Role of yoga therapy in improving digestive health and quality of sleep in an elderly population: A randomized controlled trial.

INTRODUCTION: Constipation and sleep disturbances commonly affect elderly population results in compromised physical and mental health. Mind-body interventions like yoga not only address the mental and physical health but also promote healthy ageing. This study evaluates the effect of 3 months yoga intervention on the sleep and constipation related quality of life (QoL) among the elderly. MATERIALS AND METHODS: Ninety six participants aged between 60 and 75 who did not had any history of yoga practice for past 1 year and having a zubrod score of 0-2 were randomized in to yoga (n = 48) or waitlisted control (n = 48). The yoga group received yoga interventions at a frequency of 3 sessions per week for 3 months. Pittsburg Sleep Quality Index (PSQI) and Patient Assessment of Constipation QoL (PAC-QOL) were used to assess the improvement. Intention to treat analysis method was used to include the drop-out participants. RESULTS: Eighty one participants (Yoga = 48, waitlisted control = 33) completed the study. Wilcoxon's sign rank test has shown that the yoga group had statistically significant changes in most of the parameters in PSQI and PAC-QOL (P ≤ 0.05). Mann Whitney test revealed that yoga group has better improvement in the sleep quality and constipation related QOL (P ≤ 0.05) compared to the controls. DISCUSSION: The results signify yoga can ease old age related issues like constipation and insomnia. This is encouraging for inclusion of yoga as a daily practice regimen to improve the constipation and sleep related quality of life in elderly population.

Identification of quinoline-chalcones and heterocyclic chalcone-appended quinolines as broad-spectrum pharmacological agents.

Quinoline derivatives have been reported to possess enticing pharmacological properties. In particular, quinoline-chalcones are identified as promising scaffolds for drug discovery. For a long, the quinoline analogs have been in clinical use for various medical conditions such as cancer inhibitory activity, antibacterial and antifungal, anti-plasmodial, DNA damage inhibitory activity, etc. The number of causalities recorded because of the above-mentioned clinical states is significantly large. Though drug design and discovery is a continuous process all over the world, issues like drug-resistance, low metabolic stability, and long-range side effects are potential hindrances for the continuous use of present pharmacological drugs. In this review work, we focused on the recent drug discovery based on quinoline-chalcones. The work emphasizes the potency of a wide range of quinoline chalcone analogs towards the inhibition of infections caused by the various pathogenic microbes such as bacteria, fungi, plasmodium. Alongside, the quinoline chalcones possessing DNA cleavage properties and cancer cell growth inhibitory properties are also discussed. More importantly, the strongest pharmacological molecules are identified based on the inhibitory properties, cytotoxic values, and pharmacokinetics of synthesized derivatives. Additionally, a structure-activity relationship is established amongst the evaluated molecules. Supplemented by the mechanism of action in few pharmacological activities, the potent activity is also proved by the favorable binding interactions in molecular simulation studies.

Effect of an Integrated Naturopathy and Yoga Program on Long-Term Glycemic Control in Type 2 Diabetes Mellitus Patients: A Prospective Cohort Study.

AIM: Lifestyle is an important risk factor for increasing the prevalence of diabetes in the Indian population. In this study, we evaluate the effects of naturopathy treatment, salt-restricted low-calorie diets, and yoga in long-term glycemic control in patients with type 2 diabetes mellitus. METHODS: In this prospective, longitudinal, two-arm cohort study, patients with type 2 diabetes mellitus referred from a tertiary care center undergoing a 3-month residential naturopathy treatment were compared with those undergoing only conventional management on glycemic control. Both fasting and postprandial blood glucose (PPBG) levels were assessed at baseline, 3 months following intervention, at 6 months, and 12 months from the study start. Data were analyzed using repeated-measures ANOVA with post hoc Bonferroni correction. RESULTS: Naturopathy and yoga intervention significantly reduced PPBG levels (P < 0.001), glycated hemoglobin levels (P < 0.001), and reduced requirement for antidiabetic medications (P < 0.008) in the intervention group compared to controls. The effects were more profound immediately following intervention and lasted up to 6 months from the start of the study. CONCLUSION: The results suggest benefit with an intensive residential naturopathy-based lifestyle intervention program. Randomized controlled trials are needed to further validate the findings.

