Parasympathetic Research Articles

Elevated correlations in cardiac–neural dynamics: An impact of mantra meditation on stress alleviation

Mantra meditation is a widely practiced technique with a demonstrated ability to promote relaxation and alleviate stress. This study aims to evaluate the impact of regular mantra meditation practice on electroencephalogram (EEG) patterns and heart rate variability (HRV) in young adults grappling with increased stress levels. Furthermore, the study explored possible correlations between these two physiological markers. Thirty-eight participants practiced mantra meditation for eight weeks, and their EEG and HRV were recorded before and after. The pre-post analysis evaluated brain activity and autonomic nervous system regulation alterations by examining EEG and HRV in the time, frequency, and nonlinear domains. Data analysis revealed significant correlations between EEG patterns and HRV indices following mantra meditation, suggesting a potential interconnection between neural and cardiovascular regulation. A notable increase in Root Mean Square of Successive Differences (RMSSD) and Standard Deviation of NN intervals (SDNN) within HRV, along with a decrease in Heart Rate (HR) and Stress Index (SI) and an increase in EEG alpha and theta power, accompanied by a reduction in their ratio, was observed. Three pivotal correlations consistently increased during eight weeks: Alpha/Theta Ratio (ATR) with Low-Frequency/High-Frequency Ratio (LHR), ATR with SD2/SD1 Ratio (SDR), and Relaxation Index (RI) with Stress Index (SI). After eight weeks, these correlations attained statistical significance, optimizing the balance between calmness and vigilance, boosting parasympathetic activity, and reducing chaos between the parasympathetic and sympathetic systems. The study elucidates the scientific mechanisms of mantra meditation, enriching research on its stress-reducing effects and emphasizing mental and physical well-being.

Rita Levi-Montalcini: From Persecution to the Nobel Prize and an Honorary Degree From a Canadian University.

Rita Levi-Montalcini (RLM) is recognized as a prestigious and renowned researcher of her time. She was the fourth woman to earn the Nobel Prize in Physiology and Medicine in 1986 for the discovery of nerve growth factor (NGF). We review her biography and scientific discovery, and provide an example of why her discovery is still important. She had a special relationship with McGill University, Canada, which we describe. We searched for articles and books about her for biographical and scientific material and met with Dr. Claudio Cuello, Former Chair of McGill's Faculty of Medicine. RLM was born in 1909 in Turin, Italy, where she had studied medicine. She started her career in research. Because of the anti-Jewish racial laws in Italy in 1938, she went underground and continued her projects in her bedroom. After the war, she visited St. Louis, USA, and conducted research there. Her experiments confirmed that tumors release a factor that causes nerve growth and cancer proliferation. Initially, scientists responded to this discovery with skepticism, but after its purification in 1959 and determination of its protein structure in 1971, NGF became widely accepted.Currently, crosstalk between cancers and nerves is poorly understood. The example of prostate cancer shows that surgical or chemical denervation of sympathetic nerves prevents the initiation of prostate tumors, whereas inhibition of parasympathetic nerve signaling reduces the spread of prostate cancer. McGill University awarded RLMa doctoral degree in 2011. It was the first time in itshistory that the University awarded an honorary doctorate outside of Canada, and the second one outside of Quebec.Through her discovery of NGF, RLM exemplified the power of passion and determination despite the obstacles she faced. Her relentless dedication has led to remarkable achievements.

Clinical Characteristics and Outcomes of Tympanomastoid Paragangliomas: A Report from Slovenia.

(1) Background: Head and neck paragangliomas are neuroendocrine tumors that typically originate from the parasympathetic nervous system and are predominantly non-secretory. Their clinical manifestations result from their mass effect on the surrounding tissues. The approach to treating these tumors depends on factors such as their location, size, impact on adjacent structures, and the patient's overall health and preferences. (2) Methods: A retrospective analysis of the management of temporal bone paraganglioma classes A and B (according to the modified Fisch classification) was performed at the University Medical Centre, Ljubljana, between 2011 and 2023. (3) Results: We analyzed 23 cases, 19 of which underwent surgery; complete tumor removal was achieved in 18 of them. Four patients were irradiated due to tumor progression to class C. Three of these four patients initially refused surgery and were treated with radiotherapy (RT) 7, 13, and 18 years after diagnosis. In the fourth patient, complete surgical resection was not achieved and she was treated with RT four years after surgery, due to the growth of the tumor to class C. The average follow-up time from diagnosis was 8.9 years (median 6 years; range 1-26 years). (4) Conclusions: The surgical treatment of patients with class A and B paragangliomas is effective and safe. In cases where surgery is refused but the tumor continues to grow to class C, RT is an alternative and efficient method of controlling tumor growth.

