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BACKGROUND: Varicose vein entity includes a vast majority of clinical and pathological manifestations. However, there are very few standardized methods to assess the clinical severity and predict the outcomes of surgery in such patients. Hence, this current study evaluated the role of on Clinical Assessment of varicose veins by clinical scores and correlating the outcomes of surgery in such patients. METHODS AND MATERIALS: This analytical study group consisted of 60 patients above 18 years. They were assessed for severity of varicose veins by documenting a detailed history, clinical examination findings, imaging studieson a prestructured case sheet and the result of surgery. It wasfound that majority of the patients were =60 yrs.and the left lowerlimb was predominantly affected in both sexes. RESULTS: In our study 50 % (n=30) patients had Severe grade of Venous Reflux (VRS). We found that majority had undergone the SFJ Flush ligation and multiple perforator ligation 50.0% (n=30). We also analyzed the postoperative outcome, which revealed majority had uneventful periods 66.67 % (n=40). We also found that the clinical features assessed correlated well with the venous reflux on the Duplex scan, as well as surgical outcomes and complications (Pearson correlation coefficient=0.171, P value-0.032). CONCLUSION- A statistically significant result was found for the clinical assessment scores and also correlated with the surgical outcome. [ABSTRACT FROM AUTHOR]

Background: Portal hypertension (PH) is defined as when the portal venous system pressure exceeds 10 mm Hg. Objective: To study the predictive power of noninvasive investigative parameters (clinical, biochemical, radiological) for detection of esophageal varices in patients with portal hypertension (PHT) as compared to invasive parameters (upper gastrointestinal endoscopy). Materials and methods: This was a prospective observational study. Fifty patients with Portal Hypertension were studied at tertiary care hospital, KRIMS, Karwar, during Jan 2022 to June 2022. Those who had decompensated liver diseases, HIV, hepatocellular carcinoma, metastasis in liver, parentral drug addiction, chronic febrile illness, H/O treatment taken for PHT in the form of surgery or endoscopic bending or sclerotherapy were excluded. Detailed clinical history was taken and physical examination was done. All patients underwent the required hematological, biochemical, radiological, endoscopic and histopathological investigations. Results: Platelet count/splenic size showed a significant correlation between presence or absence and grade of esophageal varices (p < 0.00015). If a cut-off value of 1,000/cu mm is taken, then 87.5% (35/40) patients with esophageal varices have ratio of<1000, while 20% (2/10) of patients with ratio <1,000 did not have any varices. It was also observed that lower the ratio, higher the grade of varices. Conclusion: Asymptomatic esophageal varices, which is quite common, can be easily diagnosed with invasive endoscopy or otherwise can be suspected with non invasive predictors like platelet/spleen size ratio in our country, where financial constraint is a major problem for investigations like endoscopy. [ABSTRACT FROM AUTHOR]

In surgical diseases, obesity is a significant risk factor for wound infection, more surgical blood loss and a longer post-operative time and increased risk of venous thromboembolism due to impairment of cardiac, pulmonary, and immunological functions. Underweight patients are at more risk for post-operative complications, including long term mortality. We obtained data prospectively from 1540 patients attending General surgery OPD from October 2022-December 2022 in Victoria hospital. Height, weight, BMI was calculated after Detailed history and clinical examination is noted. we found that hernias and varicose veins were more common with the patients with more weight. Obese patients more tend to have hernias than normal weight patients. Most patients with breast lumps belong to obese grade 2 class. In developing countries like india, where there is a stage of nutritional transition particularly in urban areas, the problems of undernutrition and over-nutrition should be addressed. [ABSTRACT FROM AUTHOR]

Introduction: Even though EVLA is increasingly popular and together with other minimally-invasive techniques is rapidly replacing surgical stripping, surgical treatment is still widely used. Our study aimed to compare the clinical outcomes and the quality of life following either endovenous laser ablation (EVLA) or conventional surgery for varicose veins of the lower limbs. Aim and Objective of the study: the present study is aimed to compare the clinical outcomes and the quality of life in varicose veins patients who had undergone endovenous laser ablation or open surgery. Materials and Methods: It is a prospective randomised study. A total of 268 patients were treated for symptomatic varicose veins since the previous year, among them 130 patients underwent open surgery and 138 patients received endovenous laser ablation. Results: Disease-specific quality of life at six weeks was significantly better in the EVLA group. Similarly, VCSS and AVVQ scores at six weeks were also better in the EVLA group. Patients in the EVLA group experienced less postoperative pain and therefore needed fewer supplementary analgesic drugs. In addition, patients in the EVLA group managed to return to work and normal activities sooner than those in the surgery group. However no statistically significant differences were found between groups for clinical recurrence, overall satisfaction, rate of complications and secondary procedures at the end of one year. Discussion and Conclusion: Both techniques -- EVLA and surgery -- yielded similar results in terms of efficacy, clinical recurrence rates and overall patient satisfaction. Although in the present study we did not find EVLA to be superior to surgical stripping in the long term, a significant difference was seen in the immediate post operative period in terms of post operative pain and the duration of time required to return to work. Therefore, we assume that EVLA should be recommended over surgical stripping, especially for patients who need to resume to work in post-operative period. [ABSTRACT FROM AUTHOR]

