AUTONOMIC FUNCTION TESTING Laboratory:

The Autonomic Function Testing Laboratory offers comprehensive, state-of-the-art tests for the autonomic nervous system (ANS). This part of the nervous system controls and regulates the automatic functions within our body including regulation of blood pressure, heart rate, airway size and airflow to the lungs, digestive tract functions, sweat production, bladder control and sexual function. In the course of certain neurological disorders including neuropathies, particularly diabetic neuropathy, the ANS can be damaged and become dysfunctional. A comprehensive report of the findings of the tests will be sent to the requesting physician. Autonomic function laboratory is now established and equipped with the state-of-the-art equipment. This laboratory is designed to quantitatively evaluate the function of the autonomic nervous system.

Equipments

1. BiopacMP150 16 channel Data acquisition system
2. Finometer midi (AD Instruments) : continuous blood pressure measuring system
3. Powerlab Data acquisition system (AD instruments)
4. Nihon kohden multichannel polygraph
5. Computerised Tilt table
6. CNAP Monitor 500 (CN Systems): continuous and noninvasive hemodynamic monitor
7. Bioharness: portable physiological monitor
8. ECG machine

Main Indications for Laboratory Evaluation of ANS

• Diagnosis of generalized autonomic failure such as diabetic autonomic neuropathy
• Detecting the presence of limited autonomic failure such as chronic idiopathic anhidrosis and POTS (Postural Orthostatic Tachycardia Syndrome)
• Diagnosis of small fiber neuropathy
• Detection and evaluation of orthostatic intolerance
• Detection of a neuropathic basis in neurocardiogenic syncope
• Evaluation of course of the autonomic disorders and their response to therapy
• Detection and evaluation of autonomic dysfunction in peripheral neuropathies
• Detection of sympathetic dysfunction in certain sympathetically maintained pain

ResearchActivites:

Assessment of the role of Sympathovagal imbalance in the genesis of CV morbidity in the following pathological conditions

• Hypertension
• Prehypertension
• Diabetes Mellitus
• Hypothyroidism
• Pregnancy induced hypertension
• Gynecological disorders viz. PCOS, Fibroid uterus

Research completed:

• Assessment of autonomic functions in patients with polycystic ovary syndrome: correlation with body mass index, insulin resistance, lipid profile and thyroid profile. Dr. Saranya K (PG), guided by Dr. G K Pal
• Oxidative stress and inflammatory markers in pregnant women with risk factors for pregnancy-induced hypertension: correlation with sympathovagal imbalance.             Dr. VidyaKarpagam (PG), guided by Dr. G K Pal
• Effect of yoga therapy on cardiac autonomic functions and oxidative stress in prehypertensive subjects: A randomized controlled study. Mr. Ramkumar T           (Ph.D.), guided by Dr. Pravati Pal
• Effect of yoga therapy on autonomic function tests and Biochemical profile of heart failure patients. Mr. BandiHari Krishna (Ph. D), guided by Dr. Pravati Pal.
• Effect of gender on autonomic dysfunctions in hypothyroidism: Correlation with BP, BMI, immunological and inflammatory markers. Mr. Naga Syam Sunder Kiran A (Ph. D), guided by Dr. Pravati Pal
• Effect of 12-week yoga therapy as a lifestyle intervention in patients of type II
• diabetes mellitus with distal symmetric polyneuropathy – a randomized control study.
• Effect of 12-week yoga therapy on cardiac autonomic functions in patients of essential hypertension – a randomized control study
• Heart rate variability and classical cardiovascular autonomic function tests    children: correlation with anthropometric parameters” Dr. Gopinath (PG) guided by Dr. G K Pal
• Effect of yoga training on autonomic functions and reaction time in different phases of the menstrual cycle. Dr. Grrishma guided by Dr.G.S.Gaur

Research ongoing:

