Date: {{$ActivityAssignDate}}

Dear Dr. {{ $doctorName }},

Subject: A survey to assess practice patterns & treatment choices of neuroprotectants in the management of acute stroke

Each year, about 22 million people worldwide suffer a stroke. Stroke is a global health-care problem that causes a substantial burden of disease and remains one of the most devastating public health problems, often resulting in death or severe physical impairment and disability. According to the Global Burden of Disease Study 2010 in the last decade stroke became the third-most-common global cause of disability-adjusted life years (DALYs), second only to ischemic heart disease. Increase in vascular risk factors—in particular, high blood pressure, tobacco smoking, alcohol, and poor diets—appears to be responsible for this increase.

Currently, intravenous fibrinolysis can be administered safely within the first 4.5 h following stroke onset; and even as late as 6 h when an arterial occlusion is demonstrated with presence of potentially salvageable tissue (ischemic penumbra). In these late cases, the results of fibrinolysis treatment are similar to those of earlier windows in terms of arterial recanalization, functional recovery and frequency of hemorrhagic transformation. Intravenous thrombolysis can be reinforced with ultrasound-enhanced treatment or sonothrombolysis and ultrasound plus microbubbles.

Ischemic neuroprotection (brain protection) may be defined as any strategy, or combination of strategies, that antagonizes, interrupts, or slows down the sequence of injurious biochemical and molecular events that, if left unchecked, eventually result in irreversible ischemic injury. Neuroprotection attempts to limit the brain damage produced by ischemia.

Citicoline, or CDP-choline, a drug that combines neurovascular protection and repair effects, has been used to treat acute ischemic stroke and other neurological disorders, with an excellent safety profile. In 2002, a formal meta-analysis of trials of CDP-choline in acute and subacute stroke suggested a beneficial and substantial treatment effect, with absolute reductions of 10%-12% in the rates of long-term death and disability

This survey is conducted to assess practice patterns & treatment choices of neuroprotectants in the management of acute stroke.

As you will be spending some extra time to give your feedback on the questionnaire based on your clinical experience, we offer to pay you by cheque a professional fee of Rs {{$contractAmount}}, on receiving the completed Survey Questionnaire Form from you.

We trust you and we are partners in promoting safe and effective drug therapy. In that spirit we hope you will consent to participate in this study. If you do, please sign and return the enclosed reply along with your visiting card for accuracy of records.