European Journal of Molecular & Clinical Medicine

Background: Venous malformations are a type of vascular malformation with abnormally developed vein, venules and venous capillaries bunching together to produce soft cystic reducible masses containing venous blood. They account for about two third of vascular malformations. It may involve skin, mucosa or any other part of the body. The aim of this study was to evaluate the efficacy and safety of intralesional bleomycin sclerotherapy in low flow venous malformations.
Materials and Methods: During 2019- 2022, 213 patients with cutaneous venous malformations were treated with bleomycin sclerotherapy at a tertiary care hospital. The diagnosis of venous malformation was made on the basis of clinical history and physical examination and confirmed by doppler ultrasonographic examination Only patients with low flow venous malformations were treated with intralesional bleomycin sclerotherapy.
Results: All were treated with intralesional bleomycin (0.1 I.U/ kg body weight) on an outpatient basis. Complete resolution (grade 4) was observed in 76(35.6%) patients and almost complete resolution (grade 3) with very minimal residual lesion or pigmentation was seen in 89(41.7%) patients thus producing a complete or near complete response in 77.3% patients.
Conclusion: Intralesional bleomycin sclerotherapy is an excellent treatment modality for the management of low flow venous malformations with very low procedural morbidity.

Idiopathic retroperitoneal lymphocele is an extremely rare entity. Their diagnosis and management is a challenge for many surgeons. This study addresses one such extremely rare case of idiopathic retroperitoneal lymphocele which was diagnosed and managed with the help of intranodal lymphangiography and embolization.
OBJECTIVE: This study aims to discuss an unusual clinical presentation of a case of idiopathic retroperitoneal lymphocele, the imaging modalities available for diagnosis and the various treatment options.
CASE PRESENTATION: A 56 year old male presented with vague abdominal discomfort on and off since last 3 years without any other significant history and a completely normal local and systemic examination. Radiological investigation with a USG guided pigtailing revealed a collection of turbid milky white fluid which was diagnosed as lymphocele on the basis of biochemical examination.MR lymphangiography raised a suspicion of a communicating lymphatic channel with the cystic cavity. Intranodal lymphangiography with lymphatic embolization was performed which showed successful therapeutic results.
CONCLUSION: Clinicians must be aware that though unusual, idiopathic retroperitoneal lymphocele can present as a differential diagnosis for retroperitoneal cystic mass. No diagnostic algorithm is yet available. Diagnosis necessitates a strong index of suspicion, proper radiographic assessment, and fluid biochemical tests

A lymphangioma (or lymphatic malformation) is congenital proliferation of lymphatic vessels accounting for approximately 4 percent of vascular tumors and 25 percent of benign vascular tumors in children.¹ One of the predominant types is lymphangioma circumscriptum consisting of multiple, grouped vesicles that may be pink, red, or black, owing to serosanguinous fluid or hemorrhage. These contain lymph fluid and are often said to resemble frogspawn. We present a case of lymphangioma circumscriptum on the right inguinal fold in a 15-year-old girl who was diagnosed clinically based on dermoscopy and histopathology and subsequently treated with sclerotherapy followed by radio frequency ablation.

Background:  Sclerotherapy and endovenous laser ablation (EVLA) have emerged as alternative treatments to surgery for patients with varicose veins, but uncertainty exists regarding their effectiveness in the medium to longer term.
Objectives: To compare the clinical effectiveness, outcome, complications, recurrence and post operative improvement in CEAP classification in patients treated with EVLA and Sclerotherapy .
Methods: This is a prospective study. All patients fulfilling inclusion criteria with varicose veins  in Krishna Hospital & Medical Research Centre, Karad will be included in the study
Results:  More than 80% of the study population was classified as C2 or C3 venous disease. After 1 and 1/2  year, the anatomic success rate was highest after EVLA , followed by sclerotherapy. The complication rate was low and comparable between treatment groups. All groups showed significant (P < .001) improvement of quality of life and Chronic Venous Insufficiency  72.10%  of patients with  C2 class showed an improvement of the "C" of the CEAP classification.
Conclusion: Endovenous ablation therapy has shown high improvement with the outcomes such as hospital stay, or post operative complications.It can be concluded that the endovenous ablation therapy is an effective method to cure varicose vein which taken significantly higher time for complication of the wound.Compared to sclerotherapy, and apart from signs and symptoms endovenous ablation therapy is an effective therapy which should be used in the management of varicose veins.

