Effect of long-term yoga training on autonomic function among the healthy adults.

Background: Autonomic dysfunction is one of the major complications in noncommunicable diseases, and there are studies to prove yoga practice improves cardiac autonomic function. So, this present study was done to compare the autonomic functions among yoga practitioners and nonyoga practitioners. Methods: This cross-sectional comparative study was initiated among 68 healthy volunteers of both sexes, after recruiting them based on inclusion and exclusion criteria in the age group of 17-30 yrs. The autonomic reactivity tests like resting heart rate, response of heart rate to standing, Valsalva maneuver, and response of heart rate to deep breathing, response of BP to standing, and sustained hand-grip were done. Results: In the autonomic reactivity test, resting heart rate (80.92 ± 11.76 vs 69.24 ± 10.64) and sustained handgrip (16.30 ± 4.53 vs 10.20 ± 3.67) significantly decreased (P < 0.05) in the participants of the yoga group compared to control group. Deep breathing test, Valsalva maneuver, 30:15 ratio in lying to standing, and BP response to standing test did not show any significant difference between the groups (P > 0.05). Conclusion: The present study revealed diminished sympathetic activity and improved parasympathetic activity among the regular yoga practicing participants. It can be practiced regularly to reduce stress and prevent lifestyle-associated disorders in the future.

Immediate effect of Kapalbhathi pranayama on short term heart rate variability (HRV) in healthy volunteers.

OBJECTIVES: Kapalbhathi Pranayam (Kapal = forehead; bhati = shining) is a breathing exercise that has been practiced to cleanse the frontal brain in traditional practices like yoga. Still, there exists a dearth of literature on the effect of Kapalbhathi pranayama on physiological systems. So this present study was carried out to find the immediate effect of "kapalbhathi Pranayam" practice for the period of 5 min on cardiac autonomic function among the healthy volunteers. MATERIALS AND METHODS: Apparently 50 healthy volunteers includes both sex were participated. They were randomly divided into Pranayama (n-25) and control (n-25) group. Pranayama group was practiced kapalbhathi pranayama 5 min (5 cycles) and control group was allowed to do normal breathing (12-16 breath/min). Lead II ECG was recorded for 5 min using simple AD converter before, immediately after practice and 20 min of recovery period. RESULTS: One way Analysis of variance (ANOVA) followed by post hoc test was done using R statistical software. There was a significant (p < 0.05) parasympathetic withdrawal (Root Mean Square of the Successive Differences (RMSSD) - p < 0.04 and HF n.u - p < 0.05) was found in the pranayama group immediately after practice and its was changed to parasympathetic domination (RMSSD - p < 0.04 and HF n.u - p < 0.05) after 20 min of recovery period. CONCLUSION: The present study suggested that though there was parasympathetic withdrawal immediately after practicing kapalbhathi pranayama, 20 min after the recovery period showed a parasympathetic domination in the pranayama group subjects. However, further studies are required to warrant the findings of this study.

Management of middle mesial canal in mandibular second molar.

The primary objective of endodontic therapy is to achieve a three-dimensional obturation of the root canal space after adequate preparation of the canal space to remove the tissue debris, microorganisms, and their byproducts. Anatomical variations have frequently been encountered in endodontic practice and have to be adequately managed by the clinician. Missed roots and canals are a major reason for failure of therapy. Technological advances have given the clinician ample opportunity to identify and treat these aberrations successfully. The present report describes a left mandibular second permanent molar requiring root canal treatment, found to have three separate canals in the mesial root. This case demonstrates a rare anatomical configuration and emphasizes the need for the clinician to be aware of and look out for such variations and use adequate diagnostic methodologies prior to and during therapy to detect such variations. The possibility of additional canals, whenever in doubt, should be explored with the assistance of technologies such as those of magnification and illumination and various diagnostic aids. Operator experience has also shown to be a key factor in negotiation and management of these aberrant canal configurations.

Immediate impact of a diabetes training programme for primary care physicians--an endeavour for national capacity building for diabetes management in India.

AIMS: India faces a huge burden from diabetes. National capacity for management of diabetes has to be strengthened by improving knowledge of physicians treating diabetes, especially in semi urban and rural areas. A training programme was formulated and conducted at national level, as a step towards this goal. METHODS: Physicians from 6 states of India (n=3023, M:F 2311:712), aged 30-55 years, with service of >or=3 years, (government n=1720, private n=1303, semi urban and rural areas (n=1581:1442)) were trained in diabetes care in 5-day workshops between March 2004 to December 2006. Impact of training was assessed by pre- and post-training knowledge scores, feedback on usefulness of training modules, prioritizing activities to be introduced in their practice and methods to be used for raising public awareness on diabetes. RESULTS: The training significantly improved knowledge on treatment, complications, pathophysiology and diagnosis of diabetes (p<0.001). The participants considered information on preventive aspects of diabetes and foot care as highly educative. Patient education and team-training were considered important in diabetes management. Interest was evinced in raising public awareness about the disease. CONCLUSIONS: Well-planned short training programmes are useful in improving knowledge and in creating enthusiasm to improve diabetes care and awareness.

Functional blocking of Staphylococcus aureus adhesins following growth in ex vivo media.

