RESUMEN
INTRODUCTION: Epilepsy is caused by dysfunction in the brain, which is characterized by an enduring disposition for unprovoked seizures that reoccur often, along with the neurological, cognitive, psychological, and social effects of the condition, which are often managed with prolonged and sometimes lifelong medications that involve antiepileptic drugs (AEDs). To confirm the diagnosis of epilepsy, at least two unprovoked seizures occurring greater than 24 hours apart should be reported. This illness affects both children and adults. Patients with epilepsy are more likely to experience sexual dysfunction compared to the general population, which often leads to a poor quality of life. The pathophysiology involved consists of the impact of epilepsy and AEDs on the control of the hypothalamic-pituitary-gonadal axis, consequently resulting in a high risk of developing testicular or ovarian dysfunction, leading to sexual dysfunction in epilepsy patients. AIM: This review aims to highlight various studies focusing on the association of developing the risk of sexual dysfunction with psychiatric comorbidities, mainly depression and anxiety, that impact the quality of life in epilepsy patients. METHODOLOGY: The search methodology involved articles from the Google Scholar and PubMed databases published between 2018 and 2023. "Sexual dysfunction", "epilepsy", "depression", "anxiety", and "quality of life" were the keywords used to search the articles. The Boolean operator "AND" and "OR" were used in between the keywords used. Following this, a total of 15 articles were included in the review based on the inclusion and exclusion criteria. CONCLUSION: The review concluded that epilepsy patients are often affected by sexual dysfunction along with associated psychiatric comorbidities that mainly involve depression and anxiety, consequently impacting their quality of life, as demonstrated by various studies. Sexual dysfunction is a common yet underdiagnosed condition in epilepsy patients due to the stigma attached to it. Hence, neurologists must keep a high index of suspicion for this problem. Furthermore, screening and monitoring for sexual dysfunction should be added to the usual epilepsy work-up.
RESUMEN
Epilepsy is a chronic neurological disorder characterized by recurrent seizures, necessitating lifelong medication management. One common side effect of these medications is sexual dysfunction. In this case report, a 37-year-old male epilepsy patient who was an office clerk by occupation presented at the outpatient department (OPD) of occupational therapy with the chief complaints of anxiety, depression, and sexual dysfunction primarily reporting of anorgasmia, which required longer foreplay to reach an effective erection leading to delayed ejaculation. The patient reported a nine-year history of complicated, partial, and generalized seizures for which he consulted the physician who prescribed him AED (antiepileptic drug) carbamazepine twice a day; however, the symptoms persisted, and the medication was changed to pregabalin. In addition to this, the patient was advised for occupational therapy intervention by the physician. In the occupational therapy department, the patient was assessed for various parameters that involved sexual functioning using the Changes in Sexual Functioning Questionnaire-Male (CSFQ-M), for anxiety using the Generalised Anxiety Disorder-7 (GAD-7) questionnaire, for depression using the Patient Health Questionnaire-9 (PHQ-9), and quality of life (QOL) using the Quality of Life in Epilepsy Inventory - 31 (QOLIE-31) questionnaire. As part of the intervention, occupational therapy was provided to the patient for four months, which mainly focused on three major areas: health promotion, remediation, and modification. Each of these methods was used at all levels of the intervention, as outlined by the EX-Permission, Limited Information, Specific Suggestions, and Intensive Therapy model (P-LI-SS-IT), which reflected positive results, as there was enhanced sexual functioning, reduced symptoms of depression, and anxiety, and improved quality of life. In conclusion, occupational therapists along with doctors and other practitioners should focus on addressing intimacy and sexuality within their practice for epilepsy patients demonstrating symptoms of sexual dysfunction, which will consequently impact an individual's QOL. Additionally, screening and monitoring of sexual dysfunction should be included during the routine assessment of patients with epilepsy.
RESUMEN
A study was conducted on the economically important fishes Labeo rohita (Hamilton 1822), Tortor (Hamilton 1822) and Labeo calbasu (Hamilton 1822) stocks from the Ken, the Paisuni and the Tons rivers in the Vindhyan region. Asymptotic length was maximum in L. rohita (946, 833 and 962 mm) as compared with T. tor (822, 787 and 946 mm) and minimum in L. calbasu (567, 612 and 692 mm) in the Ken, the Paisuni and the Tons rivers, respectively. The growth coefficient and total mortality was maximum in T. torcompared to L. rohita and minimum in L. calbasu. Fishing mortality was maximum in T. tor (2.9, 4.57 and 3.44) and minimum in L. calbasu (0.51, 1.21 and 1.18) while natural mortality was maximum in L. rohita (0.74, 0.94 and 1.86) and minimum in L. calbasu (0.47, 0.65 and 0.68). Natural mortality indicated that the habitat was more suitable for L. calbasu. Comparatively, fishing pressure was very high in T. tor than L. rohita and L. calbasu. Exploitation rate was maximum in T. tor (0.71, 0.82 and 0.84) compared to L. rohita (0.77, 0.74 and 0.56) and minimum in L. calbasu (0.52, 0.65 and 0.63) in the Ken, Paisuni and Tons rivers, respectively.
