Prediction of pre-eclampsia in diabetic pregnant women.

Background & objectives: Gestational or preexisting diabetes is one of the risk factors of pre-eclampsia. Both are responsible for higher maternal and fetal complications. The objective was to study clinical risk factors of pre-eclampsia and biochemical markers in early pregnancy of women with diabetes mellitus (DM)/gestational diabetes mellitus (GDM) for the development of pre-eclampsia. Methods: The study group comprised pregnant women diagnosed with GDM before the 20 wk of gestation and DM before pregnancy and the control group had age-, parity- and period of gestation-matched healthy women. Sex hormone-binding globulin (SHBG), insulin-like growth factor-I (IGF-I) and 25-hydroxy vitamin D [25(OH)D] levels and the polymorphism of these genes was evaluated at recruitment. Results: Out of 2050 pregnant women, 316 (15.41%) women (296 had GDM and 20 DM before pregnancy) were included in the study group. Of these, 96 women (30.38%) in the study group and 44 (13.92%) controls developed pre-eclampsia. Multivariate logistic regression analysis indicated those who belonged to the upper middle and upper class of socio-economic status (SES) were likely to be at 4.50 and 6.10 times higher risk of developing pre-eclampsia. The risk of getting pre-eclampsia among those who had DM before pregnancy and pre-eclampsia in their previous pregnancy was about 2.34 and 4.56 times higher compared to those who had no such events, respectively. The serum biomarkers [SHBG, IGF-I and 25(OH)D] were not found to be useful in predicting pre-eclampsia in women with GDM. To predict risk of development of pre-eclampsia, the fitted risk model by backward elimination procedure was used to calculate a risk score for each patient. Receiver operating characteristic (ROC) curve for pre-eclampsia showed that area under the curve was 0.68 (95% confidence interval: 0.63-0.73); P<0.001. Interpretation & conclusions: The findings of this study suggested that pregnant women with diabetes were at a higher risk for pre-eclampsia. SES, history of pre-eclampsia in previous pregnancy and pre-GDM were found to be the risk factors.

Body Temperature in Practitioners of a Yoga Breathing Technique Considered to be Heat Generating.

CONTEXT: Suryabheda pranayama is traditionally described as "increasing the inner fire" and is believed to be heat generating. AIMS: The present study aimed at determining whether the surface body temperature would increase after Suryabheda pranayama practice compared with sitting quietly for the same duration as a control. MATERIALS AND METHODS: Nineteen participants with experience of Suryabheda pranayama practice (group mean experience ± standard deviation, 30.2 ± 22.8 months) were assessed in 3 sessions on separate days. The sessions were (i) Suryabheda pranayama with physiological locks or breath retention, (ii) Suryabheda pranayama without physiological locks or breath retention, and (iii) quiet sitting (control session). The axillary surface body temperature was monitored in all three sessions before (5 min), during (15 min), and after (5 min) the intervention. Ambient temperature and humidity in the recording cabin used for testing were noted. From the ambient temperature and humidity, the heat index was derived. STATISTICAL ANALYSIS: Repeated measures analyses of variance were performed to compare values before, during, and after the 3 sessions, using SPSS version 24.0. RESULTS: The surface body temperature increased during and after Suryabheda pranayama with physiological locks (P < 0.001; P < 0.001), Suryabheda pranayama without physiological locks (P < 0.01; P < 0.001), and quiet sitting (P < 0.001; P < 0.001) compared to the respective before values. CONCLUSION: The control (i.e., quiet sitting) and experimental sessions (i.e., suryabheda with locks and suryabheda without locks) showed a comparable increase in the surface body temperature. Hence, the increase in surface body temperature during and after experimental sessions does not appear to be related to the pranayama techniques. The possible factors which may have contributed to increased surface body temperature in the control and experimental sessions have been discussed.

Body Temperature and Energy Expenditure During and After Yoga Breathing Practices Traditionally Described as Cooling.

