ABSTRACT
Myasthenia gravis is an autoimmune disease affecting the neuro-muscular junction of skeletal muscles that is characterized by fatigable muscle weakness. It commonly affects the extraocular muscles. The aim of the present study was to use a non-invasive and a quantitative tool [electronystagmography] to evaluate the different eye movement abnormalities in myasthenia gravis and the efficacy of treatment in such patients. This study was conducted on 15 patients of both genders. Oculography tests were performed to all patients deprived from medication for 12 hours, and after medical treatment by 2-3 hours. Statistical analysis was done using Excel version release 2000. None of the patients showed spontaneous nystagmus whether in eyes open or closed situations. Two of the patients showed eccentric gaze nystagmus that was direction fixed. Although the mean values of saccadic acceleration, latency and peak velocity were close to the normative values, they showed statistically significant improvement after medical treatment. The smooth pursuit and accordingly the optokinetic tests showed gain abnormalities that statistically significantly improved after therapy. This study suggests that quantitative recording of eye movements have as good or better discriminative ability and could make a significant contribution to diagnosis and efficacy of drug therapy in myasthenia gravis
ABSTRACT
Eighteen parturient patients [15 with severe pre-eclampsia and 2 patients with chronic essential hypertension] were studied before and after lumbar epidural analgesia during first stage of labour using 10ml of 0.25% of bupivacaine. The utero-placental perfusion was evaluated by determining the systolic/diastolic [A/B] ratio in the uterine and umbilical arteries using Doppler velocimetry waveform analysis. The uterine artery systolic/diastolic [A/B ratio] decreased significantly from 1.95 + 0.45 before analgesia to 1.36 + 0.20 after it [p < 0.01]. The umbilical artery systolic/diastolic [A/B ratio] also decreased from 2.85 + 0.45 before analgesia to 2.22 + 0.53 after it [p < 0.01]. These results suggest improved utero-placental perfusion and improved intervillous blood flow after epidural analgesia which mades it the the obstetric analgesia method of choice in cases of sever pre-eclampsia
Subject(s)
Female , Analgesia, Epidural , Placental Function TestsABSTRACT
The blood flow resistance in the maternal utero-placental and fetal umbilical artery circulation were studied in 20 pregnant patients with uneventful pregnancy undergoing elective lower segment Caesarean section. The systolic/diastolic [A/B] ration for utero-placental and fetal umbilical circulation were determined by Doppler velocimetry waveform analysis and were used as an index blood flow resistance. Each patients received 1 liter intravenous crystalloid infusion before an epidural bupivacaine infection. Epidural anaesthesia resulted in significant decease in the maternal utero-placental systolic/diastolic [A/B] ration associated with a decrease in fetal umbilical artery [A/B] ratio. This study suggests a beneficial fetal effect from the improved maternal uterine perfusion after epidural anaesthesia