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Neurotoxic side effects of chemotherapy are second in frequency to hematological toxicity. Unlike hematological side effects that can be treated with hematopoietic growth factors, neuropathies cannot be treated and protective treatment strategies have not been effective. The mechanism underlying chemotherapy-induced peripheral neuropathy (CIPN) is unknown. Metabolic changes resulting from the accumulation of the drug in the dorsal root ganglia cells, mitochondrial-mediated disregulation of Ca++ homeostasis and dis-regulation of neurotrophins may contribute to the pathogenesis of CIPN.For the neurologist, the diagnosis of a chemotherapy-induced peripheral neuropathy though is primarily based on case history and clinical presentation, the electrophysiological study; nerve conduction study (NCS) and electromyography (EMG) represent a valuable, useful and helpful test in the neurological evaluation of the types and grading of the severity of the neuropathy. Our objective is to evaluate role of neurophysiological test in the diagnosis of peripheral neuropathy in patient receiving chemotherapy. NCS was performed on 40 patients receiving chemotherapy with clinical diagnosis of peripheral neuropathy and 40 healthy controls. The result revealed a statistically significant prolongation in latency, reducing amplitude and slowing of conduction velocity in addition to EMG finding of spontaneous activity and large MUAPs for patient group (P <0.05). NCS plays an important role in the evaluation of chemotherapy induced peripheral neuropathy by determining the pathology and the distribution of the nerve fiber damage. [ABSTRACT FROM AUTHOR]

Background Heart rate variability (HRV) and heart rate turbulence (HRT) illustrate regulation of the heart by autonomic nervous system (ANS). The autonomic nervous system plays an important role not only in physiological situations, but also in various pathological settings such as diabetic neuropathy Diabetic autonomic neuropathy is a serious and common complication of diabetes. Objective To determine the association between HRT, HRV and diabetes control monitored by concentrations of HbA1c. Methods In 52 patients with diabetes mellitus type II of either sex attending Cardiac Care Unit (CCU) in Al-Kadhimya Hospital, 24-hour Holter ECG monitoring was performed to evaluate time domain HRV parameters (SDNN, SDNNI, SDANN, rMSSD, pNN50) and HRT parameters (TO and TS). HBA1c was measured in all patients. Regression analysis was performed to evaluate the association between tested parameters. Results Significant correlation has been observed between TO and SDNN, SDNNI and SDANN. TS correlated significantly with SDNN, SDNNI, SDANN, rMSSD, pNN50. We noted no correlation between HbA1c and HRV or HRT parameters. Conclusion We concluded that HRV time domain parameters correlate with HRT in patients with diabetes mellitus. Diabetes control estimated on basis of HbA1c value did not show correlation with HRV and HRT. [ABSTRACT FROM AUTHOR]