Medicine and Health Sciences Commons^™

A Randomized Controlled Behavioral Intervention Trial To Improve Medication Adherence In Adult Stroke Patients With Prescription Tailored Short Messaging Service (Sms)-Sms4stroke Study., Ayeesha Kamran Kamal, Quratulain Shaikh,, Omrana Pasha, Iqbal Azam Syed, Muhammad Islam,, Adeel Ali Memon, Hasan Rehman, Masood Ahmed Akram,, Muhammad Affan, Sumaira Nazir, Salman Aziz, Muhammad Jan, Anita Andani, Abdul Muqeet, Bilal Ahmed, Shariq Khoja

Department of Medicine

Background: The effectiveness of mobile technology to improve medication adherence via customized Short Messaging Service (SMS) reminders for stroke has not been tested in resource poor areas. We designed a randomized controlled trial to test the effectiveness of SMS on improving medication adherence in stroke survivors in Pakistan.

Methods: This was a parallel group, assessor-blinded, randomized, controlled, superiority trial. Participants were centrally randomized in fixed block sizes. Adult participants on multiple medications with access to a cell phone and stroke at least 4 weeks from onset (Onset as defined by last seen normal) were eligible. The intervention group, in addition …

Improving Medication Adherence In Stroke Patients Through Short Text Messages (Sms4stroke)-Study Protocol For A Randomized, Controlled Trial., Ayeesha Kamran Kamal, Quratulain Nauman Shaikh,, Omrana Pasha, Iqbal Azam Syed, Muhammad Islam, Adeel Ali Memon,, Hasan Rehman,, Muhammad Affan,, Sumaira Nazir, Salman Aziz,, Muhammad Jan, Anita Andani, Abdul Muqeet, Bilal Ahmed,, Shariq Khoja

Department of Medicine

Background: Stroke is a major cause of morbidity and mortality, especially in low and middle income countries. Medical management is the mainstay of therapy to prevent recurrence of stroke. Current estimates are that only 1 in 6 patients have perfect adherence to medication schedules. Using SMS (Short Messaging Service) as reminders to take medicines have been used previously for diseases such as diabetes and HIV with moderate success. We aim to explore the effectiveness and acceptability of SMS in increasing adherence to medications in patients with stroke.

Methods: This will be a randomized, controlled, assessor blinded single center superiority trial. …

Diagnostic Tcd For Intracranial Stenosis In Acute Stroke Patients: Experience From A Tertiary Care Stroke Center In Karachi, Pakistan., Ayeesha Kamran Kamal, Hasan Rehman, Nasir Mustafa, Bilal Ahmed, Mohammad Jan, Faisal Wadivalla, Syed Kamran

Department of Medicine

Background: Stroke is a common cause of morbidity and mortality around the world. Intracranial large artery atherosclerosis (ICAD) is a frequent etiology of stroke in the South Asian population. There is a need for widely available screening tools to identify patients that are at high risk of stroke due to ICAD for aggressive risk management. This study describes the experience of using the transcranial Doppler (TCD) as a screening tool for this purpose at a tertiary care hospital in a developing country.

Methods: 86 Patients admitted with stroke due to ICAD underwent TCD for six arteries (Right and left …

Stroke Knowledge And Screening In A High Prevalence, Low Income Community, Maria Khan,, Hasan Rehman,, Ayeesha Kamran Kamal

Department of Medicine

No abstract provided.

Study Protocol: Asymptomatic Intracranial Atherosclerotic Disease In Pakistanis., Ayeesha Kamran Kamal, Farzin Majeed,, Omrana Pasha, Muhammad Islam, Iqbal Azam Syed, Muhammad Saleem Ilyas, Munawar Hussain, Kamran Masood, Bilal Ahmed, Sumaira Nazir,, Zafar Sajjad, Scott E. . Kasner

Department of Medicine

Background : Intracranial atherosclerotic disease (ICAD) is the most frequent subtype of ischemic stroke globally. It is important to describe the determinants of early ICAD as a strategy to prevent strokes from clinically evident and progressive ICAD. Our objective is to report the determinants of asymptomatic ICAD by linking the presence or absence of ICAD on magnetic resonance angiogram (MRA) with detailed risk assessment in asymptomatic adults.

Methods : This is an observational cross-sectional analytical study. We plan to recruit 200 adult participants from the radiology departments of two tertiary care centers of Karachi, Pakistan. The participants will first be …

Study Protocol: Validation And Adaptation Of Community-Worker-Administered Stroke Symptom Questionnaire In A Periurban Pakistani Community To Determine Disease Burden., Maria Khan, Ayeesha Kamran Kamal, Omrana Pasha, Muhammad Islam, Iqbal Azam Syed, Azam Virk, Alia Nasir, Anita Andani, Muhammad Jan, Anjum Akhtar, Junaid Abdul Razzak

Department of Medicine

Background : Stroke is the second leading cause of mortality and the leading cause of disability in the world today. The disease burden is on the rise in developing nations, but there is scarcity of data from these regions to inform policy decisions. Stroke burden can be determined by clinical diagnosis alone in the public health context and is a far more feasible way to assess disease status in low- to middle-income countries like Pakistan. We aim to translate and adapt a validated stroke symptom questionnaire, train community health workers in its administration, and verify it against assessment by two …

Can Trained Field Community Workers Identify Stroke Using A Stroke Symptom Questionnaire As Well As Neurologists? Adaptation And Validation Of A Community Worker Administered Stroke Symptom Questionnaire In A Peri-Urban Pakistani Community., Maria Khan,, Ayeesha Kamran Kamal, Muhammad S. Ilyas, Muhammad Islam, Iqbal Azam Syed, Azam Virk,, Alia Nasir, Hasan Rehman,, Anita Arif,, Muhammad Jan,, Anjum Akhtar,, Minaz Mawani, Junaid Abdul Razzak,, Omrana Pasha

Department of Medicine

Background: Stroke is a leading cause of morbidity and mortality worldwide. There is a paucity of data from South Asia where stroke is highly prevalent. Validated tools administrable by Community Health Workers (CHWs) are required to identify stroke in the community in a resource strapped region such as this.

Methods: The study was conducted in a transitional slum in Karachi, Pakistan. Questionnaire for Verifying Stroke-Free Status (QVSFS) was adapted and translated into Urdu. Two CHWs, trained by a neurologist, selected 322 community dwelling subjects using purposive sampling. Each CHW collected data independently which was validated by a vascular neurologist who …