BACKGROUND In traditional yoga texts, sheetali and sitkari pranayamas are described as cooling. The present study was aimed at recording the surface body temperature, oxygen consumed, and carbon dioxide eliminated before, during, and after performance of sheetali and sitkari pranayamas. MATERIAL AND METHODS Seventeen healthy male volunteers with ages between 19 to 25 years (average age 20.7±1.8 years) were assessed in 4 sessions, viz. sheetali pranayama, sitkari pranayama, breath awareness and quiet lying, on 4 separate days, in random sequence. The axillary surface body temperature (TRUSCOPE II, Schiller, China) and metabolic variables (Quark CPET, COSMED, Italy) were recorded in 3 periods: before (5 minutes), during (18 minutes), and after (5 minutes), in each of the 4 sessions. The heat index was calculated in the before and after periods, based on recordings of ambient temperature and humidity. Data were analyzed using SPSS (Version 24.0). RESULTS Body temperature increased significantly during sheetali and sitkari (p<0.05, p<0.01; respectively) while it decreased after breath awareness and quiet lying down (p<0.01, p<0.001; respectively) when compared with respective post-exercise states. Oxygen consumption increased by 9.0% during sheetali (p<0.05) and by 7.6% during sitkari (p<0.01) while it decreased significantly during (p<0.05) and after (p<0.01) quiet lying down compared to respective pre-exercise states. CONCLUSIONS The results do not support the description of these yoga breathing practices as cooling. These yoga breathing practices may be used to induce a mild hypermetabolic state.

The impact of yoga on teachers' self-rated emotions.

OBJECTIVES: To assess (i) if teachers' age or gender could predict their baseline levels of mental well-being and anxiety and any change after yoga. (ii) Whether mental well-being or anxiety changed following 15 days of yoga in primary school teachers. Primary school teachers took part in this single group longitudinal trial (n = 302, group mean age ± SD; 41.8 ± 5.90 years). They received 240 min of yoga practice and 120 min of yoga theory each day. At baseline and after 15 days of yoga the assessments were (i) mental well-being (Warwick-Edinburgh scale) and (ii) state anxiety (Spielberger's State Trait Anxiety Inventory). RESULTS: Gender acted as a significant predictor for mental well-being scores (P = 0.001) and state anxiety (P = 0.005) in the group at baseline. Females showed higher anxiety scores and lower mental well-being scores. Following yoga the teachers showed a significant increase in mental well-being by 5.84% and a decrease in state anxiety by 4.48%. Trial registration The trial was registered retrospectively (August 15, 2019; Trial Registration Number: ISRCTN90253431).

Performance in a Corsi Block-tapping Task following High-frequency Yoga Breathing or Breath Awareness.

BACKGROUND: Uninostril yoga breathing practices have improved spatial memory scores. There has been no assessment on the effect of high-frequency yoga breathing (HFYB) on working memory and spatial memory scores using the Corsi block-tapping task (CBTT). OBJECTIVES: The present study was planned to assess the immediate effects of HFYB and breath awareness (BAW) compared to a control session on performance in a CBTT. METHODS: Fifteen participants of both sexes with ages between 18 and 24 years (group mean age ± standard deviation, 20.0 ± 1.6 years; 10 females) were recruited for the trial from a university in North India. Each participant was assessed in three sessions conducted on 3 separate days at the same time of the day. The three sessions were (i) HFYB, (ii) BAW, and (iii) quiet sitting (QS). The duration of the intervention was 18 min. The participants were assessed before and after all the three sessions. Repeated-measures-analyses of variance followed by post hoc tests with Bonferroni adjustment were performed to compare data before and after all the three sessions. RESULTS: BAW resulted in an improvement in backward total scores (P < 0.05) and the backward Corsi span (P < 0.05; one tailed). CONCLUSIONS: The results suggest that BAW improves primary working memory, spatial memory, and spatial attention. HFYB did not cause any change.

Immediate Effect of a Yoga Breathing Practice on Attention and Anxiety in Pre-Teen Children.

