A consensus statement – part I. Recommendations for the management of chronic venous disease (CVD) in India and the key role of primary care doctors

Dekiwadia, Devendra; Jindal, Ravul; Varghese, Roy; Bedi, Harinder Singh; Padaria, Shoaib; Patel, Malay

doi:10.5114/pr.2016.61533

Cited by 5 publications

(9 citation statements)

References 17 publications

(24 reference statements)

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“…Leg elevation for 1 h/day was significantly associated with prevention of venous ulcer recurrence and 45% increase of the laser Doppler flux (i.e., flow within veins) [26,27]. In accordance with this evidence, several guidelines recommend leg elevation in the management of venous ulcers [1,6,11,28].…”

Section: Recommendationsmentioning

confidence: 99%

“…Their incidence increases with age and female sex [2][3][4]. A large Indian study revealed that CVD is more prevalent at an average age of 43 years and it affects women more than men [5,6].…”

Section: Introductionmentioning

confidence: 99%

“…(Class I, Level of evidence C)[16,17,19] • Progressive resistance exercise and leg elevation aid in ulcer healing, reduce ulcer pain and oedema and prevent ulcer recurrence. (Class IIA, Level of evidence B)[1,6,[25][26][27]…”

mentioning

confidence: 99%

“…Clinical, Etiological, Anatomical, and Pathophysiological (CEAP) classification system for chronic venous disease[6,13] …”

mentioning

confidence: 99%

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Evidence-Based Clinical Practice Points for the Management of Venous Ulcers

Jindal

Dekiwadia²,

Krishna

et al. 2018

Indian J Surg

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Venous ulcer is an extremely common aetiology of lower extremity ulceration, which affects approximately 1% population in most of the countries, and the incidence rate increases with age and female gender. Proper assessment and diagnosis of both the patient and ulcer are inevitable in order to differentiate venous ulcers from other lower extremity ulceration and to frame an adequate and individualised management plan. Venous ulcers generally persist for weeks to many years and are typically recurrent in nature. This consensus aims to present an evidence-based management approach for the patients with venous ulcers. Various management options for venous ulcers include compression therapy, minimally invasive procedures like sclerotherapy and ablation techniques, surgical procedures, debridement and medical management with micronised purified flavonoid fraction (MPFF). Compression therapy is the mainstay treatment for venous ulcer. However, in failure cases, surgery can be preferred. Medical management with MPFF as an adjuvant therapy to standard treatment has been reported to be effective and safe in patients with venous ulcer. In addition to standard therapy, diet and lifestyle modification including progressive resistance exercise, patient education, leg elevation, weight reduction, maintaining a healthy cardiac status and strong psychosocial support reduces the risk of recurrence and improves the quality of life in patients with venous ulcer.

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Section: Recommendationsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

“…Clinical, Etiological, Anatomical, and Pathophysiological (CEAP) classification system for chronic venous disease[6,13] …”

mentioning

confidence: 99%

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Evidence-Based Clinical Practice Points for the Management of Venous Ulcers

Jindal

Dekiwadia²,

Krishna

et al. 2018

Indian J Surg

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“…Chronic venous disease of the lower limbs is one of the major problems observed in vascular surgery practice; however, it remains an underdiagnosed condition in general clinical practice because of many factors which can broadly be divided as patient- and healthcare provider-related factors. Patients usually neglect the disease till it impairs the quality of life or limits the overall functioning of lower extremity 1 . Primary care physicians often tend to ignore or overlook the problem because of the underappreciation of the consequences 2 .…”

mentioning

confidence: 99%

Correlation of obesity & comorbid conditions with chronic venous insufficiency: Results of a single-centre study

Mahapatra¹,

Ramakrishna²,

Gupta³

et al. 2018

Indian J Med Res

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Background & objectives:Chronic venous insufficiency (CVI) is a common clinical problem among obese patients. This study was conducted to evaluate the impact of body mass index (BMI) and associated morbidities such as diabetes, hypertension and hypothyroidism on venous disease clinical scores as per Clinical, Etiological, Anatomical, Pathological (CEAP) classification.Methods:In this study, adult patients with BMI more than 30 kg/m2 with signs of CVI were evaluated clinically and by using Duplex ultrasonography of venous system. The patients with C0, C1, C2, C3 and C4, C5, C6 clinical scores in CEAP classification were grouped as lower and higher clinical scores of CVI, respectively.Results:Of the 200 enrolled patients, 147 (73.5%) were males and were associated with higher grades of clinical scores (P=0.051). Superficial venous system was involved in 96 per cent patients and 91 per cent patients had reflux in the sapheno-femoral junction. A negative association was observed between hypertension and male gender (P=0.001). Higher BMI was associated with higher clinical scoring (P=0.053). BMI >40 kg/m2 was associated with primary aetiology (P=0.007) of CVI. There was no correlation between superficial, deep or perforator incompetence with BMI (P=0.506). Duplex-confirmed significant reflux was observed in patients with higher BMI (P=0.006). Age and BMI were positively correlated with clinical score (r=0.176; P=0.013 & r=0.140; P=0.049), respectively.Interpretation & conclusions:Our findings indicated that elderly male patients with high BMI seemed to be at a higher risk of advanced clinical grades of CVI. The impact of comorbid conditions such as diabetes, hypertension and hypothyroidism on CVI could not reach at significance in the present study.

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Venous Scenario in India

Khanna

Kumar

2021

Indian J Surg

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Varicose veins, venous thrombosis, and other venous diseases are equally prevalent in India as anywhere else in the world. Scientific and epidemiological studies of venous diseases in India are being made but at a slow pace. It requires to be enhanced. To boost such efforts, the Vascular Society of India came into existence in 1995 but little progress has been made in advancing the speciality and care for venous diseases in India. Though Vascular Society of India also deals with the venous component but to be more specific and emphatic the Venous Association of India came into existence. In April 2007, seven surgeons met to create the organization’s bylaws and registered the Venous Association of India in Chennai, Tamil Nadu, India, with the aim to promote the research and study of venous disease. These initiatives have recruited many surgeons looking into new vistas of sub or super specialization to join in the folds of Venous Association of India. These efforts have surely shown some results. As, several Indian authors have published books on venous diseases.

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A consensus statement – part I. Recommendations for the management of chronic venous disease (CVD) in India and the key role of primary care doctors

Cited by 5 publications

References 17 publications

Evidence-Based Clinical Practice Points for the Management of Venous Ulcers

Evidence-Based Clinical Practice Points for the Management of Venous Ulcers

Correlation of obesity & comorbid conditions with chronic venous insufficiency: Results of a single-centre study

Venous Scenario in India

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