Deep Venous Thrombosis among hypertensive patients in King Abdulaziz University (KAU) Hospital, Jeddah, Kingdom of Saudi Arabia

Prevalence and Risk Factors of Deep Vein Thrombosis Among Adult Surgical Patients in Aseer Central Hospital, Saudi Arabia

INTRODUCTION

Deep vein thrombosis (DVT) is a medical disorder that arises when a coagulation of blood forms in a deep vein, entirely or partially blocking veins, and commonly affects the lower limb. The occurrence is fairly common worldwide and it is said to increase with age, with males being at a higher risk than females.

OBJECTIVE

This study aims to determine the prevalence and risk factors of DVT among adult surgical patients in Aseer Central Hospital in the Aseer Region of Saudi Arabia.

METHODS

This is a cross-sectional study involving 602 adult surgical patients hospitalized in the Aseer Central Hospital. Self-administered questionnaires were used to collect data from the respondents, and the data collected were analyzed using IBM SPSS Statistics for Windows, Version 24.0 (Released 2016; IBM Corp., Armonk, New York, United States). Statistical tests of association were used among the categorical variables. Association between variables was considered significant when p-value was less than 0.05. Binary logistic regression was performed to eliminate the effect of confounders in determining the risk factors for developing DVT among the respondents.

RESULTS

The questionnaire response rate was 100%, with the mean age of the respondents being 44.2 ± 19.7 years. The prevalence of DVT was 7% (n=42). Obesity with adjusted OR (aOR) 17.9 (95%CI =5.39-59.18), hypertension with aOR 0.3 (95%CI =0.08-1.03), ischemic heart disease with aOR4.5 (95%CI =1.18-16.83), and orthopedics aOR 0.1 (95%CI=0.013-.240) were found to be independent risk factors for developing DVT among the respondents (p-value <=0.05). Other variables like diabetes, contraception, and pregnancy were not statistically associated with the development of DVT (p-value> 0.05) in these respondents.

CONCLUSION

The findings of this study indicated a significantly low prevalence in comparison to Saudi Arabian research. Key risk factors included obesity (18x higher risk), ischemic heart disease, and hypertension. Surgery location, orthopedic cast, and Doppler ultrasound also influenced risk, while age and sex weren't significant predictors.

Fibrinolytic and ACE Inhibitory Activity of Nattokinase Extracted from Bacillus subtilis VITMS 2: A Strain Isolated from Fermented Milk of Vigna unguiculata

The current research work aims at optimization, production, purification and evaluation of fibrinolytic extracellular protease from Bacillus subtilis VITMS2 isolated from fermented milk of Vigna unguiculata. The optimal production was achieved at 4.0% inoculum, pH7.0, 30 °C with (1% w/v) sucrose, (2% w/v) soya bean meal and (2% w/v) malt extract and 10 mM of CaCl_2, MgSO_4, Na₂HPO₄ and K₂HPO₄. The clear cell-free supernatant was purified using conventional ammonium sulphate salt fractionation (75%), ultrafiltration, ion-exchange (DEAE Sepharose FF) and gel filtration (Sephadex G-50). The molecular mass was determined to be 29 kDa using SDS-PAGE analysis. The purified enzyme showed strong fibrinolytic activity with a specific activity of 2418.85 U/mg and has a yield of 12.01%. The enzyme was highly stable up to 60 °C and a pH range of 10.0 until 72 h of incubation. The purified enzyme showed 97.4% in vitro thrombolytic activity. The K_m and V_max values of the enzyme was determined to be 0.0114 mM and 147.8 µmol min^-1 using the chromogenic substrate S-7388. IC₅₀ of ace inhibition was assessed to be 0.06 mg/mL suggesting anti-hypertensive property of the fibrinolytic enzyme. The above-obtained ace-inhibition results was supported by in silico molecular docking studies which revealed better binding affinity of nattokinase with a HADDOCK score of - 22.0 ± 8.5 confirms affinity towards angiotensin converting enzyme.

Predictable Risk Factors of Upper-Extremity Deep Venous Thrombosis in a Level I Trauma Center

Background

Venous thromboembolism is a common cause of morbidity and mortality in hospital patients, especially that of the lower extremities. Risk factors and diagnostic elements of upper-extremity deep-vein thrombosis (UEDVT) are poorly understood compared to those of the lower extremities. The primary objectives of this study were to identify predictive risk factors of secondary UEDVT.

Methods

This retrospective study included all nonpregnant patients aged >18 years who had undergone upper-extremity duplex scans to check for the presence of secondary UEDVT at Richmond University Medical Center from January 2014 to March 2020. Patients were stratified by presence or absence of UEDVT. Collected data points included patient demographics, comorbidities, central-line use, platelet count at time of scan, length of stay, and overall mortality. IBM 27.0 was used for all statistical analysis, with p<0.05 considered significant.

Results

A total of 1,009 upper extremity venous duplex studies were included. There were no significant differences in age, sex, race, or mean platelet levels between patients diagnosed with DVT and those without (p<0.05). After multinomial regression analysis, central venous catheter (CVC; 26.8% versus 78.5%, aOR 1.770, 95% CI 1.150–2.725; p<0.002), peripherally inserted central catheter (PICC) line (17.5% versus 82.5%, aOR3.254, 95% CI 1.997–5.304; p<0.001), hypertension (67.8% versus 28.8%, aOR 1.641, 95% CI 1.136–2.369; p<0.001), chronic kidney disease (CKD; 34.5% versus 65.5%, aOR 1.743, 95% CI 1.201–2.531; p<0.001), and malignancy (27.1% versus 74.6%, aOR 1.475, 95% CI 0.994–2.190; p<0.053) were found to be independent predictors of UEDVT.

Conclusion

Use of CVC or PICC line, preexisting diagnosis of hypertension, malignancy, and CKD were independent risk factors of UEDVT, while there was no significant correlation between increased platelet levels and UEDVT.

Analysis of risk factors for deep venous thrombosis in patients with gynecological malignant tumor: A clinical study

Objectives:

To determine the clinical characteristics and risk factors of Deep Venous Thrombosis (DVT) in patients with gynecological malignant tumor, facilitating gynecologists better prevent the fatal complication.

Methods:

The patients with gynecological malignant tumor treated in department of gynecology of our hospital between May 2013 and May 2018 were reviewed retrospectively. The clinical data of patients including gender, age, tumor staging, adenocarcinoma, surgery, operation time, hypertension, hyperlipemia, diabetes, coronary heart disease, radiotherapy, chemotherapy, hospital stay, and postoperative rehabilitation exercise were collected to analyze the clinical characteristics of patients and determine the risk factors of DVT.

Results:

In the current study, 67 patients were included in DVT group, and 554 patients were included in Non-DVT group. There were significant differences in age, hypertension, hyperlipemia, operation time, adenocarcinoma, tumor staging, radiotherapy and postoperative rehabilitation exercises between DVT and non-DVT groups (p<0.05). However, there was no significant differences in gender, coronary heart disease, diabetes, surgical treatment and hospital stay (p>0.05). In multivariate analysis, the factors including age, hypertension, adenocarcinoma, radiotherapy, and hyperlipemia were independent risk factors, while rehabilitation exercise was protective factor for DVT.

Conclusion:

In cases of gynecological malignant tumor, DVT screening should be given due importance, especially for those patients with old age, hypertension, hyperlipemia, adenocarcinoma, or history of radiotherapy. Rehabilitation exercise should be encouraged in these patients.