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Retinoblastoma

Retinoblastoma is cancer of the eye which begins in the retina. Retina is a layer of nerve cells
that lines the back of the eye. It happens when the cells form a tumor when nerve cells in the retina
change and grows in size and number. Cells usually spread in and around the eye. They can
also spread to the brain and spine. Retinoblastoma usually occur in young children below the
age of five though it appear in adults as well. Children with an inherited gene from their parents
tend to get retinoblastoma at an earlier age, and in both eyes.The early symptoms of
retinoblastoma is a cloudy white pupil(leukocoria). In bright light, the pupil can look silvery or
yellow.
Other symptoms are :IMG-20190326-WA0012
● Poor and blurred vision
● The coloured part of the eye (Iris) appear cloudy
● Crossed eyes (Eyes that appear to be looking in different directions)
● Eye redness
● Eye swelling

There are two types of retinoblastoma.

● Heritable retinoblastoma
This is the most common type of retinoblastoma. It occurs when a child inherits a
mutation (change in a gene) from a parent. Such babies will be born with retinoblastoma.

● Sporadic retinoblastoma
Occurs when a gene mutation happens in early childhood, usually after 1 year of age. It
affects just one eye.

TREATMENT

Treatment involves chemoreduction and focal treatments without the use of external beam
radiotherapy. This allows preservation of the eye in some cases, often with visual function.

Nomophobia

IMG-20190326-WA0008Have you ever been without your mobile phone for a few hours? What goes through  your mind when your phone is not within your reach? Irritated?,tensed? or restlessness?.If yes, then probably you are undergoing a state called nomophobia. Nomophobia or “nomobile-phone phobia” is the irrational fear of being without your mobile phone. This happens when your are not able to use your phone for some reason, such as the absence of a signal or running out of minutes , battery power or credit. Today it’s increasing among high school and college students. A person with this syndrome may be tensed, stressed ,or anxious when he cannot use his mobile phone . It can also be an addiction when such people cannot go to sleep with or next to their smart phone or never switch off their phone or cannot take a break from it.  However, there is debate among the medical community on its classification; is it a phobia, anxiety disorder, lifestyle disorder, or addiction?. But it is commonly perceived as a phobia. Nomophobia preoccupies an individual with his phone and turn to it if they are depressed, anxious, and lonely. It not only affects the mind, but also relationships, where a person is physically present but psychologically absent. It can affect job performance, academic performance, impairs concentration and mental health in a long run. The various symptoms of this condition include,

  •  Elevated heart rate, sweaty palms, shallow breathing.
  • Keep checking the phone every now and then for battery life and/or messages.
  • Plug and connect regularly.
  • Use of phone even at inappropriate places .
  • Health and mental well being suffers in the absence of mobile phone.

The treatment of nomophobia often does not require medical interventions.  The best remedies for this phobia includes  taking control over phone ,interpersonal counseling, cognitive behavioral therapy, addiction therapy, gradual exposure therapy and systematic desensitization. Exposure therapy is, first exposing the individual to their phobia in therapy (ie, not taking the phone in the room with them) and gradually moving to real-life scenarios (ie, moving the phone to another room for gradually increasing amounts of time). For worst cases of this phobia, anxiety medication may be required.

 

Breast Milk

Breast milk is the primary nutrition source  for the newborn. According to WHO, newborn babies should be fed exclusively with breast milk for the first six months. It is the complete nutrition source till six months of age. The rich composition of the breast milk protects the baby against infections, diseases and illness. Bless fully, the benefits of which continue even long after breast feeding has ended.

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STAGES OF BREAST MILK

Breast milk is typically studied under three stages. The colostrum, transitional milk and mature milk.

Colostrum is the thick yellow sticky breast milk produced during the end of pregnancy and during the first few days after delivery. It is high in protein, low in fat and has abundant amount of immunoglobulin(IgA) and white blood cells to fight infections. It also act as a natural laxative by helping to prevent jaundice and clearing meconium from the baby’s body.

Transitional breast milk comes in as a combination of colostrum and mature milk three to five days after birth of the baby.

Mature human milk contain fat (3%-5%), protien (0.8%-0.9%), carbohydrates (6.9%-7.2%),  calculated as lactose. The energy content of breast milk is 60-70kcal//100ml. The protein content is more than the carbohydrate content in the colostrum than the matuem milk. There is no consistent compositional difference between milks from the two breasts unless one is infected.

