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.

Content Validity of an Integrated Yoga Module for Practice During Remission in Relapsing-Remitting Multiple Sclerosis Patients.

BACKGROUND: Some investigations point to the beneficial effects of yoga in alleviating the motor and cognitive dysfunctions in multiple sclerosis (MS) patients by using varying combinations of physical, breathing, and meditative practices of yoga. There is a need for a validated yoga module with a holistic approach that can be used as a standardized protocol by researchers and therapists. PURPOSE: To develop and validate an integrated yoga module for practice in relapsing-remitting MS patients to improve their quality of life. METHODS: We did a thorough review of the literature for the development of the yoga module. We formed an expert group with 24 experts and a neurologist and used two rounds of interactive Delphi method to combine their opinion to obtain content validity of the module through online structured questionnaire prepared for the purpose on a Google Form. We incorporated all suggestions obtained by the experts. The final module (60 min per session, twice a day, five days per week) included warm-up exercises, customized asanas, relaxation techniques, and OM meditation. Advice on yogic diet and discussion using yogic concepts for stress management also form a part of the holistic approach to yoga lifestyle modification. RESULTS: Analysis divulged that 30 out of 39 practices exhibited a content validity ratio value greater than or equal to 0.42. CONCLUSION: The study has shown good content validity of the integrated yoga module. Future clinical studies are being planned to rule the feasibility and reliability of this module.

Role of Mind-Body Intervention on Lipid Profile: A Cross-sectional Study.

BACKGROUND: Yoga is a combination of physical-breathing and meditative techniques that assist in the unification of the mind-body, which improves the quality of life. It was shown that long-term Yoga practitioners had superior control over respiratory rate, reduced stress and anxiety, and a better-controlled lipid profile. PURPOSE: We aimed to investigate the lipid profile of long-term yoga practitioners who were practicing yoga for more than 1 year in comparison with the nonyoga group. METHODS: A nationwide survey was conducted in which the long-term yoga practitioners (n = 76) and nonyoga practitioners (n = 80) were recruited for assessment for the lipid parameters. RESULTS: The mean (standard deviation) values of both groups were within normal range with serum cholesterol at 189.715 ± 20.4 and 180.88 ± 29.7 and triglycerides at 216.72 ± 92.5 and 207.665 ± 88.3, low-density lipoprotein at 126.65 ± 18.5 and 120.775 ± 26.5, and high-density lipoprotein at 47.17 ± 6.6 and 44.99 ± 7.0, respectively, in yoga and no-yoga groups. CONCLUSION: The lipid profile values were similar in yoga and nonyoga practitioners in the 2017 survey.

A Perspective on Yoga as a Preventive Strategy for Coronavirus Disease 2019.

The pandemic outbreak of coronavirus disease 2019 (COVID-19) infection caused by severe acute respiratory syndrome-coronavirus 2 has led to profound public health crisis. In particular, individuals with preexisting conditions of heart disease, diabetes, cerebrovascular diseases and the elderly are most vulnerable to succumb to this infection. The current COVID-19 emergency calls for rapid development of potential prevention and management strategies against this virus-mediated disease. There is a plethora of evidence that supports the add-on benefits of yoga in stress management, as well as prevention and management of chronic noncommunicable diseases. There are some studies on the effect of yoga in communicable diseases as well but very few for acute conditions and almost none for the rapidly spreading infections resulting in pandemics. Based on the available scientific evidences on yoga in improving respiratory and immune functions, we have formulated very simple doable integrated yoga modules in the form of videos to be practiced for prevention of the disease by children, adults, and the elderly.

Perceptions of benefits and barriers to Yoga practice across rural and urban India: Implications for workplace Yoga.