Background: The prevalent issue of varicose veins in the lower extremities necessitates exploring effective and efficient treatment methods. This study aims to evaluate the efficacy of foam sclerotherapy, focusing on improvements in the venous clinical severity score and the swift return to work posttreatment. Through this research, we intend to ascertain whether foam sclerotherapy can serve as a cost-effective, safe, and satisfactory alternative to traditional treatments. Methodology: A universal sampling method was implemented to select the sample size for the study. The study cohort consisted of 31 patients who visited the outpatient department and met the established inclusion criteria. These patients underwent comprehensive history evaluation and physical examinations. Subsequent to the preliminary evaluations, the patients were subjected to necessary hematological and biochemical analyses along with appropriate radiological investigations, including USG venous Doppler studies, dictated by clinical suspicions. All participants underwent USG-guided foam sclerotherapy and their progress was monitored based on predefined outcomes. Results: The study predominantly involved males aged between 30 and 60 years. A significant enhancement in patient satisfaction was documented, with notable reductions in ulcer size in 3 out of the 31 patients who initially presented with ulcers. Moreover, the therapy ensured a 100% reduction in reported pain and swelling, with no hospital stays extending beyond one day. Remarkably, 28 out of the 32 patients managed to resume their work within a span of less than 7 days, showcasing no side effects from the treatment. Conclusion: The data gleaned from the study underscore the considerable patient satisfaction derived from foam sclerotherapy, especially concerning alleviation in pain, swelling, and enhanced ulcer healing. Furthermore, patients reported a significant reduction in lower limb pigmentation following the therapy. Not only is foam sclerotherapy cost-effective and safe, but it also facilitates a quicker return to work coupled with shorter hospital stays, establishing itself as a potent alternative in managing symptomatic varicose veins. [ABSTRACT FROM AUTHOR]

Background: Varicose vein is a common surgical disease. Diagnosis and management of the same has significantly improved since the advent of Duplex Ultrasonography. This study was undertaken to evaluate the clinical outcomes in patients with varicose veins treated with Endovenous Laser Ablation (EVLA). Materials and Methods: This retrospective and on-going prospective observational study was carried out in a tertiary care centre for a period of 18 months. Study included total 80 patients who underwent EVLA for varicose veins fulfilling inclusion and exclusion criteria. Demographic data (age, gender), clinical signs and symptoms, USG doppler findings, operative findings, and post-operative complications were recorded. Results: In this study, mean age of study patients was was 44.66 ± 14.33 years with a range from 21 to 69 years, and male preponderance (81.2%). Standing for long duration was reported in 85% of study patients, and in 80% of patient duration of disease was less than from 1 to 5 years. Dilated veins were common clinical presentation seen in 80% patients. In most of patients, hospital stay was ≤4 days. Nerve injury (27.5%) and anesthetic complications (27.5%) were the most common complications seen in this study. Conclusion: EVLA is a safe and reliable minimally invasive procedure to treat varicose vein diseases with minimal post-operative complications. [ABSTRACT FROM AUTHOR]

The standard treatment for aneurysmal bone cyst is bone curettage and grafting which was associated with high morbidity. Hence sclerotherapy came as alternative therapy, which minimally invasive hence came to popularity. This study aims to find out the radiological outcome of aneurysmal bone cyst with sclerotherapy with polidocanol. Methods: 31 patients who were diagnosed with aneurysmal bone cyst underwent sclerotherapy with polidocanol with follow-up for 2 years. We assessed time to healing and recurrence, pain relief, and radiological outcome using modified Neer's criteria for the radiological healing of the bone cysts. Result: At last follow-up, 100% had achieved complete healing. Complications were injection site necrosis, pain and hypopigmentation, all of which resolved spontaneously. Conclusions: Sclerotherapy by using polidocanol is a safe treatment option which was effective, less cost expense, good cosmetics, reduced morbidity, can do as day care procedure. Local complications due to extravasation which will reduce spontaneously. [ABSTRACT FROM AUTHOR]

