ABSTRACT
OBJECTIVE: To highlight the usefulness of duplex ultrasonography in assessing the degree of limb ischaemia in patients with peripheral arterial occlusive disease (PAOD). METHODOLOGY: Duplex ultrasonography (B mode, Color flow and spectral Doppler analysis) was used to evaluate the degree of limb ischaemia in an elderly Nigerian woman with diabetes who had clinical features of severe PAOD RESULTS: The patient was found to have moderate and severe limb ischaemia in the right and left lower limbs respectively. She subsequently had a below the knee amputation of the left lower limb. CONCLUSION: Duplex ultrasound is advised as part of the pre-operative evaluation of patients with PAOD, in order to adequately localise the diseased arterial segment and degree of limb ischaemia. However, segmental Doppler pressures with ankle brachial analysis should be utilised as a screening tool in symptomatic patients.
Subject(s)
Arterial Occlusive Diseases/diagnostic imaging , Diabetes Mellitus/physiopathology , Ischemia/diagnostic imaging , Leg/blood supply , Peripheral Vascular Diseases/diagnostic imaging , Aged , Amputation, Surgical , Diabetic Angiopathies/diagnostic imaging , Female , Humans , Ischemia/therapy , Leg/diagnostic imaging , Leg/surgery , Peripheral Vascular Diseases/surgery , Treatment Outcome , Ultrasonography, Doppler, Duplex/methodsABSTRACT
BACKGROUND: Analysis of blood pressure control has shown that optimal blood pressure control is generally low in many studies. Poor adherence to therapeutic plans and non-compliance are perhaps the most important factors responsible for poor control. In most cases poverty has been adduced to be responsible for non-compliance especially in the sub-Saharan Africa. Assessment of blood pressure control in situations where antihypertensives are given free is necessary. OBJECTIVES: To assess blood pressure control in a population where antihypertensives are given free. SETTING: International institute for tropical Agriculture (IITA). DESIGN: Cross-sectional study. SUBJECTS: One hundred and forty three consecutive hypertensive subjects (106 males and 37 females) being followed-up in the medical clinic of the International Institute for Tropical Agriculture (IITA) for variable numbers of years were studied. Blood pressure was considered to be well controlled if it was less than 140/90 mmHg and uncontrolled if higher than 140/90 mmHg. RESULTS: About 51 (36%) of the subjects may be described as being fully controlled on the treatment instituted while 54 (38%) of the subjects were not controlled at all. In about 18% of the patients, the systolic blood pressure alone was controlled while in 8% the diastolic blood pressure alone was controlled. MAIN OUTCOME MEASURES: Level of blood pressure control in this study is poor suggesting that availability of free drug alone is not enough to improve adherence to antihypertensives. CONCLUSION: The percentage of hypertensive patients with optimal blood pressure control in this population is low, although this was higher when compared to a report from a similar study where drugs were not given free to patients. Physicians managing hypertension in such establishments should pay attention to adequate dosing and appropriate combination of drugs.
Subject(s)
Antihypertensive Agents/economics , Antihypertensive Agents/therapeutic use , Hypertension/drug therapy , Adult , Cross-Sectional Studies , Female , Humans , Hypertension/physiopathology , Male , Middle Aged , Patient ComplianceABSTRACT
Nasal mucociliary clearance (NMCC) time was measured in four groups of patients: asthmatics with allergic rhinitis, asthmatics without rhinitis, bronchiectasis and normal subjects. The saccharin method was used for the study. The NMCC time was prolonged significantly in the asthmatic groups and group with bronchiectasis when compared with control subjects (P less than 0.001). It is likely that the impaired mucociliary clearance is due to a combination of mucus abnormality and ciliary malfunction.
