Therapeutic effect of transmyocardial laser revascularization [TMLR] in patients with chest pain and normal coronary angiography [cardiac syndrome X]

Patients with syndrome X coronary disease represent a heterogeneous group of patients. Medical treatment with dilators and calcium channel blockers are not very effective. We evaluated the use of transmyocardial laser revascularization [TMLR] in treating 5 patients with this syndrome. Between May 2002 to December 2005, 5 patients with cardiac syndrome X [mean age of 49.7 years] underwent TMLR. All our cases were postmenopausal women. Mean class of Canadian class of angina was 3.4. Patients were none responding to maximum medical treatment. Angiograms showed small coronary arties with a large gap between branches which corresponded with severe ischemic on Thallium scan. We used Co2 laser between 35 to 45 joules of energy and we made 20 to 30 channels on the beating heart controlled by trans-esophagus echocardiography. Our patients were followed for 2.8 years. During follow up our patients remained asymptomatic and without any need medical treatment. Mean of Canadian class of angina after intervention was 1.8. Our patients returned to full activities. TMLR is an effective treatment in patients with syndrome X and coronary insufficiency

[Correlation between sexual dysfunction and marital dissatisfaction among diabetics]

The prevalence of sexual dysfunction and marital dyssatisfaction is reported to be higher among diabetics than in the general population. Correlation between marital satisfaction and sexual dysfunction in these patients is controversial. This study assesses the correlation between marital satisfaction and sexual dysfunction in diabetic subjects. In this cross-sectional study, 100 diabetics from a diabetes clinic in Shahrekord were selected. Presence of decreased libido and arousal sexual dysfunction were assessed in subjects, using the Laumann et al questionnaire. Golombok Rust Iinventory of Marital Satisfaction [GRIMS] was used to measure marital satisfaction. The mean score of the marital satisfaction was compared in subjects with and without each type of sexual dysfunction. Decreased libido and arousal sexual dysfunction was seen in 76 [76%] and 32 [32%] subjects, respectively. Marital satisfaction was lower in those diabetics with decreased libido or arousal sexual dysfunction [p>0.05]. According to this study, marital satisfaction is expected to be worse in diabetics with sexual dysfunction. It is therefore recommended that more attention be paid to diabetics with sexual dysfunction