title: The Karachi intracranial stenosis study (KISS) Protocol: an urban multicenter case-control investigation reporting the clinical, radiologic and biochemical associations of intracranial stenosis in Pakistan.
abstract: BACKGROUND
  Intracranial stenosis is the most common cause of stroke among Asians. It has a poor prognosis with a high rate of recurrence. No effective medical or surgical treatment modality has been developed for the treatment of stroke due to intracranial stenosis. We aim to identify risk factors and biomarkers for intracranial stenosis and to develop techniques such as use of transcranial doppler to help diagnose intracranial stenosis in a cost-effective manner.
  
  
  METHODS
  The Karachi Intracranial Stenosis Study (KISS) is a prospective, observational, case-control study to describe the clinical features and determine the risk factors of patients with stroke due to intracranial stenosis and compare them to those with stroke due to other etiologies as well as to unaffected individuals. We plan to recruit 200 patients with stroke due to intracranial stenosis and two control groups each of 150 matched individuals. The first set of controls will include patients with ischemic stroke that is due to other atherosclerotic mechanisms specifically lacunar and cardioembolic strokes. The second group will consist of stroke free individuals. Standardized interviews will be conducted to determine demographic, medical, social, and behavioral variables along with baseline medications. Mandatory procedures for inclusion in the study are clinical confirmation of stroke by a healthcare professional within 72 hours of onset, 12 lead electrocardiogram, and neuroimaging. In addition, lipid profile, serum glucose, creatinine and HbA1C will be measured in all participants. Ancillary tests will include carotid ultrasound, transcranial doppler and magnetic resonance or computed tomography angiogram to rule out concurrent carotid disease. Echocardiogram and other additional investigations will be performed at these centers at the discretion of the regional physicians.
  
  
  CONCLUSIONS
  The results of this study will help inform locally relevant clinical guidelines and effective public health and individual interventions.
authors: Stroke Service, Division of Neurology, Department of Medicine, Aga Khan University Hospital, Stadium Road, Karachi-74800, Pakistan. ayeesha.kamal@aku.edu
authors: Ayeesha Kamran
authors: AK
authors: Kamal
authors: Fawad
authors: F
authors: Taj
authors: Babar
authors: B
authors: Junaidi
authors: Asif
authors: A
authors: Rasheed
authors: Moazzam
authors: M
authors: Zaidi
authors: Muhammed
authors: M
authors: Murtaza
authors: Naved
authors: N
authors: Iqbal
authors: Fahad
authors: F
authors: Hashmat
authors: Syed Vaqas
authors: SV
authors: Alam
authors: Uzma
authors: U
authors: Saleem
authors: Shahan
authors: S
authors: Waheed
authors: Lajpat
authors: L
authors: Bansari
authors: Nabi
authors: N
authors: Shah
authors: Maria
authors: M
authors: Samuel
authors: Madiha
authors: M
authors: Yameen
authors: Sobia
authors: S
authors: Naz
authors: Farrukh Shahab
authors: FS
authors: Khan
authors: Naveeduddin
authors: N
authors: Ahmed
authors: Khalid
authors: K
authors: Mahmood
authors: Niaz
authors: N
authors: Sheikh
authors: Karim Ullah
authors: KU
authors: Makki
authors: Muhammad Masroor
authors: MM
authors: Ahmed
authors: Abdul Rauf
authors: AR
authors: Memon
authors: Mohammad
authors: M
authors: Wasay
authors: Nadir Ali
authors: NA
authors: Syed
authors: Bhojo
authors: B
authors: Khealani
authors: Philippe M
authors: PM
authors: Frossard
authors: Danish
authors: D
authors: Saleheen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D002536:Cerebral Arteries / Q000473:pathology*; D002540:Cerebral Cortex / Q000098:blood supply / Q000473:pathology; D002561:Cerebrovascular Disorders / Q000150:complications* / Q000453:epidemiology / Q000473:pathology; D002985:Clinical Protocols; D003251:Constriction, Pathologic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010154:Pakistan / Q000453:epidemiology; D011446:Prospective Studies; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology