ABSTRACT
Objective: The purpose of this study was to observe the morphological pattern by CT angiography and risk factors for development of peripheral vascular disease in Bangladeshi patient suffering from peripheral vascular disease using a multidetector scanner in the evaluation of patients with peripheral vascular disease. Subject and Method: Eighty nine patients with peripheral vascular disease who were referred for evaluation of peripheral vascular disease underwent CT angiography. We scanned patients from the level of the cerebral arteries to the pedal arteries in a single helical scan. CT angiograms were produced using maximum-intensity-projection, multiplanous reformation and reconstructions. Findings were graded according to nine categories: 1, normal (0% stenosis); 2, mild (1-49% stenosis); 3, moderate (50-74% stenosis); 4, severe (>75% stenosis); 5, tortuosity; 6, aneurysm, 7, calcification, 8, Arteriovenous malformation (AVM), and 9, haematoma. Results: We found Most of the patients in our study were male (69 out of 89 patients). The mean age was 54.49 ±18.36 in male and 49.45 ±17.89 for female. Commonest risk factor in our study was hypertension 46.1%, followed by diabetes 30.3%, family history 27% smoking 23.6%, dyslipidaemia13.5%. Stenosis (5.61%) was the predominate lesion followed by haematoma (4.49%), Arterio –venous malformation (4.49%). Abdominal aorta was mostly affected in the studied population (58.43%) followed by Lower limb (37.08%), Carotid (22.47%), Renal (7.87%) and Upper limb arteries (4.49%). Conclusion: CT angiography is a noninvasive technique for the imaging of peripheral vascular disease. Since no data is available from a well designed study in PVD in our country, till then the data obtained from this study can be used in Bangladesh.
ABSTRACT
Protein-C and Protein-S deficiency states are responsible for 3-5% (Protein-C) and 2-3% (Protein-S) of patients with venous thrombosis. Some cases of arterial thrombosis have been reported. It occurs twice as often in female as in males. A 50 years old lady presented with acute severe pain in the left upper limb for 2 days. On investigation she was diagnosed as a case of bracheal artery thrombosis with Protein-C & Protein-S deficiency. Bracheal thromboembolectomy was done and discharge her with life long warfarin therapy. In one year follow up the patient had no untoward event and INR done every month and warfarin is adjusted.
ABSTRACT
Background: The peripheral arterial disease generally refers to a disorder that obstructs the blood supply to upper and lower extremities, most commonly caused by atherosclerosis. Objective: The purpose of this study was to observe the morphological pattern and risk factors for development of peripheral vascular disease in Bangladeshi patients suffering from peripheral vascular disease by CT angiography using a multidetector scanner. Method: Eighty nine patients with peripheral vascular disease who were referred for evaluation of peripheral vascular disease underwent CT angiography. We scanned patients from the level of the cerebral arteries to the pedal arteries in a single helical scan. CT angiograms were produced using maximum-intensity-projection, multiplanous reformation and reconstructions. Findings were graded according to nine categories: 1, normal (0% stenosis); 2, mild (1-49% stenosis); 3, moderate (50-74% stenosis); 4, severe (>75% stenosis); 5, tortuosity; 6, aneurysm, 7, calcification, 8, Arteriovenous malformation (AVM), and 9, haematoma. Results: We found Most of the patients in our study were male (69 out of 89 patients). The mean age was 54.49 ±18.36 yrs in male and 49.45 ±17.89 yrs for female. Commonest risk factor in our study was hypertension 46.1%, followed by diabetes 30.3%, family history 27%, smoking 23.6%, dyslipidaemia13.5%. Stenosis (5.61%) was the predominate lesion followed by haematoma (4.49%) and arterio–venous malformation (4.49%). Abdominal aorta was mostly affected in the studied population (58.43%) followed by Lower limb (37.08%), Carotid (22.47%), Renal (7.87%) and Upper limb arteries (4.49%). Conclusion: CT angiography is a noninvasive technique for the imaging of peripheral vascular disease. Since no data is available from a well designed study in PVD in our country, till then the data obtained from this study can be used in Bangladesh.
ABSTRACT
A prospective randomized study was done comparing endoscopic band ligation and sclerotherapy for the treatment of oesophageal varices. Hundred fifty cirrhotic patients with history of bleeding from varices were included in the study. Seventy-five patients got sclerotherapy and 75 got band ligation of varices. Both sclerotherapy and band ligation were continued till obliteration of varices. Clinical as well as the biochemical parameters of the two groups of patients and the severity of the liver diseases were similar in both groups. The mean period of follow up was 337 days for sclerotherapy group and 376 days for band ligation group. The mean time to eradicate the varices was significantly shorter with banding (35+/-4.1 vs 75+/-6.5, p<0.001). The mean number of treatment sessions was significantly less with banding (2.3+/-3.1 vs 5.2+/-2.1, p<.001). Rebleeding was significantly more with sclerotherapy (20 vs. 8 with p<0.01). The variables significantly associated with rebleeding were hypoalbuminaemia (p<.01), and active bleeding at index endoscopy (p<0.001). Different complications like oesophageal ulcer, bleeding from ulcer and the symptoms of oesophageal stricture were more in the sclerotherapy group. There was no significant difference in survival between the two groups. Number of blood transfusions and duration of hospitalization were less in band ligation group. There was no difference in terms of recurrence between the two groups. From the study we suggest that band ligation has less local complications and causes earlier eradication of varices than sclerotherapy. Therefore, band ligation may be the first choice of therapy for oesophageal varices.