COMPOSITION OF BREAST MILK

The nutrient rich complex composition of breast milk include water, protien, carbohydrates, fats, immunoglobulins, vitamins, minerals, enzymes and hormones. The composition may varies among mothers and within the same mother throughout a day. This variation over time helps to meet the needs of a growing child.

The principal protein of human milk is casein. It is homologous to bovine beta- casein, alpha lactalbumin, lactoferrin, immunoglobulin IgA, lysozyme and serum albumin.

The principal sugar of human milk is lactose. Apart from lactose 30 or more other oligosaccharides are also present. These amount is the aggregate to as much as 1g/100ml in mature milk and 2.5g/100ml in colostrum. Some of them has the ability to promote growth of certain strains of lactobacilli.

The principal fat elements in human milk are palmitic acid and oleic acid.

The principal mineral constituents are sodium, pottasium, calcium, magnesium, phosphorus, and chlorine. The iron, copper and zinc contents of human milk varies considerably.

BENEFITS OF BREAST MILK

  • Water: Water which makes up 90% of the breast milk keeps the baby hydrated and help to regulate body temperature , lubricate and protect internal organs.
  • Carbohydrates: Apart from being the energy provider , it is also linked to greater brain development.
  • Lipids: lipids or fats play a major role in the baby’s weight gain as he grows.
  • Protein:  It helps to build, strengthen and repair the body. Protein lactoferrin in the milk is associated with the iron transport in the body.
  • Immunoglobulins/ antibodies: They are baby’s first vaccine. It helps fight off germs, bacteria, fungi, viruses, parasites and diseases.  IgA ,the main immunoglobulin  prevents germs from entering the nanbab body and blood.
  • Vitamins protects the baby from scurvy, rickets,and other deficiency diseases.
  • Minerals helps to build strong bones, produce red blood cells and helps in the proper functioning of muscles and nerves.

Acid reflux

Acidity or acid reflux is the back flow of stomach acid to the chest cavity. It is a very common medical condition among people. It is often caused by one or multiple factors. The gastric acid which aids digestion in stomach rises up to the chest cavity or food pipe. This happens when  the lower oesophageal spincher (LES) that regulates the flow of food from oesophagus to stomach doesn’t close or opens too long.

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CAUSES

  • Hiatal hernia: This is a stomach abnormality that occurs when gastric acid builds up or fills the oesophagus as the lower part of the stomach and lower oesophagus moves above the diaphragm.
  • Excess production of acid in the stomach.
  • Excess consumption of spicy and oily foods.
  • Irregular eating patterns and habits.
  • Side effects of medices.
  • Consumption of alcohol.
  • Being pregnant.
  • Snacking just before bed time.
  • Lying on the back or bending over at waist just after a heavy meal.

SYMPTOMS

Acid reflux is generally characterised by a  burning sensation in the stomach throat and heart. The person with acidity may face difficulty in swallowing, indigestion, constipation, restlessness and prolonged sour taste in mouth. Nausea and bad breath are other common symptoms of acidity.

DIAGNOSIS

Acidity is usually self diagnosable with its symptoms. If it doesn’t help, a doctor may ask you to undergo,

a) an X-ray of stomach and oesophagus.

b)an endoscopy of gastrointestinal tract

TREATMENT

  • Antacids: It helps neutralise the stomach acidity
  • H2  receptor blockers/ histamine blocking agents like nizatidine, famotidine, cimetidine.
  • Home remedies include consuming mint leaves, ginger, clove cardomom, banana , cucumber etc.
  • Drinking a glass of milk every day helps reduce acidity.
  • Follow regular eating patterns.

Choking

Choking is a medical emergency where in a foreign body obstructs the air passage to lungs. It is often life threatening caused due to inhalation or ingestion of food or another object .This obstruction can be partial or complete.Partial obstruction allows some air passage to lungs and compete obstruction prevents air passage to lung. It prevents normal breathing and thus body is deprived of oxygen delivery leading to asphyxia. It can be fatal.

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SYMPTOMS

  • Difficulty in breathing ,gasping and wheezing
  • Difficulty to speak.
  • Clutching, and grabbing of throat or mouth.
  • Person’s face turns blue and may become unconscious.

