Clinical Research Directory

Subclinical Myocardial Dysfunction in Children With Wilson's Disease

Wilson's disease (WD) is one of the most common metabolic liver diseases in older children. The most frequent clinical presentation is liver disease. However, Wilson's disease (WD) is a multisystem disorder. It is concluded that four modes of cardiac manifestations in Wilson's disease (WD) include arrhythmias, cardiomyopathy, cardiac death, and autonomic dysfunction. Such possible cardiac involvement should be added to the clinical picture of Wilson's disease (WD) involving the hepatic and central nervous system(CNS). The data on cardiac manifestations in children is very limited and only few adult studies are available. In this study, the investigators aim to unveil subclinical cardiac dysfunction in children with Wilson's disease with apparently normal cardiac functions by conventional assessment.

Effect of Spinal and General Anesthesia on Frontal QRS Axis in Patients Undergoing Total Knee Arthroplasty

This prospective observational study aims to compare the effects of spinal and general anesthesia on frontal QRS axis in patients undergoing elective total knee arthroplasty. Adult patients aged 18 years and older with ASA physical status I to III will be included. Participants will be grouped according to the anesthesia technique applied in routine clinical practice. Standard 12-lead electrocardiography will be obtained preoperatively and postoperatively, and frontal QRS axis values will be recorded using the automatic measurements of the ECG device. The primary objective is to evaluate the preoperative-to-postoperative change in frontal QRS axis and to compare this change between patients receiving spinal anesthesia and those receiving general anesthesia. Demographic and perioperative variables, including comorbidities, intraoperative fluid administration, blood pressure, oxygen saturation, heart rate, and tourniquet time, will also be recorded. This study is designed to provide clinical information about the potential effects of anesthesia technique on cardiac electrical activity in patients undergoing total knee arthroplasty.