Assessment of flow mechanics in the lower extremity venous system.

BACKGROUND: The Reynolds number (Re) is a dimensionless parameter that describes fluid flow mechanics. Veins are compliant and collapsible vascular conduits that can accommodate large volume changes in response to small pressure changes. However, only sparse information is available about flow parameters such as the Re in the venous system. METHODS: Bilateral duplex ultrasound examination of 15 healthy volunteers (30 limbs) was performed before and after exercise (four flights of stairs) of the veins of the lower extremity (left and right sides) and inferior vena cava. These volunteers had been confirmed to not have any signs or symptoms of lower extremity venous disease via focused history and physical examination findings. RESULTS: Most of the volunteers were women (73%). Their mean age was 37 ± 12.8 years. The Re was highest in the inferior vena cava among all the veins examined (470 ± 144 before exercise and 589 ± 205 after exercise; P = .04). The association between the change in Re before and after exercise and the specific vein examined was also significant for the right and left external iliac veins, right and left common femoral veins, right and left profunda femoris veins, right and left femoral veins, and right common iliac vein. Resistance and velocity maps for the lower extremity venous system were also created. The velocity increased and the resistance decreased as one moved up the venous tree toward the right atrium. CONCLUSIONS: The Re increased for most of the lower extremity veins after exercise in our healthy volunteers. However, the critical value for turbulent flow was not reached despite the exercise.

Knowledge, attitudes and practices regarding gemstone therapeutics in a selected adult population in Pakistan.

BACKGROUND: Gemstones have been in use as part of alternative and complementary medicine for years. However, our understanding of the perceived healing powers of gemstones is limited. An extensive literature search revealed that there is a dearth of validated information on this subject. This study was therefore undertaken to explore the various aspects of the knowledge, attitudes, and practices of the public towards gemstone therapeutics. METHODS: A survey was performed in the Community Health Centre of a tertiary care teaching hospital in Pakistan. Data collection was done via a face-to-face interview based on a structured, pre-tested questionnaire. Participants included all willing persons between 18-75 years of age approached prior to their appointments at the Community Health Centre. RESULTS: The survey response rate was 86% (400/465). More than half (63%) of the study population was aware of the use of gemstone therapy. One hundred fifty-six individuals believed that gemstone use impacts health. Of this group, 39% believed that gemstone use increases physical strength. 62% believed that gemstone use is based on superstitious beliefs, whereas 28% opined that it is based on religious beliefs. 38% had used gemstones therapeutics formerly, while 24% were current users. Multiple logistic regression analysis revealed that age status and education status were significant (p < 0.05) independent predictors for both awareness of gemstone therapy and the belief that gemstone use impacts health. The elderly (aged 51-61) were 5.9-times more likely to believe that gemstones had an impact on health than the younger population (aged 18-28 years). (Adjusted Odd's Ratio = 5.9 [95% Confidence Interval = 2.9-11.9]). CONCLUSION: More than half of our sample population is aware of the use of the gemstones for their various effects. Willingness to use gemstones is associated with the beliefs about the impact of gemstone therapy on health. Friends and family seem to be the major role players influencing people's willingness to use gemstones. CAM modalities should be recognized and considered as an important therapeutic option. We feel that gemstone therapy is a relatively unexplored area and more studies should, therefore, be conducted to gather more validated information on the subject.

Knowledge, attitudes and practices survey on organ donation among a selected adult population of Pakistan.

BACKGROUND: To determine the knowledge, attitudes and practices regarding organ donation in a selected adult population in Pakistan. METHODS: Convenience sampling was used to generate a sample of 440; 408 interviews were successfully completed and used for analysis. Data collection was carried out via a face to face interview based on a pre-tested questionnaire in selected public areas of Karachi, Pakistan. Data was analyzed using SPSS v.15 and associations were tested using the Pearson's Chi square test. Multiple logistic regression was used to find independent predictors of knowledge status and motivation of organ donation. RESULTS: Knowledge about organ donation was significantly associated with education (p = 0.000) and socioeconomic status (p = 0.038). 70/198 (35.3%) people expressed a high motivation to donate. Allowance of organ donation in religion was significantly associated with the motivation to donate (p = 0.000). Multiple logistic regression analysis revealed that higher level of education and higher socioeconomic status were significant (p < 0.05) independent predictors of knowledge status of organ donation. For motivation, multiple logistic regression revealed that higher socioeconomic status, adequate knowledge score and belief that organ donation is allowed in religion were significant (p < 0.05) independent predictors. Television emerged as the major source of information. Only 3.5% had themselves donated an organ; with only one person being an actual kidney donor. CONCLUSION: Better knowledge may ultimately translate into the act of donation. Effective measures should be taken to educate people with relevant information with the involvement of media, doctors and religious scholars.