The Long-Term Impact of Therapeutic Fasting on Primary Dysmenorrhea in Young Female Adults: A Randomized Controlled Trial.

Background and objective Primary dysmenorrhea (PD) is one of the leading health issues among women. According to reports, nutrition/diet significantly affects the severity and course of PD. The present study aimed to evaluate the role of therapeutic fasting in alleviating the symptoms associated with PD, improving quality of life (QoL), and reducing absenteeism among young female adults with PD. Methods A total of 52 participants aged between 18 and 24 years were included in the study and randomly classified into two groups of 26 each. The study group (fasting group) was assigned to undergo a 10-day fasting regimen (≤500 kcal/day) while the control group was to follow a normal dietary routine. The severity of pain, associated distress symptoms, QoL, and sleep quality were measured at baseline and on the fifth day of the first, second, and third menstruation cycles after the intervention, using the Visual Analog Scale (VAS), Numerical Rating Scale (NRS), the World Health Organization Quality of Life Brief Version (WHOQOL-BREF) questionnaire, and Pittsburg Sleep Quality Index. We also recorded the rate of absenteeism among the study participants during menstruation cycles. Results We observed a significant reduction in pain (p<0.001), cramps (p=0.001), nausea/vomiting (p=0.02), dizziness (p=0.007), and mood changes (p=0.005) in the study group compared to the control group. The effects were persistent in most of the variables at the second and third follow-ups as well. The physical (p=0.005) and psychological (p<0.001) QoL significantly improved in the first month, and we observed a similar trend at the second (physical p=0.03; psychological p=0.001) and third follow-ups (psychological p=0.002) except for physical QoL, which was significant only at the second follow-up. The fasting group had significantly lower absenteeism compared to the controls during the first follow-up (p=0.001). Conclusion Therapeutic fasting may be considered a safe and effective option in the management of PD. Future trials should examine the long-term sustainability of the results.

Physiological and Psychological Effects of Medically Supervised Fasting in Young Female Adults: An Observational Study.

Background Large-scale empirical and observational studies confirm the safety and efficacy of short-term intermittent fasting; however, prolonged fasting (fasting for more than two days or more) is not well studied. This study investigated the safety, physiological, and psychological effects of a medically supervised fasting (MSF) regimen on healthy volunteers. Methods In this observational study, 117 female participants with an average age of 21.02 (± 1.45) years underwent 10 days of medically supervised fasting. Daily symptom scores and 24-hour food recalls were collected, along with serum levels of vitamin D and calcium, a complete blood count, anthropometric measurements, quality of life (QoL), and subjective mood, anxiety, and depression scores, at the baseline and at the end of fasting. Results Compared to baseline, significant improvements were observed in vitamin D levels (z = -8.79, p = 0.000), calcium levels (z = -4.08, p = 0.000), red blood cell count (z = -4.61, p = 0.000), and hemoglobin levels (z = -5.57, p = 0.00). Improvements were observed in physical QOL (t (116) = -4.51, p = 0.000); psychological QOL (t (116) = -4.70, p = 0.000); and social QOL (t (116) = -2.68, p = 0.008). We also observed significant reductions in body weight (55.83 (±11.38), 52.99 (±10.94); p = 0.00) and other anthropometric measures. More than 80% (n = 94) experienced at least one symptom associated with fasting. The symptoms associated with fasting changed significantly (p<0.05), with most symptoms peaking from day 3 to day 7 of fasting with remission from day 8 onwards. Conclusion Our findings suggest that MSF is associated with significant improvements in physiological and psychological variables. The symptoms associated with MSF are to be considered in clinical decision-making, and follow-up of patients on fasting therapy, particularly during the peaking of symptoms, may be warranted.

Unity of Disease and Unity of Cure: An Evidence-based Perspective.

