Yoga Module Development and Validation for Sickle Cell Disease.

Introduction: Sickle cell disease (SCD) is a genetic blood disorder that affects the shape and function of red blood cells (RBCs), which can lead to several health problems affecting the quality of life. SCD can be treated with certain expensive treatments such as RBC transfusion, hydroxyurea, stem cell transplantation, gene therapy, or bone marrow transplant. However, some of the most common symptoms such as pain, anxiety, and stress can also be alleviated with alternative therapies like yoga. In light of this, there is a need for the development of a specific yoga module (YM) for SCD that can complement the current therapies. Objective: To develop and validate a YM for SCD. Methodology: Concise literature reports on yoga practices used for varied symptoms/comorbidities associated with SCD were compiled and presented to focus groups. Based on the presented report and personal experience, the focus group created a preliminary version of the module. The preliminary module was further refined based on content validity ratio (CVR) following module validation by 33 yoga experts. Results: One hour ten minutes module developed by the focus group had in total 27 practices including, loosening exercises, asanas, pranayama, relaxation techniques, and meditation. After validation by the experts, 21 practices with a CVR ≥ 0.33 were retained. The predominant reason for excluding 12 practices was intensity, which may have some adverse effect on sickle cell comorbidities. Conclusion: The module developed is the first validated module for SCD.

Role of Yoga and Its Plausible Mechanism in the Mitigation of DNA Damage in Type-2 Diabetes: A Randomized Clinical Trial.

BACKGROUND: Although yoga is found to be beneficial in the management of type 2 diabetes (T2D), its mechanism of action is poorly understood. T2D is also known to be associated with increased oxidative stress (OS) and DNA damage. PURPOSE: This study examines how yoga modulates OS-induced DNA damage and the efficiency of DNA repair in T2D conditions. METHODS: In this assessor-masked randomized clinical trial, T2D subjects (n = 61), aged (Mean ± SD, 50.3 ± 4.2) were randomly allocated into Yoga group (31) that received 10 weeks of yoga intervention and Control (30) with routine exercises. Molecular and biochemical assessments were done before and after the intervention period. Structural Equation Modeling using "R" was used for mediation analysis. RESULTS: At the end of the 10th week, Yoga group showed significant reduction in DNA damage indicators like Tail Moment (-5.88[95%CI: -10.47 to -1.30]; P = .013) and Olive Tail Moment (-2.93[95%CI: -4.87 to -1.00]; P < .01), oxidative DNA damage marker 8-OHdG (-60.39[95%CI: -92.55 to -28.23]; P < .001) and Fasting Blood Sugar (-22.58[95%CI: -44.33 to -0.83]; P = .042) compared to Control. OGG1 protein expression indicating DNA repair, improved significantly (17.55[95%CI:1.37 to 33.73]; P = .034) whereas Total Antioxidant Capacity did not (5.80[95%CI: -0.86 to 12.47]; P = 0.086). Mediation analysis indicated that improvements in oxidative DNA damage and DNA repair together played a major mediatory role (97.4%) in carrying the effect of yoga. CONCLUSION: The beneficial effect of yoga on DNA damage in T2D subjects was found to be mediated by mitigation of oxidative DNA damage and enhancement of DNA repair. CLINICAL TRIAL INFORMATION: (www.ctri.nic.in) CTRI/2018/07/014825.

Study protocol for yoga-based lifestyle intervention for healthy ageing phenotype in the older adults (yHAP): a two-armed, waitlist randomised controlled trial with multiple primary outcomes.