BACKGROUND: Even though Yoga is useful for prevention of obesity, diabetes and hypertension it is not universally practiced. The purpose of the study was to determine the benefits and barriers confronted by the community members while incorporating Yoga into routine practice and at workplace. OBJECTIVE: This study explored the motivators and barriers to Yoga practice by estimating how these elements can be useful for development and incorporation of Yoga as a workplace activity and as a profession. METHODS: A nationwide multi-centered prospective study was conducted recruiting individuals of different age groups and geographical zones in India. Participants of Yoga intervention group were administered a questionnaire with 19 items on benefits (YBS) and 18 items on barriers for Yoga practice (BFYS). Data was analyzed using SPSS v21 software. RESULTS: Majority of the participants perceived Yoga improves "physical fitness", "relaxes mind and body", improves "stamina", across age groups. "Lifestyle", "Family commitments", "Physical over-exertion", "No Encouragement from family", "Occupational commitments" and "Few places to do Yoga" were perceived barriers across various geographical zones. Despite knowing the benefits of Yoga, these barriers prevented individuals from integrating it into their daily routine. CONCLUSIONS: The present study may be considered as a starting point for development of Yoga as a workplace activity and a profession based on the perceptions of its various benefits and barriers faced by a large study population spanning an entire nation.

Niyantrita Madhumeha Bharata 2017, Methodology for a Nationwide Diabetes Prevalence Estimate: Part 1.

BACKGROUND: Type 2 Diabetes Mellitus (T2DM) poses an ever-increasing threat to people's health worldwide. India has reported high rates of incidence of T2DM. The dangers make accurate assessment of its burden and intervention of lifestyle change, an urgent necessity. AIMS AND OBJECTIVES: The aim of the study was to estimate the nationwide prevalence of prediabetes and diabetes, followed by a translational lifestyle trial. METHODOLOGY: The Indian Yoga Association was commissioned in 2016-2017 by the Government of India to conduct this study which was undertaken in two phases: Phase 1 was to estimate the prevalence of prediabetes and diabetes across the country, and Phase 2 was to conduct a randomized controlled trial using a validated yoga lifestyle protocol. This paper highlights the unique methodology of Phase 1 of the study. The first stage was screening (February to April 2017) for adults (>20 years) with high risk for diabetes on Indian diabetes risk score (IDRS) on mobile app, using a random cluster sampling survey method. All households in the rural (4 villages with about 500 adult population/village) and urban (2 census enumeration blocks [CEBs] of about 1000 adult population/block) sectors of 65 districts (one per ten districts in the entire country) from 29 out of 35 states of India were approached. In the second stage, detailed assessments (sociodemographic, clinical details, A1c, lipid profile, body mass index, stress, and tobacco) were carried out on those with high risk on IDRS and on all self-reported diabetes individuals. RESULTS: In the first stage of door-to-door visit, 240,968 adults in all households of the selected clusters of villages and CEBs were approached. Of these, 162,330 responded. The respondents in the second stage for detailed assessments in the selected cohort were 50,199 (48% rural and 52% urban) adults. Of these, 7472 were self-reported known diabetes adults and the remaining were 42,737. Prevalence estimates for the country will follow in the future publications. CONCLUSION: This rapid survey completed within 3 months in the entire country using trained volunteers offers the methodology to obtain a quick estimate of diabetes and high-risk population to implement any lifestyle program.

Methodology of Niyantrita Madhumeha Bharata Abhiyaan-2017, a Nationwide Multicentric Trial on the Effect of a Validated Culturally Acceptable Lifestyle Intervention for Primary Prevention of Diabetes: Part 2.

BACKGROUND: The rapidly increasing diabetes burden, reaching epidemic proportions despite decades of efforts, reflects our failure to translate the proven evidence for prevention of diabetes. Yoga, with its holistic approach, alters the habituated patterns of lifestyles and behaviour. Motivated by the accumulating evidence, the Government of India funded a large randomized controlled trial. AIMS AND OBJECTIVES: The twin objectives were: (a) estimate the prevalence of prediabetes and diabetes through a parallel multisite stratified cluster sampling method and (b) implement NMB 2017 (niyantrita madhumeha bharata abhiyaan), a randomized control trial using yoga based lifestyle program. MATERIALS AND METHODS: Screening for Indian Diabetes Risk score(IDRS) was conducted in randomly selected clusters in all 7 zones (65 districts from 29 states/union territories) of India. This was followed by detailed assessments in those with known diabetes and high risk (≥60) on IDRS. Those who satisfied the selection criteria and consented were recruited for the two armed waitlisted randomized control trial. A validated remedial diabetesspecific integrated yoga lifestyle module was taught to the experimental arm by certified volunteers of Indian Yoga Association. Followup assessments were done after 3 months in both groups. In this article, we report the methodology of the trial. RESULTS: Response to door to door visits (n-240,968 adults >20yrs) in randomly selected urban and rural households for screening was 162,330; detailed assessments (A1c, lipid profile, BMI, stress, tobacco etc) were performed on 50,199 individuals. Of these 12466 (6531 yoga 5935 control) consented and for the RCT; 52% females, 48% males; 38% rural, 62% urban; BMI 21.1 ± 3.8; waist circumference 91.7 ± 11.9. A1c in diabetes subjects in yoga group was 7.63 ± 2.17 and 7.86 ± 2.13 in control group. CONCLUSION: This unique methodology provides the evidence to implement a validated yoga life style module using yoga volunteers in all parts of the country which is an urgent need to prevent India from becoming the global capital for diabetes.