Pre-teen children face stressors related to their transition from childhood to adolescence, with a simultaneous increase in academic pressure. The present study compared the immediate effects of 18 min of (i) high frequency yoga breathing with (ii) yoga-based breath awareness and (iii) sitting quietly, on (a) attention and (b) anxiety, in 61 pre-teen children (aged between 11 and 12 years; 25 girls). Attention was assessed using a six letter cancellation task and Spielberger's State Trait Anxiety Inventory STAI-S was used to measure anxiety before and after the three practices, practiced on separate days. Repeated measures ANOVA, followed by Bonferroni adjusted post-hoc analyses showed an increase in total attempts and net scores after high frequency yoga breathing (p < 0.05), while wrong attempts increased after yoga based breath awareness (p < 0.05). Anxiety decreased comparably after all three interventions. The 25 girls in the group had the same trend of results as the whole group with respect to the attention-based cancellation task, while boys showed no, how since change. For both girls and boys, anxiety decreased after all three 18min interventions. The results suggest that high frequency yoga breathing could be a short, useful school based practice to improve attention and reduce anxiety.

Effect of yoga on vigilance, self rated sleep and state anxiety in Border Security Force personnel in India.

BACKGROUND: Military occupations require heightened vigilance with resultant sleep disturbances, increased anxiety and reduced vigilance. OBJECTIVE: To compare yoga with physical training to reduce insomnia, anxiety and increase vigilance in security personnel. METHODS: One hundred and twelve Border Security Force personnel (BSF group, males; mean age±SD = 30.4±7.4 years) were compared with 112 personnel of a private security firm (SIS group). The BSF group received yoga for nine days and the SIS group received physical training for the same period. Assessments were at baseline and after 9 days, with the digit vigilance test (DVT), Spielberger's STAI-S, and a sleep rating questionnaire. RESULTS: (1) Between groups: (i) at baseline the BSF group had higher vigilance and more daytime naps compared to the SIS group and (ii) after nine days the SIS group had higher state anxiety compared to the BSF group (ANOVA, Bonferroni adjusted post-hoc comparisons; SPSS Version 24.0) (2) In post-pre intervention comparisons (i) the BSF group increased vigilance and decreased state anxiety after yoga, with improved sleep, while (ii) the SIS group showed increased vigilance after physical training. CONCLUSION: Yoga may improve sleep, reduce anxiety while increasing vigilance in occupations requiring vigilance.

Mental Wellbeing, Quality of Life, and Perception of Chronic Illness in Yoga-Experienced Compared with Yoga-Naïve Patients.

BACKGROUND Perception of chronic illness and a positive outlook improve recovery, and yoga can improve wellbeing. This study aimed to compare perception, mental wellbeing, and quality of life in yoga-experienced compared with yoga-naïve patients with chronic illness and to determine whether the duration of yoga practice in the yoga-experienced group had any correlation with the perception of illness, mental wellbeing, and quality of life. MATERIAL AND METHODS A cross-sectional comparative study recruited 419 patients with chronic non-communicable disease. Yoga-experienced patients (n=150) (mean age, 41.9±13.6 years) and yoga-naïve patients (n=269) (mean age, 41.2±12.6 years) were assessed for the perception of their illness, mental wellbeing, and quality of life using the Warwick-Edinburgh mental wellbeing scale (WEMWBS) and the World Health Organization quality of life (WHOQOL-BREF) self-reporting questionnaire. RESULTS The yoga-experienced group had significantly increased mental wellbeing, personal control as a dimension of their perception of illness, and psychological and environmental quality of life compared with the yoga-naïve group (all, p<0.05), when comparisons were made using the Mann-Whitney U test. The duration of yoga practised in months was positively-correlated with mental wellbeing and different aspects of quality of life. There was a negative correlation with the perception of illness suggesting that the illness was perceived to be less severe (all, p<0.05) when correlations were made using Spearman's rank correlation coefficient. CONCLUSIONS In patients with chronic illness, yoga improved mental wellbeing, aspects of quality of life, and resulted in a positive perception of illness.

