Background: Varicose veins of the lower extremities are one of the most common peripheral vascular diseases and calls for treatment due to the morbidity and economic impact due to loss of productivity and work hours. Therefore, the present study has been undertaken evaluate the various clinical aspects of varicose veins of lower limb of the patients.Methods: The clinical study and observations in this study were based on a clinical proforma which included the determination of Ratio of varicose veins to the total number of cases with vascular complaints, type of vascular complaints, The relationship between the age of the patient and the disease, The sex ratio, The relationship of occupation and the disease, The different presenting complaints, The venous system involved, The limb involved and predisposing factors in the Patients with Varicose Veins.Results: Out of the 382 patients admitted with vascular complaints, only 42 cases were afflicted with varicose veins of the lower extremities. Maximum incidence was in the age group 21-40 years (61.9%). Male preponderance was observed. The most common presenting complaint was pain which varied from dragging pain to night cramps associated with heaviness of the limbs.Conclusions: Our study reveals that the disease is most prevalent in the 2nd and 3rd decades of life. Most of the patients had long saphenous vein involvement while short saphenous vein was involved in 3 cases and 4 cases had involvement of both venous systems. Many of the patients had perforator incompetency indicating advanced hemodynamic malfunction. Therefore, it was concluded that occupation involving prolonged standing and/ or violent muscular contractions contribute to or precipitate varicose veins if not actually cause them.

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Introduction: Native or autogenous Arteriovenous Fistula (AVFs) placed for Chronic Kidney Disease (CKD) is the gold standard. Radiocephalic Arteriovenous Fistula (RCAVF) just proximal to the wrist is preferred, as it provides a larger proximal area for cannulation and can be created using End-to-Side (E-S) and Side-to-Side (S-S) techniques with good patency. Diameters of the radial artery and cephalic vein have been shown to produce predictable results in RCAVF. The distance between the radial artery and the cephalic vein at wrist or even more proximal has not been studied previously and may be instrumental in choosing either of the two surgical techniques for RCAVF. Aim: To find the optimum diameters of radial artery and cephalic vein, evaluated by Colour Doppler Ultrasound (CDU) that predicted the success of wrist RCAVF in E-S and S-S RCAVF placement techniques for Haemodialysis (HD). Materials and Methods: This prospective interventional study was carried out in the Departments of Plastic Surgery and Nephrology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Eastern Uttar Pradesh, India, from January 2019 to June 2021, to study 62 fistula in 52 patients of CKD in whom wrist RCAVF, as vascular access for HD, was constructed. The variables studied were calibre of radial artery and cephalic vein and their bearing on the surgical outcome in E-S and S-S surgical techniques. Further distance between radial artery and cephalic vein (in mm) at the wrist were meticulously studied to find its significance in both E-S and S-S surgical techniques. The outcomes measured were fistula usability (time from AVF placement to fistula maturation and subsequent functional use for HD) and AVF patency three months postoperatively. Significance of comparative variables was studied by two-tailed t-test. Results: In the present study, average age was 46.86±14.85 years and 37 patients were males while 15 were females. Mean diameter of radial artery was 2.14±0.48 mm while it was 2.12±0.49 mm in E-S and 2.16±0.45 mm in S-S technique (p-value=0.309). Mean diameter of cephalic vein was 2.24±0.64 mm, 2.26±0.67 mm in E-S and 2.22±0.61 mm in S-S technique (p-value=0.734). The distance between the both artery and vein was 5.77±4.06 mm. Thirteen RCF failed to mature (25%), 10 of these underwent secondary surgery for AVF. RCAVF became usable for HD after 7.70±1.12 weeks in E-S group and 7.59±1.19 weeks in S-S group (p-value=0.592). Primary AVF patency was 90.9% in E-S and 92.6% in S-S procedures at three months after surgery when the radial artery and cephalic vein were both larger than 2 mm. If the arteriovenous distance is less than 3 mm, the fistula can be treated using the S-S approach, and if it is greater than 3 mm, the E-S technique. Conclusion: This study demonstrated association between cephalic vein and Radial Artery Diameter (RAD) (>2 mm) with good three months RCAVF patency. It was shown that the distance between the radial artery and cephalic vein at the wrist serves as a criterion for using either the S-S or E-S surgical procedures.

Background: Road traffic accidents (RTAs) are a major cause of misery, disability and death globally, with a disproportionate number occurring in developing countries. Complications from closed head injuries are the single largest cause of morbidity and mortality in patients who reach the hospital alive. The present study assesses the outcome in the management of head injury admitted in our hospital following RTA in the period of one year. Methods: This retrospective study carried out in the department of Neurosurgery in a rural tertiary hospital, Kolar, Karnataka, India. Patients who got admitted between periods of January 2012 to January 2013 were included in the study. All patients were clinically evaluated by a team comprising of doctors from surgical, medical and orthopedics specialties in the emergency department and subsequently admitted and treated at neurosurgery. The study was conducted based on these reports and observations and outcome of patients. The results were expressed as percentages. Results: At the time of admission 41% patients were under alcoholic influence, 97% patients had history of LOC, 50% patients had ENT bleed and 7.5% had CSF leak. The GCS score of less than 8 was seen in 33% cases, 9 to12 in 52% cases and between 12 to 14 in 15% patients. As per Glasgow outcome scale (GOS), 91% of patients had good recovery, 5.5% patients had disability (hemiparesis, ptosis) and 3.5% patients died in the course of treatment. Conclusions: Head injury due to RTA is a recognized major public health problem causing death and disability among the population. So it should be managed in time and also should be looked seriously by concerned authority for reducing the incidences of head injury associated with RTA and protecting people by debilitating conditions.