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 Begins on the dorsum of the foot as a continuation of medial end of dorsal venous arch of foot.of 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 the sepheno femoral junction.(4 cm below & lateral to the tubercle).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 4.It Improves cutaneous micro-circulation as

it: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

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in 1

5 d

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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