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Evidence from clinical trials has shown positive effects of yoga on hypothyroidism. To date, there is no review of these studies. This systematic review evaluates the efficacy of yoga as a therapeutic intervention for hypothyroidism. PubMed, Medline, PsycINFO, and Science Direct databases were searched to identify relevant literature. The review included clinical studies that evaluated the effects of yoga on hypothyroidism. Studies that were not conducted inenglish, unavailable, non-experimental, or those that were reviews, case studies, case reports, not based on yoga, involved yoga as a intervention, or included a mixed population were excluded. Eleven studies (n = 516) met the eligibility criteria. Of these, four studies were RCTs, two non-RCTs and five were pretest-posttest studies. The duration of the yoga intervention varied from 1 to 6 months. Most of these studies adopted a combination of suryanamaskar, asana, pranayama and meditation. On quality assessment, one study had a low risk of bias (1 RCT), six studies had a moderate risk of bias (3 RCTs, one non-RCT and two pretest-posttest studies), and four studies had a high risk of bias (1 non-RCT and three pretest-posttest studies). The outcome measures assessed were TSH, T3, T4, and thyroid medication usage, lipid indices, BMI, heart rate variability, pulmonary measures, blood glucose, anxiety, depression, self-esteem, quality of life and sleep. The majority of the studies reported significant improvements in these outcomes following yoga intervention. This systematic review reports evidence for effects of yoga on various outcome measures in hypothyroidism, suggesting its possible role in the management of hypothyroidism. However, there is a need for adequately powered, high-quality RCT studies in the future to draw a definitive conclusion., Competing Interests: Declaration of competing interest Authors declare no conflict of interest., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Background: Chronic low back pain is associated with both psychological and functional limitation. Yoga therapy has been shown to improve both the aspects. The present study was planned to evaluate integrated approach of yoga therapy with usaul care., Aims: This controlled randomized trial was done to evaluate the clinical and molecular changes resulting from integrated approach of yoga therapy (IAYT) as an adjunct regimen and compared it with usual care for the management of chronic low back pain patients., Material and Methods: We enrolled 29 adult patients with non-specific chronic low back pain (CLBP). Patients were randomly divided into two groups. The control group received the usual care of treatment as per institutional protocol. The yoga group received IAYT as an adjunct to usual care. Primary outcomes were pain intensity assessed by verbal numerical rating scale (VNRS) and functional ability assessed by Modified Oswestry Disability Index (MODI). Secondary outcomes were pain catastrophizing, quality of life, fear of movement related to CLBP, type of pain, levels of β-endorphin and TNF-α, and salivary CGRP. All parameters were measured at baseline, 1 and 3 months., Results: A Significant decrease in VNRS score at 1 and 3 months was observed in both the groups with the yoga group showing a more significant reduction in pain over time than the control group (p = 0.036). MODI improved significantly only in the yoga group at 1 and 3 months. Intergroup comparison revealed significantly better MODI over time in the yoga group (p < 0.001). DN4, PDQ, PCS, HADS (anxiety), and Euro QOL had a statistically significant improvement at 1 and 3 months in the yoga group compared with the control group. The HADS (depression) had a statistically significant reduction scores in the yoga group at 3 months compared with the control group (p = 0.012). There was a significant reduction in TNF-α values in the yoga group compared with baseline (p = 0.004)., Conclusion: IAYT therapy helped in addressing the psychological components of pain and improved quality of life patients with chronic low back pain compared with usual care., (© 2023 World Institute of Pain.)

Purpose: Ankylosing spondylitis (AS) signficantly affect day to day activities contributing to signficant disability. Patients with AS often report to have psychological problems and poor quality of life (QoL). This study investigates the effect of a three-month tele-yogic intervention on disease activity, functional index, inflammatory markers, quality of life and mental health measures in patients with AS., Methods: One hundred and twenty AS patients were assigned to either the yoga intervention group (YG) or the control group (CG). The YG (n = 57) received a 60-min structured yoga module online for 3 months in addition to standard medical care. The CG participants (n = 52) received only standard care during the same period. Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Ankylosing Spondylitis-Quality of Life (ASQOL) and psychological and inflammatory biomarkers were assessed at baseline and after three months., Results: YG showed significant improvement in BASDAI (p = 0.001), anxiety (p = 0.0004), and depression (p = 0.001) at three months compared to baseline. The CG showed no significant change in similar outcome measures. At three months, the intervention resulted in a significant improvement in BASDI (-0.79; 95% CI (-1.3, to -0.29); p = 0.0021), BASFI (-0.86, 95% CI (-1.59, to -0.14); p = 0.0193), anxiety (-0.42, 95% CI (-0.84 to -0.01), p = 0.0468), and AS-QoL (-3.37; 95% CI (-5.21 to 1.53); p = 0.0004) compared to the CG., Conclusions: The present study suggests that yoga helps improve pain, functional index, and mental health in patients with AS. Tele-yoga intervention is feasible and effective in treating AS., Competing Interests: Declaration of competing interest The authors declare no conflict of interest., (Copyright © 2022. Published by Elsevier Ltd.)

