Prevalence of risk factors of ischemic stroke in a local Pakistani population. High-density lipoproteins, an emerging risk factor.

OBJECTIVE: To ascertain the prevalence of risk factors for ischemic stroke in Pakistani patients at Shifa International Hospital (SIH), Islamabad, Pakistan. METHODS: This retrospective cross-sectional study included patients of either gender, with no age limit admitted to the Department of Neurology at Shifa International Hospital, Islamabad, Pakistan, with the diagnosis of stroke verified by brain CT scan during a period of 2 years from January 2007 to December 2009. The data were analyzed by grouping our patients according to their age based on the frequency of risk factors. Group 1; 25-55 years (23.8%), group 2; 56-71 years (43.4%), and group 3; 72-103 years (32.7%). RESULTS: A total of 418 patients were included in the study; 137 patients were excluded due to incomplete information. The data from the remaining 281 were analyzed. The mean age of the population was 65 ± 0.8 years, and the male to female ratio was 1.30:1. The most frequent risk factors included hypertension 86.8% followed by diabetes mellitus 59.8%, dyslipidemia 59.1%, and smoking 18.1%. The highest frequency of 4 risk factors was present in the age group 56-71. Gender distribution of risk factors showed that hypertension and dyslipidemia are major risk factors in group 1. Abnormal high-density lipoproteins (HDL) emerged as the major lipid among 3 groups, especially in group 1, which predisposed to stroke. CONCLUSION: A decrease in HDL and control of blood pressure is important to reduce the risk of stroke especially in early age (namely, ≥ 25 years) and could become an increasingly useful tool to identify patients at a high risk of stroke.

Facebook as a Learning Tool: Perception of Stroke Unit Nurses in a Tertiary Care Hospital in Islamabad.

Objective To obtain the perception of nurses on the use of Facebook as a learning tool. Materials & methods We conducted a pilot observational study in which data were collected through a detailed course evaluation and feedback survey questionnaire. Twelve stroke care nurses were enrolled in a stroke course specifically designed to provide participants with information and knowledge about stroke unit nursing care. Firstly, a closed Facebook group consisting of the participants and facilitators was created. An activity in accordance with the course content was posted in the group daily. Before the start of the course, a pre-course test was conducted. The four-week course culminated in a graded written examination. Its results were compared with the pre-course test. A detailed feedback questionnaire was given to the participants at the end of the course, which was specifically designed to elicit perceptions of nurses about the use of Facebook as a learning tool. Results Of the 12 enrolled nurses, 10 completed the certification and the post-course feedback evaluation. Facebook was used by all participants as a platform to view and study the course contents. The timing of the course activities was rated "very good" by three and 'good' by six of 10 participants. However, one of the major issues faced by five participants was problematic internet access. The overall rating of the course was "very good" by five participants, "good" by three, and "satisfactory" by two of 10 participants. The post-course test showed that nine of 10 candidates passed with scores >70% compared to only two candidates getting scores >50% in the pre-course test. Conclusion Facebook use enabled participants to study the material when their schedule permitted them. The online teaching and facilitation were ideal for our full-time stroke unit nurses as reflected by their improved post-course test results.