The conundrum of deep vein thrombosis prophylaxis in burns in India and review of literature.

OBJECTIVE: The aim is to assess the practice of deep vein thrombosis (DVT) prophylaxis among the plastic surgeons attending National Academy of Burns India Conference 2012 (NABICON 2012). BACKGROUND: DVT prophylaxis in burns is a controversial issue as there is no consensus among the community of burn surgeons about the prevalence of DVT, the incidence of pulmonary embolism, the indications for DVT prophylaxis, dosage and duration of low molecular weight heparins (LMWH) and the complications related to DVT and LMWH. METHODOLOGY: A survey was conducted among plastic surgeons attending the NABICON 2012 held at New Delhi, by circulating a questionnaire. The respondents were divided into two groups based on whether burns constituted more than or less than 50% of their practice. The data thus collected were tabulated and analysed. RESULTS: Almost 70% of all the respondents practice some form of DVT prophylaxis. There was significantly higher incidence of complications related to the use of LMWH among the surgeons whose practice of burns was >50%. There was no significant difference between the two groups in relation to the incidence and complication of DVT or recommendation of DVT prophylaxis. CONCLUSION: Majority of plastic surgeons practice DVT prophylaxis routinely and consider multiple criteria such as percentage of burns, age, lower limb involvement, the degree of burns and associated co-morbidities for starting the LMWH.

Influence of hydrotherapy on clinical and cardiac autonomic function in migraine patients.

BACKGROUND: Migraine is associated with autonomic symptoms. The growing body of literature suggests that the dysfunctional autonomic nervous system might play a pivotal role in the pathogenesis of migraine. Thermal therapies have been hypothesized to modulate these changes and alleviate pain. However, data regarding the efficacy of hydrotherapy in migraine remain scant. We evaluated the effect of add on hydrotherapy procedure (a hot arm and foot bath with ice massage to head) in migraine patients. METHODS: Forty chronic migraine patients fulfilling the International Classification of Headache Disorders II criteria were recruited from the neurology outpatient clinic. Patients were randomized to receive either hydrotherapy plus conventional pharmacological care (n = 20) or conventional medication only (n = 20). Hydrotherapy group received treatment with hot arm and foot bath (103°F to 110°F) and ice massage to head daily for 20 min for 45 days. Patients were assessed using headache impact test (HIT), visual analog scale for pain and cardiac autonomic function by heart rate variability (HRV) before and after intervention period. RESULTS: There was a significant decrease in HIT score, frequency, and intensity of headaches following treatment in both the groups. However, it was more evident in add on hydrotherapy group compared to pharmacological treatment alone group. There was also significant improvement in the HRV parameters. In particular, there was a significant decrease in heart rate (P = 0.017), increase in high frequency (HF) (P = 0.014) and decrease in low frequency/HF ratio (P = 0.004) in add on hydrotherapy group. CONCLUSION: Our study shows that add on hydrotherapy enhanced the vagal tone in addition to reducing the frequency and intensity of headaches in migraine patients.

Role of cytoplasmic deadenylation and mRNA decay factors in yeast apoptosis.

Strains of Saccharomyces cerevisiae lacking factors involved in 5' to 3' mRNA decay pathway (DCP1, DCP2, DHH1, PAT1, LSM1 and LSM4) exhibit caspase-dependent apoptosis and accelerated chronological aging. In the present study, yeast strains lacking mRNA decapping activation factors (DCP2 and LSM1), cytoplasmic exosome function (SKI2) or cytoplasmic deadenylases (double deletion of CCR4 and PAN2) showed typical markers of eukaryotic apoptosis such as increased cellular reactive oxygen species levels, externalization of phosphatidyl serine, chromatin fragmentation, enhanced caspase gene (YCA1) expression and protein activity in mid-log phase cultures. The transcript levels of negative regulators of mRNA decapping (eIF4E and Pab1) were considerably elevated in strains defective in cytoplasmic deadenylation and reduced in strains lacking cytoplasmic 3' to 5' exosome function or decapping activators. Among the yeast strains studied, lsm1Δ and ccr4Δpan2Δ mutants displayed strongest apoptotic phenotype followed by mutants lacking DCP2 or SKI2. Among yeast strains exhibiting deadenylation defects, slight apoptotic phenotype was observed in ccr4Δ mutants and cell death markers imperceptible in pan2Δ mutants.

