Varicose veins: our experience in KVG Medical College and Hospital, Karnataka

Background: The varicose veins is the most common vascular disorder of the lower extremities. It affects more than 5% of adult population but in India incidence of varicose veins seems to be far less common because patients come for complications such as pain, oedema, pigmentation and ulceration leading to tip of Iceberg phenomenon. This study will help in finding epidemiology, mode of presentation and effect of surgery on venous ulcers and recurrence. The aims and objectives of the study was to study the incidence of varicose veins according to age, sex and occupation with spectrum of clinical presentation in varicose veins. To determine effect of surgery in healing of varicose ulcers if present and study of recurrence upto 6 months.Methods: This prospective study involved 50 patients admitted in KVG Medical College and Hospital, Sullia with clinical diagnosis of varicose veins. The study period was 18 months inclusive of a 6 month follow up period.Results: Most patients was between 41 to 50 years (26 %.), males (74%), left side involvement in (70%) and farmer by occupation (40%) with pain as most common presenting symptom in (76%). Long saphenous system involvement in (94%). 6 patients out of 50 showed recurrence of varicose veins. 4 patient showed recurrence out of 21 venous ulcer patients.Conclusions: For varicose veins saphenofemoral junction ligation with stripping of vein with perforator ligation showed good outcome. Venous ulcers heal well after surgery with few recurrences.

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Incidence of Recurrent Venous Ulcer in Patients Treated at an Outpatient Clinic: Historical Cohort

The International Journal of Lower Extremity Wounds ◽

10.1177/15347346211065929 ◽

2022 ◽

pp. 153473462110659

Author(s):

Michele Neves Brajão Rocha ◽

Carol Viviana Serna Gonzalez ◽

Eline Lima Borges ◽

Vera Lúcia Conceição de Gouveia Santos ◽

Soraia Assad Nasbine Rabeh ◽

...

Keyword(s):

Risk Factors ◽

Outpatient Clinic ◽

Onset Time ◽

Venous Ulcer ◽

High Recurrence Rate ◽

Ulcer Recurrence ◽

Clinical Approach ◽

Historical Cohort ◽

Venous Ulcers

The recurrence of venous ulcers is the wound reopening after a period of completed epithelisation of a previous ulcer due to exposure to causal factors and lack of prevention. Venous ulcers have a high recurrence rate that may increase through the years. Epidemiological evidence on its incidence and risk factors is scarce due to the lack of patient follow-up in outpatient clinics and adherence to treatment after healing. The objective was to analyze the incidence of venous ulcers recurrency in outpatients and the risk factors for its occurrence. It is an observational historical cohort with retrospective data collection, performed through electronic medical records. Setting: private health insurance outpatient clinic. The participants were adult patients with healed venous ulcers. Incidence of venous ulcer recurrence was calculated within individuals with healed ulcers from 2014 and 2018 with a follow-up of at least one year. Bivariate analysis and logistic regression were used to explore risk factors considering demographic, clinical, and wound-related variables. As a result, sixty-five (65) of the 134 patients with healed venous ulcers had a recurrence, leading to an incidence of 48.5%, with a mean onset time of 230.1 (SD 267) days. Patients with recurrent venous ulcers were primarily women (39/48.1%), with a mean age of 64 (SD 15.5) years, 57 (50.8%) had some comorbidity, with systemic arterial hypertension as the most frequent (47/51%). Obesity (15/88.2%) increased the risk of venous ulcers recurrence by 8.7 (OR 95% CI 2.1-60.8; P = .009) times. In conclusion, venous ulcers recurrence incidence was 48.5%, with obesity as a risk factor. This study demonstrates that the clinical approach of people with venous ulcers should not finish when the wound is healed. For ulcer recurrence prevention interventions addressing systemic factors, besides topical management of the wound, are essential.

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Otomycosis, frequency, clinical features, predisposing factors and treatment implications

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20201279 ◽

2020 ◽

Vol 6 (4) ◽

pp. 664

Author(s):

Manjunath K. ◽

Amardeep Singh ◽

Manjunatha Rao S. V.

