The effect of sequential intermittent pneumatic compression of foot and calf on popliteal artery mean systolic blood flow in patients with intermittent claudication.

OBJECTIVE: To determine the effect of intermittent pneumatic foot and calf compression on popliteal artery mean systolic blood flow in patients with intermittent claudication. The secondary objective was to determine the change in blood flow with posture. METHODS: This was a cross sectional study carried out on claudication patients at the Vascular Laboratory, Department of General Surgery, Kuala Lumpur Hospital, from January 2009 to August 2009. The effect of posture (supine to sitting to standing) and the effect of intermittent pneumatic compression (IPC) of the foot and calf on popliteal artery flow immediately and 10 minutes post compression were studied. RESULTS: Fifteen patients were studied. There was a consistent drop in flow from supine to sitting and to standing in all patients. Immediately after IPC application there was an increase in flow ranging from 29-335% (p<0.05). Increase in flow was reduced but still sustained after 10 minutes with a flow range of 17-113mL/minute with a median of 63mL/minute (p<0.05). CONCLUSION: There is a significant reduction in popliteal artery mean systolic flow from supine to sitting and to the standing position, and popliteal artery flow is significantly increased after application of IPC and even persists after 10 minutes.

Melioidosis and the vascular surgeon: Hospital Kuala Lumpur experience.

Bacterial arteritis is relatively uncommon and management of this condition, which carries high morbidity and mortality, is difficult and time-consuming. Common organisms implicated include Salmonella and Staphylococcus. Arteritis as a result of infection by Burkholderia pseudomallei (formerly Pseudomonas pseudomallei) has been rarely reported in the English literature. This organism, which is endemic in our part of the world, is well known to cause a wide spectrum of septic conditions. A review of cases managed at Hospital Kuala Lumpur revealed that bacterial arteritis due to melioidosis is not such a rare entity. We share our experience in the management of this condition using three cases as examples.