EPIDEMIOLOGY OF PRIMARY VARICOSE VEINS OF LOWER LIMB IN A TERTIARY CARE HOSPITAL.

Introduction: Epidemiological studies plays an important role in providing information on the spectrum and frequency of venous disease distribution in a population. In India, study encompassing the clinical evaluation and surgical management of varicose veins on the conventional lines seems a necessity to improve the quality care with the available resources. We have undertaken an epidemiological study on inuence of age, sex, body mass index, posture on clinical manifestations and complications of varicose veins of lower limbs in patients attending the Department of Vascular Surgery . Materials and Methods: A prospective observational study was conducted in Department of vascular surgery on patients with primary varicose veins of lower limb. Patients with secondary varicose veins, recurrent varicose veins, patients less than 18 years, deep vein thrombosis& peripheral arterial disease were excluded from the study. Results: In the present study 88.89% of ulcer patients had combined saphenofemoral(SFJ) and perforator incompetence, while 11.11% of ulcer patients had combined saphenofemoral, saphenopopliteal (SPJ)and perforator incompetence.14% patients present with combined SFJ, SPJ and perforator incompetence. The patients with higher CEAP classication had combined SFJ and SPJ valvular incompetence. Most commonly, the disease affected the males in the age group of 40-50 years. Conclusion: The present study shows that prolonged standing , obesity ,increasing age are the common risk factors for development of varicose veins.

Download Full-text

Lower Limb Varicose Veins's Clinical Profile and Management

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2020/v32i3030894 ◽

2020 ◽

pp. 1-5

Author(s):

C. Z. Perdeshi ◽

Kustub A. Kulkani ◽

Revendra N. Yadav ◽

Mayur Nagwakar ◽

Niten H. Patil

Keyword(s):

Varicose Vein ◽

Lower Limb ◽

Varicose Veins ◽

Clinical Manifestations ◽

Clinical Profile ◽

Lower Limbs ◽

Study Results ◽

Common Technique ◽

Age Range ◽

Made In

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.

Download Full-text

Study of risk factors and clinical assessment of lower limb varicose vein in a tertiary care hospital

International Surgery Journal ◽

10.18203/2349-2902.isj20173183 ◽

2017 ◽

Vol 4 (8) ◽

pp. 2480

Author(s):

Mohd Shafiuddin ◽

T. P. Bhavanishankar

Keyword(s):

Risk Factors ◽

Lower Limb ◽

Muscle Tone ◽

Varicose Veins ◽

Tertiary Care ◽

Lower Limbs ◽

Clinical Aspects ◽

Common Symptom ◽

Care Hospital ◽

Male Predominance

Background: Lower limb varicose veins are one of the common peripheral vascular diseases which requires treatment for leading the productive life without compromise. The present study was undertaken to evaluate the risk factors and various clinical aspects of varicose veins of lower limb of the patients.Methods: The clinical study involved 21 patients with lower limb varicose veins admitted in the surgical wards of Karnataka Medical College Hospital Hubli, during the period from January 1990 to February 1992. Clinical proforma was prepared before starting the study and based on this proforma the data was collected and analyzed.Results: Majority of the patients (42.8%) were under the age group of 21-30 years. Male predominance (95.3%) was seen. Majority (85.7%) of the patient’s occupation was involved in prolonged periods of standing and violent muscular efforts. The most common symptom was pain and prominent veins noted in 10 (47.64%) patients. varicosities were distributed equally in both the limbs (42.86%). Long saphenous vein involvement was seen in 18 (85.72%) cases. Incompetent perforator was observed in 20 cases.Conclusions: We conclude that occupations involving prolonged periods of standing and violent physical effort are the major contributing factors for prevalence of varicose veins. Hence care to be taken to avoid its incidence by doing the physical activities that can improve the blood circulation and muscle tone in lower limbs.

Download Full-text

Pre- and Postoperative Evaluation by Photoplethysmography in Patients Receiving Surgery for Lower-Limb Varicose Veins

International Journal of Vascular Medicine ◽

10.1155/2014/562782 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7 ◽

Cited By ~ 2

Author(s):

Orlando Adas Saliba Júnior ◽

Mariangela Giannini ◽

Ana Paula Mórbio ◽

Orlando Saliba ◽

Hamilton Almeida Rollo

Keyword(s):

