Dr. Arunagiri Viruthagiri, Consultant Vascular & Endovascular Surgeon, Kauvery Hospital Trichy, shares expert insights on whether varicose veins can indicate underlying circulatory issues and how they differ from heart conditions.
He also discusses important vascular emergencies and conditions such as aneurysms, acute limb ischemia, and the impact of diabetes on blood vessels.
#VaricoseVeins #VascularSurgery #Endovascular #AneurysmAwareness #DiabetesCare #PeripheralArteryDisease #HeartHealth #PreventiveHealth
He also discusses important vascular emergencies and conditions such as aneurysms, acute limb ischemia, and the impact of diabetes on blood vessels.
#VaricoseVeins #VascularSurgery #Endovascular #AneurysmAwareness #DiabetesCare #PeripheralArteryDisease #HeartHealth #PreventiveHealth
Category
🗞
NewsTranscript
00:00:00What is varicose veins coming from these varicose veins?
00:00:03One of the very common reasons is that
00:00:05the varicose veins are very common.
00:00:08Publicly common and circulated by the varicose veins,
00:00:12the varicose veins are in the heart.
00:00:14If you have a particular size,
00:00:18nearly 90% of the patients will die within 5-30 minutes.
00:00:24In the laser ablation,
00:00:25the veins will block the blood reverse directional flow.
00:00:29So, it is a keyhole procedure.
00:00:31Do you have diabetes if you have diabetes?
00:00:35It is not so.
00:00:36If you have a sugar test,
00:00:39you will have to go full fasting.
00:00:40If you have to test it in the morning,
00:00:42you will have to go full of sugar.
00:00:44In this case,
00:00:46there is a challenge in your mother's body.
00:00:50I have to think.
00:00:52I am glad that I made you think.
00:00:54You didn't know how to do it.
00:00:59I am very, very warm welcome to Kaveri Hospital's podcast.
00:01:03In the conversation, this particular episode,
00:01:05we have a vascular surgeon with us.
00:01:08So, different vascular conditions,
00:01:10and remedies, treatments, diagnosis,
00:01:13there are many things in the conversation.
00:01:15And to talk about that, I have Dr. Arnagiri, sir.
00:01:17Manakkam.
00:01:18Manakkam.
00:01:18I am fine.
00:01:20How are you?
00:01:20I am good, sir.
00:01:21Thank you so much.
00:01:22Absolute pleasure hosting you for the conversation.
00:01:24Thank you, likewise.
00:01:25Yes.
00:01:25And I thought in the conversation,
00:01:27we should start with your association with Kaveri.
00:01:30Please, share us about that.
00:01:31Okay.
00:01:32I am Dr. Arunagiri Virithagiri,
00:01:34a consultant vascular and endovascular surgeon.
00:01:38I have been associated with Kaveri for six years,
00:01:43and this is the seventh year, since 2019.
00:01:46About me, I did my MBBS.
00:01:49MBBS, I did from Kilpock Medical College, Chennai.
00:01:52I did post-graduation, MS General Surgery,
00:01:55when it comes to Chandigarh, PGIMR.
00:01:57That is one of the top two renowned institutes in the country.
00:02:01And after post-graduation, I was there in Jipmer, Pondicherry for a year and a half.
00:02:07Then, I did my super speciality,
00:02:10MCH Vascular Surgery from Madras Medical College.
00:02:13Vascular Surgery originated in Madras Medical College,
00:02:17way back in 1985, even earlier than that.
00:02:20But the training program, Vascular Surgery,
00:02:22first MMC across the country.
00:02:25So, we have the oldest training program,
00:02:27and I am proud that I graduated from there.
00:02:30After that, Tamanadu government service, I worked for three years.
00:02:33Then, I went to UK.
00:02:35I was in Birmingham for four years.
00:02:38After that, I returned to Trichy.
00:02:40So, since 2019, I have been in Trichy,
00:02:44practicing vascular surgery.
00:02:46I am the head of the department.
00:02:48Ian Kooda, I have a colleague called Dr. Nedinjerian.
00:02:51We have been working together for the past six years.
00:02:54From last year, we have got vascular surgery training program.
00:02:58In our department, we have got a training program,
00:03:01with two trainees across the country.
00:03:03And this year, we have got two trainees as well,
00:03:05which is a big achievement in a corporate hospital.
00:03:08And regarding the department, we have got a hybrid OT.
00:03:11Hybrid OT, where we can do both open surgery and keyhole endovascular procedures.
00:03:18We have an exclusive vascular ward.
00:03:20We treat roughly about 3,000 OPD patients every month.
00:03:26And with regards to surgeries, per year, we perform somewhere close to 800 to 1,000 surgeries every year.
00:03:34And there are seven or eight districts.
00:03:38We are the tertiary referral center.
00:03:41And we provide 24-7, Irvataral Naramo, round-the-clock emergency services.
00:03:46All these have been achieved.
00:03:49So, when I started, we didn't have any of these services.
00:03:52And with the help of the entire team, the management,
00:03:56we are able to establish the department to this level.
00:04:01That's absolutely interesting, sir.
00:04:03And it's too quite long to remember,
00:04:05and you have an interesting career as well.
00:04:08In your career, in your association, I think in my introduction,
00:04:11in the conversation is particularly going to be about vascular condition.
00:04:15And that's why we have the expert in town.
00:04:16So, vascular condition, I thought we should start from Deep Vane Thrombosis.
00:04:21Deep Vane Thrombosis, what is the name of the Pothumakkad?
00:04:24What is the name of the Pothumakkad?
00:04:26Very interesting, very important question.
00:04:30What is the Deep Vane Thrombosis?
00:04:32What is the Deep Vane?
00:04:34What is the Artery?
00:04:36What is the Artery?
00:04:36What is the Artery?
00:04:38Artery is the Thamanine.
00:04:41The Vane is the Sirain.
00:04:42Okay.
00:04:43So, Thamani,
00:04:44Irudhaithi-leh fundus,
00:04:45on the other side of the body,
00:04:46all the other side of the body,
00:04:47oxygenated blood.
00:04:48Okay.
00:04:49The source is activated,
00:04:50and the oxygen is used in all the body,
00:04:53which is oxygenated blood.
00:04:54The coroner has deteriorated by the organs,
00:04:56and every blood is weakened.
00:04:56The lungs are outlined in the heart and the lungs.
00:04:59The oxygenated blood is cleaned up,
00:05:00and the blood gets circulated
00:05:03to the rest of the body.
00:05:04The body is circulated.
00:05:06So,
00:05:07the body is inside the body of the body.
00:05:09and every body is cleaned up.
00:05:12Okay.
00:05:14And this is the wear.
00:05:16The thamaniyu, the same is the one who is wear.
00:05:18That is the blood flow or the cells on the oxygen.
00:05:23That is the one who is wear.
00:05:25That is the essential for the survival of any organ.
00:05:32Deep vein.
00:05:33We will talk about the two veins.
00:05:35Superficial vein and deep vein.
00:05:38Superficial vein is the main vein.
00:05:45Deep vein is the main vein.
00:05:48They are deeply located.
00:05:55One of the beautiful designs made by God is the human body.
00:06:01The most important structure is the artery and vein.
00:06:04Well protected.
00:06:07Deeper is the main vein.
00:06:08So, it should be easier.
00:06:09It should be easier.
00:06:09It should be easier.
00:06:10It should not get injured.
00:06:10It is always closer to the bone.
00:06:14Or well protected.
00:06:16In order to protect it from external injury.
00:06:19Okay.
00:06:19So, under deep vein,
00:06:22deep vein thrombosis.
00:06:23Deep vein thrombosis.
00:06:24So, deep vein thrombosis is the symptoms.
00:06:27How do you identify?
00:06:29Deep vein thrombosis is the symptoms.
00:06:32Suddenly, it will all start suddenly.
00:06:35It will all start suddenly.
00:06:36One day, one day, one day.
00:06:38One day, one day.
00:06:38That is the initial symptoms.
00:06:41So, it starts with pain.
00:06:44One day, one day.