Defining the role of Staphylococcus aureus adhesins in disease pathogenesis may depend on the use of bacteria grown in culture media that more closely reflect the human milieu than conventional broth. This study examined the functional effect on S. aureus adhesins following growth in an ex vivo medium containing a complex mixture of human proteins (used peritoneal dialysate) relative to growth in Todd-Hewitt broth. The adherence of S. aureus, cultured in dialysate, to fibronectin and fibrinogen was markedly reduced despite the expresion of full-length ClfA, ClfB, and fibronectin-binding proteins. Growth in dialysate resulted in the acquisition of a surface coat, as visualized by transmission electron microscopy, which was shown to contain fibronectin, fibrinogen, and immunoglobulins. Adherence of S. aureus to fibrinogen following growth in dialysate was significantly reduced by expression of protein A but was restored following growth in immunoglobulin-depleted dialysate. We conclude that bacterial adherence to solid-phase protein is critically dependent on the culture medium, that S. aureus adhesins may become saturated with target protein prior to contact with solid surfaces, and that there is an interaction between fibrinogen-binding proteins and immunoglobulin bound to protein A following contact with host proteins. These findings have important implications for future studies of S. aureus adhesins.

Influence of life style factors in development of diabetes in Indians--scope for primary prevention.

OBJECTIVE: The objective of the study was to evaluate the influence of physical activity and stress factors on the development of diabetes mellitus (DM). METHODS: One hundred and eighty-seven adult subjects (M:F 112:75), registered in the primary prevention of diabetes programme for 2 or more years were studied prospectively. The study was done only in those who had either normal glucose tolerance (NGT) or diabetes at the time of review (tR). At entry (tE), 121 (64.7%) had normal glucose tolerance (NGT) and 66 (34.3%) had impaired glucose tolerance (IGT) by the WHO criteria. Dietary modifications and regular exercise programme were advised. Dietary modifications and regular exercise programme were advised. Study subjects were reviewed during August 1997 to October 1998. At review (TR) none had known history of diabetes. At TR, the status of glucose tolerance was assessed by oral GTT and influence of intervention measures and evaluation of the role of physical and psychological stress on glucose tolerance were assessed by a questionnaire method. RESULTS: At tR, 100 (53.5%) had NGT, and 87 (46.5%) had developed diabetes (DM). Adherence to exercise and other preventive measures was poor in the DM compared to nondiabetic group (NGT) (P < 0.0012). They showed lower dietary adherence (P = 0.042) and scores on mental stress was higher than in NGT group (P < 0.001). After controlling for age, gender and the initial 2 h plasma glucose, non-adherence to exercise and high scores of psychological stress showed strong association with diabetes. CONCLUSION: In this study, significant and independent roles of physical inactivity and psychological stress factors are demonstrated in the development of diabetes.

Dietary profile of urban south Indians and its relations with glycaemic status.

This study was done to analyse the dietary profile of urban south Indian adults. It was also aimed to study, if the dietary profile influenced the glycaemic and anthropometric data. Dietary details were collected in a representative urban sample of 900 study subjects in the epidemiological survey for diabetes conducted in 1995 in the city of Madras. The details were collected by a 24-h recall method. All the dietary factors were similar in the non-diabetic (NGT) and newly diagnosed diabetic cases, but the values were lower in known diabetic cases due to dietary modifications (P < 0.001 for all compared to NGT and new diabetic cases). For further analysis, known diabetic cases were deleted and the rest were combined as one group. Men consumed higher calories (2066+/-437, range 1028-3662 kcal) than women (1745+/-343, range 870-3260 kcal) (P < 0.01). Older persons consumed lower calories and percentages of the proximate principles in diet were proportionately lower. Higher calorie consumption was due to consumption of higher quantities of food and not any specific dietary factor. BMI, WHR, plasma glucose, serum cholesterol and triglycerides were not significantly influenced by the total calorie consumption. Calorie consumption was higher in persons engaged in strenuous physical activity. Total calories and proportionately the proximate principles of diet were less in the high income group. The similarity in diet in the non-diabetic and the newly diagnosed diabetic persons showed that the development of diabetes was probably not related to changes in dietary habits. Lower consumption of calories and carbohydrates by the known cases of diabetes was due to the dietary modifications introduced in the management of the disease. Lower calorie consumption in women and older people could be related to lower physical activity. This study shows a uniform dietary pattern among the different strata of society with minor variations based on age, gender and physical activity. No difference has been noted in dietary habits of the newly diagnosed diabetic subjects and the non-diabetic adults.

Significance of impaired glucose tolerance in an Asian Indian population: a follow-up study.

A prospective study was undertaken in 107 Indians with impaired glucose tolerance (IGT) for a period ranging from 2 to 10 years. On follow-up, 32% still had an impaired glucose tolerance, 32% reverted to normal glucose tolerance and 36% developed diabetes. Careful dietary adherence and weight reduction were found to favour normalisation of glucose tolerance. Poor dietary adherence, persistent obesity and weight gain were found to precipitate diabetes. The study stresses the need for intensive diet therapy in individuals with IGT. Insulin responses were heterogeneous in IGT and non-predictive of the follow-up changes in glucose tolerance.