2 Medical BackgroundVeins of Lower Limb: These are divided into 3 groups:Deep VeinsSuperficial VeinsPerforators
3 Medical Background Deep Veins: Linear Beneath the deep fascia accompanying Arteries.These veins drain the structures deep to the deep fascia and receive blood from the superficial veins through the perforating veins.They include Planter, Ant.Tibial, Post.Tibial, Popliteal and Femoral veins.
4 Medical Background 2. Superficial Veins: Lie Superficial to the deep fascia (i.e. in the S.C tissues).Drain the skin and S.C tissues of L.L except the skin of lower 1/3 of leg (ulcer bearing area) which drained by Ankle perforators which pierce the deep fascia to end directly in the deep veins.
5 Medical Background Superficial Veins include: Long (Great) Saphenous vein:Begins on the dorsum of the foot as a continuation of medial end of dorsal venous arch of foot.It ascends in front of medial malleolus,medial aspect of leg.It ends by piercing the cribiform fascia to join the femoral vein at the sepheno femoral junction.(4 cm below & lateral to the tubercle).Communicators:The long and the short Saphenous veins are connected to each other many variable unfixed communicators.
6 Medical Background Short (Lesser) Saphenous vein: Begin on the dorsum of the foot as a continuation of lateral of dorsal venous arch of the foot.It passes below & behind the lateral malleolus to reach the back of leg to ascend the center of the calf.Commonly it ends in the popliteal fossa by joining the popliteal vein (Sapheno-popliteal junction).
7 Medical Background 3.Perforators: These veins perforate the deep fascia to connect the deep & the superficial systems. This may be:Indirect Perforators: Pass from: superficial veins muscular veins deep veins.Direct Perforators: Pass from superficial veins deep veins.
9 DIOSED-C: Composition: Diosmin is of plant origin, flavonoid fraction. Diosmin is a 7-rutinoside 3,5,7-trhydroxy-4-methoxyflavone.Flavonoid are known to reduce reactive oxygen radicals released by (PMNs)-polymorph-nuclear nutrophils in vitro.Rutin is a greenish yellow micro crystalline powder obtained from black wheat “fago pyrum esculentum”.Diosmin used similar to rutin in the treatment of venous disorders.
10 DIOSED-C: Pharmacokinetics: Diosmin is rapidly absorbed after oral administration.Diosmin has rapid onset & long duration of action.Diosmin has minimal transplacental & breast milk passage.Diosmin has long plasma elimination half-life ranging from 26 to 43 hours.Diosmin is eliminated as minor metabolites in urine mainly as Glucoronic acid conjugate.
11 DIOSED-C: Mechanism of action: Diosmin has vaso constrictive effect by local inhibition of COMT (Catechol-o-methyltransferase) enzyme activity.Diosmin enhances the sympathetic activity by increasing nor-adrenaline levels in the synaptic clefts of the vascular wall.
12 DIOSED-C: Mechanism of action: 3.Diosmin reduces the micro vascular high permeability.4.It Improves cutaneous micro-circulation as it:Normalizes capillary resistance and permeability.Inhibits the release of the main pericapillary mediators of inflammation.These described effects on skin microcirculation contribute to a better peri-ulcer nutrition.
13 DIOSED-C: Mechanism of action: 5.Diosmin has the ability to scavenge active oxygen radicals.6.Diosmin inhibits (PGE2) synthesis,(PGF2α) and thromboxane B2.7.Diosmin decrease the R.B.C aggregation which can induce a decrease of blood flow resistance and a reduction in stasis.8.Diosmin reduces the protein concentration in the intestinal tissues.
14 Diosmin:significantly increases venous tone by improving venous wall nor-adrenaline activity.Veins recover 70% of their maximal contractibility with Diosmin.Whereas it drops to 40% in controls.
15 Diosmin:Diosmin significantly improves the leg ulcer healing process.
16 Diosed-CDiosed-C shows an effective and rapid relief of signs and symptoms in acute and chronic Hemorrhoids.Diosed-C is highly effective as a basic treatment of Hemorrhoids even when complicated.
17 Diosed-CDiosed-C is an effective treatment for CVI from early phase to its complications.Diosed-C has an excellent efficacy on the disappearance of all CVI symptoms.
18 Diosed-CDiosed-C is the unique combination that allows healthy venous tone.In Gynecology Phlebology Proctology