Search

The burden of cardiovascular disease has steadily increased in India. The aim of this study was to examine the veins when they are harvested in patients undergoing CABG (coronary artery bypass grafting), prior to grafting, to look for early evidences of damage due to inflammatory processes & also for immunohistochemical evidence of inflammatory markers and to compare the findings in diabetic patients and non-diabetic patients. Materials And Methods: This study was as part of an Extramural Ad-Hoc ICMR funded project. After obtaining an informed consent, a total of 154 patients were enrolled. All patients underwent CABG & saphenous vein (SV) was harvested, sent to the lab for evaluation. The characteristic histopathological features were observed, the findings compared in both groups. Immunohistochemical evidence of inflammatory markers in the SV wall was looked for and staining for MMP-9, COX-2 and iNOS was evaluated. Florescent staining of the SV for alterations in the basement membrane was also done. Results: A predominant male population was observed with 61.68% diabetics, hypertension and hypercholestraemia were the major risk factors along with smoking. Subendothelial edema was the major histopathological finding seen. IHC staining for inflammatory markers MMP-9 and COX-2 was done and showed positive findings for both the inflammatory markers, Examination florescent staining was carried out to delineate the basement membrane. Fragmentation of the basement membrane with disruption and a fibrillary appearance was seen in patients with smoking and hypertension. A fragmented & homogenous / afibrillar basement membrane was seen in the saphenous vein of patients with diabetes. Conclusion: We inferred that quicker attrition of the vein grafts may be anticipated in individuals with significant histological findings. Studies with a larger sample size will help to further validate these conclusions. [ABSTRACT FROM AUTHOR]

Introduction: Chronic venous disease is a commonly occurring disease that includes a variety of pathological conditions like varicose veins, oedema, skin abnormalities, and ulceration, among which the most prevalent are the varicose veins. Doppler imaging is presently the first investigation for evaluating chronic venous disease. Aim: To investigate the relationship between Saphenofemoral Junction (SFJ) reflux and Great Saphenous Vein (GSV) diameter in patients with chronic venous disease and to determine the best cut-off value of GSV diameter in predicting reflux. Materials and Methods: The present cross-sectional study was conducted in the Department of Radiology, SRM Medical College and Hospital, Tamil Nadu, India, from December 2019 to June 2021 on 76 patients with chronic venous disease. The study was conducted on a GE Logic P9 ultrasound machine, the diameter of GSV was measured close to the SFJ, at the Proximal Thigh (PT); 15cm distal to the SFJ, and at the calf. The diameter of the GSV was compared with the presence of SFJ reflux. Similarly, Short Saphenous Vein (SSV) diameter was also measured posterior to the knee and was correlated with Saphenopopliteal Junction (SPJ) reflux. Chi-square and student t-tests were used for analysis with a cut-off value determined through Receiver Operating Characteristic (ROC) curve analysis. Results: The mean age of study participants was 51±15.85 years with age range of 19 years to 78 years. Of total, 42 (55.26%) had chronic venous insufficiency on the left side and 34 (44.74%) had on the right side. The mean GSV diameter at SFJ and at PT was higher in patients with SFJ incompetence and was statistically significant with a p-value of 0.001 and 0.002, respectively by t-test. Although the mean GSV diameter at calf was higher in patients with SFJ incompetence, it was statistically insignificant. The GSV diameter at the SFJ had the best cut-off value for predicting incompetence, with a mean diameter of 5.95 mm with 76.3% sensitivity and 76.3% specificity. The cut-off of SSV at the posterior knee for predicting SPJ incompetence was 4.6 mm which had a sensitivity of 72.7% and specificity of 88.7% and diagnostic accuracy of 86.84%. Conclusion: The GSV diameter at SFJ and PT help in predicting SFJ incompetence. The SSV diameter at SPJ aids in predicting SPJ incompetence. [ABSTRACT FROM AUTHOR]

To study GSV diameter at proximal thigh and its correlation with CEAP, VCSS, and quality of life. Prospective observational study. All patients diagnosed as varicose veins in the department of general surgery at a tertiary care hospital between November 2017 and October 2018 were included in the study. Secondary varicose veins and other lymphovascular disorders were not included in the study. A total of 100 patients were included in the study after exclusion criteria. Eighty were males and 20 were females. There was non-significant positive statistical correlation between the GSV diameter at proximal thigh and C scoring of CEAP, VCSS, and quality of life (CIVIQ-14 questionnaire). GSV diameter cannot be made as a sole prediction criteria for clinical severity as other factors like early detection, compliance to treatment, presence of reflux, or not are a few of the many compounding factors. [ABSTRACT FROM AUTHOR]

