DIOSED-C DIOSED-C tablets tablets
With vitamin CWith vitamin C
Medical BackgroundMedical Background
Veins of Lower Veins of Lower Limb:Limb:These are divided These are divided into 3 groups:into 3 groups:
1.1. Deep VeinsDeep Veins
2.2. Superficial VeinsSuperficial Veins
3.3. PerforatorsPerforators
Medical BackgroundMedical Background
1.1. Deep Veins:Deep Veins:• Linear Beneath the deep fascia Linear Beneath the deep fascia
accompanying Arteries.accompanying Arteries.• These veins drain the structures deep These veins drain the structures deep
to the deep fascia and receive blood to the deep fascia and receive blood from the superficial veins through the from the superficial veins through the perforating veins.perforating veins.
• They include Planter, Ant.Tibial, They include Planter, Ant.Tibial, Post.Tibial, Popliteal and Femoral veins.Post.Tibial, Popliteal and Femoral veins.
Medical BackgroundMedical Background
2. 2. Superficial Veins:Superficial Veins:• Lie Superficial to the deep fascia (i.e. in Lie Superficial to the deep fascia (i.e. in
the S.C tissues).the S.C tissues).
• Drain the skin and S.C tissues of L.L Drain the skin and S.C tissues of L.L except the skin of lower 1/3 of leg except the skin of lower 1/3 of leg (ulcer bearing area) which drained by (ulcer bearing area) which drained by Ankle perforators which pierce the deep Ankle perforators which pierce the deep fascia to end directly in the deep veins.fascia to end directly in the deep veins.
Medical BackgroundMedical Background
Superficial Veins include:Superficial Veins include:Long (Great) Saphenous vein:Long (Great) Saphenous vein:
• Begins on the dorsum of the foot as a continuation of medial end of Begins on the dorsum of the foot as a continuation of medial end of dorsal venous arch of foot.dorsal venous arch of foot.
• It ascends in front of medial malleolus,medial aspect of leg. It ascends in front of medial malleolus,medial aspect of leg. • It ends by piercing the cribiform fascia to join the femoral vein at It ends by piercing the cribiform fascia to join the femoral vein at
the sepheno femoral junction.(4 cm below & lateral to the tubercle).the sepheno femoral junction.(4 cm below & lateral to the tubercle).
Communicators:Communicators:
• The long and the short Saphenous veins are connected to each The long and the short Saphenous veins are connected to each other many variable unfixed communicators.other many variable unfixed communicators.
Medical BackgroundMedical Background
Short (Lesser) Saphenous vein:Short (Lesser) Saphenous vein:• Begin on the dorsum of the foot as a continuation Begin on the dorsum of the foot as a continuation
of lateral of dorsal venous arch of the foot.of lateral of dorsal venous arch of the foot.• It passes below & behind the lateral malleolus to It passes below & behind the lateral malleolus to
reach the back of leg to ascend the center of the reach the back of leg to ascend the center of the calf.calf.
• Commonly it ends in the popliteal fossa by joining Commonly it ends in the popliteal fossa by joining the popliteal vein (Sapheno-popliteal junction).the popliteal vein (Sapheno-popliteal junction).
Medical BackgroundMedical Background
3.Perforators:3.Perforators:TheseThese veins perforate the deep fascia to connect veins perforate the deep fascia to connect
the deep & the superficial systems.the deep & the superficial systems.This may be:This may be:
1.1. Indirect Perforators:Indirect Perforators:Pass from: superficial veins muscular Pass from: superficial veins muscular veins deep veins.veins deep veins.
2.2. Direct Perforators:Direct Perforators: Pass from superficial veins deep veins.Pass from superficial veins deep veins.
Diosed-C :Diosed-C :
Usages:Usages:• Varicose veins.Varicose veins.
• Dysfunctional uterine bleeding.Dysfunctional uterine bleeding.
• Hemorrhoid.Hemorrhoid.
DIOSED-C:DIOSED-C:
Composition:Composition:• Diosmin is of plant origin, flavonoid fraction.Diosmin is of plant origin, flavonoid fraction.• Diosmin is a 7-rutinoside 3,5,7-trhydroxy-4-Diosmin is a 7-rutinoside 3,5,7-trhydroxy-4-
methoxyflavone.methoxyflavone.• Flavonoid are known to reduce reactive oxygen radicalsFlavonoid are known to reduce reactive oxygen radicals
released by (PMNs)-polymorph-nuclear nutrophils in released by (PMNs)-polymorph-nuclear nutrophils in vitro.vitro.
• Rutin is a greenish yellow micro crystalline powder Rutin is a greenish yellow micro crystalline powder obtained from black wheat “fago pyrum esculentum”.obtained from black wheat “fago pyrum esculentum”.
• Diosmin used similar to rutin in the treatment of venous Diosmin used similar to rutin in the treatment of venous disorders.disorders.
