The "rejuvenation" of serious diagnoses such as stroke and heart attack in recent times is a serious issue that concerns both doctors and society, troubling the entire world. The paradox is that while the capabilities of medicine are expanding, and early diagnostic and treatment methods are developing, on the other hand, problems awaiting resolution persist in the system and in patient behavior.
These issues were also extensively discussed yesterday at the International Multidisciplinary Scientific-Practical Conference on Stroke and held at the Baku Health Center. After presentations by both foreign and local experts, we reached a conclusion. In fact, this is a point we all know. Before all doctors, a person must be their own doctor.
To be more specific, every person must guard their health and take timely preventive measures regarding emerging issues.
The executive director of the Baku Health Center, Azerbaijani scientist, general surgeon, Asiman Hasanov, gave a statement to Modern.az regarding the observation of diseases such as stroke and heart attack at younger ages and their causes.
A. Hasanov confirmed that one of the most serious diseases requiring urgent medical intervention and service today is stroke:
“Stroke ranks among the leading cardiovascular diseases in terms of mortality and complication rates after myocardial infarction. At the same time, the number of permanent neurological disorders and complications arising after stroke is also quite high. Stroke primarily has hemorrhagic and ischemic types. A brief explanation of these diseases for society can be given as follows.
Hemorrhagic stroke is characterized by the leakage of blood into brain tissues as a result of damage or rupture of a blood vessel wall. This accounts for approximately 15-20 percent of stroke cases. One of the most widespread forms is ischemic stroke. In this case, the blood supply and nutrition of the brain tissue in that area are disrupted due to the occlusion or thrombosis of medium or small-caliber vessels supplying the brain. Ischemia develops, ultimately leading to partial infarction of the brain tissue. One of the most challenging treatment methods and directions in the fight against stroke worldwide is the establishment of stroke centers. Precisely for this reason, stroke centers in developed countries are strategically planned to ensure timely delivery of patients to hospitals”.
Our interlocutor noted that public awareness is one of the most important stages of this process:
“Approaches such as “it's nothing” or “let them rest a bit” are unacceptable when stroke-like symptoms appear. In such cases, emergency medical services should be called immediately, or the patient should be transported to the nearest hospital. I would like to emphasize once again that conducting awareness-raising activities in this direction constitutes a priority. The diagnosis and treatment of stroke are not the work of a single doctor or department. A multidisciplinary team is involved in the process, including emergency medical services, admission and emergency departments, radiological diagnostics, neurology, resuscitation, invasive radiology, and subsequent rehabilitation stages.
In the initial stage, the type of stroke must be accurately determined. In cases of ischemic stroke, thrombolysis or thrombectomy may be applied. In hemorrhagic strokes, dynamic observation, and if necessary, trepanation and hematoma evacuation are performed. The effectiveness of treatment directly depends on the localization, diameter, and size of the stroke, as well as the time elapsed since the onset of the process, provided these measures are taken promptly”.
According to the CEO, post-stroke mortality rates have been significantly reduced in developed countries:
“In addition to mortality, patients may experience coma, bedsores, certain physiological swallowing disorders, urinary-excretory problems, and respiratory difficulties after a stroke. All these conditions sharply reduce the patient's quality of life, impair their work capacity, and can lead to disability. Furthermore, they require the best care in a hospital or home setting. This increases bed occupancy in hospitals and creates an additional social and psychological burden for family members. Consequently, it leads to an increase in healthcare system costs.
Over the years of its operation, hundreds of stroke patients have applied to the Baku Health Center. Among them were those who applied on time and those who applied at a delayed stage. It must be unequivocally understood that in cases of delayed applications, the effectiveness of treatment decreases, and full recovery rates are also low.
Nevertheless, positive and effective results have also been achieved in many patients who have suffered either ischemic or hemorrhagic stroke. In several cases, patients have fully recovered without any residual functional impairments – speech, swallowing, memory, muscle, and nerve deficits – returning to their homes, work, and normal lives. In this regard, the existence of stroke centers is kept under special attention by the World Health Organization and international bodies as one of the quality indicators of the healthcare system”.
A. Hasanov also touched upon the level of early diagnosis and prevention of stroke and heart attack in the context of modern medicine's capabilities:
“Stroke and heart attack are both events related to the damage or blockage of blood vessels supplying an organ. In hemorrhagic stroke, blood leaks out of the vessel and into brain tissues as a result of damage to the vessel wall. The diagnostic treatment of all these is an important issue. In most developing countries, cardiological centers usually operate more initially. In our country, cardiological services – cardiac surgery centers, diagnostic centers, and cardiologists with skills to work with the latest technological equipment – have developed more extensively. However, the current situation in organizing stroke-related services is not yet at the desired level. The main reason for this is that stroke requires a multidisciplinary and coordinated approach. It is imperative that emergency medical services, hospital admission and emergency departments, diagnostic departments, neurology, stroke centers, invasive radiology, intensive care units, and post-treatment rehabilitation departments work collegially and in coordination with each other. Certain activations regarding this issue have also been observed in our country in recent years”.
Asiman Hasanov emphasized that significant progress has been achieved in the healthcare sector under the leadership of the country's President, stating that this area is constantly in focus:
“In Azerbaijan, as in all other sectors, significant development in the healthcare system is evident. This manifests itself in terms of increasing technical capabilities, improving healthcare services, and strengthening human resources.
As an integral part of this policy, a Stroke Center was established at the Baku Health Center in 2021, at the initiative of the Minister of Health. Within a short period, the material and technical base of the center was formed. The staff, doctors, and paramedical personnel underwent practical training in Turkey and European countries, and also participated in scientific conferences.
Furthermore, these efforts are actively being carried out at the Baku Health Center with the consultancy of our compatriot abroad, Professor Masud Ashina of the University of Denmark, and Zaza Katsarava, the founder of the stroke project in Georgia, alongside him.
Serious steps have been intensified regarding the improvement of the material and technical base at the initiative of the Ministry of Health. Important work has also been done towards forming the center's operating principles and legal framework.
One of the main issues is the work carried out within the framework of discussions between the Ministry of Health and the State Agency for Compulsory Health Insurance towards forming package service bundles for the purpose of organizing medical services that meet international standards. We hope that in the near future, citizens will also be able to benefit from these services through compulsory health insurance. Furthermore, I believe that the establishment of stroke centers across the country and their coordinated operation with each other is very important. The management of these centers from a single database and their operation based on unified protocols will enable the provision of higher quality and more efficient services”.
Regarding the importance of the International Multidisciplinary Scientific-Practical Conference on Stroke and held at the Baku Health Center, our interviewee stated that the issue should be viewed from several aspects:
“Firstly, such meetings are very important in terms of sharing experiences, learning about new inventions and approaches at a global level, and mutual exchange. The training of young specialists and the educational role that the issues on the conference agenda play in society are also indicators of the event's significance.
Usually, new ideas and proposals also emerge after such conferences”.
