title: Doppler waveform study as indicator of change of portal pressure after administration of octreotide.
abstract: OBJECTIVE
  To estimate the effect of portal pressure lowering drug 'octreotide', by observing the Doppler waveform before and after the administration of intravenous bolus of octreotide and thus to assess indirectly its efficacy to lower the portal pressure.
  
  
  METHODS
  This quassi experimental study was carried out in Medical Department in collaboration with Radiology Department of Jinnah Postgraduate Medical Center Karachi Pakistan from September 10, 2015 to February 5, 2016. Cases were selected from patients admitted in Medical Wards and those attending Medical OPD. Diagnosis of cirrhosis was confirmed by Clinical Examination and Lab & Imaging investigation in Medical Department. Doppler waveform study was done by experienced radiologist in Radiology Department before and after administration of octreotide. Doppler signals were obtained from the right hepatic vein. Waveform tracings were recorded for five seconds and categorized as 'monophasic', 'biphasic' and 'triphasic'. Waveform changes from one waveform to other were noted and analyzed.
  
  
  RESULTS
  Significant change i.e. from 'monophasic' to 'biphasic' or 'biphasic' to 'triphasic' was seen in 56% cases while 'monophasic' to 'triphasic' was seen in 20% cases. No change was seen in 24% cases. Improvement in waveform reflects lowering of portal vein pressure.
  
  
  CONCLUSIONS
  Non invasive Hepatic vein Doppler waveform study showed improvement in Doppler waveform after administration of octreotide in 76% cases. Doppler waveform study has the potential of becoming non invasive 'follow up tool' of choice for assessing portal pressure in patients having variceal bleed due to portal hypertension.
authors.affiliation: Dr. Shahbaz Haider, FCPS. Department of Medicine, Jinnah Postgraduate Medical Centre (JPMC), Karachi Pakistan.
authors.forename: Shahbaz
authors.initials: S
authors.lastname: Haider
authors.affiliation: Dr. Qurban Hussain, FCPS. Department of Medicine, Jinnah Postgraduate Medical Centre (JPMC), Karachi Pakistan.
authors.forename: Qurban
authors.initials: Q
authors.lastname: Hussain
authors.affiliation: Dr. Sumera Tabassum, FCPS. Department of Radiology, Jinnah Postgraduate Medical Centre (JPMC), Karachi Pakistan.
authors.forename: Sumera
authors.initials: S
authors.lastname: Tabassum
authors.affiliation: Dr. Bilal Hussain, MBBS. Department of Medicine, Jinnah Postgraduate Medical Centre (JPMC), Karachi Pakistan.
authors.forename: Bilal
authors.initials: B
authors.lastname: Hussain
authors.affiliation: Dr. Muhammad Rasheed Durrani, FCPS. Department of Medicine, Jinnah Postgraduate Medical Centre (JPMC), Karachi Pakistan.
authors.forename: Muhammad Rasheed
authors.initials: MR
authors.lastname: Durrani
authors.affiliation: Dr. Fayyaz Ahmed, MBBS. Department of Radiology, Jinnah Postgraduate Medical Centre (JPMC), Karachi Pakistan.
authors.forename: Fayyaz
authors.initials: F
authors.lastname: Ahmed
keywords: Doppler waveform; Hepatic vein; Octreotide; Portal hypertension