Aims The aim of this study is to investigate the prevalence, impact of health determinants on non-communicable diseases (NCDs), and multimorbidity among urban elderly in India. Methods This is a cross-sectional study involving a total of 1,671 (870 male and 801 female) respondents aged 60-80 years. Multistage sampling was used for the recruitment of the participants. A total of 12 sample areas from 12 cities of six southern states of south India were selected. Through survey form, information regarding demographic characteristics, health-influencing lifestyle factors, and history of nine NCDs was collected. Results The mean age of participants was 68.5 ± 6.01 years.. The prevalence of hypertension was 40.4%, followed by diabetes (31.2%), arthritis (22.1%), sensory impairment (10.1%), heart diseases (7.8%), and dyslipidemia (7.0%). 74.1% of participants had at least one morbidity, and 40.0% of people had multimorbidity. Being overweight is the highest risk health determinant for hypertension, diabetes, heart disease, high cholesterol, stroke, and joint pain. Obese people have 64% more risk of hypertension than people with normal BMI. People with disturbed sleep have increased risk of hypertension, high cholesterol, and joint pain by more than 80% compared to people with proper sleep. Among the modifiable health determinants of obesity, disturbed sleep, constipation, and physical activity up to 30 minutes were positively associated with multimorbidity. Those in the age group of 70 to 80 years have a high risk for NCDs and multimorbidity compared to those in the age group of 60 to 70 years. Conclusions A healthy lifestyle is necessary to reduce the burden of NCDs among the elderly. Developing holistic health policies seems an urgent need., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Chobe et al.)

Background: The ongoing novel coronavirus disease 2019 (COVID-19) pandemic has a significant mortality rate of 3-5%. The principal causes of multiorgan failure and death are cytokine release syndrome and immune dysfunction. Stress, anxiety, and depression has been aggravated by the pandemic and its resultant restrictions in day-to-day life which may contribute to immune dysregulation. Thus, immunity strengthening and the prevention of cytokine release syndrome are important for preventing and minimizing mortality in COVID-19 patients. However, despite a few specific remedies that now exist for the SARS-CoV-2virus, the principal modes of prevention include vaccination, masking, and holistic healing methods, such as yoga. Currently, extensive research is being conducted to better understand the neuroendocrinoimmunological mechanisms by which yoga alleviates stress and inflammation. This review article explores the anti-inflammatory and immune-modulating potentials of yoga, along with its role in reducing risk for immune dysfunction and impaired mental health., Methods: We conducted this narrative review from published literature in MEDLINE, EMBASE, COCHRANE databases. Screening was performed for titles and abstracts by two independent review authors; potentially eligible citations were retrieved for full-text review. References of included articles and articles of major non-indexed peer reviewed journals were searched for relevance by two independent review authors. A third review author checked the excluded records. All disagreements were resolved through discussion amongst review authors or through adjudication by a fourth review author. Abstracts, editorials, conference proceedings and clinical trial registrations were excluded., Observations: Yoga is a nonpharmacological, cost-effective, and safe intervention associated with several health benefits. Originating in ancient India, this vast discipline consists of postures (asanas), breathing techniques (pranayama), meditation (dhyana/dharana), and relaxation. Studies have demonstrated yoga's ability to bolster innate immunity and to inhibit cytokine release syndrome. As an intervention, yoga has been shown to improve mental health, as it alleviates anxiety, depression, and stress and enhances mindfulness, self-control, and self-regulation. Yoga has been correlated with numerous cardioprotective effects, which also may play a role in COVID-19 by preventing lung and cardiac injury., Conclusion and Relevance: This review paves the path for further research on yoga as a potential intervention for enhancing innate immunity and mental health and thus its role in prevention and adjunctive treatment in COVID-19., (© 2022. The Author(s).)

