Evidence Based Medicine: Acute administration of rt-PA for acute stroke in Pakistani patients — what does the available evidence teach us?

The National Institute of Neurological Disorders and Stroke rt-PA Stroke Study-NINDS rt-PA, European Cooperative Acute Stroke Study ECASS III, AND Japanese Alteplase Clinical Trial J-ACT. Why are these studies important and noteworthy? Strokes are an important public health problem; about two thirds of stroke mortality will now be borne by the developing world. Up until late 80 s no treatment was available to improve the deficits once stroke had occurred. The NINDs Trial was the first randomized controlled trial undertaken to evaluate the efficacy of this agent.