A Systematic Review and Meta-Analysis of Premenstrual Syndrome with Special Emphasis on Herbal Medicine and Nutritional Supplements.

Herbal medicine and nutritional supplements are suggested to treat premenstrual somatic and psycho-behavioural symptoms in clinical guidelines; nonetheless, this is at present based on poor-quality trial evidence. Hence, we aimed to design a systematic review and meta-analysis for their effectiveness in alleviating premenstrual symptoms. The published randomized controlled trials (RCTs) were extracted from Google scholar, PubMed, Scopus and PROSPERO databases. The risk of bias in randomized trials was assessed by Cochrane risk-of-bias tool. The main outcome parameters were analysed separately based on the Premenstrual Symptom Screening Tool and PMTS and DRSP scores. Secondary parameters of somatic, psychological, and behavioural subscale symptoms of PSST were also analysed. Data synthesis was performed assuming a random-effects model, and standardized mean difference (SMDs) was analysed using SPSS version 28.0.0 (IBM, Armonk, NY, USA). A total of 754 articles were screened, and 15 RCTs were included (n = 1211 patients). Primary results for participants randomized to an intervention reported reduced PSST (n = 9), PMTS (n = 2), and DSR (n = 4) scores with (SMD = -1.44; 95% CI: -1.72 to -1.17), (SMD = -1.69; 95% CI: -3.80 to 0.42) and (SMD = 2.86; 95% CI: 1.02 to 4.69) verses comparator with substantial heterogeneity. Physical (SMD = -1.61; 95% CI = -2.56 to -0.66), behavioural (SMD = -0.60; 95% CI = -1.55 to0.35) and mood (SMD = 0.57; 95% CI = -0.96 to 2.11) subscale symptom groupings of PSST displayed similar findings. Fifty-three studies (n = 8) were considered at low risk of bias with high quality. Mild adverse events were reported by four RCTs. Based on the existing evidence, herbal medicine and nutritional supplements may be effective and safe for PMS.

Combination of music with lifestyle modification versus lifestyle modification alone on blood pressure reduction - A randomized controlled trial.

OBJECTIVE: To evaluate the change in blood pressure (BP) after 3 months of music intervention combined with lifestyle modifications, in comparison with conventional lifestyle modifications. METHODS: A Prospective randomized control trial was conducted on hundred prehypertensives or stage I hypertensives who were randomly divided into two groups (n = 50 each). Both the groups were given lifestyle modifications while one had added music intervention (raga bhimpalas) for 3 months. Main outcome measures were 24 h ambulatory BP monitoring, stress levels, and biomarkers of hypertension. RESULTS: Mean (SD) of diastolic BP (DBP) pre and post intervention were overall = 85.1(6.8) and 83(8.7){P = 0.004}, awake = 87.7(7.6) and 85.9(9.2){P = 0.021}. Regression analysis showed association between diastolic BP change and post-intervention stress score in the music intervention group. Significant change in BP was seen among those who were prehypertensives prior to intervention. CONCLUSION: Music decreased DBP and when used as an adjunct benefitted subjects with initial BP in prehypertension range.

Music versus lifestyle on the autonomic nervous system of prehypertensives and hypertensives--a randomized control trial.

OBJECTIVES: Ragas of Indian music are said to be beneficial in normalizing blood pressure (BP). The objective of this study was to evaluate the effect of passive listening to relaxing raga on the autonomic functions of hypertensives and prehypertensives and provide scientific evidence. METHODS: Ethical clearance was obtained from the institutional review board. A prospective, randomized controlled trial was done on hundred prehypertensives/stage I hypertensives, randomly divided into two groups (n=50 in each). Group 1 received music intervention along with lifestyle modifications while Group 2 received only lifestyle modifications (according to Joint national committee VII guidelines). Group 1 listened to raga bhimpalas played on flute for 15min daily for at least 5 days/week for 3 months. The main outcome measures were heart rate variability (HRV) (Power lab 15T, AD Instruments), BP and stress levels (State Trait anxiety inventory score). All HRV variables were log transformed for analysis. Statistical analysis was done using SPSS version 18.0 with P<0.05 being considered statistically significant. RESULTS: Group 1 exhibited significant reduction in stress levels, diastolic BP and systolic BP decreased in Group 2 after intervention. Insignificant rise in parasympathetic parameters of HRV (SDNN, RMSSD, HF ms(2), HF nu) was seen after intervention in both the groups. We found significantly increased parasympathetic and lower sympathetic parameters (LF ms(2), LF nu, LF/HF) in Group 1 and 2 males and females of Group 2. The results suggest that females of Group 1 were least compliant with the given intervention. CONCLUSIONS: Passive listening to Indian music along with conventional lifestyle modifications has a role in normalizing BP through autonomic function modification and thus can be used as a complementary therapy along with other lifestyle modifications.