00:06:45One day, one day.
00:06:46One day, one day.
00:06:50One day, one day.
00:06:51One day, one day.
00:06:52One day, one day.
00:06:52One day, one day.
00:06:53Two day.
00:06:53One day.
00:06:54One day, one day.
00:06:55One day.
00:06:55That is the clue.
00:06:55So, deep vein thrombosis.
00:06:59The possibility is very high.
00:07:01Okay.
00:07:02Is that a medical emergency, sir?
00:07:04It has to be treated immediately.
00:07:05That is a complication.
00:07:07It can be cured.
00:07:08No, there is no worries.
00:07:09And so on.
00:07:10Deep vein thrombosis is a medical emergency.
00:07:13Okay.
00:07:13The sooner we diagnose,
00:07:16seeker amma treat it safely.
00:07:20Okay.
00:07:20So, deep vein thrombosis is a medical emergency.
00:07:23That is the reason.
00:07:25The deep vein clot.
00:07:27Deep vein is in communication with the heart and lungs.
00:07:31Okay.
00:07:31So, deep vein thrombosis is ignored when we continue to walk.
00:07:37And the clot gets dislodged.
00:07:39It can go to the heart and reach the lungs through the heart.
00:07:43And the dead ear is in the bathroom.
00:07:47Bathroom is a medical emergency.
00:07:49Bathroom is a medical emergency.
00:07:51Bathroom is a medical emergency.
00:07:52That is a sudden death is in the community.
00:07:56Heart attack.
00:07:57Heart attack is a medical emergency.
00:07:59He is a medical emergency.
00:08:00The majority of the reason the heart attack is a medical emergency.
00:08:03But the call weak one is a medical emergency.
00:08:07The due diligence on the heart attack.
00:08:07Unconsciously conscious,
00:08:08that is pulmonary embolism.
00:08:13Pulmonary meant lung,
00:08:15embolism meant dislodgement of clot.
00:08:18Okay.
00:08:18So, Karl's deep vein thrombosis, dislodge, lungs at the end of the lung.
00:08:26And the complication prevent it, this is a secret to treat.
00:08:31Okay. Now, how do we diagnose?
00:08:33If one patient comes to the shoulder,
00:08:36if it's thrombosis, do we have scans for it?
00:08:41Yeah. So, in the symptoms, Karl's weak.
00:08:44This is a common scenario where the U.S. flight is near.
00:08:48Flight is near, this is a chronic disease.
00:08:52Karl's has a chronic disease.
00:08:53If we go to Kerala size, we go to the massage.
00:08:56The most common scenario is the Drombosis.
00:08:58This is a common scenario where the cerebral palsy is.
00:09:03my fracture is just for the husband's man.
00:09:07Well, when I go to Kerala, the calf's weak is aement,
00:09:09it's a pain thrombosis.
00:09:13The calf muscles are not on the side of the calf.
00:09:17Long-haul flights are not on the side of the calf.
00:09:21Now, we have to look at the automatic cars.
00:09:25You don't use the clutch.
00:09:26Clutch is not on the side of the calf.
00:09:28It's not on the side of the calf.
00:09:31If you want to go on the calf,
00:09:34the calf muscles are called the second heart.
00:09:37It's called the peripheral heart.
00:09:39If you want to use the calf muscles,
00:09:43the calf muscles pump the blood on the side of the calf.
00:09:46Movement is not on the side of the calf.
00:09:48The blood is not on the side of the calf.
00:09:50That's the deep vein thrombosis.
00:09:52So, you said,
00:09:53how do you diagnose it?
00:09:55In this scenario,
00:09:57there is a Doppler scan.
00:10:01Doppler scan is invasive or non-invasive.
00:10:05If you are pregnant,
00:10:05there is a ultrasound scan.
00:10:08It's a simple scan.
00:10:12The majority of tier 2, tier 3 towns
00:10:16are all ultrasound scans.
00:10:18The ultrasound scans are not on the side of the calf.
00:10:21The ultrasound scans are not on the side of the calf.
00:10:22It's clear.
00:10:31The ultrasound scans are not on the side of the calf.
00:10:44The ultrasound scans are not on the side of the calf.
00:10:51Okay.
00:10:51If you do treatment for 75 to 80% of the blood thinning injections,
00:10:57they improve in 4 to 5 days.
00:11:00Call week or the doctor,
00:11:01they will be able to get to the doctor.
00:11:03If they get to the doctor,
00:11:04the doctor will be able to keep the doctor on the tablet for 6 months or longer,
00:11:11depending upon the patient.
00:11:13If the patient is able to stop the doctor,
00:11:15it will be able to continue the doctor.
00:11:17For example,
00:11:18if you are pregnant and you are pregnant,
00:11:22IVF treatment is available for DVT risk.
00:11:26So, IVF treatment is available for blood thinning injections.
00:11:29But in spite of that, the clot is not available.
00:11:32Usually, it will be 6 months.
00:11:34In the hospital,
00:11:36the doctor will be able to get to the doctor.
00:11:39The doctor will be able to get to the doctor.
00:11:44So, out of 100, 75 to 80% patients,
00:11:49the doctor will be able to get to the tablets.
00:11:5115 to 20% will need a procedure called catheter directed thrombolysis.
00:12:00At the doctor's work for a doctor,
00:12:01it will be a long term.
00:12:01To be able to get to the doctor.
00:12:01It is a complex terminology that will be responsible for the doctor.
00:12:11To do the doctor,
00:12:21the doctor may be able to get to the doctor.
00:12:24and the tube vajiya clot karakera marundhe seluthi clot karaya vachiru.
00:12:30Okay.
00:12:30Clot karaya vachitamna, they will have immediate relief within the third day or the fourth day.
00:12:36Treatment usually takes 24 to 48 hours and the 48 hours treatment muruchuduk appuron,
00:12:43third day, fourth day, instant they will notice the difference.
00:12:46Okay.
00:12:46All week on koranjiru and they will be up on their feet.
00:12:49What anayya enderichu, nadakka aramichiru.
00:12:51So, treatment purutthavarikyum, broadly 80% iku first injection followed by tablets
00:12:57and the tablets noodayya duration depends upon the individual patient.
00:13:01Second component in the endovascular rah thrombolysis in the treatment.
00:13:07In the thrombolysis treatment, select pani daam pannuwa.
00:13:10Yaarukk select pannu roonna, ori young age, ori 30 to 50, ori IT professional,
00:13:15naa flight lane vandhaan kaal veekkama eitzi kaal kallu maaar irukkhi, ori oor runner or anathlet
00:13:21who wants to be back to running.
00:13:23Andhamaari irukkampoludhu, they need quick symptomatic relief, seeker maana relief thayavar.
00:13:28Andhamaari group of patients in the cathedra directed thrombolysis offer pannuroon.
00:13:33Adhukkana facilities, we have in Kaveri.
00:13:35Okay, I think path irukkka, the very next question would be,
00:13:39intensive the treat pannu naa, furthera enna mari complications irukkko,
00:13:42inno further, edadhu, baira edadhu parts oidhanal, affect akumma,
00:13:46apidhinkira aurur keelwbida arukko, would you like to answer that as well?
00:13:48Ya, sure. If left untreated, idha namma treat pannu lai, apidhina enna aaakalaan naa,
00:13:53essentially two problems can happen.
00:13:55One problem naam unadhi highlight pannu mari pulmonary embolism.
00:13:58Clot dislodge aayi, nurayilppoi aadacchudhu naa,
00:14:01it can be fatal as well. Fatal naa ui irukkabattha mudi laa.
00:14:04Okay.
00:14:05Adhu ui irukkabattha, evo lehu pere iukk muididhu,
00:14:07apidhina, odhi 10 to 15 percent muidhila.
00:14:09So it is not a small number.
00:14:11Okay.
00:14:11Adhanal, DVT appropriate time ila diagnose pannu,
00:14:14adhukkana treatment korekta aeduttu,
00:14:16adhukkana treatment duration yung complete pannu.
00:14:19Okay.
