Osteonecrosis múltiple inducida por glucocorticoides / Multiple osteonecrosis induced bye glucocorticoids / Osteonecrose múltipla induzida por glicocorticóides

La osteonecrosis múltiple es una entidad poco frecuente que se define por el compromiso de al menos tres regiones diferentes. Es indispensable el abordaje multidisciplinario de los pacientes que la padecen tanto para el diagnóstico como el tratamiento oportuno. Presentamos el caso clínico de un paciente joven que presenta una osteonecrosis múltiple con compromiso de ambas caderas, hombros, rodillas, codo derecho y cuello de pie izquierdo. El principal factor de riesgo presente en nuestro caso es el consumo de glucocorticoides.

Multiple osteonecrosis is a rare entity that is defined by the involvement of at least three different regions. A multidisciplinary approach to patients who suffer from it is essential for both diagnosis and timely treatment. We present the clinical case of a young patient who presented multiple osteonecrosis with involvement of both hips, shoulders, knees, right elbow, and neck of the left foot. The main risk factor present in our case is the consumption of glucocorticoids.

A osteonecrose múltipla é uma entidade rara que se define pelo envolvimento de pelo menos três regiões diferentes. Uma abordagem multidisciplinar aos pacientes que sofrem com isso é essencial para o diagnóstico e tratamento oportuno. Apresentamos o caso clínico de um paciente jovem que apresenta osteonecrose múltipla envolvendo quadris, ombros, joelhos, cotovelo direito e pescoço do pé esquerdo. O principal fator de risco presente no nosso caso é o consumo de glicocorticóides.

BALB/c and C57BL/6 mouse strains influence gastric function outcomes with administration of cisplatin and dexamethasone

Abstract Our aim was to evaluate the effects of cisplatin and dexamethasone alone and combined on gastric contractility and histomorphometry of BALB/c and C57BL/6 mice. BALB/c and C57BL/6 male mice (8-week-old) were randomly separated into: Control; Cisplatin (7.5 mg/Kg); Dexamethasone (2.0 mg/Kg); and Dexamethasone plus Cisplatin (2.0 mg/Kg of dexamethasone 1-hour prior to 7.5 mg/Kg of cisplatin). Drugs were administered intraperitoneally for three days. Body weight and food intake were evaluated on 2nd day. Alternating Current Biosusceptometry technique was employed to measure gastric contractions on 3rd day. Afterward, mice were killed for gastric histomorphometric analysis. Cisplatin decreased food intake and caused bradygastria in BALB/c mice; however, the amplitude of gastric contractions decreased in both BALB/c and C57BL/6. Dexamethasone and cisplatin combined restored the gastric frequency and food intake only in BALB/c, but drug combination reduced the gastric amplitude of contractions in both strains. Dexamethasone alone increased gastric mucosa thickness in C57BL/6 and decreased muscular thickness in BALB/c. In conclusion, the mouse strains presented differences in acute effects of cisplatin and dexamethasone alone and combined on gastric function. This reinforces the importance of choosing the appropriate mouse strain for studying the acute effects of drugs on the gastrointestinal tract.

Hydroxymethylnitrofurazone (NFOH) decreases parasitaemia, parasitism and tissue lesion caused by infection with the Bolivia Trypanosoma cruzi type I strain in Swiss and C57BL/6 mice

Abstract The chemical hydroxymethylation of the antimicrobial nitrofurazone leads to the prodrug NFOH, also increases the anti-T. cruzi activities (in vitro and in vivo), as well as showed non-genotoxic (Ames and micronucleus assays). In the present study, we assessed the anti-T. cruzi effect of the NFOH In vivo - in acute Swiss and C57Bl/6 experimental Chagas models. The treatment started at 5 days post-infection during 20 consecutive days (orally, once day, 150mg/kg), and the parasitaemia as well as histopathology analysis were performed. In both experimental murine models, NFOH was able to reduce parasitemia blood avoiding parasitic reactivation, during immunosuppression period (dexamethasone 5mg/kg, 14 days), in 100% of the mice, and decrease tissue parasite nests, demonstrating absence of amastigote forms in all organs (100%) analyzed, data similar to benznidazole (BZN). Therefore, the results shown here pointing to the NFOH as promising compound for further preclinical studies, being a high potential drug to effective and safe chemotherapy to Chagas disease.

