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The rectal electric activity or electrorectography was recorded transcutaneously in 24 healthy volunteers (mean age 39.6 years). A silver-silver chloride electrode was applied lateral to each of the two sacroiliac joints, and a third one was placed midway between the left greater trochanter and the ischial tuberosity. The reference electrode was applied to the right lower limb. At least two 20-min recording sessions were performed for each of the 24 subjects. In addition, an intrarectal electrorectographic recording was done in 10 of the 24 subjects using silver-silver chloride electrodes attached to the rectal mucosa by suction. Pacesetter potentials (PPs) were recorded transcutaneously. The wave was triphasic with a small positive, a large negative and another small positive deflection. PPs had a regular rhythm and were reproducible. The mean frequency was 3.1 cycles/min. The transcutaneously recorded PPs could be confirmed by the intrarectal route. Both routes had similar electrorectographic recordings, except for the action potentials (APs) which did not show in the transcutaneous electrorectogram. In conclusion, the study demonstrates that PPs could be recorded transcutaneously. Transcutaneous electrorectography is simple, easy, reproducible and cost-effective, and may prove to be a useful investigative tool in the diagnosis of anorectal disorders.

Introduction: Heart disease secondary to chronic anemia and hemosiderosis remains the major cause of morbidity and mortality in thalassemic patients. Chronic anemia and the tissue hypoxia it induces impair free fatty acid oxidation and ATP production in myocardial cells. The use of L-carnitine, a butyric acid derivative, may help overcome some of these defects. Objective: To investigate the effect of L-carnitine therapy on cardiac function in thalassemia major patients. Materials and Methods: Cardiac function was evaluated in 30 patients attending our clinic. The mean (±SD) age was 15.87 ± 3.19 years. The studies we performed included echocardiography, Doppler and multigated equilibrium radionuclide angiography (MUGA). Systolic and diastolic function was evaluated before starting L-carnitine treatment and after 6 months of oral L-carnitine (50 mg/kg/day). Results: Echocardiography studies revealed no significant changes in systolic and diastolic function after L-carnitine therapy (p > 0.05). Analysis of the data taken by MUGA performed in 20 of the patients, however, showed a significant improvement of diastolic function after 6 months of L-carnitine therapy. The mean peak filling rate (end-diastolic volume/s) increased from 3.15 ± 1.06 to 3.61 ± 1.68 (p < 0.03). The time to peak (during filling) decreased significantly from 143.45 ± 42.04 to 117.70 ± 24.40 s (p < 0.02). Systolic function showed a significant increase in the left ventricular ejection fraction from 58.25 ± 9.92 to 63.95 ± 10.11% (p = 0.0001). Conclusion:L-Carnitine may be an effective drug for improving the cardiac status of thalassemic patients. MUGA is the most accurate technique of those used here for assessing left ventricular function in these patients.

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