Study Of Autonomic Neuropathy Research Articles

Study of Autonomic Neuropathy with Special Reference to the Gall Bladder Volume in Type 2 Diabetes Mellitus

Study of Autonomic Neuropathy with Special Reference to the Gall Bladder Volume in Type 2 Diabetes Mellitus

Study of Autonomic Neuropathy in Cardiovascular System in Chronic Renal Failure Patients on Maintenance Hemodialysis

Autonomic nervous system abnormalities are major causes of morbidity and mortality in patients with chronic renal failure (CRF) on hemodialysis and are generally considered a part of polyneuropathy. Postural hypotension, impotency, gastrointestinal disturbance, gastrointestinal motility, and sweating abnormalities are common symptoms. The most frequent complication in patients with CRF on hemodialysis is intradialytic hypotension, and it has been suggested that intradialytic hypotension is mostly related to autonomic neuropathy. The pathogenesis of autonomic neuropathy is unclear, but a reduced response to norepinephrine by the end organ and the toxic effect of metabolic toxins are considered to be some of the causes. Five cardiovascular reflex tests are generally used to determine autonomic neuropathy: the heart rate reaction to the Valsalva Maneuver, the heart rate variability during deep breathing, the heart rate response to standing up, the blood pressure response to standing up, and the blood pressure response to hand grip exercise.

A Study of Autonomic Neuropathy in Chronic Diabetes Mellitus in a Teaching Hospital

A Study of Autonomic Neuropathy in Chronic Diabetes Mellitus in a Teaching Hospital

A study on autonomic neuropathy scorings in patients of chronic renal failure with and without symptoms

Abstract: Introduction: Chronic renal failure may be asymptomatic or symptomatic. Autonomic neuropathy is commonly associated with chronic renal failure. In recent years, there has been a growing interest in the cardiovascular autonomic neuropathy in chronic renal failure because of its association with an increase in mortality in these patients. So the study of autonomic neuropathy in patients of chronic renal failure with and without symptoms was taken up. Methods: The following clinical tests for autonomic neuropathy were done in 100 patients. Heart rate variability in response to deep breathing, heart rate variability in response to standing heart rate in response to valsalva maneuver, blood pressure response to standing and BP response to sustained hand grip exercise were recorded. Values obtained from the various tests were tabulated into a worksheet and a scoring system was applied to each test as recommended by Bellavere et al. The degree of autonomic neuropathy was assessed using CAN score. Mean CAN scores were compared in patients with and without symptoms using ANOVA test. P value<0.01 was considered to be statistically significant. Result: We found out that autonomic neuropathy autonomic neuropathy scorings is significantly higher in symptomatic chronic renal failure patients. Conclusion: So study of autonomic neuropathy can guide clinicians to prevent early complications in chronic renal failure patients.

Structural and functional investigations of the murine cavernosal nerve: a model system for serial spatio‐temporal study of autonomic neuropathy

To illustrate the ultrastructural fibre composition of the rat cavernosal nerve at serial levels, from its origin in the main pelvic ganglion to its termination in the corpus cavernosum of the distal penile shaft, and to develop a technique that permits repeated electrophysiological recording from the fibres that form the cavernosal nerve distinct from the axons of the dorsal nerve of the penis (DNP). For the light microscope and ultrastructural studies, Sprague-Dawley rats were anaesthetized and the pelvic organs and lower limbs were perfused with glutaraldehyde through the distal aorta. Tissue samples were embedded in epoxy resin and prepared for light and electron microscopy. Frozen tissue was used for the immunohistochemical studies and sections were stained with rabbit anti-nitric oxide synthetase 1 (NOS1). For the electrophysiology, anaesthetized rats were used in sterile conditions. Nerve conduction velocity for the cavernosal nerve was assessed from a point 2 mm below the main (major) pelvic ganglion after stimulating the nerve at the crus penis; multi-unit averaging techniques were used to enhance the recording of slow-conduction activity. Recordings from the DNP were obtained over the proximal shaft after stimulation at the base of the penis. Step-serial sections of the cavernosal nerve revealed numerous ganglion cells in the initial segments and gradually fewer myelinated fibres at distal levels. At the point of crural entry, the nerve contained almost exclusively unmyelinated axons. As it descended the penile shaft, the nerve separated into small fascicles containing only one to four axons at the level of the distal shaft. In the corpus cavernosum, vesicle-filled presynaptic axon preterminals were close to smooth muscle fibres, but did not seem to be in direct contact. Immunohistochemical evaluation of NOS1 activity showed intense staining of the fibres of the DNP and most of the neurones in the main pelvic ganglion. There was also scattered NOS1 activity in the nerve bundles of the corpus cavernosum. Electrophysiology identified activity in C fibres on the cavernosal nerve and in Aalpha-Adelta fibres in the DNP. These results show that it is possible to perform integrated cavernosal pressure monitoring and ultrastructural and electrophysiological studies in this model. These yielded accurate data about the erectile status of the penis, and the state of unmyelinated and myelinated fibres in the DNP and cavernosal nerves of the same animal. This study provides a useful template for future studies of experimental diabetic autonomic neuropathy.