Impact of Nadi Shuddhi Pranayama on Apnea Hypopnea Index, Respiratory Distress Index, and Oxygen Desaturation Index Among Adolescents With Sleep Apnea Syndrome.

Background Sleep apnea syndrome has gained significant recognition over the last decade as a potential cause of substantial childhood morbidity. This study aimed to evaluate the impact of the Apnea Hypopnea Index (AHI), Respiratory Distress Index (RDI), and Oxygen Desaturation Index (ODI) among adolescents with sleep apnea syndrome. Objectives The objective of this study is to compare the impact of Nadi Shuddhi Pranayama with routine treatment modalities on the AHI, RDI, and ODI among adolescents with sleep apnea syndrome. Specifically, the study aims to evaluate the effectiveness of Nadi Shuddhi Pranayama in improving AHI, RDI, and ODI in this population. Methods This study was an interventional case-control study and enrolled 34 adolescents aged 10 to 18 years who were diagnosed with sleep apnea syndrome. The participants were divided into two groups: the Nadi Shuddhi Pranayama group (n=17) and the control group (n=17). Baseline assessments included the collection of demographic information, medical history, and polysomnography results to determine the AHI, RDI, and ODI. Follow-up assessments were conducted post-intervention to measure changes in the AHI, RDI, and ODI. Results There were no significant differences between groups in terms of age (p = 0.176) or gender distribution (p = 0.300). After the intervention period, participants in the Nadi Shuddhi Pranayama group showed significant improvements in the Apnea Hypopnea Index compared to the standard care group (p = 0.007). However, there were no significant differences in the Respiratory Distress Index (p = 0.547) or Oxygen Desaturation Index (p = 0.304) between the groups post-intervention. Subgroup analysis based on severity categories (Mild, Normal) for the Apnea Hypopnea Index showed a significant difference between the Nadi Shuddhi Pranayama and standard care groups (p = 0.037). However, there were no significant differences in the Respiratory Distress Index (p = 0.300) and Oxygen Desaturation Index (p = 0.169) between the groups in this subgroup. Conclusion These findings suggest that Nadi Shuddhi Pranayama may improve the Apnea Hypopnea Index in adolescents with sleep apnea, particularly in those with mild symptoms, but did not significantly affect the Respiratory Distress Index or Oxygen Desaturation Index.

Comparative Study of Myofascial Exercise and the Voluntary Breathing Technique on the Apnea-Hypopnea Index Among Adolescents.

Background Myofunctional therapy has shown promise in addressing sleep-disordered breathing. This study aimed to investigate the efficacy of myofascial exercise and voluntary breathing techniques in reducing the apnea-hypopnea index (AHI) among adolescents. Methodology In this randomized controlled study, adolescents aged 13-18 with sleep-disordered breathing were randomly assigned to one of three groups (n=40 per group): myofascial exercise, voluntary breathing techniques, and a standard care control group. Baseline assessments, including the AHI and sleep quality, were conducted before the interventions. A polysomnography (PSG) sleep study was performed in a sleep laboratory, with recordings conducted over six to eight hours during the night to calculate the AHI. The myofascial exercise and voluntary breathing technique groups received their respective interventions, while the control group received standard care. Post-intervention assessments were conducted to measure changes in AHI and other outcomes. Results The study found no significant differences in age, BMI, and gender among the three groups. However, significant differences were observed in AHI and sleep quality measures. The control group's AHI was 8.72 ± 1.78, whereas the myofascial exercise group (4.82 ± 1.42) and the voluntary breathing group (6.81 ± 1.83) exhibited more substantial reductions (p < 0.001). Similarly, while baseline sleep quality scores did not differ, significant improvements were observed in all groups post-intervention, with more substantial enhancements in the myofascial exercise (4.38 ± 1.19) and voluntary breathing (7.23 ± 1.76) groups. The analysis of baseline AHI categories revealed no significant differences, but at follow-up, significant variations emerged among the groups, indicating greater reductions in AHI categories in the myofascial exercise and voluntary breathing groups compared to the control group. Conclusion These findings indicate that incorporating myofascial exercises or voluntary breathing techniques into treatment plans for adolescents with sleep-disordered breathing can result in significant improvements in AHI and overall sleep quality.

An Efficient Cardiac Arrhythmia Onset Detection Technique Using a Novel Feature Rank Score Algorithm.

The interpretation of various cardiovascular blood flow abnormalities can be identified using Electrocardiogram (ECG). The predominant anomaly due to the blood flow dynamics leads to the occurrence of cardiac arrhythmias in the cardiac system. In this work, estimation of cardiac output (CO) parameter using blood flow rate analysis is carried out, which is a vital parameter to identify the subjects with left- ventricular arrhythmias (LVA). In particular, LVA is a resultant component of characteristic changes in blood rheology (blood flow rate). The CO is an intrinsic parameter derived from the stroke volume (SV) characterized by end-diastolic/systolic volumes (EDV/ESV) and heart rate. The pumping of blood from left ventricle (LV) reconciles in to R-R intervals depicted on ECG, which are used for heart rate estimation. The deviation from the nominal values of CO implies that, the subject is more prone to LVA. Further, the identification of subjects with LVA is accomplished by computing the features from the ECG signals. The proposed Feature Ranking Score (FRS) algorithm employs different statistical parameters to label the score of the extracted features. The feature score enables the selection optimal features for classification. The optimal features are further given to the Least Square- Support Vector Machine (LS-SVM) classifier for training and testing phases. The signals are acquired from public domain MIT-BIH arrhythmia database, used for validating the proposed technique for identifying the LVA using blood flow.

