ABSTRACT
Introduction: Varicose veins of the lower extremities are one of the most common peripheral vascular diseases. A variety of treatments methods have emerged as an alternative to traditional surgery but are limited by their need for equipment and expertise which increases the cost of treatment making it unviable especially in rural India. Thus traditional surgery still forms the mainstay of treatment. Aims: To evaluate and compare the outcomes in patients undergoing Trendelenberg’s procedure with stripping and without stripping of varicose veins. Materials and methods: The study comprised of 50 patients who were admitted with varicose veins. They were allocated into two groups of 25 each where they either underwent Trendelenberg’s procedure with stripping or without stripping of varicose veins. The patients were followed up for six months to assess the efficacy of the procedure as per the parameters of the study. Results were analyzed using SPSS software. Percentages and proportions were used for qualitative data; mean and standard deviation were used for quantitative data. Chisquare test and student t test were applied where appropriate. Results: In the group undergoing stripping, 28% (7 of 25) patients developed hematoma, post operative pain scores on day 0,3,7 and 10 were 3.8±0.9, 2.6±0.7, 1.1±0.6 and 0.2±0.4 respectively. Mean post operative ambulation was achieved on 3.88 days and recurrence at 6 months was seen in 12% (3 of 25) patients. In the group undergoing ligation alone, 4% (1 of 25) patients developed hematoma, post operative pain scores on day 0,3,7 and 10 were 3.0±0.8, 1.6±0.8, 0.8±0.5 and 0.1±0.3 respectively. Mean post op ambulation was achieved on 2.16 days and recurrence at 6 months was seen in 20% (5 of 25) patients. Conclusions: With lesser rates of hematoma formation, better post operative pain scores and quicker ambulation in patients undergong ligation of veins alone, we conclude that Trendelenberg’s procedure without stripping is a better procedure than Trendelenberg’s procedure with stripping of veins in the treatment of varicose veins.
ABSTRACT
Background: Acute appendicitis is the commonest cause of acute surgical abdomen. Appendicectomy is the most frequently performed urgent abdominal operation and is often the first major procedure performed by a surgeon in training. Delay in diagnosis and treatment results in increased rate of perforation, morbidity, mortality and hospital stay.Methods: A prospective study where a total of 100 patients with clinical, radiological and histopathological diagnosis of acute appendicitis or appendicular perforation were studied. The liver function tests were carried out in all the patients.Results: In a study group of 100 patients (74 males and 26 females); 59 cases were acute appendicitis and 41 cases were appendiceal perforation proven histopathological. Out of which 48 cases had elevated serum bilirubin levels i.e., 17 in acute appendicitis group and 31 in appendicular perforation group. The mean serum total bilirubin is 1±0.4 in acute appendicitis cases and 1.9±1.13 in the appendicular perforation cases. Similarly, the sensitivity and specificity of elevated serum bilirubin as a diagnostic marker in appendicular perforation was found to be 75.6% and 71.2% respectively.Conclusions: Elevated serum bilirubin levels appears to be a promising new supplemental diagnostic serum marker in Appendicular Perforation and perhaps be a decision-making investigation.