Guinness world record attempt as a method to pivot the role of Yoga in Diabetes management.

BACKGROUND: Attempts for Guinness world record have continued worldwide but these attempts were rarely aimed to promote public health. Diabetes is one of the rapidly growing lifestyle disorders in India which requires awareness reinforcements among the local population. In recent studies, Yoga has proved to be useful in lifestyle modification and Diabetes management. However, most individuals from rural and urban localities in the country are unaware of this fact. PURPOSE: The purpose was to organizing a nationwide attempt under the Niyantrit Madhumeh Bharat (NMB) programme to break the world record to be the largest Diabetes lesson, to spread awareness among general population. METHODS: Present article represents the perspective of the Chandigarh chapter of NMB programme and its experience in Guinness world record attempt. Diabetes awareness lesson was organized in the city as per the standards defined by the Guinness Book and outcomes of the entire campaign were assessed at the end of the campaign. RESULT: Total 498 individuals participated in the campaign. Among them, 268 participants were questioned at the end of the campaign about the role of Yoga in Diabetes. 247 participants (92%) were agreed that Diabetes can be modified by Yoga and 9 participants (3%) disagreed. The remaining 12 participants (5%) did not give any response. CONCLUSION: We noticed that most of the participants became aware of the role of Yoga in Diabetes.

Effects of Yoga in Managing Fatigue in Breast Cancer Patients: A Randomized Controlled Trial.

BACKGROUND: Cancer-related fatigue is widely prevalent in cancer patients and affects quality of life in advanced cancer patients. Fatigue is caused due to both psychologic distress and physiological sequel following cancer progression and its treatment. In this study, we evaluate the effects of yogic intervention in managing fatigue in metastatic breast cancer patients. METHODS: Ninety-one patients with metastatic breast cancer were randomized to receive integrated yoga program (n = 46) or supportive therapy and education (n = 45) over a 3-month period. Assessments such as perceived stress, fatigue symptom inventory, diurnal salivary cortisol, and natural killer cell counts were carried out before and after intervention. Analysis was done using an intention-to-treat approach. Postmeasures for the above outcomes were assessed using ANCOVA with respective baseline measure as a covariate. RESULTS: The results suggest that yoga reduces perceived stress (P = 0.001), fatigue frequency (P < 0.001), fatigue severity (P < 0.001), interference (P < 0.001), and diurnal variation (P < 0.001) when compared to supportive therapy. There was a positive correlation of change in fatigue severity with 9 a.m. salivary cortisol levels. CONCLUSION: The results suggest that yoga reduces fatigue in advanced breast cancer patients.

Prevalence of type 2 diabetes among Yoga practitioners: A pilot cross-sectional study in two districts in India.

