Waleed Shahzad, Hafiza Faiza Mushtaq, Tehmina Inayat, Muhammad Hassan, Haris Majid Rajput, Mazhar Badshah.
Awareness of Stoke among General Practitioners.
Pak J Neurological Sci Jan ;13(4):15-9.

Stroke is the 2nd leading cause of death and 3rd leading cause of disability after cancer and ischemic heart disease. The recognition of acute stroke symptoms and knowledge about timely and prompt referral of a patient for possible thrombolysis is a need of time for which general practitioners (as they have to be the first responders many a times across Pakistan) need to be equipped with the advance knowledge about stroke treatment. Methods: In this cross-sectional observational study we assessed a total of 100 GPs practicing within a radius of 60km from a tertiary care teaching hospital in Islamabad where thrombolysis is being offered routinely to patients with acute ischemic stroke (AIS). They were interviewed using a standard questionnaire designed containing basic questions on stroke management. Results: Of the 100 GPs interviewed, 70% felt that tissue plasminogen activator (tPA) can be used in treating AIS but only 20% chose tPA as the best treatment option while 31% opted for other agents like citicholine along with antiplatelets plus tPA.Only 28% were aware that tPA should be given within 3 hours while 64% mentioned intra-arterial thrombolysis as a treatment option.Only 54% felt the need for good diabetic control and 25% wanted aggressive lowering of blood pressure. 43% chose normal saline as fluid of choice. Conclusions: Majority of the GPs are not aware about the beneficial effects of thrombolysis and are not updated regarding blood pressure and glucose control in the setting of acute ischemic stroke.

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