00:14:19Kaamana, makkal pannu thawari, enna, treatment one month kak eduttu,
00:14:22enna kaal vikkaan sarayay aeduttu adhanal naa,
00:14:24maathre ay niruthi ikan doctora nne,
00:14:25thirumpavuun, they come with a new problem.
00:14:27Okay.
00:14:27Adhukkana sayakkudad.
00:14:35So one very important complication that can take away the life of your near ones is pulmonary embolism.
00:14:43Second complication, enna, enna, post-throbotic syndrome, enna, post-throbotic syndrome enna,
00:14:49innta kaal ila irukkara clotu, karayiradhu, avuang-avuanggul oduhye individual body oduhye tendency ee pyruttu irukkku.
00:14:58Uru silla pere ikkku 25% fulla karanjurom.
00:15:01Uru 25% ikku 50% karayalaan.
00:15:03Uru 25% ikku 25% karayalaan.
00:15:05Uru 25% ikku karayalaan.
00:15:06Uru 25% ikku karayalaan.
00:15:07Uru 25% ikku karayalaan.
00:15:07Uru 25% ikku karayalaan.
00:15:08Andh particular group of patients ikku thang,
00:15:11innta thrombolysis, catheter-directed thrombolysis roomba helpful laa irukkku.
00:15:14Okay.
00:15:14Uru 25% ikkatu karayalaan thaundhu.
00:15:15Iku, of jihli vishayanaana, catheter director thrombolysis roomba them.
00:15:17Uru 25% ikku karayalaan.
00:15:21Uru 25% ikku karayayaan.
00:15:29Uru 25% ikku karayalaan.
00:15:32So, to the question 2 main complications are,
00:15:36Pulmonary embolism and the DVT klot clearera aahadhu nala.
00:15:47So, to keep it precise, in case our physical activities are regular walking, jogging and the conditions are prevented.
00:15:57Yeah, sure. So, precise, last question is how do we prevent?
00:16:02It is very very important.
00:16:04And why? Medicine is always better than cure.
00:16:08So, if we ask this, I don't think we practice it regularly.
00:16:14So, how do we prevent? Common things that are sedentary lifestyle avoid.
00:16:19Keep yourself active.
00:16:20If you are in a job where you don't have to move, take a break.
00:16:24One or two hours, take a 15-minute break.
00:16:26Coffee, go outside, have a walk, have a chat.
00:16:31Go outside, have a 10-15-minute break or a walk.
00:16:35Flight travel, hydrate yourself well.
00:16:38Narayya, thangni, drink plenty of water.
00:16:41Alcohol or juice, alcohol dehydrates you.
00:16:46It does not offer you additional water.
00:16:49So, remember that, our water will be adequate to hydrate.
00:16:55And long-haul flights, keep your legs moving.
00:16:58Nadoo, once you go to rest room, hesitate.
00:17:02Just have a stroll, have a walk around in long-haul flights.
00:17:06Travel, if we go to the car,
00:17:0710 hours, 12 hours, cruise mode.
00:17:09You will two hours, once take a break.
00:17:12Stretch your legs, walk out.
00:17:14That's what we do.
00:17:16Surgery, post-surgery, patients,
00:17:19seeker-maa away, they will walk around.
00:17:21Seeker-maa, they will walk around.
00:17:21Seeker-maa, they will walk around.
00:17:22The DVT-VT-VT-VT-VT-VT-VT-VT-VT-VT.
00:17:35The first event is to keep ourselves active.
00:17:37Hydrate ourselves well with drinking plenty of water.
00:17:42And during travel, keep your legs moving.
00:17:45Okay.
00:17:46So, that is actually well-spoken, sir.
00:17:47I think we are moving on to the next condition
00:17:49called Vericose Vains.
00:17:50In the Vericose Vains,
00:17:51you can see now,
00:17:53especially for the choreographers,
00:17:55anchors, hosts like us.
00:17:57In the Vericose Vains,
00:17:57you can see what happens.
00:17:59Yeah.
00:18:00Vericose Vains is a very common problem.
00:18:03I have a significant proportion of patients
00:18:08I see with Vericose Vains.
00:18:10Okay.
00:18:11Vericose Vains is a very common problem,
00:18:12Tamil, Surund, Neen,
00:18:15Thaditha Narambukal.
00:18:16That is the Vericose Vains.
00:18:17In English,
00:18:19Dilated, Elongated and Tortuous Vains.
00:18:22That is the Vericose Vains.
00:18:23Okay.
00:18:24Vain is a very common structure.
00:18:27Okay.
00:18:28The first condition is a deep vein.
00:18:30In the Vericose Vains is a superficial vein.
00:18:33Okay.
00:18:35In the Vail,
00:18:35In the Vail,
00:18:35In the Vail,
00:18:36In the Vail,
00:18:36In the Vail.
00:18:36In the Vail,
00:18:49In the Vail,
00:18:58In the Vail,
00:19:08In the Vail,
00:19:09In the Vail,
00:19:09In the Vail.
00:19:27Okay.
00:19:27So,
00:19:27In the Vail,
00:19:28In the Vail,
00:19:29In the Vail,
00:19:29In the Vail,
00:19:29In the Vail,
00:19:29In the Vail,
00:19:31In the Vail,
00:19:33Apart from Pregnant Women,понaginner,
00:19:36you will know the
00:19:36most important thing to see, the most important thing
00:19:39is, barber, cook,
00:19:43so many
00:19:44chefs from
00:19:45Malaysia, Dubai, Singapore,
00:19:46they come
00:19:47over here
00:19:47for Vericose
00:19:48Vain. Get treated and go.
00:19:50So, chef and barber are important.
00:19:52At the time, police constables, police job, traffic police,
00:19:59as you said, anchors, essentially,
00:20:03as you know, varicose veins are common.
00:20:07Okay. How do we diagnose this condition?
00:20:10Varicose veins, because it is evident,
00:20:13when you don't know about it,
00:20:14the majority of the diagnosis is patient.
00:20:16He has the patient's condition.
00:20:17Okay.
00:20:18The patient's condition is called,
00:20:19if the doctor is saying that I am a nurse,
00:20:20I'm a nurse.
00:20:22Publicly, common,
00:20:23the issue circulated in the area,
00:20:25the varicose veins are the heart.
00:20:29Common, varicose veins are the heart.
00:20:31Okay.
00:20:32Varicose veins are diagnosed when you are diagnosed,
00:20:37there are varicose veins.
00:20:38But varicose veins are the same,
00:20:41we have to panic,
00:20:43that is not the issue.
00:20:43Sorry.
00:20:44The other thing is, when you are in the pharmacist,
00:20:49it's a doctor who has been trained in the industry,
00:20:52but I want to learn something about it.
00:20:52I don't know, I work in this industry but I really do things about it.
00:20:52I want to learn a lot of the society.
00:20:53If I do, I will continue to say that,
00:20:59the diabetes of the doctor has gone off.
00:21:07There's a lot of pain.
00:21:08There's a pain in the cr沒有.
00:21:10One day, one day to a day, one day, a day, a day.
00:21:14One day, a day, a day of sleep.
00:21:16The pain is not there.
00:21:18They have to seek medical attention.
00:21:21It's time to take care of the doctor.
00:21:24It's started to become black.
00:21:27And the pigmentation is coming.
00:21:28They have to seek.
00:21:30They've got to seek medical attention.
00:21:34Okay.
00:21:35Anna maari ulcer vandhi ruch chuna, definita they have to seek vascular surgeons advice for varicose veins.
00:21:41Call weak, one call matto, I nai kya rohmana ra nina vengudhu.
00:21:45So, the varicose veins narambu surundan narambu gala irukkara vengalikku,
00:21:49vali, weakam, call la pulli pulli pigmentation, aripu, bleeding, call la punnu.
00:21:56In the maari problems irukkama bolludhu. They have to seek vascular surgeons advice.
00:22:01Okay. So, ippure vandha vengal pahathakapparou,
00:22:03what will be the treatment, what will you advise to the patients?
00:22:07Okay.
