COMPILATION OF ACYTER BULLETINS April 2009 - February 2012 Editor: Dr. MADANMOHAN Programme Director, ACYTER, JIPMER Editorial board: Dr. GK PAL Professor and Head, Dept. of Physiology, JIPMER and Dr. ANANDA BALAYOGI BHAVANANI Programme Co-ordinator, ACYTER, JIPMER ADVANCED CENTRE FOR YOGA THERAPY, EDUCATION AND RESEARCH (ACYTER) (A collaborative venture between Morarji Desai National Institute of Yoga (MDNIY), New Delhi and Jawaharlal Institute of Post Graduate Medical Education and Research (JIPMER), Pondicherry)
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ACYTER Bulletin Compilation-April 2009 to Feb 2012
Compilation of the bulletins of the ACYTER from April 2009 to February 2012. The ADVANCED CENTRE FOR YOGA THERAPY, EDUCATION AND RESEARCH (ACYTER) is a collaborative venture between Morarji Desai National Institute of Yoga (MDNIY), New Delhi and Jawaharlal Institute of Post Graduate Medical Education and Research (JIPMER), Pondicherry, India.
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COMPILATION
OF
ACYTER BULLETINS
April 2009 - February 2012
Editor:
Dr. MADANMOHAN
Programme Director, ACYTER, JIPMER
Editorial board:
Dr. GK PAL
Professor and Head, Dept. of Physiology, JIPMER
and
Dr. ANANDA BALAYOGI BHAVANANI
Programme Co-ordinator, ACYTER, JIPMER
ADVANCED CENTRE FOR YOGA THERAPY, EDUCATION
AND RESEARCH (ACYTER)
(A collaborative venture between Morarji Desai National Institute of
Yoga (MDNIY), New Delhi and Jawaharlal Institute of Post
Graduate Medical Education and Research (JIPMER), Pondicherry)
WORKSHOP ON “INTRODUCING YOGA IN MEDICAL CURRICULUM”
ACYTER and Department of Physiology, JIPMER organized a two day National Workshop on “Introducing Yoga in the medical curriculum” on 19th and 20th March 2009 at JIPMER.
The workshop was organized in collaboration with Morarji Desai National Institute of Yoga
(MDNIY), New Delhi under auspices of Department of AYUSH, Govt of India.
The workshop was
inaugurated by Dr
KSVK Subba Rao,
Director JIPMER. Dr
Ishwar V Basavaraddi,
Director, MDNIY, New
Delhi and Dr AK Das,
Medical Superintendent,
JIPMER were guests of
honour.
The national workshop
deliberated on the need,
feasibility and modality
of introducing yoga
science in the medical curriculum for medical students in particular and medical professionals in
general.
20 resource persons from MDNIY, DIPAS, sVYASA, Karuna Trust, Iyengar Yoga Institute,
Mumbai Yoga Institute, Kaivalyadhama, ICYER and JIPMER as well as 150 participants from all
over the country participated in the workshop that covered the theory, practicals and therapeutic aspects of yoga and evaluation methods for such a course.
The following are the recommendations of the workshop:
1. The workshop appreciated the Department of AYUSH and Morarji Desai National
Institute of Yoga, New Delhi for making efforts to integrate yoga science in the medical
curriculum and create awareness of yoga amongst the medical students in particular and
medical professionals in general.
2. It was recommended to introduce yoga science to medical students in particular and
medical professionals in general through a “Foundation Course in Yoga Science”.
3. It is recommended that 14 hours of yoga
theory be included in
theory lectures for 1st,
2nd
and 3rd
professionals and 32
hours practicals be
included in the 2nd
professional.
4. It was also
recommended that a
48 hour foundation
course be conducted
after class hours for
interested
professionals through
the yoga units of the institutions as per the syllabus that has been prepared by the MDNIY
in consultation with eminent yoga and medical experts.
Quarterly Bulletin of ACYTER- April 2009 3
MASS YOGA AWARENESS PROGRAMME IN SCHOOLS OF PUDUCHERRY
DURING THE NATIONAL YOGA WEEK 2009
The Ministry of Health and Family Welfare sponsored the NATIONAL YOGA WEEK 2009 from
16 to 22 of February 2009 and Morarji Desai National Institute of Yoga (MDNIY), New Delhi
organised a mass awareness programme for health, happiness and harmony through yoga with the theme of “Role of Yoga in School
Health”.
As part of the National Yoga Week, a
MASS YOGA AWARENESS
PROGRAMME was conducted in
schools in different parts of the country
through the active participation of leading and eminent yoga institutes who
have come together under the banner of
the Indian Yoga Association, a self
regulatory body for yoga sponsored by
the Department of AYUSH, Ministry of
Health and Family Welfare,
Government of India.
