In vitro antihistamine-releasing activity of a peptide derived from wasp venom of Vespa orientalis

Objective: To investigate the antihistamine-releasing effect of a peptide isolated from wasp venom of Vespa orientalis. Methods: This peptide was separated from crude venom by chromatography methods and mass spectrometry. Then various concentrations (2, 4, 8, 16, 32, 64, 128 and 256 μmol/L) of the peptide were incubated with mast cells and lactate dehydrogenase assay was performed. Results: No significant effect was observed in lactate dehydrogenase absorbance under 128 μmol/L concentration. This implied that the peptide did not cause cell death in mast cells and consequently, histamine release did not happen. Moreover, the results showed the IC

25 Hydroxyvitamin D concentrations in patients with optic neuritis as a clinically isolated syndrome and healthy controls

The onset of multiple sclerosis in the majority of the cases occurs as a clinically isolated syndrome [CIS]. We sought to assess serum levels of 25-hydroxyvitamin D [25-OHD] in CIS patients and healthy controls. In this cross-sectional study 40 patients [36 women and 4 men] with CIS manifesting as a single isolated optic neuritis and 40 Age- and sex-matched healthy controls [35 women and 5 men] were enrolled between late October 2010 and early March 2011. General vitamin D deficiency was defined as serum 25-OHD levels of lower than 20 ng/ml and was classified as mild [15 < 25-OHD <20 ng/ml], moderate [8 < 25-OHD <15 ng/ml], and severe [25- OHD <8 ng/ml]. We found no difference in the median interquartile range [IQR] between CIS patients and controls [17.95 [10.40- 29.13] vs. 17.00 [12.25-31.00]; P=0.57]. However, when stratified by the levels of deficiency, among CIS patients a significantly higher proportion had severe vitamin D deficiency in comparison to healthy controls [20% vs. 2.5%; P=0.034]. Nevertheless, the frequency of general [62.5% vs. 60%, P=0.82], mild [25% vs. 30%, P=0.80], and moderate [17.5% vs. 27.5%, P=0.42] vitamin D deficiency were not different between the two groups. Our findings do not indicate any significant difference of serum 25-OHD between CIS patients and healthy controls. However, in our series severe vitamin D deficiency was more frequent among CIS patients.

Orbital Doppler Evaluation of Blood Flow Velocities in Optic Neuritis

PURPOSE: To evaluate orbital blood flow velocities and optic nerve diameter with Doppler and gray-scale sonography in patients with acute unilateral optic neuritis (ON). METHODS: Orbital Doppler and gray-scale sonography was performed in 46 eyes of 23 patients aged 19- to 47-years with acute unilateral ON. ON was diagnosed by an ophthalmologist on the basis of clinical presentation, presence of decreased visual acuity and assessment of visual evoked potentials. The peak systolic velocity (PSV) and end-diastolic velocity (EDV), as well as the resistance index (RI) and pulsatile index (PI) of the ophthalmic artery (OA), central retinal artery (CRA), posterior ciliary arteries (PCAs) and optic nerve diameter were measured in both eyes. We compared results from affected and unaffected eyes using the paired t-test. The area under the receiver operating characteristic (ROC) curves was used to assess the diagnosis of ON based on measured blood flow parameters of the OA, CRA and PCAs and optic nerve diameter. RESULTS: The mean (standard deviation) optic nerve diameter in eyes with ON was 4.1 (0.8) mm, which was significantly larger than the 3.0 (0.4) mm diameter measured in unaffected control eyes (p 0.05). The mean RI in the PCAs was slightly lower in the eyes with ON than in the contralateral eyes (0.60 vs. 0.64, p < 0.05). The area under the ROC curves indicated that optic nerve diameter was the best parameter for the diagnosis of ON. CONCLUSIONS: Optic nerve diameter was related to ON, but orbital blood flow parameters were not.

Adjunctive local application of lidocaine during scleral buckling under general anesthesia

To evaluate the effect of local lidocaine application on the incidence of the oculocardiac reflex [OCR] during scleral buckling [SB] for rhegmatogenous retinal detachment [RRD] under general anesthesia. In a randomized clinical trial, eyes with RRD scheduled for SB under general anesthesia were randomized to adjunctive local application of 1 ml lidocaine 2% versus normal saline to the muscles after conjunctival opening. Surgical stimulation was initiated 5 minutes afterwards. Additionally, 100 mg of lidocaine 2% was added to 50 ml of normal saline in the treatment group which was used for irrigation during surgery; control eyes were irrigated with normal saline. The incidence of the OCR, rate of postoperative nausea/vomiting [PONV], total intravenous [IV] analgesic dose, duration of surgery, and period of hospitalization were compared between the study groups. Thirty eyes of 30 patients including 22 [73.3%] male and 8 [26.7%] subjects with mean age of 49.4 +/- 16.3 years were operated. OCR and PONV occurred less frequently, and total intravenous analgesic dose was significantly lower in the lidocaine group [P < 0.05 for all comparisons]. However, no significant difference was noted between the study groups in terms of duration of surgery and period of hospitalization. Adjunctive local application of lidocaine during SB under GA for RRD decreases the rate of OCR and PONV, reduces the intravenous analgesic dose, but does not affect the duration of surgery or hospitalization

Preoperative sub-tenon block decreases perioperative pain severity and adveres complications

This study was designed to evaluate the efficacy of sub-tenon block [preemptive analgesia] after general anesthesia and before beginning the repair of retinal detachment [RD] surgery by using scleral buckle and cryopexy. Sixty eight patients scheduled for RD surgical repair with "American Society of Anesthesiologists" [ASA] I or II were included in this clinical trial study. The patients were randomly and blindly divided into two equal groups. The surgery was done under general anesthesia in both groups, but in the case group, sub-tenon block was given as preemptive analgesia after the induction of general anesthesia with similar methods and before the start of surgery. The incidences of intra and postoperative [up to 24 hours] oculocardiac reflex [OCR], ischemic heart disease [IHD] changes, nausea and vomiting [PONV], delirium, total analgesic drug consumption and ocular severity of pain were significantly lower in the case group compared with the control group [p<0.05]. Mean blood pressure, heart rate, time of discharge from the hospital, frequency of requirement to analgesic drug, intra and postoperatively were significantly lower in the case group compared with the control group [p<0.05]. According to this research, the use of sub-tenon block in RD surgery effectively reduces PONV, postoperative pain, analgesic drug requirements, delirium, discharge time from the hospital, IHD, hemodynamic changes and OCR, therefore it is recommended for daily routine ophthalmologic surgeries