Varicose veins are defined as dilated usually tortuous, subcutaneous veins >3mm in diameter measured in upright posture with a demonstrable reflux. Varicose veins affect mainly the economically productive age group individuals. The aim of my study was to analyze the age, sex, occupation, mean age of presentation, clinical presentations, complications, treatment options, surgical complications and hospital stay in a case varicose vein patient and to compare with the standard literature results. The study was conducted on 50 patients who came to MKCG MCH Brahmapur, Odisha for treatment during the period of Jun 2012-Jun 2014. The patients underwent thorough clinical examination and Doppler ultrasound of the involved limbs to see for the incompetency of venous system. The data of the study was represented by bar graphs and pie charts. Majority of the patients were of 20-40 years (70%). In our study males constituted 84% and females 16%. The common complaints were tiredness and aching sensations in the leg. But a significant number of patients in our study were having symptoms of advanced disease like hyperpigmentation (26%), ulcer (18%), eczema (16%) and edema (4%). This was probably because these patients neglected their disease in the early stage. Manual workers constitute 28% of our study. Occupations like manual laborer, salesman, farmers, and security guards constitute around 36%. Left sided lesions are common than right side. Long saphenous segment is more commonly involved than short saphenous segment. Both segments are involved in 10% of patients. Sapheno femoral incompetence is the most common observed pathology. The perforators below the knee are commonly involved than lateral perforators. Trendelenburg procedure with stripping of the involved segment is commonly done procedure. Next common is sub facial ligation. Skin staining is the common complication postoperatively. Recurrence occurs in 2% of patients. Mean hospital stay was 11 days' minimum and 29 days maximum. It was finally concluded that varicose veins affected younger age group. Males dominated than females because male dominated society. It affects mostly individuals with long standing occupation. The patients were treated effectively and good results were obtained.

Background: This study aims to categorize macroglossia patients into mild, moderate, and severe groups and formulate a treatment plan depending upon the severity of tongue involvement.Methods: Eight patients presented with macroglossia between 2018 and 2020 are reviewed retrospectively. The patients were categorized into three subgroups depending upon the clinical presentation and subjected to either sclerotherapy or surgical debulking. The clinical outcome as a reduction of size and symptomatic improvement were analyzed and categorized after a minimum of 6 months follow-up.Results: Eight patients (5 males and 3 females) aged 10-40 years with a mean age of 28.25 (SD 10.29) years were included in the study. Of eight patients, four cases were of vascular malformation, three of neurofibroma, and one was due to amyloidosis. Four patients were treated with surgery, three with sclerotherapy while one patient was managed with combined modalities. On average, 58% and 28% volume reduction were achieved with surgery and sclerotherapy respectively. Excellent, very good, and good results were obtained in 1, 3, and 4 cases respectively. Pain (2/8), edema (2/8), and distal congestion (1/8) were noted as a complication.Conclusions: Macroglossia results from various causes and the common cause being VM. Surgery and sclerotherapy are the mainstay treatment for such a condition. They remain effective when used alone or in combination and also in a staged manner depending upon the severity of macroglossia.

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.