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.
The most widespread clinical emergency in India is perforation peritonitis. Following improvements in operational procedures, antimicrobial treatments, and care in ICUs, peritonitis control is often very complicated, complicated, and challenging. MPI provides the highest precision of risk-assessment such that specific predictions for patients with peritonitis could be estimated. The objective of this research is to determine the prognosis for perforated peritonitis patients using the peritonitis index from Mannheim. It is also targeted at a) assessing the results in Mannheim peritonitis test perforation cases b) evaluating elevated incidents of perforated peritonitis on the Peritonitis Scale with Mannheim. C) Determining the function of the Mannheim Peritonitis Index in decision-making on peritonitis surgery. This research measured the diagnosis of perforated peritonitis patients utilizing peritonitis score of Mannheim’s Index. In the present study, we observed that the majority of the study subjects were males (65.38%), and many of the cases ranged from the age group of 46-55 years (25%), as well as 36-45 years (23.07%). The majority of the cases had duodenal perforation (42.30%), followed by gastric perforation (28.84%), appendicular perforation (13.46%), filial perforation (9.61%), jejunal (3.8%), colonic perforation (1.9%). We observed that the majority of the study subjects reported the MPI score between 21-29 (46.15%), followed by (38.46%) cases who reported MPI score of more than 29, and 15.38% who reported MPI score less than 21.
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