INTRODUCTION: Diabetes is one of the major health diseases in the world today. The efficacy of Yoga in the management of type 2 diabetes is well-established. The aim of this study was to assess the prevalence of type 2 diabetes among Yoga practitioners in two districts of India (one each in West and South of India). METHODOLOGY: In this cross-sectional field study, 155 Yoga practitioners from Pune and 192 from Ernakulam districts were assessed using the diabetes risk test and fasting blood sugar. The data collected were entered in a statistics software package and analyzed using the Pearson's correlation analysis, t-test, univariate ANOVA, and linear regression to understand the predictors of risk for diabetes. RESULTS: The overall prevalence of diabetes among Yoga practitioners in Central Pune was 3.6% (95% confidence interval [CI]: [0.01-0.04]). 18.9% of participants (95% CI: [0.16-0.19]) were diagnosed to be "at risk" for diabetes. In Ernakulam, the overall prevalence of diabetes among practitioners was 26% (95% CI: [0.05-0.06]) with 12% of practitioners (95% CI: [0.05-0.06]) diagnosed to be "at risk" for diabetes (prediabetic). Higher age and lesser duration of Yoga practice were significant predictors of diabetes. CONCLUSION: It is essential for every person above the age of 40 to undergo regular health check-ups and screening for diabetes and involve oneself in lifestyle modification programs such as Yoga for significantly long duration of time on a daily basis, to better manage diabetes.

Decoding the integrated approach to yoga therapy: Qualitative evidence based conceptual framework.

AIM: The aim of this study was to define, decode, and append to the conceptual frame-work of the integrated approach to yoga therapy (IAYT). MATERIALS AND METHODS: Four stakeholders who followed two in-patients with depression over a period of 2 weeks in the residential center Arogyadhama (of Swami Vivekananda Yoga Anusandana Samsthana, Bangalore, India) were interviewed before the start of the IAYT treatment and prior to discharge of the patient. The patients were also interviewed pre and post and were observed once during their session. The data from the audio recordings from eight in-depth interviews were transcribed manually and qualitative analysis was conducted. RESULTS: The conceptual frame-work of IAYT depicts that patient related factors ("co-operation of patient", "patients awareness of his/her condition"), therapist related factors ("ability to guide", "the assistance to the patients", "explanation of the exercises") and treatment related factors ("combination of psychiatric or Ayurvedic medication with yoga", "counseling during the IAYT treatment", duration of treatment), play an integrated role in reaching the "aim of IAYT" and experiencing "improvements and changes". CONCLUSION: The IAYT is a holistic program and the ability of the patient to cooperate with and integrate the available factors (therapist related and treatment related) could enable best results.

Effect of integrated yoga on anxiety, depression & well being in normal pregnancy.

OBJECTIVE: To study the effect of integrated yoga on Pregnancy experience, anxiety, and depression in normal pregnancy. METHODS: This Prospective Randomized control study recruited 96 women in 20th week of normal pregnancy. Yoga group (n = 51) practiced integrated yoga and control group (n = 45) did standard antenatal exercises, one hour daily, from 20th to 36th week of gestation. Mann-Whitney and Wilcoxon's tests were used for statistical analysis. RESULTS: There was significant difference between groups (Mann-Whitney p < 0.001) in all variables. There were significant changes within groups (Wilcoxon's p < 0.001) in both groups. Pregnancy related experience (PEQ) reduced in yoga by 26.86%, State (STAI I) anxiety (decreased 15.65% in yoga, increased 13.76% in control), Trait (STAI II) anxiety (decreased 8.97% in yoga, increased 5.02% in control) and Depression (HADS) (decreased 30.67% in yoga, increased 3.57% in control). CONCLUSION: Yoga reduces anxiety, depression and pregnancy related uncomfortable experiences.

Yoga for high-risk pregnancy: a randomized controlled trial.

BACKGROUND: Improvements in technology have increased the chances of survival for the micro-premature infant and the very low birth-weight infant but have significantly increased the financial burden of health care organizations. This economic burden has a significant impact on third-party payers and on society in general. AIM: The study was designed to assess yoga therapy (YT) module on maternal stress level in high risk pregnancy. SUBJECTS AND METHODS: In the present study, sixty-eight pregnant women (38 in the control group with standard antenatal care and 30 in the YT group) with 27.2 (5.2) years of mean age recruited from the outpatient services of medical college and hospital in Bangalore, South India, were participated. The study was a single-blind randomized controlled clinical trial. Perceived stress scale (PSS) was measured during the 12(th), 20(th), and 28(th) weeks of pregnancy. SPSS version 16.0 (Chicago, IL, USA) was used for all data analysis. When the data were found to be normally distributed, the RMANOVA were used to assess the PSS scores between the yoga and control groups. Significant values were set at P < 0.05. RESULTS: There was a significant difference in the PSS level of the YT group with significantly reduced scores at the second follow-up (28(th) week of pregnancy) compared to the control group (P = 0.02). Women who took part in the YT module reported significantly fewer pregnancy discomforts decrease in PSS (P = 0.02) than the control group where the stress level was increased (RMANOVA test using SPSS-16). CONCLUSION: The present study suggests that the YT module can decrease the stress level during high-risk pregnancy complications. Thus, practicing YT during high-risk pregnancy is not only a cost-effective option but also a feasible and safe option. Additional well-designed studies are needed before a strong recommendation can be made.