Background: Amidst the adversities of the COVID-19 pandemic, the health care system has seen a new paradigm shift towards e-health or telehealth services. In the advent of catering to the geometrically increasing health care needs of the patients suffering from various chronic health conditions when in social isolation, the need for such shifts is paramount. Patients with Ankylosing spondylitis using immunosuppressants with variable degrees of disabilities are at higher risk from this isolated status. This study aims to assess the efficacy of e-Yoga as a treatment option for these patients., Methods: The proposed study is a single-center, parallel-group prospective randomized, open-blinded end-point trial. Patients aged between 30 and 50 years will be recruited from the members of Antardhwani: A society of ankylosing spondylitis based in Ahmedabad, Gujarat. Yoga experts will administer a scientifically developed and validated Yoga module via e-Yoga modalities. A total of 135 patients will be recruited and randomly allocated to Yoga and control groups. Data will be recorded at baseline and three months on disease activity, degree of functional limitations in patients, quality of life, inflammatory biomarkers, depression, and anxiety using Bath AS Disease Activity Index (BASDAI), Bath AS Functional Index  ( BASFI), AS Quality of Life index  ( ASQOL), C reactive protein (CRP), Erythrocyte sedimentation rate (ESR), Physical health questionnaire-4 (PHQ-4), respectively., Discussion: The study will report the efficacy of e-Yoga in catering to the physical and mental insufficiencies of inpatients with Ankylosing spondylitis amidst COVID-19 pandemic. The study is prospectively registered in the Clinical Trial Registry of India (CTRI/2020/08/027215)., Competing Interests: The authors declare no conflict of interests., (© 2021 Elsevier Ltd. All rights reserved.)

Background: Yoga and Ayurveda are ancient sciences which emphasize on the cure of disease and the proportion of health. Both sciences are also known to reduce the aging process and are helpful in aging-related disorders., Objective: This study investigates the effects of Yoga and Ayurveda Rasayana combined intervention on cognition among the elderly with mild cognitive impairment., Materials and Methods: Seventy-two elderly persons (average age 63.3 ± 6.44 years) received Ayurveda Rasayana (AR) (n = 23) or Integrated Yoga (IY) (n = 25) or combined (IY plus AR) intervention (n = 24) for eight weeks. AR treatment consisted of Brahmi ghrita, and IY consisted of asana, pranayama, meditation, and relaxation techniques. Executive function, verbal fluency, attention, processing speed, short-term and working memory, and learning and verbal memory were assessed at the baseline and after eight weeks., Results: Within-group analysis shows that there was a significant time main effect (p < 0.05) in all cognitive measures in the three groups (IY, AR, and IY plus AR) except Digit backward test. Bonferroni post hoc test shows a significant difference in pre to post in all variables. In the between-group analysis, there was a substantial group difference for Rey's Auditory Verbal Learning Test- hits, F (2,69) = 4.376 (P < 0.016), Rey's Auditory Verbal Learning Test-Average, F (2,69) = 4.727 (0.012), Digit backward test, F (2,69) = 5.766 (0.005) after eight weeks of intervention., Conclusion: Both Ayurveda Rasayana and Integrated Yoga intervention were found effective in improving cognitive abilities among the elderly with MCI. Combined Ayurveda Rasayana and Yoga intervention significantly improved learning, attention, processing speed, and working memory compared to individual response among elderly persons with MCI., (Copyright © 2020 The Authors. Published by Elsevier B.V. All rights reserved.)

Background: Ankylosing spondylitis (AS) is a chronic inflammatory disease that causes significant disability and reduced quality of life. Scientific studies on yoga have revealed its various health benefits in chronic conditions, including autoimmune diseases. However, whether yoga is feasible for AS patients or not is not studied. Further, no validated yoga module is available for AS patients., Objective(s): This study intended to develop a yoga module for AS patients and investigated its feasibility of use., Materials and Methods: The study was completed in three stages. In Stage I, six yoga experts prepared a list of 64 yoga practices based on the classical and contemporary yogic literature review. Of these practices, 41 were included in the designed yoga module. In Stage II, 41 experts with a minimum of five years of experience in yoga therapy were invited for yoga module validation. The usefulness of the practices was rated by experts on a 3-point scale (1: not at all useful, 2: moderately useful, and 3: very much useful). The Lawshe content validity ratio (CVR) method was used for the content validity of the yoga module. Practices with a CVR score of > 0.3 were retained in the final yoga module. In Stage III, a certified yoga instructor administered the validated yoga module to 19 AS patients (average age: 35.5 ± 10.7 years) thrice weekly for a month. Feasibility was assessed on the basis of the attrition rate, retention rate, attendance of the participants, and the subjective response on practical sessions using a structured checklist., Results: Of the 41 practices in the module, 31 had a CVR score of > 0.3 and were included in the final yoga module. Of the 25 participants, 19 (76%) completed the study while six dropped out (24%). Nineteen patients reported greater improvement in pain and flexibility. They found yoga relaxing and easy to practice. Most participants (65%) were able to practice a minimum of 30 min/day., Conclusion: The present study offers a validated yoga module consisting of 31 practices for AS patients. The results of the pilot suggested that the module is feasible, acceptable, and easy to practice for AS patients. We recommend that AS patients should practice this yoga module for a minimum of 30 min every day under the supervision of a yoga expert., (Copyright © 2021 The Authors. Published by Elsevier B.V. All rights reserved.)