INTRODUCTION: The conceptualisation of healthy ageing phenotype (HAP) and the availability of a tentative panel for HAP biomarkers raise the need to test the efficacy of potential interventions to promote health in older adults. This study protocol reports the methodology for a 24-week programme to explore the holistic influence of the yoga-based intervention on the (bio)markers of HAP. METHODS AND ANALYSIS: The study is a two-armed, randomised waitlist controlled trial with blinded outcome assessors and multiple primary outcomes. We aim to recruit 250 subjects, aged 60-80 years from the residential communities and old age clubs in Bangalore city, India, who will undergo randomisation into intervention or control arms (1:1). The intervention will include a yoga-based programme tailored for the older adults, 1 hour per day for 6 days a week, spread for 24 weeks. Data would be collected at the baseline and post-intervention, the 24th week. The multiple primary outcomes of the study are the (bio)markers of HAP: glycated haemoglobin, low-density lipoprotein cholesterol (LDL-C), systolic blood pressure, and forced expiratory volume in 1 s for physiological and metabolic health; Digit Symbol Substitution Test, Trail Making Tests A and B for cognition; hand grip strength and gait speed for physical capability; loneliness for social well-being and WHO Quality of Life Instrument-Short Form for quality of life. The secondary outcomes include inflammatory markers, tumour necrosis factor-alpha receptor II, C reactive protein, interleukin 6 and serum Klotho levels. Analyses will be by intention-to-treat and the holistic impact of yoga on HAP will be assessed using global statistical test. ETHICS AND DISSEMINATION: The study is approved by the Institutional Ethics Committee of Swami Vivekananda Yoga Anusandhana Samsthana University, Bangalore (ID: RES/IEC-SVYASA/143/2019). Written informed consent will be obtained from each participant prior to inclusion. Results will be available through research articles and conferences. TRIAL REGISTRATION NUMBER: CTRI/2021/02/031373.

Effect of yoga on plasma glucose, lipid profile, blood pressure and insulin requirement in a patient with type 1 diabetes mellitus.

OBJECTIVES: The objective of the study is to evaluate the short-term effect of yoga on plasma glucose, lipid profile, blood pressure and insulin requirement in a patient with type 1 diabetes mellitus (T1DM). CASE PRESENTATION: A 28-years old female was diagnosed with T1DM at the age of seven. She was under Human Mixtard insulin 30-70, thrice/day for 15-15-15 units. She had a history of poor glycemic control, diabetic ketoacidosis and hypoglycemic shock. At the age of 27, she got admitted with complaints of general weakness, joints stiffness and weight loss in our holistic health centre and underwent two weeks of yoga. Results showed a better reduction in the plasma glucose levels, lipid profile, blood pressure and insulin dose and an increase in hemoglobin levels with no episodes of hypoglycemia after yoga. CONCLUSIONS: Yoga might be considered as a safer and effective adjuvant in the management of T1DM.

Correlation of Electrophotonic Imaging Parameters With Fasting Blood Sugar in Normal, Prediabetic, and Diabetic Study Participants.

INTRODUCTION: Electrophotonic imaging (EPI), also known as gas discharge visualization, is a technique of capturing images of phenomena not quantifiable by the naked eye. Different sectors at the tip of fingers represent various organs and systems as per the Chinese system of acupuncture. The images from these fingertips can be used to determine the state of health. This is done with the help of a CCD camera fitted in the EPI equipment and the specific software relevant for analysis. AIM: To observe the correlation between EPI parameters and fasting blood sugar (FBS) levels in normal, prediabetic, and diabetic study participants. MATERIALS AND METHODS: A total of 102 participants were selected for this study from various yoga camps and Arogyadham at Swami Vivekananda Yoga Anusandhana Samsthana Yoga University, Bengaluru, India. The selected participants belonged to 3groups-normal, prediabetic, and diabetic-depending on the FBS levels. The distribution of participants was 29 normal, 13 prediabetic, and 60 diabetic. RESULTS: Regression analysis in the case of prediabetics showed a significant relationship of FBS with pancreas and right kidney. In the case of normal participants, a significant relationship of FBS was found with area and form coefficient of the EPI gram. For diabetics, regression analysis showed significant relationship of FBS with immune organs, left kidney, area, intensity, and entropy of EPI grams. CONCLUSION: FBS correlates differently in the normal, prediabetic, and diabetic groups. In the prediabetic group, correlation of FBS with EPI parameters pancreas and right kidney is noteworthy and in line with latest findings in medical research.