CAUSES

It occurs when a foreign body blocks the air passage to lungs. The object may block either the upper or lower air passages. The most common causes of choking are food and toys. Nuts, seeds, peanut butter are the causes of choking in children.Toy and toy parts also have high potential to completely block the airway in children.

TREATMENT

  • Alternate back blows and abdominal trust.

a)Five back blows: Stand behind the person choking /kneel down behind a hoking child.Bend the person so that his upper body is parallel to the ground and blow between the shoulder blades using the heel of your hand. Repeat it five times.

b)Wrap the person in your arms at his waist. Position one fist above the person’s navel and hold the fist in the other hand and deliver a hard and quick upward thrust to the abdomen.continue doing this five times.

In case of infants less than one year.

  1. Hold the infant face down in a seated position.
  2. Support his head and neck with your hand so that the head is lower than the trunk.
  3. Blow the infant gently between the shoulder bones using the heels of your arm five times.
  4. If the infant is still not breathing,turn him face up n your fore arm resting on your thigh with the head lower than the trunk.
  5. Give five chest compressions at the center of breast bone using two fingers.Press down to a depth of 1.5 inches and let the chest rise again between each compressions.

 

Alopecia Areata

 

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Alopecia areata is a medical condition in which hair falls out in round patches..It is an autoimmune disease which is affected by one’s genetic makeup along with factors such as stress and extremes of dieting. The fall out of hair can be from the scalp or elsewhere on the body. Though the hair re grows, it may fall out again and often the hair loss lasts for years. It can occur in all age groups and otherwise healthy people.

SYMPTOMS

  • Hair fall out in patches: Patches of hair are usually noticed on one’s pillow or in shower. Hair fall out may occur on scalp, eyebrows, eyelashes and beards.
  • In severe cases some patients go bald
  • Nail problems: Nails show pinpoint pitting, white spots and loss their shine often splits.
  • Exclamation mark hair: Hair may grow narrow at the end and as round patch at the bald end.

CAUSES

It is an autoimmune disease where the body attacks its own hair follicles. It is not contagious. Alopecia areata patients may have a family history of this disease and are at a higher risk for thyroid disease, vitiligo, asthma , eczema and hay fever.

DIAGNOSIS

  • Skin biopsy: A small piece of skin is removed and studied under a microscope by a dermatologist.
  • Blood tests: To look for any chances of other autoimmune diseases.

TREATMENT

Currently there is no approved treatment and complete cure so far. Some immunosuppressants and hair regrow medicines are often prescribed by dermatologists to help hair regrow.

Immunosuppressants like corticosteroids and hair regrow medicines such as minoxidil, anthralin and diphencyprone are some other medicines that triggers allergic reactions that help hair regrowth.

Light therapy or photo chemotherapy is a radiation treatment which uses both oral medication called psoralens and UV light.Essential oils like tea rose, rosemary ,lavender, peppermint and oils like coconut, olive,castor and jojoba help reduce symptoms.

The effectiveness of treatment may vary among patients. However hair regrowth may only be temporary. Hair may regrow and fallout again.

Constipation

Constipation refers to less than three bowel movements in a week. It is the inability to completely empty your bowel or pass stool regularly. A person affected by constipation has a delayed or infrequent emptying of dry hardened feces. Though it affects people of all ages, it affects twice as many women as men and is more common in older adults and during pregnancy. IMG-20190318-WA0019Constipation occurs as a result of too much absorption of water from the food by the body before the waste is stored in the rectum. However, constipation can also occur due to many other reasons.

Causes

a. Reduced fiber in diet which includes fruits, vegetables and cereals.
b. Change in eating habits or lifestyle or routine.
c. Ignoring the urge to pass stool.
d. Side effects of certain medicine.
e. Reduced or lack of fluid intake.
f. Depression and anxiety.
g. Physical inactiveness or lack of exercise.
h. In many people milk and dairy products can cause constipation.

Complications

Constipation can cause complications like rectal bleeding after continually trying to pass stool, anal fissures around the anus due to straining to open the bowel, swollen inflamed blood vessels of veins in the rectum and fecal impactions in which dried stools collect in rectum and anus leading to an obstruction in the path.

