الفهرس 
Deep Vein ThrombosisOnly 14 pages are availabe for public view
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Abstract
Deep Vein thrombosis (DVT) is a silent killer (Autar; 1996).
It is a serious threat to recovery from surgery and is the third most common vascular disease, after ischemic heart disease and stroke (Anands et al., 1998).
Deep-vein thrombosis (DVT) is common among the general population, which, if left untreated, Can lead to fatal pulmonary embolism (PE); therefore the early diagnosis of DVT is essential. A present study revealed that 10% of mortality in general hospitals in United Kingdom was from pulmonary embolism (Sandler, 1989).
The aim of this study is to compare the use of low molecular weight of heparin followed by warfarin and rivaroxban in treatment of acute deep vein thrombosis.
A) Patients
Two hundred patients assumed clinically to have deep vein thrombosis and the diagnosis confirmed by color-coded duplex scan have been the material of this study.
The patients will be randomly allocated into 2 groups, 100 patients each:
• group I: the patients will be given the low molecular weight heparin followed by warfarin for 3 months.
• group II: the patients will be given the rivaroxban for 3 months.
B) Method
All patients will be subjected to the following:
1) Clinical assessment:
A- Medical history:
• disease duration, history of pervious DVT, history of the risk factors for the DVT(cancer, recent surgery, hospitalization, inherited thrombophilia); the patients are subgrouped into those with provoked DVT and those with unprovoked DVT.
B- Clinical examination:
1- General examination (pulse, blood pressure, temperature)
2- local examination:
• The affected limb will be examined for pain, swelling, redness. measurement of the girth of the leg 10 cm below the tibial tuberosity, tender calf, pitting odema, homan’s sign and temperature of limb..
2) Laboratory investigation:
• Complete blood count (CBC).
• coagulation profile (PT, PTT).
• d-dimer assay pre giving medication and at 10days of
• treatment, at 1 month then after 3 monthes.
• ESR and CRP pre giving medication and at 5 days of treatment, then 10 days.
3) Imaging procedure:
• All patients will be studied with color-coded duplex scan premedication, at admission, prior of discharge, 1 month then after 3 monthes.
4) Treatment
• All patients confined to bed with leg elevation taking pain killer,
• All patients taking Anticoagulation
In group (A) clexane at dose 1MG/Kg/12H overlapped with warfarin for 4-5 Days until INR elevate 2-3. At dose 10mg per oral as initial dose then maintenance dose 2-10 mg per day.
In group (B) Rivaroxaban given dose 15mg twice daily for3 weeks then 20mg once daily till end 3 months.