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DEEP VENOUS THROMBOSIS

DEEP phlebothrombosis
It is obstruction of peripheral veins by clot by primary ,simple and non inflammatory method.

PREDISPOSING FACTORS 
1.PATIENT FACTORS
-Elderly
-prolonged bed rest
-obesity
-oral contraceptive
-pregnancy particularly period of time
2.MEDICAL CONDITIONS
-myocardial pathology
-congestive coronary failure
-malignancy second sight. exocrine gland and respiratory organ
-inflammatory viscus illness
-nephritic syndrome
 3.SURGERY
-hip fracture
-abdominal or girdle surgery
4.BLOOD DISORDER
-polycythemia vera
-thrombocythemia
-mylofibrosis
5.DEFICIENCY OF medicinal drug
like
-antithrobin three
-protien c and s
-factor a pair of or v city
-antiphospholipid protein
CLINICAL options
- Pain typically within the calf ,sometime additionally in ankrle and joint.feeling of tightness rather than pain

- deep calf tenderness. pain in calf on force flexure of the foot (Homan\'s sign).tenderness in limb triangle.

- multiplied heat in affected leg

-fullness of superficial veins

-increased native temperature

-local swelling and in period

-thrombosed vein is also palpable
slight native cynosis or discoloration
ow grade febricity
sphygmomamanometry cuff  pain check is positive- pressure cuff is tied the concerned a part of the extremity and slowly inflate to two hundred metric linear unit of hg and so defleted. In traditional condition ,pain and discomfort is skilled throughout inflation at or higher than a hundred and sixty metric linear unit.hg however in blood vessel occlusion pain is skilled between eighty to a hundred and fifty metric linear unit. hg
DIAGNOSIS
1.VENOUS imaging
it is AN correct technique of characteristic deep vein occlusion from the amount of common vena femoralis to vena poplitea however it\'s less correct for diagnosis calf vein occlusion.
COLOUR DUPLEX SCANING
it permits instant image of blood flow and its direction.thus reflux at the salphenofemoral junction and among the deep blood vessel system and therefore the striated muscle vein is detected while not invesive techniques.
MANAGEMENT
TREATMENT OF ESTABLISHED occlusion
GENERAL MEASURES
complete bed rest till the method becomes quiescent
elevation of extrimites to deminish swelling
no active and passive movement of limb.

-avoidance of coughing,straining at stool and deep respiration.

-dehydration ought to be avoided
MEDICAL TREATMENT
ANTICOAGULANT
-HEPARIN-5000 units initial bolus injection with continuous infusion or hypodermic followed by maintenance dose of 30000 to 40000 unite/24 hours for seven days .
 therapy
-streptokinase,urokinase area unit simpler than anticoagulant medication in inducement fast resolution of recent thrombi.
SURGICAL TREATMENT
 excision
-if  free- floating clot in ileo-femoral section or within the rare patient with gangrene caused by phlebothrombosis
INFERIOR VENACAVAL INTERRUPTION
-Intraluminal and extraluminal, used  in patient with acute phlebothrombosis  and absolute reason to medicinal drug medical care.
PREVENTION OF occlusion IN HIGH RISK PATIENTS
ANTICOAGULANT
-low dose anticoagulant medication 5000 unites subcutaneously a pair of hours before operation then each eight hours for seven days is effective in preventing embolism.
DEXTRAN
-act by coating blood vessel epithelial tissue and busy with blood platelet viscosity and aggregation
DRUGS
-which inhibits blood platelet aggregation like dipyridamole,aspirin and clopidrigel
.EARLY walking
-post-operative and post-partum.

5.Deep respiration exercises in bed
.ELEVATION OF FOOT
of bed for bed -fast patient
prevention of multiplied abdominal pressure by tight binders
correction of rate of flow.

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