A 36-year-old normotensive woman developed symptoms of visual loss and dizziness two days after undergoing a liposuction procedure. When evaluated 10 days afterward, her Snellen acuity was 20/20 OD and 20/25 OS, with mild optic disc swelling OS, mild visual field constriction OD, and an inferior altitudinal defect OS. Hematocrit was 23.5%. After transfusion, her vision stabilized and the dizziness abated. When a patient has undergone a procedure where blood loss can occur, symptoms of visual loss and dizziness should alert the surgeon to the possibility of anemia or hypotension-associated ischemic optic neuropathy.
INTRODUCTIONPrecise regulation of body fluid osmolality is essential. It is controlled by a finely tuned, intricate homeostatic mechanism that operates by adjusting both the rate of water intake and the rate of solute-free water excretion by the kidney, i.e., water balance. Abnormalities in this homeostatic system can result from genetic diseases, acquired diseases, or drugs and may cause serious and potentially life-threatening deviations in plasma osmolality. Anti-diuretic hormone (ADH) released from posterior pituitary has a crucial role in the control of water content of the body through its actions on the cells of the distal part of nephron and collecting tubules in the kidney. One of the main stimulus to ADH release is an increase in plasma osmolality which produces a sensation of thirst. A decrease in circulating blood volume, i.e., hypovolemia is another stimulus and here the stimuli arise from baroreceptors in cardiovascular system or from angiotensin release. ADH binds to the V 2 receptors in basolateral membrane of cells of distal tubule and collecting ducts of the nephron. Its main effect in collecting duct is to increase the rate of insertion of water channels into luminal membrane thus increasing the permeability of membrane to water thereby leading to water reabsorption from the nephron. Several drugs affect the action of ADH.Diabetes insipidus (DI) is either due to deficient secretion of arginine vasopressin (AVP), also known as ADH by the pituitary gland (central DI) or due to renal tubular unresponsiveness to AVP (nephrogenic DI). This leads to polyuria, polydipsia with hyposthenuria, causing dehydration and hypernatremia if the patient is deprived of water. 2Vasopressin acts as an anti-diuretic by reabsorbing water via the principle cells of collecting ducts and the thick ascending loop of Henle, thereby increasing the plasma blood volume and decreasing the plasma osmolality. 3 ABSTRACTBackground: Diabetes insipidus is a disease characterized by high amounts of urine excretion. Antidiuretic drugs are used to treat this condition. Hence, our study intends to evaluate the anti-diuretic effect of fluvoxamine, a selective serotonin reuptake inhibitors in albino rats. Methods: Albino rats were divided into three groups of six animals each. The control group was fed with distilled water 10 ml/kg body weight, standard group received 4 units of vasopressin and test group received fluvoxamine 18 mg/kg body weight. On the day of experiment, diuresis was induced in all the groups by giving frusemide in a dose of 20 mg/kg body weight after loading with saline at 25 ml/kg body weight. The animals were confined in diuretic cage for a period of 5 hrs and urine output was noted. Urine was analyzed for electrolyte concentration (Na
INTRODUCTIONWater comprises from 75% body weight in infants to 55% in elderly and is essential for cellular homeostasis and life. Maintaining a constant water and mineral balance requires the coordination of sensitive detectors at different sites in the body linked by neural pathways with integrative centers in the brain that process this information. These centers are also sensitive to humoral factors (neurohormones) produced for the adjustment of diuresis, natriuresis and blood pressure (angiotensin mineralocorticoids, vasopressin, atrial natriuretic factor). Instructions from the integrative centres to the "executive organs" (kidney, sweat glands and salivary glands) and to the part of the brain responsible for corrective actions such as drinking are conveyed by certain nerves in addition to the above mentioned substances. 1 Antidiuretic hormone released from posterior pituitary has a crucial role in control of water content of the body through its actions on the cells of the distal part of nephron and collecting tubules in the kidney. One of the main stimuli to anti diuretic hormone release is an increase in plasma osmolality which produces a sensation of thirst. A decrease in circulating blood volume i.e hypovolemia is another stimulus and here the stimuli arise from baroreceptors in cardiovascular system or from angiotensin release. Antidiuretic hormone binds to the V 2 receptors in basolateral membrane of cells of distal tubule and collecting ducts of the nephron. Its main effect in ABSTRACT Background: Diabetes insipidus is characterized by polyuria, polydipsia with hyposthenuria, causing dehydration and hypernatremia if the patient is deprived of water. Vasopressin analogues and drugs causing water retention are used in this condition. The aim of the present study was to evaluate the antidiuretic effect of eslicarbazepine in albino rats. Methods: The animals were divided into 3 groups each containing 6 animals. The first group was constituted by the control group which received distilled water. The second was the standard group which received vasopressin. The third group was constituted by the test group which received the test drug eslicarbazepine. The test drug was given for a period of 5 days. On 5th day, one hour after administration of respective drugs in different groups, diuresis was induced in all groups of animals by Furosemide after they were loaded with normal saline after overnight fasting. The volume of urine collected was measured at the end of 5 hours from each of the group along with sodium, potassium and chloride concentrations. Results: There was significant water retention and urine was concentrated in the test group which received eslicarbazepine when compared to the control group. Conclusions: Eslicarbazepine has significant water retaining capacity in albino wistar rats. Further evaluation is required before using it in diabetes insipidus.
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