Browsing by Author "Satyendra K Tiwary"

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Assessment and grading of pigmentation in chronic venous insufficiency
(SAGE Publications Ltd, 2020) Satyendra K Tiwary; Praveen KG Kumar; Neeraj Dhameeja; Puneet Kumar; Ajay K Khanna; Soumya Khanna
Introduction: Chronic venous insufficiency causes skin pigmentation of the leg ranging from small patches of mild dyschromia to extensive areas of severe skin pigmentation. It is thought that the pigmentation is mainly due to haemosiderin or melanin deposition. Erythrodiapedesis which occurs as a result of venular hypertension causes erythrocytes to migrate across the microvascular network into the dermis. Methods: We categorized the grading of pigmentation into four grades: +, few spots; ++, pigmentation over gaiter area; +++, pigmentation involving leg and ankle; ++++, heavily pigmented (dark). Skin biopsies were taken from the patient while undergoing surgery; two biopsies were taken from each patient, one from apparently normal skin and other from the site of pigmentation. A total of 45 patients diagnosed as chronic venous insufficiency with pigmentation were included in the study and five patients included in control. The biopsy specimens were sent to pathology department for H&E, Perls stain and IHC for S100. Results: Majority of cases, i.e. 62% of limbs fall under (++) grade of pigmentation, followed by (+) grade of pigmentation in 20%, while (+++) and (++++) constitute 9% of the cases each. Increased melanin deposition was seen in 40 pigmented skin biopsies and 3 normal skin biopsies from the case group, and normal melanin deposition was seen in all the non-varicose controls. Conclusion: We have tried to categorize pigmentation in chronic venous insufficiency into four grades. As the grade of pigmentation increases the per cent of cases with ulceration is increasing. It was observed that presence of melanin deposition irrespective of the grade of pigmentation was distributed more towards the advanced clinical classification (C5 and C6). © The Author(s) 2019.
Colonic lipoma presenting with intussusception
(SAGE Publications Inc., 2021) Puneet Kumar; Mahesh Tiwari; Ajay K Khanna; Satyendra K Tiwary
Colonic lipomas are rare benign tumours, although they constitute the most common non-epithelial neoplasm of the gastrointestinal tract. They mostly remain asymptomatic and rarely present with intussusception. A 62-year-old male presented with acute intestinal obstruction. On laparotomy, intussusception of the descending colon was detected, with a single sessile polyp measuring 3 cm×3 cm as the lead point. A left hemicolectomy was performed, and histopathological examination revealed a lipoma of the colon. © The Author(s) 2020.
Reply of letter to the editor: Assessment and grading of pigmentation in chronic venous insufficiency in Phlebology 2020
(SAGE Publications Ltd, 2023) Satyendra K Tiwary; Praveen KG Kumar; Neeraj Dhameeja; Puneet Kumar; Ajay K Khanna; Soumya Khanna
[No abstract available]
Study of association of varicose veins and inflammation by inflammatory markers
(SAGE Publications Ltd, 2020) Satyendra K Tiwary; Anoop Kumar; Shiv Prakash Mishra; Puneet Kumar; Ajay K Khanna
Objective: In varicose veins, increased levels of inflammatory markers are indicators of endothelial damage and increased procoagulant activity. These findings support the assumption that the constitution of blood in varicose veins differs from that of systemic blood. The purpose of the study was a correlative study of blood constituents in varicose veins and peripheral veins (normal vein) in same individual with varicose vein which was done by comparing the level of concentration of interleukin-6, fibrinogen, haemoglobin from blood of varicose veins and normal peripheral vein (antecubital vein). Method: Using citrated plasma samples withdrawn from arms and legs of same patient and plasma obtained by centrifugation of citrated venous blood at 5000 r/min for 10 min was used for correlation. Serum concentration of interleukin-6 and fibrinogen were determined by human enzyme-linked immunosorbent assay Kit for both interleukin-6 and fibrinogen, which is based on the standard sandwich enzyme-linked immunosorbent assay technology. This assay employs a monoclonal antibody specific for human interleukin-6 coated on a 96-well plate. Result: Expressed as median (interquartile range) in pg/mL, leg samples from patient having varicose vein has significantly increased interleukin-6 in cases as compared to controls (p value of '0.001). Leg samples from patient having varicose vein has significantly increased fibrinogen concentration than their arm samples (p value of '0.001). Concentration of haemoglobin significantly increased in leg samples as compared to blood withdrawn from arms (p value of 0.012). Conclusion: Blood withdrawn from the site of varicose vein appears to have significantly increased concentration of interleukin-6, fibrinogen and haemoglobin when compared to same patient’s antecubital blood sample supporting the hypothesis that inflammation is increased in tissues drained by varicose vein. © The Author(s) 2020.