BACKGROUNDThe first written reference of varicose veins appears to be the Ebers Papyrus dated 1550 B.C. It is one of the oldest documented pathological conditions in existence today. This study deals with its aetiology, pathology and the different modes of treatment and their efficacy in detail. MATERIALS AND METHODS50 patients with lower limb varicose veins admitted in the Department of General Surgery, KIMS, Karad from October 2014 to July 2016 were included in the study. All patients were subjected to detailed history taking, clinical examination and relevant investigations. Depending on the merits of the disease, appropriate treatment options are selected. All the results are evaluated and analysed by comparing with other standard results. RESULTSIn this study, there were 34 males and 16 females (M:F = 2.1:1). Most of the patients were between 20 -50 yrs. of age (80%); 56% of patients had occupations, which involved prolonged standing. In this study, 48% of patients had positive family history. The most common presenting complaint was prominent veins (100%) and pain in 54% of patients. Right limb was involved in 38% and the left limb involved in 52% of patients. Long saphenous vein was involved in 98% of patients, the second commonest being perforators which were involved in 86% of patients. Majority of the patients had combined saphenofemoral and perforator incompetence (70%). Duplex ultrasound was very accurate in diagnosing perforator incompetence. Treatment was depended upon the individual cases. In patients with venous ulcers Bisgaard's method of treatment was followed till the ulcer heals and then the patient was subjected to further definitive treatment. SFJ ligation with stripping was the most common surgery performed. Among post-operative complications, wound infection was the most common (14%). CONCLUSIONThis study showed that the prevalence of varicose veins of lower limb have a male predominance and is more common in younger age group. Family history and occupation are important contributing factors in the development of lower limb varicose veins. Left lower limb involvement is more than the right. Duplex ultrasound is the investigation of choice of lower limb varicose veins. Saphenofemoral flush ligation with stripping is very effective in the treatment of varicose veins.
Retroperitoneal Lymphangiomas are rare and account for only 1% of lymphangiomas. They usually present in infancy, rarely they may present symptomatically in adulthood. We present a case of a 19-year old female with a symptomatic retroperitoneal lymphangioma. It was treated with complete surgical excision. Retroperitoneal lymphangiomas are rare. Imaging alone cannot differentiate them from other retroperitoneal cystic masses. Surgical excision is the treatment of choice and required for final diagnosis.
OBJECTIVE : To evaluate the effectiveness of metformin therapy in preventing early pregnancy loss in pregnant women with polycystic ovary syndrome (PCOS). MATERIALS AND METHODS : This is a prospective cohort study conducted in the Obstetric Department of Krishna Institute of Medical Sciences, Karad, Maharashtra, India for a period of 2 years. This study involved 100 nondiabetic pregnant women with PCOS. They were divided into two groups, namely, the group that received metformin throughout pregnancy (metformin group) and the group that got pregnant but, did not receive metformin (control group). A comparison was made between the two groups of patients with respect to certain basal characteristics (age, body mass index, previous obstetric outcome, serum glucose with free testosterone). Statistical analysis was performed using Chi-square test to compare the differences between the two groups. RESULTS : There were 50 patients who received metformin during pregnancy (metformin group) compared with 50 patients who did not receive the treatment (control group). The rate of early pregnancy loss in the metformin group was 10% (5/50) compared with 36% (18/50) in the control group (p < 0.001). For patients in the metformin group with a history of previous miscarriage, the rate of pregnancy loss was 45% (35 cases/50 pregnancies). CONCLUSION : Metformin therapy in pregnant women with PCOS was associated with a significant reduction in the rate of early pregnancy loss
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