00:22:08Nambha first topic la pese na maari ye, idukku to further diagnose,
00:22:12yenga problem irukkana identify panta adhukkai, it needs a Doppler scan.
00:22:15Doppler scan dao go to investigations.
00:22:17Okay.
00:22:18So, uru 90% of the time Doppler scan matto me poodhu.
00:22:21Vara yadu hume tebhu.
00:22:22Okay.
00:22:23On an average, uru Doppler scan ode a cost now is about 1200 to 1500.
00:22:29Okay.
00:22:29So, rumbe expensive test kada yadhu.
00:22:31Okay.
00:22:32The Doppler l e kandu pit qe bechala.
00:22:33Okay.
00:22:33Doppler l e enna kandu pit qe poong, Bdinninnna,
00:22:35Number 1.
00:22:37Varicose vane ullllh patient ullllh ullh ullh ullh ullh luckkere rathakpoida nallax irukkha.
00:22:41That's why the varicose veins are completely different.
00:22:46So, the deep veins are very different.
00:22:51That's why the varicose veins are very different.
00:22:53That's why varicose veins are very different.
00:22:59Anatomic location.
00:23:01Where is the actual problem?
00:23:08That's why the varicose veins are very different.
00:23:15Is that a misconception?
00:23:17You know, there are some misconceptions and some truth.
00:23:23Misconception is that,
00:23:25In the skinned individuals,
00:23:27to bite the skin of the veins,
00:23:30the varicose veins is not in a Fashion sense.
00:23:33The spread of the skin is very different.
00:23:35The spread of the varicose veins is very different.
00:23:37That's a very earlier sign.
00:23:39This is called for the Vareicose Vane.
00:23:40So, this is the Thread Vane or the Reticular Vane.
00:23:42To qualify for the varicose veins,
00:23:45that's why we're very different.
00:23:46Size of 3-4 mm.
00:23:51So, if you want to know the varicose veins, that's why you want to know the varicose veins.
00:23:57If you want to know the varicose veins, you can measure the size of the varicose veins.
00:24:01But if you want to know the varicose veins, you can get clarified with the doctor's advice.
00:24:08So, if you want to know the varicose veins, that's why you want to know the varicose veins.
00:24:18So, being aware is good, but you don't need to panic about the veins seeing in your thigh and leg.
00:24:26Right. In the DVT case, if you want to know the complications, if you are not treated,
00:24:32if you want to know the varicose veins, that's why you want to know the complications and serious conditions,
00:24:37in case of the treatment.
00:24:38Yeah.
00:24:40Varicose veins, the sad part is that, varicose veins are coming soon.
00:24:46Okay.
00:24:47Heart, lung, major problem is coming.
00:24:50Okay.
00:24:51Very rarely eccentric.
00:24:52In general, in medical terminology, we used to say, common things are common.
00:24:57So, that's why common things are public in the interview.
00:25:00It's not a good purpose.
00:25:01So, common varicose veins is that heart gets into the problem.
00:25:05But varicose veins is that majority of the population is suffering because of the mouth,
00:25:09the mouth is weakly and the mouth isdirection.
00:25:13Yeah.
00:25:13For my name is a Nazi constable.
00:25:16For me, it doesn't matter as a shoe area, the mouth is full of the mouth.
00:25:20It has some teeth in the mouth as well as the mouth is full and the mouth is full of
00:25:25the mouth.
00:25:26This mouth is full of the mouth is full and people are cut off and they have a mouth with
00:25:27the mouth.
00:25:27The mouth is full of the mouth.
00:25:29And the smell when customers are coming.
00:25:32That's why I'm going to get the smell again.
00:25:34So, loss of livelihood is a significant problem in varicose veins.
00:25:39Why?
00:25:40The varicose veins, working population affects 20 to 50.
00:25:44Okay.
00:25:44Now, if you have a car, a vehicle, a vehicle, a vehicle, a vehicle, a vehicle that could apply for
00:25:51anchors as well.
00:25:52Unsightly, it affects that job.
00:25:54So, if you have a car, it's not going to suffer.
00:25:59Varicose veins is a very common, simple condition.
00:26:03It can be diagnosed easily.
00:26:06It can be treated easily with very good outcomes.
00:26:10Okay.
00:26:10The most important misconception is that varicose veins are not going to be treated.
00:26:15It is not going to be treated.
00:26:20Varicose veins are not going to be treated.
00:26:22That is not going to be treated.
00:26:24It is not going to be treated.
00:26:24Treatment is not going to be treated but the wipe is not going to be treated.
00:26:27Now, the current technologies of the current, the virus is less than 10% of the problem,
00:26:3390% of the virus is not going to be treated.
00:26:37So, serious problem in varicose veins is loss of livelihood.
00:26:41They are the stigma, mental stress, more than the physical ailment, there is a lot of stigma and psychological problem
00:26:53caused by this.
00:26:54I get it, sir.
00:26:55Treatment has been paid for surgical or non-surgical.
00:26:59With regards to treatment, there are three components.
00:27:03First component is stockings.
00:27:06Second component is surgery. Surgery is removed from the surgery.
00:27:11Third component is laser.
00:27:14Now, if you advise about stockings, I know that it is related to a problem.
00:27:20I don't have pain or swelling.
00:27:23I am not keen on intervention.
00:27:26The stockings help.
00:27:31Okay.
00:27:31Stockings, original varicose veins, treat and cure.
00:27:36It keeps in check.
00:27:38Okay.
00:27:39So, arostors, anchors, routine work,
00:27:43but further progress prevent, they can wear stockings.
00:27:47Okay.
00:27:47But, stockings, the problem is tropical climate.
00:27:51Hot and humid place.
00:27:53Stockings are not very easy to wear.
00:27:55That's why you can wear it.
00:27:58So, if you have a patient,
00:28:00if you have a patient,
00:28:01if you have a patient,
00:28:01if you have a patient,
00:28:02if you have a patient,
00:28:04you can use stockings.
00:28:06Okay.
00:28:06Inno one of the symptoms,
00:28:07stockings,
00:28:08100% of the symptoms,
00:28:08advice is to have 5 or 10% of the symptoms.
00:28:1290% of the symptoms are coming.
00:28:14So, that's why judiciously stockings are used.
00:28:18Okay.
00:28:19Next treatment,
00:28:21now,
00:28:21who has a definite treatment,
00:28:23first day,
00:28:24the weak, ulcer,
00:28:27pigmentation,
00:28:28bleeding,
00:28:28bleeding,
00:28:29one of the symptoms are coming.
00:28:30Major symptoms are coming.
00:28:31Major problem is coming,
00:28:33one of the symptoms are coming.
00:28:34What do you do?
00:28:35Now,
00:28:36in our department,
00:28:3890 to 95%
00:28:39we do laser surgery.
00:28:41Laser is the standard of care
00:28:44in our unit,
00:28:45in the state,
00:28:46in the country,
00:28:47across the globe.
00:28:48Across the globe,
00:28:49laser ablation is the preferred treatment.
00:28:51In the laser ablation,
00:28:53what do you do?
00:28:54In the laser ablation,
00:28:55Varicose veins,
00:28:55is the only get-eating valve.
00:28:59This valve is grey.
00:29:02Block a valve.
00:29:04So,
00:29:05what do you do?
00:29:05In the vein,
00:29:08it's just a reversal of flow.
00:29:12Normally,
00:29:12one-way traffic means,
00:29:13blood,
00:29:14hard-to-nook,
00:29:15it goes on.
00:29:15In the vein,
00:29:19the vein is pressure.
00:29:21It's there,
00:29:21the vein is way up.
00:29:22It's a wing.
00:29:23Right.
00:29:24That blood is a problem.
00:29:27So, in the laser ablation,
00:29:29that vein,
00:29:30blood reverse directional flow
00:29:32block.
00:29:33Okay.
00:29:33So, it is a keyhole procedure.
00:29:35Kall, stitch, thayel,
00:29:37that's why we can treat that.
00:29:42Surgery,
00:29:43a small role.
00:29:45Vain is very small.
00:29:462 cm.