Keyword(s):

Salicylic Acid ◽

Antifungal Agents ◽

Clinical Presentation ◽

Predisposing Factors ◽

Descriptive Statistics ◽

Research Centre ◽

Medical College ◽

The Difference ◽

Hospital Research

Background: The aim of this study was to determine the frequency of otomycosis, the clinical presentation, predisposing factors and treatment outcome.Methods: This observational study was conducted at ENT Department of Basaveshwara Medical College and Hospital, Research centre, Chitradurga from May 2018 to June 2019, 13 months study. There were 50 patients with documented diagnosis of otomycosis. There were 19 (38%) males and 31 (62%) females. The age of patients ranged from 3 years to 65 years with mean age of 32.5 years. Mean follow-up time was 1 year (~13 months). The frequency, predisposing factors and most common symptoms of otomycosis were recorded along with the response to different Antifungal agents were observed and results were recorded in percentages. Data were analysed using SPSS 12 software. Results are based on descriptive statistics. Results: We prescribed 1% clotrimazole drops or lotion in 58% of patients and 2% salicylic acid in 31% cases. Both of these agents are effective. Topical 1% clotrimazole drops yielded highest resolution rate with lowest recurrent rate. To analyse the efficacy of 1% clotrimazole and 2% salicylic acid. We applied Z-test to calculate the difference between two proportions of patients before treatment with those patients who remained uncured after treatment.Conclusions: Otomycosis commonly prevented with hearing loss, pruritus, otalgia and otorrhoea. It usually resolves with local toilet of ear and installation of antifungal agents.

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Strip-tract revascularization as a source of recurrent venous reflux following high saphenous tie and stripping: results at 5–8 years after surgery

Phlebology The Journal of Venous Disease ◽

10.1177/0268355514535927 ◽

2014 ◽

Vol 30 (8) ◽

pp. 569-572 ◽

Cited By ~ 15

Author(s):

Alexandra E Ostler ◽

Judy M Holdstock ◽

Charmaine C Harrison ◽

Barrie A Price ◽

Mark S Whiteley

Keyword(s):

Response Rate ◽

Great Saphenous Vein ◽

Varicose Veins ◽

Duplex Ultrasonography ◽

Venous Reflux ◽

Primary Varicose Veins ◽

And Inversion ◽

Saphenofemoral Junction ◽

Subfascial Endoscopic Perforator Surgery

Objective We have previously reported strip-tract revascularization 1 year following high saphenous ligation and inversion stripping. This study reports the 5–8 year results in the same cohort. Methods Between 2000 and 2003, 72 patients presented with primary varicose veins and had undergone high saphenous ligation and inversion stripping plus phlebectomies with or without subfascial endoscopic perforator surgery. Of the 64 patients who had attended for follow-up at 1 year, 35 patients (male:female, 16:19; 39 legs) underwent duplex ultrasonography 5–8 years after surgery (response rate 55%). Duplex ultrasonography was performed and all strip-tract revascularization and reflux and groin neovascularization was documented. Results Eighty-two percent of legs of patients showed some evidence of strip-tract revascularization and reflux. Full and partial strip-tract revascularization and reflux was seen in 12.8% and 59% of limbs of patients, respectively, and 10.2% limbs of patients had neovascularization only at the saphenofemoral junction only. Seven limbs of patients showed no revascularization. Conclusion Five to eight years after high saphenous tie and stripping, 82% of legs of patients showed some strip-tract revascularization and reflux and 12% showed total revascularization and reflux of the stripped great saphenous vein.

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Management of venous ulcers according to their anatomical relationship with varicose veins

Phlebology The Journal of Venous Disease ◽

10.1177/0268355516676124 ◽

2017 ◽

Vol 33 (1) ◽

pp. 44-52 ◽

Cited By ~ 1

Author(s):

Yun-Nan Lin ◽

Tung-Ying Hsieh ◽

Shu-Hung Huang ◽

Chia-Ming Liu ◽

Kao-Ping Chang ◽

...