ACYTER organized the mass yoga awareness
programme in 48 schools of Puducherry with the
cooperation of the Education Department,
Government of Puducherry. The inaugural
ceremony for the yoga week in Puducherry was
held at Kendriya Vidyalaya, JIPMER campus on
16 February 2009 and the valedictory function at
the Indira Nagar Government Higher Secondary
School on 20 February. Shri MA Fathimaraj,
Deputy Director Education (Sports and Youth
Services) was the Chief Guest at the valedictory
function.
Daily yoga camps of 1½ hours duration on the theme of the national yoga week were conducted in
48 government and private schools of Puducherry by 28 yoga teachers under the direction of Prof
Dr. MADANMOHAN, Director-Professor & Head, Dept of Physiology, JIPMER, and Programme
Director, ACYTER and coordinated by Mrs. Meena Ramanathan, Coordinator Yoga courses,
Pondicherry University Community College. The International Centre for Yoga Education and
Research (ICYER) and Pondicherry Yogasana Association extended active cooperation for the
conduct of the yoga classes.
More than 5,000 students as well as their
teachers and parents were sensitized to the
importance of yoga for school health
during this programme. Yoga is the best
means to improve the psychosomatic
health of everyone, especially children.
Regular yoga practice enhances the
personality of children, improves
concentration and memory power, helps
endure stressful situation during
examinations, increases immunity and
improves overall health. The main
objective of the programme was to
increase awareness about the benefits of yoga among the children and there was much awakening
as evidenced by feedback from the schools.
Quarterly Bulletin of ACYTER- April 2009 4
INTRODUCING YOGA TO MEDICAL STUDENTS: THE JIPMER EXPERIENCE
The holistic science of yoga has a great future as it has the potential to prevent as well as manage a number of
stress-induced chronic diseases that defy allopathic
medicine. A holistic physician and practitioner of yoga
will be able to render better medicare and will be a boon
to the society.
It was my heart’s desire to introduce yoga to medical
students as a branch of physiology & contemporary medicine. The opportunity came with the active
collaboration and financial support from MDNIY. The
objectives of the programme were:
• To promote awareness among medical students about the effectiveness of yoga as an
inexpensive means for achieving holistic health.
• To impart knowledge, skill & attitude about theoretical & practical aspects of yogic science.
• To motivate medical students to take up further studies, therapy & research in yoga.
• To introduce yoga in medical curriculum as a branch of physiology & contemporary medicine.
I designed a 60 hour programme that included i) lectures (12 h), ii) lecture-demonstrations (3 h)
iii) practice sessions (36 h) iv) students seminar on yoga therapy modules (6 h) and v) pre-test,
post-test, administration of questionnaires & programme evaluation by the students (3 h).
The programme had an overwhelming response with excellent co-operation from the medical undergraduates. In light of the encouraging student feedback, the following are the suggestions:
• Yoga should be made an integral part of medical curriculum, as a branch of physiology and
contemporary medicine. Complementary and alternative health systems are already being
taught in many standard modern medical schools in different parts of the world.
• The ideal time in an undergraduate medical programme where yoga can be incorporated is
during the first semester and again during the sixth and / seventh semesters. The former will
help them in combating and adapting to the totally new and extremely stressful first year
undergraduate medical curriculum. The latter will help in better understanding of the science
of yoga and its applications in clinical practice.
• It is suggested that there should be a space fully furnished, having the right ambience and
comfort that will facilitate the teaching and practice of yoga. The space should be exclusively
devoted to the yoga training programme.
• From the students’ standpoint, practice sessions with integrated theory, morning practice
sessions and training schedule within college hours are among the major recommendations.
Students also wanted a facility to continue yoga practice on a regular basis even after the
completion of the introductory programme.
Bulletin of ACYTER- July 2009 1
The Advanced Centre for Yoga Therapy, Education and Research
(ACYTER), a collaborative venture between JIPMER, Puducherry and
Morarji Desai National Institute of Yoga (MDNIY), New Delhi was
established by a MOU between JIPMER and MDNIY on 7th
June 2008.
This advanced centre will focus on the role of yoga in the prevention
and management of cardiovascular disorders and diabetes mellitus. The
centre will also popularize the science of yoga amongst medical
professionals and general public.
MDNIY will be providing financial assistance and necessary academic
input related to yoga and take steps to initiate collaborative research
projects on yoga and its applications related to cardiovascular diseases
and diabetes mellitus. JIPMER will be offering its infrastructure and
faculty for purposes of collaborative ventures with MDNIY in the field
of yoga and its applications to cardiovascular diseases and diabetes
Director- Professor & Head, Department of Physiology & Programme
Director, ACYTER
All over the world, cardiovascular disease imposes a significant morbidity and mortality. Inspite of greatly improved diagnostic and
curative cardiology, millions die of heart disease every year. It is a
matter of concern that relatively young Indian professionals who are at
the peak of their career and productivity become victims of angina. The
most important cause is stress and strain of “modern” life characterized
by competition, great speed and greater greed.
