Yoga as an adjuvant therapy in heart failure patients on optimal medical management analysed using echocardiographic parameters.

BACKGROUND: Heart failure (HF) is a chronic complex disease that prevails as a prime cause of concern for healthcare sectors worldwide, with a concordant objective to improve the long-term prognosis. Analysis of the available literature is evidence that yoga therapy and basic lifestyle modifications have considerably augmented heart failure patients' quality of life and enhanced left ventricular ejection fraction and NYHA functional class. AIM: Our study aims to establish the long-term outcomes of yoga therapy to validate the addition of yoga therapy as a complementary treatment in managing HF. METHODS: A prospective non-randomized study was conducted at a tertiary care center including seventy-five HF patients with NYHA class III or less who underwent coronary intervention, revascularization, or device therapy within the past six months to one year and continuing guideline-directed optimal medical therapy (GDMT). Thirty-five participants were part of the Interventional Group (IG), and forty were in the Non-Interventional Group (Non-IG). The IG received yoga therapy and GDMT, while the non-IG were only under standard GDMT. Echocardiographic parameters were compared at various follow-ups up to one year to see the impact of Yoga therapy on HF patients. RESULTS: A total of 75 heart failure patients, including 61 males and 14 females. The IG and non-IG had 35 subjects (31 males and 4 females) and 40 subjects (30 males and 10 females), respectively. Echocardiographic parameters were observed to compare the IG and Non-IG groups, and those did not demonstrate any significant difference between the two groups (p-value > 0.05). But, the echocardiographic parameters of the IG and non-IG from baseline to six months and one year showed a significant improvement (p-value of <0.05). The functional outcome (NYHA classes) was assessed after follow-up, and a p-value <0.05 showed a substantial improvement in the IG. CONCLUSION: Yoga therapy results in better prognosis, functional outcome, and left ventricular performance in HF patients with NYHA III or less. Hence this investigation has attempted to justify its importance as adjuvant/complimentary treatment for HF patients.

The Effect of Specific Techniques of Nasal Breathing [Pranayama] on Intra-Ocular Pressure in Normal Individuals, a Randomized Trial.

Purpose: Glaucoma is an optic neuropathy where intraocular pressure is the only modifiable risk factor. Yoga is thought to adversely affect intra-ocular pressure (IOP) but we do not know if yogic breathing exercises can influence IOP. With this study, we aimed to determine the effect of specific nasal breathing techniques on intra-ocular pressure in normal individuals. Patients and Methods: One hundred and sixty-four normal subjects were randomly assigned to one of four specific breathing groups - right nostril breathing (RNB), left nostril breathing (LNB), alternate nostril breathing (ANB), normal breathing (NB). The IOP was measured in both eyes at baseline and following the breathing exercise; and the change was analyzed. Results: Eighty-five women and 79 men participated and there was no significant difference in baseline age or IOP between the groups. In RNB, IOP reduced significantly in both right and left eyes, from 14.3 ± 3.0mmHg to 13.9 ± 2.6mmHg, (p=0.022) and from 14.7 ± 3.2mmHg to 14.2 ± 3mmHg (p=0.016) respectively. In LNB, there was no significant IOP change in the right eye, whereas in the left eye, there was a significant reduction from 14.2 ± 2.7mmHg to 13.3 ± 2.5mmHg (p< 0.0001). There was no significant IOP change in ANB and NB. Conclusion: Specific breathing techniques like right and left nostril breathing, alternate nostril breathing are safe and do not raise IOP in normal subjects. Additionally, right and left nostril breathing techniques have a beneficial effect of lowering IOP.

Effects of Yoga on Cognitive Functions Among Adolescents.

Context: Yoga is beneficial in enhancing mental health and consequently cognitive growth. Some studies have show that yoga practice can improve cognitive functioning in children. Objective: The study intended to evaluate the effectiveness of a school-based yoga intervention on the cognitive abilities-attention and memory-of adolescents. Design: The research team conducted a one-group, pretest-posttest study. Setting: The study occurred at a rural residential school in Udupi, Karnataka, and South India. Participants: Participants were a convenience sample of 36 adolescents, with a mean age of 12.19 ± 0.4 years, in the seventh grade at the school. Intervention: A senior yoga expert prepared a structured, yoga-intervention module, which was implemented, with each session lasting one hour and occurring five days a week for 12 weeks. Outcome Measures: The Digit Span Forward (DSF) and Digit Span Backward (DSB) tests and Letter-Number Sequencing (LNS) test were used by a trained research examiner to evaluate cognition. Results: Comparing the mean DSB, total digit span score, and LNS at baseline and postintervention showed significantly higher posttest scores than pretest ones, with P = .005, P = .005, and P = .001, respectively. Conclusions: Yoga training improves cognitive functions and is a simple, low-cost, and effective adjuvant modality.

Epidemiological Determinants of Mental Well-Being and Quality of Life among Homemakers with Hypertension: A Cross-Sectional Analysis.

BACKGROUND: Stress is a major contributor to the physiology of hypertension (HTN) and is linked closely to mental well-being and overall quality of life (QoL). Health issues pertaining to women's health have usually focused on reproduction, while mental well-being has largely been neglected. OBJECTIVES: The objective of the study was to assess the perceived stress and QoL among homemakers with HTN. MATERIALS AND METHODS: A community-based cross-sectional study was carried out, among 426 homemakers with HTN residing in Udupi, Karnataka. The sociodemographic and disease characteristics, Cohen's Perceived Stress Scale-10, World Health Organization QoL Brief Questionnaire (WHOQOL-BREF), anthropometry, and vitals were measured. RESULTS: Of the study participants, 245 (57.5%) were aged ≤60 years and 317 (74.4%) had been diagnosed with HTN in the past decade. Low and high perceived stress was seen among 306 (71.8%) and 120 (28.2%) women, respectively. Among the four domains of WHOQOL-BREF, the physical domain had the highest mean (±standard deviation) score of 67.44 (±16.50), whereas the lowest score of 54.49 (±19.75) was observed in the social domain. The odds of high stress among single women and those with a pill burden of >2/day were 1.93 (P=0.004, 95% CI=1.228, 3.054) and 1.77 (P=0.038, 95% CI CI=0.962, 3.270) respectively. The QoL was significantly better among those aged <60 years, married, and literate women. CONCLUSIONS: Mental well-being among the hypertensive homemakers was good, with low perceived stress and high mean scores of QOL domains.