Keyword(s):

Recurrence Rate ◽

Varicose Veins ◽

Venous Ulcer ◽

Perforating Veins ◽

Venous Ulcers ◽

Kaplan Meier ◽

High Satisfaction ◽

Anatomical Relationship ◽

Primary Varicose Veins ◽

Satisfaction Rates

Background Adequately excising varicose and incompetent perforating veins is necessary for reducing their recurrence rate of venous ulcer. Method In total, 66 venous ulcers (C6) in 1083 legs with primary varicose veins were managed through endoscopic-assisted surgery. In an endoscopic operative view, the nonvaricose, varicose, and incompetent perforating veins were clearly visualized and precisely dissected. The varicose and incompetent perforating veins were divided and completely excised. Result The varicose veins were traced to the base or periphery of the 55 ulcers. Moreover, 89.4% of the ulcers healed within 14 weeks. Kaplan–Meier analysis revealed a five-year recurrence rate of 0.0%, and the satisfaction mean score was 4.6. Conclusion Endoscopic-assisted surgery can be used to radically excise varicose veins complicated with venous ulcers; the surgery yields low recurrence and high satisfaction rates.

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Recurrence patterns after endovenous laser treatment of saphenous vein reflux

Phlebology The Journal of Venous Disease ◽

10.1177/0268355515596288 ◽

2016 ◽

Vol 31 (7) ◽

pp. 496-500 ◽

Cited By ~ 11

Author(s):

Ronald S Winokur ◽

Neil M Khilnani ◽

Robert J Min

Keyword(s):

Laser Ablation ◽

Varicose Veins ◽

Endovenous Laser Ablation ◽

Recurrent Varicose Veins ◽

Saphenous Veins ◽

Recurrence Patterns ◽

Endovenous Laser Treatment ◽

Saphenofemoral Junction ◽

Patterns Of Recurrence

Introduction The patterns of recurrent varicose veins after endovascular ablation of the saphenous veins are not well described. Methods The current study describes the ultrasound defined recurrence patterns seen in 58 patients (79 limbs) who returned for evaluation of recurrent varicose veins from a cohort of 802 patients treated with endovenous laser ablation and subsequent sclerotherapy from March 2000 to March 2007 with clinical follow-up until May 2014. Findings The most common ultrasound defined recurrence patterns leading to the varicose veins were new reflux in the anterior accessory saphenous and small saphenous veins as well as recanalization of the treated saphenous segment. Neovascularization at the saphenofemoral junction and incompetent perforating veins as the source of the recurrent veins were not seen. Conclusions The patterns of recurrence following thermal ablation of saphenous veins are different to those seen after surgery. Specifically, new reflux in other saphenous veins is responsible for most recurrent varicose veins and neovascularity seems to be unusual following endovenous laser ablation.

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Foreign body in urinary bladder: our experience and review of literature

International Surgery Journal ◽

10.18203/2349-2902.isj20195388 ◽

2019 ◽

Vol 6 (12) ◽

pp. 4327 ◽

Cited By ~ 1

Author(s):

Mohd Hamid Shafique Ahmed ◽

Prakash W. Pawar ◽

Ajit S. Sawant ◽

Jitendra Sakharani ◽

Amandeep Arora ◽

...