Good health and freedom from disease is the greatest achievement, a
blessing indeed and both modern medicine as well as yoga aim at it.
Both systems have sound scientific basis and universal outlook. They are complementary and bound
to come together. It is gratifying that yoga has started using modern technology and scientific
methods while science has started studying the effects of yogic techniques. The ancient marvel of
yoga is the priceless gift of India to the world. Yoga is beneficial in health as well as disease as it is
holistic and has promotive, preventive as well as curative potential. Our body, mind and spirit are
intricately interrelated and constantly influence one another. The holistic science of yoga has been
designed to have subtle effect on our whole being- body, mind as well as spirit. The all-pervasive
stress and stress-induced disorders like hypertension and angina are fast growing epidemics and
bane of "modern" society. The holistic science of yoga is the best method for prevention as well as
management of stress and stress-induced disorders. The psycho-physiological responses to yoga are
opposite to the stress response. Shavasan, yoganidra, meditation and slow, rhythmic pranayam
breathing are very effective in calming the mind and promoting psychosomatic health. Cardiac
patients are sensitive and reactive. Yoga relaxation techniques calm the mind and make one
emotionally balanced. Consequently, minor disturbances do not cause emotional upsets and
cardiovascular problems.
Hypertension is prevalent throughout the world and many patients are on life-long medication as a
way of life. Drugs are expensive and have many adverse side effects. Hence, non-drug management
like yoga should be the first choice. If diagnosed early, majority of cases of essential hypertension
can be managed effectively by yoga alone. In more advanced cases, yoga can decrease drug dosage
and improve the overall quality of life. Besides being inexpensive, safe and effective, yoga improves overall health and can be combined with allopathic medication. For best results, yogic lifestyle
should be adopted early in life as it has been demonstrated that atherosclerotic plaques in coronary
arteries form early in life. Moreover, in a recent study, we have demonstrated that the levels of total
and LDL cholesterol are higher in prehypertensive as compared to normotensive subjects. Hence,
yogic relaxation and yogic diet should be adopted early in life to prevent progression of the
condition and development of hypertension. The effectiveness of yoga in the management of
hypertension has been demonstrated from our laboratories and also by earlier workers. Hence, it is recommended that yogic relaxation techniques should be adopted as the first line of treatment for
pre-hypertension, borderline hypertension and mild hypertension. In an interesting study, we have
recently demonstrated that yoga relaxation training is beneficial in patients with benign ventricular
ectopics.
Therapeutic effect of yoga may be due to i) management of stress ii) improvement of cardio-
respiratory function and overall fitness and iii) modulation of autonomic function. Stress is an
important causative factor in cardiovascular diseases like hypertension and angina. In an interesting work from our laboratories, we have demonstrated that subjects trained in yoga can achieve a state
of deep psychosomatic relaxation associated with highly significant decrease in oxygen
consumption within five minutes of practising savitri pranayam (a slow, rhythmic and deep
breathing) and shavasan. These findings are consistent with the report that yoga training not only
produces a significant decrease in basal anxiety level, but also attenuates the change in anxiety score
in stressful situations such as examination. It has also been reported that yoga training helps in
development of resistance against stress.
Bulletin of ACYTER- October 2009 3
Practice of asans and pranayams results in overall improvement in physical fitness and cardio-
respiratory functions. In a study conducted on medical students, we have demonstrated that yoga
training of 12 weeks duration produces a significant increase in respiratory pressures, breath holding
time and handgrip strength. This indicates an improved physical strength and cardio-respiratory
function. We have also reported that after yoga training, exercise-induced stress to cardiovascular system is less severe. Yoga training promotes emotional and physiological balance. In an interesting
study, it was found that a brief (15 min) yoga based relaxation training normalizes the function of
autonomic nervous system by deviating both sympathetic and parasympathetic indices towards more
“normal” middle region of the reference values. These studies show that yoga has a great potential
to improve our physiological functions, psychosomatic health and overall performance.
PROPOSALS SUBMITTED FOR NEW YOGA RESEARCH PROJECTS
Dr Madanmohan, Programme Director ACYTER, has submitted two research proposals to the
JIPMER Research Council. The first proposal entitled, “Effect of yoga therapy on patients of type
II diabetes mellitus with neuropathy” plans to investigate the physiological, bio-chemical,
psychological and clinical effects of 6 months yoga therapy in patients of diabetes mellitus with
neuropathy. The second proposal entitled “Effect of yoga therapy on autonomic function and
biochemical profile of patients of essential hypertension” plans to investigate the autonomic and
biochemical effects of 6 months yoga therapy in patients of essential hypertension.
