Sex Differences in Prehospital Stroke Medicine (SESAME): A Systematic Review and Meta-Analysis.

Background: Several studies have evaluated sex discrepancies in the prehospital management of patients with acute stroke. This systematic review and meta-analysis aims to summarize reported knowledge about sex differences in dispatch center and emergency medical service management. It proposes a roadmap of questions and the next necessary steps to ensure equitable prehospital stroke care.

Predictors of glycemic control, quality of life and diabetes self-management of patients with diabetes mellitus at a tertiary hospital in Ghana.

Background: The burden of diabetes mellitus (DM) in Sub-Saharan Africa is high and continues to increase. Effective DM management focuses on key goals such as glycemic control, prevention of complications and improvement of quality of life (QOL). This study therefore assessed predictors of glycemic control, QOL and diabetes self-management (DSM) of patients with DM in a tertiary hospital in Ghana.

A scoping review of the utilization of mobile stroke units in low and lower middle-income countries: current evidence, implications and future direction.

Background: Low and Lower-Middle-Income Countries (LMICs) have the highest stroke incidence, prevalence, and case fatality rates globally. Current evidence suggests Mobile Stroke Units (MSUs) outperform traditional Emergency Medicine Services (EMS) in time metrics, cost-effectiveness, and long-term outcomes. MSUs could potentially improve stroke outcomes in resource-constrained settings by addressing critical challenges related to prehospital delays, health-seeking behavior, and access to expertise.

Sonographically measured optic nerve sheath diameter as a predictor of stroke severity and outcome among Ghanaian acute stroke patients.

Background: Elevated intracranial pressure (ICP) is a veritable and potentially modifiable predictor of adverse stroke outcome. Sonographically measured optic nerve sheath diameter (ONSD), a non-invasive proxy for ICP, could potentially be utilized as an objective measure of severity and outcome among acute stroke patients.

Objective: To evaluate the relationship between admission ONSD, stroke severity, and functional outcomes among patients with acute stroke.

The Significance of the WHO/ISH Absolute Cardiovascular Risk Prediction Scores among Recent Stroke Survivors in Ghana-Insights from the PINGS2 multicenter study.

Background: The leading cause of stroke remains atherosclerotic cardiovascular disease. The World Health Organization/International Society of Hypertension risk score represents an effort to produce a risk assessment tool for atherosclerotic cardiovascular disease that is regionally specific. No previous work has described absolute cardiovascular risk scores among recent stroke survivors in West Africa via this tool.

An unusual case of crusted scabies in an immunocompetent adult: A case report.

Key Clinical Message: Although rare, crusted scabies can affect immunocompetent individuals with no identifiable risk factors. A high index of suspicion, regardless of an individual's immunological status or absence of traditional risk factors, should be maintained by health professionals to facilitate prompt referral to a dermatologist.

Abstract: Crusted scabies is an uncommon variant of human scabies characterized by extensive crusted and scaly hyperkeratotic papules, and plaques resulting from profound proliferation of mites in the skin.

Effect of a Cardiovascular Polypill on Poststroke Cognition Among Ghanaians: Secondary Analysis of a Randomized Clinical Trial.

Background: Poststroke cognitive impairment is prevalent worldwide, with no satisfactory preventative therapeutic strategies. We report on the effect of a cardiovascular polypill on cognitive performance among recent stroke survivors.

Methods And Results: The SMAART (Stroke Minimization through Additive Anti-atherosclerotic Agents in Routine Treatment) trial was a phase II randomized trial primarily assessing the polypill versus usual care for secondary prevention after a recent ischemic stroke.

Stroke occurrence by hypertension treatment status in Ghana and Nigeria: A case-control study.

Background: Hypertension is preeminent among the vascular risk factors for stroke occurrence. The wide gaps in awareness, detection, treatment, and control rates of hypertension are fueling an epidemic of stroke in sub-Saharan Africa.

Purpose: To quantify the contribution of untreated, treated but uncontrolled, and controlled hypertension to stroke occurrence in Ghana and Nigeria.

Epigenetics as a target to mitigate excess stroke risk in people of African ancestry: A scoping review.

Background: Globally, individuals of African ancestry have a relatively greater stroke preponderance compared to other racial/ethnic groups. The higher prevalence of traditional stroke risk factors in this population, however, only partially explains this longstanding disparity. Epigenetic signatures are transgenerational and could be a plausible therapeutic target to further bend the stroke disparities curve for people of African ancestry.

Deciphering the contextual barriers to mainstreaming the implementation of stroke thrombolysis in a Ghanaian hospital: Findings from the activate mixed-methods study.

Background: Each year, stroke-related death and disability claim over 143 million years of healthy life globally. Despite accounting for much of the global stroke burden, acute stroke care in Low-and-Middle-Income Countries remains suboptimal. Thrombolysis, an effective treatment option for stroke, is only received by a minority of stroke patients in these settings.

Participation by patients from low- and middle-income countries (LMICs) in trial evidence supporting secondary stroke prevention guideline recommendations.

Background: One out of every four strokes is a highly preventable recurrent stroke. However, while low-and-middle-income countries (LMICs) experience a disproportionate global burden of stroke, individuals in these regions seldomly participate in pivotal clinical trials, which form the basis for international expert consensus guideline recommendations.

Objective: To evaluate a contemporary and globally prominent expert consensus secondary stroke prevention guideline statement for the participation of clinical trial subjects recruited from LMICs in formulating key therapeutic recommendations.

Polypill Programs to Prevent Stroke and Cut Costs in Low Income Countries: Moving From Clinical Efficacy to Pragmatic Implementation.

Current projections are that the already overwhelming burden of strokes and atherosclerotic cardiovascular diseases in low- and middle-income countries (LMICs) will continue to rise over the coming decades as the prevalence of traditional vascular risk factors burgeon in these countries. Cardiovascular polypills containing combinations of antihypertensive(s), a statin, with or without aspirin or folic acid in the form of a single pill, represent a viable strategy for both primary and secondary prevention of atherosclerotic cardiovascular diseases in LMICs. Large multicenter trials in LMIC and high-income country (HIC) settings have now clearly demonstrated the beneficial effects of the cardiovascular polypill versus placebo (or usual care) in reducing primary stroke risk by 50%.

Atherosclerotic event risk and risk reduction therapies among Ghanaian hemorrhagic stroke survivors.

Background: Intracerebral hemorrhage (ICH) stroke constitute up to 40% of incident strokes in Africa. While ICH patients are at high risk for atherosclerotic events, the risk-benefit of anti-atherosclerotic therapies in this patient population is uncertain.

Purpose: To assess whether utility of statins and/or antithrombotic agents after surviving an ICH correlates with atherosclerotic risk of an observational cohort.

Factors Linked to Chronic Kidney Disease Among Stroke Survivors in Ghana.

Background: Chronic kidney disease (CKD) is associated with poor outcomes among stroke survivors. In Africa, where both stroke and CKD incidence rates are escalating, little, if anything, is known about the burden of CKD among stroke survivors.

Objective: To assess the frequency and factors associated with CKD among stroke survivors by primary stroke types.