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Leukenia (cause, symptoms and treatment)

Leukemia or Leukeamia is a type of cancer, caused by abnormality of blood cell which produces large amount of abnormal blood cell and disrupt the production of normal blood cell, results in decrease in the amount of the normal blood cell.   Symptoms  The number of embryonic white blood cells will increase as the mitosis process keeps going which will affect the organs that produce different types of blood cells, including the amount of platelets to be reduced (platelets play an important roles in blood clotting process). As a result, the patient may develop bruised marks, excessive bleed, and red spots on the skin (petechiae).   In addition,  as the number of normal white blood cell in the patient decreases, they will get infected more easier than normal people. In similar, as the number of red blood cells has decreased, some symptoms of different diseases could be spotted such as anemia that can cause difficulties in breathing. Besides, there may also be other symptoms such as fever, chills, weight loss, fatigue, headache. When cancer cells spread to the liver and spleen, It will make the liver and spleen grow,as well as it could cause pain when it spread to the bone and joint.   Type of Leukemia Leukemia is classified into 2 types: acute type and chronic type     •              Acute leukemia is caused by the rapid proliferation of embryonic blood cells, prohibiting bone marrow to produce normal blood cells. It usually occurs in children and may cause death within months without receiving immediate treatment. •              Chronic leukemia (chronic leukemia) is caused by the execcessive production of abnormal blood cells. With large amount of abnormal blood cells in the body. Typically, acute leukemia often happens in adults at various ages. Morover, leukemia can be classified based on white blood cell charactheistics which are lymphoid and myeloid. •              Lymphocytic leukemia occurs when large amount of abnormal lymphoid cells, including lymphocytes and plasma cells are found in the bloodstream. •              Myelogenous leukemia is an abnormal increase in myeloid cells, including eosinophils, neutrophils, and basophils, in the bloodstream. Threfore, the leukemia can be categorized into 4 types which are: •              Acute lymphocytic leukemia (Acute Lymphoblastic Leukemia or ALL) can be found in children under 10 years old and in over 65 years adults. •              Acute myelogenous leukemia (Acute Myeloid Leukemia (AML) or acute nonlymphocytic leukemia) is more common in adults than children while •              Chronic lymphocytic leukemia (CLL) is common found in adults over 55 years old and can be seen in some children with slight impact. •              Chronic myelogenous leukemia (CML) is found in adults with a rare chance in children. In summary, AML and CLL leukemia can be found in adults, whereas ALL leukemia can be found in children.   Cause The leukemia is mostly caused by abnormal genetic information which leads to abnormal cell division and results in continuous multiplication of cancer cells amount. Therefore, we can summarize the causes of leukemia as follows.   •              carcinogen •              Ionizing radiation •              Chromosomal aberration •              some viruses   Medical laboratory examination This section of the article is not complete. You can help Wikipedia by adding content to this section.   Treatment Treatment is varied based on leukemia type in each patient. The principle of treatment is to control the disease in the first phase (remission), the prevent it from recurrence (relapse). Many patients can be cured.   Method of treatment Chemotherapy can be given either by injection or by ingestion. Some cancers may need to be given through the spinal cord. Radiotherapy can be given in two cases: radiation to the area where the cancer is taken place, such as the spleen and testes, or to the whole body to prepare for bone marrow transplantation. Bone marrow transplantation is done by giving high-dose chemotherapy together with radiation to destroy cells, after new bone marrow is injected. Patients need to stay in the hospital until their production of blood cell return to normal function.   Immunization biological therapy by using interferon against certain types of cancer cells.   Other necessary treatments Receiving treatment of blood cancer has many complications, some treatments are simultaneously required. As patients are susceptible to infection, they should avoid crowded places, especially during outbreaks. If the infection is severe, antibiotic therapy will be applied.   Anemia is a common and high impact complication. In case of high severity, it may cause the patient to become tired easily. Transfusions should be done for those whose skin get pale. Patients should have an oral examination prior to treatment.   Treatment side effects Theoretically, chemotherapy is to destroy the rapidly dividing cells to prevent them from rapid spreading. This method is destructive to the cancer cell as great as normal cell. Therefore, as a result of normal cell destruction, several side effects can be experienced e.g., Nausea, vomiting, loss of appetite, hair loss, infertility.   For bone marrow transplantation patients, there is a chance of infection from abnormal bleeding Reference - http://en.wikipedia.org/wiki/