Objectives: Type 2 diabetes mellitus (T2DM) is a major burden on global health and economy. Various Yogic techniques are found to be beneficial in the management of T2DM. Mind Sound Resonance Technique (MSRT) is one of the yoga-based meditation techniques observed to be effective in clinical settings., Methods: Thirty-two patients with T2DM were randomized to either MSRT or supine rest (SR) sessions on two separate days separated by a washout period of one day. Fasting blood glucose levels were measured before and immediately after the sessions. State anxiety and subjective feeling of relaxation were assessed using Spielberg's state anxiety inventory (STAI) and Visual Analogue Scale (VAS) respectively., Results: There were significant differences between MSRT and SR groups in fasting blood glucose (p=0.019), STAI scores (p<0.001) and subjective relaxation (p<0.001). Within group analyses revealed significant reductions (p<0.001) in fasting blood glucose and STAI scores, along with an increase in subjective relaxation following the practice of MSRT, whereas, non-significant changes were found following the SR session., Conclusions: A single session of MSRT was found to reduce blood glucose levels and state anxiety along with enhanced relaxation when compared to SR., (© 2021 Walter de Gruyter GmbH, Berlin/Boston.)

Background: Cognitive decline and psychological health problems are the most frequently observed and under-treated issues among the elderly. Many studies have assessed the efficacy of Yoga on cognitive and mental health parameters among the elderly. However, up to date, there is no systematic review done to evaluate the role of Yoga-based interventions on cognition and mental health in the elderly., Objective: This review evaluates the beneficial effect of Yoga in improving cognitive and mental health in the elderly., Methodology: A comprehensive search has performed on Medline, Google Scholar, PubMed, and PsycINFO electronic database from their inception to January 2019. The literature search was constructed around search term for "mental health", "cognition", "yoga" and "elderly". Out of 3388 records, we were considered only Randomized control trials (RCTs) with Yoga-based interventions on the older people for this review. Risk of bias was assessed using Delphi list and PEDro criteria., Results: After filtering out irrelevant studies, in our search, we come across 13 RCTs, and they included in this systematic review. Of 13 RCTs, four studies assessed only cognitive parameters and five studies assessed only psychological parameters, and four studies evaluated both. Study quality was fair to moderate of included RCTs on the Delphi list and PEDro criteria. Maximum studied variables in cognition were executive functions, memory, attention, and language while in mental health depression, anxiety, stress, and mood. Yoga-based interventions have some beneficial effects on attention, executive functions among cognitive variables, and depression among mental health parameters among the elderly., Conclusion: The present review indicates that Yoga-based interventions have some positive evidence in improving attention, executive functions and memory of cognition, while depression in mental health compared to active control among the elderly. However, methodological limitations and small number of studies preclude confirming the potential benefits of Yoga-based interventions on cognition and mental health among the elderly. Further, this review strongly recommends more randomized control trials with standard study methodology, use of validated modules of Yoga intervention, and long term follow up to have definite conclusions., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Background: Hypertension has remained an imperative risk factor for cardiovascular and cerebrovascular diseases, increasing the national burden of premature deaths over the decades., Purpose: There is limited data on the prevalence of hypertension and its distribution across all geographic regions in India. This nationwide survey was conducted in 2017 to assess the prevalence of hypertension and prehypertension among the Indian adults., Methods: A multilevel stratified cluster sampling technique, with a random selection among the urban and rural populations, was adopted to achieve a sample of 70,031 adults from 24 states and 4 union territories. Blood pressure was measured twice using automated oscillometric machines with a minimum of 3-min gap, and the average was recorded. This was later categorized into prehypertension (elevated blood pressure) and hypertension subgroups as defined by the new 2017 American Heart Association guidelines., Results: The prevalence of prehypertension and hypertension in our study population across all ages was found to be 18.2% and 24%, respectively. Prehypertension was common at a younger age, whereas the prevalence of hypertension was higher in the older age groups. The urban population (24.4%) and males (24.7%) were positively associated with prehypertension and hypertension. The western zone had the highest prevalence of hypertension, whereas the eastern population had the lowest., Conclusion: Our study revealed an alarmingly high prevalence of hypertension, accounting up to one hypertensive in every four adults in India. There is a need for more robust national strategies for identifying and treating hypertension to reduce the national and the global burden of hypertension by 25% before 2025., Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© 2021 Indian Academy of Neurosciences (IAN).)