Lower Limb ◽

Varicose Veins ◽

Lower Limbs ◽

Varicose Vein Surgery ◽

Postoperative Evaluation ◽

Perforating Veins ◽

Primary Varicose Veins ◽

Ceap Classification ◽

The Mean ◽

Deep Vein

Objective. To evaluate the effectiveness of surgery in treating primary varicose veins in the lower limbs by photoplethysmography (PPG) and duplex mapping (DM).Method. Forty-eight lower limbs were clinically evaluated according to the CEAP classification system and subjected to PPG and DM exams. Each limb had a venous refill time (VRT) of <20 seconds and a normal deep vein system (DVS) by DM.Results. The mean pre- and postoperative VRTs were 13.79 and 26.43 seconds, respectively (P<0.0001). After surgery, 42 limbs (87.50%) had normal results by PPG (VRT > 20 seconds). Four limbs (8.33%) showed improved VRTs, but the VRTs did not reach 20 seconds. In the 2 limbs (4.17%) that maintained their original VRTs, the DM exams showed the presence of insufficient perforating veins.Conclusion. In most cases, PPG allows for a satisfactory evaluation of the outcome of varicose vein surgery.

Download Full-text

A prospective observational study to analyse clinical profile of varicose vein cases treated in a tertiary care hospital

International Surgery Journal ◽

10.18203/2349-2902.isj20190516 ◽

2019 ◽

Vol 6 (3) ◽

pp. 769

Author(s):

Maragadha Mani ◽

Anand A.

Keyword(s):

Observational Study ◽

Clinical Presentation ◽

Vascular System ◽

Varicose Veins ◽

Demographic Data ◽

Tertiary Care ◽

Lower Limbs ◽

Leg Pain ◽

Care Hospital ◽

Presenting Symptoms

Background: Varicose veins are common vascular disorder. The study was conducted to analyse the clinical presentation, treatment options and complications of varicose veins.Methods: This observational study was conducted in Thanjavur Medical College Hospital. Adults with clinically diagnosed unilateral or bilateral varicose veins of lower limbs were studied in surgical wards between August 2013 to July 2014. The demographic data and presenting symptoms, signs and previous treatment were collected using a structured proforma. Thorough clinical examination, duplex scan and abdominal and pelvic examination were done in all cases to find out the secondary causes. Peripheral vascular system was examined. All the patients were followed regularly for the period of one month to one year after treatment.Results: A total of 60 cases were included. Most participants belonged to 2nd and 3rd decade of life. 55 (91%) participants were male and5 (9%) participants were females. 45 (75%) participants were agriculturists. 10 (17%) participants had bilateral involvement. Most participants 30 (50%) participants had 1 to 5 years duration of disease, most common clinical presentation of the study participants was varicosity with 70.0%, followed by lipodermo sclerosis, leg pain, hyperpigmentation, pruritus as 63.0%, 56.0%, 15% and 11.6% respectively. 17 (28.33%) patients were present with a venous ulcer. 32 (53%) participants were managed surgically, and 28 (47%) participants were managed conservatively. Most participants were treated with multiple ligation 21.8% followed by trendelenburg operation+ stripping18.75%.Conclusions: Regarding the treatment, surgery is the treatment of choice for primary varicose veins and conservative treatment for secondary varicose veins.

Download Full-text

Expression of the proinflammatory marker CD34 in varicose leg veins

Phlebologie ◽

10.12687/phleb2221-1-2015 ◽

2015 ◽

Vol 44 (01) ◽

pp. 19-23

Author(s):

I.V. Samsonava ◽

M. M. Galishevich ◽

S. A. Sushkou

Keyword(s):

Lower Limb ◽

Varicose Veins ◽

Control Sample ◽

Lower Limbs ◽

Control Group ◽

Posterior Tibial ◽

Vena Saphena Magna ◽

Primary Varicose Veins ◽

Deep Vein ◽

Cd34 Expression

Summary Objective: To study the CD34 expression in the leg veins with primary varicose veins. Material and Methods: The study included 18 patients with lower limbs varicose veins and deep vein valves insufficiency of C3 and C4 clinical classes (CEAP). To correct blood flow phlebectomy was accompanied by posterior tibial veins resection. Using immunohistochemistry, we compared the expression of CD34 in resected posterior tibial veins specimens and vena saphena magna distal fragment. Results: Posterior tibial veins wall in patients with lower limb varicosity and deep veins valves insufficiency vary the CD34 degree expression comparing with the control group. Total area of expression was significantly greater than in control sample. CD34 expression area was also significantly greater in vena saphena magna than in control group. CD34 expression comparison in the specimens from patients with varicose veins showed its significantly higher degree in the vena saphena magna than in tibial veins. Conclusion: With primary varicose veins superficial and deep leg veins develop unidirectional increase of CD34 expression, that can be assumed as a pathogenetic factors of further disease progression and involvement of deep vein valves.

