Hematological Side Effects of Valproate Used for the Treatment of Epilepsy

Aim:Valproate is a commonly used antiepileptic drug with hematologic and non-hematologic side effects at therapeutic doses. The aim of this study was to investigate the relationship between the known hematological side effects of valproate and duration, dose and serum levels of this drug.Materials and Methods:The study population consisted of patients with epilepsy followed by pediatric neurology outpatient clinic, who had been using valproate for at least 3 months. Duration of treatment, valproate doses, hemogram and serum valproate levels of patients were recorded from their files. Patients with other systemic and/or hematological diseases and those who were taking drugs other than valproate were not included in the study.Results:Serum valproate levels and complete blood count results were obtained in 80 of 112 patients who met the criteria. Thirty of them (37.5%) were female. The mean age was 8.2±4.8 years (1-16 years) and the mean duration of treatment was 19.93±16.4 months (3 months-10 years). Valproate use dose ranged from 20 to 60 mg/kg day. At least one hematologic side effect was detected in 34 (42%) patients. These side effects were macrocytosis (18.7%), thrombocytopenia (17.5%), leukopenia (12.5%) and anemia (7.5%). There was no correlation between thrombocytopenia and valproate using time, but a significant correlation was found between dose and serum levels. There was a relationship between macrocytosis and serum valproate level only. No correlation was found between leukopenia and anemia and duration of treatment, dose and serum levels.Conclusion:Hematological side effects of valproate used in the treatment of epilepsy are not uncommon, and these side effects are unpredictable. Therefore, it was concluded that complete blood counts should be sufficient in the follow-up of the patients and families should be informed about the side effects

Retrobulbar hemodynamics during healthy and preeclamptic pregnancy

Objective: We aimed to evaluate retrobulbar hemodynamics during healthy and preeclamptic pregnancy. Methods: We studied retrobulbar hemodynamics in 21 healthy pregnant, 20 preeclamptic and 21 non-pregnant fertile women. The peak systolic velocity, end-diastolic velocity and resistivity index (RI) of the ophthalmic artery (OA), central retinal artery (CRA) and posterior ciliary artery (PCA) were measured by color Doppler imaging. Results: The systolic and diastolic blood pressures of the preeclamptic women (155±8.5 and 105±7.5 mmHg, respectively) were significantly higher than those of healthy pregnant women (110±5.5 and 70±7.5 mmHg, respectively, p=0.008). The RI values of OA, CRA and PCA in healthy pregnant women were significantly lower than those of the non-pregnant women. The RI of the CRA and PCA in preeclamptic women were significantly higher than those of healthy pregnant women. Although there was no statistical significant difference, the RI of the OA was lower in preeclamptic women than healthy pregnant women. Conclusion: Resistance of all retrobulbar arteries decreased during healthy pregnancy. On the other hand, increased resistance was detected in PCA and CRA, besides the nonsignificant decrease in OA during preeclamptic pregnancy. Different auto regulator control mechanisms in response to hypertension seem to be responsible for the different conducts of different sized arteries of orbita during preeclamptic pregnancy. ©Copyright 2012 by Gazi University Medical Faculty

Schwannoma of the Lower Eyelid in a 13-Year-Old Girl

WOS: 000262734100015PubMed: 19273927A 13-year-old girl presented with a history of a slowly enlarging, mobile, right lower eyelid mass of 2 years' duration. Excisional biopsy revealed the characteristic histopathologic features of a schwannoma. After complete excision, there was no recurrence at 1-year follow-up. Schwannoma is a rare eyelid tumor, appearing sporadically and in a solitary form, which should be considered in the differential diagnosis of eyelid tumors in children

Comparison of central corneal thickness, thinnest corneal thickness, anterior chamber depth, and simulated keratometry using Galilei, Pentacam, and Sirius devices

Purpose: The aim was to evaluate the agreement in the central corneal thickness (CCT), thinnest corneal thickness (TCT), anterior chamber depth (ACD), and mean simulated keratometry (simK) measurements using Pentacam, Galilei, and Sirius Scheimpflug systems in normal eyes. Methods: Anterior segment measurements were performed with Pentacam, Galilei, and Sirius devices in 32 healthy subjects. The right eye of each participant was selected. Measurements obtained with the 3 systems were compared using repeated-measures analysis of variance and Bonferroni multiple comparisons test. Results: Analysis of variance determined a significant difference in the anterior segment measurements of CCT, TCT, ACD, and simK between the 3 devices (P < 0.001). Pairwise comparisons of CCT and TCT measurements were significantly different except for the comparison between Pentacam and Sirius. All pairwise comparisons for ACD were statistically significant. The pairwise comparison results for simK values showed that the Galilei and Sirius systems demonstrated better agreement with each other than with Pentacam. Conclusions: The results of this study suggest that the Pentacam, Galilei, and Sirius Scheimpflug systems should not be accepted as interchangeable for CCT, TCT, ACD, and simK in healthy subjects. Copyright © 2014 by Lippincott Williams & Wilkins