Background: This study compares the efficacy of vacuum therapy against conventional iodine povidone dressing with respect to area and time of ulcer.Methods: This study is a randomized controlled trail which was conducted in Meenakshi Medical College hospital and research institute Enathur Kanchipuram. The number of patients selected were 50, which were divided into 2 groups, Group A which consisted of 25 and received vacuum therapy, Group B which consisted of 25 and received povidone-iodine solution.Results: This study was a 16 days study, mean area of ulcer on day 0 was 11.25 cm2 in group B, 10.89 cm2 in group A. On day 6, mean area of ulcer was 10.44 cm2 in group B, 8.98 cm2 in group A. Mean area of ulcer was 10.39 cm2 in group B, 7.66 cm2 in group A on the end of the day 16. The results show that both the groups showed decrease in the area of ulcers, but patients in group A who underwent vacuum therapy have shown greater decrease in the mean area of ulcer. The decrease in surface area of ulcer was statistically significant i.e. p=0.025. There was a greater decrease in infection in group A on 16th day compared to group A on 16th day. On day 0, 48% and 60% growth of microorganisms was observed in patients of group B and group A respectively (p=0.428). On day 16, 28% and 8% growth of microorganisms was observed in patients of group B and group A respectively (p=0.034).Conclusions: Vacuum therapy was more effective compared to conventional method of povidone-iodone solution dressing in rate of healing and time of healing.

Background: This randomised study was conducted to evaluate clinical, patient based outcomes after RFA and conventional surgery in a selected population. Methods: This study was conducted in the Meenakshi Medical College Hospital and Research Institute, Enathur, Kanchipuram, Tamil Nadu, India. Results: In present study, it was reported that 150 patients in total were assessed in the study, out of which, 110 were randomised, 100 underwent the intervention as a daily procedure. 50 patients underwent RFA and 50 patients had conventional surgery. In group R, males were 15, females were 35; in group C, males were 17 and females were 33. In CEAP classification, in C2 class, there were 40 in group R, 39 in group C; in C3 class, there were 8 in group R, 6 in group C; in C4-6 class, 2 were in group R and 5 were in group C. The highest total clinical severity score was 1 i.e. 30 in group R and 32 in group C. Highest venous disability score was in 1 i.e. 46 in group R, 42 in group C. Main outcomes after RFA and conventional surgery for great saphenous varicose veins. Theatre time was 80 mins in group R, 52 mins in group C, procedure time was 74 mins in group R, 46 mins in group C, pain in first week (VAS score) was 1.5 in group R, 3.5 in group C, duration of analgesia was 3 days in group R, 11 days in group C, in 4 days group R patients returned to normal activity, in 13 days group C patients returned to normal activity. Numbness/reduced sensation was followed up after 1 week and 6 week, in group R, 8 patients and in group C, 16 patients have shown numbness/reduced sensation after 1 week; 6 patients in group R and 14 patients in group C have shown numbness/reduced sensation after 6 weeks. Conclusions: This study concluded that compared to conventional surgery, RFA took longer time to perform but it gave better and significantly early outcome in patients with varicose veins.

Background: To compare fistula in ano open method with lift method ligation of intersphincteric fistula track.Methods: This is a prospective study which consisted of 70 patients suffering from fistula-in-ano who were admitted to surgery department. All patients above 18 years of age, cases of transsphincteric low anal fistula, maturation of tract were included in the study. Results: In this study, 60 patients were included totally, of which, 10 patients were excluded as 5 patients had tuberculosis, 2 had Crohn's disease and 3 were excluded as they lost follow up. Hence, 50 patients were included in the study. 40 were males and 10 were females with a male to female ratio of 4:1 in this study. The average age of fistula in ano was 45.34±10.39 years. The incidence of fistula in ano was maximum in the age group of 46-55 years. The minimum incidence was in the age < 30 years. The most common primary fistula is intersphincteric track (46%), followed by transsphincteric track (42%). The most common type of fistula in ano patients was discharge from the tract which was in all patients, in others, perianal pain and bleeding was observed. Fistula in ano can be divided into low and high level of fistula. High level of fistula-in-ano was found in 64 % of patients and low level of fistula-in-ano was found in 36% of patients. Recurrence was seen in 6 patients with high suprasphincteric track who were ligated below the internal opening and 10 patients had a recurrence with transsphincteric track of which 6 were obese which made identifying the fistula track difficult. Conclusions: The LIFT procedure is advantageous as no chance of incontinence prevails as the infective focus is removed without dividing any part of sphincter complex, other advantages are that it is easy to learn, perform, safe, high healing rate, low morbidity and easily treat fistula in ano at primary health care level.