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Varicose Veins: Symptoms, Causes, Treatment and Cost

Last Updated: Dec 21, 2022

What are Varicose Veins?

Sometimes increasing blood supply-induced pressure causes veins to twist and expand. They look overfilled with blood, dilated, swollen, and bulgy. This situation is known as Varicose veins. Alternately, they are also named Varicisitis or Varicoses. Affected veins often appear in prominent red and blue color.

Summary- Varicose veins refer to lumpy, bulgy, enlarged veins. They may appear colored and are usually observed in the legs and feet.

What are the symptoms of Varicose Veins?

Although varicose veins are an unusual condition they are not uncommon. As per studies conducted, about 20% of adults or 3 out of 10 people will develop this condition in their lifetime. If no one in your family has had this condition before then chances are you will not be able to tell if it's varicose veins or not.

To help you with this we have compiled a few symptoms of varicose veins that will help you seek the right treatment:

  • Blue or dark purple veins
  • Twisted and cord-like veins on the legs that seem to be bulging out
  • Varicose veins pain marked by throbbing or burning sensation
  • Swelling and muscle cramping within the lower leg
  • Heaviness or achiness in the legs
  • Increased pain after sitting or standing for a long duration
  • Itchiness around the area of the veins
  • Changed skin colour

These are some of the most commonly reported varicose veins symptoms.

Summary- Varicose veins disorder lead to several symptoms like unusual change in skin color, swelling and pain in muscles, heaviness, etc. The appearance of blue or purple veins is its most common symptom.

What are the first signs of Varicose Veins?

A survey revealed that more than 10 million people are diagnosed with varicose veins each year. Most of these cases are due to a family history of the condition or because of pregnancy. Although there is no way you can absolutely stop this condition from occurring, there are a few glaring signs that you should watch out for.

These first signs of varicose veins, if spotted early on, can make treatment quick and easy. These signs are:

  • Swelling of feet: If you notice swelling of the feet after a long day quite frequently, it could indicate that you have a possibility of developing varicose veins. An instance of swollen feet, if it happens once or twice is not dangerous. But if it happens regularly, it might be something to worry about.
  • Spotting on the lower legs: If there is a family history of varicose veins and you are apprehensive about developing this condition at some point of time in your life, you should watch out for red spots on your lower legs. Red spots indicate that blood vessels in that region of the leg have either burst or weakened.
  • Aching legs: Leg soreness and achiness are quite common after doing physical activity on foot or walking a considerable distance. But if you feel extreme cramping after a session/period of physical activities you will likely get varicose veins soon.
  • Shining legs: A very unusual symptom of varicose veins is shiny legs. This is one of the first signs of the condition and in it, you will notice an abnormal pigmentation on the skin of your legs. This can happen in association with itchiness and skin peeling.
Summary- Varicose veins disorder possesses some easily identifying initial signs. Pain, swelling, spotting of legs, etc. are some of the common first signs experienced by a patient.

What causes Varicose Veins?

The primary cause of varicose veins is improper circulation when the vein walls start to weaken. As the blood pressure build-up in the veins keeps increasing, the weak walls cause your vein to get bigger and bigger. As the vein keeps on expanding, the valves responsible for the movement of blood in one direction of the vein cannot function optimally or normally. Blood pools up in the vein making it bulge, swell and twist.

You can have weak veins for the following reasons:

  • Age
  • Weight issues
  • Hormones
  • Restrictive/tight attire
  • Pressure within the vein from sitting or standing for long durations
Summary- Varicose veins may take place due to different causes. It may include heredity, excess pressure, hormonal imbalance, etc.

How serious are Varicose Veins?

Most of the time symptoms of varicose veins are not dangerous. But there are stages when dangerous complications can start taking place.

So, if you are wondering when to worry about varicose veins, here are the situations:

  • Minor bleeding in close proximity to the skin
  • Ulcers on the skin surface close to varicose veins
  • Blood clots (thrombophlebitis)

Having varicose veins could also make you vulnerable to getting:

  • Pulmonary Embolism: This is a life-threatening condition in which the blood clot breaks off and moves to the lungs
  • Deep Vein Thrombosis (DVT): A condition when a blood clot develops within a deep vein in either the lower leg or the thigh
Summary- Usually, varicose veins do not possess life-threatening issues. However, they may lead to some adverse consequences.
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Risk factors for Varicose Veins

About 20-40 million people suffer from the condition of Varicose veins every year. By mere sight, you can gauge if someone has this condition or not if they have blue bulging veins on their legs. Some factors that put you at greater risk of developing this condition as opposed to others are listed down below:

Obesity

Being overweight and obese can put you at risk of varicose veins because being bottom-heavy exerts pressure on the veins in the lower legs.

