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Neurology India, Vol. 54, No. 4, October-December, 2006, pp. 444 Letter To Editor Stroke awareness program: The necessary facts for a successful campaign Pati Sandipan, Nambron R SHO, Department of Neurology, University Hospital North Staffordshire Code Number: ni06152 Sir We read with interest the study published by Pandian et al ,[1] which is a hospital-based prospective study in Northwest India, evaluating the knowledge of stroke among stroke patients. This is an important study as it will help us to identify the extent and nature of an effective educational program needed for urban and semi-rural parts of India. Based on this study we would like to draw attention to certain aspects: 1) Seventy-three per cent of participants in the study were not able to recognize the symptom although 62% of them had the knowledge of at least one warning symptom. Furthermore, 83% of them were having higher education and lived in urban area. This is a disturbing fact as it signifies that knowledge of symptom and identifying them during onset are two different issues. Stroke can present in many ways and it is important that we reinforce the link between different presentations of stroke and its diagnosis, in educational programs. Higher education improves knowledge about the disease but one's perception towards it may still be different and doctors need to explore that fact. Regardless of the manner in which stroke prevention information is communicated to patients, it is important for providers to submit feedback regarding what the patient actually understands and believes.[2] 2) The study did not specify whether the present stroke patients had any previous history of cerebrovascular accident or suspected TIA as in that case the knowledge of the subjects about the disease will be better. 3) Further, we gather from the study that 27% of patients were able to self-recognize stroke symptoms and 38% of patients arrived at the hospital early, within six hours. However, the study does not attempt to correlate these two data to specify how many among the 27% arrived early at hospital. This would be interesting as it would reveal whether all patients who recognized stroke symptoms were able to interpret the symptom as "emergency" and sought appropriate help immediately. Studies have shown that even after self-recognition of stroke symptoms, patients have responded late as they interpreted their symptoms as "not serious".[3] For prompt treatment and prevention of stroke effective educational campaigns are necessary. While designing these programs it should be recognized that patients often fail to identify and misinterpret stroke symptoms and this is independent of their educational status. References
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