Stellate Ganglion Block may represent an effective therapeutic for Primary Sjögren’s Syndrome

Primary Sjogren’s syndrome (pSS) is a systemic autoimmune inflammatory disease characterized by xerophthalmia and xerostomia,leading to a notable decline in patients’ quality of life. Recent studies have shown a link between the autonomic nervous system (ANS) dysfunction and pSS. The salivary and lacrimal glands are innervated by both sympathetic and parasympathetic nerves, highlighting the role of the ANS. Stellate ganglion block (SGB), a commonly used nerve block technique in clinical settings, exhibits the ability to modulate both the ANS and the immune response. Therefore, our hypothesis suggests that SGB may alleviate xerostomia and xerophthalmia in pSS patients through a short-term mechanism involving the adjustment of ANS balance and vasodilation to facilitate glandular secretion. Additionally, the long-term efficacy of SGB in pSS may be attributed to its neuroimmunomodulatory effects. Furthermore,it is likely that SGB could also improve a variety of ANS-related extra-glandular symptoms in pSS, including digestive, cardiovascular, neurological, and psychological issues.

Alleviation of physiological stress response by apple aroma

ABSTRACT Objective The study evaluated the potential of apple aroma to alleviate physiological stress response induced by a short-term cognitive stressor. It investigated the effects of apple aroma on cardiac and peripheral autonomic nervous system activity under stressful conditions. Methods Within-subject experiments were conducted with 25 healthy male university students with a 30-minute calculation task under three conditions: Apple, Chamomile (CHA), and Di propylene glycol (DPG) (scentless air). The aroma administration was precisely controlled and counterbalanced. Cardiac activity on electrocardiograms and nose tip temperature were recorded throughout the experiment. A visual analog scale and a scent questionnaire were subjective measures. Results Apple aroma demonstrated a significantly smaller increase in heart rate (t [24] = 3.36, p = 0.008 vs. DPG, t [24] = 4.06, p = 0.001 vs. CHA), and a decrease in the high-frequency component of heart rate variability (t [24] = 2.81, p = 0.029 vs. DPG, t [24] = 3.48, p = 0.006 vs. CHA) compared to the other conditions, representing a smaller enhancement of cardiac sympathetic nervous system activity and smaller suppression of cardiac parasympathetic nervous system activity respectively. Conclusion Apple aroma showed efficacy in alleviating the physiological stress response in terms of cardiac activity. Apple was also considered significantly preferable and comfortable compared to the other conditions, which would be beneficial in the context of aromatherapy.

Role and mechanism of autonomic nervous system regulation in primary glaucoma

The regulation of blood flow in the human eye, aqueous humor production, and the outflow channels of aqueous humor are all controlled by the autonomic nervous system (ANS), encompassing both sympathetic and parasympathetic nerves. Patients with primary glaucoma often exhibit autonomic nervous system dysfunctions, which may exacerbate visual impairment. The homeostasis of the autonomic nervous system is influenced by circadian rhythms, physical exercise, emotional states, medications, and other factors. Previous studies have indicated that activities such as aerobic exercise, yoga breathing, and meditation can promote the restoration of autonomic nervous system balance, thereby reducing intraocular pressure. However, further evidence is required to substantiate the efficacy of ANS activity regulation as an effective adjunct therapy for primary glaucoma. This review examines the role and mechanisms of autonomic nervous system regulation in the context of primary glaucoma.