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Get ready before get elderly

Get ready before get elderly   Advancements in technology, especially medical and public health give people a better life quality. Average life expectancy is higher than in the past as we can obviously see that the number of elderly people is increasing. Physical condition will adapt according to the laws of nature. Inevitably, during the last period of life, preparation should be made in order to adapt to social situations & environment and live happily. Here are the principles:   1.It must be accepted that when entering the old age, physical and mental strength will change in a lesser way. Therefore, some adaptation is necessary based on the social and work responsibilities. 2.Be healthy, get yourself workout and health check regularly. 3.Clear your mind and mind your surroundings, both people, environment. 4.Help yourself as much as possible, don't be discouraged, get help when necessary. Good preparation will make yourself more confidence, able to live with family and society happily.     Adaptation and Manner 1.To act appropriately and be a good role model - Elderly should act appropriately, behave be a good role model for your children, grandchildren, and family members. 2.Be a mentor - advice and encouragement to children, grandchildren, and family members when it is necessary. Elderly are the ones who have gone through problems and many obstacles. Your experiences can be used as a lesson for your child, grandchildren which is valuable and can encourage them. However, bringing up serious or tragic past events is something that should be carefully taken into consideration because it has a serious effect on stress in the elderly. 3.Help with household stuff according to your abilities and your physical condition e.g. such as cleaning the house, cooking, watering the plants, raising grandchildren, doing handicrafts, sewing, etc. 4.Role and status changing acceptance - Elderly must realize that getting older or retirement, it affects your roles and status such as becoming more of recipient than a giver like once you have always been both in your family and society, withdraw from leading society and turn to a follower. 5.Accepting and understanding others - Elders must accept and adapt to be able to live with children, grandchildren and family members happily, listening to others opinions, encouraging and honoring them. This contributes to the relationship build-up between family members with the elderly in a better way. 6.Help yourself as much as you can - Most elderly do not want to bother their children, grandchildren, or caretakers. Therefore, taking care yourself helps to reduction of being burden of others. It is considered to strengthen and maintain relationships.  

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“Urticaria”, a fatal disease? What cause of it?

Urticaria Dr. Thanyathat Socheaya - Dermatologist, Vibhavadi Hospital   Urticaria is a very well-known disease. It can be commonly found in adult which many of them have had experienced it.   Some of them said, everyone would have got this disease one in their life.   Urticaria caused by a reaction of the blood vessels in the skin itself which can occur from several reasons, resulting in distinct red rash with wavy and very itchy. It may grow only in certain parts of the body (usually grow over the body). It may last for a few hours or days, or even progress to chronic urticaria with daily occurrence and last for years.   Urticaria can also occurs in children.   There are many causes of urticaria which may be caused by allergies to certain substances such as •              From dietary •              By contact •              Inhaling •              Injection It may also cause along with other complication.   Major causes of urticaria Food Food allergies are the most found – protein especially seafood such as shrimp, shellfish, crab, fish, eggs, nuts or even some fruit.   Some patients may easily notice the cause, such as eating shrimp. However, some cases cannot be diagnosed that easy. Of course, the patients avoid eating shrimp, but they may end up with urticaria, by just ate chili paste or curry paste (with shrimp as an ingredients) without realized.   Therefore, you should closely observe yourself including in children, eating ice-cream or snack, etc.   Besides dietary, some food additives is allergy to most people and can cause urticaria especially, yellow and green color usually use Tartrazine in many thai dessert, so watch out what you have.   Medicine It is one of the causes that this disease can simultaneously take place right after taking the medicine (either by ingestion or injection)     Some cases may take 7-10 days until the symptoms appear. For instance, antibiotics, especially penicillin sulfa are the major cause. Additionally, painkillers, sleeping pills, contrast agents used in x-ray examination, or even vitamins may also cause it.   Infectious disease Some infection could lead to urticaria, such as intestinal parasite (e.g., flatworms and dysentery) are often found as causes of the disease in children. In addition, infection in other parts of the body such as yeast infection in vagina, roundworm has always been found to be the cause of urticaria in adult. Even tooth decay is also a cause (Treatment or removal of tooth decay, can cure it in some patients)   Touching, getting bitten or stunk by insects such as mites, gnats, bee slugs, wasps, wasps, wasps, fire ants, wasps, bees, may sometimes cause urticaria with severe symptoms. Swelling could be spotted all over the body. Some may get shocked or even be dead shortly after being stung.

