[Oral manifestations of patients with congenital heart disease]

Congenital heart disease [CHD] can have oral manifestations that even the patient may not be aware of. These manifestations could be linked to the disease itself or the treatment associated with it. Also, since a history of CHD may alter the treatment plan of some of the oral diseases or some oral diseases may affect the course of CHD, the current research was designed to better understand such interrelationships. In this cross-sectional descriptive study, 42 CHD patients that were admitted to the department of Internal Medicine of Imam Reza Hospital, Mashhad, Iran, were randomly investigated for a period of one year through a questionnaire and routine examinations and the final results are descriptively presented. In 17 cases [40.5%], cyanotic mucosa was reported and in 6 cases [14.4%] pale tissues were noted. In 2 cases cleft palate [4.7%] and cleft lips [4.7%] were recorded. Oral manifestations recorded for patients with CHD were Cyanosis, pale tissues and cleft and palatte and lip. Although clefting and palate lip can not be directly linked to CHD, their presence in conjunction with CHD should be considered

Quantitative assessment of cardiac function in children with beta-thalassemia major, using the doppler myocardial performance index

Introduction: Cardiac disease and early death due to my ocardial injuries because of Iron overload and hemosiderosis are still the major problems in the management of patients with beta-thalassemia major [BTM]. Valuable echocardiographic techniques have been limited in early detection of cardiac dysfunction in these patients. A new Doppler index combining systolic and diastolic time intervals [the Tei index] has been reported to be useful for assessment of global ventricular function in many cardiac diseases. The purpose of this study was to assess global ventricular function in children with BTM using Tei index and also to determine its correlation with hematologic parameters

Material and Methods: This analytic cross sectional study was performed on 59 patient with Beta-Thalassemia Major during Jan.2003 until Feb.2004 in hematologic clinics of Imam Reza and Dr. Sheikh Hospitals. Complete physical examination and Doppler Echocardiographic study was done for all the patients and patients' Tei indexes were compared with normal values in other studies statistically

Results: The mean Tei index of left ventricule [LV] and right ventricule [RV] was 0.35 +/- 0.11 [mean +/- SD] and 0.28 +/- 0.12 [mean +/- SD] respectively. There was a significant difference between both right and left ventricular Tei index in-patients with BTM and healthy children. There was also a significant correlation between mean blood transfused volume per year and Tei index in both right [PV70.05] and left ventricule [PV 70.05]. We also find a significant difference between two groups of thalassemic patients according to their mean pre-transfused Hgb per year [Hgb> 9 g/dl and Hgb>9 g/lit] for left ventricular Tei index

Conclusion: The Tei index is a simple, feasible and reproducible measure of global cardiac function in-patients with BTM with early Myocardial dysfunction