Changes in Shape and Size Discrimination and State Anxiety After Alternate-Nostril Yoga Breathing and Breath Awareness in One Session Each.

BACKGROUND Yoga breathing techniques like high-frequency yoga breathing (HFYB) and breath awareness (BAW) have been associated with improved performance in the shape and size discrimination task. A PubMed search of the literature revealed that alternate-nostril breathing has been shown to improve performance in attention tasks, but the effect on tactile perception has not been studied. Hence, the present study was designed to assess the immediate effects of alternate-nostril yoga breathing (ANYB) compared to breath awareness on shape and size discrimination and state anxiety. MATERIAL AND METHODS Fifty healthy male volunteers ages 20-50 years (group mean ±S.D., 28.4±8.2 years) were recruited. Each participant was assessed in 3 sessions conducted on 3 separate days at the same time of day. The 3 sessions were (i) alternate-nostril yoga breathing (ANYB), (ii) breath awareness (BAW), and (iii) quiet sitting (QS), and the sequence of the sessions was randomly allocated. The shape and size discrimination task and state anxiety were assessed before and after all 3 sessions. Repeated measures analysis of variance (RM-ANOVA) followed by post hoc tests for multiple comparisons, which were Bonferroni-adjusted, were performed to compare data before and after all 3 sessions using SPSS version 18.0. RESULTS The errors scores in the shape and size discrimination task showed a significant reduction after the ANYB session (p<0.001). A significant reduction was found in the level of state anxiety after breath awareness (p<0.05) and quiet sitting sessions (p<0.001). CONCLUSIONS The present results suggest that ANYB: (i) improves performance in a task which requires perceptual sensitivity and focused attention, but (ii) does not reduce state anxiety following this task.

Changes in Reaction Time after Yoga Bellows-type Breathing in Healthy Female Volunteers.

BACKGROUND: Previously, yoga bellows-type breathing (bhastrika pranayama) reduced reaction time (RT) or reduced anticipatory responses in male participants or a mixed group of male and female participants. AIMS: The present study as a control trial aimed to assess the effects of yoga bellows-type breathing on RT in females exclusively. METHODS: The sample consisted of 25 healthy females, aged between 19 and 32 years (group mean ± standard deviation, 22.8 ± 3.5 years). All of them had prior minimum experience of yoga including yoga bellows-type breathing of 12 months. The RT was assessed in each participant before and after three randomized sessions differed in the intervention given held on three separate days. The sessions were (i) YOGA bellows-type breathing or bhastrika pranayama(BHK), (ii) Breath awareness (BAW), and (iii) Sitting quietly (CTL) as a control session. The duration of the intervention was 18 min, and the participants were assessed for RT before and after the intervention. RESULTS: Repeated measures ANOVA, post hoc tests with Bonferroni adjusted showed that the time taken to obtain a correct response reduced significantly after 18 min of BAW (P < 0.05) and CTL (P < 0.05). However, no changes were seen in the RT after BHK. CONCLUSIONS: The results suggest that different interventions may optimize performance in tasks requiring attention in females compared to males.

Increased Mental Well-Being and Reduced State Anxiety in Teachers After Participation in a Residential Yoga Program.

BACKGROUND Reducing stress in the workplace improves mental health. Teaching is of social importance, but it may receive inadequate recognition and rewards. The present study compared mental well-being and state anxiety in primary school teachers who practiced 15 days of yoga in a residential setting with those who continued their usual routine. MATERIAL AND METHODS We enrolled 236 primary school teachers to participate in the study. We assigned 118 primary school teachers (group mean ±S.D., age 41.5±6.0 years, 74 females) to the experimental group; they underwent 15 days of yoga training for 6 hours/day) in a residential yoga center. The non-yoga control group (group mean ±S.D., age 42.3±6.0 years, 79 females) consisted of 118 teachers who continued with their normal teaching routine. RESULTS After 15 days in the residential yoga program, there was an increase in overall mental well-being (p<.001) and lower state anxiety (p<.01) (repeated-measures ANOVA, followed by post hoc multiple comparison tests). At baseline, the non-yoga control group had higher levels of state anxiety, presumably related to their remaining in the workplace. CONCLUSIONS The study was a 15-day, comparative, controlled trial. The results show that after 15 days of participation in the residential yoga program, primary school teachers increased all aspects of mental well-being and had reduced state anxiety.

