Purely Endovenous Polytherapy for Varicose Veins - How Good is It?

Introduction: Varicose veins are common disorder causingleg pain, blue veins and ulcer in humans. Varicose veinsproduce symptoms due to junctional incompetence, perforatorincompetence or both. In a unique combination of treatmentmodality we have used RFA for large vein ie GSV and SSV, glueembolization for incompetent perforator and sclerotherapyfor superficial varicosity. In our mind Combination of thesetherapies have synergistic action and better short term andlong term outcome and our aim is to find the same.Material and methods: Study was done in department ofradiology Geetanjali Medical College and Hospital,Udaipurfrom january 2019 to july 2019. Patients with varicose veinswho underwent combination polytherapy in interventionalradiology subdivision of were included in the study. Closurefast RFA system with 7cm ablation zone catheter fromMedtronic was used in all cases.Results: In our study of 27 patients all had leg pain and visiblevericocity as presenting symptoms 15 patients had pain withvenous edema and 12 patients had active ulcers. On followup at 1 month 11 patient had ulcer healing mean duration was2 weeks 1 patient had to undergo skin grafting. At 6 monthsfollow up 2 patients had residual symptomatic varicosity andsegmental recanalization of GSV. The long term obliterationrate was 92.59%. 5 patients had mild leg pain on prolongedstanding. Complications were bruising of overlying skin in5 patients but none had ulceration. Thrombophlebitis in 1patient and transient paraesthesia in 3 patients however nonehad permanent deficits. We did not record any DVT.Conclusion: For treatment of varicose veins especially inthe presence of venous stasis ulcers, treatment with triplecombination therapy is associated with faster ulcer healingand lower recurrence rate of ulcer as well as varicocities.

Inducible cellulase production from an organic solvent tolerant Bacillus sp. SV1 and evolutionary divergence of endoglucanase in different species of the genus Bacillus

Abstract Bacteria are important sources of cellulases with various industrial and biotechnological applications. In view of this, a non-hemolytic bacterial strain, tolerant to various environmental pollutants (heavy metals and organic solvents), showing high cellulolytic index (7.89) was isolated from cattle shed soil and identified as Bacillus sp. SV1 (99.27% pairwise similarity with Bacillus korlensis). Extracellular cellulases showed the presence of endoglucanase, total cellulase and β-glucosidase activities. Cellulase production was induced in presence of cellulose (3.3 times CMCase, 2.9 times FPase and 2.1 times β-glucosidase), and enhanced (115.1% CMCase) by low-cost corn steep solids. An in silico investigation of endoglucanase (EC 3.2.1.4) protein sequences of three Bacillus spp. as query, revealed their similarities with members of nine bacterial phyla and to Eukaryota (represented by Arthropoda and Nematoda), and also highlighted of a convergent and divergent evolution from other enzymes of different substrate [(1,3)-linked beta-d-glucans, xylan and chitosan] specificities. Characteristic conserved signature indels were observed among members of Actinobacteria (7 aa insert) and Firmicutes (9 aa insert) that served as a potential tool in support of their relatedness in phylogenetic trees.