How Is It Possible to Treat Diseases Without Medicine?: A Qualitative Study on the Attitude and Perceived Benefits of Yoga and Naturopathy Among Patients Admitted at an Inpatient Hospital.

Background: Yoga and naturopathy (Y&N) is a system of medicine primarily focusing on restoration of health and well-being. Objective of this study is to understand the knowledge, attitude, and perception about Y&N among the inpatients of a government Y&N institution in south India. Methods: Focus group discussion was conducted in eight adult patients aged between 30 and 60 years who took Y&N treatments for a period of 10 days or more. Purposive sampling method was adopted. Oral informed consent was obtained. Results: Knowledge about the Y&N system of medicine was primarily through referral or "word of mouth." Perceived benefits were both physical and psychological. Uniqueness of the hospital as mentioned by participants includes individual attention, tailor-made treatment protocols, and one-to-one care to the needy patients. Conclusion: An integrated approach is very much essential that might bring about better treatment outcomes in patients.

Effects of Therapeutic Calf Massage on Cardiac Autonomic Function in Healthy Volunteers-a Pilot Study.

Background: Calf massage is a therapeutic intervention that improves circulation and relieves us from pain & tightness. The calf massage also improves autonomic performance by modulating the vagal tone of the cardiovascular system. Therefore, the current study was intended to determine therapeutic calf massage on cardio autonomic activity in healthy subjects. Objective: To assess the immediate effect of a single 20-min session of calf massage on cardiac autonomic modulation through heart rate variability (HRV) measurement. Materials & Methods: In this study, 26 apparent healthy female participants aged between 18 and 25 years participated. Massage over the calf muscles on both legs for 20 min was performed, and resting cardiovascular parameters and HRV parameters were measured at baseline, immediately after the massage, and during the recovery periods (10 and 30 min after the massage). Data were analyzed using one-way ANOVA followed with post hoc analysis. Results: Immediately after the massage intervention, heart rate (HR), systolic (SBP), and diastolic (DBP) blood pressure were decreased (p < .01), and the reduction was persisted at 10 min and 30 min of the recovery period (p < .01). In HRV parameters, the root mean square of successive differences (RMSSD) and high-frequency normalized unit (HF n.u.) increased, and low frequency (LF n.u.) decreased after the massage, and at the 10 and 30 min of the recovery period. Conclusion: The present study reports suggest a significant reduction in heart rate and blood pressure after the massage therapy. A drop in sympathetic tone and raise in parasympathetic tone can also attribute to the therapeutic effect.

Foot reflexology for reduction of blood pressure in hypertensive individual: A systematic review.

IMPORTANCE: Hypertension is the modifiable risk factor associated with cardiovascular diseases and all-cause mortality. Foot reflexology has been proposed to reduce the blood pressure for the patients with hypertension but the available evidences are uncertain. OBJECTIVE: We conducted a systematic review and meta-analysis, know the efficacy of foot reflexology on blood pressure reduction in patients with hypertension. DATA SOURCES AND SELECTION: A systematic search of electronic databases such as PubMed, Scopus, ClinicalTrials.gov, Embase, and Cochrane library since inception till January 2022. Randomized controlled trial with foot reflexology as an intervention for lowering blood pressure (BP) in hypertensive patients was included in the study. DATA EXTRACTION AND OUTCOME MEASURES: Data was independently extracted by four authors. Systolic and diastolic blood pressure was the primary outcome measure. Standardized mean difference (SMD) and 95 % confidence interval (CI) were calculated to determine the effect size. RESULTS: The pooled effect of SBP (SMD: -2.70, 95 % of CI: -6.79, 1.39, I2 - 97 %, P < 0.001) and DBP (SMD: -2.12, 95 % of CI: -5.95, 1.71, I2 - 97 %, P < 0.001) changes are not favorable for foot reflexology in terms of reducing blood pressure. CONCLUSION: Findings from the studies showed that foot reflexology interventions were not much effective in the reduction of blood pressure among patients with hypertension.

Immediate effects of the practise of Sheethali pranayama on heart rate and blood pressure parameters in healthy volunteers.

