Background: There is no data on the use of subcutaneous low-molecular-weight heparin (SC LMWH) in cases that require thrombolysis. Objective: Having used SC LMWH with thrombolytics for more than 10 years, we aimed to review our data, share our experiences and find out whether the use of SC LMWH with thrombolytics had been effective and safe. Method: This is a retrospective cohort study. Patients who were diagnosed as acute pulmonary embolism (PE) and received either SC LMWH treatment or SC LMWH with thrombolytics in our hospital (a tertiary hospital) between 2000 and 2010 were included in the study. For both treatments, the rates of mortality and complications were calculated. Results: A total of 392 patients, 210 female (53.5%) and 182 male (46.5%) with an average age of 60 years, ±16 SD, with acute PE, were included in the study. Of these patients, 107 (27.2%) were massive and 285 (72.8%) were nonmassive and were administered SC LMWH plus thrombolytics and only SC LMWH, respectively. The mortality rate was 16.8% (18 of 107) in patients who were massive and 3.5% (10 of 285) for those who were nonmassive (p < 0.001). Major hemorrhage occurred in 3.7% (n = 4) and 0.7% (n = 2) and minor hemorrhage in 12.1% (n = 13) and in 3.8% (n = 11) of the cases who received SC LMWH plus thrombolytics and SC LMWH, respectively. Conclusion: SC LMWH use with thrombolytics seems to be feasible and safe. Prospective, large, randomized control trials are still required in order to confirm these results.

Aims and Scope Eurasian Journal of Medicine (Eurasian J Med) is an international, scientific, open access periodical published by independent, unbiased, and tripleblinded peer-review principles. The journal is the official publication of

Purpose: Although it is affected at an early stage, there is a lack of studies investigating right ventricular (RV) function in patients with mitral stenosis (MS). We aimed to investigate the correlation between conventional echocardiographic variables and tricuspid annular plane systolic excursion (TAPSE), used as an indicator of RV dysfunction.Methods: We enrolled 59 consecutive patients with MS and assigned them in group 1 if TAPSE ≤16, or group 2 if: TAPSE >16.Results: The mean age of the patients was 42.2 ± 8 years, and 74.6% were females.In univariate analysis, maximal mitral valve gradient, mean mitral valve gradient, systolic pulmonary arterial pressure, RV strain, and RV strain rates were associated with RV dysfunction. In multivariate analysis, both strain variables were found to be independent predictors of RV dysfunction. Kaplan Maier survival analysis showed that patients with lower RV strain had more rehospitalization rate during the one-year follow-up period.Conclusions: RV dysfunction is common in patients with MS and is associated with higher rehospitalization rate and morbidity. Evaluation of RV strain and strain rate for early detection of RV dysfunction and prediction of rehospitalization may be an appropriate approach in mitral stenosis. K E Y W O R D S echocardiography, mitral stenosis, right ventricle, strain

Introduction: Giardia intestinalis causes diarrhea and malabsorption, especially in developed countries. Although it primarily affects the gastrointestinal system, on rare occasions it causes allergic symptoms such as itching, urticaria, and eczema. Here we describe the case of a 19-year-old man with no past medical history who presented to our hospital with an atypical urticarial rash. Diagnosis: The only abnormal result in laboratory findings of stool parasitology was G. intestinalis. The patient was diagnosed with urticaria due to giardiasis. Intervention and outcomes: The patient was prescribed Bilastine tablet 20 mg 1 × 1 and referred to the Infectious Diseases Department for treatment. Co-Trimoxazole 400 mg/80 mg tablets 2 × 1 and Metronidazole 500 mg tablets 3 × 1 were prescribed. The urticaria had disappeared at the follow-up visit. The patient confirmed that urticarial symptoms did not recur. Conclusions: Despite their rarity, Giardia and other parasite infections can cause allergic symptoms. Parasitic factors should be considered in patients, especially those living in the communal areas, who present with treatment-resistant urticaria.