Context: One of the governing principles of naturopathic medicine is the concept of Unity of Disease and Unity of Cure (UDUC). Many naturopathic physicians and students find it challenging to provide a scientific basis for UDUC because conventionally every disease has varying etiologies. Objective: The review intended to explore the basis of UDUC, examining the available theoretical evidence around this fundamental tenet of naturopathic medicine, to promote its effective use when consulting new patients and planning the subsequent treatment. Design: The research team performed a narrative review by searching PubMed, PubMed central, Scopus, Google scholar databases, textbooks on naturopathy and websites of professional bodies representing naturopathic medicine. The search used the keywords 'Naturopathic Medicine', 'Naturopathy', 'Holism', 'Self-healing', 'Pyschosocial determinants and health', 'unity of disease and unity of cure', 'health and disease', 'Multi-model approach', 'whole-system practice' and 'Global naturopathic practice'. Setting: The review took place at Sant Hirdaram Medical College of Naturopathy and Yogic Sciences for women in Bhopal, Madhya Pradesh, India. Results: The present review provides a comprehensive overview of the scientific evidence behind UDUC under four layers: psychological factors, lifestyle factors, physiological alterations, and disease manifestation. The data presented in this review substantiate the presence of these four layers in the manifestation of various clinical conditions like musculoskeletal disorders, obstetric and gynecological disorders, cardiometabolic disorders, infectious disorders, and gastrointestinal disorders. Conclusions: It's very evident that the global naturopathic profession embraces traditional philosophies as the core of their practices. However, the field needs measures, such as the formulation of international working groups and the organization of continuous medical-education programs, congresses, and exchange programs, to facilitate crosstalk among practitioners from different parts of the world, which may assert the importance of philosophical tenets such as UDUC in clinical practice.

Characteristics of patients who use yoga for pain management in Indian yoga and naturopathy settings: a retrospective review of electronic medical records.

Objectives: The aim of this study is to identify the characteristics of patients who underwent yoga therapy for pain in yoga and naturopathy clinical settings in India. Methods: Electronic medical records of patients who received yoga therapy for pain in three inpatient yoga and naturopathy hospitals were reviewed retrospectively from January 2021 to September 2022. Demographic characteristics and details on pain condition, socioeconomic status, comorbidities, ancillary therapies received, and insurance status were collected. In addition, we prospectively collected data on adherence to yoga practice through a telephonic interview. Results: A total of 984 patients were identified from a pool of 3,164 patients who received yoga therapy for pain for an average of 9.48 (1.13) days. Patients aged between 8 and 80 underwent therapy for varying pain conditions and diseases that include pain in the extremities, pain due to infection, trauma, degenerative diseases, autoimmune diseases, and spine and neurological diseases. The majority of the patients were females (66.3%), from middle class families (74.8%), and who did not have any insurance coverage (93.8%). Most of the patients were under naturopathy treatment (99.8%), followed by ayurveda (56%), and physiotherapy (49.3%), along with yoga therapy. All patients reported a significant reduction in pain post-integrated yoga therapy (p < 0.001). Adherence to yoga was significantly associated with underlying pain conditions, the presence of comorbidities, the types of therapies used, and socioeconomic status (p < 0.001). Conclusion: This study highlights the real-time application of yoga in pain management in Indian yoga and naturopathy settings, as well as implications for future research.

Patient-centric holistic integrative therapies as an adjuvant in checking the progression of chronic kidney disease: A case study.

OBJECTIVE: Chronic kidney diseases (CKDs) characterized by progressive loss of kidney function impart significant burden on the patients. Besides physical disabilities, CKD affects the mental health and quality of life of the patients. Recent studies suggest the need for interdisciplinary patient-centric care in the management of CKD. METHODS: The present study introduced patient-centric holistic integrative therapies (YNBLI) in a 64-year-old female diagnosed with CKD in 2021, who presented with breathlessness, fatigue, loss of appetite, and anxiety. She is a known case of type 2 diabetes, hypertension and osteoarthritis of knee. She was advised for dialysis by her nephrologists', however, she was reluctant to undergo dialysis due to anxiety about the side effects and lifelong dependency on dialysis. She initially underwent a 10-day YNBLI program at our inpatient setting followed by adhering to the home-based YNBLI for 16 weeks. RESULTS: She showed significant improvement in the kidney function, hemoglobin levels, quality of life and symptoms with no adverse events. The improvements were consistent throughout the 16 weeks after discharge. DISCUSSION: This study presents the effective use of patient-centric holistic integrative therapies (YNBLI) as an adjuvant in the management of CKD. Future studies are warranted to substantiate these findings.

Impact of COVID-19 vaccines on the health status of young female adults from India: A cross-sectional study.