Avaliação in vitro do potencial cariogênico e erosivo de corticosteroide de uso tópico / In vitro evaluation of cariogenic and erosive potential of topic corticosteroid

Introdução: o tratamento com bochechos de dexametasona elixir é bastante descrito na literatura para casos de lesões erosivas e ulceradas em mucosa bucal. Excipientes acrescentados aos medicamentos os tornam mais palatáveis e estáveis, embora possam resultar em efeitos adversos que comprometem a saúde bucal. Objetivo: este estudo propôs-se a avaliar, in vitro, o pH, a acidez total titulável (ATT) e o teor de sólidos solúveis totais (SST) de diferentes marcas de dexametasona elixir disponíveis no mercado da cidade de Salvador, correlacionando-os ao potencial erosivo e cariogênico do medicamento para os dentes. Metodologia: seis marcas (A, B, C, D, E e F) de laboratórios distintos foram incluídas neste estudo. O valor do pH foi aferido utilizando-se pHmetro e agitador magnético; a ATT foi determinada adicionando-se hidróxido de sódio (NaOH) 0,1 N e a aferição do SST foi através de refratômetro. Os dados foram expressos em valores médios e desvios padrão. Resultados: o pH de todas as marcas investigadas apresentou medidas abaixo de 5,5, logo, todas apresentaram potencial erosivo. Na avaliação da ATT, maior volume de NaOH 0,1N foi necessário pela marca D para alcançar pH 5,5 e 7,0. Dentre as marcas investigadas, a marca B foi a que apresentou maior teor de SST em sua composição. Conclusão: soluções para uso local de dexametasona elixir possuem potencial erosivo e alto teor de SST, tornando-se, então, importante a orientação de instrução de higiene oral dos pacientes que possuem maior risco de desenvolver alterações dentárias.

Introduction: treatment with mouthwash dexamethasone elixir is sufficiently described in the literature for cases of erosive and ulcerated lesions in oral mucosa. Excipients added to drugs make them more palatable and stable, however, may result in adverse effects that compromise the health of the oral cavity. Aim: this study sets out to evaluate in vitro pH, titratable total acidity (TTA) and the total soluble solids content (TSS) of different brands of dexamethasone elixir available on the market of Salvador city, correlating them to the potential of cariogenic and erosive medicine for the dental units. Methodology: six distinct laboratories brands (A, B, C, D, E and F) were included in this study. The pH value was assessed using a pH meter and magnetic stirrer, the TTA was determined by adding sodium hydroxide (NaOH) 0.1 N and measurement of TSS was made with refractometer. The data were expressed as average and standard deviations. Results: the pH of all brands investigated presented measures below 5.5, so, all presented erosive potential. In TTA, greater volume of NaOH 0, 1N was required by D brand to achieve pH 5.5 and 7.0. Among the brands investigated, brand B was the one that presented the highest content of TSS in its composition. Conclusion: solutions for local use of dexamethasone elixir have erosive potential and high content of TSS, becoming so important the guidance of oral hygiene instruction of patients who have higher risk of developing dental changes

Avaliação dos níveis séricos de glicose e insulina no uso de alendronato de sódio e atorvastatina cálcica na osteoporose induzida com dexametasona / Evaluation of serum levels of glucose and insulin in the use of sodium alendronate and atorvastatin calcium in dexamethasone-induced osteoporosis

Introdução: Além da indução da osteoporose, os glicocorticoides ocasionam aumento da resistência à insulina e gliconeogênese hepática, tendo como consequência a hiperglicemia. Objetivo: Avaliar comparativamente os efeitos do alendronato de sódio e da atorvastatina cálcica nos níveis séricos de glicose e insulina na osteoporose induzida com dexametasona. Métodos: A indução da osteoporose consistiu na administração de dexametasona na dose de 7,5 mg/kg de peso corporal, uma vez por semana durante 4 semanas, à exceção dos animais do grupo controle (G1). Os animais foram distribuídos nos seguintes grupos: G1 (grupo controle sem osteoporose), G2 (controle com osteoporose sem tratamento), G3 (com osteoporose tratado com alendronato de sódio 0,2 mg/kg) e G4 (com osteoporose tratado com atorvastatina cálcica 1,2 mg/kg). No período de 30 e 60 após o início do tratamento, foram coletadas amostras de sangue para as dosagens dos níveis séricos de glicose e insulina. Resultados: Os grupos G2 e G3, quando comparados com o grupo normal G1, apresentaram aumento da glicemia e insulinemia durante todo o período experimental. O grupo G4 apresentou, com 30 dias, aumento da glicemia e insulinemia e, com 60 dias, aumento da glicemia e queda da insulinemia. Conclusão: Os resultados demonstraram o quadro de hiperglicemia consequente do aumento da resistência à insulina, presentes na indução da osteoporose pela dexametasona. O alendronato de sódio não ocasionou nenhuma melhora da glicemia e insulinemia. A atorvastatina cálcica ocasionou agravamento da hiperglicemia e hiperinsulinemia, potencializando o quadro de resistência à insulina e levando a uma insuficiência relativa de insulina característica do diabetes mellitus tipo 2.