Diagnosis

Constipation is generally diagnosed based on one’s symptoms and medical history. General physicians throws up a questionnaire based on which a diagnosis is made, like

a. Do your bowels open less than three times a week?
b. Do you need to strain to open your bowel on more than a quarter of occasion?
c. Do you pass a hard or pellet like stool on more than a quarter of occasion?
The physician may then suggest for some tests for diagnosis like,
a. Physical examination: It includes internal rectal examination to feel for any stool that may have collected. This test is rarely carried out in a child.
b. Blood tests to rule out other conditions.
c. X-rays to produce images of the inside of your abdomen.

Treatment

The often recommended and first treatment includes changes in diet and lifestyle. Increasing the intake of dietary fiber, drinking plenty of fluids regular and more exercise helps to prevent constipation. Oral laxatives medications are recommended by doctors to empty bowels .Also try resting your feet on a height so that your knees are above your hips .This helps passing stool easier.

Gestational Diabetes

Gestational Diabetes Mellitus (GDM) is the diabetes that occurs during pregnancy and usually disappears after delivery.As gestational diabetes can harm mother and unborn baby,it is important to manage it. GDM appears in the second half of pregnancy ,in 24 -28 weeks.So it is necessary to conduct a screening for blood glucose around this period.31.GDM

Causes 

In pregnancy, the placenta produces hormones that help the baby grow and develop. These hormones also block the action of the woman’s insulin. This is called insulin resistance. Because of this insulin resistance, the need for insulin in pregnancy is 2 to 3 times higher than normal. If you already have insulin resistance, body may not be able to cope with the extra demand for insulin production and the blood glucose levels will be higher resulting in gestational diabetes being diagnosed.
When the pregnancy is over and blood glucose levels usually return to normal and the gestational diabetes disappears, however this insulin resistance increases the risk of developing type 2 diabetes in later life.

Risks

Blood sugar that is not well controlled in a woman with gestational diabetes can lead to problems for the pregnant woman and the baby:

Extra Large Baby
GDM causes the baby’s blood sugar to be high. The baby is “overfed” and grows extra large.The baby can be born with nerve damage due to pressure on the shoulder during delivery.

Cesarean Section
Besides causing discomfort to the woman during the last few months of pregnancy, an extra large baby can lead to problems during delivery for both the mother and the baby. The mother might need a C-Section to deliver the baby.

Preeclampsia
Preeclampsia is when woman has high blood pressure, protein in her urine and swelling in fingers and toes.Women with diabetes have high blood pressure more often than women without diabetes. High blood pressure might lead to the baby being born early and also could cause seizures or a stroke in the woman during labor and delivery

Hypoglycemia
If a woman’s diabetes was not well controlled during pregnancy, her baby can very quickly develop low blood sugar after birth. The baby’s blood sugar must be watched for several hours after delivery.

Testing for GDM

All women are screened for gestational diabetes at their 24 to 28 week routine check up. Women who are at higher risk may be tested more often. You are at higher risk of developing gestational diabetes if you:

  • are overweight
  • over the age of 25 years
  • a family history of type 2 diabetes
  • come from some Asian backgrounds
  • have had gestational diabetes before
  • have previously had polycystic ovary syndrome
  • have had a large baby before

Glucose tolerance test
Tests include the glucose challenge test and the oral glucose tolerance test (OGTT).‘Glucose tolerance test’ is the diagnostic test used to find out if you have gestational diabetes. It requires fasting for 10 hours (generally overnight). A blood test is taken, followed by a 75g glucose drink and further blood tests at one and two hours later. You will be required to remain at the laboratory for the two-hour duration of the test. If the results of the glucose challenge test show high blood glucose, you will return for an OGTT test to confirm the diagnosis of gestational diabetes.
diagnosis of gestational diabetes doesn’t mean that you had diabetes before you conceived, or that you will have diabetes after giving birth.
If you are diagnosed with GDM,you will need to consult diabetologist also in addition to your gynaecologist.

Mangement,Treatment and Prevention

Managing gestational diabetes includes following a healthy eating plan and being physically active. If your eating plan and physical activity aren’t enough to keep your blood glucose in your target range, you may need insulin.
You can lower your chance of getting gestational diabetes by losing extra weight before you get pregnant if you are overweight. Being physically active before and during pregnancy also may help prevent gestational diabetes.
If you had gestational diabetes, you are more likely to develop type 2 diabetes. Your child is more likely to become obese or develop type 2 diabetes. You may be able to lower your and your child’s chances of developing these problems by reaching a healthy weight, making healthy food choices, and being physically active.

