Effect of massage on blood pressure in patients with hypertension: A meta-analysis.

BACKGROUND: Hypertension (HTN) is a chronic medical condition that affects 1.13 billion people globally. Successful management of HTN is accomplished through both pharmacological and non-pharmacological interventions. Massage therapy, a widely practiced complementary and alternative medicine therapy that alleviates physical discomfort and promotes overall well-being. The current meta-analysis aims to evaluate the effect of massage on blood pressure in patients with HTN. METHODS: Electronic databases, including PubMed, Prospero, Scopus, ClinicalTrials.gov, Embase, and the Cochrane Library, were searched from their inception up to March 2021. All experimental trials that met the (PICO) criteria were included. The primary outcome of the study was blood pressure. A meta-analysis was conducted using a random-effects model to generate a summary of treatment effects, expressed as the effect size (Standardized Mean Difference - SMD), along with a 95% Confidence Interval (CI). RESULTS: Six studies were included in the review, in which 290 patients participated, 148 were in the experimental group and 142 in the control group. Meta-analysis showed a minimal reduction of systolic blood pressure (SMD: -0.65 mmHg, 95% CI: -4.75, 3.55) and diastolic blood pressure (SMD: -0.68 mmHg, 95% CI: -2.43, 1.06) with considerable heterogeneity (I2> 94%). CONCLUSION: The findings demonstrated that massage therapy resulted in a minimal reduction in blood pressure among patients with hypertension. To suggest massage as an effective intervention to reduce blood pressure further randomized control trials are recommended. Additionally, the literature is limited and still emerging, further large prospective studies with long follow-ups are warranted to verify the findings from this meta-analysis.

Aromatherapy for Postpartum Depression: A Systematic Review and Meta-Analysis.

Objective: The incidence and prevalence of postpartum depression is increasing due to multiple factors. Aromatherapy is a widely used complementary and alternative (CAM) therapy in the management of depression. This systematic review and meta-analysis was done to find the effect of aromatherapy on postpartum depression. Materials and methods: Electronic databases like PubMed, Scopus, Cochrane Library and Science Direct since inception till February 2021 were searched using related keywords to obtain eligible studies. Randomised controlled trial studies (RCTs) reporting the effects of aromatherapy therapy in women with postpartum depression were included. Aromatherapy studies conducted on population other than postpartum women were excluded. The primary outcome was depression scores obtained by using valid depression scales. Meta-analysis was performed using the random-effects model of Der Simonian and Laird to produce summary treatment effects in terms of Hedges' g effect sizes with 95% confidence interval (CI). Results: A total of 4 RCTs (n=303) were included. The results indicate that aromatherapy (Hedges' g =-0.94, 95 CI= -2.55, 0.61, I2=88%, p<0.01) reduces depression levels among postpartum women without statistical significance. Conclusion: The available evidences suggest aromatherapy may be effective in reducing post-partum depression. The number of scientific evidences currently available are very limited and more studies with robust study designs are required to strongly recommend aromatherapy in the management of post-partum depressions. However, being a safer intervention with no adverse effects being reported in previous studies, aromatherapy could definitely be added as an effective complementary therapy in the management of post-partum depression along with conventional medicine.

Does hydrotherapy influence plasma glucose levels in type 2 diabetes? - A scoping review.

OBJECTIVES: Hydrotherapy is a commonly used treatment modality to manage various conditions including diabetes in the Naturopathy system of medicine. The objective of the current scoping review is to find the effectiveness of hydrotherapy on plasma blood glucose levels in type 2 diabetes. CONTENT: Arksey and O'Malley's five-stage framework was adopted for this scoping review. The studies which used hydrotherapy intervention for the management of diabetes or the effect of hydrotherapy on plasma glucose levels were considered eligible. PubMed/MEDLINE, EMBASE, Cochrane library, and Google scholar were searched for English- language published articles till December 20, 2022. The following Medical Subject Headings (MeSH) and keyword search terms were used ("diabetes" OR "type 2 diabetes" OR "diabetes mellitus" OR "plasma glucose level") AND ("hydrotherapy" OR "water therapy" OR "balneotherapy"). Two investigators independently assessed the studies for inclusion. Review articles, abstracts, and articles including the aquatic exercises as interventions were excluded. SUMMARY: In total, six studies met the inclusion criteria. Out of six, two studies used hot therapies, two studies cold therapy, and the remaining two used both hot and cold as interventions. The study results showed that hydrotherapy can be used as an effective intervention tool for blood glucose levels in patients with type 2 diabetes. OUTLOOK: Integrating hydrotherapy treatments alongside conventional management can reduce blood glucose levels and thus reduce diabetes-related complications.

