Management of Deep Vein Thrombosis:Xarelto is the right choice

Cardiovascular diseases[CVD] are the number one cause of death globally and caused 31% of all global deaths in 2012 according to the world health organization,[WHO].Out of six different diseases that make up this group, DVT associated with Pulmonary embolism[PE] alone caused 61% of the deaths while the rest five diseases combined together, caused 37% of these deaths. Total annual death caused by this DVT and PE, group is 300,000 annually in the USA, Nigeria data is not available in year 2012.Evaluating treatment options for this high risk threat is worth the effort. Venous Thrombo embolism[VTE]is better controlled using Xarelto, over a 4 -6months course than using warfarin and chymotrypsin based medications. This case controlled study showed that xarelto showed sustained patient out comes within 14 days of treatment ,[24.76 % reduction of calf muscle circumference or normalization of size of calf muscle],warranting extension of the treatment to more 6 months as against warfarin that showed a reversible and reduced patient outcome after 21days [a longer period],[ of 11.26 %reduction of left calf muscle circumference], hence warranting stopping it. Xarelto also had minimal side effects, papillary petechial skin rash, which were reversed within 1 month of stoppage of drugs and relapse did not occur after 6 months of discontinuing the initial 6 months therapy.1.Erythropoietin injection 4000 iu sub cut at 6 weekly interval x 3 doses, caused an increase in platelet count[21.2% and Haemoglobin concentration Hb [erythrocyte count by extension] by 11.4%.This helped to counter more adverse effects from use of warfarin.
2.Dexamethsaone tablets which inhibited cox2 and cox 1 pathways of platelet aggregation and adhesion factors releases, was better than acetyl salicylic acid low dose for blood clot formation prevention.
3.Rivobaraxan had a 24% reduction in swelling size of body part leading to normalization after 14 days of treatment and purpuric skin rashes appeared after 4 months which stopped after 1 month of discontinuing therapy. Warfarin chymotrypsin combination gave an 11.4% reduction in body part swelling and no side effects was noticed since platelet count was under close watch.
4.Both ESR reduced by 27.35% and clotting time reduced by 50% ,as blood clot dissolved and clotting time normalized to [8-12 minutes] from a pre treatment level of 24 minutes. Chi square test measurement with confidence interval or probability of 0.05 was used to analyse sample measurements in cm.