Background: As gag REFLEX is considered as a complication during most of the dental procedures, developing new techniques have always been a task for clinicians to overcome the problem.Aim: The aim of this study was to evaluate the effect of salt (Nacl) to temporarily eliminate the gag REFLEX during intraoral radiography.Material and Methods: A group of 256 patients (128 male, 128 female) were selected who had history of gag REFLEX from those reffered to Dental Radilogy Department a Kerman university. Patients were devided in to two groups. During the course of this study of case who used salt, and control group who used starch (as Plasebo).Salt was poured on anterior 2/3 the oftonque, five seconds before taking the dental radiograph. The same proucedure was accomplished with starch for the second group. Incase of an elemination of gag REFLEX afterpouringsaltor starch, the subject will be recorded as positive responder, other wise as negative.Results: Among 128 patients who were examined with salt, 113 individuals showed a positive respond (88.3%).While, among 128 patients who were examined with starch only 3 individuals showed a positive respond(2.3%).Conclisions: A possitive effect of NaCl could be councluded to relief the gag REFLEX based on the results of this study.

Introduction: Nerve conduction studies and needle electromyography (EMG) play a central role in the evaluation of patients with neuromuscular disorders. The tibia nerve H-REFLEX is one of the most common parameters in clinical electro diagnosis, especially in the diagnosis of SI radiculopathy. H- REFLEX is important because involvement of SI root most common in disc hernia causes rapid changes.Objective: The purpose of this study was to determine the mean values of tibia H-REFLEX in healthy individuals aged 20 years and older.Materials and Methods: In this cross-sectional study 110 asymptomatic volunteers were controlled. All of them were placed in prone position with flexed knee by 20 degree tibia H-REFLEX latency was recorded by Medelec machine from midcalf on each side. Stimuli were applied at the midpopliteal crease. Data were analyzed by EpiInfo software and by using ANOVA tests to compare means of different groups. The results were reported as mean (CI 95% of mean).Results: 55.5% were male and 44.5% were female. Mean age of subjects was 41.6 years and mean height was 165.26 cm. The mean H-REFLEX latency for 220-tibia nerve (110 of right & 110 of left) was 26.46 m/sec (Cl 95%=26.62-26.28 m/sec).The maximum mean H-REFLEX latency was 28.23 m/sec in over 60 years old age group and the least mean H-REFLEX latency was 25.93 m/sec in 40-60 years old age group (P<0.0001). Mean of H-REFLEX latency were 25.92 m/sec in less than 150 cm height group and was 29.78 m/sec in more than 180 cm height group (P<0.0001). Conclusion: Since from references, age and height have major effect on normal value of H-REFLEX latency and this is also evident in this study, and on the side, there is a significant difference in H-REFLEX values measured in different studies; so we recommend the use of normal values according to standardized measurement in each region or clinic.

Introduction: Blink REFLEX (BR) is a new electro diagnostic test mediated through a REFLEX arch with fifth cranial nerve in its afferent and seventh cranial nerve in its efferent side. BR responses are designed R1, R2 and R2c responses. Anatomic locations of this REFLEX arch in central nervous system are still undefined and various results have been reported in different studies, for example in hemispheric strokes, exclusive abnormalities of R2 responses or abnormalities in both RI and R2 (unilateral or bilateral) have been reported.Materials and Methods: Twenty patients with hemispheric strokes were evaluated during 1.5 year period and were compared with age and sex matched normal volunteers. BR was performed in similar circumstances in both groups and results were compared with each other.Findings: BR was abnormal in 19 patients and was normal in only one patient. R1 response was normal in 18 patients and was prolonged in two patients. R2 response was absent or prolonged in 18 patients (in 15 patients bilaterally) and was normal in two patients. The most prevalent observed risk factors in the study population were Hypertension and Diabetes mellitus respectively.Conclusion: BR was abnormal in 95% of the patients and R2 response abnormalities were detected in 90% of the patients (Bilateral in 75%). The most common observes pattern of BR abnormalities in hemispheric strokes was bilateral absence or prolongation of R2 responses.

Oculocardiac REFLEX (OCR) has been described to occur with mechanical manipulation of the eye, eyelids or orbit. There are no reports in the literature of OCR during intravitreal injection (IVI). This may be due to the fact that heart rate is not monitored during the procedure. We aimed to evaluate OCR during IVI. A total of 532 patients were enrolled in the study at Asociacion para Evitar la Ceguera en Mexico. Mexico City, Mexico. IVI was performed on one eye in every patient with diabetic retinopathy (DR), age related macular degeneration (AMD) or choroidal neovascularization (CNV) secondary to pathological myopia. Heart rate was monitored with a pulse oximeter before, during and after injection. OCR was defined as a 20% decrease or more of basal heart rate. The population enrolled included 270 females and 262 males with mean age of 63. 8 years. A decrease in heart rate of 20% or more occurred in 18 patients during IVI (3. 3%; 95% confidence interval 1. 85% and 4. 92%). OCR was asymptomatic in these patients. OCR occurred in 3. 3% of our patients during IVI. Hence, OCR must be considered when performing IVI...

The activation of oculucardiac REFLEX (OCR) is common during the strabismus surgeries. OCR is known as a trigemino-vagal REFLEX, which leads to the various side effects including bradycardia, arrhythmia, or in some cases cardiac arrest. This REFLEX could be activated during intraorbital injections, hematomas, and mechanical stimulation of eyeball and extraocular muscles surgeries. The incidence of OCR varies in a wide range, from 14% to 90%, that depends on anesthetic strategy and drug used for the surgery. The efficacy of various anticholinergic and anesthetic agents on declining the OCR REFLEX has been evaluated in different studies, especially in children. Although the detection of OCR goes back to 1908, its exact effect is not well recognized during strabismus surgery. In this review, we aimed to summarize the studies investigated the efficacy and potential of various anesthetic medications on inhibiting the OCR in children undergoing strabismus surgery.