The role of the presence of fragmented QRS in predicting disease severity in patients with pulmonary hypertension

Pulmonary arterial hypertension is a malignant pulmonary vascular disease primarily caused by increased pulmonary vascular resistance, which leads to right ventricular hypertrophy, fibrosis, right heart failure and death. Fragmented QRS (fQRS) indicates non-homogeneous ventricular activity caused by myocardial fibrosis. This study aims to investigate the importance of fQRS in patients with pulmonary hypertension (PH) and to determine the role of the presence of fQRS in indicating the severity of the disease. The study included 94 (85 patient group 1 PH and 9 patient group 4 PH) patients. The patients were divided into two groups according to the presence of fQRS in their surface electrocardiography (ECG). The patients' laboratory, transthoracic echocardiography, and right heart catheterization parameters were compared between the two groups . FQRS was detected in 55 (58%) patients, and the mean age of these patients was 51.8±18.0, and 29.1% of them were male. Systolic pulmonary arterial pressure (PAP) measured by transthoracic echocardiography (p [Med-Science 2022; 11(4.000): 1619-24

Evaluation of per-operative cough stress test during transobturator mid-urethral sling surgery

Purpose: Currently, it is unclear how the mesh tension should be adjusted on the transobturator tape surgery (TOT) for improving continence. The aim of this study was to evaluate the effects of per-operative cough stress test on TOT. Materials and methods: Between March 2007 and December 2011, 206 women with SUI were enrolled in this study. Patients were randomly categorized to treatment with TOT (96) or TOT with cough stress test (110). The IIQ-7 and the UDI-6 were used to identify satisfaction level. At the end of 1st year, two groups were compared patient characteristics, operation time, duration of hospital stay, cure and complication rates. Results: The cure rate was 84.37% 81/96) versus 83.63% (92/110) in TOT and TOT with cough test groups, respectively. Postoperatively ten patient (10/110, 9.09%) suffered voiding difficulties (> 250 ml residual urine) in TOT with cough stress test group. Five patients were discharged with transurethral catheter, whereas, in traditional TOT group, two patients (2/96, 2.1%) had transient postoperative voiding difficulty and two patients were treated with repeated catheterization for 1 week (p < 0.05). Postoperative groin pain was present in 7/96 (8%) versus 24/110 (22%) in TOT and TOT with cough test groups, respectively (p < 0.05). TOT with cough stress test group had an higher rate of complications like, retention of urine, necessitating to cut the tape, mesh erosion and pain in groin or leg. No patient had resistant voiding difficulty or prolonged urinary retention (> 1 week) in traditional TOT group. Conclusions: We believe that per-operative cough stress test leads to overtreatment of stress urinary incontinence when the complication rates were considered