Q ) Endovenous Laser Ablation (EVLA) of varicose veins is best suited for those :
a) With needle phobia
c) Excess tortuousity
d) Primary varicose veins
EVLA is thermal ablation of varicose veins in which laser fibre is inserted in the lumen and ablation is done from inside. It is a good modality for primary and recurrent varicose veins and work in both long and short segments.
This treatment is not effective in cases where there is needle phobia or the veins are having excessive tortuousity or thrombophlebitis. This procedure is done under ultrasound guidance and wire is passed from the superficial to the deep veins.
Q) A young 18 years old unrestrained car driver has an head on collision with a truck and becomes unconscious. He is intubated on the site of accident and resuscitated with IV fluids. He is brought to the emergency in a state of shock,( BP 90/60 and pulse 120/min) but opens eyes on commands. On examination he does not have pallor but neck veins are distended.
There are no signs suggestive of head or spine injury. Xray chest reveals normal cardiac chambers, no free gas and mild pleural effusion on left with no evidence of fracture ribs.
What will be the next step of management
a) Resuscitation and simultaneous CT thorax
b) Resuscitation and simultaneous Echo cardiography