Dysfunction of the autonomic nervous system in gastro-esophageal reflux disease: Consequences for the cardiovascular system

ObjectiveThe pathophysiology of gastro esophageal reflux disease (GERD) implicates autonomic dysregulation of the lower esophageal sphincter tone. Our goal is to investigate whether this dysregulation of the autonomic nervous system (ANS) function observed in isolated GERD cases can affect other systems, such as cardiovascular regulation.Methods: Twenty-five participants were included in the study, 11 patients with isolated GERD and 14 controls. All patients and 7 controls responded to a COMposite Autonomic Symptoms Score 31 (COMPASS 31) questionnaire and underwent functional explorations including EMLA test, sympathetic skin response (SSR), 24-hour heart rate recording and ambulatory blood pressure measurement (ABPM). Seven additional controls underwent a 24-hour heart rate recording only. ResultsGERD patients (Age: mean 36.81±7.82; SR= 0.22) showed high clinically dysautonomic scores (COMPASS 31) (p = 0.015), increased Heart rate variability (HRV) parameters (daytime, nighttime, 24-hour SDNN (standard deviation of the RR interval (NN)), respectively p = 0.003, p < 0.001, p = 0.001; daytime and nighttime very low frequencies (VLF) respectively p = 0.03 and p = 0.007), impaired nocturnal dipping of blood pressure (3/11 patients) and high positivity of EMLA test (7/11, p = 0.037). These outcomes were strongly correlated with clinical dysautonomic assessment. No difference was observed between patients and controls regarding SSR. ConclusionOur data suggests a high parasympathetic tone amongst patients with GERD and a dysregulation of parasympathetic and sympathetic balance in the cardiovascular system with an impairment of the peripheral sympathetic fibers of cutaneous microcirculation, assessed by the EMLA test. GERD may be an inaugural symptom of autonomic neuropathy. Further functional exploration of peripheral small fibers seems to be necessary.

An evolutionary perspective for integrating mechanisms of acupuncture therapy

This study applies an evolutionary medicine perspective to comprehend the therapeutic effects of acupuncture. It draws upon modern evolutionary theory to integrate the currently fragmented theories regarding the efficacy of acupuncture in alleviating pain and promoting healing. We explore the interaction between the nervous and immune systems in the context of survival and homeostasis, and elucidate both the local and systemic effects of acupuncture therapy on pain relief and tissue healing. The mechanisms involved are categorized into two main types: local effects, which include immune cell migration, local vasodilation, and the release of adenosine; and distal systemic effects, which involve the regulation of the descending pain control system and the autonomic nervous system, with a particular focus on the parasympathetic nervous system. In conclusion, this integrated perspective not only deepens our understanding of acupuncture within a scientific narrative but also underscores the need for further research to validate and expand our knowledge, thereby enhancing its scientific credibility and clinical applicability.

The non-haemorrhagic vagal response to trauma: a review of hypotensive and bradycardic responses to injury in the absence of bleeding.

Trauma has the potential to cause haemorrhage, tissue damage, pain, visceral manipulation and psychological distress. Each of these consequences of trauma can cause changes in autonomic outflow, which dictates a patient's vital signs. Patients who are hypotensive and bradycardic due to a vagally mediated parasympathetic response to pain, psychological distress and visceral manipulation may be confused with those who exhibit bradycardia and hypotension following significant blood volume loss. This review summarises literature that describes specific stimuli, patterns of injury and patient characteristics that are associated with a non-haemorrhagic vagal response to trauma. Twenty-six records described predominantly parasympathetic responses to trauma (both blunt and penetrating) and surgery ("iatrogenic trauma"). Such a non-haemorrhagic vagal response occurs following a wide variety of injury patterns. Patient age and sex are poor predictors of the likelihood of a non-haemorrhagic vagal response. The development and resolution of a non-haemorrhagic vagal response occurs over a heterogenous time period. It is unclear whether speed of onset and resolution is linked to the pattern of injury or other factors causing a predominantly parasympathetic response following non-haemorrhagic trauma. The pattern of injury, patient demographic and speed of onset / resolution associated with the non-haemorrhagic vagal response to trauma may is heterogenous. It is therefore challenging to clinically distinguish between the hypotensive bradycardia due to hypovolaemia secondary to haemorrhage, or a parasympathetic response to trauma in the absence of bleeding.