Purpose: Reports suggest that females experience more adverse events post-coronavirus disease 2019 (COVID-19) vaccination compared to males. However, no gender-specific data on the impact of vaccines on the Indian population are available. The present study was intended to understand the impact of COVID-19 vaccines on the health status of young Indian female adults and to identify the factors associated with experiencing adverse events post-vaccination. Methods: A web-based survey was conducted among 433 young female adults who have taken at least one dose of the COVID-19 vaccine. The prevalence and duration of systemic and generalized symptoms were analyzed using descriptive statistics. The factors associated with symptoms post-vaccination were analyzed using binary logistic regression. Adjusted odds ratios and 95% confidence intervals were computed. A P value of ≤ 0.05 was considered to be statistically significant. Results: Of the 404 surveys returned (93.3%), 371 respondents have received both vaccine doses. COVISHIELD™ was the vaccine of choice among 73% of respondents and nearly 91% of the respondents reported a re-infection post-vaccination. At least one form of the symptom as a side effect of vaccination was experienced by 88.4% (n = 357) of the participants. This included generalized symptoms (77.5%) followed by musculoskeletal (53.2%), localized (38.9%), psychological (35.1%), gastrointestinal (25.5%), gynecological (24%), and endocrine symptoms (22.5%). Presence of chronic ailments was significantly associated with experiencing localized symptoms (OR 2.21, 95% CI 1.25-3.91), psychological symptoms (OR 2.41, 95% CI 1.34-4.34), neurological symptoms (OR 2.98, 95% CI 1.38-6.46), gastrointestinal symptoms (OR 4.76, 95% CI 2.59-8.75), respiratory symptoms (OR 2.45, 95% CI 1.29-4.67), endocrine symptoms (OR 2.92, 95% CI 1.58-5.38), and gynecological symptoms (OR 4.05, 95% CI 2.21-7.44). Older than 21 years was significantly associated with the experience of gynecologic symptoms (OR 2.12, 95% CI 1.24-3.64). Not being re-infected post-vaccination has lower odds of experiencing psychological, gastrointestinal, and respiratory symptoms. Conclusion: Our result suggests serious planning and counseling are warranted while disseminating COVID-19 vaccination among young female adults especially those with comorbidities to foster trust and coverage.

Effect of health education-based yoga & naturopathy lifestyle interventions on personality of patients with non-communicable diseases: A randomized controlled trial.

BACKGROUND: Personality traits play a role in the progression and management of chronic diseases. However, a change in personality is seldom considered an outcome in the management of chronic diseases. The present study explored if a health education-based yoga & naturopathy lifestyle intervention group (HYNLG) can induce change in the personality traits, vitality, quality of life (QoL), and satisfaction in patients with non-communicable diseases compared to a therapy-centric yoga & naturopathy lifestyle intervention (TYNLG). METHODS: This randomized control trial included 56 participants who were equally randomized into the HYNLG and TYNLG groups. Both groups received a 10-day inpatient regimen that included hydrotherapy, mud therapy, diet therapy, supervised fasting, sunbathing, acupressure, and massage therapy. Additionally, HYNLG received a 10-day orientation (1 h/d) on concepts centered around belief systems, lifestyle changes, and their impact on health. Vedic Personality Inventory, SF-12 QoL questionnaire, visual analog scale, Hamilton Anxiety Inventory, and Visit-Specific Patient Satisfaction Questionnaire were used as outcome measures. The changes between the time points were analyzed using parametric and non-parametric tests, and Pearson correlation was used to investigate the association between the variables. RESULTS: The Sattva (balance and stability) personality trait has significantly increased in HYNLG, while the Rajas (activity and imbalance) and Tamas (inertia and dullness) personalities have decreased. HYNLG also demonstrated a significant improvement in mental QoL, vitality, anxiety reduction, and patient satisfaction when compared to TYNLG. CONCLUSION: These findings may have serious clinical and public health implications as they provide insights on the usefulness of introducing a health education component into lifestyle modification programs.

Is delayed regulation of yoga and naturopathic medicine in India breeding quackery?

The combined discipline of Yoga & Naturopathy (Y&N) constitutes one of the official indigenous medical systems under the Ministry of Ayurveda, Yoga & Naturopathy, Unani, Siddha, Sowa-Rigpa, and Homoeopathy (AYUSH), Government of India (GoI). The GoI has recently regulated all the systems under AYUSH, except Yoga & Naturopathy, through the National Commission for Indian System of Medicine (NCISM) Bill, 2020 [1]. However, Y&N has been left out from the NCISM Bill, despite the recommendations of the Department-related Parliamentary Standing Committee on the National Commission for Indian System of Medicine Bill, 2019 [2: p 20], and NITI Aayog [3: p 15]. On the contrary, GoI has proposed a board for regulating Y&N without defining its statutory value or timeline.

Effect of Medically Supervised Prolonged Fasting Therapy on Vitamin D, B12, Body Weight, Body Mass Index, Vitality and Quality of Life: A Randomized Control Trial.

