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Article
Autonomic Dysfunction in Interictal Period

Author: *Dr.Bassam Mahmood Flamerz M.B.Ch.B , F.I.B.M.S**Dr.Akram M. Ibrahim Al-Mehdawi,
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2012 Volume: 8 Issue: 1 Pages: 18-23
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: migraine is a chronic neurovascular disorder characterized by intermittent attacks of sever headache with or without aura that can include various combinations of neurological, gastrointestinal tract (G.I.T), and autonomic changes, without evidence of primary structural abnormalities. The Autonomic nervous system involvement suggested by many symptoms and signs including nausea, diarrhea, constipation, coldness in the extremities, paroxysmal tachycardia and chest pain.Objectives: To evaluate autonomic functions in patients with migraine and to clarify the autonomic dysfunction weather its sympathetic, parasympathetic, or combined. Also to assess the severity of this dysfunction and its relation to age, gender and type of migraine.Methods: This study enrolled 60 patients with migraine, 42 females and 18 males with an age range between 14-45 y. with 30 healthy volunteer as control group, The using of a questionnaire paper, autonomic nervous system disability scale and set of autonomic cardiovascular reflexes test were also applied .Results: The migraineurs with disabling attack may be prone to autonomic nervous system hypofunction which may be either a risk factor for migraine headache, or be a consequence of frequent disabling attacks, moreover autonomic nervous system dysfunction and migraine may share a common neural substrate. The Parasympathetic part of autonomic nervous system is affected more than sympathetic according to Ewing classification of autonomic function tests which is significant statistically in comparison to control, and 16(26.7%) of patients showed definite dysautonomia(score >2) while 44(73.3%) of patients were normal. Palpitation and postural dizziness are the most frequent symptoms in patients with migraine . Autonomic dysfunction among migraineurs is not rare also prolong course of illness is strongly correlated with autonomic dysfunction which is affect parasympathetic part more than sympathetic, for this reason the clinician should look carefully for the autonomic symptoms when they assess patient with migraine because most of those symptoms were disablingConclusions: The assessment of autonomic function tests should be a routine work in patient with migraine. The heart rate response to deep breath and valsalva are simple informative and beside to evaluate the parasympathetic part of autonomic nervous systemKey words: migraine, autonomic dysfunction, sympathetic, parasympathetic.


Article
The Frequency of Autonomic Neuropathy in Type 2 Diabetic Patients

Authors: Asaad Abdullah Abbas --- Abbas K. Ressan --- Ali HAshim Hussein
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2016 Volume: 15 Issue: 2 Pages: 127-131
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

Abbas K. Ressan, Asaad Abdullah Abbas,Ali HAshim HusseinINTRODUCTION:Autonomic nervous system (ANS)The ANS supplies and influences every organ inthe body and closely integrate vital processes,such as Blood Pressure (BP), temperature andadaptation to environmental change (1).Accordingly, sensory, motor, visceral andneuroendocrine function can be modulated bythis system (2).Baghdad Teaching Hospital.The clinical signs and symptoms that occur indisturbances of autonomic response which isinfluenced by the organ involved. The normalbalance of sympathetic (ST) and parasympathetic(pst) innervations, the nature of underlying illnessand stage of progression of the disease (3).To investigate the prevalence of D.A.N. wasdefined by simple non- invasive tests in type 2diabetic Iraqi patients and it is relation to theduration of the disease.ABSTACT:BACKGROUND:Autonomic Nervous System Innervates vascular and visceral smooth muscle, exocrine andendocrine glands and parenchymal cells through out the various organ system. Diabetic autonomicneuropathy is classified as subclinical or clinical upon the presence or absence of symptoms Awidespectrum of symptoms affecting many different organ system can occur including CVS, GUS,pupillary, automotor and neuroendocrine systems.OBJECTIVE:To investigate the frequency of diabetic A.N.P as defined by simple non – invasive test in type 2diabetic Iraqi patients and it is relation to the duration of disease.PATIENTS AND METHODS:Fifty type 2 diabetic patients , were evaluated with a five bed side tests to detect autonomicneuropathy and a history of related symptoms was taken there were 30 ( 60%) males and 20 (40%) females in the age range 30– 70 years .The five tests were carried out were, heart rate variation during deep breathing, HR response tovalsalva, HR response to standing, BP response to sustained hand grip, BP fall in response tostanding.Resting ECG (to measure QTc interval) fasting plasma glucose and 2hr., post prandial plasmaglucose were done to each patient.RESULTS:Of these 50 patients 34(68%) had evidence of neuropathic abnormality of parasympatheticinvolvement 19(38%)patients 13(26%), patients had evidence of combined parasympathatic andsympathatic involvement and only 2(4%), patients had only sympathetic involvement. Increaseincidence was seen in older age group and poor glycemic control. Autonomic neuropathy morecommon in patients who had the disease for more than 5 yrs. There was no correlation withprolonged QTC intervals.CONCLUSION:Diabetic ANP is a common complication and related to poor diabetic control and the duration ofdiabetes. While it is not associated with prolonged QTC interval .