Measuring Respiratory Pressures with Mercury Manometer in Low Economic Health Care Settings- An Analytical Study.

INTRODUCTION: Health care economics restricts many health centers from using hi-tech diagnostics equipment. Mercury manometers are used for calibration of pressure transducers. If standardized it would be a cost effective, simple alternative to transducers in low economic settings. AIM: To analyse the feasibility of mercury manometer usage in respiratory pressure measurement. MATERIALS AND METHODS: The experimental study was conducted with 30 healthy volunteers of age group 17-19 yrs. They were recruited by using simple random sampling method. The volunteers were made familiarized to lab environment, instrument and techniques of maximum inspiratory (Pimax) and expiratory pressures (Pemax). Then parameters were recorded using mercury manometer connected to different syringes as mouth piece (2.5 ml, 10 ml, and 20 ml) and with sphygmomanometer. Statistical analysis was done by using IBM SPSS statistics version 21. RESULTS: The Pimax was 111.07 ± 6.53 with a 2.5 ml syringe as mouth piece. With 20 ml syringe it was 61.47 ± 9.98. PEmax with 2.5 ml syringe was 70.33 ± 8.19 with a confidence limit of 2.93 and with sphygmomanometer was 99.33 ± 8.16 with a confidence limit of 2.92. There was a change in recorded pressure and the correlation analysis result showed a significant difference from both above and below 10 ml mouth piece range. CONCLUSION: Mercury manometers could be used for recording respiratory pressures in low economic facilities once standardized. Size of syringe to be used as mouth piece needs further more works although this study finds 10 ml syringe as suitable.

Study to Predict Vascular Dysfunctions in High Risk Young Adults- An Immediate Non-Invasive Investigation to Prevent Early Vascular Ageing.

INTRODUCTION: Normal vascular is associated with gradual change of vascular structure and function, resulting in increased arterial stiffening and decreased arterial compliance. Arterial stiffness is a marker of vascular ageing and a predictor of cardiovascular events. Premature or early vascular ageing is measured by pulse wave velocity or the arterial augmentation index based on pulse wave analysis. AIM: To study the predictor of vascular dysfunctions in high risk young adult offsprings of type 2 diabetes mellitus and hypertensive parents. MATERIALS AND METHODS: The analytical cross-sectional studies were carried out in 90 subjects (45 males and 45 females), aged 18-25 years. They were divided into three groups based on their family history, known case of type 2 DM or hypertension in their parents. Group 1- control, Group 2- DM, Group 3-Hypertensive. In all subjects, anthropometrical data, blood pressure and peripheral pulse wave velocity were measured. One-way ANOVA was applied to determine the predictor factors of pulse wave velocity within and between groups. The following parameters were included in these analyses: age, gender, body mass index, hip waist index, heart rate, blood pressure and pulse wave velocity. RESULTS: A post-test analysis revealed that peripheral pulse wave velocity (PWV), early part of systolic phase (P1) was increased significantly than later part systolic phase (P2), p-value in both diabetic and hypertensive groups were compared with control group. (p≤0.001, ANOVA) Augmentation index (P2/P1) was also increased significantly in both diabetic and hypertensive groups than control group (p≤0.001, ANOVA). CONCLUSION: The findings of present study suggest that, although related, peripheral augmentation index AIx and PWV provide early identification of high risk groups. Implication of life style modification is the first intervention to consider in adults followed by drug therapy to control risk factors. Specifically, AIx might provide a more sensitive marker of arterial aging in younger individuals.

Small group discussion: Students perspectives.

CONTEXT: Various alternative methods are being used in many medical colleges to reinforce didactic lectures in physiology. Small group teaching can take on a variety of different tasks such as problem-solving, role play, discussions, brainstorming, and debate. Research has demonstrated that group discussion promotes greater synthesis and retention of materials. AIMS: The aims of this study were to adopt a problem-solving approach by relating basic sciences with the clinical scenario through self-learning. To develop soft skills, to understand principles of group dynamics, and adopt a new teaching learning methodology. SUBJECTS AND METHODS: Experimental study design was conducted in Phase I 1(st) year medical students of 2014-2015 batch (n = 120). On the day of the session, the students were grouped into small groups (15 each). The session started with the facilitator starting off the discussion. Feedback forms from five students in each group was taken (n = 40). A five point Likert scale was used ranging from strongly agree to strongly disagree. Data were analyzed using IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp. RESULTS: Our results show that 70% of the students opined that small group discussion were interactive, friendly, innovative, built interaction between teacher and student. Small group discussion increased their thought process and helped them in better communication. CONCLUSIONS: The small group discussion was interactive, friendly, and bridged the gap between the teacher and student. The student's communication skills are also improved. In conclusion, small group discussion is more effective than the traditional teaching methods.