Age

Varicose veins are more common amongst older people due to increased inactivity because, with ageing, the veins become less elastic causing the veins to function less effectively. women who have reached the stage of menopause should remain cautious as they expect to develop varicose veins after 45.

Pregnancy

The rise and fall of estrogen levels play a big role in causing varicose veins. Menopause triggers the decline of estrogen levels and pregnancy boosts an increase in estrogen. Both these stages of hormonal changes in a woman’s life can make an individual susceptible to developing varicose veins. Pregnancy gives rise to an increase in blood supply which applies pressure on the veins and makes the veins varicose.

Periods of Inactivity

As already stated, long periods of inactivity can put both men and women at risk of developing varicose veins. Such inactivity can be due to health reasons, due to old age, and also because of the nature of your profession. We must also include exercise in our daily routine because sitting or standing for hours increases the risk of varicose veins.

Smoking Habits

Smoking makes your blood vessels narrower, hindering their normal function and circulation. Narrow blood vessels will exert pressure on the varicose veins.

Family History

A survey conducted with a group of participants revealed that more than 50% of patients diagnosed with varicose veins had a parent who suffered from the condition. This signifies that genetics is a determinant.

A family history of varicose veins should keep you in alert mode to maintain a healthy lifestyle, an active routine, refrain from smoking and undergo regular check-ups in case of appearance of wrinkled, dark-coloured skin accompanied by dryness and itchiness.

What is the difference between varicose veins and spider veins?

One important point to be kept in mind is that spider veins and varicose veins are both types of venous diseases. Venous diseases are marked by damaged vein walls that obstruct normal circulation. This compels blood to collect and flow in a backward fashion, against gravity, exerting painful pressure on the veins. The collection of blood will stretch and twist the veins, increasing swelling, valve incompetence, the possibility of blood clots and slow blood flow.

Aside from varicose veins and spider veins, venous diseases comprise disorders such as Deep Vein Thrombosis (DVT), Blood clots, chronic venous insufficiency, superficial venous thrombosis and ulcers.

Although spider veins and varicose veins are part of the same category of diseases, what differentiates the two disorders are that spider webs are thinner than varicose veins and have the appearance of blue or red spider webs. Spider veins can occur anywhere on the body while varicose veins are exclusively limited to the legs and feet.

Summary- despite of them belonging to the same category of venous disorder, they have a different appearances. Varicose veins are confined to feet and legs only while spider veins can appear anywhere on the body.

How can you prevent Varicose Veins?

Varicose veins can be prevented by reducing the risk of its causative factors. We should pay attention to improving blood flow to avoid clots which is one of the common factors for this disorder. We should keep changing our posture from time to time. A good also plays an important role in the overall well-being of the body. Additionally, To help you manage your condition, here are some other effective dos and don’ts.

Dos

  • Wear Compression Stockings: Compression stockings and socks keep the vein valves in a healthy fashion which allows the veins to carry out the function of blood circulation and reduce pooling, swelling and pain. Compression hosiery can also relieve you of cramps. There are degrees of compression support hosiery that will be prescribed to you depending on the extent of vein damage.
  • A Healthy Lifestyle is a Must: Managing your weight, especially if you are obese can prevent your varicose veins from aggravating. Consume a diet composed of complex carbohydrates, protein, healthy fats, fibre and potassium. Limit your salt intake. The importance of hydration for ensuing blood circulation is an often forgotten fact. By drinking adequate water you can keep your veins functioning properly.
  • Exercise is Essential: Strength training and resistance training may not suit you. And that’s definitely not an issue. You can manage your varicose veins by simply walking every day. You can practise yoga daily and target poses that focus on inversion. These poses bring the feet higher than the heart and include a shoulder stand, headstand and legs-up-the-wall asana.
  • Sleeping Positions for Pregnant Women: Varicose veins are most common amongst pregnant women. If symptoms of varicose veins have started to appear then sleeping on the left side can help ease the associated uneasiness. You can also wear compression stockings to control the surging blood in your veins induced by heightened estrogen levels. Keeping your feet elevated on a foot stool can also be an option.

