Usefulness of Yoga in the management of tinnitus during COVID-19: A narrative review.

The emergence of Coronavirus disease 2019 (COVID- 19) has resulted in an unprecedented global health crisis. Tinnitus is the most commonly reported symptom when the COVID-19 impacts the auditory-vestibular system. There are a variety of management strategies for amelioration of tinnitus including Yoga. The present review deals with three issues: one, occurrence of tinnitus in persons affected by COVID-19; two, the impact of COVID-19 situation on tinnitus severity; and three, the potential of Yoga as an intervention strategy. Literature search was carried out through search engines like PubMed, Cochrane, Web of Science and Google scholar using keywords like 'tinnitus', 'COVID-19' and 'Yoga'. The relevant studies were identified and the findings summarized in a narrative manner. Based on the evidence obtained in the present review, the authors propose that yoga can be used as an effective strategy in overcoming the psychosocial factors associated with COVID-19 particularly in this pandemic and related lockdown situation. It is also proposed here that teleyoga can serve as a practical, feasible and safe mode for providing therapeutic services for tinnitus-related issues particularly in the present pandemic situation.

Effect of Yoga on Quality of Life in Patients with Pulmonary Tuberculosis: A Randomized Control Trial.

Introduction: Yoga is emerging as one of the holistic approaches to respiratory diseases. The scope of yoga is expanding in communicable diseases with physical, mental, and societal benefits. Aim and Objective: The present study aims to evaluate the effect of integrated yoga as an adjuvant therapy to the National Tuberculosis Elimination Programme (NTEP) on assessing health-related Quality of Life (QoL) in patients with pulmonary tuberculosis (PTB). Setting and Design: A randomized controlled trail study was conducted in a tertiary care teaching hospital. Methodology: The study screened 826 PTB patients; 72 patients were found suitable and agreed to participate. The PTB patients were randomly assigned to either a yoga group (n = 36) or a control group (n = 36) using the sequentially numbered opaque sealed envelope technique. The control group received standard-of-care treatment as per NTEP, and the yoga group practiced 45 min of integrated yoga for 8 weeks along with standard of care. The World Health Organization Quality of Life (WHOQOL-BREF) questionnaire was used to collect the data at baseline and after 8 weeks of intervention. Results: The results of within-group comparisons in both the groups showed that there was a significant improvement in physical (P < 0.01), psychological (P < 0.01), and social (P < 0.01), with P ≤ 0.05 being considered statistically significant except environmental domain. Between groups, analysis shows that in the preintervention, there was no difference between the yoga and control group as P > 0.05. After the yoga intervention, there was an enhancement in QoL scores with three domains except the environmental domain (P = 0.28). Conclusion: The study evidence supports the use of yoga as a complementary therapy for the NTEP in patients with PTB may improve their QoL.

Oxidative stress serves as a key checkpoint for IL-33 release by airway epithelium.

BACKGROUND: Interleukin (IL)-33 is implicated in the pathophysiology of asthma and allergic diseases. However, our knowledge is limited regarding how IL-33 release is controlled. The transcription factor nuclear factor-erythroid-2-related factor 2 (Nrf2) plays a key role in antioxidant response regulation. OBJECTIVE: The goal of this project was to investigate the role of cellular oxidative stress in controlling IL-33 release in airway epithelium. METHODS: Complementary approaches were used that included human bronchial epithelial cells and mouse models of airway type-2 immunity that were exposed to fungus Alternaria extract. The clinically available Nrf2 activator 2-cyano-3,12-dioxooleana-1,9-dien-28-oic acid methyl ester (CDDO-Me) was used to evaluate the role of Nrf2-induced antioxidant molecules. RESULTS: Human bronchial epithelial cells produced reactive oxygen species (ROS) when they were exposed to Alternaria extract. ROS scavengers, such as glutathione (GSH) and N-acetyl cysteine, prevented extracellular secretion of ATP and increases in intracellular calcium concentrations that precede IL-33 release. Administration of CDDO-Me to mice enhanced expression of a number of antioxidant molecules in the lungs and elevated lung levels of endogenous GSH. Importantly, CDDO-Me treatment reduced allergen-induced ATP secretion and IL-33 release by airway epithelial cells in vitro and protected mice from IL-33 release and asthma-like pathological changes in the lungs. CONCLUSIONS: The balance between oxidative stress and antioxidant responses plays a key role in controlling IL-33 release in airway epithelium. The therapeutic potential of Nrf2 activators needs to be considered for asthma and allergic airway diseases.

Effect of integrated Yoga on neurogenic bladder dysfunction in patients with multiple sclerosis-A prospective observational case series.

BACKGROUND: Neurogenic bladder dysfunction (NBD) is a common distressful symptom in multiple sclerosis (MS) affecting quality of life. Yoga has been widely used in treating various symptoms of patients with MS. OBJECTIVES: To evaluate the effect of integrated Yoga for NBD in patients with MS as an adjunct to standard medical care. DESIGN: This open arm, pre-post study design assessed the outcome measures at base line and after 21 days of integrated Yoga intervention. SETTING: study was conducted at the center for neurological rehabilitation at KWA-Klinik Stift Rottal in Bad Griesbach, Germany. Eleven MS patients with NBD (mean age 46.7±11.24 years) with mean duration 17.2 years volunteered to participate in the study. INTERVENTIONS: integrated Yoga which includes preparatory yogic loosening and breathing practices, Nadishuddi pranayama (alternate nostril breathing), moola bandha (anal lock), kapalbhati (rapid nostril breathing) and deep relaxation technique was given for 2h per day for continuous 21 days. OUTCOME MEASURES: ultrasound scanning for post void residual urine volume (PVR), micturition check list (MCL), incontinence impact questionnaire-7 (IIQ-7) andurogenital distress inventory-6 (UDI-6) were used. RESULTS: Paired sample t-test showed significant improvement in post void residual urine (62.34%, p<0.05), scores on micturition frequency checklist (25%, p<0.05), incontinence impact questionnaire-7 (32.77%, p<0.05) and uro-genital distress inventory-6 (26.33%, p<0.05). CONCLUSION: This study points to the safety and effectiveness of integrated Yoga for bladder symptoms as an adjunct to standard care in multiple sclerosis patients with neurogenic bladder dysfunction in Germany. Further trails are necessary to confirm these findings.

