Case study on Deep Vein Thrombosis with its Systemic management
Mr. Pawan. N. Karwa1, Dr. Ramesh D Ingole2, Mr. Avinash. B Thalkari3
1Gurukrupa Institute of Pharmacy, [Degree] Malipargaon Phata Majalgaon, Dist. Beed, Maharashtra, 431131.
2DJPS College of Pharmacy, Pathari.
3Vasant Pharmacy College, Kaij
*Corresponding Author E-mail: karwapawan99@gmail.com
ABSTRACT:
Deep vein thrombosis commonly known as DVT has globally about 1–2 per 1000 population cases. The rate of Mortality is high; About 6% death cases occurs within primary 30 days of DVT by the primarily through pulmonary embolism, and also about 13% of patients with the pulmonary embolism. Among treated patients, about 20–50% develop post-thrombotic syndrome (PTS) after DVT, and 3% develop chronic thromboembolic pulmonary hypertension after pulmonary embolism.3,4 After 3–6 months of anticoagulation, VTE recurs in up to 40% of patients within 10 years. The risk of recurrence is two- to threefold higher after unprovoked than provoked VTE. Deep Vein thrombosis (DVT) is a life-threatening condition which may lead to sudden death as an immediate complication due to formation of thrombo-embolism. DVT is associated with various risk factors such as prolonged immobilization, inflammation, and/or coagulation disorders including muscular or venous injury. Deep venous thrombosis (DVT) frequently occurs in the lower limb. Successful treatment of DVT exclusively by the use of the different remedies has rarely been recorded in peer-reviewed journals. The present case report intends to record yet another case of DVT in a patient cured exclusively Since this report is based on a single case of recovery, results of more such cases are warranted to strengthen the outcome of the present study.
KEYWORDS: Venous thromboembolism, Epidemiology, Risk factors, Complications, Treatment.
Deep vein thrombosis (DVT) also known as the silent killer is the third common vascular disease, after ischemic heart disease (IHD) and the stroke. The mechanism for DVT which is known as Virchow’s triad, includes the venous stasis, hypercoagubility and endothelial injury. DVT can also likely cause pulmonary embolism due to dislodgement of thrombus1. About 67 per 100000 among the general population is been caused by DVT2. DVT commonly is seen to affect the leg veins including the femoral vein, popliteal vein and the deep veins of the pelvis. Common causes under the DVT includes Immobility, hypercoagubility and trauma to the vein3. Increasing in the age and stroke/paralysis are the clinical conditions predispose to venous thrombo embolism (VTE) observed in the adults4. Common complain with patient suffering from DVT is the pain in the calf muscles and thighs and may present with swollen legs. There may be tenderness, palpable thick vein, distended veins, discoloration or cyanosis5. Treatment of DVT includes in the reduction of the propagation of thrombus, to limit the damage to the venous valves and to prevent pulmonary embolism.1 Venous thrombosis (VT) of deep vein thrombosis is one of the severe life-threatening condition which may lead to sudden death as an immediate complication due to formation of thrombo-embolism.
It may cause long- term morbidity due to development of pulmonary embolism (PE) or post thrombotic limb and venous ulceration. Deep venous thrombosis (DVT) frequently occurs in the lower limb6, males are more prone to suffer recurrence7 (about 5% annually) with previous history of unprovoked thrombosis8, the risk being higher than that of provoked venous thrombosis9. Both DVT and PE are known to have a steep age gradient relationship10, the annual incidence being 1:100 000 in children, 1:10 000 in reproductive age, 1: 1000 in later middle age and 1:100 in very old age. Approximately, over half a million premature deaths occur in Europe, and three hundred thousand in USA due to venous thrombosis11; the estimated number of affected adults in the US by VTE is feared to be about 1.82 million by 205012. Overall this disease is relatively rare in Indian subcontinent and Asia although the incidents are day by day increasing in recent years13. The possible risk factors alarming in the development of venous thrombosis are: age, major surgery, malignancy, trauma, prolonged bed rest, myeolo-proliferative disease, ankle sprain, infection, varicose vein, certain oral contraceptive drugs etc.8,14
2. Common clinical symptoms of DVT:
Pain, calf tenderness, swelling, dilated superficial veins, pyrexia, redness or no apparent sign or symptoms. Sometimes cellulitis in the lower limb may develop into a DVT by accidental injury or infection. leg pain, swelling, erythema and dilated superficial veins. Arm DVT has similar symptoms localised to the arm. Some DVTs are asymptomatic. Differential diagnoses for limb DVT include cellulitis, lymphoedema, chronic venous insufficiency, haematoma and, for leg DVT, ruptured Baker cyst.15
3. Case Presentation:
3.1 The Patient:
The patient was a farmer belonging to a middle Classes family. His age was around 46 years and with about 5 feet 7 inches tall, and Good BMI with weight around 60kg.
3.1.1 Mind and Disposition:
· Hurried about work
· Very particular about reaching for his work before scheduled time.
· Exceedingly conscious about his physical appearance (after scarring)
· Conscientious about her work.
4.2 family History:
No family history with DVT.
4.3 Personal History and Case presentation:
The male patient was an diagnosed case of IT femur facture 3 months ago. He was a non diabetic with no family history of diabetes. He was a non addicted person. He was admitted with a complain of swelling in his C/O Rt lower limb. An venous Doppler of Rt Lower limb was done with primary indication observed by the patient by consulting a family physician. So there we was treated with Enoxaparin. But he was not fully recovered and was have not having symptomatic relief in fact there was a increase in the swelling. And so he was shifted to Aurangabad, Maharashtra. Later on again colour dopler was planned but no significant changes were observed comparing to Previous reports. So thrombectomy was planned but due to the chronicity in RT femoral vein the catheter was not able to pass through it. So catheter based locally thrombolysis in the RT common iliac vein was carried out with the alteplase patient improved symptomatically and was discharged in the stable condition. Next follow up was given after 10 days of discharge.
3.4. Patients basic reports:
RR-20 min ; BP-120/80 MMHG; PR- 80 /min; SPO- 90 / min
4. Treatment given:
IVF NS @ 50ml/Hr; INJ Clexane 0.6 mlS/C BD; INJ Monocef 1gm IV 12 hrs; INJ PAN 40 MG IV 12 HRS; INJ Alteplase via catherter for 24 hrs; TAB homocheck OD; TAB Aspirol 75 mg OD; INJ Kamimol 1mg SOS; TAB XTOR 10 mg HS
Conditions on discharge:
· Stable
· Conscious
· Oriented
· Afebrile
· Moving all 4 limbs.
5. CONCLUSION:
The patient was finally diagnosed from DVT using the Catherter and is now fit and fine.
6. CONSENT:
Signed “Informed Consent” was obtained from the patient on his first visit to the clinic after he filled up the form and agreed to undergo treatment for his ailment exclusively under care of the doctor.
7. CONFLICT OF INTEREST:
None.
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Received on 21.04.2021 Modified on 13.05.2021 Accepted on 28.05.2021 ©A and V Publications All right reserved Research J. Science and Tech. 2021; 13(3):170-172. DOI: 10.52711/2349-2988.2021.00026 |
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