Introduction: In addition to the induction of osteoporosis, glucocorticoids cause increased insulin resistance and hepatic gluconeogenesis resulting in hyperglycemia. Objective: Evaluate the effects of sodium alendronate and atorvastatin calcium on serum glucose and insulin levels in osteoporosis induced by dexamethasone. Methods: The induction of osteoporosis consisted of the administration of dexamethasone at a dose of 7.5 mg / kg body weight, once a week for 4 weeks, except for the control animals (G1). The animals were divided into the following groups: G1 (control group without osteoporosis), G2 (control with untreated osteoporosis), G3 (with osteoporosis treated with sodium alendronate 0.2 mg / kg) and G4 (with osteoporosis treated with atorvastatin calcium 1,2 mg / kg). In the 30 and 60 period after the start of the treatment blood samples were collected for dosages of serum glucose and insulin levels. Results: The G2 and G3 groups, when compared with the normal group G1, presented increased glycemia and insulinemia throughout the experimental period. The G4 group presented a 30-day increase in glycemia and insulinemia and at 60 days increased glycemia and decreased insulinemia. Conclusion: The results demonstrated the hyperglycaemia associated with the increase in insulin resistance present in the induction of osteoporosis by dexamethasone. Sodium alendronate did not cause any improvement in glycemia and insulinemia. Atorvastatin calcium caused worsening of hyperglycemia and hyperinsulinemia enhancing insulin resistance, leading to a relative insufficiency of insulin characteristic of type 2 diabetes mellitus.

Experimental model of glucocorticoid-induced insulin resistance

ABSTRACT PURPOSE: To evaluate metabolic effects in experimental model of glucocorticoid-induced insulin resistance. METHODS: Twenty Wistar male rats were randomly divided into two groups, which were treated with intraperitoneally injected dexamethasone 1mg/Kg/day for ten days consecutively (Group D; n=10) and placebo (Group C; n=10). The variables analyzed were: from the first to the 10th day - body weight (before and after treatment); food and water daily consumption; on the 10th day - glycemia, insulinemia, HOMA-beta and HOMA-IR. The blood samples for laboratory analysis were obtained by intracardiac puncture. Also on the 10th day liver fragments were taken for analyzing glycogen and fattty. RESULTS: Group D animals compared to group C had: weight reduction (g), (D=226.5±24.7 vs C=295.0±25.4; p=0.001); increased glycemia (mmol/l) (D=19.5±2.1 vs C=14.2±3.1; p=0.0001); diminished insulinemia (mU/l) (D=0.2±0.1 vs C=2.0±0.4; p=0.0001); reduced HOMA-β (D=0.2±0.1 vs C=4.2±1.7; p=0.0002); diminished HOMA-IR (D=0.2±0.1 vs C=1.3±0.4; p=0.0002). Histological examination of the liver showed that 100% of group D and none of group C had moderate fatty. (p=0.2). CONCLUSION: Animals treated with glucocorticoid, in this experimental model, expressed hyperglycemia, hypoinsulinism and decreased peripheral insulin sensitivity.