Spiritual well-being and its influence on fatigue in patients undergoing active cancer directed treatment: a correlational study.

INTRODUCTION: Spiritual well-being and fatigue are key parameters in assessing health related quality of life that determine treatment tolerance, treatment outcomes and reflect patient's coping ability in the illness-wellness disease trajectory. MATERIALS AND METHODS: A total of 200 patients on active cancer treatment were enrolled to the study. Functional assessment of chronic illness therapy-spirituality (FACIT-Sp) and FACIT-Fatigue scales were used to assess spiritual well-being and fatigue scores during their cancer treatment. Data were analyzed using one-way analysis of variance and bivariate relationships determined using the Spearman Correlation analysis. Linear regression analysis was performed to determine predictors of fatigue score during treatment. RESULTS: Mean spiritual well-being score was 20.96 out of 48 and scores were significantly higher in females compared with males (P = 0.03), lower with higher stage (P = 0.008) and lower in head and neck and gastrointestinal malignancies (P = 0.03) when compared with gynecological and breast malignancies. Fatigue was present in all the 200 patients studied and the mean fatigue score was 13.09. Higher fatigue scores were observed in patients with advanced stages of cancer (Stage IV) (F [3,199] = 5.67, P = 0.001). There was a significant inverse relationship between fatigue scores with spiritual well-being (P < 0.001). Spiritual well-being score emerged as a significant primary negative predictor (ß = -0.23, P = 0.001) for fatigue scores followed by stage of disease (ß =0.23, P = 0.001) and gender (ß = -0.18, P = 0.01) as significant secondary predictors. CONCLUSION: Fatigue during cancer directed treatment is influenced by spiritual wellbeing, disease stage and gender. Further studies should examine the mediating variables that influence fatigue.

Effect of Argyreia speciosa root extract on cafeteria diet-induced obesity in rats.

OBJECTIVES: To evaluate the antiobesity effects of the ethanolic extract of Argyreia speciosa roots in rats fed with a cafeteria diet (CD). MATERIALS AND METHODS: Obesity was induced in albino rats by feeding them a CD daily for 42 days, in addition to a normal diet. Body weight and food intake was measured initially and then every week thereafter. On day 42, the serum biochemical parameters were estimated and the animals were sacrificed with an overdose of ether. The, liver and parametrial adipose tissues were removed and weighed immediately. The liver triglyceride content was estimated. The influence of the extract on the pancreatic lipase activity was also determined by measuring the rate of release of oleic acid from triolein. RESULTS: The body weight at two-to-six weeks and the final parametrial adipose tissue weights were significantly lowered (P < 0.01 and P < 0.05, respectively) in rats fed with the CD with Argyreia speciosa extract 500 mg/kg/day as compared to the CD alone. The extract also significantly reduced (P < 0.01) the serum contents of leptin, total cholesterol, low density lipoprotein (LDL), and triglycerides, which were elevated in rats fed with CD alone. In addition, the extract inhibited the induction of fatty liver with the accumulation of hepatic triglycerides. The extract also showed inhibition of pancreatic lipase activity by using triolein as a substrate. CONCLUSIONS: The ethanolic extract of Argyreia speciosa roots produces inhibitory effects on cafeteria diet-induced obesity in rats.

Effects of yoga program on quality of life and affect in early breast cancer patients undergoing adjuvant radiotherapy: a randomized controlled trial.