00:29:47It is effective.
00:29:50So,
00:29:50very large veins,
00:29:52surgery has a role.
00:29:53But, majority of the patients,
00:29:55laser is preferred treatment.
00:29:57Okay.
00:29:58So, if you say something,
00:29:59I was just thinking,
00:30:00you know,
00:30:01you know,
00:30:02you know,
00:30:03challenging cases.
00:30:05So, I am a little inquisitive
00:30:07and I would like to hear from you.
00:30:08You know,
00:30:10you know,
00:30:12challenging cases.
00:30:13It was too difficult to handle,
00:30:14but I did it.
00:30:15You know,
00:30:16share it.
00:30:16You know,
00:30:18you know,
00:30:19a bouncer ball marriage.
00:30:20I have to think.
00:30:22Okay.
00:30:23As to...
00:30:24I am glad that I made you think.
00:30:27I don't think you know,
00:30:30I think to sum it up as,
00:30:33this is one case,
00:30:36would be difficult,
00:30:37but still.
00:30:38For example,
00:30:41one case,
00:30:41one farmer,
00:30:42a farmer in India,
00:30:43there is a hay baller machine.
00:30:47The hay baller machine means,
00:30:48the hay baller machine means,
00:30:49the vai kool is cut out the machine.
00:30:50That vai kool is cut out the machine.
00:30:53The vai kool is cut out the machine.
00:30:53The vai kool thread is cut out the vai kool thread.
00:30:58Okay.
00:30:59There is a guard.
00:31:01As we skip helmet on the ground, the guard is on the ground.
00:31:06The guard is on the ground, his hand got drawn in.
00:31:12His hand, lower half of the forearm or the lower arm, got crushed.
00:31:17It was all arap.
00:31:18Hand was drawn in and crushed.
00:31:21If it was crushed, the blood supply was cut.
00:31:23When the blood supply was cut, his hand was in threat.
00:31:27He is a 35-year-old young family, two kids.
00:31:34The patient was from Ariyalur.
00:31:38I remember the wife's face as well.
00:31:41So, they came.
00:31:41They removed the arm.
00:31:44In mid-arm, the arm removed the arm.
00:31:47Then, we jointly involved.
00:31:50In the cases, plastic surgeons, orthopedic surgeons, they were involved.
00:32:16He had a perfectly functioning hand.
00:32:20He was able to use his hand as normal.
00:32:22He was able to use his hand as normal.
00:32:23So, the patient had a wife to what she told me was,
00:32:29My family, you are the family deity.
00:32:32You are the family deity.
00:32:33You are the one.
00:32:33I am the one.
00:32:34I am the one.
00:32:35Abdeen, she told me. So, that is the impact we create in people's lives.
00:32:41Another patient, Abdeen, is a meat shop work partner person.
00:32:47Meat shop work partner person, 28-year-old obese guy.
00:32:56His mother is extremely worried.
00:32:59He was not offered the right treatment.
00:33:08We evaluated him, treated for varicose veins. Within 4 weeks, ulcer healed.
00:33:14Ulcer healed, within 3 months, his marriage got fixed up and they came and gave the first invitation to me.
00:33:22So, there are many such stories, but briefly, I can share these two stories.
00:33:29If you tell me, there is a wholesome feeling.
00:33:32The amount of satisfaction that you get out of your work is something that I cannot put it in words
00:33:37is what I can say.
00:33:38Alright, let's move to the next vascular condition.
00:33:41We were talking about varicose. I think it's time that we also talk about aneurysm.
00:33:45So, what is aneurysm?
00:33:47What's a problem in the van?
00:33:49We discussed about a problem in the vaines.
00:33:51Sirai as a weapon than other v志, then we also talked about naturalintBaby.
00:33:54We have identified a disease in the previous one.
00:33:54So, the autorities are very small.
00:33:58Our cooters are very small.
00:33:59Our business is are of skeletal, skulls, skulls, kidney, malnegies…
00:34:01They're all *** will in this vein
00:34:03may cause oxygen to the blood pain.
00:34:05Ok.
00:34:05This Campus is aneurysm.
00:34:06Can you tell aneurysm to your vag
00:34:08Schweiz on earth is 951.
00:34:11It becomes dilated.
00:34:14If you notice a balloon, you can see a balloon on a particular size.
00:34:19You can see a balloon on a particular size.
00:34:25You can see a balloon on a particular size.
00:34:29But if you see a balloon on a balloon,
00:34:39it is a fatal life-threatening condition.
00:34:43It hardly gives time to react.
00:34:45So, it is that serious a problem.
00:34:48The aneurysm is updated.
00:34:49How do we treat it and what are the symptoms?
00:34:51So, aneurysm is not a good thing or a bad thing.
00:34:57Symptoms are very low.
00:34:58So, patients are very low.
00:35:02Again, the arteries are deeply located.
00:35:06If you see a symptom related,
00:35:09back pain,
00:35:11very low,
00:35:12it is not a symptom.
00:35:13So, symptoms are less.
00:35:15But symptoms are very low.
00:35:16It is the symptom.
00:35:17One is acute onset chest pain.
00:35:20Okay.
00:35:21Severe in intensity back pain or abdominal pain.
00:35:24It is the symptom.
00:35:25But majority of the aneurysms,
00:35:27we encounter the same as we have,
00:35:29if we go to a CT scan,
00:35:32it is a aortic aneurysm.
00:35:34Aortic aneurysm is the main blood vessel.
00:35:38From the heart to the legs.
00:35:40Okay.
00:35:40And the aorta is a weak aneurysm.
00:35:44So, majority of the time,
00:35:46it is an incidental finding.
00:35:49When a scan is being done for some other purpose,
00:35:52there are only a few patients,
00:35:55who come with symptoms.
00:35:56Okay.
00:35:57So, in case symptoms,
00:35:58identify the symptoms of Dean,
00:36:01the next step would be the treatment.
00:36:02So, treatment of Dean,
00:36:03where to suggest aneurysm ?
00:36:05How much is surgical?
00:36:06surgical, non-surgical medications,
00:36:07medications on?
00:36:08So, aneurysm is a common even
00:36:13practicing physicians and surgeons.
00:36:16Aneurysm shows that everyone gets alert.
00:36:19On the public,
00:36:21normally there are any home
00:36:22That's why we are also in a bad condition.
00:36:26If you're going to need an aneurysm,
00:36:27you will need to go to a particular threshold.
00:36:30If you're going to need an aneurysm,
00:36:31you can be able to reach the threshold.
00:36:33If you're going to reach the threshold,
00:36:37we can say the endovascular repair.
00:36:41It's not subject to the endovascular repair.
00:36:43What are the reasons?
00:36:45So, small size aneurysm.
00:36:47I'll classify you to small size and large size.
00:36:50Okay.
00:36:50The small size aneurysm is not.
00:36:53Blood pressure control, heart rate control,
00:36:56smoking is not.
00:36:57Active lifestyle is maintained.
00:36:59Plus, regular follow-up is not.
00:37:01Size increase is not.
00:37:03Okay.
00:37:06Smoking cessation is very very important.
00:37:10Large size aneurysm.
00:37:11If you have a particular size,
00:37:12what do you do,
00:37:13we subject them to a CT scan called CT angiogram.
00:37:17That is a CT scan.
00:37:19That is a specialized CT scan to evaluate the entire aorta.
00:37:23The first aorta,
00:37:24the first arteries,
00:37:25the first arteries,
00:37:25the size of an aneurysm.
00:37:27It is suitable for treatment.
00:37:29It is not suitable for treatment.
00:37:30In terms of treatment,
00:37:32currently,
00:37:33large size aneurysm is not.
00:37:34Treatment is not.
00:37:36That is two treatments.
00:37:37One is open surgery.
00:37:38Second treatment is endovascular aneurysm repair.
00:37:42That is a short form E-VAR.
00:37:46In the thoracic part is T-VAR.
00:37:50Thoracic endovascular aneurysm repair.
00:37:53That is a simplified surgery.
00:37:56First,
00:37:57what do you do in the open surgery?
