Ayeesha Kamran Kamal, Ahmed Itrat, Imama Naqvi, Maria Khan, Roomasa Channa, Ismail Khatri, Mohammad Wasay.
Ischemic stroke care - official guidelines from the pakistan society of neurology.
Pak J Neurological Sci Jan ;5(1):38-43.

Pakistan is the sixth most populous country in the world, with an estimated population of 165 million. Non communicable disease including stroke now accounts for 41% of the total disease burden of Pakistan. In a population dense country like Pakistan, an estimated 4.8% may be suffering from stroke; this translates to 7.2 million individuals, compared to 700,000 annually in the United States. Data on the modifiable risk factors for stroke show an alarmingly high prevalence within the population of Pakistn. Hypertension - the single most preventable cause of stroke- affects one in three adults aged greater than 45 and 19% of the population aged 15 and above. The National Health Survey of Pakistan showed that diabetes mellitus is present in 35% of people greater than 45 years of age. Coronary artery disease can cause cardio-embolic stroke and is a surrogate for atherosclerosis in the cerebrovascular system: a population based cross sectional survey showed a prevalence of 1 in 4 middle aged adults with men and women at equal risk. The overall prevalence of obesity is 28 % in women and 22 % in men. The prevalence of tobacco use is 40% in men and 12% in women. Such a scenario calls for a systematic, need based and cost-effective guideline for diagnosis, acute management and secondary prevention of stroke which is cognizant of the resource limitations of Pakistan. These guidelines are a step in that direction.

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