Study of the clinical profile and management of varicose vein disease in lower limbs

2021 ◽  
Vol 20 (1) ◽  
pp. 19-23
Author(s):  
Nilesh Sinha ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 6-10
Author(s):  
Raunak Kumar Gupta ◽  
Dilip Kumar Acharya ◽  
Sanjay .M . Datey

Introduction: Varicose veins are part of the spectrum of chronic venous diseases and include dilated, tortuous veins of lower limbs, spider telangiectasia and reticular veins. Varicose vein disease is a very common problem of the western world and mostly their patients come for treatment because of cosmetic reasons. Indian scenario is different as mostly patients from lower socioeconomic strata of the society come for complications like ulceration, dermatitis etc. of varicose veins come for treatment. This problem sometimes results in chronic absenteeism from work, economic losses and change of occupation in many individuals. Methods: This observational study was carried out from 1st January 2017 to 30th June 2018 in Sri Aurobindo Medical College and Postgraduate Institute, Indore. Clinical profile of 52 patients of varicose vein disease was studied. All the patients were thoroughly examined and the pertaining data recorded. This data was tabulated and compared with the available literature on this subject. Results: Fifty two cases of varicose vein disease were studied. The commonest age group affected with the disease was between 41 to 50 years. Male patients were more and comprised of 84.6% of total number. Sapheno femoral junction valve was incompetent in 73.1 % cases as compared to saphenopopliteal junction[34.6%].Obesity was an important factor in causation of varicose vein disease. Flush ligation at SFJ with stripping was the commonest surgical procedure carried out our center. Conclusion: It is found that varicose vein disease with its associated sequelae brings the patient for treatment in our scenario. Long saphenous vein is the commonly affected part of the superficial venous system because of incompetency of the valve at SFJ. Although various etiological factors can be attributed to varicose vein disease but occupation and obesity remain the main factors. Accurate assessment of problem and adequate surgery will prevent recurrence. Key words: Varicose veins, venous ulcers, recurrent varicose veins.


Author(s):  
C. Z. Perdeshi ◽  
Kustub A. Kulkani ◽  
Revendra N. Yadav ◽  
Mayur Nagwakar ◽  
Niten H. Patil

The lower limbs’ venous system has the pressure of posture, and blood has to be pushed against gravity into the heart cavity. This issue is generally approached either by a cautious approach or by surgical interference, all of which are constrained. Attempts to study different clinical manifestations of varicose veins are being made in the present study. The overall number of 50 varicose vein patients was analysed and the study results were reported. Varicosity veins of the lower limb is a fairly normal pathological entity. In the 20-50 age range, the condition is more common. The main modality of the procedure is surgery. The most common technique performed is Saphenofemoral flush ligation with stripping. 


2015 ◽  
Vol 174 (3) ◽  
pp. 15-19
Author(s):  
B. S. Sukovatych ◽  
M. B. Sykovatykh

An analysis of the results of complex examination and treatment of 181 patients with varicose vein disease (according to CEAP classification C3-C6) was made. Patients were divided into 2 groups. The first group included 106 (58,6%) patients with venous clinical severity score C3 and the second group - 75 (41,4%) patients with score C4-C6. An ultrasonic scintiangiography was used to determine the localization, intensity and length of blow-out in venous system of affected limb. The study found out 2 mechanisms of development of incompetent perforating veins. A superficial blood reflux influenced on the progress of venous insufficiency in 41 (38,7%) patients of the first group. The superficial and deep blood refluxes facilitated to development of the disease and were detected in 67 (89,4%) patients of the second group. It was stated, that there is a direct relation of perforating blood reflux rate with the level of intensity of superficial and deep blood reflux. The more expression of the refluxes took place, the more cases of incompetent perforating veins.


Author(s):  
V. V. Kirillova ◽  
L. A. Sokolova ◽  
V. N. Meshchaninov ◽  
V. S. Myakothyh

Introduction. Diagnostics of congestive events in chronic heart failure (CHF) in elderly people is increasingly relevant due to the general aging of the population, which determines the search for new research methods. The aim is to evaluate the diagnostic capabilities of bioimpedance method in determining the severity of congestion in elderly patients with CHF. Materials and methods. 86 elderly patients with CHF of different clinical stages were examined, 36.0% of them were burdened with varicose vein disease of the lower limbs. Total body water content was assessed by active impedance at 50 kHz, extracellular fluid content — at 5 kHz. Results. Active resistance at 50 kHz in patients with CHF II B was 473.92±29.39, with CHF II A - 569.24±58.97, with CHF I — 601.33±24.64 ohms, respectively, at 5 kHz — 555.52±27.44, 633.50±51.32 and 722.50±15.85 ohms respectively. No total and/or extracellular fluid retention was detected in CHF II A without lower limb varicosity, and in 10 (58.8%) patients — in cases of its presence. Retention of total and/or extracellular fluid was detected in 74.4% of CHF stage II B patients, and 48.3% of them had varicose vein disease of the lower limbs. Discussion. Patients with CHF stage II B have the highest amount of total and extracellular fluid in the body compared to patients with CHF stage II A and CHF stage I, but the method is insensitive for diagnosis of fluid retention in the small circle of the circulation and differential diagnosis of the genesis of edema in varicose vein disease of the lower limbs. Conclusion. Bioimpedance imaging can be used for additional diagnostics of CHF in elderly patients in order to estimate the amount of total/extracellular fluid in the body to build personalized treatment and prevention programs.


Author(s):  
S. N. Zhabin ◽  
A. A. Shitikov ◽  
A. V. Tsukanov ◽  
E. G. Obedkov ◽  
S. S. Dudchenko ◽  
...  