Histological, histochemical and immunohistological comparative study between Ranitidine and Rebamipide in Gastric Mucosal protection after Dexamethasone induced injury in adult male albino rats

Background: Gastritis can be caused by many factors, one of them is drugs, and among these drugs is dexamethasone that has many uses in medicine. Dexamethasone prevent synthesis of gastric mucous barrier by surface epithelial cells, so the stomach wall will be injured by digestive enzymes and stomach HCl. Treatment of gastritis can be done by antisecretory drugs like H2 receptors blocker as ranitidine or by drugs that stimulate prostaglandins synthesize by surface epithelial cells of gastric mucosa to form the mucous barrier like rebamipide

Aim of the work: Comparison between ranitidine and rebamipide to detect which mechanism is better in gastric mucosal protection after dexamethasone administration

Material and methods: Twenty male albino rats were included in this study, they were divided into four groups, control group, dexamethasone administrated group, dexamethasone and ranitidine administrated group, dexamethasone and rebamipide administrated group, each group contained five rats. The examined samples were stained with hematoxylin and eosin stain, PAS and Alcian blue stains and TdT reaction, all of the results were statistically analyzed

Results: The result showed improvement of the gastric mucosa by using both of ranitidine and rebamipide as protective agents against injury induced by dexamethasone but the improvement was better in the group that was administrated rebamipide as indicated by better number of healthy cells, low numbers of damaged cells and better formed mucous barrier

Conclusion: The drug that stimulates mucous barrier formation is better than antisecretory drug in gastric mucosa protection

Comparative adverse effects of low-dose oral prednisolone and oral mini pulse dexamethasone in patients of vitiligo

To compare the adverse effects of low-dose oral prednisolone and oral mini pulse dexamethasone in patients of vitiligo. A clinical trial was carried out from January 2013 to December 2013. Total sixty patients of vitiligo were enrolled and 30 of group A patients were treated with low dose oral prednisolone [0.3 mg/kg body weight] daily and 30 of group B patients were treated with oral dexamethasone pulse therapy [10 mg per week] for 16 weeks. During 12 week follow-up, increased body weight, headache, dyspepsia and fatigue were more frequent in group A as compared to group B. Similarly, in group A other side effects noted were acne [33.3%], mooning of face [26.6%], striae [26.6%], hypertrichosis 13.2%, purpura [6.7%] and among the female patients, menstrual abnormality [71.4%] whereas in group B, no patient developed these problems from baseline to follow-up period [p<0.05] Low dose oral prednisolone was found to be associated with more adverse effects than oral dexamethasone pulse therapy in treating vitiligo

Histoquímica e morfometria da placenta de ratas tratadas com dexametasona / Placental morphometry and histochemistry in rats treated with dexamethasone in early pregnancy

A dexametasona, um glicocorticóide sintético, tem a capacidade de atravessar a placenta aumentando o nível de circulação de corticosteróides da mãe para o feto durante a prenhez. Quando administrada nas fases finais da prenhez pode produzir efeitos indesejáveis na formação da placenta e em vários órgãos da prole. Assim, o presente estudo objetivou investigar o efeito da administração da dexametasona (0,8mg/dia/animal) nos cinco primeiros dias da prenhez, sobre o desenvolvimento placentário de ratas. Utilizou-se 30 ratas albinas, divididas em dois grupos: Grupo I -ratas prenhes sem aplicação de dexametasona, sacrificadas ao 7º e 14º dia; Grupo II -ratas submetidas à aplicação de dexametasona nos cinco primeiros dias de prenhez, sacrificadas ao 7º e 14º dia. Os resultados mostraram que a dexametasona não afetou o número e a histologia dos sítios de implantação, porém, promoveu alteração no disco placentário ocasionando hipertrofia na camada de células trofoblásticas gigantes. Não foram evidenciadas alterações no teor de colágeno, porém houve interferência no metabolismo do glicogênio no espongiotrofoblasto trofospongio. Na morfometria de linhas houve diferença entre os grupos na região de labirinto e células trofoblásticas gigantes, porém a morfometria de pontos só ratificou as alterações percebidas na região do labirinto.

The dexamethasone, a synthetic glucocorticoid, has the ability to cross the placenta by increasing the level of movement of corticosteroids from mother to fetus during pregnancy. When administered in the late stages of pregnancy can produce effects undesirable on placental formation. The present study aimed to investigate the effect of administration of dexamethasone (0.8mg/day/animal) in the first five days of pregnancy, on placental development in rats. We used 30 albino rats, divided into two groups: Group I -pregnant rats without the application of dexamethasone, sacrificed to the 7th and 14th day. Group II -rats subjected to the application of dexamethasone in the first five days of pregnancy, sacrificed to the 7th and 14th day. The results showed that dexamethasone did not affect the number and histology of the implantation sites, but promoted changes in the disk placental causing hypertrophy in trophoblastic giant cell layer. No changes were found in the content of collagen, but there was interference with the metabolism of glycogen in spongiotrophoblast. The morphometry of lines showed, a difference between groups in the region of labyrinth and trophoblast giant cell. However, in morphometry of points there was a difference between groups in the region of labyrinth.

