Dr. Ajaya N Jha
Chairmannstitute of Neurosciences
What is Medanta secondary stroke prevention clinic (SPC)?
Medanta secondary SPC will take care of the patients who have already suffered any kind of above mentioned strokes and efforts will be directed to prevent them from having any further strokes. It will also adopt strategies to reduce the burden of the family in dealing with their member with stroke.
Specialized consultations offered:
Comprehensive assessment of the risk factors of stroke and specialists consultations will be offered in the clinic under the guidance of:
Who will take care of clinical assessment, management of Hypertension, Dyslipidaemia and formulating long term treatment plan and addressing a particular concern with regards to specific stroke subtype.
To help in management of Diabetes.
Evaluating cardiac disorders causing stroke viz. poor cardiac function, clots in the heart and cardiac rhythm disorders especially Atrial Fibrillation.
Addressing the interventional aspects of stroke prevention viz. Carotid artery stenting for carotid artery stenosis in the neck, endovascular management of Aneurysms, Arterio-venous malformations and fistulas.
Addressing dietary aspects of Diabetes, Obesity and high cholesterol.
To monitor BP and sugar levels and conducting patient educating programs for lifestyle modifications to prevent future strokes.
Will address the various components of rehabilitation after a stroke. This includes comprehensive assessment by the team of Speech therapist, Physiotherapist and Occupational therapist. The rehabilitation program directed towards quitting smoking, alcohol and drug abuse.
Managing the level of anticoagulation in the therapeutic range with drugs like warfarin, dosage adjustment and dietary modification. Patient teaching modules for preventing complications associated with anticoagulation.
To address the concerns of memory, behaviour and personality that affect patients with stroke.
To address the post stroke depression and educate the family to adopt steps to make it easier for the patient transition into the family and society.
Why Medanta stroke prevention clinic?
At Medanta Secondary SPC, every effort will be directed by a comprehensive team of medical professionals, interventionists, rehabilitation professionals, nurse practitioners and nutritionist towards identifying the risk factors and addressing them with utmost clarity based on current international standards and recommended guidelines.
This team will also connect with the patient and family at the emotional level and address the needs of the patient, family and society to improve the functional outcome in the long run. It will not only help the patient recover, but will also prevent them from having any further cerebrovascular event.
The clinic will also provide the opportunity for patient, patient interaction and family, family interaction and forming Medanta stroke support group in the long run.
Some preventive measures
Knowing your stroke risk factors, following your doctor's recommendations and adopting a healthy lifestyle are the best steps you can take to prevent a stroke. If you've had a stroke or a TIA, these measures may help you avoid having another stroke. Many stroke prevention strategies are the same as strategies to prevent heart disease. In general, healthy lifestyle recommendations include:
One of the most important things you can do to reduce your stroke risk is to keep your blood pressure under control. If you've had a stroke, lowering your blood pressure can help prevent a subsequent transient ischemic attack or stroke. Exercising, managing stress, maintaining a healthy weight and limiting the amount of sodium and alcohol you eat and drink are all ways to keep high blood pressure in check. Adding more potassium to your diet also may help. In addition to recommending lifestyle changes, your doctor may prescribe medications to treat high blood pressure.
Eating less cholesterol and fat, especially saturated fat and Trans fats, may reduce the plaque in your arteries. If you can't control your cholesterol through dietary changes alone, your doctor may prescribe a cholesterol-lowering medication.
Smoking raises the risk of stroke for both the smoker and non-smokers exposed to second hand smoke. Quitting tobacco use reduces your risk of stroke.
You can manage diabetes with diet, exercise, weight control and medication.
Being overweight contributes to other stroke risk factors, such as high blood pressure, cardiovascular disease and diabetes. Weight loss of as little as 10 pounds may lower your blood pressure and improve your cholesterol levels.
A diet containing five or more daily servings of fruits or vegetables may reduce your risk of stroke.
Aerobic exercise reduces your risk of stroke in many ways. Exercise can lower your blood pressure, increase your level of high-density lipoprotein (HDL or "good") cholesterol and improve the overall health of your blood vessels and heart. It also helps you lose weight, control diabetes and reduce stress. Gradually work up to 30 minutes of activity - such as walking, jogging, swimming or bicycling - on most, if not all, days of the week.
Alcohol can be both a risk factor and a preventive measure for stroke. Heavy alcohol consumption increases your risk of high blood pressure, ischemic strokes and haemorrhagic strokes. However, drinking small to moderate amounts of alcohol may help prevent ischemic stroke and decrease your blood's clotting tendency.
Your doctor may recommend an overnight oxygen assessment to screen for obstructive sleep apnoea (OSA). If OSA is detected, it may be treated by giving you oxygen at night or having you wear a small device in your mouth.
Certain street drugs, such as cocaine and methamphetamines, are established risk factors for a TIA or a stroke. Cocaine reduces blood flow and can cause narrowing of arteries.
If you've had an ischemic stroke or TIA, your doctor may recommend medications to help reduce your risk of having another stroke. These include:
Platelets are cells in your blood that initiate clots. Anti-platelet drugs make these cells less sticky and less likely to clot. The most frequently used anti-platelet medication is aspirin. Your doctor can help you determine the right dose of aspirin for you.
Your doctor may also consider prescribing Aggrenox, a combination of low-dose aspirin and the anti-platelet drug dipyridamole, to reduce the risk of blood clotting. If aspirin doesn't prevent your TIA or stroke or if you can't take aspirin, your doctor may instead prescribe an anti-platelet drug such as clopidogrel (Plavix).
These drugs, which include heparin and warfarin (Coumadin), reduce blood clotting. Heparin is fast acting and may be used over a short period of time in the hospital. Slower acting warfarin may be used over a longer term.
Warfarin is a powerful blood-thinning drug, so you'll need to take it exactly as directed and watch for side effects. Your doctor may prescribe these drugs if you have certain blood-clotting disorders, certain arterial abnormalities, an abnormal heart rhythm or other heart problems. Other newer blood thinners may be used if your TIA or stroke was caused by an abnormal heart rhythm.
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