OBJECTIVES: Sheetali pranayama, a cooling pranayama is best known for its calming and relaxing nature, widely used for many conditions like depression, anxiety and hypertension. The aim of the study was to evaluate the immediate effect of the practice of Sheetali pranayama on heart rate and blood pressure parameters in healthy volunteers. METHODS: Apparently, 60 healthy volunteers were involved, from both sexes. They were split into pranayama (n=30) and control (n=30) groups at random. Sheetali pranayama was performed for 5 min (5 cycles) in the pranayama group and normal breathing (12-16 breaths/min) was permitted in the control group. Heart rate (HR) and blood pressure (BP) were recorded with RMS polyrite in the supine position after 5 min of rest. RESULTS: The HR in the pranayama group significantly decreased (p=0.04). Systolic (SBP) and diastolic blood (DBP) pressure, pulse pressure (PP) and mean arterial pressure (MAP) decreased significantly (p<0.05) relative to control after pranayama practice. Pre-Post inter-group results has also shown that the pranayama group has substantially decreased HR and BP indices. CONCLUSIONS: Present study shows that the practice of Sheetlai pranayama creates a relaxed state, and parasympathetic activity overrides sympathetic activity in this state. It indicates that in healthy volunteers, pranayama strengthens the resting cardiovascular parameters.

Effect of six months pranayama training on stress-induced salivary cortisol response among adolescents-Randomized controlled study.

BACKGROUND: A combination of yoga practices has been documented to reduce stress and stress-induced cortisol levels. The objective of the current study is to examine the effects of six months of a single pranayama practice (Bhramari [Bhr. P]) on reducing salivary cortisol response to the cold pressor test (CPT) among adolescents. METHODS: Twenty-six healthy adolescents between the ages of 11 and 19 were randomly assigned to either yoga group (n-13) or control group (n-13). Yoga group participants were trained to do Bhr. P for 45 min, thrice a week for six months. All participants underwent CPT at baseline and at end of six months. Saliva samples were collected at baseline (t0), at 20 min (t1), 40 min (t2), and 60 min after the CPT (t3). RESULTS: Contradictory to our hypothesis, participants in the yoga group exhibited a higher salivary cortisol response to the CPT at t1 (p = 0.04) when compared to the control group. However, the t3 salivary cortisol levels showed a statistically significant reduction (p = 0.03) in yoga group when compared to the control group. A significant interaction with time (F (1, 88) = 316.5, p = .001, ηp2:0.91) and between the group × time (F (3, 88) = 2.83, p = 0.04, ηp2:0.8) was found after the intervention. CONCLUSIONS: An increase in the cortisol responsiveness observed in the study is an indication of the adaptive capability achieved through regular yoga training, evidenced by an initial rise in cortisol followed by a rapid fall below baseline after 60 min. Further research is required to conclusively determine the changes in cortisol levels over time in response to stress in long-term yoga practitioners.

Effects of 12 sessions of steam bath intervention on spirometry parameters among healthy adult volunteers.

OBJECTIVES: Steam bath is extensively used around the world. However, its physiological influence is not understood in detail. Objective of the current study is to examine the effects of 12 sessions of steam bath on spirometric parameters among healthy participants. METHODS: Forty healthy adult volunteers of both sex (14 male and 26 female) aged 26.38 ± 8 years participated in the study. A steam bath session (10-15 min) was given once a week for 12 weeks. The spirometric parameters [forced expiratory volume in the 1st second (FEV1, L), forced vital capacity (FVC, L), FEV1/FVC ratio (absolute value), maximal mid-expiratory flow (MMEF, L/s) and peak expiratory flow (PEF, L/s)] were measured by Helios 401 spirometer. RESULTS: Compared to baseline, post-intervention spirometric parameters showed significant (p<0.05) improvement in the FVC (82.40 ± 11.24 to 96.91 ± 18.76), FEV1 (86.13 ± 14.39 to 91.17 ± 12.48), FEV1/FVC ratio (86.96 ± 3.64 to 93.75 ± 4.80), MMEF 25-75% (86.96 ± 3.64 to 94.16 ± 11.57), peak expiratory flow rate (79.82 ± 14.90 to 92.18 ± 18.96). CONCLUSIONS: Taking steam bath improves the spirometric parameters of healthy adult participants. However, future randomized controlled trials with on a large scale have to done to validate our findings.

Effect of Yoga on Oxidative Stress in Type 2 Diabetes Mellitus: A Systematic Review and Meta-analysis.