Don’t

  • Sitting and Standing at a Stretch: Sitting or standing at a stretch makes it difficult for the blood to travel against the force of gravity. This will lead to pressure build-up in the veins eventually causing the blood to pool near the ankles. This can be identified by swollen and throbbing calves and feet.

    When this happens, the best way to alleviate discomfort is to do small exercises, even if you are restricted to your desk. Stretching, peddling and bending the knees will help keep blood circulation ongoing, relieving the pressure on the veins. Try to elevate the legs for 15 minutes every day, at least thrice a day.

Summary- We must be vigilant about the prevention of varicose veins disorder. The above-stated can be followed to do the same.

Varicose Veins - Diagnosis and Tests

A varicose vein is not a serious condition but you should speak to a general physician if the varicose veins start to bring about pangs of discomfort, the skin over the veins is irritated and sore, the aching pain in the legs is going out of control and interfering with quality sleep at night. Once you do decide to visit a general physician, here is what you can expect.

Summary- We must go for a detailed diagnosis if we face problems in carrying out daily chores. It must not be skipped at all.

How are Varicose Veins diagnosed?

When you fix an appointment with a General Physician, he/she will first check the legs to notice signs of swelling. You will also be asked to describe how you are feeling and if there are particular moments when the pain is excruciating. The General Physician will also try to find out the source of your condition:

  • If you are pregnant
  • If your Body Mass Index (BMI) is within safe parameters
  • If you have a family history of this condition
  • If there is a record of leg-related injury in the past such as a broken bone

Once the cause of swelling and discomfort has been determined to be due to varicose veins, a specialist will check you on the following grounds:

  • If the veins have symptoms of pain, aching, swelling, discomfort, heaviness
  • Changes in the skin colour of the leg caused by improper blood flow
  • Another indication of improper blood flow in the leg is the skin condition, eczema
  • Painful and hard varicose veins
  • A skin ulcer right below the knee which has either healed or not healed within two weeks
Summary- Doctors advise different diagnostic tests to the patient for a detailed examination. They also pay attention to his/her medical history.

What tests are done for Varicose Veins?

Although varicose veins can be easily determined by physical examination, in some cases, a specialist may also ask you to undergo a Doppler or duplex ultrasound test.

The main purpose of this test is to check for circulation in the veins within the legs by trying to identify blockage. A blockage will be confirmed if there is a thrombus or blood clot formation. The ultrasound takes about 30 to 45 minutes within which time the blood flow will be heard by the examiner through the veins.

At the time of the ultrasound test, the examiner will ask you to lie down on the stretcher and your clothes will be removed from the bottom half of your body such as the waist. Recording of the blood flow will be made with the help of a smooth, small probe on parts of your legs. You can expect to get the results of the test within two to three days.

Summary- The patient has to undergo some tests like blood tests, duplex ultrasound tests, lab tests, etc. They help to rule out the exact situation.

What are possible complications of Varicose Veins?

Varicose veins are not life-threatening and complications, if any, are few and rare. These can include:

  • Blood clots: The veins can become enlarged and lead to swelling and pain. Such symptoms can also be a sign of a blood clot
  • Ulcers: If you notice discoloured skin near your ankles, it can be a sign of a skin ulcer.
  • Bleeding: Veins very close to the skin can become enlarged due to constant swelling and can burst to cause minor bleeding.
Summary- The above-stated issues are some of the common complications led by varicose veins. However, they can be tackled easily with proper treatment.

Home Remedies for Varicose Veins?

Varicose veins can be hard to avoid, especially, if it occurs due to a case of family history, pregnancy or due to age. By following these few tips for home remedies, you can manage your condition and prevent it from becoming worse.