Download Full-text

Homeostatic feelings – a novel explanation of vein symptoms derived from an experimental patient study

VASA ◽

10.1024/0301-1526/a000807 ◽

2019 ◽

Vol 48 (6) ◽

pp. 492-501

Author(s):

Werner Blättler ◽

Erika Mendoza ◽

Christine Zollmann ◽

John Bendix ◽

Felix Amsler

Keyword(s):

Rating Scale ◽

Varicose Veins ◽

Stress Test ◽

Numeric Rating Scale ◽

Lower Limbs ◽

Venous Disease ◽

Scale Range ◽

Patient Groups ◽

Primary Varicose Veins ◽

Ceap Classification

Summary. Background: Vein symptoms (VS) entail diffuse leg discomfort and pain coinciding with a perception of weighty or swollen legs. Their traditional classification as a form of venous disease may be inaccurate as they occur in patients with no or any venous disorder. We hypothesized that VS would emerge from a primordially standing associated perturbation in the lower limbs which is not necessarily connected with a venous disorder. Patients and methods: Patients were sorted into groups according to the CEAP classification, VS only (C0s), primary varicose veins (C2p), varicose veins plus oedema (C2p and C3), and venous dermatopathy (C4). Patients completed questionnaires before and one week after they were exposed to a test of stationary standing. Results: Patients (N = 127) in the four groups differed by sex, age and body weight. The VS experienced in the preceding week scored the same in all groups at 3.1 on a numeric rating scale (range 0–10; SD 1.6). During standing, lower leg volume increased and symptoms emerged to the same extent across patient groups and were reduced similarly by compression (volume by 1.7 %, symptoms by 41.7 %). The emergence of symptoms was neither correlated with leg volume increase per se, nor with limiting this increase by compression. Symptoms recorded at baseline correlated with the symptoms provoked by the stress test with bare legs while the symptoms reported at follow-up, when stockings were worn regularly, correlated with the stress test with compression. Conclusions: VS, in terms of neuropsychology, reflect a homeostatic disturbance experienced in the presence and absence of venous disease. Thus, VS are not distinctive for the presence of venous disease insofar as they may reflect dynamic homeostatic feelings resulting from a standing-related disequilibrium in the legs’ internal environment.

Download Full-text

Study of different surgical management approach in lower limb varicose veins at tertiary care hospital

International Surgery Journal ◽

10.18203/2349-2902.isj20173184 ◽

2017 ◽

Vol 4 (8) ◽

pp. 2520

Author(s):

Mohd Shafiuddin ◽

T. P. Bhavanishankar

Keyword(s):

Wound Infection ◽

Lower Limb ◽

Varicose Veins ◽

Tertiary Care ◽

Management Approach ◽

Care Hospital ◽

Contributing Factors ◽

College Hospital ◽

Male Predominance ◽

Medical College

Background: The present study was conducted with the aim to evaluate the clinical features and management of varicose veins in terms of recurrence and symptoms improvement.Methods: This clinical study was conducted for a period of two years during January 1990 to February 1992. A total of 21 patients who presented with symptoms of varicose veins in lower extremities to Karnataka Medical College Hospital Hubli were involved in the study. After thorough clinical examination and investigation all the patients are subjected to relevant treatment.Results: Long saphenous system is the most common venous system affected by varicosity in 18 (85.7%) cases. Incompetence of perforator veins was seen in about 20 (95.3%) cases. Trendelenburg’s operation was done in all cases of long saphenous involvement. Sub fascial ligation of perforators was done in 2 patients. Wound infection is the common postoperative complication observed in 5 patients. Preoperative stay in hospital was longer in patients with ulcer (13 days), whereas patients with postoperative wound infection (14 days) had longer postoperative stay.Conclusions: This study showed that the prevalence of lower limb varicose veins has a male predominance and is more common in younger age group. Occupation involving standing for longer periods of time is one of the important contributing factors in the development of varicosities. There is no single method of appropriate treatment for all cases. Multiple ligations of saphenous vein and excision of varicosed tributaries were done in 9 patients. If cases are selected properly with good operative technique the complications are negligible.

Download Full-text

Varicose veins of lower limb: clinical presentation and management

International Surgery Journal ◽

10.18203/2349-2902.isj20193340 ◽

2019 ◽

Vol 6 (8) ◽

pp. 2905

Author(s):

Akshay Nagre ◽

Satish Deshmukh ◽

Murtaza Akhtar

Keyword(s):