Introduction: Most common cause of chronic venous insufficiency (CVI) is Great saphenous vein (GSV) followed by short saphenous vein (SSV) insufficiency. Various modalities for the treatment of CVI are Endovenous thermal (by laser or radiofrequency) ablation, Foam sclerotherapy and Ligation and stripping of GSV. Endovenous thermal therapy is costly for the patients residing in the developing country. Herewith we have compared quality of life and early complications between ligation and stripping (L & S) of GSV and Endovenous laser therapy (EVLT). Method: Patients of CVI were diagnosed clinically and radiologically by duplex doppler USG. Fifteen patients in group 1(L & S) and 22 patients in Group 2 (EVLT) were followed at the 6 weeks, 3 months and 6 months. Early post procedural outcomes were documented at one week. Generic health was assessed by SF 36 tools and Specific health was assessed by Aberdeen varicose vein questionnaires (AVVQ) at baseline (preprocedural), at 6 weeks,3 months and at 6 months. Results: Postoperative pain in group 1 and group 2 patients were in 20.0% and 04.5% patients respectively(p>0.05). Paresthesia was in 26.7% and 9.1% respectively (p >0.05). Skin hyperpigmentation was 00.00% and 4.5% respectively (p 0.403). In both groups, infection was found in 20.0% and 04.5% respectively (p 0.137). Tract haematoma along GSV was in 13.3% and 0.00% respectively in both groups.Physical function, role limitation due to physical problems and emotional problems, emotional well-being, social function, pain, general health at end of 6 weeks and at end of 6 months were slightly better in EVLT patients but was insignificant (p >0.05). DVT and recurrence were absent in both groups. Conclusion: Regarding treatment of CVI, Early post-operative complications, Short term General and disease specific QoL is slightly better in patients having EVLT than L & S, but is statistically insignificant. [ABSTRACT FROM AUTHOR]

Background: Missile cardiovascular injuries have taken an epidemic proportion in Kashmir valley since the eruption of militancy in 1990. Present study was undertaken to analyse the pattern, presentation and management of missile cardiovascular injuries. Patients and Methods: Three hundred and eighty-six patients with missile cardiovascular injuries since Jan 1996 to Oct 2008 were studied retrospectively. All patients of cardiovascular injuries due to causes other than missiles were excluded from the study. Results: All patients of missile cardiac injuries were treated by primary cardiorrhaphy. Right ventricle was the most commonly affected chamber. Left anterior thoracotomy was most common approach used. Most of the patients of missile vascular group were treated by reverse saphenous vein graft or end-to-end anastomosis. Most common complication was wound infection (20.83%) followed by graft occlusion (1.94%) in missile vascular group. Amputation rate was 4.66%. Amputation rate was higher in patients with delay of >6 hours and associated fractures. Conclusion: Missile cardiac injuries should be operated early without wasting time for investigations. Clinical status at arrival, time interval till management, nature of injury and associated injuries, tell upon the mortality. Missile vascular injury needs prompt resuscitation and revascularization at the earliest. Time interval till revascularization and associated fractures has a bearing on mortality and morbidity. [ABSTRACT FROM AUTHOR]

Background: Bear mauling is rarely reported in medical literature due to its rare occurrence. Present study was undertaken to describe the pattern and management of bear maul vascular injuries in Kashmir. Patients and Methods: Study of patients with bear maul vascular injury from 1st Jan 2004 to 31st Dec. 2008. Fifteen patients with bear maul vascular injury were studied. All patients of bear maul without vascular injury were excluded from the study. Results: Most of the patients were treated by reverse saphenous vein graft or end to end anastomosis. Most common complication was wound infection (20%) followed by graft occlusion (13.33%). There was no operative death. Conclusion: Bear attacks are very common in Kashmir. Vascular injury due to bear maul needs prompt resuscitation and revascularization. Results are very good provided timely intervention for revascularization is done. [ABSTRACT FROM AUTHOR]