Objectives: Indigenous populations around the world have a higher health disparity and an increased risk of diabetes. Scientific literature on the prevalence of diabetes in India is not available, and the current work is a pilot study to explore the risk of diabetes in one such indigenous population in India., Study Design: This is a cross-sectional survey and screening study., Methods: The study took place in a remote tribal hamlet of Machuru in South India. A door-to-door survey was conducted in the hamlet with a population of 555. The Indian Diabetes Risk Score (IDRS) questionnaire was completed by 160 individuals older than 25 years. Capillary blood glucose levels were measured to compare the glycaemic status with the predicted IDRS., Results: Of 160 adults who completed the questionnaire, 37 were at high risk (23.13%) as per the IDRS, 52 at medium risk (32.5%) and 71 at low risk (44.38%). None of the respondents knew their family history of diabetes owing to the lack of awareness about the condition. Interestingly, the villagers had a sedentary lifestyle owing to their unique family dynamics but a healthy diet. Five participants were diagnosed with diabetes, and 18 were diagnosed with impaired fasting glucose or prediabetes., Conclusions: The IDRS might not be an accurate measure to understand the risk of diabetes in this particular population owing to their unique family dynamics and a lack of awareness about diabetes. The best possible way to assess the diabetes risk might be through blood examination., (Copyright © 2018 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.)

Background: Yoga is an ancient system of wellness with Asana and Pranayama as its most popular and propagated modules for management of lifestyle disorders., Objectives: The aim of the study was to characterise the liver abnormalities, biochemical changes, and stress levels after Yoga intervention in prediabetic females., Materials and Methods: 37 females were randomly divided into Yoga practising and non-practising control groups. The Yoga practising group performed Diabetic Yoga Protocol (DYP) for 3 months. Parameters including size of liver, fatty infiltration, and grade of severity were measured using ultrasonography along with biochemical parameters and stress levels at baseline and after Yoga practice., Results: The glycosylated hemoglobin (HbA1c) and glucose levels were found significantly reduced in prediabetic (p = 0.015) women after practising DYP, although cholesterol levels increased in menopausal women. No escalation of fatty liver was noted among women practising DYP., Conclusion: DYP reduced the HbA1c and stress levels and therefore, could be a cost-effective tool for preventing prediabetes to diabetes progression., (Copyright © 2019 Diabetes India. Published by Elsevier Ltd. All rights reserved.)

Background: Evidence suggests that individuals with human immunodeficiency virus (HIV) often exhibit poor physical and mental health, which contributes to a reduced Quality of Life (QoL). Yoga is a form of alternative therapy that has positive influences on general health and QoL., Objectives: This study examined the effects of yoga on i) anxiety, depression, and psychological well-being and ii) QoL among individuals with an HIV positive status., Methodology: Sixty individuals with HIV-positive (aged 30-50 years) from rehabilitation centres across Bangalore were randomly assigned to the yoga intervention group (n = 30; 11 men) or the wait-listed control group (n = 30; 10 men). Participants in the yoga group underwent 8 weeks of intense yoga practice performed an hour a day for 5 days a week. The yoga practice consisted of physical postures, breathing practices, relaxation techniques, and meditation. Participants in the wait-listed control group followed their normal routine. Anxiety, fatigue, depression, and QoL were assessed twice for all subjects in each group - once at the start of the study to establish a baseline and once more at the end of the 2-month study period to assess any changes. Data analysis was performed on the assessments using SPSS software version 10., Results: Between group analysis demonstrated that a significantly different reduction in anxiety (p < 0.001), depression (p < 0.001), and fatigue (p < 0.001) was observed in the yoga group compared to the control group, as well as significant improvements in well-being (p < 0.001) and all domains of QoL (p < 0.001) in the yoga group compared to the control group., Conclusion: This study indicates that yoga intervention appears to improve the psychological health and QoL of individuals who are HIV-positive. Therefore, based on these findings, yoga may be recommended as a complementary therapy to enhance conventional HIV care., (Copyright © 2018. Published by Elsevier Ltd.)

Context: Providing care to patients suffering from chronic neurological problems is a stressful job. While providing care to the patients, professional caregivers experience various kinds of physical and mental challenges that affect their mental health and sleep. Yoga is a form of mind-body medicine shown to be an effective intervention in improving physical and mental health., Objective: To examine the effects of an integrated yoga (IY) intervention on anxiety, depression, stress, and sleep quality among professional caregivers of older adults with Alzheimer's disease., Setting: This study was conducted in an Alzheimer care institution located in Bangalore City in southern India., Participants: Participants were professional female caregivers of older adults with Alzheimer's disease. Participant age range was between 20 and 50 y (mean, 34 ± 8.4 y). A total of 30 participants were enrolled in the study. Seventeen participants followed IY intervention and 13 were considered in a wait-list group., Intervention: Participants in the IY group received a structured IY intervention comprising yoga asanas, pranayama, meditation, and relaxation techniques, 1 h/d, 6 d/wk, for 1 mo. Participants in the wait-list control group followed their daily activities., Outcome Measures: Blood pressure, heart rate, anxiety, depression, stress, and sleep quality were assessed at baseline after 1 mo for both the groups. Data were analyzed with an appropriate statistical test using SPSS Version 16 software (IBM, Armonk, NY, USA)., Results: The IY group showed significant improvement in heart rate, blood pressure, stress, depression, anxiety, and sleep quality after 1 mo compared with baseline. In contrast to the IY group, the wait-listed control group showed significant increase in anxiety, depression, and stress and significant decrease in sleep quality after 1 mo compared with baseline., Conclusions: The present study showed the potential use of IY intervention in reducing stress, anxiety, and depression. The study also suggests that IY improves sleep quality among professional caregivers. However, further studies using a randomized controlled trial method with a larger sample size and for a longer duration should be conducted to confirm the present findings.