For any queries regarding the procedure and treatment facilities,email us at query@gtsmeditour.com .

Read about:Organ transplantation

 

Organ transplantation

Organ transplantation may be considered as one of  the miracles of twentieth century medicine.Transplant can save lives .Organ transplantation is the best therapy for terminal and irreversible organ failure. In some cases ,transplant  can also restore function to improve quality of life like transplanting the cornea is not necessary for life, but can restore sight.A transplant is an organ, tissue or a group of cells removed from the donor and transplanted into the recipient or moved from one site to another in the same person.To reduce the risk of rejection of the donated organ, the recipient will probably need to take immunosuppressive medication for the rest of their life.

30.Organdonation

 Types of Transplant

Autotransplantation
It is the transplantation of tissues in the same person.A transplant from one part of body to another part is called an autograft.

Below are a few examples of autografts

  • skin graft – uses healthy skin to help heal a wound or burn on another part of the body
  • blood vessel graft – provides an alternative route for blood flow to bypass a blocked artery, for example, in heart bypass surgery
  • bone graft – reconstructs a damaged area of the body, for example, in spinal fusion
  • bone marrow graft – for example, in a person with cancer, bone marrow collected before chemotherapy can replace their blood stem cells after high-dose chemotherapy.

The main advantage of autograft is that there is least probability of rejection, so long-term medication,immunosuppressants is not needed. However, the retrieval of the tissue results in a new wound in addition to the transplant site, from which the person will need to recover.

Allotransplantation
It is the transplantion from other people.A transplant between two people who are not genetically identical is called an allotransplant .Donor organs and tissues can be from people who are living, or people who have died because of a significant brain injury or lack of circulation.
Allotransplantation can create a rejection process where the immune system of the recipient attacks the foreign donor organ or tissue and destroys it. The recipient may need to take immunosuppressive medication for the rest of their life to reduce the risk of rejection of the donated organ.
For some transplants like bone marrow, there is also the possibility that immune cells in the donated bone marrow will recognise the host’s body as foreign and attack the cells of the host. This is known as graft-versus-host disease (GvHD).A transplant between identical twins is called an isograft. The recipient will almost never reject an isograft and so immunosuppressants are not needed.

Xenotransplantation
It is the transplantation from other species.A transplant across species is called a xenotransplant.Heart valves from cows and pigs have been used for many years to replace faulty heart valves in people. The animal valves are treated before use to reduce the risk of the immune system rejecting the valve. Heart valves may also be replaced with human valves (allotransplant) or mechanical heart valves.

Transplantable organs and tissues

According to WHO,Kidney transplantation is by far the most frequently carried out transplantation globally.Although end stage renal disease patients can be treated through other renal replacement therapies, kidney transplantation is generally accepted as the best treatment both for quality of life and cost effectiveness.
Transplants can be for:

  • organs – heart, kidney, liver, lung, pancreas, stomach and intestine
  • tissue – cornea, bone, tendon, skin, pancreas islets, heart valves, nerves and veins
  • cells – bone marrow and stem cells
  • limbs – hands, arms and feet.

Although less in number,multi-organ transplants also occur each year. Common multi-organ transplants include heart and lungs or pancreas and kidney.
Medical advances and research  have opened new opportunities for innovation in transplant and are expanding to include face transplants!

For any queries regarding treatment facilities,email us at query@gtsmeditour.com .

Read about:Varicose vein

 

Varicose vein

Varicose veins are swollen, twisted veins that can be visible just under the surface of the skin. Although it usually occurs in the legs, they also can form in other parts of the body also.Varicose vein is quite a common condition.29.varicosevein

Veins have one-way valves that help keep blood flowing toward your heart. If the valves are weak or damaged, blood can back up and pool in your veins. This causes the veins to swell, which can lead to varicose veins.
Many factors can raise your risk for varicose veins. Examples of these factors include family history, older age, gender, pregnancy, overweight or obesity, lack of movement, and leg trauma.Varicose veins are treated with lifestyle changes and medical procedures. The goals of treatment are to relieve symptoms, prevent complications, and improve appearance.