Background: Recent research indicates prolonged fasting for more than 7 days is beneficial in priming the vitamin D metabolism. However, methodological limitations in previous studies, such as insufficient sample size and a lack of control group, limits its generalizability. The present study evaluated the impact of prolonged fasting (10 days) on vitamin D, vitamin B12, body mass index (BMI), weight, hemoglobin, vitality and quality of life (QoL) compared to a normal diet. Methods: This randomized control trial was conducted in an in-patient private yoga and naturopathy setting between February and April 2022. A total of 52 participants (mean age 51.57 ± 13.67 years) with varying medical conditions were randomized into a fasting group (FG) or a normal diet group (NDG) with 26 participants in each group. The FG was on a fasting diet (500 kCal/day) which included holy basil herbal tea, lemon honey water, and water (3 L). The NDG (1500 kCal/day) consumed a routine diet that included Indian bread, pulses, steamed rice, vegetable salads, and beverages. Results: The FG has shown significant increase in the Vitamin D levels (P = .003, d = 0.475), vitality (P = .006, d = 0.425), physical QoL (P < .001, d = 0.549), psychological QoL (P = .002, d = 0.488), and environmental QoL (P = .004, d = 0.457) compared to NDG. No significant changes were observed in vitamin B12, weight, BMI, haemoglobin, and social QoL. A weak to moderate (ρ = 0.330-0.483) positive correlation was observed between vitality scores and QoL domains, whereas BMI scores showed an inverse correlation (ρ = -.280) with vitamin D levels. Conclusion: The results suggest that prolonged fasting for 10 days can improve vitamin D levels, improve vitality, and promote quality of life compared to a normal diet. Unlike previous studies, the FG does not differ from the NDG concerning weight and BMI. Nevertheless, fasting may be utilized as an effective tool to tackle vitamin D deficiency and associated health insufficiencies.

Ashtanga Yoga Ethics-Based Yoga Versus General Yoga on Anthropometric Indices, Trigunas, and Quality of Life in Abdominal Obesity: A Randomized Control Trial.

Introduction: The philosophical tenets of yoga such as Ashtanga yoga (AY) and Trigunas are seldom considered while designing yoga programs for chronic diseases. This randomized control trial explored the impact of AY principle-based yoga on the anthropometric indices, personality traits, and quality of life (QoL) in abdominal obesity (AO). Materials and Methods: Sixty-two participants with AO were randomized (n = 31 in each arm) into an AY arm or general yoga (GY) arm. For 12 weeks, both the AY and the GY received the same yoga protocol; however, the AY received an additional AY-based orientation session fortnightly. Changes in waist circumference, hip circumference (HC), height, weight, body mass index (BMI), waist-hip ratio, Vedic Personality Inventory for gunas, and World Health Organization QoL-BREF were measured at baseline and at the end of 12 weeks. Results: By the end of 12 weeks, the AY arm significantly differed from the GY arm in HC (P = 0.05) and BMI scores (P = 0.03). The AY arm has shown a significant increase in the sattva guna (P < 0.001) and reduction in the rajas (P < 0.001) and tamas gunas (P = 0.03). There was a significant improvement in the physical and social QoL domain, whereas the other variables examined remained insignificant. The increase in sattva guna was negatively correlated with waist circumference (P = -0.489) and BMI (r = -0.553). Conclusion: Exposing participants to progressive AY philosophy can change the personality traits which are further associated with melioration in the determiners of AO. Future yoga programs for chronic disorders may consider including AY philosophy for substantive outcomes.

Medical Education, Practice, and Regulation of Acupuncture in India.

Acupuncture is one of the most-utilized forms of integrative medicine therapy across the globe, owing to this modality's wide range of therapeutic benefits. The history of acupuncture use in India is 3000 years old; however, the first documented use of acupuncture in India emerged in 1959. Presently, acupuncture is included as an independent therapy in the yoga and naturopathy (Y&N) category, an indigenous system of medicine under the purview of the Ministry of Ayurveda, Y&N, Unani (Perso-Arabic Medicine), Sidha (Indian Medicine), and homeopathy (AYUSH), and Sowa-Rigpa (Tibetan Medicine), of the government of India. Acupuncture has been taught to Y&N medical graduates through state-run medical universities at both undergraduate and postgraduate levels since 1989 and 2014, respectively. In addition, there are many short-term courses on acupuncture offered by nonmedical universities and academies. Y&N physicians are licensed to practice acupuncture in many states of India; however it is practiced by physicians of other medical systems as well as by nonlicensed practitioners. This is largely due to the nonuniform and flawed regulatory framework of acupuncture practice in India. The government of India, through a task force, is exploring the possibility of recognizing acupuncture as an independent system of medicine and regulating its practice. While the status of acupuncture and its use among integrative medicine physicians has definitely grown in the past 5 decades, the challenges-rooting out quackery, ensuring rigorous training, empowering existing practitioners, maintaining global standards, defining the scope of practice, etc.-warrant an unbiased and firm approach to safeguard acupuncture's scientific and academic rigor.