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The interest towards traditional medicine is growing in easter asia and europe due to recent migration trends.

Stroke carries a poor prognosis for death and disability.  The international, multicenter, randomized, placebo-controlled, double-blind CHIMES trial is currently testing the hypothesis that a 3-month course of the traditional Chinese medicine MLC601 (NeuroAiD) is superior to placebo in reducing neurological deficit and improving functional outcome after acute ischemic stroke in patients receiving standard stroke care. On Cerebrovascular diseases the main paper description of the study design a population.

maputo

The burden of stroke is increasing in developing countries that struggle to manage it efficiently. A gorup od Portuguese doctors  identified determinants of early case-fatality among stroke patients in Maputo, Mozambique, to assess the impact of in-hospital complications. Paper published on Int J of Stroke official journal of the WSO. On the same issue a paper on low cost lysis perspective with streptokinase.

air pollution from mumbai to nairobi, a study confirms that air pollution peaks may contribute to increase the risk of hospitalization for stroke and particulate matter seems to be a significant risk factor, especially for lacunar stroke

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Seems more and more evident that  levels of air pollution considered safe by health care authorities such as WHO can contribute to higher rates of cognitive decline, stroke, and heart attack, according to many paper recently published.

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Concentrating on the modern era, ‘War and Medicine’ are considered in the constant evolving relationship between warfare and medicine, beginning with the disasters of the Crimean War and continuing through to today’s conflicts in Afghanistan and Iraq.

This CT scan shows a clear skull fracture due to “arm blanche” beating (see above).

The young (37y old) Bangladesh citizen was working in Tripolis with other houndreds) and attacked during the 2011 summer revolution. Admitted in a local medical centre slowly recovered from a non commotive head trauma. Succeding to cross the Sicily channel on a boat was rescued by Italian Coastal guards. In January while admitted in refugee camp in central Italy suffered of an ischemic stroke (see down).

A 50-year-old Nigerian man was admitted for generalized non febrile seizures. Two weeks before his GP prescribed antimalaric prophilaxis with clorochine for a planned trip in his home country. He suffered of a minor stroke 2 years before with no residual disability. He had also history of arterial hypertension treated with ace inhibitors and aspirin. At admission he was treated with lorazepam i.v. for a second generalized crisis at admission, and started carbamazepine 1000 per day. No other critical events were found during in hospital staying. A CT scan demonstrated the known subcortical right hemispheric hypodensity with no sulcal effacement or swelling features. Three months later carbamazepine was gradually intterrupted. After few months a new trip to Lagos was planned and chosen an antimalaric prophilaxis with Proguanil/Atovaquone (Malarone). The drug was well tolerated and no side effects were detected.

Take home message:
while choosing antimalaric prophilaxis a medical history of stroke and TIA may encourage the use of non epileptogenic drugs.

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