Roll Back Stroke: The Way Forward for Physicians and Patients

The 6-lettered word "Stroke" is an ancient disease, likened Biblicallyto "666" in Revelation 13 verse 18. Globally, it is the commonestcause of acquired long-term disability. While its incidence has beendeclining in high-, low/middle-income countries (LMICs) have witnessed an increase. This increase is driven byepidemiologic-transition/modernizatio n-complex, healthcaredisparities, and increasing prevalence of vascular risk-factors. Despitethe disproportionate burden of stroke in LMICs, these countrieshave the lowest rate of access to acute reperfusion-interventions leadingto greater stroke-related morbidity /mortality. Effective primordial,primary, secondary, and quaternary prevention-strategies coordinated at all levels of care are needed to reduce stroke incidenceand poor outcomes. The World Stroke Organization (WSO) hasproposed achieving global primary prevention through 1) Population-wide approach to limiting stroke risk-factors exposure, 2) App-basedmotivational population-wide approach to mitigating stroke risk-fa cto rs, 3 ) u se of lo w-co st co mbi n at io n /po ly- p il l to tre at hypertension/dyslipidemia and 4) addressing behavioural risk-factorsthrough interventions by community health-workers.The need to set-up stroke-units, post-hospitalisation rehabilitation-centres, stroke-registers/registries, stroke-clubs, and encouragecommunity health-education, must be emphasised for optimal care inLMIC.13 Community Health Empowerment (CHE) withthe AcronymBE FAST / STRoke as warning signs of stroke must be emphasised(B: Balance-loss; E: Eye vision-loss; F: Facial Asymmetry; A: Armweakness; S: Speech difficulties; T: Time is brain; Or first 3-lettersof STRoke ­ Can Patient Smile? Talk? Or Raise-arm?). Strokehemorheology/blood-flow and treatment involve 3Ps' of pathogenicprinciples/strategies (Passenger, Passage, Power). Its complicationsinclude the 10D's: Death, Disability, Depression, Dementia, Delirium,Dysphagia, Dehydration, Deep-Venous Thrombosis, Decubitus-ulcers, Dysphasia, Seizures.

Detection of Hepatitis E Virus RNA in Chicken Droppings and Pig Feces in Ogun and Lagos States, South Western, Nigeria.

Background/Aim: Hepatitis E virus (HEV) is a major cause of sporadic and epidemic cases of enteric non-A non-B hepatitis in humans. It estimated that 14 million symptomatic cases of HEV infection, with 300,000 deaths and 5,200 stillbirths occur annually worldwide, with developing countries in the Indian subcontinent, Southeast and Central Asia, the Middle East, and northern and western parts of Africa being the most affected. This study was carried out to detect the presence of HEV RNA in commercial chicken and pigs in some parts of Ogun and Lagos states, South Western, Nigeria. Materials and Methods: A total of 550 fecal samples were collected from chicken and pigs in both states. HEV RNA was extracted from the fecal samples and amplified by nested-PCR. Gel electrophoresis was used to evaluate the nested-PCR products. Results: HEV RNA was detected in 10(1.8%) of the 550 samples. This comprised of 5(6.7%) positive from chicken droppings and 5(1.7%) from pigs feces. The result also showed that 3(4.3%) of chicken droppings collected from Ogun state were positive while there was no positive cases recorded in pig feces. Similarly 2(40%) of chicken droppings collected in Lagos state were positive while 5(1.7%) of pig feces were also positive. Conclusion: The detection of HEV among commercially available chicken and pigs poses a great economic danger to poultry farmers and a tremendous public health risk to consumers of pork meat in Nigeria.