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Curcumin and dexmedetomidine have been shown to have protective effects in ischemia-reperfusion injury on various organs. However, their protective effects on kidney tissue against ischemia-reperfusion injury remain unclear. We aimed to determine whether curcumin or dexmedetomidine prevents renal tissue from injury that was induced by hind limb ischemia-reperfusion in rats. Fifty rats were divided into five groups: sham, control, curcumin (CUR) group (200 mg/kg curcumin, n ¼ 10), dexmedetomidine (DEX) group (25 lg/kg dexmedetomidine, n ¼ 10), and curcumin-dexmedetomidine (CUR-DEX) group (200 mg/kg curcumin and 25 lg/kg dexmedetomidine). Curcumin and dexmedetomidine were administered intraperitoneally immediately after the end of 4 h ischemia, just 5 min before reperfusion. The extremity re-perfused for 2 h and then blood samples were taken and total antioxidant capacity (TAC), total oxidative status (TOS) levels, and oxidative stress index (OSI) were measured, and renal tissue samples were histopathologically examined. The TAC activity levels in blood samples were significantly lower in the control than the other groups (p < 0.01 for all comparisons). The TOS activity levels in blood samples were significantly higher in Control group and than the other groups (p < 0.01 for all comparison). The OSI were found to be significantly increased in the control group compared to others groups (p < 0.001 for all comparisons). Histopathological examination revealed less severe lesions in the sham, CUR, DEX, and CUR-DEX groups, compared with the control group (p < 0.01). Rat hind limb ischemia-reperfusion causes histopathological changes in the kidneys. Curcumin and dexmedetomidine administered intraperitoneally was effective in reducing oxidative stress and renal histopathologic injury in an acute hind limb I/R rat model. ARTICLE HISTORY

The difference in impact on maternal and fetal oxidative stress of supplemental 40% compared to 21% oxygen mandates further large-scale studies that investigate the role of oxygen supplementation during elective CS under spinal anesthesia.

Oxidative stress indices might be modified with preferred anesthetic agent and sevoflurane showed more favorable effects than desflurane in view of oxidative stress.

Background and Objective. Oxidative stress is believed to play a role in the development of preeclampsia (PE). It is known that an increased cystatin C level is also associated with PE. The aim of this study was to investigate the relationship between oxidative stress parameters and cystatin C levels in patients with severe PE. Material and Methods. Forty-four patients with severe PE and 40 healthy pregnant women were recruited for the study. All study subjects were divided into 2 groups: group 1 (n=44) consisted of patients with severe PE, and group 2 (n=40) included healthy pregnant subjects. Blood samples were obtained from all subjects in order to measure the cystatin C level, total antioxidant status, and total oxidant status. The oxidative stress index was calculated. Results. The group 1 had significantly higher cystatin C, total oxidant status, oxidative stress index levels and lower total antioxidant status level as compared with the group 2 (P=0.001, P<0.001, P<0.001, P=0.036, respectively). The serum cystatin C level was significantly correlated with the oxidative stress index (r=0.609, P<0.001). Conclusions. The present study demonstrated that both oxidative stress and cystatin C levels were increased in patients with PE, and the increased cystatin C levels seem to be a consequence of oxidative stress. Correspondence to

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Levetiracetam, a pyrolidine-derivate analogous to piracetam is a new antiepileptic drug reported to have a high degree of tolerability in both adults and children with epilepsy. It is approved in Europe for monotherapy and adjunctive treatment of partial seizures with or without secondary generalization, as well as for adjunctive therapy of myoclonic seizures and primarily generalized tonic-clonic seizures [1]. Common adverse events of levetiracetam include somnolence, agitation, asthenia, headache, abnormal behaviour, depression, mood disorder and suicidal intent. Hematologic adverse effects are extraordinary. Lafora disease is the most common and severe form of adolescent-onset progressive myoclonus epilepsies a group of devastating inherited neurodegenerative disorders characterized by progressively worsening myoclonus, epilepsy, early dementia and death [2]. We present a case of pancytopenia most likely induced by levetiracetam in a 16-years-old girl with Lafora disease.A sixteen-year-old girl was admitted to our ICU with the complaint of short of breath. She was diagnosed as Lafora disease 3 years ago. She was receiving sodium valproat therapy for her epileptic seizures. Routine laboratory results were in normal range. Levetiracetam 1000 mg  2 was added to sodium valproat therapy. On the day of admission, complete cell count (CBC) showed haemoglobulin: HGB 8.4 g/dl (normal range 12-18.1 g/dl); platelet: PLT 280.9  10 3 /ml (normal range 142-424 10 3 /ml); white blood cells (WBC) 7.2  10 3 /ml (normal range 4.3-10.3 10 3 /ml). Four days later, CBC showed pancytopenia with HGB 6.2 g/dl, PLT 7383  10 3 /ml, and WBC 2.2  10 3 /ml levels. The patient received 3 units of packed red blood cells. Pancytopenia induced by levetiracetam was suspected and the drug was withdrawn. Four days later, improvement in the CBC was observed, with hemoglobin level at 11.9 g/l, platelet count of 180  10 3 /ml, and WBCs 7.2  10 3 /ml. CBC levels remained within normal ranges over the following days. According to the Naranjo probability scale, levetiracetam-induced pancytopenia was possible [3].Serious blood dyscrasias are uncommon in patients taking antiepileptic agents [1]. Pancytopenia has been associated with use of carbamazepine, phenobarbital, phenytoin, and valproate. The mechanism for the antiepileptic effect of levetiracetam is still unknown but its favourable pharmacokinetic profile, good tolerability and rapid effects make it very popular as an antiepileptic agent. Our case represents pancytopenia associated with levetiracetam in a Lafora disease patient. Most adverse effects of levotiracetam occur during the first 4 weeks of therapy and do not appear to be dose related. Abnormal liver function test results, hepatic failure, hepatitis, weight loss, leukopenia, neutropenia, pancreatitis and pancytopenia with bone marrow suppression have been identified in patients taking levetiracetam in postmarketing surveillance studies. Two cases of levetiracetaminduced pancytopenia have been described in the literature. First cas...