Regulation and Crosstalk of Cells and Factors in the Pancreatic Cancer Microenvironment.

Pancreatic cancer is a highly malignant form of cancer that distinguishes itself from other gastrointestinal tumors through significant fibrosis and unique perineural invasion. These characteristics underscore the complexity of neural regulation within the pancreatic cancer Tumor Microenvironment (TME). This review aimed to explore the regulatory mechanisms and crosstalk among stromal cells and their factors within the pancreatic cancer microenvironment. We begin by reviewing the major components of the pancreatic cancer microenvironment, analyzing interactions among crucial cell types, such as Cancer-associated Fibroblasts (CAFs) and immune cells, and revealing the dynamic changes between tumor cells and surrounding nerves, immune, and stromal cells. We discuss the role of neural factors, including the Nerve Growth Factor (NGF) and Brain-derived Neurotrophic Factor (BDNF), in the progression of pancreatic cancer and the mechanisms by which the sympathetic and parasympathetic nervous systems regulate tumor cell growth, migration, and invasion. Interactions among stromal cells, cytokines, and neural factors in the pancreatic cancer microenvironment promote fibrosis and perineural invasion. A deeper understanding of the regulation and crosstalk among components in the pancreatic cancer microenvironment offers new perspectives for inhibiting fibrosis and perineural invasion in pancreatic cancer.

The brain–heart-immune axis: a vago-centric framework for predicting and enhancing resilient recovery in older surgery patients

Nearly all geriatric surgical complications are studied in the context of a single organ system, e.g., cardiac complications and the heart; delirium and the brain; infections and the immune system. Yet, we know that advanced age, physiological stress, and infection all increase sympathetic and decrease parasympathetic nervous system function. Parasympathetic function is mediated through the vagus nerve, which connects the heart, brain, and immune system to form, what we have termed, the brain–heart-immune axis. We hypothesize that this brain–heart-immune axis plays a critical role in surgical recovery among older adults. In particular, we hypothesize that the brain–heart-immune axis plays a critical role in the most common surgical complication among older adults: postoperative delirium. Further, we present heart rate variability as a measure that may eventually become a multi-system vital sign evaluating brain–heart-immune axis function. Finally, we suggest the brain–heart-immune axis as a potential interventional target for bio-electronic neuro-immune modulation to enhance resilient surgical recovery among older adults.

Closed-loop baroreflex model with biophysically detailed afferent pathway.

In this work, we couple a lumped-parameter closed-loop model of the cardiovascular system with a physiologically-detailed mathematical description of the baroreflex afferent pathway. The model features a classical Hodgkin-Huxley current-type model for the baroreflex afferent limb (primary neuron) and for the second-order neuron in the central nervous system. The pulsatile arterial wall distension triggers a frequency-modulated sequence of action potentials at the afferent neuron. This signal is then integrated at the brainstem neuron model. The efferent limb, representing the sympathetic and parasympathetic nervous system, is described as a transfer function acting on heart and blood vessel model parameters in order to control arterial pressure. Three in silico experiments are shown here: a step increase in the aortic pressure to evaluate the functionality of the reflex arch, a hemorrhagic episode and an infusion simulation. Through this model, it is possible to study the biophysical dynamics of the ionic currents proposed for the afferent limb components of the baroreflex during the cardiac cycle, and the way in which currents dynamics affect the cardiovascular function. Moreover, this system can be further developed to study in detail each baroreflex loop component, helping to unveil the mechanisms involved in the cardiovascular afferent information processing.