DIOSED-C:DIOSED-C:
Pharmacokinetics:Pharmacokinetics:• Diosmin is rapidly absorbed after oral administration.Diosmin is rapidly absorbed after oral administration.
• Diosmin has rapid onset & long duration of action.Diosmin has rapid onset & long duration of action.
• Diosmin has minimal transplacental & breast milk Diosmin has minimal transplacental & breast milk passage.passage.
• Diosmin has long plasma elimination half-life ranging Diosmin has long plasma elimination half-life ranging from 26 to 43 hours.from 26 to 43 hours.
• Diosmin is eliminated as minor metabolites in urine Diosmin is eliminated as minor metabolites in urine mainly as Glucoronic acid conjugate.mainly as Glucoronic acid conjugate.
DIOSED-C:DIOSED-C:
Mechanism of action:Mechanism of action:1.1. Diosmin has vaso constrictive effect by local Diosmin has vaso constrictive effect by local
inhibition of COMT (Catechol-o-inhibition of COMT (Catechol-o-methyltransferase) enzyme activity.methyltransferase) enzyme activity.
2.2. Diosmin enhances the sympathetic activity Diosmin enhances the sympathetic activity by increasing nor-adrenaline levels in the by increasing nor-adrenaline levels in the synaptic clefts of the vascular wall.synaptic clefts of the vascular wall.
DIOSED-C:DIOSED-C:
Mechanism of action:Mechanism of action: 3.Diosmin reduces the micro vascular high 3.Diosmin reduces the micro vascular high
permeability.permeability. 4.It Improves cutaneous micro-circulation as it:4.It Improves cutaneous micro-circulation as it:• Normalizes capillary resistance and Normalizes capillary resistance and
permeability.permeability.• Inhibits the release of the main pericapillary Inhibits the release of the main pericapillary
mediators of inflammation.mediators of inflammation.These described effects on skin microcirculation These described effects on skin microcirculation
contribute to a better peri-ulcer nutrition.contribute to a better peri-ulcer nutrition.
DIOSED-C:DIOSED-C:
Mechanism of action:Mechanism of action:5.Diosmin has the ability to scavenge 5.Diosmin has the ability to scavenge
active oxygen radicals.active oxygen radicals.6.Diosmin inhibits (PGE2) synthesis,(PGF26.Diosmin inhibits (PGE2) synthesis,(PGF2αα) )
and thromboxane B2.and thromboxane B2.7.Diosmin decrease the R.B.C aggregation 7.Diosmin decrease the R.B.C aggregation
which can induce a decrease of blood which can induce a decrease of blood flow resistance and a reduction in stasis.flow resistance and a reduction in stasis.
8.Diosmin reduces the protein 8.Diosmin reduces the protein concentration in the intestinal tissues.concentration in the intestinal tissues.
Diosmin:Diosmin:
• significantly increases venous tone by improving venous significantly increases venous tone by improving venous wall nor-adrenaline activity.wall nor-adrenaline activity.
• Veins recover 70% of their maximal contractibility with Veins recover 70% of their maximal contractibility with Diosmin.Diosmin.
• Whereas it drops to 40% in controls.Whereas it drops to 40% in controls.
70%60% 57%
40%
0%10%20%30%40%50%60%70%
% of maximal venous
contractability
Diosmin Troxerutin Rutin Control
Venous contractability
Diosmin:Diosmin:
• Diosmin significantly improves the leg ulcer Diosmin significantly improves the leg ulcer healing process.healing process.
0%20%40%60%80%
100%
% of patients
No change Improvement orresolution
Placebo Diosmin
Diosed-CDiosed-C
• Diosed-CDiosed-C shows an effective and rapid relief of signs shows an effective and rapid relief of signs and symptoms in acute and chronic Hemorrhoids.and symptoms in acute and chronic Hemorrhoids.
• Diosed-CDiosed-C is highly effective as a basic treatment of is highly effective as a basic treatment of Hemorrhoids even when complicated.Hemorrhoids even when complicated.
0%20%40%60%80%
100%120%
Anal fissure Thrombosis Anal inflammation% o
f pat
ient
s im
prov
emen
t in
15
days
Excellent Good
Diosed-CDiosed-C
• Diosed-CDiosed-C is an effective treatment for is an effective treatment for CVICVI from early from early phase to its complications.phase to its complications.
• Diosed-CDiosed-C has an excellent efficacy on the disappearance has an excellent efficacy on the disappearance of all of all CVICVI symptoms. symptoms.
01020304050607080
CrampsParesthesis
Pain Leg Heaviness
DiosminPlacebo
Diosed-CDiosed-C
• Diosed-CDiosed-C is the is the unique combinationunique combination that allows healthy that allows healthy venous tone.venous tone.
InInGynecologyGynecology PhlebologyPhlebology ProctologyProctology