Background: A significant number of women in India are suffering from hypothyroidism. Hypothyroidism is characterized by elevated lipid profiles and thyroid stimulation hormone (TSH). It leads many comorbid conditions such as coronary artery disease, obesity, depression, osteoporosis, sleep apnea, and etc. Yoga is proven to be effective in reducing weight, dyslipidemia, depression and it brings the balance in autonomous nervous system. We aimed to study the effect of 6 months yoga practice on lipid profile, thyroxine requirement and serum TSH in women suffering from hypothyroidism., Methods: Twenty-two household women suffering from hypothyroidism between the age range of 30 and 40 (mean±SD; 36.7±3.2) years, with average 4±1.12-year history of hypothyroidism were included in this study. Subjects with known cardiac issues, hypertension, history, recent surgery, slip disc and low back pain were excluded from this study. None of the subjects were on any other medication except thyroxine which was kept during the intervention phage (mean 65.78±22.74 mcg). All the subjects underwent 6 months of yoga practice 1 h daily for 4 days a week. Lipid profile, thyroxine dosage and serum TSH level were assessed before and after intervention. Data was analyzed using paired sample t test & Wilcoxon's signed rank test., Results: The paired sample t-test showed significant reduction in total cholesterol (p=0.006; -8.99 %), low-density lipoprotein (LDL) (p=0.002; -9.81 %) and triglycerides (p=0.013; -7.6 %), and there was a significant improvement in high-density lipoprotein (HDL) (p=0.02; +9.65 %) along with nonsignificant reduction in TSH level (p=0.452; -9.72 %). Wilcoxon signed-rank test showed significant reduction in thyroxine medication score (p=0.029; -15.30 %) from., Conclusion: 6 months practice of yoga may help in improving cholesterol level, serum TSH, may also help in reducing the thyroxine requirement in female patients suffering from hypothyroidism. However, further randomized controlled studies need to be conducted to confirm the present finding.

Background: The dramatic rise in the prevalence of obesity and type 2 diabetes mellitus (T2DM) is associated with increased mortality, morbidity as well as public health care expenses worldwide. Previous research suggests that yoga holds promise for obesity and T2DM management., Objective: The objective of the present study was to assess the effect of intensive integrated approach of yoga therapy (IAYT) on body fat and body mass index (BMI) and resting metabolism in mid-life overweight patients with T2DM (BMI, Mean ± SD, 27.05 ± 4.51)., Materials and Methods: Twenty-four mid-life patients (6 females) with T2DM (Age, Mean ± SD, 55.38 ± 7.96 years) participated in the study and practiced IAYT for 7 days. The IAYT works at five layers of human existence (physical, vital, mental, intellectual and bliss) to bring positive health. The body fat and BMI and resting metabolism were recorded before and after IAYT using Karada Scan body composition monitor HBF-375 from Omron Healthcare Singapore PTE LTD., Statistical Analysis: SPSS-16 was used to analyze the data. Shapiro-Wilk test showed that the data was not normally distributed. Further, the Wilcoxon signed-ranks test was used to analyze the change in means of pre- and post-measurements., Results: Data analysis showed that there was a significant decrease in body fat and BMI and resting metabolism (in all assessments, P < 0.001)., Conclusion: The present study suggests that 7 days practice of IAYT has a great promise for the management of overweight in mid-life patients with T2DM. Additional well-designed studies are needed before a strong recommendation can be made.