Severe hypokalemia due to combination use of dexamethasone and calcium gluconate for diabetics with infection: a case report / 法医学杂志

The combination use of dexamethasone and calcium gluconate can be applied to hypersensitivity. Severe hypokalemia is a usual complication of dexamethasone and calcium gluconate therapy, which occurs frequently with therapeutic use. Fatal cases, accidental and intentional, occur frequently in forensic practice. The current case report presented a 43-year-old man with diabetes mellitus with infection, to whom dexamethasone and calcium gluconate were administered in the private clinic. With the development of such clinical symptoms of severe hypokalemia as quadriplegia, he was confirmed to have severe hypokalemia through a biochemical test before dying of arrhythmia. And also it presented pathophysiologic mechanism underlying severe hypokalemia as well as suggestions for clinical practice regarding combination use of dexamethasone and calcium gluconate.

Recurrent central serous chorioretinopathy with dexamethasone eye drop used nasally for rhinitis

Central serous chorioretinopathy [CSC] is characterized by serous retinal detachment at the posterior pole. Several factors have been implicated in the pathogenesis, and endogenous or exogenous corticosteroids are thought to play a major role. Here we present a case of a 35-year-old male with complaints of a dark circle in front of his right eye. Fundus examination, optical coherence tomography and fundus fluorescein angiography were performed. The patient was diagnosed with CSC. CSC resolved completely within seven weeks. Four weeks later the CSC recurred and spontaneously resolved over eight weeks. Overall, the patient had three additional recurrences of CSC in the same eye over the next year. A detailed history taking revealed the patient was using 0.1% dexamethasone eye drops nasally for recurrent rhinitis for few days prior to each episode of CSC. This indicates the strong correlation between steroids given by any route and the pathogenesis of CSC

Protective role of magnesium sulphate in dexamethasone induced histopathological alteration in spermatogenic cells of albino rats

This study has been undertaken to assess the spermatoprotective role of magnesium sulphate [MgSO[4]] on the histology of the seminiferous tubules in dexamethasone induced spermatogenic cells damage in albino rats. Prospective experimental study. This study was conducted at the Department of Anatomy, Basic Medical Sciences Institute [BMSI], Jinnah Postgraduate Medical Centre [JPMC], Karachi from April 2012 to May 2012. Thirty male albino rats of 90-120 days of age and around 200-250 grams of weight were selected and divided into three groups [A, B and C]. Each group comprising of ten rats. Group-A served as control, group-B was given dexamethasone [Dexa] at the dose of 4mg/kg/day intraperitoneally for 20 days. Group-C was administered MgSO[4] at the dose of 20mg/kg/day intramuscularly and Dexa at the same dose as given in group- B. The rats were sacrificed at the end of the experimental period and histopathological changes in the germ cells were recorded. The microscopic examination of group-B rats revealed marked changes in most of the seminiferous tubules such as, vacuolization, detachment of basement membrane, atrophy, sloughing, widening of the interstitial spaces and disorganization of the spermatogenic cells series. Group-C which was protected with magnesium sulphate, showed restoration of basement membrane and spermatogenic cell series. The present study concluded that magnesium sulphate [MgSO[4]] administration reduced the damaging effects of dexamethasone in testes

protective role of magnesium sulphate on steroid induced liver damage in albino rats

Dexamethasone causes metabolic disorders and morphological adverse effects on several organs of the body such as testes, kidney, bone, eye and liver etc. Most commonly it causes damage to liver morphology and its functions. Magnesium is an essential mineral of the body, currently is a subject of interest in medicine. Therefore the present study was designed to observe the ameliorating role of magnesium on dexamethasone induced liver damage and correlate the result with previous studies. Experimental Study. This study was conducted in the Department of Anatomy, Basic Medical Sciences Institute, Jinnah Postgraduate Medical Centre, Karachi, from 21 April to 10 May 2012. Thirty adult albino rats, weighing from 200-300 grams were taken for this study. The rats were divided into 3 groups, Group A served as control, Group B received inj. dexamethasone 4mg/kg and Group C received inj. dexamethasone 4mg/kg with inj. Magnesium sulphate[MgSO[4]] 20mg/kg for 20days at the end of which they were sacrificed and liver tissue sections stained with haematoxylin and eosin. There was marked decrease in weight observed in rats receiving dexamethasone. Haematoxylin and eosin stained sections showed dilated central vein and sinusoids. Moderate fatty infiltration showed in vacuolated hepatocytes with absent or distorted nuclei in dexamethasone group which were protected and reverted to a major extent in Magnesium sulphate along with dexamethasone receiving group. This study has proved that use of Magnesium sulphate along with dexamethasone ameliorates dexamethasone induced damaging effects on liver

