A Prospective Study of Clinical Profile, Predisposing Factors and Management of Deep Venous Thrombosis

Introduction: Deep venous thrombosis (DVT) of lower limbsis one of the most common cause for the majority of deathscaused by pulmonary embolism. Deep vein thrombosis is theformation of blood clots in the deep veins which commonlyaffects the leg veins such as the calf veins, femoral vein, orpopliteal vein or veins of the pelvis. The aim of the studywas to evaluate clinical profile of patients in form of age,sex, etiological factors of deep venous thrombosis in ourinstitute. Also study risk the factors in patients of deep venousthrombosis.Material and Methods: Study was a prospective studywhich was conducted on 108 symptomatic patients of deepvein thrombosis which were proved by colour dopplerultrasonography. All patients who were more than 18 years ofage and either sex were taken into study.Results: In our study 37.03% of the patients were malesand 62,97% were females with majority belonging to 21-30 years of age group (33.82%). In this study the youngestpatient was 20 years old female and the oldest patient was96 years old female. Male: Female ratio was 1:1.7. The leastcommon age group affected is extreme of age i.e. ≥ 20 yearsand > 60 years of age in both sexes. The most common limbaffected is left lower limb 62 patients (57.40) and right limbinvolvement is seen in 39.81% of patients. Bilateral lowerlimb DVT is present in two patients and one patient was upperlimb DVT. Predisposing factors associated with thrombosisin deep veins maximally seen in 46 patients in 42.59% due tounknown cause. Pregnancy and post-partum was the secondmost common predisposing factor associated with DVTwhich is seen in 33 patients in 30.55%. Thrombosis due toorthopaedic trauma is seen eight patients only. Chronic illnessand malignancy was present in 19.44% of patients.Conclusion: It is very important for accurate diagnosis ofDVT to prevent potentially fatal complications like pulmonaryembolism (PE) and pulmonary hypertension. Also it is veryimportant to avoid anticoagulants therapy with associated riskof bleeding in patients of misdiagnosed and negative colourdoppler findings. Because clinical features are nonspecific;hence new strategies were evolved for diagnosing thiscondition.

Duchenne muscular dystrophy: prevalence and patterns of cardiac involvement.

In about 10% cases of Duchenne muscular dystrophy (DMD), death is due to cardiac dysfunction. The recognition of cardiomyopathy in DMD is thus important. OBJECTIVE: To assess cardiac involvement in DMD patients by clinical, radiographic, electrocardiographic (ECG) and echocardiographic monitoring and correlate clinical parameters, CPK levels, presence of gene deletion and steroid therapy with cardiac involvement. METHODS: Thirty patients beyond 6 years age, with DMD in advanced stage disease/non-ambulatory were recalled. A detailed clinical evaluation, CPK levels, gene deletion studies were carried out. Cardiac investigations included Chest X-ray, 12 lead ECG and echocardiography. RESULTS: Nineteen patients were non-ambulatory at the time of enrollment. Symptoms or signs suggestive of cardiac dysfunction were seen in only 10%. Gene deletion was identified in 70.3%. Around one-third patients had cardiomegaly. ECG abnormalities were present in 93.3% patients and commonest abnormality was R > 4 mm in V1. Ejection fraction (EF) < 55% was observed in 64.2% and EF < 50% in 17.8%. CONCLUSION: Cardiomyopathy of DMD is characterized by lack of symptoms and few physical signs. Presence of subtle changes like sinus tachycardia may suggest early cardiac involvement. Thus echocardiography is required for evaluation of cardiac dysfunction. Presence of gene deletion was associated with higher CT ratio. Older children have been found to have higher heart rates. No other significant correlation with clinical parameters, CPK levels, genotype and steroid therapy was observed. Early detection possibly leads to appropriate treatment thus reducing the morbidity.

Biodegradable microspheres of curcumin for treatment of inflammation.

Curcumin, a natural constituent of Curcuma longa (turmeric, CAS 458-37-7) was formulated as prolonged release biodegradable microspheres for treatment of inflammation. Natural biodegradable polymers, namely, bovine serum albumin and chitosan were used to encapsulate curcumin to form a depot forming drug delivery system. Microspheres were prepared by emulsion-solvent evaporation method coupled with chemical cross-linking of the natural polymers. Curcumin could be encapsulated into the biodegradable carriers upto an extent of 79.49 and 39.66% respectively with albumin and chitosan. Different drug:polymer ratios did not affect the mean particle size or particle size distribution significantly. However, the concentration of the crosslinking agent had remarkable influence on the drug release. In-vitro release studies indicated a biphasic drug release pattern, characterized by a typical burst-effect followed by a slow release which continued for several days. Evaluation of antinflammatory activity using Freund's adjuvant induced arthritic model in Wistar rats revealed significant difference between both the formulations, albumin microspheres and chitosan micropheres as well as against control. It was evident from the present study that the curcumin biodegradable microspheres could be successfully employed as prolonged release drug delivery system for better therapeutic management of inflammation as compared to oral or subcutaneous route.