BACKGROUND: Diabetes mellitus has a significant impact on public health. Oxidative stress plays a major role in the pathophysiology of Type 2 Diabetes Mellitus (T2DM), leading to various complications of T2DM. Yoga is being widely used in the management of T2DM. The primary objective of this systematic review and meta-analysis is to understand the effects of yoga on oxidative stress parameters among adult patients diagnosed with T2DM. MATERIALS AND METHODS: Electronic databases such as PubMed, Scopus, Cochrane Library and Science Direct from start of the study till March 2020 were searched to obtain eligible studies. Study designs of all nature were included (except case studies and reviews). The primary outcome was Malondialdehyde (MDA) and secondary outcomes included fasting plasma glucose, HbA1C and Superoxide Dismutase (SOD) levels. RESULTS: A total of four trials with a total of 440 patients met the inclusion criteria. The results of meta-analysis indicated that yoga significantly reduced MDA (SMD: -1.4; 95% CI -2.66 to -0.13; P = 0.03; I2 = 97%), fasting plasma glucose levels (SMD: -1.87: 95% CI -3.83 to -0.09; P = 0.06; I2= 99%), and HbA1c (SMD: -1.92; 95% CI - 3.03 to -0.81; P = 0.0007; I2 = 92%) in patients with T2DM. No such effect was found for SOD (SMD: -1.01; 95% CI -4.41 to 2.38; P = 0.56; I2= 99%). CONCLUSION: The available evidence suggests that yoga reduces MDA, fasting plasma glucose and HbA1C, and thus would be beneficial in the management of T2DM as a complementary therapy. However, considering the limited number of studies and its heterogeneity, further robust studies are necessary to strengthen our findings and investigate the long-term benefits of yoga.

Yoga and Naturopathy intervention for reducing anxiety and depression of Covid-19 patients - A pilot study.

BACKGROUND: Coronavirus disease 2019 (Covid-19) infection has caused a prominent psychological and mental havoc among the patients. Till now, there is paucity in literature for the management of psychological problems among patients with Covid-19. So we aimed in our study to assess the effect of Yoga and Naturopathy intervention on anxiety and depression of Covid-19 patients. METHODS: This quasi experimental study was conducted among 130 Covid-19 positive patients admitted in a tertiary care hospital. Yoga and Naturopathic intervention was given for 60 min a day for two weeks. Hospital anxiety depression scale (HADS) and Corona anxiety scale (CAS) was used to assess the generalized anxiety and depression among the patients. RESULTS: Average age of the patients participated was 44 with the range from 36 to 53 years. Among them 85 were male and 45 were female. Of all 130 patients, 33% had symptoms of borderline depression, 9.2% had severe depression, 40% had borderline anxiety and 12.3% had severe anxiety. In CAS, 59 patients (45.38%) reported Covid-19 related dysfunctional anxiety. All the patients showed a significant reduction in the HADS- anxiety (P < 0.01), HADS-depression (p < 0.01) and CAS (p < 0.01) score after the intervention. CONCLUSION: The present study showed significant reduction of anxiety and depression level among the Covid-19 patients. These interventions can be added to the conventional care for better mental and physical wellbeing of the patients after validating the findings with justified study design.

Effect of Sheetali pranayama on cardiac autonomic function among patients with primary hypertension - A randomized controlled trial.

BACKGROUND: Sheetali pranayama is a cooling pranayama practiced for hypertension (HTN). The effects of Sheetali pranayama, as a solitary intervention on cardiovascular and autonomic changes in hypertension is unknown. MATERIALS AND METHODS: The current study was conducted on 100 patients with HTN, randomly allocated to HTN with pranayama (Intervention group,n = 50) and HTN without pranayama (control group,n = 50) group. The intervention group practiced Sheetali pranayama for a period of 3 months. Blood pressure and HRV was assessed before and after the intervention. RESULTS: Intervention group showed a significant (P < 0.05) reduction in blood pressure variables when compared to the control group. In short term HRV, time and frequency domain parameters showed parasympathetic dominance (P < 0.05) in the intervention group. CONCLUSION: Sheetali pranayama significantly reduces blood pressure in patients with HTN and improved heart rate variability. Sheetali pranayama could thus be practiced in addition to regular medications for the efficacious management of HTN.

Immediate effect of Kapalbhathi pranayama on short term heart rate variability (HRV) in healthy volunteers.

