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S troke and diabetes belong to the most frequent causes for disabilities or death However appropriate and timely treatment can prevent these consequences The German Stroke Unit concept along with the interdisciplinary structured diabetes treatment with specific organizational structures qualifications and therapeutical strategies are therefore being transferred to many regions around the world STRokE aNd dIaBETES PREVENTIoN aPPRoPRIaTE SoLUTIoNS FRom oNE SoURcE The state of Rheinland Pfalz has established system solutions for the management of diseases like stroke and diabetes as international best practices which can be adapted and transferred to other regions These system solutions combine industrial input medical and paramedical solutions as well as organizational standards and qualification concepts based on scientific excellence and practical experience With its experts in Stroke network and the Diabetes Cluster Rheinland Pfalz the state has achieved a unique position in stroke management and diabetes care which meets a high international demand For example the first stroke centre in the United Arab Emirates was established in the Emirate of Dubai with the help of experts from Rheinland Pfalz Also in the Sultanate of Oman the establishment of a comprehensive stroke unit according to German and European standards is supported SETTING UP STRokE caRE STEP By STEP The first essential step is public understanding of a stroke as an emergency that has to be treated in a specialized stroke unit Accordingly the emergency system has to be qualified to recognize strokes and pre notify the stroke unit Specialized dedicated stroke units in hospitals have proven to produce better results than regular hospital treatment Here thrombolysis therapy can be applied with 4 5 hours after stroke onset Therefore clear standard operation procedures as well as continuous monitoring of patients early mobilization and measures for secondary prevention are essentials of a stroke unit These requirements are met by certification criteria of the German Stroke Unit concept and can be transferred to different regions of the world in order to improve the treatment of strokes Qualified staff especially includes stroke nurses This course has been developed in Germany and adapted to the requirements in the gulf region The first classes for stroke nurses are scheduled to begin in October in Dubai and include local training e learning as well as practical training and bedside teaching in German stroke units Telemedicine approaches have especially been successful in secondary prevention Difficult to detect atrial fibrillation as a major risk factor for re insults can be identified by simple ECGs which are taken from the patients and transferred via internet for an evaluation based on mathematical algorithms in Rheinland Pfalz Reports can be provided in less than an hour providing safe information for a possible need of anticoagulation as essential secondary prevention n cURRENT STaTUS The department of Neurology at Royal Hospital Muscat has celebrated a new mile stone as the first Stroke Unit started to function as a separate entity as of February 2 2013 This Stroke Unit is the first in the country hopefully paving the way for more units being distributed in the different districts and regions of Oman in the near future The total capacity of the Stroke Unit consists of 11 electronically monitored beds 6 beds for male patients and another 5 for female patients During the stay in the unit patients are monitored for 3 days and a dedicated rehab team is involved in the care process which includes two physiotherapists an occupational and a speech therapist I believe that enhancing the public awareness of early recognition of stroke symptoms with great emphasis on the availability of t PA therapy within 4 5 hrs of the onset of the symptoms is an extremely mandatory step Therefore our next main task will be to work on establishing stroke campaigns On the other hand collaborations with international parties with regards to stroke care are also very crucial and we are extremely delighted with our par tnership with the Rheinland Pfalz group The Rheinland Pfalz group is very cooperative and have expressed their full and continuous support to us in the different domains of stroke care including scheduling future structural nursing training We here at Royal Hospital are looking forward to expanding our future cooperation with the Rheinland Pfalz group dörte Büchel Chief Officer Health Economy Ministry of Economics of rheinland pfalz hEaLTh caRE SoLUTIoNS FRom RhEINLaNd PFaLZ FOCUS dr amal al Hashmi Consultant neurologist Head of Stroke Unit royal Hospital Muscat 24 ISSUE 11 MAJLIs