Brain stroke: ICMR launches new programme to improve treatment outcome

With brain stroke killing thousands of young Indians each year, Indian Council of Medical Research has initiated a new research programme that seeks to improve the stroke treatment outcome in Indian hospitals.
 
The pattern of stroke – one of foremost killing diseases – in India is different when compared to the rich nations. About 19-42% of Indian stroke patients die within 28 days irrespective of the treatment they receive in the hospitals. Nearly a quarter of them are below 45 years.
 
With 27 hospitals and research centres, the Indian Stroke Clinical Trial Network aims to come up with innovative solutions to this health threat after carefully studying Indian patients for the next 3-5 years.
 
At least three Bengaluru-based institutions – NIMHANS, St Johns Hospital and BGS Hospital – are part of the chain. The participating hospitals had a discussion at Hyderabad on Thursday to finalise the nitty-gritty of the programme.
 
“We aim to improve the intervention measures in stroke treatment and reduce mortality. We are starting with three projects that have been approved by the ICMR,” principal investigator Jeyaraj Pandian, who heads the neurology department at the Christian Medical College, Ludhiana told DH.
 
Hypertension (systolic blood pressure above 150) is the main culprit behind the rising number of stroke cases in India. Compared to the developed world, it is hitting the Indian population 12-15 years earlier.
 
But stroke comes with higher mortality and morbidity in India in the absence of improved rehabilitation measures, which are better abroad.
 
One of the three approved projects would focus on this aspect of stroke-management using mobile telephony. Stroke patients would be fed with follow-up information on rehabilitation measures and post-discharge care at home through in cell phones.
 
The researchers will check whether increased availability of information with the stroke patient family could lead to better treatment outcome.
 
“The aim is to reduce the number of deaths within 28 days and minimising the chances of relapse. It's five-year project beginning in October. ICMR would be providing a fund of Rs 4.5 crore to create the infrastructure for the trial,” Pandian said.
 
The second project is to use Ayurvedic medicines in conjunction with standard treatment for better rehabilitation. This would be carried out in collaboration with two Ayurvedic centres in Kerala. Though approved by the ICMR, budgeting for this project is yet to be done.
 
The third one is part of a global programme to find out whether blood pressure control can bring additional benefits to the TPA treatment, in which an expensive medicine (TPA or tissue plasminogen activator) is used to clear the blockage inside a blood vessel.
 
“It is part of a global trial for which we have to recruit about 200 patients by August 2018. We are awaiting permissions from the health ministry,” Pandian said.