Objectives: To compare the immediate effect of mind sound resonance technique (MSRT) with supine rest (SR) on state anxiety and psychomotor performance in 15 (eight male and seven female) right-handed generalized anxiety disorder patients (GAD) with an age range of 34.8 ± 12.8 years., Materials and Methods: Self as control design was followed. Diagnosis of GAD was made by a psychiatrist using sections of the Mini International Neuropsychiatric Interview (MINI). Participants practiced MSRT or SR (as control intervention) for 30 min at the same time for two consecutive days. The sequence of intervention was assigned randomly to the participants. State anxiety was assessed using state trait anxiety inventory (STAI; Form X1). Digit letter substitution task (DLST) was used to assess psychomotor performance, which involves visual scanning, mental flexibility, sustained attention, psychomotor speed and speed of information processing. Intervention was given in a quiet dark room on an empty stomach. Subjects received a training of MSRT and SR for 1 week before the data were taken. A pre-recorded audiotape was used to administer the technique of MSRT. Difference in scores after baseline and intervention was used to check normality, and was found to be normally distributed by the Kolmogrov-Smirnov test. The changes in STAI, DLST and difference in scores before and after two interventions (MSRT and SR) were compared using the paired samples t test., Results: As compared with baseline, STAI scores reduced and DLST scores increased significantly (STAI; P < 0.01; DLST; P < 0.01) after MSRT. After SR, there was a significant reduction in STAI scores from baseline (STAI; P < 0.05), but there was no significant change in the DLST scores (P = 0.26). Comparison of the difference in scores for DLST and STAI before and after the two interventions (MSRT and SR) showed a significantly higher score for DLST (P < 0.05) and a significantly lower score for STAI (P < 0.01) for MSRT as compared with SR., Conclusion: This pilot study suggests that MSRT may have a potential role in reducing state anxiety and enhancing psychomotor performance in patients suffering from GAD immediately after the practice. These findings need confirmation from studies with a larger sample size and randomized controlled design, which are implicated in the future.

Chemotherapy drugs and radiotherapy are highly toxic and both damage adjacent healthy cells. Side effects may be acute (occurring within few weeks after therapy), intermediate or late (occurring months or years after the therapy). Some important side effects of chemotherapy are: nausea, vomiting, diarrhea, mucositis, alopecia, constipation etc; whereas radiation therapy though administered locally, can produce systemic side effects such as fatigue, anorexia, nausea, vomiting, alteration in the taste, sleep disturbance, headache, anemia, dry skin, constipation etc. Late complications of these therapies also include pharyngitis, esophagitis, laryngitis, persistent dysphagia, fatigue, hepatotoxicity, infertility and cognitive deficits. These arrays of side effects have a devastating effect on the quality of life of cancer survivors. Due to the inadequacy of most of the radio-protectors and chemo-protectors in controlling the side effects of conventional cancer therapy the complementary and alternative medicines have attracted the view of researchers and medical practitioners more recently. This review aims at providing a comprehensive management protocol of above mentioned chemo-radiotherapy induced side effects based on Ayurveda, which is an ancient system of traditional medicine practiced in Indian peninsula since 5000 BC. When the major side effects of chemo-radiotherapy are looked through an ayurvedic perspective, it appears that they are the manifestations of aggravated pitta dosha, especially under the group of disorders called Raktapitta (haemorrhage) or Raktadushti (vascular inflammation). Based on comprehensive review of ancient vedic literature and modern scientific evidences, ayurveda based interventions are put forth. This manuscript should help clinicians and people suffering from cancer to combat serious chemo-radiotherapy related side effects through simple but effective home-based ayurveda remedies. The remedies described are commonly available and safe. These simple ayurveda based solutions may act as an important adjuvant to chemo-radiotherapy and enhance the quality of life of cancer patients.

Cancer stem cells (CSCs) are stem-like tumor populations that are reported to contribute towards tumor growth, maintenance and recurrence after therapy. Hypoxia increases CSC fraction and promotes acquisition of a stem-cell-like state. Cancer stem cells are critically dependant on the hypoxia-inducible factor-1 (HIF-1) for survival, self-renewal, tumor growth and maintenance of their undifferentiated phenotype. Recent researches show that stage of differentiation of the tumor cells is predictive of their susceptibility to natural killer cell (NK) cell mediated cytotoxicity and cancer stem cells are significant targets of NK cell cytotoxicity. Studies also show that reversion of tumor cells to a less-differentiated phenotype can be achieved by blocking NFκB. Yoga therapy (yogic lifestyle modifications encompassing physical postures, breathing practices, relaxation techniques and meditations) is known to modulate neural, endocrine and immune functions at the cellular level through influencing cell cycle control, aging, oxidative stress, apoptosis and several pathways of stress signaling molecules. Yoga therapy has also been shown to enhance natural killer cell activity and modulate stress and DNA damage in breast cancer patients receiving radiotherapy. Recent study found that brief daily yogic meditation may reverse the pattern of increased NFκB-related transcription of pro-inflammatory cytokines in leukocytes. Thus, yoga therapy has the potential to reduce cancer stem cell survival, self -renewal and tumor growth by modifying the tumor micro-environment through various mechanisms such as; 1) reducing HIF-1 activity by enhanced oxygenation, 2) promoting NK cell activity directly (or indirectly through down regulating NFκB expression), thereby enhancing NK cell mediated CSC lysis, and 3) by minimizing the aberrant expressions or activities of various hormones, cytokines, chemokines and tumor signaling pathways. Yoga therapy may have a synergistic effect with conventional modalities of treatment in preventing cancer progression and recurrences.

