The Effects of Yoga on Cardiovascular Risk Factors among Patients with Type 2 Diabetes Mellitus: Systematic Review and Meta-Analysis.

Type 2 diabetes mellitus (T2DM) is a fastest evolving metabolic disorder and India houses second highest number of patients with diabetes after China. Cardiovascular diseases are the major cause of mortality among patients with T2DM. Yoga is an ancient Indian practice that proves to be effective for patients with diabetes. The present systematic review and meta-analysis has been conducted to see the benefits of yoga on blood pressure, lipid profile, and anthropometric measures among patients with T2DM. The articles were extracted from three databases - PubMed, The Cochrane library, and Google scholar. Only English language articles, with PEDro score≥6, were included in the current study. The duplicates were removed using Mendeley. Fourteen randomized controlled trials (RCTs) and three 3 non-RCTs were included in the analysis. The meta-analysis was done using Review Manager 5.3. The results reveal that yoga is effect in improving blood pressure (P<0.01), lipid profile (P<0.01) except HDL (P=0.06), and anthropometric measures (P<0.01) except waist-hip ratio (P=0.79). Heterogeneity was also high for most of the variables. It may be concluded from the results that the yoga is effective in improving of blood pressure, lipid profile, and anthropometric measures. However, high heterogeneity sought the need of more high quality RCTs to affirm these findings.

Erratum: A systematic review and meta-analysis on effect of spinal mobilization and manipulation on cardiovascular responses.

[This corrects the article DOI: 10.1142/s1013702520500122.].

A systematic review and meta-analysis on effect of spinal mobilization and manipulation on cardiovascular responses.

BACKGROUND: Spinal pain or misalignment is a very common disorder affecting a significant number of populations resulting in substantial disability and economic burden. Various manual therapeutic techniques such as spinal manipulations and mobilizations can be used to treat and manage pain and movement dysfunctions such as spinal mal-alignments and associated complications. These manual therapeutic techniques can affect the cardiovascular parameters. OBJECTIVE: The objective of this systematic review and meta-analysis is to assess the effect of spinal manipulation and mobilization on cardiovascular parameters. METHODS: We conducted a systematic review and meta-analysis to assess the effects of spinal mobilization and manipulation on cardiovascular responses. Mean changes in Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP) and Heart Rate (HR) were primary outcome measures. RevMan 5.3 software was used for the meta-analyses. Quality of the included studies was assessed by PEDro Rating scale. Risk of bias was assessed by Cochrane collaboration tool of risk of bias. RESULTS: Results of meta-analysis showed that there was statistically significant decrease in SBP ( MD =- 4 . 56 , 95% CI =- 9 . 20 , 0.08; p ≤ 0 . 05 ) with moderate heterogeneity ( I 2 = 75 % , p < 0 . 0002 ) in experimental group as compared to control group. There was statistically non-significant decrease in DBP ( MD =- 1 . 96 , 95% CI =- 4 . 60 , 0.69; p = 0 . 15 ) with high heterogeneity ( I 2 = 91 % , p < 0 . 00001 ), Change HR was statistically non-significant ( MD =- 0 . 24 , 95% CI =- 3 . 59 , 3.11; p = 0 . 89 ) with moderate heterogeneity ( I 2 = 60 % , p = 0 . 01 ). Exclusion of short duration studies in sensitivity analysis revealed a statistically significant change in DBP ( MD =- 0 . 94 , 95% CI =- 1 . 85 , - 0 . 03 ; p = 0 . 04 ). However, the result was statistically non-significant for HR after sensitivity analysis. CONCLUSION: Spinal manipulations and mobilizations may result in significant decrease of systolic as well as diastolic Blood Pressure.

Pulmonary Pathology Among Patients with Type 2 Diabetes Mellitus: An Updated Systematic Review and Meta-analysis.

BACKGROUND: Restrictive lung pathology was reported in the previous meta-analysis among patients with Type 2 Diabetes mellitus (T2DM) which is date back to 2010. OBJECTIVE: To see the effect of T2DM on pulmonary functions through updated systematic review and meta-analysis. DATA SOURCE: PubMed. STUDY ELIGIBILITY CRITERIA: English language case-control or cross-sectional studies, published between 1 January 2010 to 31 August 2018. PARTICIPANTS AND INTERVENTION: T2DM and non-diabetic subjects were compared for at least one of the pulmonary function variables i.e. Forced expiratory volume in 1st second (FEV1), % FEV1, Forced vital capacity (FVC), % FVC and % FEV1/FVC. STUDY APPRAISAL AND SYNTHESIS METHODS: Methodological quality of the study was assessed using Newcastle-Ottawa Quality Assessment Scale. Meta-analysis was done using Review Manager 5.3 (RevMan 5.3) and meta-regression was conducted using R statistical software. RESULTS: We selected 22 articles that met our inclusion and exclusion criteria. Results reveal that among patients with T2DM all variables were reduced except %FEV1/FVC which shows statistically nonsignificant results with P=0.46. This confirms that T2DM patients have a restrictive type of lung pathology. LIMITATION: Only articles from the PubMed database were included. Conclusion and Implications of Key Findings: This review affirms the existing evidence of restrictive pathology among patients with T2DM. The future study could be conducted to see the effect of various rehabilitation protocols on pulmonary function among patients with T2DM.

The talk test-A costless tool for exercise prescription in Indian cardiac rehabilitation.

Exercise-based cardiac rehabilitation (CR) plays a vital role in improving function and preventing mortality of cardiovascular disease (CVD) patients. Outpatient (Phase II and III) CR is almost nonexistent in India because of several reasons such as time, cost, distance, education level, scarcity of resources and so forth. Cardiologists or cardiac surgeons can directly advise patients and their family members to do an optimal dose of exercise in low-resource settings, that is, rural, low-income, or low-educated patients. Talk test is a no-cost, subjective tool for exercise prescription which is gaining popularity in CR because of its simplicity. This brief descriptive review covers history, administration, physiological mechanisms, reliability and validity, and safety among cardiac patients along with limitations of the 'talk test'. This review also theoretically discusses how the talk test could be used in primary and secondary prevention of CVD. Finally, it advocates Indian CR team to use this simple validated tool as a self-monitoring tool of exercise intensity.

Recent Advances in Anti-inflammatory Potential of Pyridazinone Derivatives.

Pyridazinone and its derivatives have various ranges of biological and pharmacological activities including anti-inflammatory, antifeedant, anticonvulsant, antidiabetic, herbicidal, antihypertensive, antiplatelet, antifungal, antibacterial, anticancer and antiviral activities. Pyridazinone magic moiety has allowed the generation of a huge number of structurally different derivatives. Most of the pyridazinone derivatives are derived from substitution of the pyridazinone oxygen, nitrogen and C4/C5/C6 carbon positions. Pyridazinone can be used for the synthesis of a large variety of heterocyclic compounds and as intermediate for a broad spectrum of drug synthesis. Constant use of non-steroidal anti-inflammatory drugs is often accompanied by side effects such as bleeding, nephrotoxicity and gastrointestinal lesions. To minimise these side effects some of the pyridazinone derivatives are synthesised with an improved gastrointestinal tract and renal safety profile linked to other non-steroidal anti-inflammatory drugs. In this review, we have discussed the pyridazinone nucleus which serves as an important therapeutic agent in the field of nonsteroidal anti-inflammatory drugs. This nucleus has a wide spectrum in bioorganic and medicinal chemistry and application in drug discovery.