00:37:58We have to make a cut,
00:38:00open the abdomen
00:38:01and the aneurysm segment
00:38:03is a man-made graft replace.
00:38:07Remplace before the surgery!
00:38:08The first transplant:"
00:38:09The first transplant can be eliminated in the hospital.
00:38:10Okay.
00:38:12In the endovascular repair,
00:38:13what do we do in the hospital?
00:38:14The whole transplant can remove the nerve,
00:38:15the heart,
00:38:18the patient can remove the
00:38:20For aneurysm,
00:38:21the blood flow is due to each other.
00:38:23The stent graft will start with two-thirds graft.
00:38:25That the aneurysm gets excluded.
00:38:28That the blood flow will again.
00:38:29So,
00:38:29keep a deep pressurized.
00:38:30The aneurysm will come out,
00:38:33that pressure is still under the blood flow.
00:38:34And the pressure is still under the blood flow.
00:38:39Thereby, we eliminate the risk of rupture.
00:38:45These are complex procedures, can be done only in specialised centre
00:38:51and I am proud to say that our Kaveri Hospital Trichy is one such centre.
00:38:55Beautiful, sir. Very nice.
00:38:57It is heightened that we also address about acute limb ischemia, sir.
00:39:01There is a medical emergency of penis. Can we know about that?
00:39:04Yeah. Acute limb ischemia is a medical emergency.
00:39:07Why is it? Acute is sudden. Limb is sudden.
00:39:12Ischemia is a lack of blood flow.
00:39:15So, sudden is a medical emergency because
00:39:20if not addressed in time, it could lead to amputation.
00:39:25It will happen soon.
00:39:27It will happen soon.
00:39:28Okay. So, in case you are in the condition,
00:39:32I am going to diagnose your treatment and symptoms if you can sum it up for us.
00:39:36Yeah, sure.
00:39:37So, symptoms I am going to say,
00:39:44So, the key point here is suddenness.
00:39:48It is behind a~~~
00:39:49Don't wake your eyes.
00:39:51Durant your legs MAY SAME.
00:39:52Do not wake your eyes.
00:39:52Unless you don't wake your eyes� пал.
00:39:56No cold.
00:39:57No cold.hen'tikumam
00:40:09It takes
00:40:10The wipe is coming, but the temperature is still in the face, the face is still in the face, the
00:40:16face is still in the face.
00:40:17That is the Acutelum Schema.
00:40:19If it comes to the heart problems, smoking problems, diabetes problems, the body is still in the face.
00:40:27So, suddenly, the face and the face are still in the face, the acutelum is still in the face.
00:40:40In terms of treatment, it needs surgery.
00:40:50Medically managed one small proportion, one 10% medically managed.
00:40:56Majority will need surgery in the form of thrombectomy.
00:41:00The clot remove, the blood supply establish.
00:41:03That has to be done at the middle of the night.
00:41:08In the middle of the night, we can do it.
00:41:10The more time we leave,
00:41:12the tissues of the neck and the neck will be removed.
00:41:17Another option is thrombolysis.
00:41:19Thrombolysis is the clot of the treatment.
00:41:22So, either thrombectomy or thrombolysis is done, the blood supply will restore.
00:41:27This is a golden time.
00:41:30The golden time is generally 6 hours.
00:41:32But 6 hours, I generally tell this as soon as possible.
00:41:39If you seek this, reach the nearest vascular surgeon as soon as possible.
00:41:45And if the hand or the leg is in a salvageable state, we will be able to restore the blood
00:41:51supply and save the lips.
00:41:53Right.
00:41:54Now, also we should talk about this peripheral vascular disease.
00:41:58So, if you look condition space,
00:41:59either in the peripheral vascular disease, what difference and how do we identify?
00:42:04Compared to aneurism, peripheral vascular disease is a much more common problem in our society.
00:42:10Okay.
00:42:11Aneurism is not common in our society.
00:42:14Even though we move on to get the right perspective,
00:42:18Aneurism is not common in the western population.
00:42:21Okay.
00:42:22Than the Indian population.
00:42:24Okay.
00:42:24Indian population, Kerala or Punjab has a higher prevalence of aneurism compared to Tamil Nadu.
00:42:30Why?
00:42:32In our society, people die much earlier before they even develop aneurisms.
00:42:40Okay.
00:42:40So, they don't live long enough to develop aneurisms.
00:42:44So, things are slightly changing.
00:42:46Probably, our life expectancy is increasing.
00:42:50In the past decade or two decades, life expectancy increased.
00:42:53So, we are seeing more aneurisms now than we did 10 or 15 years before.
00:42:59Okay.
00:43:00So, life expectancy increased.
00:43:02Why we are seeing more than age?
00:43:04We are seeing more than age.
00:43:06We are seeing more than age.
00:43:06We are seeing more than age.
00:43:07Aneurism is the aging process of the aorta.
00:43:10Okay.
00:43:10So, on the aging process of aorta, we are seeing more than age.
00:43:14Obviously, you won't develop an aneurism.
00:43:17So, when people start living longer, they develop aneurisms more often.
00:43:24So, that is the key.
00:43:25In the peripheral arterial disease, it is a much more common problem.
00:43:28Why do you say diabetes?
00:43:30India is the diabetic capital of the world.
00:43:33If you look at the numbers, they are mind-boggling numbers.
00:43:38One in 11% living in the world is developing diabetes.
00:43:41One in 7% living in India is developing diabetes.
00:43:46So, diabetes is an important factor for developing peripheral arterial disease.
00:43:51And number 2, it has now become very fashionable for smoking.
00:43:56Everyone has a cigarette, a swag.
00:43:59Everybody has a cigarette is the second most important factor for developing arterial disease.
00:44:09So, peripheral arterial disease is more common.
00:44:13In the 2 factors, it is the most important factor.
00:44:15Diabetes mellitus and smoking.
00:44:18Right.
00:44:19So, in this case, one of the P.V.D. is going to be diabetic food?
00:44:24That's why peripheral arterial disease can occur in combination with diabetes, without diabetes as well.
00:44:31Diabetes is not available.
00:44:32Okay.
00:44:32Exclusive are smokers.
00:44:34Diabetes is not available.
00:44:36Okay.
00:44:36So, it can be part of both the spectrums.
00:44:39Okay.
00:44:40Can be part of both the spectrums.
00:44:41Generally, peripheral vascular disease is a person who is always present on him.
00:44:48If you mean the pediatrician organism will become a drug for a drug.
00:44:50Okay.
00:44:51If a medical doctor is çıkart, it is a person who is coming in the bathroom.
00:44:54Okay.
00:44:55But peripheral arterial disease is a person who is continuing to occur in the bathroom,
00:44:58I have been 1.5 kilometer from the doctor.
00:45:01In the past one month, over 200 meters the doctor will be used to say that
00:45:05So how do you mean what you do?
00:45:08They tell me what they say...
00:45:09Then they say, doctor, is fine.
00:45:12If someone'siors are worried, they say, doctor,
00:45:14does not understand?
00:45:16If they say doctor, that was a doctor.
00:45:17So that's the pain is reproducible.
00:45:22If there's a doctor, you can call the doctor.
00:45:26If he's going to call the doctor,
00:45:28it's wrong.
00:45:32If he saw the doctor,
00:45:35The higher level of block, aorta illa iliac,
00:45:39the higher level of block is blocked by the buttock or thigh.
00:45:43The lower level of block is blocked by the calf and the calf is blocked by the calf.
00:45:48So, pain on walking is one common problem.
00:45:53Second commonest thing is,
00:45:54Veral is caused by the gangrene, it is the commonest presentation.
00:45:58So, one of the commonest things is the commonest presentation.
00:46:02Once, they come from the Road to the vaerate,
00:46:02or the family went to the age leader,
00:46:05or the other went to the age-old,
00:46:07or the other who went to the age of the age,
00:46:10or after a child, she had to go to the age-old,
00:46:12in 15 days, she went to the hospital.
00:46:16So, they know they have a peripheral artery disease,
00:46:20but if they happen to the hospital,
00:46:23they will have peripheral artery disease.
