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ISLAMIC MEDICAL EDUCATION RESOURCES-04

0602-DEEP VEIN THROMBOSIS (DVT)

By Professor Omar Hasan Kasule Sr.

DEFINITION

A thrombus is a solid mass composed of blood constituents that lodges in a vein and may cause blockage or an inflammatory reaction. Thrombosis occurs most often in the deep veins of the lower limb. Fragments may break off a thrombus and act as seeds of new thrombi elsewhere in the circulatory system.

 

INCIDENCE

Most cases of DVT are not detected. DVT occurs in 50% of patients who undergo prostatectomy. It also occurs in 10% of patients who suffer from myocardial infarction.

 

RISK FACTORS

Thrombi form in situations of either increased coagulability of the blood or stasis in which blood flow decreases. Risk factors of DVT related to or both of the 2 conditions above include old age, obesity, varicose veins, immobility associated with long-haul air travel, immobility in bed for several days, pregnancy, trauma or surgery, malignancy, cardiac failure, clotting anomalies, and hematological disorders such as sickle cell anemia.

 

PREVENTION

Primary prevention is prophylactic use of anti-coagulants and avoiding prolonged immobility in persons at risk of developing DVT. Secondary prevention is treatment with anticoagulants. 

 

IMPACT ON ACTIVITIES OF DAILY LIVING

If a thrombus has formed physical movements in salat will have to be limited because it may be dislodged and may go to other parts of the circulatory system. In cases of thrombophlebitis, tayammum (dry ablution) is carried out instead of wudhu (wet ablution).

 

EXERCISES ON COMPUTATION OF DISEASE PARAMETERS

1. A rehabilitation ward housing disables veterans of recent wars recorded the following information about patients who developed DVT while on the ward. The observations started on 01-01-2005 and ended on 06-31-2005. During this period no new patients were admitted and none of the old ones was discharged or died. Since DVT was so common, all patients were asked on asked to complete a questionnaire on possible risk factors of DVT. Using this information compute (a) the incidence of DVT on the ward per year (b) The risk ratio for each of the risk factors and (c) the odds ratio for each of the risk factors. PBL group #1 will do (b) and PBL group #2 will do (b). Both groups will do (a).


 

No.

Name

Sex

Race

Date DVT

Age >40

Obese?

Immobile?

Cancer?

Surgery?

1

Ali

M

C

Jan 3

Y

Y

Y

Y

Y

2

Mohd

M

M

Feb 5

Y

Y

Y

Y

Y

3

John

M

C

None

N

Y

N

Y

Y

4

Joshi

M

I

None

N

Y

N

Y

Y

5

Cheung

M

C

Mar 6

Y

N

Y

N

N

6

Patel

M

I

Apr 7

Y

Y

Y

N

N

7

Mustafa

M

C

May 1

Y

N

N

N

N

8

David

M

I

None

N

N

N

N

N

9

Ong

M

C

Jan 4

N

Y

Y

N

N

10

Ismail

M

M

Feb 7

Y

N

Y

N

Y

11

Ibrahim

M

I

Mar 8

N

N

Y

N

Y

12

Omar

M

I

Mar 31

Y

Y

N

N

N

13

Abdullah

M

M

None

N

N

N

Y

N

14

Anwar

M

C

None

Y

N

N

Y

N

15

Junid

M

M

May 8

Y

Y

Y

Y

Y

16

Chaudry

M

I

Feb 5

N

Y

Y

N

Y

17

Ahmad

M

C

Jan 11

N

Y

Y

N

Y

18

A/Rahman

M

I

Feb 20

N

N

N

N

Y

19

Sihirin

M

C

None

Y

N

N

Y

Y

20

Saleh

M

C

May 15

Y

N

N

N

N

21

Sarah

F

M

None

Y

N

N

Y

N

22

Janet

F

I

Jan 3

N

Y

Y

N

Y

23

Nicole

F

C

Feb 5

Y

N

Y

Y

Y

24

Maryam

F

M

None

N

Y

Y

N

N

25

Aisha

F

C

Apr 5

Y

Y

N

Y

N

 

Professor Omar Hasan Kasule, Sr. February 2006