain to diagnose the cluster headache and then they start treatment for the painful condition. There could be thousands of patients of this neurological condition but due to lack of diagnosis, people and physicians were not aware of its severity and sensitivity in Pakistan. All the required medicines are available to treat migraines and cluster headaches but the issue is of its identification and diagnosis. Pakistan Society of Neurology is commendable for its holding of such conferences and training sessions to help the young doctors learn from the experiences of trained neurologists, he added.

Prof. Muhammad Wasey, Chairman of the Neurology Update thanked international and national experts for sharing their knowledge and expertise which would help participants and young neurologists to learn about typical neurological disorders, their management and prevention.