Stroke and approach of unani treatment
Stroke is a major public health problems leading cause of death worldwide. 15 million people had stroke annually, of which 5 million die, and 5 million left permanently disabled which causes a tremendous burden on family and community (WHO). Stroke is defined as a sudden focal neurological syndrome, specifically the type caused by cerebrovascular disease Stroke is defined as a sudden focal neurological syndrome, specifically the type caused by cerebrovascular disease The WHO has defined stroke as rapidly developing clinical signs of focal (at times global) disturbance of cerebral function, lasting more than 24 hours or leading to death with no apparent cause other than that of vascular origin.
Types of stroke with causes
Ischemic stroke results from the following causes:
A clot (embolus) forms in a part of the body other than the brain, travels through blood vessels, and becomes wedged in a brain artery.
A blood clot (thrombus) forms in a brain artery and stays attached to the artery wall until it grows large enough to block blood flow.
Hemorrhagic stroke results from the following causes
A bleeding aneurysm. A weak or thin spot on an artery wall that, over time, has stretched or ballooned out under pressure from blood flow. The wall ruptures and blood spills into the space surrounding brain cells.
Artery walls lose their elasticity and become brittle and thin, prone to cracking.
Arteriovenous malformation (AVM). A tangle of defective blood vessels and capillaries within the brain that have thin walls that can rupture.
Determinants/risk factors:
Risk factors that cannot be changed:
Elderly age.
Male Sex womans after menopause.
Family history.
Heart attack.
A history of migraine headaches.
A prior stroke.
Sickle cell anemia.
Berry aneurysms.
Risk factors that can be changed with medical treatment
High blood pressure.
High blood cholesterol levels.
TIAs, or mini-strokes.
Cardiovascular disease.
Diabetes.
Blood clotting disorders.
Sleep apnea.
Risk factors that can change through lifestyle modifications
Cigarette smoking.
Birth control pills.
Drinking large amounts of alcohol.
Obesity.
Lack of exercise.
Poor diet.
Stress.
Alamaat (Clinical features):
The signs and symptoms may vary from one person to another depending on the type of stroke, the part of the brain affected and the extent of damage. But they all tend to begin suddenly. The most common warning signs of a stroke are:
Numbness in your arm, leg or face, especially on one side of the body
Trouble walking, loss of balance or coordination
Trouble speaking and understanding others who are speaking
To help recognize the onset of a stroke, remember the F.AST acronym.
Face: Ask the person to smile and check if one side of their face droops.
Arms: Ask the person to raise both arms and check if either of their arms drift downward.
Speech: Ask the person to repeat a simple phrase and check if their speech is slurry or strange.
Time: Every minute counts. If you observe even one of these signs, call an ambulance immediately. Moreover, some treatments for stroke work only if administered within 3 to 4 hours of the onset of symptoms.
Other possible signs and symptoms include
Trouble seeing in one or both eyes
Sudden severe headache with no known cause
Dizziness
Complete paralysis
Line of treatment/ principles of treatment
Usoole Ilaj (Line of Management/Principles of Treatment)
A) The treatment of disease in Unani system of medicine is carried out by using one of fourth modes or with combination viz.
1. Ilaj bid Dawa (pharmacotherapy): Mufrada Advia (Single Drugs) b) Murakkab Advia (Compound Drugs),
2. Ilaj bit Tadbeer (Regimental therapy)
3. Ilaj bit taghzia ( Dieto-therapy)
4. Ilaj bil Yad (surgical therapy)
B) Correction of Su-i-mizaj
C) Removal of predisposing cause
Tashkhees (Diagnosis)
The diagnosis of disease due to Sue mizaj can be made through various points doctor will perform a detailed neurological exam.
Ilaj (Treatment)
Preventives Therapeutic approaches for Stroke in Unani medicine can be broadly classified into three or four main categories. The goal of Unani medicine is to prevent a stroke treatment the underlying cause.
Ilaj bil Dawa (pharmacotherapy): Single and compound formulations for the prevention of Stroke mentioned in Unani treatment.
Recommended Dawa-e Mufrada( Singe drugs):
Garlic (Allium sativum). Garlic helps prevent ischemic stroke in three ways:
Garlic reduces blood pressure
Garlic lowers cholesterol levels
Garlic is an anticoagulant.
Ginkgo (Ginkgo biloba). Ginkgo biloba is used both to prevent and treat stroke. It helps to prevent blood clots from developing and increases blood flow to the brain. This herb has also been shown to inhibit free-radical formation. Raw herb dosage- 300mg daily.
Ginseng (Panax ginseng). Asian ginseng may decrease endothelial cell dysfunction. Endothelial cells line the inside of blood vessels. When these cells are disturbed, it may lead to a heart attack or stroke. The potential for ginseng to quiet down the blood vessels may prove to be protective against these conditions.
Turmeric (Curcuma longa). Early studies suggest that turmeric may prevent heart attack or stroke. Many studies show that the compound curcumin, which is found in turmeric, helps prevent the formation of blood clots.
Coconut water (or coconut juice): it helps to control high blood pressure and gives protection against stroke.
Ginger (Zingiber officinale): Ginger is a cardiac tonic, as it decreases cholesterol and helps poor circulation. Ginger prevents blood from clotting excessively. In one Indian study, taking about two teaspoons of ginger a day for a week neutralized the blood-clotting effect of 100 grams of butter.
Recommended Dawa-e Murrakaba( Compound drugs):
a) Khamira Marwareed should be taken orally in dose of 3-5 grams (Adult) or 1-2 grams (Children) according to age, weight, health it may be taken with Arq Gaozaban 125ml, or water.
b) Tablet Alisa/Garlitab
Ilaj bit taghzia ( Dieto-therapy) or Dietary modifications:
Follow a Heart Brain-Healthy Diet
Avoid refined cereals.
Give more weightage to fibrous foods.
Avoid fatty foods.
Avoid junk, fast and sugary foods.
Restrict red meat and liquor.
Drink Wisely
Eating plenty of foods rich in vitamin E, along with other antioxidants like vitamin C, selenium, and carotenoids, reduces your risk for stroke.
Ilaj bit Tadbeer (Regimental therapy)/lifestyle modifications:
Exercise a Little Everyday
Avoid sedentary lifestyle Maintain Healthy Body Weight
Stress, strain and anxiety should be avoided or Control Your Stress Level
Get Enough Quality Sleep
Get Regular Health Screenings
Manage Health Problems
Prognosis and complications:
There are many possible complications associated with stroke, including
Seizures
Paralysis
Cognitive (thinking) deficits
Speech problems
Emotional difficulties
Daily living problems
Pain
Memory deficits
Many people begin to recover from a stroke almost immediately after it has occurred.
The recovery process is most rapid in the first 3 months after a stroke, but improvement will continue for 6 months to a year. Many stroke survivors even report that they slowly continue to regain function for years after their stroke. It is very important not to lose hope.
The writer can be reached at: dr.jalalshorna.bd@gmail.com