Surveillance fœtale : limites actuelles et nouvelles pistes basées sur l’analyse du système nerveux autonome fœtal

ObjectiveCurrently, fetal monitoring during labor is based on visual analysis of the fetal heart rate (FHR). This test is imperfect, with high intra- and inter-observer variability and a moderate to poor prediction of the occurrence of neonatal acidosis or anoxic-ischaemic encephalopathy. In situations where there is an intermediate risk of acidosis, it is possible to use second-line tests such as blood scalp sampling (with pH or lactate measurement) or ST segment analysis of the fetal ECG. However, these invasive tests have many limitations and their place is debated. Some authors suggest a more physiological approach to FHR assessment. The main actor in maintaining fetal homeostasis is the autonomic nervous system (ANS). Its activity can be assessed by analysing heart rate variability (HRV). The aim is to assess whether HRV can be used to identify situations at risk of acidosis. Materials and methodsOur team has developed an index, the Fetal Stress Index, to measure HRV. To test it in a situation of acidosis, we used a pregnant ewe model. We also developed in parallel a human fetal ECG recording system. ResultsIn our experimental model, we have shown that this index reflects variations in the parasympathetic system and correlates with the onset of acidosis. As its use in clinical practice requires the acquisition of a beat-to-beat FHR signal, we have also developed an abdominal patch that allows highly accurate analysis of the fetal ECG. ConclusionThe future is therefore to validate the FSI as a marker of acidosis in a prospective cohort using the signal obtained from our patch. This could be a new tool for fetal monitoring during labor.

A Study of Cardiac Autonomic Neuropathy in Patient with Diabetes Mellitus.

Atherosclerotic coronary artery disease, diabetic cardiomyopathy, and cardiac autonomic neuropathy (CAN) are the three categories into which the cardiovascular consequences of diabetes can be grouped. After all other potential causes have been ruled out, cardiovascular autonomic neuropathy-often referred to as CAN in the literature-is defined as the impairment of autonomic regulation of the cardiovascular system. Finding people with CAN is crucial because, if detected early enough, comprehensive therapies focusing on lifestyle, glucose management, and cardiovascular risk factors can reverse the course of CAN and delay its progression. In order to better understand CAN in individuals with diabetes mellitus (DM) and how it relates to risk factors, the current study was conducted. Sixty consecutive diabetic patients were selected to be included in our study, diagnosed as per the American Diabetes Association (ADA) and the European Association for the Study of Diabetes. The presence of CAN was assessed with the help of Ewing's Battery, composed of five bedside tests. Out of 60 patients, a total of 53 patients (88.3%) with DM had CAN. Of these, 38.3% showed early CAN, 38.3% showed definite CAN, and 7% showed severe CAN. The abnormal E:I (exhalation/inhalation) ratio, noticed in 75% of patients, was the most frequently observed abnormal autonomic function test that tests the parasympathetic nervous system. The ECG's QTc interval prolongation provides good specificity for diagnosing CAN as well as assessing its severity, but the majority of cases showed low sensitivity. Since CAN has a significant association with mortality, every patient diagnosed with DM should be evaluated for CAN at the time of diagnosis as well as on an annual basis thereafter, as recommended by the ADA. Optimal glycemic management and lifestyle modification at the initial stages of diabetes may prevent CAN-related complications.

Stress Response Profiles and Physical Aggression in Early Childhood

This study examined the applicability of the four stress response patterns proposed by the Adaptive Calibration Model (ACM; Del Giudice et al., 2011) in 12-month-old children (N = 214; 116 boys) and their associations with physical aggression at 12, 20, and 30 months of age. Salivary alpha-amylase (sAA) and pre-ejection period (PEP) served as indices of the sympathetic nervous system, respiratory sinus arrhythmia as an index of the parasympathetic nervous system, salivary cortisol as an index of the hypothalamic-pituitary-adrenal axis, and heart rate as a measure of overall autonomic nervous system activity. A fear challenge was administered at 12 months to measure baseline, response, and recovery levels of the stress systems, while maternal reports were used to evaluate physical aggression at the various time points. Through latent profile analysis, three stress response profiles were identified: (1) ANS Responders, (2) Moderate Responders (across all stress systems), and (3) Hormonal Responders. Despite some deviations, each profile could be associated with a corresponding ACM stress response pattern, primarily due to the inclusion of both sAA and PEP as measures of sympathetic activity. At 12 months, ANS Responders showed higher levels of physical aggression, whereas Hormonal Responders exhibited higher levels of physical aggression at 20 months. The findings confirm that differences in stress response patterns can be observed as early as 12 months of age. Moreover, this study emphasizes the importance of using multiple indices of stress responsivity to identify such distinct patterns. Finally, stress response profiles that differ from the most common (moderate) profile, are associated (albeit not consistently) with higher levels of physical aggression at different ages during early childhood.

