Muhammad Fozan Khan, Farzana Behttani, Omer Nasim, Muhammad Shahid Iqbal, Sohail Khan, Muhammad Khizar Hayat.
Cross-sectional study of knowledge of stroke Management amongst doctors of a tertiary Care Hospital; Peshawar, Pakistan.
Pak J Neurological Sci Jan ;14(3):6-11.

Background: Stroke is one of the leading causes of mortality and neurological disability worldwide. ‘Time is brain’ and prompt management of stroke is vital to improve the outcomes. Knowledge of stroke management is important for clinicians working in various specialties and this study focused on evaluation of this vital aspect. Objective: To document the knowledge of stroke management amongst doctors, working at different stages of career in different specialties at a tertiary care hospital. Materials & Methods: A questionnaire was developed using current stroke guidelines of the Royal College of Physicians London and American Heart and Stroke Association. The questionnaire was distributed among 73 doctors working in various specialties and grades. Data analysis was done using SPSS version 21.0. Results: House officers (n=33), Medical officers (n= 7), Post graduate trainees (n=20), Registrars (n=3), Consultants (n=9) participated. Diffusion weighted (DWI) MRI was recognised as the best diagnostic tool for acute ischaemic stroke (58.33%). BP management knowledge in haemorrhagic stroke was poor (60.56%). Less than half (40.85%) chose tissue plasminogen activator (t-PA) as the preferred initial treatment. Majority were unaware of percutaneous endoscopic gastrostomy (PEG) for unsafe swallowing (45.07%). Few recognised (19.72%) that the upper limit in blood pressure management for acute ischaemic stroke was 220/120 without other end organ damage. Only (55.56%) thought that IPCs (intermittent pneumatic compressions) were the safest method for DVT prophylaxis. Conclusion: The survey shows that the knowledge of doctors was inadequate. Improving medical training of stroke management and awareness of stroke as an emergency (‘Brain attack’) needs to be improved for optimal outcomes.

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