• Association of cardiovascularautonomic function and aerobic capacity with insulin resistance and inflammatory markers in non diabetic first degree relatives of type II diabetes (Dr. Vivek Kumar Sharma  and Dr. Senthilkumar).
• Effect of Gender on Heart rate variabilities and classical cardiovascular autonomic function tests in adolescents; correlation with anthropometric parameter.(Dr.Jayasree)
• Sympathovagal imbalance in pregnancy induced hypertension ; correlation with endothelial dysfunction and inflammatory markers.( Ms.Subha).
• Association of sympathovagalimbalance  with cardiovascular and metabolic dysfunction and effects of yoga therapy in the alteration of these dysfunctions in pre diabetes and diabetes. (Ms ShravyaKeerthi)
• Effect of Yoga on sympathovagal imbalance , oxidative stress , inflammatory markers, insulin resistance, and lipid profile in male type II diabetics

PULMONARY FUNCTION TEST LABORATORY

The laboratory is involved in measuring the lung volumes and capacities. Our lab is equipped with spirometer, body Plethysmograph and Blood gas analyzer.

The pulmonary functions are evaluated to access fitness of the patients prior to anaesthesia. Also baseline pulmonary functions are obtained prior to thoracic radiation in cancer patients. Clinical correlation of PFT parameters are used in the management of various lung pathologies especially COPD and asthma.

Research completed:

Effect of slow and fast pranayamas on pulmonary function, hhandgrip strength in young healthy volunteers – A randomized controlled study.

Research ongoing:

Effect of yoga on pulmonary , cardiovascular, metabolic functions and psychological stress in post – total mastectomy patients undergoing radiotherapy.

ELECTROPHYSIOLOGY LABORATORY

Electrophysiology laboratory of the department takes pride in harbouring unique expertise in the following technically demanding investigations for the past four decades. Nerve conduction studies, Auditory & Visual evoked potentials, Somatosensory evoked potentials, Repetitive nerve stimulation studies, H & F reflex studies, Electromyography are few of the routine investigations done on patients.

Research completed:

Somatosensory evoked potentials in healthy subjects: A study for technical standardization & normative data for south Indian population. Dr.SarathBabu V (PG) guided by Dr. G.S. Gaur

Research ongoing:

Effect of slow breathing excising on stress score , resting HRV and pulmonary function in young healthy male volunteers

OBESITY RESEARCH LABORATORY

This laboratory provides facilities to measure the body mass index, fluid assessment and Body Composition analysis using Bodystat® QuadScan 4000. Also, provides facilities to record autonomic function testing by using “BIOPAC MP 36”.

INSTRUMENTS:

Bodystat QuadScan 4000

• It is a multi-frequency Bioelectrical Impedance Analyser, which offers a quick, easy, economical, portable and non-invasive alternative to other methods of fluid assessment and Body Composition analysis.
• It measures/calculates the body composition status (Body Fat percentage and Fat Weight, Lean Mass, Dry Lean Mass), hydrational status (Extracellular Water percentage and volume, Intracellular Water percentage and volume, Total Body Water and its percentage) and the nutritional information (Basal Metabolic Rate (BMR), Body Cell Mass (BCM) and Illness marker).

Research applications:

• Subjects undergoing haemodialysis treatment.
• Monitor change of Body Cell Mass in patients with cancer and wasting diseases e.g. HIV;
• Evaluate effectiveness of Drug Therapy on Nutritional and Body Composition Status;
• Track fluid shifts in the lungs;
• Monitoring of Hydrational and Body Composition Status in competitive athletes to improve upon and maintain performance potential;
• Any area where the monitoring of fluid volume and fat/lean ratios are critical.

Anthropometric Tools

• Anthropometric tools are designed for assessing the human physique and measuring changes with growth, exercise, and nutrition. These equipments are ideal for medical epidemiology and anthropometric assessment.

Biopac MP36

• In addition to which the EMG, EEG and EOG.

Portable Bioharness

• It is a portable data acqusition system.

Ongoing Projects:

Sympathovagal imbalance in pregnancy induced hypertension ; correlation with endothelial dysfunction and inflammatory markers.

Association of cardiovascularautonomic function and aerobic capacity with insulin resistance and inflammatory markers in non diabetic first degree relatives of type II diabetes (Dr.Vivek Kumar Sharma andDr.Senthilkumar).