00:46:26Okay. So, in case they identify how they feel,
00:46:28there is an emergency or a hospital
00:46:32It is not as alarming as an aneurysm or DVT, but it needs early attention.
00:46:40So, early attention I mean, it is preferable to see within a week, at least a week.
00:46:45Okay.
00:46:45If there is a medical emergency, if there is a foul smell, fever, urine output, urine
00:46:54the dead tissue and blood mix, they are developing septicemia.
00:46:59Okay.
00:47:00It is a medical emergency.
00:47:02Veral is a medical emergency.
00:47:04Three to seven days, the vascular surgeon is very essential.
00:47:09Okay.
00:47:10It is common mistake.
00:47:11Veral is a medical emergency.
00:47:14It is a medical emergency.
00:47:17Veral is a medical emergency.
00:47:19is campfire.
00:47:20What is the first sheet?
00:47:24Then for patients to be diagnosed..
00:47:29In a healthcare
00:47:34orthodox administration, they are talking about high blood pressure.
00:47:39Swear, right?
00:47:39So, when you put Pfizer every time to get angry, Northićer�?
00:47:43Parkinson1.
00:47:47And there is a domestic cerebrowal kingdom.
00:47:48One broader terminology. Amputation is a disaster for the patient and the family.
00:48:06The patient is a setback. Why is that? Calls are very important for mobility.
00:48:17If we go to the bathroom, we will go to the bathroom and we will go to the bathroom.
00:48:22As brain and heart, for our day-to-day living, the legs are very important.
00:48:28As a vascular surgeon, the motto is Amputation-Free India or Amputation-Free World.
00:48:37Who is calling in the hospital?
00:48:40That has been achieved.
00:48:44We have had large campaigns by the Vascular Society of India
00:48:48for Amputation-Free India and Amputation-Free World every year on August 6th.
00:48:54National Vascular Day.
00:48:55We have to conduct this.
00:48:56So, Amputation treatment is not available.
00:49:00Amputation is not available.
00:49:02Amputation is not available.
00:49:02But not in all.
00:49:05Amputation is not available.
00:49:07If you have to preserve the treatment, PID.
00:49:10If you have to preserve the treatment,
00:49:13you can locate it.
00:49:15Locate it.
00:49:16We use Doppler scan, CT scan, MRI scan, MRI scan.
00:49:21What is the problem?
00:49:21What is the block?
00:49:25There are two treatments.
00:49:27One is angioplasty or stenting.
00:49:30Like the heart.
00:49:31Heart attack, the heart is angioplasty or stenting.
00:49:45So, in the past six years, we have treated in the PID related close to 600 patients.
00:49:57And out of 600 patients,
00:49:59One 80 to 85 percent, we have salvaged the legs.
00:50:03Kaala kaapaath irukko.
00:50:04One 10 to 15 percent have either lost their toes or the leg.
00:50:09So, if you look at the numbers,
00:50:11In the number of 100 people we have caught,
00:50:13we have treated and asked,
00:50:17At least, when the number is around,
00:50:19We were able to achieve their legs and the number is all back on their feet.
00:50:24From that point to the level,
00:50:26The treatment is not available.
00:50:27Bottom line is the limit.
00:50:30The blood supply is watching the blood supply needs to prepare every year.
00:50:36They need either angioplasty or surgery.
00:50:38depending upon patient factors and the blockage related technical factors.
00:50:44Okay, so PVD was talking about we were also actually talking about diabetes.
00:50:49I have always had this question.
00:50:51Diabetic patients are easier food to affect.
00:50:54Why is it so? Why is it interconnected?
00:50:57Very important question.
00:50:59Diabetes patient is a part of the lifestyle.
00:51:09To your question, diabetes,
00:51:10why is it affected by multiple diseases?
00:51:17Diabetes, as a disease, can affect from head to toe.
00:51:22Can affect, brain affect, heart affect, kidney affect, liver affect.
00:51:29Similarly, the skin also affects the nerves first.
00:51:35Okay.
00:51:35Nerves, we know that we know that we can move the nerves.
00:51:39This is a nerve.
00:51:41This is a sensory nerve.
00:51:42This is a sensory nerve.
00:51:43This is a motor nerve.
00:51:45This is an effect of arteries.
00:51:46Blood vessels affect.
00:51:48That is the most important part of the blood supply.
00:51:58This is a sensory nerve.
00:52:04This is a sensory nerve.
00:52:06This is a sensory nerve.
00:52:11Diabetic patients should never walk barefoot, epime footwear wear. So common reasons, nerve effect, artery blood, vessel effect and shape
00:52:21effect and shape effect.
00:52:24Or improper footwear, bad footwear use. Bad footwear means high heel use.
00:52:34Biomechanics should understand the body.
00:52:46Diabetic foot can affect various organs.
00:52:51Diabetic foot can affect various organs.
00:52:52Diabetic foot ulcer is coming.
00:52:53In the 5th grade, where does it fit in, only a medical person can evaluate.
00:53:00So vascular surgeon is coming.
00:53:02Neuropathy, diabetologist and physician.
00:53:06Complete evaluation is needed.
00:53:08Number one, what we do is,
00:53:11if we have a pulse,
00:53:13we can see a pulse in the back.
00:53:16We can see a pulse in the back.
00:53:19The pulse check is inexpensive.
00:53:23Inexpensive, there is no money involved.
00:53:24There is no money involved.
00:53:25The pulse check is a pulse in the back.
00:53:27The pulse check is a pulse in the back.
00:53:29The pulse check is 90% adequate.
00:53:33So it's a very simple test.
00:53:35Number two, the sensation is adequate.
00:53:37This is a monofilament test,
00:53:40a sensation adequate or neuropathy,
00:53:43let's check.
00:53:45If you have an acute muscle and anxiety,
00:53:48the underlying problem is the
00:53:51The foot ulcer is recovered.
00:53:53If you have a blockage, you will improve blood flow.
00:53:58If you have a neuropathy, you will maintain the sugar control, foot wear.
00:54:04The foot wear is offloading.
00:54:09There are surgical procedures.
00:54:14The problem is, we neglect the problem.
00:54:20Only when the problem becomes Boothagaramma,
00:54:22you will know the problem is,
00:54:24you will die in the same time.
00:54:27So, do not ignore the early signs.
00:54:31If you have a problem, you will identify the problem.
00:54:37Diabetic patients, we always give importance to the face.
00:54:41The face is very important.
00:54:44And all of them, the question is,
00:54:46Face is the index of the mind.
00:54:48That's the point.
00:54:49If you have a patient's mind,
00:54:52I say to my patient,
00:54:54Foot is the index of the heart.
00:54:56The path is the index of the heart.
00:54:59The path is the end of the heart.
00:54:59So, all diabetic patients,
00:55:03They have to inspect their feet every day.
00:55:06Call a daily check.
00:55:08Nail cut to the body underline.
00:55:12Con foot is correct.
00:55:16Correct on the time,
00:55:17Treatment,
00:55:18We will have to run the whole.
00:55:22It's the end of the heart.
00:55:25So, it's a goal.
00:55:33That's the goal of the heart,
00:55:36From the heart.
00:55:37Okay.
00:55:38Every 30 second, we are losing a foot. This is the statistics.
00:55:43Over 60 winadikale, ulagathile, or amputation adandhute irukkui.
00:55:48It is that serious a problem.
00:55:50So, in the mothth podcastle, if there is one key message, the key message is this.
00:55:56All diabetic patients, please take care of your feet.
00:55:59Paathath paramaringe.
00:56:01As you look at your face, look at your feet.
00:56:04And whenever there are early signs, do not ignore it.
00:56:07Seek medical attention appropriately.
00:56:10Maintain good blood sugar levels.
00:56:13I have to ask you to ask you, alternate forms, use it.
00:56:17Without even checking the blood sugar, it is a very bad thing to do.
00:56:21Diabetes is one of the controls.
00:56:2325-30 years, you can live a normal life.
00:56:26If you don't keep it under control, it will take your life in 5 years time.
