The acute effect of pseudoephedrine on choroidal thickness.

PURPOSE: To investigate the acute effects of pseudoephedrine (PE) on choroidal thickness in healthy young patients. METHODS: Fifty patients with nasal and sinus congestion who were prescribed 60 mg oral PE at the otolaryngology department were recruited for this study. The enhanced depth imaging (EDI) optic coherence tomography (OCT) (Spectralis OCT; Heidelberg Engineering, Heidelberg, Germany) choroidal thickness measurements were performed at baseline and 1, 3 and 6 hours at 7 points. RESULTS: The right eyes of 50 healthy subjects (22 women and 28 men) were included in this study. The mean choroidal thickness at fovea was 293.12 µm, 279.80 µm, 295.80 µm, and 294.52 µm at baseline, 1, 3 and 6 hours respectively. A significant reduction in choroidal thickness versus baseline was observed at all points at 1 hour. CONCLUSIONS: The choroidal thickness decreased 1 hour after oral administration of PE and returned to baseline thickness at 3 hours. We suppose that this transient decrease might be associated with vasoconstriction due to activation of sympathetic alpha adrenoceptors.

Tularemia during pregnancy.

Tularemia is a zoonotic infection caused by Francisella tularensis with a worldwide distribution and diverse clinical manifestations. Although F. tularensis has been recognized as a human pathogen for a century, there are few reports regarding the occurrence of tularemia in pregnant women and its effect on the fetus; only seven cases have been reported in the literature. In view of the sparse literature, it is not clear whether tularemia increases the risk of adverse pregnancy outcomes. In this paper we review tularemia infection during pregnancy, its complications and management. In addition, we present a case of tularemia that occurred in the first trimester of pregnancy and resulted in third-trimester intrauterine fetal death, highlighting the consequences of tularemia in pregnancy and the importance of early detection and treatment.