The relationship between emotions and HRV under the stimulation of bra images

It is a stressful ordeal in general to buy bras online aimlessly. The wise approach for eCommerce platform is to use emotion recognition to effectively assess consumers’ needs through the bra images, which can quickly close their preferences and accurately recommend them suitable bras. However, the significant physiological features that can be used for emotion recognition in fashion are still in the exploratory stage. This study focuses on the relationship between cardiac activity and emotional responses (the different levels of Satisfaction (S) and Attractiveness (A) under the stimulation of bra images. Firstly, we labelled 96 bra images in the dimensions and selected 45 bra images to make three groups of emotional stimuli using k-means clustering analysis. Then, we collected Photoplethysmogram (PPG) signals from 46 subjects consisting of 11 males and 35 females simulated by three groups of the stimuli, extracted 10 metrics of heart rate variability (HRV), and then analyzed the relationships between HRV and emotions based on their subjective evaluation. The males and females have different cardiac activity patterns under the same emotion, that the parasympathetic of males are more active than females. In a non-neutral emotion, the parasympathetic nervous system would keep an activated state. However, it is dominated by the parasympathetic nervous system whether in high or low satisfaction. While high and low attractiveness are respectively dominated by the sympathetic and parasympathetic nerves. The results of this study have certain significance for understanding the physiological phenomenon of emotions and further help to explore emotion recognition technology which can be used in product development to enhance the competitiveness of enterprises.

Pupillometry and autonomic nervous system responses to cognitive load and false feedback: an unsupervised machine learning approach.

Pupil dilation is controlled both by sympathetic and parasympathetic nervous system branches. We hypothesized that the dynamic of pupil size changes under cognitive load with additional false feedback can predict individual behavior along with heart rate variability (HRV) patterns and eye movements reflecting specific adaptability to cognitive stress. To test this, we employed an unsupervised machine learning approach to recognize groups of individuals distinguished by pupil dilation dynamics and then compared their autonomic nervous system (ANS) responses along with time, performance, and self-esteem indicators in cognitive tasks. Cohort of 70 participants were exposed to tasks with increasing cognitive load and deception, with measurements of pupillary dynamics, HRV, eye movements, and cognitive performance and behavioral data. Utilizing machine learning k-means clustering algorithm, pupillometry data were segmented to distinct responses to increasing cognitive load and deceit. Further analysis compared clusters, focusing on how physiological (HRV, eye movements) and cognitive metrics (time, mistakes, self-esteem) varied across two clusters of different pupillary response patterns, investigating the relationship between pupil dynamics and autonomic reactions. Cluster analysis of pupillometry data identified two distinct groups with statistically significant varying physiological and behavioral responses. Cluster 0 showed elevated HRV, alongside larger initial pupil sizes. Cluster 1 participants presented lower HRV but demonstrated increased and pronounced oculomotor activity. Behavioral differences included reporting more errors and lower self-esteem in Cluster 0, and faster response times with more precise reactions to deception demonstrated by Cluster 1. Lifestyle variations such as smoking habits and differences in Epworth Sleepiness Scale scores were significant between the clusters. The differentiation in pupillary dynamics and related metrics between the clusters underlines the complex interplay between autonomic regulation, cognitive load, and behavioral responses to cognitive load and deceptive feedback. These findings underscore the potential of pupillometry combined with machine learning in identifying individual differences in stress resilience and cognitive performance. Our research on pupillary dynamics and ANS patterns can lead to the development of remote diagnostic tools for real-time cognitive stress monitoring and performance optimization, applicable in clinical, educational, and occupational settings.