  • Do not wear high heels and very tight clothes. However, you can purchase compression stockings that are designed to promote blood circulation to the heart
  • Keep yourself involved in low-intensity workouts that get the calf muscles working such as cycling, yoga, walking or swimming
  • Applying plant-based essential oils such as horse chestnut oil extract and sea pine extract can help to reduce leg pain, swelling and oedema. Ensure to use a diffuser or dilute in a carrier oil such as castor oil before application for deeper penetration.
  • Keep moving for 5-10 minutes, the key is not to sit or stand in the same posture or place for too long
  • Massage your legs daily with a moisturiser or essential oils for healthy blood circulation
  • You can elevate your legs for 15 minutes while sitting or lying down, thrice daily for more effective results
  • Eat foods enriched in flavonoids that aid in blood circulation such as onions, spinach, broccoli, bell peppers, cherries, blueberries, apples, garlic and cocoa
  • You should tweak your diet and incorporate more fibre and potassium into your diets such as potatoes, leafy green vegetables, almonds, pistachios, white beans, lentils and fish like salmon.

These home remedies only provide temporary relief and will not solve your problem. To get effective treatment for your condition, undergo laser therapy from a reliable health partner which will target the damaged vein instrumental behind the occurrence of varicose veins. Pristyn Care provides you with an array of treatment options both minimally invasive and quick. These painless laser methods are affordable and effective forms of varicose veins treatment.

What to eat in Varicose Veins?

Foods that are your best bet for varicose veins are:

  • Blackberries: Full of anti-inflammatory properties and antioxidants, blackberries keep the blood vessels functioning properly and protect against blood clots by strengthening the capillaries.
  • Avocados: Includes vitamin E and vitamin c. Vitamin E is a natural blood thinner and vitamin C is effective for reducing inflammation.
  • Ginger: The easiest go-to ingredient from your pantry for any vein-related disorder is ginger which breaks down fibrin within blood vessels preventing the veins from hardening and increasing blood circulation
  • Beets: They support vein health by allowing increased oxygen flow through the blood vessels and lowering the blood pressure
  • Flaxseeds and chia seeds: These seeds are high in fibre and safeguard against bloating
Summary- We must plan our diet carefully to combat varicose veins issues. Some foods like avocados, beets, chia seeds, etc. help to support the treatment process.

What not to eat in Varicose Veins?

Some foods are good for varicose veins and some can seriously aggravate your symptoms causing a great degree of discomfort:

  • Foods high in sugar and salt: This includes all kinds of processed and packaged foods
  • Fried foods: Deep-fried foods and junk food will clog the arteries obstructing blood flow
  • White bread: Refined carbohydrates such as white bread strips the body of nutrients that aid in strong veins formation
  • Milk and Cheese: These foods slow down digestion and make an individual feel constipated. This causes varicose veins to swell
  • Alcohol: This causes dehydration and slows down the venous system
Summary- Some foods serve as roadblocks to the healing process. We must exclude alcohol, white bread, junk foods, etc. from our diet.

When should I talk to my doctor about varicose veins?

If you notice any of these symptoms you should book an appointment with a general physician:

  • Aching and heaviness within the legs
  • Skin discolouration
  • Pain that aggravates after standing or sitting for prolonged hours
  • Itchiness around the veins
  • Cramping, swelling, throbbing and burning sensation in the lower leg
Summary- As soon as we start some adverse symptoms like pain, heaviness, itchiness, etc. we must consult a doctor.

Which doctor to consult for Varicose Veins?

You should fix an appointment with a general physician who will carry out an initial screening of your condition. This will include examining the affected legs and asking you a few standard questions regarding your family history, lifestyle and overall health condition. Once your condition is confirmed to be varicose veins you will be referred to a vascular specialist.

Summary- We should consult a specialized general physician for varicose veins treatment. We should share every detail about the disorder with him/her.

What questions should I ask my doctor?

Following are some of the standard questions that you should pose to your doctor:

  • Can one do treatments in the office?
  • Which course of treatment is the most effective for my case?
  • What will be the most cost-effective way of treating varicose veins
Summary- We must discuss every doubt regarding varicose veins treatment with the doctors. We must ensure treatment processes and their after-effects.

Varicose Veins Treatment

There is no cure for varicose veins but certain treatment methods can help alleviate the symptoms and provide you comfort:

  • Wearing elastic or compression stockings
  • Practising leg elevation to increase blood circulation
  • Undergo sclerotherapy which injects a solution into the vein directly
  • Vein surgery involves removing the vein to prevent varicose veins from further occurring
  • Laser therapy which closes off the damaged vein
Summary- The above-stated simple steps support the treatment processes. They help to speed up the recovery processes.

Which are the best medicines for Varicose Veins?