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Tilt table test

Tilt table test           Tilt table test is a special test used to test in a group of fainting patients when the cause of fainting is unknown to find out an appropriate treatment. Fainting can be caused by many reasons. Some may be the problems of the brain, heart. or disorders of the autonomous nervous system. Tilt Table test is applied to detect whether there is any malfunction of autonomous nervous system or not which is possibly the most common cause of fainting.   Definition of fainting It is a sudden lack of awareness of consciousness (typically less than 1 minute) as a result of hypoxia in the brain without local neurological abnormalities such as epilepsy, etc. Although fainting is rarely fatal, but its recurrence can cause anxiety and injury to the body or brain abnormalities.   Test indicators This test is applied for patients who faint regularly or easily from common activities, such as standing in line for a long time, exposure to the sun, dehydration, lack of rest, sleep deprivation, drinking a lot of alcohol.   Principles of testing Patient will lie over the adjustable bed at 70 – 80 degrees for 15-20 minutes. Some may apply medicine to accumulate the blood that flow to the lower body part. The specialist then analyzes by observing heart rate, blood pressure, ECG characteristics. Patient's show fainting symptom during the test will immediately recover afterward.   Preparation Abstain of water and food at least 3-6 hours before the test to prevent choking due to nausea and vomiting.

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Allergy Skin Testing

Diagnosis and treatment of patients with allergies In addition to history taking and physical examination, Allergy testing should also be performed to determine which substances the patient is allergic to. This may be done through blood tests, nasal tests (in the case of allergic rhinitis) or skin tests. In general, skin testing is preferred as it is quick, easy, giving immediate results at less cost.   Benefit of allergy skin testing In addition to medicine taking, principles of looking at and treating allergy patients is to avoid of allergens contact. However, there are many allergens surrounding us which is difficult to avoid them at all time. But if we know which substances we are allergic to and avoid them directly, it will improve the treatment results. In addition, all patients requiring allergy vaccination treatment. It is necessary to undergo an allergy test first to see if you are allergic to any substance in order to be treated with an appropriate solution prior to the substance that the they are allergic to. From what age can you take the test?            In general, it can be tested at any age. But young children ( with less than 6 months) and in the elderly may give a false negative result because the sensitivity of the skin is less.   Preparation before the test      1. Refrain from antihistamines for 7 days prior to the test.      2. for those who took some medications may contain antihistamines, such as cold medications, nasal decongestants, anti-itch medications, must be abstained 7 days prior to the test.      3. Patients with heart disease, hypertension, should mention the name of the drug you are taking to the doctor who will be testing because some drugs must be stopped before the test.      4. Topical steroids may suppress the result which should be abstrained prior to the test as well.      5. Do not need to withhold water and food before taking the test.   Test Reagent           They are the the purified extract from allergens, for example, dust mite extracts. Hair and dandruff of animals such as dogs, cats, horses, rabbits, ducks, chickens, geese, birds Debris of insects in the house such as cockroaches, flies, fungi plant pollen such as weeds, ferns, perennials, grasses Foods such as cow's milk, eggs, nuts, meat, seafood, vegetables and fruits some kind. It must be a solution that has a standardized production process. Each substance are separated into different bottles. It provides reliable test results. Different types of reagents can be used at a differ amount depending on the age and history of each patient.   There are 2 types of test 1. Skin Prick Test (SPT) Dropping an allergen on the patient's skin using a needle to poke gently through droplets and within the epidermis (no bleeding) then wipe off the solution and wait for 15 minutes for the results. If the patient is allergic to any substance, red bumps caused will be detected on the tested spot of that substance. Nowadays, plastic rods with a pointed fork-like tip (Duotip) are used instead of needles, dipping the solution and then poke it on the patient's skin without a single drop of the drug which make it easier to be used. SPT is widely accepted and recommended for skin testing diagnosis of allergies because it is a safe way, less likely to cause severe allergic reactions, easy to do, less time required, the solution does not need to be diluted thus makes the solution more durable and more time correlated with clinical symptoms comparing to intradermal skin test.   2. Intradermal Skin Test (IKT)           This method is done by injecting an allergen solution into the skin and wait for 15 minutes until the results show up. The disadvantage of this method is that patients, especially children, are found to be less cooperative during the test as it can cause pain. Moreover, the side effects like severe allergic reactions may occur more often as many substances are injected into the body, especially in patients who took certain medications (which is generally very rare, < 1%). However, the test should not be performed in patients with severe symptoms such as severe asthma, itching at the test spot occurs frequently and may resolve on its own or by taking antihistamines.   Best wishes from Pediatric Clinic, Vibhavadi Hospital (Outpatient) Tel. 0-2561-1111 , 0-2941-2800 press 1 Check-up time 07.00 – 20.00