Effect of the integrated approach of yoga therapy on platelet count and uric acid in pregnancy: A multicenter stratified randomized single-blind study.

BACKGROUND: Yoga improves maternal and fetal outcomes in pregnancy. Platelet Count and Uric acid (Ua) are valuable screening measures in high-risk pregnancy. AIM: To examine the effect of yoga on platelet counts and serum Ua in high-risk pregnancy. MATERIALS AND METHODS: This stratified randomized controlled trial, conducted by S-VYASA University at St. John's Medical College Hospital and Gunasheela Maternity Hospital, recruited 68 women with high-risk pregnancy (30 yoga and 38 controls) in the twelfth week of pregnancy. The inclusion criteria were: Bad obstetrics history, twin pregnancies, maternal age < 20 or > 35 years, obesity (BMI > 30), and genetic history of pregnancy complications. Those with normal pregnancy, anemia (< 10 grams%dl), h/o clotting disorders; renal, hepatic or heart disease; seizure disorder; or structural abnormalities in the pelvis, were excluded. The yoga group practiced simple meditative yoga (three days / week for three months). RESULTS: At baseline, all women had normal platelet counts (> 150×10(9)/L) with a decrease as pregnancy advanced. Ua (normal at baseline) increased in both groups. No one developed abnormal thrombocytopenia or hyperuricemia. Healthy reduction in platelet count (twelfth to twentieth week) occurred in a higher (P < 0.001, Chi(2) test) number of women in the yoga group than the control group. A similar trend was found in uric acid. Significantly lesser number of women in the yoga group (n = 3) developed pregnancy-induced hypertension (PIH) / pre-eclampsia (PE) than those in the control group (n = 12), with absolute risk reduction (ARR) by 21%. CONCLUSION: Antenatal integrated yoga from the twelfth week is safe and effective in promoting a healthy progression of platelets and uric acid in women with high-risk pregnancy, pointing to healthy hemodilution and better physiological adaptation.

The effects of yoga in prevention of pregnancy complications in high-risk pregnancies: a randomized controlled trial.

OBJECTIVE: While previous studies have shown the potential effects of yoga in normal pregnancies, this randomized controlled trial investigated the effects of yoga in prevention of pregnancy complications in high-risk pregnancies for the first time. METHODS: 68 high-risk pregnant women were recruited from two maternity hospitals in Bengaluru, India and were randomized into yoga and control groups. The yoga group (n=30) received standard care plus one-hour yoga sessions, three times a week, from the 12th to the 28th week of gestation. The control group (n=38) received standard care plus conventional antenatal exercises (walking) during the same period. RESULTS: Significantly fewer pregnancy induced hypertension (PIH), preeclampsia, gestational diabetes (GDM) and intrauterine growth restriction (IUGR) cases were observed in the yoga group (p=0.018, 0.042, 0.049, 0.05 respectively). Significantly fewer Small for Gestational Age (SGA) babies and newborns with low APGAR scores (p=0.006) were born in the yoga group (p=0.033). CONCLUSION: This first randomized study of yoga in high-risk pregnancy has shown that yoga can potentially be an effective therapy in reducing hypertensive related complications of pregnancy and improving fetal outcomes. Additional data is needed to confirm these results and better explain the mechanism of action of yoga in this important area.

A comprehensive yoga programs improves pain, anxiety and depression in chronic low back pain patients more than exercise: an RCT.