OBJECTIVES: Kapalbhathi Pranayam (Kapal = forehead; bhati = shining) is a breathing exercise that has been practiced to cleanse the frontal brain in traditional practices like yoga. Still, there exists a dearth of literature on the effect of Kapalbhathi pranayama on physiological systems. So this present study was carried out to find the immediate effect of "kapalbhathi Pranayam" practice for the period of 5 min on cardiac autonomic function among the healthy volunteers. MATERIALS AND METHODS: Apparently 50 healthy volunteers includes both sex were participated. They were randomly divided into Pranayama (n-25) and control (n-25) group. Pranayama group was practiced kapalbhathi pranayama 5 min (5 cycles) and control group was allowed to do normal breathing (12-16 breath/min). Lead II ECG was recorded for 5 min using simple AD converter before, immediately after practice and 20 min of recovery period. RESULTS: One way Analysis of variance (ANOVA) followed by post hoc test was done using R statistical software. There was a significant (p < 0.05) parasympathetic withdrawal (Root Mean Square of the Successive Differences (RMSSD) - p < 0.04 and HF n.u - p < 0.05) was found in the pranayama group immediately after practice and its was changed to parasympathetic domination (RMSSD - p < 0.04 and HF n.u - p < 0.05) after 20 min of recovery period. CONCLUSION: The present study suggested that though there was parasympathetic withdrawal immediately after practicing kapalbhathi pranayama, 20 min after the recovery period showed a parasympathetic domination in the pranayama group subjects. However, further studies are required to warrant the findings of this study.

Effects of hot foot and arm bath in bronchial asthma: A single case report.

BACKGROUND: Managing the condition of corticosteroid resistant asthmatic patients is quite difficult and challenging despite the plethora of new and modern medications. Hot Foot and Arm Bath (HFAB) is a widely used treatment modality for the management of bronchial asthma in Naturopathy. However, no scientific documentation or study is available so far assessing its effectiveness. CASE SUMMARY: A 33-year-old male was admitted to our hospital, with major complaints of wheezing and dyspnea for two weeks before admission, with a known case of asthma and occasional use of inhalers. Spirometry tests showed a reversible obstructive pattern (pre-bronchodilator FEV1, 1.64L; post-bronchodilator FEV1, 2.02L; reversibility, 16%). The patient underwent HFAB application for 3 days in the morning, and the pulmonary function test was recorded before and immediately after HFAB. The pulmonary function's parameters such as FVC, FEV1, FEV1/FVC ratio, PEF 25-75 %, and PEFR showed significant improvement immediately after the HFAB on day 2 and day 3 when compared to day 1. CONCLUSIONS: The findings suggest that HFAB application has an immediate action on improving lung function in patients with bronchial asthma and could be used as effective adjuvant therapy for the management of bronchial asthma. This is the first case report on HFAB application for bronchial asthma and future extensive studies with a large population would validate our findings.

Effect of Yoga Intervention on Short-Term Heart Rate Variability in Children with Autism Spectrum Disorder.

BACKGROUND: Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by impairment in social interactions, communication, restricted, and repetitive behaviors. Evidence-based treatment options for ASD are limited. Yoga is practiced by over 20 million people worldwide, and multiple studies have investigated yoga as a possible effective intervention for children with ASD. AIM: The aim of this study is to investigate the effect of yoga intervention on short-term heart rate variability (HRV) in children with ASD. METHODOLOGY: In this study, 50 children (38 boys and 12 girls) with ASD were recruited from Swabhimaan Trust, Palavakkam, Chennai. They were randomly grouped into ASD with yoga intervention group (n = 25) and ASD without yoga intervention group (n = 25) by simple lottery method. Yoga group children underwent yoga training for 3 months, and the control group did not receive any such training. For short-term HRV, 15 min electrocardiogram recording in sitting posture was recorded in lead II using a simple analog amplifier. RESULTS: In HRV, time domain parameters such as mean RR interval (0.72 [0.74] to 0.94 [0.92]), standard deviation of the NN intervals (52.04 [54.23] to 74.48 [72.80]), and root of the mean squared differences of successive NN interval (32.60 [34.40] to 40.83 [42.90]) significantly increased in ASD children after yoga intervention. In frequency-domain parameters, high frequency (HF) in n. u (48.08 [47.24] to 58.37 [59.22]) shows a significant increase and low frequency (LF) in n. u (52.4 [51.82] to 40.51 [40.12]), and LF/HF ratio (1.29 [1.31] to 0.78 [0.79]) shows a significant decrease in ASD with yoga intervention group children after 3 months of yoga training. CONCLUSION: Yoga interventions have been successful in bringing parasympathetic dominance in ASD children, and the greater advantage is being a noninvasive way of intervention to support children with ASD and help them to achieve physiological as well as psychological balance.