Introduction: Lower extremity varicose vein disease is one of the common problems in vascular surgery. Clinically, this disease is accompanied by a wide range of complaints and external symptoms, which eventually lead to a worse patients’ quality of life. The integrated approach is being applied to the disease treatment, which involves the use of various phlebotropic drugs as conservative therapy along with minimally invasive surgical correction and sclerotherapy.Objective: to improve the quality of phlebotropic therapy for patients with lower extremity varicose vein disease, based on the study of factors that shape the patient’s compliance with the effective treatment of clinical symptoms. The term «compliance» means the precise and informed implementation of the doctor’s recommendations during the treatment by the patient. Most often, «compliance» is assessed by the drug use index, which is the quotient of dividing the number of days on which the full dose of the drug was taken by the duration of the entire study period. Materials and methods: The analysis of 368 + 111 patients with lower extremity varicose vein disease was carried out. Of these, 111 patients turned out to be beyond the correct study of compliance (a phlebectomy was performed in a hospital). 368 patients were divided into the following groups: Group 1: the patients, who were assigned modern surgical treatment of varicose veins (endovenous laser coagulation, scleroobliteration); Group 2: the patients, who withdrew from assigned interventions. As it turned out, the different groups of patients differed in compliance.Results. The patients who were shown and performed surgical treatment – 320 (86.9%), can be considered highly compliant with the prescribed conservative therapy – the average value of the compliance index is 0.83, compared to the representatives who refused to perform the recommended surgical procedures recommended by them – 48 (13.1%), the compliance index is 0.78.In the course of the investigation, the factors shaping compliance with phlebotropic drugs were identified, a comparative assessment was carried out on the main indicators of the effectiveness of phlebotropic drugs.Conclusion. Thus, the compliance of the patients suffering from LEVVV during the treatment with phlebotropic drugs varies depending on the multiplicity and convenience of the form of the drug, on the effectiveness of the proposed phlebotropic therapy according to the influence on the complaints and symptoms, on the psychological readiness of the patient to entrust the result of the final treatment of the disease to the surgeon.


Epigenomics ◽  
2018 ◽  
Vol 10 (8) ◽  
pp. 1103-1119 ◽  
Author(s):  
Mariya A Smetanina ◽  
Alexander E Kel ◽  
Ksenia S Sevost'ianova ◽  
Igor V Maiborodin ◽  
Andrey I Shevela ◽  
...  

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_5) ◽  
Author(s):  
A Hamami ◽  
A Babakhouya ◽  
A El Ouali ◽  
A Ghannam ◽  
M Rkain ◽  
...  

Abstract Background Vasculitis in children constitute a heterogeneous group of pathologies considered as a rarity in our context and therefore deserves to be better known. Despite their individualization for more than forty years throughout the world, they continue to be a challenging condition both in terms of diagnosis and treatment. The objective of our study is to report the epidemiological profiles of vasculitis and to assess the clinical and Para clinical profile of our patients, in order to contribute to a better knowledge of these conditions in our context, whose early diagnosis allows the starting of an appropriate treatment and the improvement of the prognosis. Material and methods This is a retrospective study, in which we collected data of all children in whom the diagnosis of vasculitis was confirmed, and who were hospitalized in the pediatric department of the University Hospital Center (CHU) Mohamed VI of Oujda over a period of 3 years from July 2014 to July 2017. Results Thirty-three patients were selected; 25 boys (76%) and 8 girls (24%), including 16 patients with Kawasaki disease; 14 patients with Henoch-Schonlein purpura (HSP); 2 patients with Polyarteritis nodosa (PAN); and 1 patient with Takayasu. A male predominance was noted with a sex ratio of 3.16. HSP represented 42.42% of the cases, the most affected age group was between 5 and 9 years in 45% of cases. Purpura was the most frequent symptom (100%) with petechial appearance in 77% of cases and localized in the lower limbs in all cases (100%). Joints were affected in 13 cases (93%), abdominal symptoms were found in 81.82% of cases, with one case of melena and 3 cases of rectal bleeding. The renal symptoms were mainly biological and were dominated by urinary proteinuria (45%), microscopic hematuria in one case, macroscopic hematuria in 3 cases, hypertension in one case and nephrotic syndrome in one case. Five patients developed renal insufficiency, two children had moderate renal insufficiency and three had severe renal insufficiency. Kawasaki disease represented the majority of cases: 16 cases (48.48%), affecting children between 4 and 41 months of age with an average age of 22 months, with most affected age group was between 12 and 24 months in 55%. The appeal signs were multiple dominated by fever which represents 100% of cases, skin rash in 82%, ocular redness in 45%, enanthema in 45%, oedema of the extremities in 45%, and adenopathy in 6% (one case). The inflammatory syndrome was present in all patients. Cardiac Doppler ultrasound was performed in 14 patients. It was abnormal in 22% of cases. 11 patients received a course of IGIV (54.54%), at a dose of 2 g/Kg in a single 12-h infusion. Aspirin was administered in all patients. The evolution was favorable in 15 patients, only one case was complicated by giant aneurysms of both coronaries, which evolved to a slight decrease in size and disappearance of the pericardial effusion. Valvular abnormality was noted in one case and minimal pericardial effusion in one case. Conclusion This study confirmed that incidence of vasculitis in children in our context is average, this can be seen on the non-negligible number of cases (33 cases) collected over a period of 3 years. Early diagnosis of this condition key to allow an initiation of an appropriate treatment and improvement of the prognosis.


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