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อะไรคือไขมันร้าย ไขมันดี ไตรกลีเซอไรด์

Bad cholesterol VS. Good Cholesterol and Triglyceride   Talking about cholesterol in detail can provide both the benefits and harms. To be more specific, it is necessary to define which one of them really cause us harm so we would be able to mentioned them as bad cholesterol. Bad cholesterol has a large structure and low density which is also known in medical term as Low Density Lipoprotein, abbreviated as LDL-Cholesterol (LDL-C).   This LDL-C is the real culprit. The more they are, the more problems will occurs with arteries such as blood clogging. On the other hand, another type of cholesterol, which has a high density, called High Density Lipoprotein (HDL), is the hero of our body or good fat (Good Cholesterol), it helps collecting waste or excess fat from the artery walls returns to the bloodstream. and taken to the waste disposal processing plant, namely the liver, to convert cholesterol from fat into bile for further fat digestion.   Now, we should know that between high LDL and HDL levels, which one of them have a greater amount over the other. Normally, our blood is able to detect the level of cholesterol (Total Cholesterol), triglycerides (Triglyceride, another type of fat) and HDL. They can be calculated by using the following formula: LDL-C = Total Cholesterol – (Triglyceride/5)-HDL The normal value of LDL should not exceed 160 mg% for normal subjects and not 130 mg% in people with coronary artery disease, while HDL should be over 45 mg%. Avoid consumption of highly saturated foods will reduce LDL levels which can commonly found in animal fats, in some types of vegetable oils such as palm oil, coconut oil, coconut milk. The point is that is that most of those food products, being consumed are delicious e.g. fried chicken, potato chips, fast food, they're all made from these oils because it's cheap and not very rancid as well. It’s also found from the research that LDL-C levels in people in Asia is growing alarmingly after multinational food popped up like mushrooms and became a favorite among young people and working people until it became the consumption culture of the new generation. Therefore, it is not surprising that coronary artery disease is becoming more and more common. and even more found in younger people than in the past   Best wishes from Vibhavadi Heart Center, "heart" friends near you, call 0-2561-1111 press 1  

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Arthroscopic surgery - small incision, less pain, quick recovery