Causes

Weak or damaged valves in the veins can cause varicose veins. After your arteries and capillaries deliver oxygen-rich blood to your body, your veins return the blood to your heart. The veins in your legs must work against gravity to do this.One-way valves inside the veins open to let blood flow through, and then they shut to keep blood from flowing backward. If the valves are weak or damaged, blood can back up and pool in your veins. This causes the veins to swell.
Weak vein walls may cause weak valves.If these walls become weak, they lose their normal elasticity. They become like an overstretched rubber band. This makes the walls of the veins longer and wider, and it causes the flaps of the valves to separate.When the valve flaps separate, blood can flow backward through the valves. The backflow of blood fills the veins and stretches the walls even more. As a result, the veins get bigger, swell, and often twist as they try to squeeze into their normal space. These are varicose veins.
Many factors can raise your risk for varicose veins. Examples of these factors include family history, older age, gender, pregnancy, overweight or obesity, lack of movement, and leg trauma.

Associated vein problems

Telangiectasias
Telangiectasias are small clusters of blood vessels usually found on the upper body, including the face.These blood vessels appear red. They may form during pregnancy, and often they develop in people who have certain genetic disorders, viral infections, or other conditions, such as liver disease.Telangiectasias can be a sign of a more serious condition.

Spider Veins
Spider veins are a smaller version of varicose veins and a less serious type of telangiectasias. Spider veins involve the capillaries, the smallest blood vessels in the body.Spider veins often appear on the legs and face. They’re red or blue and usually look like a spider web or tree branch. These veins usually aren’t a medical concern.

Varicoceles
Varicoceles are varicose veins in the scrotum and may be linked to male infertility.

Other types of varicose veins include venous lakes, reticular veins, and hemorrhoids. Venous lakes are varicose veins that appear on the face and neck. Reticular veins are flat blue veins often seen behind the knees. Hemorrhoids are varicose veins in and around the anus.

Diagnosis

Duplex Ultrasound
Duplex ultrasound combines traditional with Doppler ultrasound. Traditional ultrasound uses sound waves to create a picture of the structures in your body, in this case the blood vessels and anything that may be blocking the flow of blood. Doppler ultrasound uses sound waves to create pictures of the flow or movement of the blood through the veins. Duplex ultrasound combined with traditional together gives a picture of the blood flow in your arteries and veins.

Angiogram
Although it is not very common, an angiogram givest a more detailed look at the blood flow through your veins.An angiogram helps to confirm whether you have varicose veins or another condition.

Treatment

Varicose veins are treated with lifestyle changes and medical procedures. The goals of treatment are to relieve symptoms, prevent complications, and improve appearance.For more severe symptoms like pain, blood clots, or skin disorders ,one or more medical procedures may be needed.

Medical procedures

Sclerotherapy
Sclerotherapy uses a liquid chemical which is injected into the vein to cause irritation and scarring inside the vein. It causes the vein to close off, and it fades away.This procedure often is used to treat smaller varicose veins and spider veins.

Microsclerotherapy
Microsclerotherapy  is used to treat spider veins and other very small varicose veins.A small amount of liquid chemical is injected into a vein which scars the inner lining of the vein, causing it to close off.

Laser Surgery
The laser light makes the vein fade away.Laser surgery mostly is used to treat smaller varicose veins. The main advantage is that no cutting or injection of chemicals is involved.

Endovenous Ablation Therapy
Endovenous ablation therapy uses lasers or radiowaves to create heat to close off a varicose vein.A device at the tip of the catheter inserted to the vein heats up the inside of the vein and closes it off.

Endoscopic Vein Surgery
For endoscopic vein surgery, a small cut is made in your skin near a varicose vein. A tiny camera is used at the end of a thin tube to move through the vein and a surgical device at the end of the camera is used to close the vein.Endoscopic vein surgery usually is used only in severe cases when varicose veins are causing skin ulcers.

Ambulatory Phlebectomy

For ambulatory phlebectomy,  doctor will make small cuts in your skin to remove small varicose veins. This procedure usually is done to remove the varicose veins closest to the surface of your skin.

Vein Stripping and Ligation
Vein stripping and ligation typically is done only for severe cases of varicose veins. The procedure involves tying shut and removing the veins through small cuts in your skin.

 

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