Laser Ablation ◽

Lower Limb ◽

Clinical Presentation ◽

Varicose Veins ◽

Tertiary Care ◽

Active Phase ◽

Lower Limbs ◽

Female Ratio ◽

Endovenous Laser Ablation ◽

Male Preponderance

Background: Varicose veins is a common clinical condition affecting the lower limbs. Usually patient comes for a cosmetic problem, it can cause complications giving rise to significant morbidity if not treated in time. Different options are available for surgical management. The present study has been carried out to study demographic factors, evaluate clinical presentation and outcome of various modalities of management of varicose veins of lower limb.Methods: The present study was carried out in a tertiary care academic hospital from October 2016 to October 2018 and 54 cases were enrolled. The clinical presentation of varicose veins were studied. Mean age and gender preponderance were calculated. All patients underwent clinical tests and venous doppler and accordingly appropriate treatment in the form of conservative, surgical or endovenous laser ablation was given. Complications following the procedures were studied.Results: A total of 39 (72%) patients out of 54 were below the age of 50 years. Prominent veins over lower limb was most common presentation. Sapheno-femoral junction was most commonly involved vein. Male preponderance was observed with a male to female ratio of 12.5:1. Venous Doppler had accuracy of 92.59% in detecting sapheno-femoral and perforator incompetence. Results of endovenous laser ablation are similar to surgery but with less morbidity.Conclusions: This study revealed the disease is prevalence in active phase of life with male preponderance. Majority of the patients had great saphenous vein incompetency and the complications are more when both great saphenous and perforator systems are involved. Venous Doppler is the investigation of choice as it has high accuracy.

Download Full-text

A STUDY ON THE CLINICAL PROFILE AND OUTCOME OF CHILDREN WITH SCORPION STING IN TERTIARY CARE HOSPITAL JHALAWAR, RAJASTHAN

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v4i5.1119 ◽

2020 ◽

Vol 4 (5) ◽

Author(s):

Kalu Ram Meena ◽

Abhishek Bansal ◽

K. C. Dagal

Keyword(s):

Rural Areas ◽

Tertiary Care ◽

Clinical Manifestations ◽

Complete Recovery ◽

Lower Limbs ◽

Medical Emergency ◽

Care Hospital ◽

Tertiary Care Centre ◽

Scorpion Sting ◽

Duration Of Hospitalization

Background: Scorpion sting envenomation is a life threatening emergency in tropical and subtropical countries with a potential of severe and often fatal clinical manifestations among children. Methods: This retrospective study was conducted in a tertiary care centre in Jhalawar (Rajasthan) over a period from 1 April 2019 to 30 Sept. 2019. Total 26 children admitted with a history of scorpion sting were included in this study. Results: With regard to severity, 7 (26.92%), 15 (57.69%), and 4 (15.38%) patients were classified into classes I, II and III, respectively. The duration of hospitalization ranged from 1 to 5 days with mean hospitalization stay of 2.36 ±1.2 days. The duration was longer in younger children and the patients who reported to the hospital very late. All patients were discharged after complete recovery. Conclusion: Scorpion sting envenomation is a common medical emergency among children. It is common in rural areas and among boys. The site of sting was predominantly in the lower limbs and during nights of summer season. Keywords: Scorpion sting, Children, Rural.

Download Full-text

Study on clinical profile and management of varicose veins of lower limbs

International Surgery Journal ◽

10.18203/2349-2902.isj20191030 ◽

2019 ◽

Vol 6 (4) ◽

pp. 1097

Author(s):

Gorijavolu Naveen Kumar ◽

C. V. N. M. Dattatreya ◽

M. Krishna Naik

Keyword(s):

Varicose Veins ◽

Tertiary Care ◽

Signs And Symptoms ◽

Venous System ◽

Lower Limbs ◽

Morbidity Rate ◽

Care Hospital ◽

Heart Chamber ◽

Clinical Presentations ◽

Long Term Follow Up

Background: The venous system of the lower limbs has the burden of posture, and blood has to be forced to the heart chamber against gravity. Commonly this problem is tackled either by a conservative approach or by surgical interference, both of which have their limitations. In the present study, an attempt is being made to study various clinical presentations of varicose veins, their management and complications.Methods: The data for the study was obtained from the patients admitted and treated in Tertiary Care Hospital, Kurnool for a period of two years from November, 2015 to November, 2017. Patients presenting with signs and symptoms of varicose veins, who were diagnosed as having varicosities of the superficial veins by clinical examination, were taken up for the study, after explaining the nature of the disease and various modalities of treatment available.Results: It is found that varicose veins and their associated symptoms and complications constitute the most common chronic vascular disorders leading to surgical treatment. It is more common in middle-aged group and in males. Patients presented with spectrum of symptoms and signs, dilated and tortuous veins being more common presentations. Long saphenous system is the most common venous system affected.Conclusions: Complications are negligible if cases are meticulously selected and operated. The present procedures enable the patient to lead almost normal life after surgery and the morbidity rate is very negligible. Though the newer trends in the management of varicose veins are showing good results, they need a long term follow up.

Download Full-text