الفهرس 
THROMBOPHILIAOnly 14 pages are availabe for public view
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Abstract
Thrombosis is the leading cause of death worldwide from venous thromboembolism or arterial thrombosis. Venous thromboembolism (VTE) is a multi-factorial disease and it involves interaction between acquired and inherited risk factors.
Deep venous thrombosis (DVT) is the most common type of venous thromboembolism (VTE), it constitutes a major health care problem due to high morbidity and mortality. The clinical diagnosis of DVT is unreliable so the laboratory and diagnostic imaging tests are mandatory to exclude or confirm DVT.
D-dimer, the final degradation product of cross-linked fibrin, is typically elevated in patients with acute venous thromboembolism. With its high sensitivity and negative predictive value. D-dimer testing may have a role for ruling out the diagnosis in patients with suspected deep venous thrombosis (DVT) or pulmonary embolism.
The aim of this study was to assess the role of D-Dimer and its effectiveness in diagnosis and ruling out DVT in clinically suspected patients, as well as the possibility of reducing the need of Ultrasoungraphy.
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Summary
The current study was carried out on 50 individuals. They were divided into group I (20 healthy individuals with no symptoms signs or history of DVT, group II (12 patients clinically suspected to have episode of DVT documented by positive Duplex ultrasound and group III (18 patients clinically suspected to have episode of DVT but showed negative ultrasound .
The comparison between all studied groups regarding clinical data revealed statistical significant difference between group I and group II as regards history of DVT and history of surgery. Also a statistical significant difference was detected between group I and group III regarding history of DVT, oral contraceptive pills and smoking.
As for, demographic data in our study, a statistically significant difference was detected between group I and group III only.
In this study, D-dimer level was significantly higher in duplex positive patients (Group II) than both control group and duplex negative patients (Group III).
In the present study, a cut off value for D-dimer was established by ROC curve to differentiate between control group from duplex positive patients. It was found that cut off
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Summary
value> 1.8 have a sensitivity of 100%, specificity of 78.9%, PPV of 60%, NPV of 100% and diagnostic accuracy of 0.93%.
Another cut off value of > 2.1 was established to differentiate between duplex positive patients and duplex negative patients with sensitivity of 91.7%, specificity of 66.7%, PPV of 64.7%, NPV of 92.3% and diagnostic accuracy of 0.87%.
from this study it is noteworthy to conclude that:
D-dimer (DD) represents a simple, relatively noninvasive test that may allow clinicians to exclude the disease without a requirement for further imaging tests in a substantial proportion of patients.