Reviewer ’s report  
 
Title:  Gender and  thrombolysis therapy in stroke patients with incidence dyslipidemia  
 
Version: 1 Date: 25 Sep 2018 
 
Reviewer:  Godfred Odei  Boateng  
 
Reviewer’s report:  
 
Dyslipidemia increases the risk of chronic diseases such as stroke and stroke -related mortality in 
more me n than women. Although questions have been raised on the use of recombinant tissue 
plasminogen activator (rtPA) for the treatment of Ischemic stroke, the risk it presents to patients 
has led the exclusion of some patients from the therapy. This study aimed  at examining the 
gendered differences in the inclusion and exclusion of patients from the therapy. This may be the 
first study to examine such differences and provides sufficient evidence to determine the risk 
factors that can be targeted to eliminate gen der differences and improve the use of rtPA in the 
management of acute ischemic stroke patients.  There are a few minor comments that need to be 
addressed before the paper goes for publication.  
 
1. The introduction of the paper was well written and is lo gically coherent. However, I will 
ask that the authors indicate the questions or hypothesis guiding the study in the 
concluding paragraph of the introduction.   
 
2. It will add depth to the paper if the authors provide statistical evidence for the number o f 
men and women who are at risk of stroke and those who died from stroke to show for the 
gender differences (e.g. reference could be made to the past year).  
 
3. The authors excellently provided a general overview of the data collection process and do 
refer to the description of the GHS registry in previous studies. However, it will be 
beneficial to readers if the authors briefly provided a description of the GHS registry 
highlighting how data on each of the variables was previously collected and coded for the 
analysis.  
 
4. The authors make an important statement regarding data collection as being scrutinized 
under quality control checks. The statement will be more complete if the authors 
indicated who embarked on the quality control checks and how it was d one (could refer 
to the protocol).  
 
5. The current statement of the authors on ethics committee approval of the study does not 
state which institution approved the study and when it was approved. The authors should 
kindly add such details for clarity. I s ee this at the end of the manuscript but could be 
repeated within the manuscript (Kindly refer to the journal author guidelines).  
 
6. The authors should clarify whether rtPA in this study is used as a form of thrombolysis 
therapy for clarity. Its current application in the study is a bit confusing. The authors 
should consistently refer to rtPA or thrombolysis therapy to eliminate any confusion.  
 
7. The paragraphs in the discussion are well developed; however, there seems to be a 
missing piece. The implica tions for the treatment of men and women with dyslipidemia. 
Currently, the paper does not address factors that increase the likelihood of being 
excluded from a thrombolysis therapy and how that can be checked.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in you r comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further 
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the qual ity of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary  from an 
organisation that may in any way gain or lose financially from the publication of this 
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose 
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the 
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare t hat I have no competing interests' 
below. If your reply is yes to any, please give details below.  
 
I declare that I have no com peting interests  
 
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