OBJECTIVES: This study compares the effects of an integrated yoga program with brief supportive therapy in breast cancer outpatients undergoing adjuvant radiotherapy at a cancer centre. METHODS: Eighty-eight stage II and III breast cancer outpatients were randomly assigned to receive yoga (n = 44) or brief supportive therapy (n = 44) prior to their radiotherapy treatment. Intervention consisted of yoga sessions lasting 60 min daily while the control group was imparted supportive therapy once in 10 days. Assessments included European Organization for Research in the Treatment of Cancer-Quality of Life (EORTCQoL C30) functional scales and Positive and Negative Affect Schedule (PANAS). Assessments were done at baseline and after 6 weeks of radiotherapy treatment. RESULTS: An intention to treat GLM repeated measures ANOVA showed significant difference across groups over time for positive affect, negative affect and emotional function and social function. There was significant improvement in positive affect (ES = 0.59, p = 0.007, 95%CI 1.25 to 7.8), emotional function (ES = 0.71, p = 0.001, 95%CI 6.45 to 25.33) and cognitive function (ES = 0.48, p = 0.03, 95%CI 1.2 to 18.5), and decrease in negative affect (ES = 0.84, p<0.001, 95%CI -13.4 to -4.4) in the yoga group as compared to controls. There was a significant positive correlation between positive affect with role function, social function and global quality of life. There was a significant negative correlation between negative affect with physical function, role function, emotional function and social function. CONCLUSION: The results suggest a possible role for yoga to improve quality of life and affect in breast cancer outpatients.

Anxiolytic effects of a yoga program in early breast cancer patients undergoing conventional treatment: a randomized controlled trial.

OBJECTIVES: This study compares the anxiolytic effects of a yoga program and supportive therapy in breast cancer outpatients undergoing conventional treatment at a cancer centre. METHODS: Ninety-eight stage II and III breast cancer outpatients were randomly assigned to receive yoga (n=45) or brief supportive therapy (n=53) prior to their primary treatment i.e., surgery. Only those subjects who received surgery followed by adjuvant radiotherapy and six cycles of chemotherapy were chosen for analysis following intervention (yoga, n=18, control, n=20). Intervention consisted of yoga sessions lasting 60min daily while the control group was imparted supportive therapy during their hospital visits as a part of routine care. Assessments included Speilberger's State Trait Anxiety Inventory and symptom checklist. Assessments were done at baseline, after surgery, before, during, and after radiotherapy and chemotherapy. RESULTS: A GLM-repeated measures ANOVA showed overall decrease in both self-reported state anxiety (p<0.001) and trait anxiety (p=0.005) in yoga group as compared to controls. There was a positive correlation between anxiety states and traits with symptom severity and distress during conventional treatment intervals. CONCLUSION: The results suggest that yoga can be used for managing treatment-related symptoms and anxiety in breast cancer outpatients.

Effects of yoga on symptom management in breast cancer patients: A randomized controlled trial.

OBJECTIVES: This study compares the effects of an integrated yoga program with brief supportive therapy on distressful symptoms in breast cancer outpatients undergoing adjuvant radiotherapy. MATERIALS AND METHODS: Eighty-eight stage II and III breast cancer outpatients were randomly assigned to receive yoga (n = 44) or brief supportive therapy (n = 44) prior to their radiotherapy treatment. Intervention consisted of yoga sessions lasting 60 min daily while the control group was imparted supportive therapy once in 10 days during the course of their adjuvant radiotherapy. Assessments included Rotterdam Symptom Check List and European Organization for Research in the Treatment of Cancer-Quality of Life (EORTC QoL C30) symptom scale. Assessments were done at baseline and after 6 weeks of radiotherapy treatment. RESULTS: A GLM repeated-measures ANOVA showed a significant decrease in psychological distress (P = 0.01), fatigue (P = 0.007), insomnia (P = 0.001), and appetite loss (P = 0.002) over time in the yoga group as compared to controls. There was significant improvement in the activity level (P = 0.02) in the yoga group as compared to controls. There was a significant positive correlation between physical and psychological distress and fatigue, nausea and vomiting, pain, dyspnea, insomnia, appetite loss, and constipation. There was a significant negative correlation between the activity level and fatigue, nausea and vomiting, pain, dyspnea, insomnia, and appetite loss. CONCLUSION: The results suggest beneficial effects with yoga intervention in managing cancer-and treatment-related symptoms in breast cancer patients.

Clinical trials in India.

The concept of outsourcing for the development and global studies on new drugs has become widely accepted in the pharmaceutical industry due to its cost and uncertainty. India is going to be the most preferred location for contract pharma research and development due to its huge treatment naïve population, human resources, technical skills, adoption/amendment/implementation of rules/laws by regulatory authorities, and changing economic environment. But still 'miles to go' to fulfill the pre-requisites to ensure India's success. In spite of all the pitfalls, the country is ambitious and optimist to attract multinational pharmaceutical companies to conduct their clinical trials in India.