The two neighboring southwestern states of India, Karnataka and Maharashtra, have high incidence of HIV/AIDS and are among the six most high prevalence HIV infected states. In Karnataka state, the northern districts of Bagalkot, Belgaum and Bijapur (the three Bs) and in Maharashtra state, the southern districts of Sangli, Satara, and Solapur (the three Ss) are the areas with the highest incidence of HIV/AIDS. We have evaluated the incidence of maternal to child transmission (MTCT) of HIV-1 infection in Belgaum District which is more than 500 kilometers distance by road from the campus in greater Bangalore (Karnataka State). We have obtained the prenatal CD4 counts of HIV infected pregnant mothers. We have also screened the HIV infected children in two orphanages (rehabilitation centres for HIV infected children) in Belgaum District. The clinical conditions of these infected children were assessed for their CD4 counts, anti-retroviral therapy (ART) intake status, outpatient illnesses and body composition. We have observed that there is an influence of the age factor on the CD4 counts of the HIV infected children. Further, in view of the role of our recently found involvement of sulfatide, 3-O- galactosylceramide, in inhibition of HIV-1 replication and enhancement of hematopoiesis which is otherwise inhibited due to such infection, we have discussed the possible role of sulfatides that biologically occur in the fetal adnexa (placentatrophoblasts /amnion/chorion-umbilical cord), in containing HIV infection as a potential safer alternative to the ART regimens currently approved to be clinically practiced. Lastly, we have discussed the complementary and alternative medicine (CAM) therapies such as evidence based yoga and ayurveda as add-on to ART in potential elimination of MTCT of HIV infection. Out of a total of 150 children delivered by HIV infected mothers, 13 children were found to be positive as determined by the dried blood smear (DBS) for virological testing, giving an incidence of about 8.66% in the Belgaum district during the last two years, in spite of the prescription of currently available ART regimens. All the 13 HIV-transmitting mothers had normal vaginal deliveries. Though 12% of the total 150 deliveries required lower segment caesarean section (LSCS), none among them resulted in MTCT of HIV. Comparison of the prenatal CD4 counts between transmitting and non-transmitting mothers did not show significant differences (p=0.25) thus suggesting indirectly that HIV-1 proviral loads (undetermined / unavailable) need not necessarily determine the fate of incidence of vertical transmission. The mean age of 44 HIV infected children (14 females, 30 males) that were screened in two orphanages was 10.8±3.1 years. Out of these 44 children, 27 were taking ART (61.36%) with mean duration of consumption being 2.8±2.28 years. Fifty percent (n=22) of the children were suffering from at least one outpatient illness, out of which 13 were taking ART. Their mean basal metabolic rate (BMR), body mass index (BMI), muscle mass, fat mass and fat % were 795.45±106.9, 14.55±1.9 kg/m(2), 9.54±3.4 kg, 3.69±2.24 kg and 15.04±7.8% respectively. Comparison between the children taking ART (on-ART, n=27) and those not taking ART (non-ART, n= 17) showed that though there was no significant difference in the average age of the two groups, on-ART children had significantly higher BMR (p=0.05), and muscle mass (p=0.004), than non-ART. The CD4 counts, BMI, fat mass and fat percentage did not show significant statistical differences between the two groups. The CD4 counts of the children (both on-ART and non-ART) of age 8 years and below (n=12) were found to be significantly higher (p=0.04) than those of age 14 and above (n=10). All the children in age group of 14 years and above (n=10) except one child were on ART, whereas 7 out of 12 children in age group of 8 years and below were on-ART. In one of the rehabilitation centers called Aadhar, among non-ART children, a significant correlation was observed between the age of the child and CD4 counts (measured separately in the months of June 2011 and December 2011). Both the CD4 counts measured in June 2011 (n=6; r=-0.82, p= 0.04) as well as in December 2011 (n=6; r=-0.97, p=0.001) showed a significant decline as the age progressed. Also, at the same center, among on-ART children, the CD4 counts in June 2011 (n=7) and December 2011 (n=8) were significantly different between the children in the age group of 8 below years, and those in the age group of 14 years and above (p= 0.005). As HIV infected children grow in age, they may lose maternal derived immunity as shown by the decrease in CD4 counts, irrespective of their ART status. It is to be expected from these results that the conferred maternal immunity (possibly primarily humoral and secondarily cytotoxic immune responses) to the virus acquired at child birth taper off and eventually overcome by the generation of mutant HIV strains in the children, as the life spans of the infected children progress. We have discussed safer therapeutic interventions whose efficacy on HIV/AIDS may be synergistic to or even substitute the existing treatment strategies. Some of such interventions may even be customized to help eliminate MTCT. Further, these virus infected pregnant mother patient blood / serum samples could prove useful in the vaccine development against HIV infection.