Keyword(s):

Foreign Body ◽

Urinary Bladder ◽

Foreign Bodies ◽

Clinical Presentation ◽

Presentation Mode ◽

Medical College ◽

Urinary Tract Symptoms ◽

History Of ◽

Lower Urinary

Background: The objective of the study was to study clinical presentation, mode of insertion, and management of intravesical foreign bodies in patients treated at our hospital.Methods: This was a retrospective study conducted between January 2018 to June 2019. Six patients underwent treatment for urinary bladder foreign body at Lokmanya Tilak Municipal Medical College and Sion Hospital, Mumbai, Maharashtra, India. Medical records were analyzed retrospectively with regard to nature of foreign body, each patient’s clinical presentation, the mode of insertion and how the foreign was managed.Results: A total of six foreign bodies were retrieved from patients’ urinary bladders. The patients range in age from 28 to 65 years (mean age was 45 years). The Clinical presentation includes Lower urinary tract symptoms. Four patients were male and two were female. Circumstance of insertion was iatrogenic in 5 patients and self-insertion in 1 patient. Five patients were treated endoscopically (cystoscopy retrieval with or without cystolithotrity) and one patient with supra pubic cystostomy. Post-operative hospital stay was of 1 to 2 days. Mean follow up period was 3 months. Psychiatric referral and counseling were done in patients with history of self-insertion of foreign body in urinary bladder.Conclusions: Foreign body in the urinary bladder remain a challenge to the urologist. Removal of the foreign body without injury to the urinary bladder or the urethra gives good outcome.

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Assessment of a New One-Layer Adhesive Bandaging Method in Maintaining Prolonged Limb Compression and Effects on Venous Ulcer Healing

Phlebology The Journal of Venous Disease ◽

10.1177/026835559200700203 ◽

1992 ◽

Vol 7 (2) ◽

pp. 59-63 ◽

Cited By ~ 14

Author(s):

J. P. Travers ◽

K. L. Dalziel ◽

G. S. Makin

Keyword(s):

Ulcer Healing ◽

Varicose Veins ◽

Venous Ulcer ◽

Control Group ◽

Acrylic Adhesive ◽

Venous Ulcers ◽

Hospital Patients ◽

The One ◽

Experimental Group ◽

Adhesive Bandage

Objective: To evaluate the effective duration of compression of acrylic adhesive bandaging compared to non-adhesive bandaging and to compare rate of venous ulcer healing using one layer adhesive bandaging as compared to standard three layer bandaging. Design: The first trial involved patients who had undergone bilateral operations for varicose veins. Adhesive acrylate bandage was applied to the experimental limb and non-adhesive crepe to the control limb. The second trial involved patients with venous ulcers randomly allocated to two groups. The experimental group used the one layer acrylic adhesive bandage whilst the control was treated by the three layer bandage technique (zinc oxide paste bandage followed by a non-adhesive compression bandage and tubular overlay). Setting: Hospital patients in the first trial and clinic patients in the second. Patients, participants: First trial, 11 patients with bilateral varicose veins of which 10 completed. Second trial, 15 patients in the experimental group and 12 patients in the control group all of which completed. Results: Non-adhesive bandaging lost effective compression after 24 hours. Acrylic adhesive bandage maintained effective compression after 1 week. The rate of venous ulcer healing was similar between the one layer adhesive bandage group and three layer group. One layer adhesive bandaging took only one quarter of the time to apply (p<0.01%). Conclusions: Adhesive bandaging produced more effective sustained compression than non-adhesive crepe. Adhesive bandaging was as effective as the currently used three layer bandaging technique in healing venous ulcers and was quicker to apply.

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Conventional versus invagination stripping varicose veins: which is better?

International Surgery Journal ◽

10.18203/2349-2902.isj20200281 ◽

2020 ◽

Vol 7 (2) ◽

pp. 348

Author(s):

Varun Sudarshan Shetty ◽

Iqbal Ali ◽

Varugu Suryateja Reddy

Keyword(s):