Hemorrhoidectomy is the procedure of choice for treating hemorrhoids most effectively. Now a day’s the emphasis is on conservative therapies and newer outpatient methods for treating hemorrhoids.
 Material and Methods: In 2 non-consecutive series of 50 patients, sodium tetradecyl sulphate and 50% dextrose water were injected. Dextrose is used as a 50% concentration (not diluted), while sodium tetradecyl sulphate is diluted 1:2 with distil water before administration.
 Results: Total 127 patient were recruited , Sodium Tetradecyl Sulphate(std) group 63 patients were selected and in dextrose 50% group 63 patients were selected. Mean age of std group was 38.75 years and d50% group was 39.5 years. Peak incidence of disease is between age group 20 to 50 years. Mean  number of sessions required of STD – 1.61(±0.60), Mean  number of sessions required of D50% - 2.40(±0.49) t =6.52 ; p  <0.0001 The mean sessions of sclerotherapy required for D50% group was significantly higher.
 Conclusion: STD performs better than D50%. Within 12 weeks, no sclerotherapy patients relapsed. Sclerotherapy has been well. Neither patient objected to therapy. No patient objected to a second or third injection. Sodium tetra decyl sulphate was more expensive than 50% dextrose sclerotherapy. Dextrose 50% requires multiple sessions. Our low-income patients mostly accepted government-funded care. Dextrose 50% may be preferable for sclerotherapy.

Background: Varicose veins are the most common chronic vascular disorders requiring
surgical treatment at one stage or other. Though considerable advances in
understanding of venous patho physiology and modern imaging techniques have
revolutionized the concept of management of varicosity of lower limb, the treatment of
primary varicose veins still remain unsatisfactory. Objectives of the Study: To study the
clinical signs & symptoms of the patients admitted for varicose veins. To study the
prevalence of varicose veins in the patients admitted to Govt Medical College &
Hospital, Suryapet, To study the age & sex distribution, To study the complications of
varicose veins, To evaluate & manage the varicose veins & its complications, To study
the outcome of surgery.
Materials and Methods: A prospective follow up study was undertaken for 40 patients
who were admitted for various symptoms of varicose vein during August 2012 to
August 2014. They were subjected to detailed history taking and examination with
relevant investigations including Doppler venous study and were subjected to
treatment. They were followed up to assess long-term morbidity and late complications.
Results: Total 40 patients admitted for varicose veins admitted during the period from
Aug 2020 to Aug 2021 were studied. Out of 40 patients studied, 24 (60%) patients were
agriculturists, who admitted of having been exposed to prolonged hours of standing
.Among the 40 cases studied, 57 limbs showed varicose veins, of which 32limbs had long
saphenous vein and communicating system involvement (64%). 20 limbs had long
saphenous vein involvement (40%) alone. Among 32 limbs with long saphenous
and communicating system involvement, 45 had pain (90%), 12 had edema (24%), 29
had disfigurement (58%), 14 ulcers (28%). Of the 46 limbs that underwent surgery 26
(52%) underwent saphenofemoral flush ligation with stripping of LSV and subfascial
ligation of perforators & 10 (20%) underwent saphenofemoral flush ligation alone.
Conclusion: Definite relationship exists between occupation involving prolonged
standing and primary varicose veins. The involvement of long saphenous and
communicating system together is commonest followed by long saphenous involvement
alone. Patients with involvement of long saphenous and communicating system or long
saphenous and short saphenous system were more symptomatic than others
Complications of varicose veins were responded well to operative treatment. Results of
surgical treatment are good.

Background: Infantile Haemangioma (IH)has long been considered as an angiogenic disease because of the tangled disorganized mass of blood vessels
in the tumor. This study aimed to prove the safety and efficacy of medical treatment prior to surgical intervention in management of haemangioma.
Patients and methods: This study was involved patients with infantile haemangioma disfiguring or complaining who admitted to  Zagazig University Hospitals. All patients presented to vascular surgery department were subjected to medical treatment with beta blockers and followed up every 2 months for 6 months for possibility of surgical intervention.
Results: The current study included patients with infantile haemangioma disfiguring or complaining, their mean age was 2.95±1.57. Male patients represent 54.2% and female represent 45.8% of studied group. The majority of outcome were excellent (29.2%), very good (8.3%), good (37.5%) and bad (16.7%). Bleeding reported at 4 cases with 16.7% ulceration and infection 8.3%.  Medical management was in 66.7% and surgical in 33.3% and combined were in 29.2%.  There was significant decrease at all time from pre to 6 month.   The association between basic demographic and hemangiomas characters and type of management were significantly associated with surgical. Surgical management significantly associated with bleeding, and associated with ulceration and infection but not significantly.
Conclusion: Propranolol may be more effective and safer in treatment of infantile hemangiomas (IH) and may also be used as a first-line therapy than previously established therapies, and may be an alternative when more widely accepted treatments for IH have failed. Surgical procedures can keep back for complicated IH in which conservative medical therapy is ineffective or contraindicated.