Knowledge, attitude and perception of complementary and alternative system of medicine in Tamilnadu and Pudhucherry, South India.

OBJECTIVES: Complementary and Alternate medicine (CAM) remains as the major source of healthcare for majority of the Indian population. This widespread resource needs to be strengthened, adequately trained and effectively utilized in the national health care delivery system for delivering an integrated and effective health care system. METHODS: A cross sectional study was conducted involving 200 adults in two different settings-a community setting (n=100), and a hospital setting (n=100). A semi-structured questionnaire was used. RESULTS: Both in the community and in the hospital, siddha (80%) was the most well-known system of medicine, followed by Yoga (72%) and Naturopathy in the study population. However, the knowledge about the various available CAM therapies still seemed to be limited. CONCLUSIONS: Opinion on the integrated approach along with conventional medicine was welcoming. Still more awareness about these systems is required to facilitate integrative medicine in healthcare settings.

Effect of Bhramari Pranayama intervention on stress, anxiety, depression and sleep quality among COVID 19 patients in home isolation.

Background: COVID-19 outbreak is considered to be a major public health concern as it has a negative impact on the patient's psychological health. In addition, patients under home isolation might be more panic and in stress. In this study, we examined the effect of Bhramari Pranayama (Bhr.P) intervention on patients' psychological distress during home isolation. Methods: Ninety-two asymptomatic COVID-19 patients were recruited from the host hospital and willing patients who satisfied the inclusion criteria (n = 42) were selected for the study. The patients were given Bhr.P intervention (20 min) through online for 15 days. Participants were assessed with Depression Anxiety and Stress Scale-21 (DASS-21), Pittsburgh Sleep Quality Index (PSQI), and Quality of life (WHOQOL-BREF) at baseline and post-intervention. Results: Bhr.P practice has shown a significant (P < 0.05) reduction in DASS-21 score of depression, anxiety and stress. In addition, the patients stated significant improvement in quality of sleep (PSQI; p < 0.05) and quality of life (WHOQOL-BREF; p < 0.05) after the intervention. Conclusion: Our findings indicate that Bhr.P intervention had a positive impact on psychological health as well as quality of sleep among the COVID-19 patients during home isolation. However, it needs to be confirmed by multi-site randomized controlled trials.Clinical trial registration: CTRI/2021/04/032845.

Yoga for children in the new normal - experience sharing.

OBJECTIVES: Covid-19 Pandemic has affected everyone's mental health. In addition to several preventive measures such as wearing a mask, using sanitizer, measures also need to be taken to prevent anxiety and depressive disorders due to this unexpected crisis situation. Practicing yoga is one of the simple, scientific methods to combat stress and prevent anxiety among children. METHODS: The scientific evidence and anecdotal experiences on benefits of yoga is described in this paper, highlighting the importance of yoga in nurturing the mental well-being in children. RESULTS: Scientifically designed and conducted studies as part of the research programs by health professionals objectively conclude that mental health parameters improve significantly with yoga as an intervention. In addition to mental health, yoga will also improve the physical health and boost immunity among children which will also help in reducing the infection rate in children. CONCLUSIONS: As a way forward, authors strongly recommend establishing yoga as a curriculum at scale to cover the vast vulnerable population of young children who are the future of the nation.

Effects of Bhramari Pranayama on health - A systematic review.

Pranayama, a branch of yoga practice is extremely beneficial to mankind in maintaining sound physical and mental health and this article aims to attain an insight on the studies conducted on the effectiveness of Bhramari Pranayama (Bhr.P) on health. The studies done until May 2016 were found using Medline, Embase, Google scholar and manual search. Studies conducted on the health effectiveness of Bhr.P specifically were included on the basis of prisma guidelines. The data were defined by their objectives, methodology, study setting, findings, interventions done and implications suggested in the study. Methodological Quality Rating Scale (MQRS) and Newcastle-Ottawa Scale (NOS) were used in reviewing and reporting results of the included studies. 6 studies satisfied the inclusion criteria; 2 studies were done on the cold pressor test, one on heart rate and BP, one on EEG changes, one each on the inhibitory response and tinnitus condition. In the included studies, the Bhr.P practices have shown para-sympathetic dominance. There are some encouraging effects of Bhr.P on various physiological systems. Methodological quality of the included studies was evaluated to be very low and none of them were RCTs. Yet the available studies are heterogeneous, dealing in different grounds and this heterogeneity serves as a resource for the limited scope of studies on Bhr.P. Therefore, further large-scale, properly designed, randomized trials of Bhr.P on various systems have to be done to justify these effects efficiently.