Changes in vigilance, self rated sleep and state anxiety in military personnel in India following yoga.

OBJECTIVES: To study the effects of 9 days of yoga on self-rated sleep, state anxiety and performance in a vigilance test among border security force (BSF) personnel. Seven hundred and twenty-two BSF personnel took part in the trial. They were all males, with an average age of 30.9 ± 7.4 years. All of them were involved in guarding the country's border. They were deputed for 9 days residential training in yoga. Before and after training they were assessed for self-rated sleep, state anxiety and vigilance. RESULTS: The results suggest the benefits of yoga in BSF personnel. The BSF personnel showed a significant increase in scores in the vigilance test, a decrease in state anxiety, and improved self-rated sleep.

Alternate-Nostril Yoga Breathing Reduced Blood Pressure While Increasing Performance in a Vigilance Test.

BACKGROUND Reports suggest that vigilance or sustained attention increases sympathetic activity. A persistent increase in sympathetic activity can lead to an increase in blood pressure. Alternate-nostril yoga breathing has been shown to be useful to (i) improve attention and (ii) decrease the systolic and diastolic blood pressure. Earlier studies did not report simultaneous recordings of the blood pressure and performance in vigilance tests after alternate-nostril yoga breathing. With this background, the present study was planned to determine if 15 minutes of alternate nostril yoga breathing could improve the performance in a vigilance test without an increase in blood pressure. MATERIAL AND METHODS Fifteen healthy male volunteers participated in the study (group mean age ±SD, 22.4±2.4 years). Participants were assessed on 3 separate days in 3 different sessions. These were (i) alternate nostril yoga breathing, (ii) breath awareness, and (iii) sitting quietly as a control. Blood pressure and the digit vigilance test were simultaneously assessed before and after each session. RESULTS Systolic blood pressure (p<0.01), mean arterial blood pressure (p<0.05), and the time taken to complete the digit vigilance test (p<0.05) significantly decreased following alternate-nostril yoga breathing. The time taken to complete the digit vigilance test differed significantly between sessions (p<0.05). The time taken to complete the digit vigilance test was also significantly decreased after sitting quietly (p<0.01). CONCLUSIONS Alternate-nostril yoga breathing appears to improve performance in the digit vigilance test, along with a reduction in systolic blood pressure. This is suggestive of better vigilance without sympathetic activation.

Hemisphere specific EEG related to alternate nostril yoga breathing.

BACKGROUND: Previously, forced unilateral nostril breathing was associated with ipsilateral, or contralateral cerebral hemisphere changes, or no change. Hence it was inconclusive. The present study was conducted on 13 normal healthy participants to determine the effects of alternate nostril yoga breathing on (a) cerebral hemisphere asymmetry, and (b) changes in the standard EEG bands. METHODS: Participants were randomly allocated to three sessions (a) alternate nostril yoga breathing (ANYB), (b) breath awareness and (c) quiet sitting, on separate days. EEG was recorded from bilaterally symmetrical sites (FP1, FP2, C3, C4, O1 and O2). All sites were referenced to the ipsilateral ear lobe. RESULTS: There was no change in cerebral hemisphere symmetry. The relative power in the theta band was decreased during alternate nostril yoga breathing (ANYB) and the beta amplitude was lower after ANYB. During quiet sitting the relative power in the beta band increased, while the amplitude of the alpha band reduced. CONCLUSION: The results suggest that ANYB was associated with greater calmness, whereas quiet sitting without specific directions was associated with arousal. The results imply a possible use of ANYB for stress and anxiety reduction.