Tissue reaction to Endométhasone sealer in root canal fillings short of or beyond the apical foramen

OBJECTIVE: This study evaluated the response of periapical tissues to the endodontic sealer Endométhasone in root canal fillings short of or beyond the apical foramen. MATERIAL AND METHODS: Twenty root canals of premolars and incisors of 2 mongrel dogs were used. After coronal access and pulp extirpation, the canals were instrumented up to a size 55 K-file and the apical cemental barrier was penetrated with a size 15 K-file to obtain a main apical foramen, which was widened to a size 25 K-file. The canals were irrigated with saline at each change of file. The root canals were obturated either short of or beyond the apical foramen by the lateral condensation of gutta-percha and Endométhasone, originating 2 experimental groups: G1: Endométhasone/short of the apical foramen; G2: Endométhasone/beyond the apical foramen. The animals were killed by anesthetic overdose 90 days after endodontic treatment. The individual roots were obtained and serial histological sections were prepared for histomorphological analysis (H&E and Brown & Brenn techniques) under light microscopy. The following parameters were examined: closure of the apical foramen of the main root canal and apical opening of accessory canals, apical cementum resorption, intensity of the inflammatory infiltrate, presence of giant cells and thickness and organization of the apical periodontal ligament. Each parameter was scored 1 to 4, 1 being the best result and 4 the worst. Data were analyzed statistically by the Wilcoxon nonparametric tests (p=0.05). RESULTS: Comparing the 2 groups, the best result (p<0.05) was obtained with root canal filling with Endométhasone short of the apical foramen but a chronic inflammatory infiltrate was present in all specimens. CONCLUSIONS: Limiting the filling material to the root canal space apically is important to determine the best treatment outcome when Endométhasone is used as sealer.

Dexametasona para profilaxis de náuseas y vómitos postoperatorios: efecto sobre la glicemia en pacientes con diabetes mellitus tipo 2 y en no diabéticos sometidos a cirugía laparoscópica / Effects on blood glucose of prophylactic dexamethasone for postoperative nausea and vomiting in diabetics and non-diabetics

Background: Postoperative nausea and vomiting (PONV) prophylaxis with dexamethasone may produce significant hyperglycemia in the postoperative period. Aim: To evaluate if this effect is of greater severity in type 2 diabetics compared with non-diabetic patients. Material and Methods: Forty non-diabetic and thirty type 2 diabetic patients undergoing laparoscopic cholecystectomy were studied in a prospective and double-blind fashion manner. Patients were randomly distributed into 4 groups: Group I, non-diabetics control (n = 20), Group II, non-diabetics dexamethasone (n = 20), Group III, type 2 diabetics control (n = 15), and Group I V, type 2 diabetics dexamethasone (n = 15). Immediately after induction, patients in groups I and III received isotonic saline and patients in the dexamethasone groups received 8 mg iv of the steroid. Capillary blood glucose concentrations were measured at baseline and every 2 hours during the first 12 hours since the start of surgery. A linear mixed effect model, adjusted for baseline capillary glucose concentration, age and duration of surgery was used to analyze the data. Results: No effect of the presence of diabetes mellitus was observed in the evolution of glucose concentrations. There was a difference in capillary glucose concentrations between patients who received dexamethasone and placebo that started 2 hours post-intervention, reaching a mean maximum difference of 34 mg/dl (adjusted model, p < 0.001) at 10 hours post-intervention. Conclusions: In this study, Type 2 diabetic patients did not show a higher susceptibility than non-diabetics to develop postoperative hyperglycemia after the use of prophylactic dexamethasone for PONV.

