Guidelines and recommendation on surgery for venous incompetence and leg ulcer

Study on Black Spot Disease Detection and Pathogenic Process Visualization on Winter Jujubes Using Hyperspectral Imaging System

In this work, the potential of a hyperspectral imaging (HSI) system for the detection of black spot disease on winter jujubes infected by Alternaria alternata during postharvest storage was investigated. The HSI images were acquired using two systems in the visible and near-infrared (Vis-NIR, 400-1000 nm) and short-wave infrared (SWIR, 1000-2000 nm) spectral regions. Meanwhile, the change of physical (peel color, weight loss) and chemical parameters (soluble solids content, chlorophyll) and the microstructure of winter jujubes during the pathogenic process were measured. The results showed the spectral reflectance of jujubes in both the Vis-NIR and SWIR wavelength ranges presented an overall downtrend during the infection. Partial least squares discriminant models (PLS-DA) based on the HSI spectra in Vis-NIR and SWIR regions of jujubes both gave satisfactory discrimination accuracy for the disease detection, with classification rates of over 92.31% and 91.03%, respectively. Principal component analysis (PCA) was carried out on the HSI images of jujubes to visualize their infected areas during the pathogenic process. The first principal component of the HSI spectra in the Vis-NIR region could highlight the diseased areas of the infected jujubes. Consequently, Vis-NIR HSI and NIR HSI techniques had the potential to detect the black spot disease on winter jujubes during the postharvest storage, and the Vis-NIR HSI spectral information could visualize the diseased areas of jujubes during the pathogenic process.

Venous pseudoaneurysm of the great saphenous vein stump as late complication of flush saphenofemoral ligation and stripping

Guidelines now recommend endovenous thermal ablation over open treatment of saphenous incompetence, but flush saphenofemoral ligation and stripping remain relevant when appropriately applied and expertly executed. Complications are rare but could be severe, needing further surgical correction. We report a unique case of a late venous pseudoaneurysm of the great saphenous vein stump after flush saphenofemoral ligation and stripping, successfully treated with surgical sac excision. We highlight the importance of continuous follow-up for patients previously submitted to open venous surgery.

A multicenter review of epidemiology and management of varicose veins for national guidance

BACKGROUND

Varicose vein is a common surgical problems in India. This study was done to assess the clinico-epidemiological profile, risk factors and management practices in varicose veins.

MATERIALS AND METHODS

Medical records of 170 varicose vein cases admitted in tertiary care hospitals in Mangalore between May 2011 to April 2014 were reviewed retrospectively.

RESULTS

Majority of cases 53(31.2%) were of the age group 41-50 years. Majority were males 127(74.7%) and majority were unskilled workers 101(59.4%). Superficial veins were involved in 123(72.4%) cases. Perforator followed by great saphenous vein were most frequently involved. Veins on the left side were more involved than on the right. Common symptoms at the time of presentation was ulceration 98(57.6%) followed by pain in the legs 96(56.5%). Ulceration was seen significantly more among females (p = 0.027) and among house wives (p = 0.004). Complications like eczema 46(27.1%), non-healing ulcers 21(12.3%) and deep vein thrombosis 10(5.9%) were reported among cases. Eczema was present significantly more among elderly patients aged above 60 years (p = 0.019). Risk factors like prolonged standing was observed in 86(50.6%) cases. This history was significantly seen among males (p = 0.001) and among those involved in unskilled occupations (p < 0.001). Recurrence of varicose vein was reported in 23(13.5%) cases. It was associated with patients of the age group 21-30 years (p = 0.021). Doppler ultrasound was the most common 120(70.6%) investigation done. Micronized purified flavonoid fraction was used in management in 15(8.8%) cases. Conservative management methods like limb elevation 50(29.4%) and compression stocking 36(21.2%) was advised to patients. Saphenous vein stripping was the most common surgical procedure 40(23.5%) performed.

CONCLUSION

The high risk groups identified in this study need to be made aware of risk of developing varicose veins. Use of compression stocking at work place added with newer procedure in management could help in betterment in their quality of life.