How specific are venous symptoms for diagnosis of chronic venous disease?

I feel this is very important to know this fact, before we confirm and treat CVI patients based on only few symptoms. The recently introduced Endovenous ablative therapies are offered to lot of patients due to the safety and ease with which these procedures are performed. It would be useful to base our interventions with adequate supportive clinical features after exclude the other possible conditions. If we take these precautions there will be more satisfaction and improvement therapeutic effectiveness.

Pinjala R K
13th Jan 2014

Fruit juice - may be better to avoid concentrated juices!

Some of us like Fruit juices and believe they are safe. But are they safe?

Dear NIMS Doctor,

Fruits and fruit juices are considered to be safe and good for the health by many of us. Some of us take whole fruit while some prefer to take the readymade fruit juices. Now there are alerts to avoid the fruit juices and recommendations are in favour of whole fruit intake. If one would still like to take juices it is better to dilute them adequately.

Fruit juice should be removed from the recommended list of five-a-day portions of fruit or vegetables in the U.K. as it contained as much sugar as many soft drinks, an adviser to the government on obesity has said. Susan Jebb, head of diet and obesity research at the Medical Research Council’s Human Nutrition Research unit in Cambridge, said she did not see juice as a healthy option.

“I would support taking it out of the five-a-day guidance,” she said. “Fruit juice isn’t the same as intact fruit and it has got as much sugar as many classical sugar drinks. It is also absorbed very fast so by the time it gets to your stomach your body doesn’t know whether it’s Coca-Cola or orange juice, frankly,” she told Sunday Times.

“I have to say it is a relatively easy thing to give up. Swap it and have a piece of real fruit. If you are going to drink it, you should dilute it,” she said.

Ms. Jebb said she had herself stopped drinking orange juice and advised others to do so, or at least drink it diluted.

The paper quoted her as saying she would support a wider tax on sugar-heavy drinks.

Ms. Jebb works closely with the U.K. government on diet and obesity issues, and leads the government’s so-called health responsibility deal, which oversees voluntary pledges by the food and drink industry to improve public health. Her comments follow a similar warning in September by two U.S. scientists, Barry Popkin and George Bray, who exposed the health risks of fructose corn syrup in soft drinks in 2004.

Popkin, a professor of nutrition at the University of North Carolina, told the Guardian that fruit juices and fruit smoothies were “the new danger”.

“Think of eating one orange or two and getting filled. Now think of drinking a smoothie with six oranges and two hours later it does not affect how much you eat. The entire literature shows that we feel full from drinking beverages like smoothies but it does not affect our overall food intake, whereas eating an orange does,” he said. “So pulped-up smoothies do nothing good for us but do give us the same amount of sugar as four to six oranges or a large coke. It is deceiving,” Mr. Popkin said.