A selective review of dharana and dhyana in healthy participants.

Attention is an important part of the process of meditation. Traditional Yoga texts describe two stages of meditation which follow each other in sequence. These are meditative focusing (dharana in Sanskrit) and effortless meditation (dhyana in Sanskrit). This review evaluated eight experimental studies conducted on participants in normal health, who practiced dharana and dhyana. The studies included evaluation of autonomic and respiratory variables, eLORETA and sLORETA assessments of the EEG, evoked potentials, functional magnetic resonance imaging, cancellation task performance and emotional intelligence. The studies differed in their sample size, design and the method of practicing dharana and dhyana. These factors have been detailed. The results revealed differences between dharana and dhyana, which would have been missed if the two stages of meditation had not been studied separately.

Heart rate variability in chronic low back pain patients randomized to yoga or standard care.

BACKGROUND: Chronic pain can alter the autonomic balance with increased sympathetic activity reflected in altered heart rate variability (HRV). It has been proposed that yoga can be useful to correct the autonomic imbalance in patients with chronic pain who have reduced HRV. METHODS AND DESIGNS: In the present randomized controlled trial 62 patients with chronic low back pain associated with altered alignment of intervertebral discs (aged between 20 and 45 years, 32 males) were randomized to 2 groups. One group received yoga for 3 months while the other group carried out standard medical care based on the physician's advice. The duration was the same, i.e., 3 months. The heart rate variability and rate of respiration were assessed at baseline and at the end of 3 months. RESULTS: There was a significant difference in the baseline (pre) values between groups (p = 0.008) for respiration rate which was higher in the yoga group. The changes reported below are pre-post comparisons within each group. The yoga group showed a significant (p < 0.05; repeated measures ANOVA, post-hoc analyses) decrease in the LF power of HRV, rate of respiration and a significant increase in the HF power of HRV and in the pNN50. CONCLUSION: The results suggest that yoga practice can shift the autonomic balance towards vagal dominance in patients with chronic low back pain associated with altered alignment of intervertebral discs. TRIAL REGISTRATION: The study is registered with the Clinical Trials Registry of India ( CTRI/2012/11/003094 ) and can be accessed at.

A Functional Near-Infrared Spectroscopy Study of High-Frequency Yoga Breathing Compared to Breath Awareness.

BACKGROUND High-frequency yoga breathing (breath rate of 2.0 Hz) has been associated with changes in oxy-hemoglobin in the prefrontal region of the brain. The present study assessed the effects of high-frequency yoga breathing (HFYB) at 1.0 Hz on frontal oxy-hemoglobin (oxy-Hb) and deoxy-hemoglobin (deoxy-Hb). MATERIAL AND METHODS Forty healthy male participants were recruited for the study. The experimental group consisted of 20 participants 23-40 years old (group mean ±S.D., 26.4±4.7 years) with at least 3 months of experience performing HFYB (group mean ±S.D., 16.3±9.8 months). The control group consisted of 20 participants ages 23-38 years (group mean age ± S.D., 27.4±4.1 years), who were seated quietly for the same duration and their average experience of yoga practice was (±S.D.) 4.3±2.7 months. Each participant in the experimental group was assessed at 2 sessions (HFYB and breath awareness [BAW]) on alternate days. Hemodynamic changes were assessed using a functional near-infrared spectroscopy sensor placed over the forehead. Data were analyzed using repeated-measures analyses of variance followed by post hoc Bonferroni adjustment. RESULTS A significant reduction was observed in oxy-Hb during and after HFYB on the left and right sides compared to values before. We also found a significant reduction in deoxy-Hb during and after the quiet sitting control session compared to pre-session values on left and right sides. CONCLUSIONS The decrease in oxy-Hb during and after HFYB suggests that there was no frontal activation during HFYB when practiced at the rate of 1.0 Hz.

