Friday, November 05, 2010

This is the MRAngiogram of the a patient with Bilateral lower limb Claudication. He is diabetic, underwent Coronary bypass grafting 16 years back in USA. Ankle pulses are not palpable. He is living alone and unable to walk few yards. But he is able to slowly climb the stairs according to him. MRA showed occlusion of the superficial femoral artery on both the sides. Echo cardiogram showed 30% ejection fraction, Moderate mitral regurgitation and pulmonary hypertension. We discussed about the possibility of interventions and medical therapies in improving his leg condition. The risk of investigations and interventions seems to be higher in this gentleman that too without the family members near him. He was advised to continue medical therapies and attend the out patient clinic for monthly follow up and consideration of interventions or bypass in the due course of time. Do you recommend angioplasty of the SFA from popliteal route in this case! Please suggest your opinion and points in favour of your suggestion.

e-Cigarette
The electronic cigarette was invented by a Chinese medicine practitioner Hon Lik in China in 2003 and introduced to the market the next year. The company he worked for, Golden Dragon Holdings, later changed its name to Ruyan (meaning "to resemble smoking") and started selling abroad.

The electronic cigarette, e-cigarette or personal vaporizer, is a battery operated device that provides inhaled doses of nicotine or non-nicotine vaporized solution. It is an alternative to smoked tobacco products, such as cigarettes, cigars, or pipes. In addition to purported nicotine delivery, this vapor also provides a flavor and physical sensation similar to that of inhaled tobacco smoke, while no smoke or combustion is actually involved in its operation. Manufacturers promote electronic cigarettes as a safer alternative to smoking cigarettes by claiming that most of the harmful material produced by the combustion of tobacco in traditional cigarettes is not present in the atomized liquid of electronic cigarettes. Despite claims that electronic cigarettes are safer, manufactures include warning labels with their products.