Primary hypoparathyroidism: psychosis in postpartum period.

We report a 30-yr-old lady who was being treated as postpartum psychosis. Patient had generalized tonic clonic convulsions and was found to have bilateral cataract. Her serum calcium, serum magnesium and serum parathyroid were low. On correction of serum magnesium her PTH did not increase. She was hence diagnosed as primary hypoparathyroidism. On correction of her serum calcium her psychosis improved.

Maggot debridement therapy in chronic wound care.

OBJECTIVE: To review the current evidence on the mechanism of actions and clinical applications of maggot debridement therapy. DATA SOURCES: Literature search of PubMed and Medline was performed up to January 2007. STUDY SELECTION: Original and major review articles related to maggot debridement therapy were reviewed. Key words used in the literature search were 'maggot debridement therapy', 'wound healing', and 'chronic wound management'. DATA EXTRACTION: All relevant English and Chinese articles. DATA SYNTHESIS: The mechanism of such maggot therapy was shown to be due to the debridement, disinfection, and wound healing enhancement actions of maggot excretions/secretions. The efficacy of maggot debridement therapy in chronic wound management has been demonstrated in chronic venous ulcers, pressure ulcers, and diabetic ulcers. There is also a new delivery system for the excretions/secretions, which has been shown to be as effective as using live maggots. CONCLUSIONS: Maggot debridement therapy has been shown to be a safe and effective means of chronic wound management. However, there are a number of limitations when considering its local applicability. Future development of the delivery system may help to overcome some of these limitations and improve its acceptability.

A case report of patient practising yoga leading to dental erosion.

The article presents the case of a patient who was practising Yoga (Kunjal kriya) which led to dental erosion. Dental erosion can be due to extrinsic or intrinsic causes. The intrinsic causes include vomiting due to anorexia nervosa, regurgitation due to abnormality in gastro-intestinal tract or rumination. A 38-year-old male patient presented with a rare aetiology of dental erosion. He had practiced kunjal kriya one of the yogic exercises described in ancient India. In kunjal kriya the patient vomits on an empty stomach in order to clean his or her gastro-intestinal tract. The patient had practiced this form of exercise for over 12 years which had led to severe dental erosion. A proper case history should be evaluated for every patient so that they can be counselled for any factors that could be detrimental to dental health. Early diagnosis is paramount in recognising the aetiology of dental erosion so that detrimental effects on the dentition can be prevented.

Transcutaneous absorption of oil in preterm babies--a pilot study.

This study was conducted to determine transcutaneous absorption of oil in preterm neonates. A mixture of coconut oil and Meadowfoam oil which contains unique fatty acids, which acted as marker fatty acids was applied to the skin of babies. One mL blood was collected before and one hour after post oil application. Both pre and post oil application serum samples were hydrolysed and derivatised with 2-phenyl hydrazine hydrochloride in order to detect fatty acids by HPLC analysis on C-8 column. None of the pre oil application serum sample showed the presence of the marker fatty acids. The post oil application serum sample of all the 12 babies showed the presence of marker fatty acids of Meadowfoam oil which indicates transcutaneous absorption of oil in preterm babies.

Therapeutic potential of yoga practices in modifying cardiovascular risk profile in middle aged men and women.

AIMS OF STUDY: To study effect of yoga on the physiological, psychological well being, psychomotor parameter and modifying cardiovascular risk factors in mild to moderate hypertensive patients. METHODS: Twenty patients (16 males, 4 females) in the age group of 35 to 55 years with mild to moderate essential hypertension underwent yogic practices daily for one hour for three months. Biochemical, physiological and psychological parameters were studied prior and following period of three months of yoga practices, biochemical parameters included, blood glucose, lipid profile, catecholmines, MDA, Vit. C cholinesterase and urinary VMA. Psychological evaluation was done by using personal orientation inventory and subjective well being. RESULTS: Results showed decrease in blood pressure and drug score modifying risk factors, i.e. blood glucose, cholesterol and triglycerides decreased overall improvement in subjective well being and quality of life. There was decrease in VMA catecholamine, and decrease MDA level suggestive decrease sympathetic activity and oxidant stress. CONCLUSION: Yoga can play an important role in risk modification for cardiovascular diseases in mild to moderate hypertension.

Effect of yogic practices on subjective well being.

Forty eight healthy volunteers who participated in the practice of yoga over a period of 4 months were assessed on Subjective Well Being Inventory (SUBI) before and after the course in order to evaluate the effect of practice of yoga on subjective feelings of well-being and quality of life. A significant improvement in 9 of the 11 factors of SUBI was observed at the end of 4 months, in these participants. The paper thus, reiterates the beneficial effects of regular practice of yoga on subjective well being.