Disc extrusions and bulges in nonspecific low back pain and sciatica: Exploratory randomised controlled trial comparing yoga therapy and normal medical treatment.

BACKGROUND: Previous trials of yoga therapy for nonspecific low back pain (nsLBP) (without sciatica) showed beneficial effects. OBJECTIVE: To test effects of yoga therapy on pain and disability associated with lumbar disc extrusions and bulges. METHODS: Parallel-group, randomised, controlled trial. Sixty-one adults from rural population, aged 20-45, with nsLBP or sciatica, and disc extrusions or bulges. Randomised to yoga (n=30) and control (n=31). Yoga: 3-month yoga course of group classes and home practice, designed to ensure safety for disc extrusions. CONTROL: normal medical care. OUTCOME MEASURES (3-4 months) Primary: Roland Morris Disability Questionnaire (RMDQ); worst pain in past two weeks. Secondary: Aberdeen Low Back Pain Scale; straight leg raise test; structural changes. RESULTS: Disc projections per case ranged from one bulge or one extrusion to three bulges plus two extrusions. Sixty-two percent had sciatica. Intention-to-treat analysis of the RMDQ data, adjusted for age, sex and baseline RMDQ scores, gave a Yoga Group score 3.29 points lower than Control Group (0.98, 5.61; p=0.006) at 3 months. No other significant differences in the endpoints occurred. No adverse effects of yoga were reported. CONCLUSIONS: Yoga therapy can be safe and beneficial for patients with nsLBP or sciatica, accompanied by disc extrusions and bulges.

Association of cytokines in hepatitis E with pregnancy outcome.

AIMS: The aim of this study was to evaluate tumour necrosis factor-alpha (TNF-α), interleukin (IL)-6, interferon gamma (IFN-γ) and transforming growth factor-beta1 (TGF-ß1) in hepatitis E infection during pregnancy and its relation with pregnancy outcome. METHODS: A total of 272 pregnant and 219 non-pregnant women with hepatitis and 262 age and gestational age matched healthy pregnant women and 208 age matched, healthy non-pregnant women were evaluated on the basis of history, clinical examination, liver function profile. Serological tests of hepatitis A, B, C and E and cytokines using commercially available (ELISA) kits. The patients with hepatitis E were further evaluated for viral load by Real Time PCR. All these were followed till delivery for pregnancy outcome. RESULTS: HEV viral load in acute viral hepatitis (AVH) and fulminant hepatic failure (FHF) of pregnant women were comparatively higher than non-pregnant women. Significantly higher levels of TNF-α, IL-6, IFN-γ and TGF-ß1 were present in HEV infected pregnant women compared to non-pregnant women and controls. TNF-α, IL-6 and IFN-γ had significant positive correlation with viral load, serum bilirubin and prothrombin time in pregnant women. Higher levels of all four cytokines were found in pregnant women with HEV infection having adverse pregnancy outcome compared to that of pregnant women with non-HEV infection and controls. CONCLUSION: In conclusion, severity of HEV infection and associated adverse pregnancy outcome might be mediated by cytokine in pregnancy.

Reaction time following yoga bellows-type breathing and breath awareness.

The reaction time (RT) was assessed in two groups of healthy males, yoga group (M age = 29.0 yr.) and non-yoga or control group (M age = 29.0 yr.), with 35 participants each. The yoga group had an average experience of 6 months, while the control group was yoga-naïve. The yoga group was assessed in two sessions, (i) bhastrika pranayama or bellows breathing and (ii) breath awareness, while the control group had a single control session. The two experimental sessions, one with each type of breathing, and the control session consisted of pre- (5 min.), during (18 min.), and post-session epochs (5 min.). Assessments were made in the pre- and post-session epochs using a Multi-Operational Apparatus for Reaction Time. Following 18 min. of bhastrika pranayama there was a statistically significant reduction in number of anticipatory responses compared to before the practice. This suggests that the immediate effect of bhastrika pranayama is to inhibit unnecessary responding to stimuli.