The role of a novel digital microcapillary instrument in detecting blood and plasma hyperviscosity.

AIM: to test the precision and accuracy of a Digital Microcapillary instrument in measuring blood and plasma viscosity. METHODS: about 40 blood samples were drawn for precision test. The samples were obtained from patients admitted for Medical Check-Up at CiptoMangunkusumo Hospital (RSCM) in December 2011.Accuracy test was evaluated using cross-sectional design and involving 135 patients with acute ischemic stroke. The patients underwent either inpatients or outpatients care at Department of Clinical Pathology, Department of Neurology,and Emergency Unit of RSCM, Fatmawati Hospital Jakarta, Prikasih Hospital Jakarta, and Bhakti Yuda Hospital Depok. The precision test was evaluated by calculating the coefficient of variation (CV), interrater variability of Cronbach Alpha, and reliability coefficient of Bland Altman. The accuracy of the test was evaluated with a diagnostic test. The gold standard used for these tests was Brookfield LV-DV III viscometer. RESULTS: the results of precision test were: CV = 0.04; interrater variability of blood and plasma viscosity = 0.94 and 0.82, respectively; the Bland Altman mean difference = -0.19. The results of accuracy test were: sensitivity of blood and plasma viscosity measurement were 88.9% and 100%, respectively; specificity of blood and plasma viscosity measurement were 88.9% and 84%, respectively. CONCLUSION: the digital microcapillary has high sensitivity and specificity; therefore the instrument can be considered to be used as screening test tool to measure blood and plasma viscosity.

Alternative therapies for stroke treatment in Asia.

Patients seek alternative therapies for stroke in Asia due to dissatisfaction with poststroke recovery. Most alternative therapies are of unproven benefit in rehabilitation. Well-conducted trials are needed to better define the role of alternative therapies in the process of poststroke recovery; the CHInese Medicine Neuroaid Efficacy on Stroke recovery is ongoing. However, further studies, better health education and rehabilitation services and centers are also required.

Management of cholesterol to reduce the burden of stroke in Asia: consensus statement.

Stroke is a major cause of morbidity and mortality in Asia, and its pattern is changing. The incidence of haemorrhagic stroke is declining while the incidence of ischaemic stroke caused by large artery atherothromboembolism is increasing secondary to an increase in the prevalence of hypercholesterolaemia. The Working Group on Stroke and Lipids Management in Asia Consensus Panel assembled leading experts from the region to reach a consensus on how to address this challenge. The group discussed the observational epidemiology of the relationship between cholesterol and risk of stroke, the clinical trial evidence base for cholesterol-lowering for stroke prevention, and issues specific to stroke and lipid management for Asian doctors and patients. Stroke guidelines from many of the Asian countries have recently recommended consideration of statins for recurrent stroke prevention in patients with previous ischaemic stroke or transient ischaemic attack. However, because these recommendations have yet to be implemented widely, there is a need to educate Asian physicians and patients about the importance of adequate control of hypercholesterolaemia. Further trials of statins in Asian patients are also needed, particularly in those with intracranial stenosis.