Introduction: The Venous Clinical Severity Score (VCSS) was designed to give more strength to CEAP classification and to provide a method for serial assessment particularly to CEAP clinical class 4 and class 6. Even though the VCSS has been very useful, several areas of deficiency are also noted over time. VCSS was again revised by American Venous Forum with an intention to improve the VCSS, and also by preserving its strengths Aim of the Study: To Compare VSS system with CEAP system postoperatively in assessing the outcome of varicose veins surgery. Methodology: A Prospective Longitudinal Clinical Study done in 30 patients from November 2019 to June 2021in the Department of General Surgery, Narayana Medical College and Hospital, Nellore. Duplex ultrasound for each patient to assess the following CEAP clinical class, CEAP 18-point clinical score, VCSS, VDS. Patients were followed up in the post-operative period for 6 weeks and 6 months and CEAP class, CEAP score, VCSS score and VDS will be recorded to assess the venous outcome at 6 weeks, 6 months. Results & Conclusion: CEAP score and VCSS percentage reductions at 6 weeks and 6 months follow-up were almost similar, VCSS showed slightly higher reduction compared to CEAP score, implying almost equally good sensitivity in measuring outcomes compared to CEAP clinical class. Venous Disability Score (VDS) reduced to 100% by 6 months follow-up and found superior compared to other scores. Thus, reflecting that VCSS along with CEAP class has more use in determining overall severity of venous disease and its outcomes post-surgical intervention, when compared to other venous assessment tools. [ABSTRACT FROM AUTHOR]

Background: To compare ambulatory phlebectomy and compression sclerotherapy for varicose veins. Material and Methods: Sixty- four cases of varicose veins of both genders were randomly divided into 2 groups of 32 each. Group I underwent ambulatory phlebectomies and group II underwent foam sclerotherapy. Parameters such as Clinical Etiology-Anatomy-Pathophysiology (CEAP), diameter of great saphenous vein, presenting primary symptoms, Grading of primary symptom relief, change in disease severity and post-procedure symptoms were compared. Results: Group I comprised of 17 males and 15 females and group II had 16 males and 16 females. Parameters CEAP C2-C3 legs was seen in 26 and 27, C4-C6 legs was seen in 6 and 5, GSV diameter was 8.6 mm and 7.5 mm, The mean procedure time was 40.2 minutes and 25.3 minutes. Primary symptoms were pain in 13 and 11, oedema in 5 and 3, night cramps in 8 and 5, bleeding in 2 and 7, ulcer in 6 and 4 and itching in 7 and 3 in group I and II respectively. Post-procedure symptoms were transient skin pigmentation in1 and 3, superficial thrombophlebitis in 0 and 2, bleeding in 1 and 3, transient loss of sensation in 0 and 1 and small ulcers in 1 and 4 in group I and II respectively. The difference was significant (P< 0.05). Good improvement (+3) was seen in 85% and 60%, moderate improvement (+2) in 10% and 20%, mild improvement (+1) in 5%and 8%, unchanged (0) in 0 and 7% and mild worsening (-1) in 0 and 5% in group I and II respectively. Conclusion: Ambulatory phlebectomy is an effective therapy for varicose veins of the leg. Primary symptom reliefare significantly higher in ambulatory phlebectomy group. [ABSTRACT FROM AUTHOR]

Background: Infantile Haemangioma (IH) is a benign vascular tumor characterized by endothelial cell proliferation of blood vessels in skin or visceral organs and generally lesion enlarges in what is called proliferative phase and overall growth by 9 months age. The present study aimed to detect the best time of surgical intervention in management of infantile hemangioma. Patients and methods: A prospective clinical trial study was included in carried out in Zagazig University Hospitals. Patients with infantile haemangioma full filing inclusion criteria were evaluated and received medical treatment with beta blockers if not complicated and followed up for possibility of surgical intervention. Results: Major site was forehead with 25% followed by back & scalp each with16.7% then abdomen, abdomen & back and Lip with 8.3% each and finally arm, buttocks, chest wall and face with percentage of 4.2%. The majority were good with 37.5%, excellent with 29.2% and bad with 16.7%. Bleeding reported at 4 cases with 16.7% ulceration and infection 8.3%. Medical management was in 66.7% and surgical in 33.3% (8 cases), 6 cases were excision and 2 cases had injection (one of them need excision) and combined were in 29.2% . There was significant decrease at all time from pre and 2 month and from pre to 4 month and from pre to 6 month. There were significantly associated with surgical intervention also irregular shape, firm consistency and multiple lesion were significantly associated with surgical method. Surgical management significantly associated with better outcome. Conclusion: Surgery procedure for IH may be considered when there are likely to be significant functional or cosmetic deficits despite medical therapy or when these deficits might be more severe with the prolonged treatment time frame associated with medical options. [ABSTRACT FROM AUTHOR]

The article presents randomized control study on the role of tetracycline in prevention of post modified radical mastectomy seroma. Topics include modified radical mastectomy (MRM) is the principal treatment of breast cancer, provides sufficient tumor clearance, and decrease the local recurrence rate; and topical sclerotherapy with Tetracycline has long been used successfully in the treatment of malignant pleural effusions to cause obliteration of the pleural space.