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Recently, we showed an extremely low rate of thrombolytic therapy in patients suffering acute ischaemic strokes in Mashhad, in Northeast Iran.1 During the 12-month study period (starting from September 2011), the overall rate of intravenous tissue plasminogen activator was 1.2% (n=1144 ischaemic strokes). The mean onset-to-needle and door-to-needle times were 172 and 58 min, respectively.1 A similar problem can be expected for other emergency conditions in our region, such as acute coronary disease, in which the time-to-needle duration is a life-saving criterion. Such a low rate of thrombolytic therapy can be explained in several ways—from patients’ health-seeking behaviours during the emergency conditions to prehospital/in-hospital infrastructures and facilities.1
Any delay in the golden minutes of emergency conditions, starting immediately after the …
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