Patterns of chronic ischaemia of the upper limbs in the central province of Sri Lanka (original) (raw)
Related papers
2019
OBJECTIVE To look into the factors responsible for delay in presentation of Iimb ischemia patients to a vascular surgeon. Methods The prospective cohort study was conducted at the Aga Khan University Hospital, Karachi, from October 01, 2016, to August 10, 2018. Patients coming with delayed presentation of both acute and chronic limb ischemia were included. All the patients were assessed by qualified vascular surgeons. SPSS 23 was used for data analysis. Results Of the 55 patients, 33(60%) had acute and 22(40%) had chronic limb ischaemia. Mean age of acute cases was 44±23.72 years and it was 60±12.49 years for chronic cases. Overall, the commonest reason behind delay was non-referral by primary physician which was the case with 11(33.3%) patients in the acute group, and 13(59%) in the chronic group. The limb loss in the acute group was 20(60%) and 8(36%) in the chronic group.. Conclusion Delayed presentation of patients with limb ischaemia is mainly due to non-referral. A robust camp...
BMC Public Health, 2015
Background: Peripheral arterial disease (PAD), a slowly progressive atherosclerotic disease affecting vital organs of the body, is increasingly recognized as a health burden worldwide. Epidemiological information on peripheral arterial disease is scarce in Sri Lanka. The present study intended to estimate the prevalence and associated factors of PAD among adults aged 40-74 years in Gampaha district, Sri Lanka. Methods: A cross-sectional study was carried out to estimate the prevalence of PAD among adults aged 40-74 years in four randomly selected divisional secretariat areas in Gampaha district in 2012-2013. The sample size of 2912 adults was obtained from 104 clusters using multistage probability proportionate to size sampling. The number of individuals to be included in the 5-year age groups between 40 and 74 years was determined based on the population proportion of the respective age groups in the district. Cluster size was 28, and equal numbers of males and females were selected for each age group per cluster. PAD was defined as having an ankle-brachial pressure index ≤ 0.89. Results: The age-and sex-standardized prevalence of PAD, adjusted for the sensitivity of the ankle-brachial pressure index was 3.6 % (95 % CI 2.9-4.3 %), and no significant difference was found between males (3.7 %) and females (3.6 %) (p = 0.08). Eighty-eight individuals were newly identified as having PAD, and a significant trend of prevalence with increasing age was observed (p < 0.001). Histories of diabetes mellitus, hypertension, dyslipidemia, coronary artery disease, cerebrovascular accident, smoking, and erectile dysfunction among males were significantly associated with PAD (p <0.001). Only one third of those with PAD experienced claudication symptoms. Conclusions: PAD was found to be a hidden disease in the Gampaha district population. Although there is minimal attention on PAD at present, the disease is likely to become a problematic public health concern in Sri Lanka, particularly with its aging population. Primary prevention measures to modify risk factors of PAD, including screening activities for early identification, should be a priority.
European Journal of Vascular and Endovascular Surgery, 2006
Objective. To study the prevalence and possible risk factors for chronic critical lower limb ischaemia (CLI) in an unselected population of 20,291 Norwegian men and women 40-69 years of age. Methods. Between 1995 and 1997, all residents 20 years or older in Nord-Trøndelag County, Norway, were invited to participate in a population study (the HUNT 2 Study). Among the 71.2% who attended, 20,291 participants 40-69 years of age responded to questions specifically aimed at identifying CLI. Chronic critical ischaemia was suspected if participants indicated: (1) ulcers on toes, foot or ankle that had failed to heal and/or; (2) persistent pain in the forefoot while in the supine position, but with relief of this pain when standing up. Using logistic regression analyses, we estimated the association between the prevalence of CLI and smoking, diabetes mellitus, previous cardiovascular events, blood lipids and glucose levels, and body mass index (BMI). Results. The age-adjusted prevalence of CLI was 0.26% among men and 0.24% among women, and there was no gender difference in any age group (age-adjusted ORZ0.91, 95% CIZ0.52-1.58). The presence of increased age, diabetes mellitus, angina pectoris, high triglyceride levels, and high BMI were all independently associated with higher prevalence of CLI. Conclusion. The prevalence of CLI was 0.24%, similar for both genders, and increased with age. Risk factors usually seen in atherosclerotic patients were associated with suspected CLI.
Acute Limb Ischaemia: Case Report
Acute limb ischaemia (ALI) is de ned as a sudden decrease in limb perfusion that threatens the viability of the limb. Physical ndings may include absence of pulse distal to the occlusion, cold and pale or mottled skin, reduced sensation, decreased strength and may be associated with ischemic stroke and myocardial infarction. A 41-year-old male came to emergency room (ER) with necrosis in the left and right legs and feet. Patient was diagnosed with acute limb ischaemia. Duplex sonography femoralis, angiojet and percutaneous intra arterial thrombolysis were done 2 days after the rst symptoms. The patient was amputated on both legs and the patient recovered.
Acute non-traumatic arm ischaemia
British Journal of Surgery, 1998
Background Much attention has been paid to the management of acute leg ischaemia. Acute arm ischaemia is perceived as less of a problem because the risk of limb loss is lower. After conservative treatment up to half the patients have late symptoms, such as forearm claudication. Methods This study was a review of all published English language data on acute arm ischaemia. The entire Medline database was searched and other references were derived from the material perused. There were no randomized or controlled studies. Results The incidence of acute arm ischaemia is one-fifth that of acute leg ischaemia. Patients with arm ischaemia tended to be older with a mean age of 74 years compared with 70 years for acute leg ischaemia. Since the development of the embolectomy catheter, embolectomy can be performed in most patients under local anaesthetic. Collected outcome included successful restoration of the circulation in 65-94 per cent of patients and amputation in 0-18 per cent. The mortality rate ranged from 0 to 19 per cent, despite the use of local anaesthesia, mostly from associated cardiac disease. Management by a vascular specialist may be beneficial, particularly in complex cases. Conclusion An active approach to the management of acute arm ischaemia is safe and effective and reduces the risk of late disabling symptoms.
ASYMPTOMATIC CAROTID ARTERY PREVALENCE IN CRITICAL LIMB ISCHEMIA IN SOUTH INDIAN POPULATION
Aim: -To study the prevalence of ASYMPTOMATIC CAROTID ARTERY DISEASE and to identify predictive factors of carotid artery disease, in patients with critical limb ischemia in south Indian patients Materials and methods: -Total of 250 patients with critical limb ischemia admitted in department of vascular surgery, madras medical college, Chennai, underwent carotid duplex scanning by department of radiology, madras medical college, Chennai and a questionnaire was used to collect data concerning known risk factors. Results: - The mean age of the patients was 50±20 years; there were 242 (96.8%) men and 8 (3.2%) women; 72% of the patients had a history of smoking, 10.4% had coronary artery disease, 5.6% had hypertension, 5.6 % had dyslipidemia and 17.2% had diabetes mellitus. Eighteen (7%) patients had carotid artery disease detected by carotid artery duplex scanning of which insignificant Carotid artery disease found in 10 patients, significant carotid artery stenosis in 5 patients and complete occlusion of ICA in 3 patients. Conclusion: -All patients with peripheral vascular disease with large vessel occlusion due to atherosclerosis have to be screened for carotid artery disease.