00:56:31Use footwear when you go out.
00:56:34Maintain a healthy lifestyle.
00:56:35Walk for 45 minutes every day.
00:56:38Eat a balanced healthy diet.
00:56:40Fast food, junk food.
00:56:41Alla harukku shawarma.
00:56:43One bhaengar kreza eititzi.
00:56:45Inna mari illaamah, home cooked food.
00:56:48And good vegetables.
00:56:49Home grown.
00:56:50Illa pakkatla.
00:56:51Nambha sandhela.
00:56:52Udavar sandhela irukkui.
00:56:53Angi inna nalla vegetables vanggi.
00:56:55Saapputamu.
00:56:56So, prevention is better than cure.
00:56:59If we look after ourselves well, we can prevent these disastrous complications.
00:57:04Okay.
00:57:05So, you should trust me.
00:57:06I think you can be an anchor also, sir.
00:57:10You have reduced my job in the whole podcast session.
00:57:12I am just staying quiet because I really love hearing to you.
00:57:15And when we are talking about vascular conditions, I think you all have to do a conclusion.
00:57:21But one last question I would like to ask you is,
00:57:23Diabetic food inna unna sorrla liya?
00:57:25Diabetes irukkari, yalla arkum varrata kaana vajpagal irukkha?
00:57:28Illa chosen people.
00:57:28Kada yadu.
00:57:29It is not so.
00:57:31Diabetic food, diabetes ullamung yalla arkum varrata illa.
00:57:35In my own family, we have diabetic patients.
00:57:38They are well controlled.
00:57:39They are having diabetes for 30 years.
00:57:41Okay.
00:57:42Without never ever having a food problem.
00:57:44Okay.
00:57:45So, I am not quoting anecdotal evidence.
00:57:48I am quoting from my own family.
00:57:49So, diabetes irukkari, yalla arkum footals varrata illa.
00:57:53Okay.
00:57:53It is just that paying attention and accepting the fact.
00:57:57Nambu oorile periya problem enana denial.
00:57:59They don't accept that there is a problem.
00:58:02Enakko ondhu prachna illa.
00:58:03Veli ili eandhu paakkadhik enakko ondhu prachna illa.
00:58:05There is a constant denial.
00:58:07The first thing to live a healthy life is,
00:58:10you have to accept certain facts.
00:58:12I am getting old.
00:58:13I have diabetes.
00:58:14Enakko pressure irukkhe.
00:58:16I have to look after self mel.
00:58:18Abdihing arah acceptance.
00:58:19You have to accept that there are these problems.
00:58:22When you accept, you will seek solution.
00:58:25If you don't accept, if you deny, you will never seek solution.
00:58:28You will never ask for help.
00:58:29Only when you accept, you ask for help.
00:58:32So, the key thing is, accept that diabetes irukkhe.
00:58:35Parawala.
00:58:36Diabetes were small problem daan.
00:58:38Ouro advanced cancer irukkharada vete, it is parawala.
00:58:40Nambal veday innoho mousamana condition la, health condition la, yavadho pere irukkha.
00:58:44It is pariya vishiyan la.
00:58:45It is namal ala control la vetchikha mudi yun.
00:58:47Appah diabetes irundha allay na maath saattay irukkha mudi yun.
00:58:49Diabetes irundha, you can maintain a healthy diet.
00:58:52You can adjust your diet.
00:58:54Nambal prime minister has announced world millets day.
00:58:57Millets are a fantastic food.
00:59:00Diabitish irunna, yallath yun millets maathnoon illa.
00:59:02Incorporate millets one meal a day.
00:59:04One meal a day incorporate.
00:59:06Step by step.
00:59:08So, if you modify your diet, walk for 45 minutes every day for 7 days a week.
00:59:15Wear footwear.
00:59:17Do regular checkups once in 3 months or once in 6 months to see whether your blood sugar,
00:59:24blood sugar control la irukkha.
00:59:25The HPA one seen or mukhyamana test irukkha.
00:59:28And the test reflects the blood sugar level for the past 3 months.
00:59:33Nambal makkhalen enna pundwaangana,
00:59:35ennei shugar test pundwa pundwa pundwa pundwa mothal naalfu lho fasting irundharu vang.
00:59:38Irudhutu kaala yunpohay test irukkha.
00:59:39Enak shugar kamya adana irukkha.
00:59:41Ok.
00:59:41So, that is like cheating yourselves.
00:59:44So, in the HPA one see eduthamna,
00:59:46munu maathath le sugar level elune inna irukkha.
00:59:47Oke, apudu ing again thA jagutu tarinjura wo.
00:59:49Ah adi vettavelecchcambhaращ,
00:59:51shugar control la irukkha illa yo apudu ing again thCaa.
00:59:53Adana wando yunga avraeage value 6.5 to 7.
00:59:56I see patients with HPA one see of 13,
01:00:0018 ofany care,
01:00:01apandei na haamwaayage sugar values around 500.
01:00:04which is unacceptable.
01:00:06Oh aign one who underw 어때,
01:00:07your Czech,
01:00:08I have worked in the U K.
01:00:09Apak 120 there would be shocked.
01:00:15But that's the state of affairs in our country.
01:00:19So, diabetes to the question particular specific as long as you accept you have diabetes,
01:00:28you manage your diet well, manage your exercise well, wear footwear, do regular check-ups,
01:00:34you can live your lifetime without a single foot ulcer.
01:00:37Okay.
01:00:37Sir, we need to understand our body is biomechanics of Dean's or not,
01:00:42the base money you have to choose the footwear of Dean's or not.
01:00:44How do we understand that?
01:00:46If you look at the footwear, you can choose the footwear, how do you say it?
01:00:51All the way biomechanics of the foot understand is something.
01:00:56Biomechanics are scientific, there is a pressure study.
01:01:00You have to walk on something to understand the pressure mechanics.
01:01:03All the way pressure mechanics subject to the footwear will be a bit too much.
01:01:07So, generally, one footwear is very important.
01:01:10You need to have a good insole.
01:01:13You need to have a good insole.
01:01:16You need to have a good insole.
01:01:19You need to have a good insole.
01:01:22You need to have a decent thickness of the sole.
01:01:24Generally, high heels is very important.
01:01:28So, a good sole thickness, having a good insole.
01:01:32And crowded.
01:01:36The other thing, what they use is pointed footwear.
01:01:39Use it very sharply pointed.
01:01:41All the way is toe slab is crowded.
01:01:43Never use pointed footwear.
01:01:44All the way is breathing space.
01:01:47These are, I think, common basic things about footwear.
01:01:51So, if you have a problem that comes to the footwear, we have orthotist.
01:01:56We have orthotist.
01:01:56What is orthotist?
01:01:57What is orthotist?
01:01:58What is orthotist?
01:01:58What is orthotist?
01:01:58What is orthotist?
01:01:59What is orthotist?
01:01:59There is a thick and thick and thick and thick and thick.
01:02:00And the other side, we can make a hole.
01:02:03To depressurize that segment.
01:02:05Those adjustments can be done for patients who have developed foot ulcer.
01:02:10But for a common man, I have to be careful about footwear.
01:02:14So, Melissa, that is hard insole without any questioning, it is crowded.
01:02:22And another important thing is, wearle footwear is very well.
01:02:26Wearle has to be protected within the footwear.
01:02:29Heel is very well.
01:02:30It has to be inside the footwear.
01:02:33These are common things.
01:02:34Right.
01:02:35Thank you, sir.
01:02:36I think in the entire conversation, not vascular conditions, to keep it short, physically active
01:02:41because it is a big takeaway.
01:02:48I think it is a fantastic take-off message.
01:02:52It is a long answer of Quran.
01:02:58Not really, sir.
01:02:58I am actually loving the conversation.
01:03:00Please go ahead.
01:03:01These are big problems in the society.
01:03:04I take this opportunity to highlight the societal problems.
01:03:07And the purpose of the podcast is not me getting a lot of patience.
01:03:11As long as the message gets conveyed to the public, I feel really happy.
Comments