Dubai: Around 10,000 cases of stroke were reported in 2015, of which nearly 2,000 people would likely die if proper care were not extended to them, a study conducted by the Bill and Melinda Gates Foundation that was released on Sunday shows.
Nearly 8,000 people are admitted to hospitals across the UAE every year for stroke treatment and the average age for incidence of stroke is 45, about 20 years earlier than the worldwide average of 65, said Dr Sohail Abdullah Al Rokn, consultant neurologist and head of the stroke programme at the Rashid Hospital, Dubai.
Dr Rokn is also the president of the Emirates Neurology society and stroke chapter. He was speaking at the second stroke academy conference for the region.
Dr Rokn said high cholesterol, hypertension, obesity and smoking were contributing factors to the high incidence of stroke in the UAE. “Our studies show that 25 per cent of heart disease patients get stroke, one out of three stroke patients above 45 are diabetics, one out of five stroke patients above 45 are hypertensive, smoking increases the risk of stroke by three times. So if you are a diabetic, hypertensive and a smoker, your risk of stroke is 20 times higher than others, if you are a woman with all the conditions, then you are at 30 times higher risk than others and if you are also obese in addition to all other symptoms, your risk of stroke is over 40 times higher than others,” he said.
“The first 60 minutes after a patient suffers [a stroke] is really a golden period or critical window in not just saving a person’s life but preventing permanent disability. Once it is established the patient is having a stroke, the health care specialists will administer the Tissue Plasminogen Activator (TPA) injection,” said Dr Al Rokn.
“In the first one minute after a patient experiences stroke, nearly two million brain cells die, within an hour a patient ages 3.6 years and, if proper initiatives are not taken up by the year 2030, it is estimated that there will be 12 million stroke deaths in the region.”
The high incidence of strokes in the UAE saw the Dubai Health Authority (DHA), in collaboration with Boehringer Ingleheim, launching the Acute Network Striving for Network in Stroke Excellence, or the Angel’s Initiative, on Sunday to train the region’s physicians in protocols and treatments pertaining to stroke.
Karim El Alaoui, Managing Director and head of Prescription Medicine at Boehringer Ingleheim, told Gulf News: “This is an international collaboration on stroke advisory protocols that was present in the world but has now been opened for Middle East, Africa and Turkey and includes the UAE. It is a free website to educate physicians on how to identify a stroke patient, how to deal with it with 16 procedural and quality protocols and provides six training kits with two videos. It is basically a standardised method for treatment and management of stroke to save life and prevent permanent disability, which is one of the biggest burdens to the family and victim of the stroke.”
Physcians in UAE and across the region can log on to http://angels-initiative.com/accessibility-statement register and download the protocols.
Four specialised stroke intervention units across the UAE
The UAE has set up four specialised stroke units with a combined strength of 50 beds at Rashid Hospital, Saudi German Hospital, Al Ain Hospital and Cleveland Clinic that follow all the standard life-saving protocols for stroke treatment.
The Stroke initiative has established similar units across the GCC and Middle East so that hospital and health care staff can collaborate to ensure that not a single minute is lost and set guidelines to treat stroke patients are followed.
“Prevention is the key which can happen with education and awareness of the community but, once it happens, quick treatment can help minimise damage and reverse the condition,” said Dr Al Rokn.
Other panellists who spoke at the conference include leading neurologists and cardiologists from across the region such as Dr Peter Hauf from South Africa, Dr Hesham Ammar from Egypt, Dr Mustafa Al Shamiri and Dr Adel Hazzani from Saudi Arabia and Dr Geroges Badoui from Lebanon.
Irregular heartbeat leading cause of stroke
Atrial Fibrillation (AF) or irregular heartbeat is one of the major causes of stroke and early screening could avert it, pointed out Dr Nooshin Bazargani, board member of the World Heart Foundation and chair of the Prevention Working Group of the Emirates Cardiac Society.
AF, which affects people over 57 years of age mostly, is an irregular heart rhythm where blood can pool in the heart’s upper chamers (atria) and form blood clots that could travel to the brain resulting in a stroke. While people with irregular heart rhythm may manifest some symptoms such as breathlessness, headache or weakness, in many cases, patients may be asymptomatic — meaning they show no symptoms. Regular screening can prevent strokes in such patients. Such risks can be detected within six seconds by a simple pulse check.
Dr Bazargani said: “According to the Gulf cardiac registry that was created in 2010, the average age of AF patients in the region was found to be 57 while, globally, the average age for this condition is 67. In the UAE, nearly 99,000 people of a population of 9 million were found to have this condition, which means it affects one per cent of the population. Lifestyle diseases such as hypertension, obsesity, ischaemic heart disease are risk factors that exacerebate the condition and this could be a likely reason for the rise. People who have AF can be treated with New Age Anti Coagulants after screening and can easily prevent incidence of stroke,” she said.
How to detect a stroke.
Follow the FAST Principle
F- Face Drooping
A - Arms weakness, inability of the patient to lift an arm
S – Speech garbled
T- Time to call emergency and rush patient to hospital as the first 60 minutes are very crucial