At present, endoscopic surgery can be applied for many diseases, such as appendectomy, hernia, large intestine, small intestine, thyroid, or even breast surgery, etc. Endoscopic surgery causes less injury with a smaller size of surgical wound, quick recovery, back home and return to normal daily life faster.   Arthroscopic surgery is divided into two types:   1. Open surgery (Open surgery), a simple surgery. 2. Minimally Invasive Surgery, a small incision by using tools to assist in the surgery.   What is arthroscopic surgery? Arthroscopy is a surgery which a long tube-shaped camera are inserted into the joint, looking straight through the camera over the 20 past years ago. Later, the video cameras and special small surgical instruments were added, allowing the doctor to check for abnormalities in the joints and perform surgery by drilling to make a hole into the joints. This helps doctor to clearly diagnose by looking through the monitor connected from the video cameras, providing a right surgical treatment, with a better result over normal surgery that requires opening the wound and cutting out healthy tissue to see the surgery area clearly which is a major problem of joint surgery. To see inside the joints, it is necessary to open the scarred synovial membrane and easy to cause adhesion. Besdies, opening large wounds have a higher risk of infection and the joint surface that has been exposed to a large wound has a high risk of infection.   Endoscopic surgery can diagnose and treat the disease at the same time as the doctor can see abnormalities in the bone joints straight away. There is no need to open the wound extensively, just penetrates through the synovial membrane into the joint, and being operated the membrane around the joint is still enclosure at the same time. Chance of infection is reduced, preventing the joint surface from drying out. The healing time of the surgical wound and the synovial membrane is shorter. The muscle and rehabilitation of the operated joint returns to normal faster in which the anesthesia is unnecessary but an anesthetic to a specific part instead only. Using this endoscopic method to diagnose osteoarthritis It will help the doctor to check and diagnose more precisely than doing an X-ray CT scan or MRI because they can see the cause. and lesions directly   Advantages of endoscopic surgery • Minimally invasive - endoscopic surgery for bone joints treatment. There will be a surgical wound that is much smaller than normal surgery. The wound size is 0.8-1.0 cm. • Fast recovery - The fast recovery, shorten hospital staying, compared to normal surgery depending on the disease under operation. For example, a cloth cut of the large intestine spend 7-14 days in the hospital earlier is reduced to only 3-5 days, allowing patients to return to normal life faster. • Reduce infection – stitches may not be necessary. The small surgical incision will help reduce the wound from surgery as the doctor doesn't need to cut the synovial membrane or surrounding tissue. This reduces the risk of infection and complications during surgery. It also helps to maintain the moisture of the joint skin as well.   What will happen after endoscopic surgery? endoscopic surgery generally takes place relatively quickly. After the surgery, the patient firstly stays at the hospital and then can go back to stay at home.   Self-care taking after surgery 1. Take painkillers when feel pain, plus other drugs as prescribed by the doctor. 2. Apply warm or cold compresses according to the doctor's advice. 3. Get plenty of rest to allow your body to recover quickly. 4. Perform light exercise or physical therapy to help the muscles and joints gain back strength. Recovery time for each patient may vary depending on the condition of the joints and surgery. The doctor will follow up on the patient's symptoms after the surgery until he recovers.   Contraindications for endoscopic surgery A patient who does have problems with easily bleeding or blood clotting poorly should be avoided will cause the patient to lose a lot of blood during surgery. Patients who have been through radiotherapy or have had many surgeries until there is quite a lot of fasciae because it makes it difficult to perform endoscopic surgery. In addition, there will be no space for blowing air to expand the abdominal cavity, resulting in no space for convenient surgery.       Dr. Max Sorjia Jirapongsathorn Department of surgery

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Body Wipe, reduce fever in patients with Tepid Sponge - 354 words

Body Wipe, reduce fever in patients with Tepid Sponge - 354 words          Bathing to reduce fever in children is a very common procedure, especially in between the ages of 6 months and 6 years who are prone to seizures from high fever. Drying your child will help lower his body temperature by using water as a conductor of heat from the body. Indicators 1. Patients’ temperature > 38.2 degree Celsius 2. Children with a history of seizures > 38.0 degree Celsius   equipment      1. 1 – 2 Bath basins, add warm water, about 1/2 of the basin.      2. 2-4 small towels      3. A large towel   Procedure 1. Prepare a place to wipe the child and the air conditioner should be turned off. 2. Take off the patient's clothes. 3. Lay a towel over the wiped area to prevent water from wetting the mattress. 4. Use a towel, moistened with warm water, and wring out enough water to dampen it, start wiping the face, and rest it on the forehead, neck, and repeat 3-4 times. 5. Wipe the chest and body area. 6. wipe the far arm from the forearm towards the upper arm and armpits are wiped in a reverse pore manner to cool down, repeat 3-4 times and rest the cloth around the crook of the arm and armpit. 7. Wipe the arm near the body by repeat the above step 8. Wipe the leg from the tip of the leg towards the thigh and groin 3-4 times and rest the cloth below the knee, groin area. 9. Wipe the legs near the body. by repeat the above step 10. Lie on your side and wipe your back. Starting from the coccyx to the neck, repeat 3-4 times. 11. Dry yourself. and put on the patient's clothes.   Remarks:      - Patients with fever means the pediatric patient has a body temperature greater than 37.8 C.      - wiping to reduce fever should be done for about 10-20 minutes or as appropriate. The water in the bath should be changed frequently to maintain the temperature of the water to be warm and constant all the time approximately 15 minutes after wiping the fever reducer, the patient's temperature is measured again.  