Insulin signaling proteins in pancreatic islets of insulin-resistant rats induced by glucocorticoid

Chronic administration of glucocorticoids induces insulin resistance that is compensated by an increase in p-cell function and mass. Since insulin signaling is involved in the control of p-cell function and mass, we investigated the content of insulin pathway proteins in pancreatic islets. Rats were made insulin resistant by daily administration of dexamethasone (1mg/kg, b.w., i.p.) for 5 consecutive days (DEX), whilst control rats received saline (CTL). Circulating insulin and insulin released from isolated islets were measured by radioimmunoassay whereas the content of proteins was analyzed by Western blotting. DEX rats were hyperinsulinemic and exhibited augmented insulin secretion in response to glucose (P < 0.01). The IRa-subunit, IRS-1, Shc, AKT, p-p70S6K, ERK1/2, p-ERK1/2, and glucocorticoid receptor protein levels were similar between DEX and CTL islets. However, the IRp-subunit, p-IRp-subunit, IRS-2, PI3-K, p-AKT and p70S6K protein contents were increased in DEX islets (P < 0.05). We conclude that IRS-2 may have a major role, among the immediate substrates of the insulin receptor, to link activated receptors to downstream signaling components related to islet function and growth in this insulin-resistant rat model.

Radiographic assessment of photodynamic therapy as an adjunctive treatment on induced periodontitis in immunosuppressed rats

OBJECTIVE: The aim of this study was to assess radiographically the effect of photodynamic therapy (PDT) as an adjunctive treatment to scaling and root planing (SRP) on induced periodontitis in dexamethasone-induced immunosuppressed rats. MATERIAL AND METHODS: The animals were divided into 2 groups: ND group (n=60): saline treatment; D group (n=60): dexamethasone treatment. In both ND and D groups, periodontal disease was induced by the placement of a ligature in the left first mandibular molar. After 7 days, ligature was removed and all animals received SRP, being divided according to the following treatments: SRP: saline and PDT: phenothiazinium dye (TBO) plus laser irradiation. Ten animals per treatment were killed at 7, 15 and 30 days. The distance between the cementoenamel junction and the height of the alveolar bone crest in the mesial surface of the mandibular left first molars was determined in millimeters in each radiograph. he radiographic values were analyzed statistically by ANOVA and Tukey's test at a p value <0.05. RESULTS: Intragroup radiographic assessment (ND and D groups) showed that there was statistically signifcant less bone loss in the animals treated with PDT in all experimental periods compared to those submitted to SRP. Intergroup radiographic analysis (ND and D groups) demonstrated that there was greater bone loss in the ND group treated with SRP compared to the D group treated with PDT at 7 and 30 days. CONCLUSION: PDT was an effective adjunctive treatment to SRP on induced periodontitis in dexamethasone-induced immunosuppressed rats.

[Abu-Najma] Syndrome: exogenous steroid induced Cushing's with serious consequences. A report of two cases

We describe and report two cases of what we called Abu-Najma Syndrome, caused by the ingestion of 'Abu-Najma' tablets: dexamethasone containing tablets promoted as [beauty tablets]. We believe the use of Abu-Najma is fast spreading among young ladies in Sudan. The syndrome has very serious consequences; a concerted effort is required to increase public awareness and prevent the problem. The commonest cause for Cushing's syndrome as well as secondary adrenal failure is the use of exogenous steroids. In this setting steroids are almost always prescribed for treatment of a medical condition. Side effects are usually discussed with the patients beforehand. However, self medication with steroids for non-medical reasons puts patients at increased risk of side effects. The use of steroid containing preparation either topical or oral for cosmetic reasons is on the increase. The following case histories illustrate the dangers associated with such a practice

Cataract; corticosteroid induced intraocular pressure elevation after extraction

To observe the tendency of corticosteroids to raise the intraocular pressure after prolonged use of 0.1% dexamethasone eye drops during post operative period of cataract extraction. Observational study. From August 2008 to December 2009. In the study 50 patients were included. These patients had age related cataract in one or both eyes. The IOP of every patient was measured preoperatively with the help of Goldman applanation tonometer. After cataract extraction, every patient received 0.1% dexamethasone eye drops four times a day for one month. The IOP was measured fortnightly. Department of Ophthalmology, Allied Hospital, Faisalabad and the clinics of the authors. Topical administration of 0.1% Dexamethasone Eye Drops ,four times a day for one month after age related cataract extraction caused elevation of intraocular pressure more than 21 mm Hg in 8% of general population