Cardiac autonomic dysfunction in drug naïve hot water epilepsy

AbstractPurposeThis study aimed to characterize the role of autonomic nervous system dysfunction in hot water epilepsy (HWE). Heart rate variability (HRV) has been established as a good index of cardio-autonomic regulation.MethodologyForty-five patients with HWE (age: 24.6±10.1 years; M:F=37:8) and 45 age and gender matched controls (age: 24.17±10.37 years; M:F=37:8) were studied. Five minutes resting lead II electrocardiogram (ECG) was obtained (AD instruments) under standard conditions and analyzed for time and frequency domain HRV parameters using LabChart software.ResultPatients with hot water epilepsy showed significant increase in LF nu (Low frequency normalized unit) and LF/HF denoting an interictal increase in sympathetic activity. In addition, reductions were noted in parasympathetic function [RMSSD (root mean square successive difference of RR intervals), HF (High frequency) nu and LF/HF].ConclusionThis study has demonstrated an impaired sympatho-vagal balance characterized by increased sympathetic activity and reduced parasympathetic activity in patients with HWE. The present study supports the notion that the hypothalamus is involved in both, the pathogenesis of HWE and autonomic regulation

Development and validation of Ayurveda based assessment scale for anxiety

Background: Anxiety scale based on Ayurveda would help Ayurveda physicians to measure and initiate appropriate treatment strategies. Objectives: The objective of the study was to develop a clinical assessment scale for anxiety based on Ayurveda science. Materials and methods: Ayurveda assessment scale for anxiety (AAA) was developed and subjected to various psychometric evaluations. Patients of generalized anxiety disorder with social phobia (GAD with SP) (n = 31) meeting DSM-IV-TR criteria and age, sex-matched healthy subjects (n = 31) were enrolled from NIMHANS Psychiatry OPD. Two independent Ayurveda experts evaluated both patients and healthy subjects using AAA, Hamilton Anxiety Rating Scale (HARS), and Beck Anxiety Inventory (BAI). Reliability and validity assessments were carried out. The sensitivity to treatment-induced change was evaluated in a randomized controlled clinical trial. 72 patients of GAD with SP meeting DSM-IV-TR criteria, aged between 20 and 55 years, and either sex participated in the study. The duration of intervention was 30 days. The assessments were done through HARS, BAI, Beck Depression Inventory (BDI), AAA and Clinical Global Impression scales (Severity, Improvement, and Efficacy). Results: The Interrater reliability was between - good to very good score. Validity of AAA with HARS and BAI was significant (p 0.60). Conclusions: The psychometric properties such as interrater reliability, validity (criteria, convergent, divergent, face) and sensitivity to change of AAA were promising