INTRODUCTION: Previously, outpatient Yoga programs for patients with chronic low back pain (CLBP) lasting several months have been found to reduce pain, analgesic requirement and disability, and improve spinal mobility. This study evaluated changes in pain, anxiety, depression and spinal mobility for CLBP patients on short-term, residential Yoga and physical exercise programs, including comprehensive yoga lifestyle modifications. METHODS: A seven day randomized control single blind active study in an residential Holistic Health Centre in Bangalore, India, assigned 80 patients (37 female, 43 male) with CLBP to yoga and physical exercise groups. The Yoga program consisted of specific asanas and pranayamas for back pain, meditation, yogic counselling, and lectures on yoga philosophy. The control group program included physical therapy exercises for back pain, and matching counselling and education sessions. RESULTS: Group×time interactions (p<0.05) and between group differences (p<0.05) were significant in all variables. Both groups' scores on the numerical rating scale for pain reduced significantly, 49% in Yoga (p<0.001, ES=1.62), 17.5% in controls (p=0.005, ES=0.67). State anxiety (STAI) reduced 20.4% (p<0.001, ES=0.72) and trait anxiety 16% (p<0.001, ES=1.09) in the yoga group. Depression (BDI) decreased in both groups, 47% in yoga (p<0.001, ES=0.96,) and 19.9% in controls (p<0.001, ES=0.59). Spinal mobility ('Sit and Reach' instrument) improved in both groups, 50%, in yoga (p<0.001, ES=2.99) and 34.6% in controls (p<0.001, ES=0.81). CONCLUSION: Seven days intensive residential Yoga program reduces pain, anxiety, and depression, and improves spinal mobility in patients with CLBP more effectively than physiotherapy exercises.

Development and feasibility of need-based yoga program for family caregivers of in-patients with schizophrenia in India.

CONTEXT AND AIM: Yoga has been found to be effective in the management of stress. This paper describes the development of a yoga program aimed to reduce burden and improve coping of family caregivers of inpatients with schizophrenia in India. MATERIALS AND METHODS: Based on the assessment of caregiver needs, literature review, and expert opinion, a ten-day group yoga program was initially developed using the qualitative inductive method of inquiry. Each day's program included warm-up exercises, yogic asanas, pranayama, and satsang. A structured questionnaire eliciting comments on each day's contents was given independently to ten experienced yoga professionals working in the field of health for validation. The final version of the program was pilot-tested on a group of six caregivers of in-patients with schizophrenia admitted at NIMHANS, Bangalore. RESULTS: On the question of whether the program would help reduce the burden of caregivers, six of the ten experts (60%) gave a rank of four of five (very much useful). Based on comments of the experts, several changes were made to the program. In the pilot-testing stage, more than 60% of the caregivers assigned a score of four and above (on a five-point Likert scale, five being extremely useful) for the overall program, handouts distributed, and performance of the trainer. Qualitative feedback of the caregivers further endorsed the feasibility and usefulness of the program. CONCLUSION: The developed yoga program was found to be acceptable to caregivers of in-patients with schizophrenia.

Effect of integrated yogic practices on positive and negative emotions in healthy adults.

BACKGROUND: Studies on affective wellbeing have shown the beneficial role of positive emotions on cognitive processing and the harmful role of negative emotions on coping, stress and health status. Studies have shown that yoga practices reduce anxiety and depression and improve wellbeing. OBJECTIVE: The aims of the study were to, (i) examine the safety and feasibility of conducting a weeklong free yoga camp, and (ii) assess its impact on the negative and positive affect in normal healthy volunteers. MATERIALS AND METHODS: In this open-arm study450 participants were taught integrated yoga module. It included asanas, pranayama, relaxation, notional correction and devotional sessions. Assessment was carried out on the first and last day of the camp, using a modified version of Positive Affect Negative Affect Scale (PANAS). It has ten questions each to measure positive (PA) and negative affect (NA). Nine questions have been added which are referred as other positive affect (OPA) and other negative affect (ONA) domains. RESULTS: Three hundred and twelve sets of pre-post data were analyzed. There was an increase in PA of PANAS by 13% (P<0.001, Wilcoxon's signed rank test) and OPA by 17% (P<0.001). The NA reduced by 47% (P<0.001) and ONA by 48% (P<0.001). CONCLUSION: It is feasible and safe to conduct a weeklong yoga camp in an urban setting, and integrated yoga practices can reduce the negative affect and increase the positive affect within one week.