Restoring rest: exploring yoga’s influence on sleep quality in cancer patients

Sleep disturbances are prevalent among cancer patients, significantly impacting their quality of life and prognosis. Yoga, an ancient mind-body practice, is increasingly recognized for its potential to improve sleep quality in this population. This narrative review explores yoga's impact on sleep quality in cancer patients, examining mechanisms, scientific evidence, and implications for future research and clinical practice. Yoga enhances sleep through psychological and physiological mechanisms. Practices like asanas, pranayama, and meditation activate the parasympathetic nervous system, promoting relaxation and reducing stress. Additionally, yoga promotes mindfulness, helping individuals manage psychological distress and improve sleep quality by reducing rumination and anxiety. Numerous studies, including randomized controlled trials, demonstrate significant improvements in sleep parameters among cancer patients practicing yoga. Meta-analyses and systematic reviews further support these findings, highlighting yoga's broad applicability and effectiveness. However, existing research has methodological limitations, such as variability in intervention protocols and reliance on self-reported sleep measures. Future research should focus on larger, more diverse populations and employ objective sleep assessments to validate findings. Investigating long-term effects and identifying effective practices for different patient subgroups are essential. In conclusion, yoga holds significant potential as a therapeutic intervention for improving sleep quality in cancer patients. Integrating yoga into standard cancer care can effectively address sleep disturbances and enhance well-being. Ongoing research and innovative approaches are needed to fully harness yoga's therapeutic potential, ensuring evidence-based practices that improve patient outcomes.

Differences in livor mortis in Wistar rats due to organophosphate induction and normal mortality: A randomized experimental study

Background: Pesticide intoxication, a significant global health issue, particularly in developing nations, is often caused by the most toxic pesticides, organophosphates. These substances activate the sympathetic and parasympathetic nervous systems, producing a characteristic livor mortis. It is a secondary sign of death that can be used to estimate the time and cause of death. Objective: This study aims to determine the difference in livor mortis due to organophosphate poisoning and ordinary death (decerebration) using Wistar rats.Methods: From March to April 2023, we conducted an experimental study with a posttest-only control group at the Laboratory of Animal Experiments, Faculty of Medicine, Sebelas Maret University. We used 32 male Wistar rats weighing 150-200 g, divided into control and test groups. The test group received organophosphate diazinon 1.16 ml through a nasogastric tube, while the control group was decerebrated. The data was processed with univariate analysis and an independent t-test.Results: There was a significant difference in the appearance and the persistence time of livor mortis between the control and test groups (p &lt; 0.05). The color of livor mortis in the control group was purplish blue, while in the test group, it was reddish to blackish blue. Most of our samples displayed a distribution of livor mortis in the abdominal and dorsal regions, with a some displaying an abdominal distribution only.Conclusion: Our study reveals significant differences in the appearance and persistence time, as well as the color and distribution of livor mortis between decerebrated and organophosphate-induced dead rats.

Cardiac Autonomic Neuropathy in Diabetic Peripheral Neuropathy.

Background Cardiac autonomic neuropathy (CAN) is the most underdiagnosed consequence of diabetes because standard hospital settings do not provide consistent diagnostic criteria or testing resources. It is still unclear how diabetic peripheral neuropathy (DPN) and CAN are related. Therefore, this study aimed to determine the prevalence of CAN in individuals with type 2 diabetes mellitus who had isolated DPN without other microvascular or macrovascular complications. Methodology A total of 35 type 2 diabetes mellitus patients with isolated DPN (group 1) and an equal number of sex- and age-matched patients without DPN (group 2) underwent CAN testing. Results were compared between the two groups. Results A significantly higher prevalence of isolated parasympathetic (28.57 vs. 11.42%), isolated sympathetic (22.85 vs. 8.57%), and combined autonomic dysfunction (37.14 vs. 2.85%) was found in the neuropathic group compared to the non-neuropathic group. Group 1 exhibited more abnormal parasympathetic nervous system test results and increased diastolic pressure during sustained handgrip compared to group 2 (all p-values <0.05). Conclusions A significantly higher prevalence of cardiac autonomic dysfunction is seen in patients with DPN without other microvascular or macrovascular complications, irrespective of age, sex, or duration of diabetes mellitus. Patients with a higher body mass index were found to have significantly increased cardiac autonomic dysfunction.