Below is a list of 5 drugs generally taken for varicose veins treatment:

You are advised to consult a doctor before you start taking any of these medications. Self-diagnosis is not at all suggested for any condition.

Summary- Medicines are prescribed by doctors to support the treatment process. Sotradecol, Varithena, Asclera, etc. are some of the commonly prescribed medications.

Varicose Veins Treatment without surgery

Some non-surgical treatment options for varicose veins are:

  • Elevating Your Legs

    This increases the flow of blood and reduces the pressure on the veins. To do this, you need to elevate your legs above or up to your waist, each time for 15 minutes several times throughout your day.

  • Injection Therapy

    Also known as sclerotherapy, the doctor will inject a solution into the veins which makes the vein walls stick together. After some time, the veins turn into scar tissue and will fade away.

  • Compression Hosiery

    This includes supportive socks or stockings that compress the veins and lower discomfort. The mechanism of compression aids in blood circulation and halts the veins from stretching too much.

  • Ablation Therapy

    This procedure uses intense heat on the targeted veins. There are two ways of doing this, one that uses laser energy and the other uses radiofrequency.

Summary- Non-surgical processes of varicose veins treatment comprise Ablation therapy, injection therapy, sclerotherapy, etc. These therapies help to alleviate symptoms of varicose veins.

What are the surgical treatments for Varicose Veins?

Some surgical treatment options for varicose veins treatment are:

Laser Therapy

This is a minimally invasive, quick and painless procedure also known as endovenous thermal ablation. The surgeon will use a long and narrow tube and laser technology to close off the damaged vein causing varicose veins

Phlebectomy

This surgical method treats varicose veins on the surface. Minute cuts are made near the damaged vein which is then removed.

Vein Surgery

Also known as ligation and stripping, the surgeon or healthcare provider will tie off the affected vein (ligation) to prevent blood pooling and remove (strip) the concerned or damaged vein to stop recurrence.

Summary- Surgical treatments of varicose veins consist of certain processes, such as vein surgery, laser therapy, and phlebectomy. They are executed through different steps.

What is the procedure of Varicose Veins surgery?

  • Varicose Veins Surgery: A varicose veins stripping surgery is done on outpatients implying that the patient will be released on the same day of surgery. The entire duration of the surgery is about one hour to one and a half hours and is not very complicated.

    The doctor can administer general anaesthesia or spinal anaesthesia and can also provide anti-anxiety medications if you are feeling severely anxious about the surgery.

    During the procedure, the surgeon will make several tiny cuts towards the bottom and top of the damaged vein. One incision will be made in either the ankle or calf or near the groin region. Then a thin plastic wire will be inserted into the vein at the top incision and will be tied to the vein through the incision made at the bottom.

  • (Endovenous) Laser Surgery: Before the varicose veins surgery starts you may be asked to wear goggles to protect the eyes from the intense laser light. Your surgeon will numb the entire length of the vein that is to be treated with an injection that carries a numbing solution. The surgeon can also conduct a Doppler ultrasound prior to the surgery and at the time of surgery to check the status of the vein.

    A small incision will be made into the skin through which a catheter will be inserted. As the surgeon pulls out the catheter very gradually, the laser will heat up the varicose vein line, which will then close up and shrink.

Summary- Varicose veins treatment comprises a specific procedure. Distinct steps are followed pre-and post-surgery.

How long does it take to recover from Varicose Veins?

If you are undergoing varicose veins surgery, you will require up to 3 weeks before you can resume work or start involving yourself in physically exerting activities. You will also be required to wear compression hosiery such as socks and stockings for up to a week post-surgery.

Summary- The recovery phase of different patients are variable. It may require 2-3 weeks to resume a normal lifestyle.

What is the cost of Varicose Veins treatments in India?

The approximate varicose veins surgery cost if undertaken by any reputed healthcare partner in India will be around INR 70,000.

Summary- The cost of varicose veins treatment is a little high-priced. It may cost up to 70 thousand.

Are the results of the Varicose Veins treatment permanent?

If you undergo non-surgical treatment options, then the procedures will help bring about temporary relief from the swelling and the discomfort. On the other hand, if you undergo surgical treatment options such as laser therapy or vein surgery, it will treat your varicose veins condition effectively but cannot guarantee that recurrence won’t take place in the future.

However, by following up on the post-treatment guidelines thoroughly, managing your weight and looking after your diet you can ensure that varicose veins don’t appear again.

