Therapeutic Profile of Stroke Patients Managed with Neuroprotective Regimens

Ishaq Khan1*, Javeria Khan2, Gazala Shams3 and Javed Shabbir4

1Department of Neurology, Attended University of Peshawar, Nowshera-Rawalpindi-Islamabad, Pakistan

2Department of Qureos, Shaheed Zulfikar Ali Bhutto Institute of Science and Technology, Karachi, Sindh, Pakistan

3Department of Gynecology, University of Peshawar, Peshawar, Pakistan

4Department of Statistics, Quaid-i-Azam University, Islamabad, Pakistan

*Corresponding Author:
 Ishaq Khan,
Department of Neurology, Attended University of Peshawar,
Nowshera-Rawalpindi-Islamabad,
Pakistan,
Tel: 2028733307;
E-mail: ishaqkhan1@gmail.com

Received date: January 17, 2022, Manuscript No. IPSRT-22-12520; Editor assigned date: January 19, 2022, PreQC No. IPSRT-22-12520 (PQ); Reviewed date: February 02, 2022, QC No. IPSRT-22-12520; Revised date: March 17, 2022, Manuscript No. IPSRT-22-12520 (R); Published date: March 28, 2022, DOI: 10.36648/ IPSRT/22.06.150

Citation: Khan I, Khan J, Shams G, Shabbir J (2022) Therapeutic Profile of Stroke Patients Managed With Neuroprotective Regimens. Stroke Res Ther Vol:6 No:4

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Abstract

Development of safe and affective neuroprotective drugs for stroke management has been a medical subject for a number of years. Several clinical trials were withdrawn in vainness due to lack of optimum therapeutic outcomes. Nonetheless, recently a number of encouraging facts have highly supported demanding enthusiasm linked to management of stroke. Neuroprotectives have worked in growing window time period of suitability fostering endovascular thrombectomy. Stroke is a notable cause of morbidity and mortality around the globe. Greater understanding of the pathophysiology of neuronal damage in ischemic stroke has created interest in neuroprotection as a managing strategy. Neuroprotection is an increasingly recognized management strategy in ischemic stroke that promises to involvement clinicians in reducing stroke mortality rates and improving the quality of life of survivors.

Keywords

Neuroprotectives; Stroke; Pathophysiology

Introduction

As per Fugal-Meyer assessment stroke recovery (Post stroke evaluation scale for balance, motor/sensory function and joint functions, helps in follow up of rehabilitation) [1]. 

Items scored on 3 points scale

0=cannot perform

1=Performs partially

3=Performs fully [2].

Purpose: Is to evaluate and assess the graded rate of recovery on Fugal-Meyer Assessment and to classify sensory-motor dysfunction, balance and ability to perform activities [3-5].

Materials and Methods 

In therapeutic comparative study, stroke patients (n=425) were included to analyse the degree of neurological improvement with neuroprotective agents. Nearly 99% patients reported for treatment 24 hours to 12 years after an episode of stroke. In therapeutic dose, neuroprotective regimen administered in addition to standardized rehabilitation therapy. Post treatment, patients followed for therapeutic response [6] (Table 1).

Table 1.Post treatment, patients followed for therapeutic response.

Clinical condition Number of patients Age of patients Duration of NISTR* treatment Stroke patients pre- treatment clinical presentation Post treatment outcome* as per fugal-meyer assessment*
Polycythemia vera 5 20 -40Years 14-21 Days Semiconscious-conscious with CVA 1-2*Optimal
Valuvlar heart diseases /including rheumatic heart diseases       10 14-55Years 16-21 Days Semiconcoius-uncncious with CVA 1-2
Hypertension 80 15-95Years 10-20Days Semiconcoius-uncncious with CVA 1-2
Diabetes mellitus with/without hypertension 120 18-80Years 14-21Days Semiconcoius-uncncious with CVA 1-2
Obesity with/without dyslipidemia 90 25-80Years 14-21Days Semiconscious-conscious with CVA 1
Alcohol /illicit drugs abuse/smoking 15 30-65Years 14-21Days Semiconscious-conscious with CVA 2
Post HCV 20 30-60Years 10-21Days Semiconscious-conscious with CVA 1
Post COVID-19 2 25-50Years 14-21Days Semiconcoius-uncncious with CVA 1-2
Cardio-vascular conditions(coronary artery diseases, septal defects, post-operative Coronary Artery Bypass Graft(cabg), other cardiac repairing  procedures [7-8] 50 50-89Years 14-21Days Semiconcoius-uncncious hemiplegia with CVA 1-2
Gillian Barre syndrome 10 30-50Years 15-21Days Semiconscious-conscious with CVA 1-2
Rheumatoid arthritis/ systemic sclerosis, connective tissues diseases [9] 10 50-90Years 7-30 Days Conscious with CVA 1-2

Results

Degree of clinical improvement is correlated with duration of neurological damage. Patient’s pre and post treatment outcome evaluated as regards baseline clinical manifestations (immediately after treatment as well as 2 and 3 months after stroke onset) [10-14] (Figure 1).

Figure 1: Schema of pathophysiology of stroke, Therapeutic outcome with neuroprotectives.

Discussion

 Over the last 2 decades, innovative research has yielded some success in the treatment of patients with acute stroke [15-19]. Resort to an urgent imaging of brain (computerized tomographic scan of brain/magnetic resonance of brain, prompt reperfusion of brain with recanalization and/or neuroprotective drugs after extensive research could benefit stroke patients. Getting through evidence based retrospective data; majority of stroke patients treated with in earlier first hour could have a better outcome [20]. This mandate ground breaking research and modification of health care system in providing timely prehospital treatment. This can be accomplished by regular checkup of blood pressure and sugar. Change in diet, life style [21]. Smooth management of high blood blood pressure, blood sugar use of thrombolytic (aspirin /clopidogril [22-28].

Conclusion

Earlier therapeutic intervention in stroke patients with less degree of neurological damage has better prognostic outcomes than later on.

Clinical Implications: Neuroprotectives as the last hope in stroke treatment, now a days are mandatory to lessen morbidity/mortality outcomes.

References

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