INAUGURAL LECTURE BY PROFESSOR MAYOWA ,O. OWOLABI, DEPARTMENT OF MEDICINE
Exploring the stroke quadrangle through the TransOmics and Spiritual binoculars: two wings of an eagle
ABSTRACT
My lecture describes some of my key contributions to knowledge focusing on stroke. At least one out of every four individuals will develop stroke in their lifetime. Every minute, at least one Nigerian and 6 Africans develop stroke. Africa is the global capital of stroke with leading incidence, prevalence and case fatality, and the burden continues to increase! The motivation to overcome this leading burden of disease in Africa, prompted me to propose the stroke quadrangle to the rescue. The quadrangle comprises 1) epidemiological surveillance to unravel and monitor the burden of stroke and its transomic and environmental risk and outcome determinants; 2) primordial, primary and secondary prevention; 3) acute and hyperacute care, and 4) rehabilitation and reintegration. To reduce the burden of stroke, concerted actions are required to improve surveillance, prevention, acute care and rehabilitation.
It is crucial to unravel and monitor the genomic and environmental risk factors for stroke occurrence, type and outcome. The Stroke Investigative Research and Educational Network (SIREN) study has established risk factors for stroke which should be targeted for prevention at population and individual levels in Africa. The topmost risk factors for stroke in Africa are hypertension, dyslipidaemia, regular meat consumption, elevated waist-to-hip ratio (potbelly), diabetes mellitus, stress, added salt at table, cardiac disease, physical inactivity, and current cigarette smoking. Daily consumption of green leafy vegetables is strongly protective against all types of stroke.
Furthermore, as attested to by Nature journal, we are pioneering the next chapter in African genomics. We are identifying transomic risk factors for stroke to develop new tools for its diagnosis and prognosis and new treatments to aid recovery.
The stroke quadrangle is now being used by the African Stroke Organization, whose establishment I co-pioneered as Co-Chair, International Stroke Conference and the World Health Organization - World Stroke Organization- Lancet Neurology commission on stroke which I lead. I am privileged and humble to be the Convener and lead Co-Chair of a pioneering conference among global stroke experts, the World Stroke Organization and the World Health Organization. We are fighting stroke in a revolutionary way by placing proof in pragmatism through the launching of the global Stroke Control Observatory and burden Reduction Ecosystem (gSCORE) based on the principles of the COntrol UNique to Cardiovascular diseases In Low and middle income countries (COUNCIL) initiative implementation cycle which I proposed.
The seed of life model which I proposed while studying stroke survivors who need rehabilitation, recognizes the physical and spiritual spheres. Indeed, the concept of spirituality is increasingly gaining grounds in Medicine. The spiritual sphere is essential for high quality of life and meaningful rehabilitation of stroke survivors. The stroke recovery cycle which I proposed based on transcultural consistent determinants of post-stroke quality of life expands the philosophy of rehabilitation and investigate interventions beyond healing the body to healing the spirit. If we heal the spirit, through the mind we may also heal the body. Above all, science and spirituality; and synergy of Reason and Resonance are required for longevity and immortality.