Blood Loss ◽

Varicose Veins ◽

Adult Population ◽

Research Centre ◽

College Hospital ◽

Suitable Alternative ◽

Medical College ◽

Group A ◽

Prospective Comparative Study ◽

Group B

Background: Varicose veins are dilated, tortuous veins. It is an extremely common condition causing substantial morbidity. Prevalence of varicose veins ranges between 5% to 30% in adult population. Surgery is preferred over conservative treatment in symptomatic primary varicosis of the great saphenous vein (GSV). This study aims to compare the efficacy of GSV stripping by invagination technique in comparison to the conventional method in terms of time taken to strip the vein, the length of vein stripped, post-operative pain, area of bruising and intra-operative blood loss.Methods: The study was conducted in Dr. D. Y. Patil Medical College, Hospital and Research Centre located in Pimpri, Pune between July 2017 to September 2019.It is a prospective comparative Study. Subjects were randomly divided into 2 groups alternately where group A and B were operated by conventional and invagination techniques respectively and their outcomes were compared.Results: The mean age of the cases in Group A (conventional stripping) was 52 years and in group B (Invagination stripping) was 53 years. Blood loss was significantly more in conventional stripping compared to invagination stripping (p<0.001). The post-operative (after 1 week) mean VAS of the cases in Group A was 3.1 and 2.3 respectively while in group B it was 2.9 and 2.1 respectively. Time taken to get back to activity was significantly more in conventional stripping compared to invagination stripping (p<0.001).Conclusions: From this study we concluded that Invagination stripping is a suitable alternative to time honoured conventional varicose vein stripping with added advantage of less blood loss, less postoperative pain and shorter time span to get back to work.

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Nursing Interventions Aimed at Persons with Venous Ulcers: an Integrative Review

Aquichan ◽

10.5294/aqui.2020.20.1.7 ◽

2020 ◽

Vol 20 (1) ◽

pp. 1-14

Author(s):

Johana Enyd Cifuentes Rodriguez ◽

Sandra Guerrero Gamboa

Keyword(s):

Venous Ulcer ◽

Integrative Review ◽

Delivery Mode ◽

Nursing Interventions ◽

Wound Area ◽

Face To Face ◽

Venous Ulcers ◽

Theoretical Foundations ◽

Nursing Professional

Objectives: This work sought to identify and describe the theoretical foundations, components, duration, delivery mode, and results of the nursing interventions aimed at persons with venous ulcers as available in the literature. Materials and method: Integrative review between 2000 and 2018 in the Pubmed, Ovidnursing, and EBSCOhost electronic databases. Results: This review includes 16 articles. Most of the interventions were of educational nature; three were developed in the community (through the Leg Club model) and the other ones were delivered by a nursing professional, face to face. The minimum time of duration for these was eight weeks, with telephone follow up. The most-common result variables were venous ulcer healing and reduction of the wound area. Conclusions: Diversity existed in relation with the components of the interventions and the results expected. Report of the interventions must be reinforced, along with the use of nursing theories that support their design.

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Rapid healing of chronic venous ulcers following ultrasound-guided foam sclerotherapy

Phlebology The Journal of Venous Disease ◽

10.1258/026835507779700662 ◽

2007 ◽

Vol 22 (1) ◽

pp. 34-39 ◽

Cited By ~ 29

Author(s):

P A Hertzman ◽

R Owens

Keyword(s):

Venous Insufficiency ◽

Ultrasound Guided ◽

Foam Sclerotherapy ◽

Venous Ulcers ◽

Long Term Follow Up ◽

Rapid Healing ◽

Saphenofemoral Junction ◽

Term Response

Objective: To measure the short term response of venous ulcers in patients treated with ultrasound-guided foam sclerotherapy (UGFS) at a two-week clinic in Honduras. Methods: Nine females (ages 25-86; mean 48.1 years) with 13 venous ulcers and saphenofemoral junction reflux were treated with UGFS (polidocanol 3% foam; 1–4 injections; 2–11 cc; Mean Volume 5.4 cc). The dimensions of each ulcer and of the great saphenous vein (GSV) were measured before treatment and one week later. Results: At one week follow-up 2 ulcers healed, 2 GSVs closed, and there was significant improvement in ulcer dimensions (p=0.00) and size of GSV (p=0.00). Conclusions: Venous ulcers in patients with serve venous insufficiency responded quickly to UGFS. Long-term follow-up will be important to determine the sustainability of these results.

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