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Venous abnormalities

Venous abnormalities   Blood circulation   The blood circulation can be easily explained if we look at its three main components: the heart, arteries, and veins.   The heart pumps oxygen- and nutrient-rich blood through an intricate network of arteries to every cell in the body. Oxygen and nutrients pass through the cells of the vascular system called “Capillaries”. The waste products of the metabolic process for energy and oxygen-depleted blood are pumped back to the lungs to be exchanged for oxygen-rich again before flowing back to the heart to begin new cycle.   The heart helps pump blood throughout the body. The venous tube uses an antigravity mechanism to transport blood back to the heart pulsation of the heart breathing that moves the chest and muscles of the body. All of them play an important role in the transport of blood back to the heart.   Function of the veins and valves of the veins.   The important task of returning blood to the heart is due to the contractile mechanisms of the muscles and the so-called venous valves. The invisible continuous movement of muscles throughout the body slowly squeezes the veins and pushes the blood from one valve to the other. Each valve consists of two leaflets that act like a pair of water gates. This prevents the gravity of the earth from pulling the blood back down into the legs.   The legs of a normal healthy person have veins with smooth and elastic walls to adapt to changes in intravenous pressure. When the calf muscles contract, the venous valves open in the direction toward the heart to allow enough blood to flow through the muscles to relax. The valve then closes to prevent the return of blood.   But if the walls of the veins are damaged due to varicose veins or blood clots that cause the arteries to become clogged, then the clogged arteries will swell until the valve cannot close well. When the body is in a standing position, the blood flowing back to the heart stops at the legs. Pressure within the saphenous vein (Saphenousvein) under the skin will be higher until the veins are swollen. The most common initial symptom is feeling that the legs are tired or calf pain, especially when standing for a long time. Later, the blood will accumulate on the feet and ankles until it becomes swollen. The skin that covers the ankles will thin. and dark in color or may rupture into a wound called a stasis ulcer (Venous stasis ulcer)  