Article
Assessment of parasympathetic autonomic functions in ulcerative colitis patients
تقييم وظائف الجهاز العصبي اللاودي المستقل عند مرضى التهاب القولون التقرحي

Author: Ahmed H. AL-Hillawi احمد هشام
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: PISSN: 00419419 / EISSN: 24108057 Year: 2013 Volume: 55 Issue: 3 Pages: 265-269
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Ulcerative colitis has been reported to be associated with autonomic dysfunction, mainly of vagal involvement. Objectives: To Determine whether there is a parasympathetic dysfunction in ulcerative colitis patients in remission state or not.Materials and methods: Three standardized tests of parasympathetic function, based on heart rate variation in response to certain stimuli (heart rate response to Valsalva maneuver, to deep breathing and to standing from supine position) were used on 54 ulcerative colitis patients in remission, and 41 healthy volunteers as a control group. Results: For all of the three tests, patients group gave significantly lower results (P˂ 0.05) which was the least level of significance. Conclusion: Ulcerative colitis is associated with vagal dysfunction which could be a hidden cause for the underlying inflammatory status because of the recently established anti-inflammatory role of vagus nerve. Key Words: Parasympathetic function tests, Ulcerative colitis, Vagus nerve.

المقدمة: التهاب القولون التقرحي من الامراض الالتهابية المزمنة التي تصيب الغشاء المخاطي للقولون ويعتقد ان له تأثيرا سلبيا على وظائف الجهاز العصبي المستقل. يعمل هذا البحث على دراسة وظائف الجهاز العصبي اللاودي لدى مرضى مصابين بالتهاب القولون التقرحي لتبيان ما اذا كان هنالك قصور في وظائف الجهاز اللاودي. طريقة العمل: تمت دراسة وظائف الجهاز العصبي اللاودي المستقل عند اربعة وخمسين مريضا مصابا بالتهاب القولون التقرحي وواحد واربعين شخصا طبيعيا كمجموعة ضابطة. لقد درست استجابات سرعة ضربات القلب الخاضعة لتأثير الجهاز اللاودي المستقل لبعض المحفزات ومقارنة نتائج مجموعة المرضى مع نتائج المجموعة الضابطة. النتائج: عند مقارنة النتائج لمجموعة المرضى مع المجموعة الضابطة تبين ان هناك فروقا ذات معنى بين المجموعتين حيث ان مجموعة المرضى كان لها معدلات اوطأ من المجموعة الضابطة في جميع الاختبارات المستعملة. الاستنتاجات: هنالك قصور في وظيفة الجهاز اللاودي لدى مرضى التهاب القولون التقرحي, و يعتقد ان هذا القصورقد يكون له اثر في استمرار حالة الالتهاب المزمن لدى هؤلاء المرضى من خلال التأثير المضاد للالتهاب الذي يمتلكه الجهاز اللاودي عبر العصب التائه. مفتاح الكلمات: اختبار وظائف الجهاز العصبي اللاودي, التهاب القولون التقرحي, العصب التائه.

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