During the last year 2010, we have seen changing concepts in medicine. The management of diabetes, Hypertension, Hyperlipidaemia improved and results of vascular therapies significantly improved by the addition of statins to all therapies. Thrombolytic therapies have not taken any progress in peripheral vascular surgery, though the catheter directed thrombolysis in the iliofemoral venous thrombosis got the attention in few centres with cath lab facilities. There has been better acceptance for the low molecular weight heparins and the market is flooded with number of LMWH brands and too much of noice in the market. Oral anticoagulation has not changed much but there are hopes about the oral antithrombotic drugs such as Apixaban, Riveroxaban which are going to come in to the market soon. Vascular surgical education is still going slowly in the country and very centers are giving the training for surgeons interested to learn. Endovascular aneurysm repair has shown rapid strides in the western countries but in India it is going very slowly due to the high cost of the prosthesis and also due to lack of adequate skills to do the procedure. Vascular Trauma due to road side accidents continued to be most common vascular emergency in our hospital after the orthopedic trauma.There are three DNB trainees in the department and two of them are going to complete examinations soon. On average 50 patients are attending and seeking the consultations in the vascular surgery out patient clinic every day at NIMS hospital. Carotid body tumors, cervical ribs, carotid disease, vascular malformations are treated as before and their numbers remained the same. The number of patients attending the out patient clinic with Venous problems, varicose veins, Deep vein thrombosis and diabetic foot increased this year. Similarly more number of patients are presenting with cellulitis with resistant bacterial infections which are MRSA and ESBL+ve. They are requiring dual antibiotic therapies and Inj daptomycin has shown very good results in some patients who failed to respond to Tiecoplanin. We have shown interest to consider the cell therapies for neovascularization in advanced ischemia patients but we are still waiting and organizing for the cell therapies by forming a team with the physicians. A workshop was done in which varicose veins were treated by the Radiofrequency ablation device and the early results were satisfactory in those patients. We presented papers in the Asian vascular society (July'10)in Japan and received awards for two of our papers. We participated and presented papers in the VAICON Bangalore, VSICON Chennai.
We welcome the new year 2011 and hope that there will be significant changes in the patient care and we will develop the more cost effective therapies in vascular surgery with improved quality of life.
with best wishes,
Pinjala R K
Pinjala R K