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Varicose veins

Varicose veins Varicose veins is an abnormality conditions of veins. It mainly refers to abnormalities of the blood vessels in the legs which is commonly causes many patients to seek for medical treatment. In the leg veins, blood is transported back to the heart under a pressure of about 20 mm Hg. The blood in the leg muscles goes into the deep veins. Blood from the skin and surrounding tissues flows through the veins. When there is an abnormality of the combination of veins at this location, it causes Blood flows down the superficial veins, causing the expansion of the peripheral veins called varicose veins.   Cause of varicose veins •          Aging – this abnormality is found in 70% of elderly (with over 70 years old) •          Some of your family have been exposed to this abnormality. The chance is as twice as high. •          Found in female than male •          During pregnancy, due to high level of hormones •          The occupation who should stand still for a long time •          Overwieght people •          Food intake (12% more of incidents are found for the west country)   The mechanism, underlying the occurrence of varicose veins is unknown, but it is thought to be an abnormality of the venous walls or valves in the veins.   Manifestations of varicose veins   Many patients come to see the doctor as it show unattractive look.the superficial veins is about 3-15 millimeters in size. It usually starts in the calf without any symptoms. In more cases, there may feel pain, fatigue, or tired in the legs after standing for a long time. There are often more symptoms in the afternoon or evening. The patient feels good when lying down and raising their legs high. A very small varicose veins, spider web like is about 0-5 millimeters, with red or purple. For those that are 1-3 millimeters in size with a green line underneath the skin are considered as the early stage of varicose veins.   Some complications may come right after for long-lasting varicose veins e.g. an inflammation of the varicose veins themselves or sometimes clogged ( very rarely), heavy bleeding after an accident with large varicose veins under the thin skin which can cause large amounts of blood loss. This  can be easily cured by having the patient lie down with his legs elevated and covered with elastic cloth, which will help stop the bleeding. Lastly, wounds on the ankle is found to be only 5%.   Diagnosis   Many doctors conduct diagnosis by relying on the patient's physical examination history along with a radiological examination with Doppler Ultrasound or Duplex Ultrasound This can be helpful for the cases with suspected deep vein thrombosis, such as having a history of swollen legs or have a wound on the ankle or suspected congenital varicose veins, such as Klippel-Trenaunay syndrome.   Treatment   There are many ways to treat varicose veins such as using of medical stockings or bandage, intravascular injection or surgery. This  depends on the size of the varicose vein and the patient's symptoms. In most cases, early treatment can be done by instructing the patient to avoid standing or sitting for long period, maintain your body weight, and keep exercising by walking in order to increase the strength of the muscles around the calves, which will reduce the symptoms of varicose veins.   Appying medical stockings Symptoms of varicose veins may be alleviated by the use of medical stockings or elastic bandages, resulting in an up-size of its length. The suitable type is the type that is worn below the knee at the size of bending about 20-30 mm Hg. The use of medical stockings or elastic bandages may be helpful in early stages of varicose veins but you cannot be prevented from the occurrence of or make varicose veins disappear   The most common problems with medical stockings or elastic bandages are forgetting to use them or being uncomfortable wearing them in hot weather. In addition, complications, especially patients with arterial disease were reports of ischemia of the legs requiring amputation. Therefore, we strongly recommend you to check the pulse at the ankle before use.   Intravascular injection to the artery viens   This method is suitable for varicose veins that are smaller than 3 millimeters, which are branches in the skin without showing abnormality of the valves in the veins. It is applied to the shallow part or use in cases where the surgery was done.  But there are still some small varicose veins left.   Indications for intravascular injection therapy      • Very small varicose veins, about 0.5 mm.      • Varicose veins between 1-3 mm.      • Solitary varicose veins      • varicose veins below the knee   Contraindications of intravascular injection therapy      • Patient history with allergic reactions to injectable substances.      • Varicose veins      • Large varicose veins associated with deep vein problems.      • Principle of intravascular injection is an injection of a substance that causes the veins to constrict into the varicose veins, which there are many types of substances that commonly used is called Hydroxpolyethoxidoxecaine (Aethoxysclerol), with a concentration ranging from 1-3%.   Complications from varicose vein injection   An uncommon, yet serious complication is an allergic reaction to the injected substance. In rare cases, it may only cause itching or a rash, but in severe cases it may cause shock to death.   In the case of non-intravascular injection, it may cause the skin to become darken or cause lesions on the skin. In addition, injecting large amounts of it can cause venous inflammation. However, the incidence of deep vein thrombosis (Deep Venous thrombosis) is very rare.   Surgery for varicose veins          Indications for surgery are           1. Patients with leg pain and abnormal valves in the veins           2. Varicose veins that have complications such as bleeding or having inflammation of varicose veins There are two types of surgical treatment that are currently available: conventional venous stripping and endovenous laser surgery.   Conventional venous stripping is a surgery that is commonly used in all patients with the above indications. This surgery will leave scars on the patients in the groin area and below the knee. However, this type of surgery is still the standard treatment for patients with varicose veins.   Endovenous laser surgery is a new way to treat varicose veins that is gaining popularity nowsaday because the laser is used to treat varicose veins without leaving any visible wounds after surgery. However, this type of surgery cannot be used to treat patients with very large or tortuous varicose veins. Moreover, the equipment used in the treatment is still expensive.  

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