MO747AN ASSESSMENT OF COMPLEXITY OF CARDIOVASCULAR SIGNALS USING ENTROPY IN HEMODIALYSIS SESSION AND GLUCOSE INJECTION DURING HEMODIALYSIS IN END STAGE RENAL DISEASE PATIENTS WITH AND WITHOUT DIABETES MELLITUS TYPE 2

Background and Aims Few studies have focused on the imbalance of the autonomic nervous system during hemodialysis (HD), although it seems to be an important factor for the maintenance of blood pressure. The aim of this work was to assess the impact of hemodialysis (HD) and glucose injection upon entropy of heart rate and blood pressure during HD session in end stage renal disease (ESRD) patients with and without diabetes mellitus (DM) type 2. Method 21 patients without DM (NDO), in age 54,95 +/-13,08 y.o., and 10 DM patients, in age 69,70 +/- 8,27 y.o., were studied during HD. 30 minutes after dialysis begins, 40% glucose solution was administered in the amount of 0.5g/kg body dry-weight (constant rate of 1 mL/s). The cardiovascular signals were extracted from the recordings using Portapres® system. The analysis was performed using Amplitude Aware Permutation Entropy (AAPE). The parameters of AAPE were set as d=7, A=0.5. All statistical analysis were performed on significance level α=0.05. The comparisons between groups were conducted with Mann-Whitney test with Holm corrections. The comparisons in time points were performed using Friedman test with post-hoc (Wilcoxon test with Holm corrections). The calculations of AAPE and all statistical analysis were performed with Matlab R2020a and R. Results The results are presented in table. It was found that AAPE(HR) tends to decrease during dialysis (NS) and increases only in the DM group after glucose injection (p=0.019); without difference between groups. There were no differences in AAPE of blood pressure between the groups, but hemodialysis reduces AAPE(fiSYS) in both groups (p<0.001 in both DM and NDO groups) and AAPE(fiDIA) in NDO (p<0.01). AAPE(TPR) is high before dialysis, and decreases during HD in both groups (p<0.0001). There is no effect of glucose injection on AAPE(HR) in both groups, but AAPE(fiSYS) and AAPE(fiDIA) increase in NDO (p<0.001, p<0.01, p<0.05 respectively); without difference between groups. AAPE(TPR) tends to increase after glucose injection (p<0.05 for NDO, NS for DM). Conclusion AAPE(HR)tends to decrease during HD, and glucose injections increase AAPE(HR) in DM patients. Hemodialysis reduce, and glucose injections increase AAPE of blood pressure especially in NDO. A weaker response to hemodialysis and glucose injection in diabetic patients may be caused by impairment of the autonomic system, and may have clinical impact – may leads to faint. Glucose administration does not prevent autonomic system disorders in patients with DM.

PROSPECTIVE STUDY SHOWING EFFECTS OF GENERAL ANAESTHESIA ON TEMPERATURE CHANGES IN INDIAN ADULTS

During intraoperative period patients are often unconscious or their autonomic system is partially blocked, and the operation suite is generally air-cooled. There are various other settings in operation theatre causing hypothermia under anaesthesia which can change patientÂ’s thermohomeostasis. This study will discuss the factors affecting the temperature changes during general anaesthesia in Indian Adults.

OPTIMIZATION OF LOCAL ANESTHESIA OF DENTAL PATIENTS DURING CYSTECTOMIES OF RADICULAR CYSTS THAT HAVE GROWN INTO THE MAXILLARY SINUS OR NASAL CAVITY

The aim: To provide clinical evaluation of the effectiveness of anesthesia for cystectomy of radicular cysts that have grown into the maxillary si-nus or nasal cavity using different techniques of endonasal block-ade of the nasopalatine nerve. Materials and methods: Clinical observations were conducted on 52 patients of different age and sex. These patients were diagnosed with large radicular cysts (more than 3.0 cm in diameter) that had grown into the maxillary sinus (33 cases) or into the nasal cavity (19 cases). The surgical excisions of cysts (oroantral cystectomies) were performed un-der local potentiated anesthesia. Patients were divided into two clinical groups, depending on the methods used for endonasal blockade of the nasopalatine nerve: the main and the control group. Patients in the main group underwent endonasal blockade of the nasopalatine nerve at the point of its emergence from the pterygopalatine ganglion. In the control group, the neural blockade was performed at the entry of this nerve into the incisive canal. Pain sensitivity and perception in patients were studied using subjective and objective methods. The data was analyzed by means of the Pearson’s chi – square tests. Results: During the enucleation of radicular cysts that grew into the inferior nasal meatus and maxillary sinus in patients of the main group there was no pain observed. There were no manifestations of pain-induced stress neither from the side of autonomic system, nor physical or emotional manifestations of pain, which confirmed the effectiveness of nasopalatine nerve anesthesia. In patients of the control group during similar operation the full effect of local anesthesia was achieved in 56.0% of cases (χ2 – 9,270, р = 0,003). The rest of the patients during cystectomies showed some signs of pain-induced stress from the side of autonomic system or in the form of physical or emotional manifestations. Conclusions: Endonasal blockade of the nasopalatine nerve at the point of its emergence from the pterygopalatine ganglion invariably provided a complete analgesia during enucleation of radicular cysts that have grown into the maxillary sinus or nasal cavity. Anesthesia of the nasopalatine nerve at its entry into the incisive canal allows pain-less cystectomy of radicular cysts that have spread to the front of the inferior nasal meatus from the front teeth.

Evaluation of the effects of aerobic exercise in the aqueous environment on heart rate variability by using Poincare plot nonlinear method

Background and Aim: Heart rate variability used as a non-invasive method to investigate the effect of aerobics exercise on the cardiac autonomic system. The aim of this study was the nonlinear analysis of the effect of aerobic exercise in the water on the cardiac autonomic system in academic young's males. Materials and Methods: A total of 28 young men were randomly assigned to two groups of control and aerobic exercise in water. In the pre-test period and after the training intervention, all parameters of heart rate variability were measured by examining heart rate sequences, In the pre-test period and after the training intervention, all parameters of heart rate variability were measured by examining heart rate sequences, and then the standard deviation of the recorded sequences was interpreted by using the Poincare plot method. Independent t-test and paired t-test were used to compare the differences in the research stages. Results: Regular participation in aerobic exercise in water caused a significant (45.1±9.2 vs. 34.1±12.3) and standard deviation of time intervals of heart rate sequences compared to their adjacent sequence compared to the control group (P=0.03). The longitudinal standard deviation of time intervals of heart rate sequences compared to the pre-test (P=0.04) had a significant increase (79.5±12.5 vs. 56.9±15.8 After transferring the absolute results to normal, the normal state of the standard deviation of time intervals of heart rate sequences compared to its adjacent sequence compared to the control group (P=0.03) had a significant increase (44.7±12.05 vs. 36.5±13.52). Also, the normal state of the longitudinal standard deviation of time intervals of heart rate sequences compared to the pre-test (P=0.02) increased significantly (76.4±15.29 vs. 61.3±9.32). Conclusion: Performing aerobic exercise in an aqueous environment can be used as a useful training method to improve the responsiveness of the cardiac autonomic system.