Summary- The surgical treatment of varicose veins often provides permanent results whereas non-surgical treatment posses temporary relief only.

Who is eligible for the Varicose Veins treatment?

Anyone who is suffering from varicose veins is eligible for treatment both surgical as well as non-surgical

Summary- People who are affected by varicose veins must go for treatment.

Who is not eligible for the Varicose Veins treatment?

People who are not suffering from varicose veins issues and their aftereffects are not eligible for the treatment.
Summary- People who are overall healthy need not be treated for Varicose veins.

What are the post-treatment guidelines for Varicose Veins treatment?

After undergoing varicose veins treatment, here is what you need to do:

  • Wear compression hosiery such as socks and stocking 24*7 for the first three days After this period, you must continue wearing the compression stockings and socks but only during the daytime
  • Do not involve yourself in high-intensity workouts for the next two weeks
  • You should refrain from consuming alcohol and smoking for the first couple of days after your treatment
  • Try to walk for 30-60 minutes daily for the next two weeks immediately after the treatment.
Summary- After the treatment, doctors instruct some post-treatment guidelines to the patient. The above-stated guidelines are necessary for the recovery process.

What can happen if a Varicose Veins is not treated?

Varicose veins are not a life-threatening condition and if left untreated will not do you a lot of harm. However, in certain extreme cases, varicose veins can swell to a great extent and cause discomfort. They can also cause the following problems:

  • Blood ulcers
  • Blood clots
  • Minor bleeding near the skin close to the varicose veins
Summary- Varicose vein is one of those situations that need urgent care. If not handled in a timely manner, it could cause serious problems in the future.

What are side effects of Varicose Veins treatments?

Some minor side effects felt after varicose veins treatment are as follows:

  • Skin discolouration
  • Swelling
  • Pain and discomfort
  • Bruising

Some major complications that patients can experience in certain rare cases are:

Summary- Varicose veins treatment also leads to some minor adverse effects. Bruising, blood clots, swelling, etc. are some of them.

Varicose Veins - Outlook / Prognosis

The overall prognosis for varicose veins treatment is quite positive. The condition is not dangerous and will not cause you health complications. By undergoing surgery you effectively treat yourself for the condition. Varicose veins can cause slight discomfort but do not put your health in jeopardy.

Summary- Varicose veins treatment is a quite successful procedure. It barely causes any health complications.

Frequently Asked Questions (FAQs)

When to worry about varicose veins?

If you notice symptoms like skin discolouration, swelling and pain in the legs, these are signs of varicose veins

Are varicose veins dangerous?

No, this condition is not serious and does not cause health complications. Those with varicose veins can experience discomfort along with swelling.

Are varicose veins painful?

In most cases, varicose veins are not painful. Some people do experience discomfort and can describe this as throbbing pain or deep ache.

How to get rid of varicose veins on legs?

To get rid of varicose veins you must select your footwear wisely (avoid wearing heels), avoid tight pieces of clothing, avoid sitting or standing in one place continuously for more than four hours, manage your weight, massage your legs with essential oils, exercise and follow a low sodium diet.

What do varicose veins look like?

Varicose veins look like twisted, bulging cords on the legs that are blue or dark purple coloured.

How to ease painful varicose veins?

To get some relief from painful varicose veins you should wear compression stockings or socks, involve yourself in low-impact exercises and keep your feet elevated for a couple of minutes throughout the day. You can do this by just raising your legs up to your waist or you can rest your legs on a foot stool.

Can varicose veins cause blood clots?

Although varicose veins are not dangerous, in very severe cases they can lead to blood clots.

Do compression socks help varicose veins?

Yes, wearing compression stockings or socks exerts pressure gently on the veins in your lower legs. This increases blood circulation and prevents further varicose veins from appearing.

Can varicose veins disappear with exercise?

Exercise for varicose veins can only help to tone the muscles and improve blood circulation which will ease discomfort and lower your chances of developing varicose veins. Varicose veins cannot be cured and cannot also be totally prevented because factors like family history, age, hormonal changes and pregnancy can put you at risk of developing varicose veins in the future.

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Written ByDr. Amit C MD - Physical Medicine & RehabilitationPediatrics
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Reviewed ByDr. Bhupindera Jaswant SinghMD - Consultant PhysicianGeneral Physician
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