YOGA THERAPY OPD AT SUPER SPECIALTY BLOCK
Yoga therapy OPD is functioning in Super Specialty Block of JIPMER. From July to September
1080 patients (251 new and 829 old cases) of various conditions attended consultation in the OPD
with Dr Ananda Balayogi Bhavanani and Dr Zeena Sanjay. Patients who attended consultation were prescribed individualized and generalized yoga therapy for diabetes mellitus (169), hypertension
neurology (9), ENT disorders (7) and other complaints (10). Patients have reported benefits and
expressed thanks to ACYTER, JIPMER and MDNIY for this facility.
YOGA THERAPY SESSIONS
Yoga therapy sessions continue to be conducted on Mondays, Wednesdays and Fridays from 10:00
am – 11:00 am for patients of diabetes, 11:00 am – 12:00 noon for patients of cardiovascular diseases and 12:00 noon – 1:00 pm for patients of other disorders. The yoga instructors, G Dayanidy
and L Vithiyalakshmi are conducting the sessions both individually and in groups as per directions
of the therapists given in the OPD. Patients have reported satisfaction with the therapy sessions and
are attending regularly. 463 patients of diabetes, 295 of hypertension and 328 of other conditions
attended the sessions between July-September.
YOGA CLASSES FOR NORMAL SUBJECTS
Yoga classes for normal subjects are being conducted on Mondays, Wednesdays and Fridays
between 6:30 – 7:30 am & 4:30 – 5:30 pm. 61 participants attended the classes regularly in July-
September. Suryanamaskar, basic asanas, pranayamas and relaxation techniques are being taught in
the general classes. The Senior Citizen’s Clinic is being conducted on every Thursday from 11:00
am to 12:30 pm and was attended by 117 patients from July to September.
YOGA AWARENESS AT PUDUCHERRY GOVT DENTAL COLLEGE
Dr Ananda Balayogi Bhavanani, Programme Co-ordinator ACYTER was invited to give a talk on
“Yoga for Positive Health” at the first clinical society meeting held at the Mahatma Gandhi Post
Graduate Institute for Dental Sciences, Puducherry on 12 August. The talk was attended by the
Director, Dean, senior professors and about 100 UG and PG students of the college. G Dayanidy,
yoga instructor ACYTER gave an excellent demonstration on the occasion. The Director Dr Shyam Singh expressed his willingness to have a yoga orientation programme for the staff and students of
the institute and ACYTER plans to conduct such a programme in the near future.
Bulletin of ACYTER- October 2009 4
YOGA AWARENESS AT JIPMER NURSING COLLEGE
Dr Madanmohan, Programme Director ACYTER and Dr Ananda Balayogi Bhavanani, Programme
Co-ordinator ACYTER presented a series of talks at the JIPMER Nursing College for participants of
the Nursing Workshop on AIDS/HIV conducted in August and September. More than 150
participants were sensitized to the benefits of Yoga and other alternative and complementary
therapies though the talks. Shri G Dayanidy, yoga instructor ACYTER gave excellent demonstration during the talks.
ACADEMIC ACTIVITES
Academic programmes by staff of ACYTER as well as
invited faculty are being conducted at ACYTER Hall
every Saturday from 11am to 1pm. Many staff and
students of JIPMER as well as yoga enthusiasts from
Puducherry have been attending the talks. The
following talks were given in the period July to
September.
1. Naturopathy & its applications by Dr. Zeena Sanjay
2. Yoga for diabetes by Selvi L Vithiyalakshmi
3. Yoga for hypertension by Shri G Dayanidy
4. Music therapy by music researchers from Belgium
5. Introduction to siddha medicine by Dr. Rajalakshmi
6. Benefits of herbal medicines by Shri Paramakethu
7. Pranayama and its therapeutic benefits by Shri S.
Jayasettiaseelon
8. Yoga for positive health by Dr Zeena Sanjay
9. Yoga for special children by Mrs. Meena
Ramanathan
10. Methods of yogic diagnosis by Dr Ananda Balayogi
11. Yoga for sleeping disorders by Shri G Dayanidy
12. Shatkriyas by Selvi L Vithiyalakshmi
A delegation of yoga teachers from Australia and New
Zealand visited ACYTER on 9 September and
expressed their admiration for the programme and its
activities. They were especially appreciative that Indian Government was bringing yoga into the mainstream
health care system through advanced centers at
JIPMER, NIMHANS, DIPAS and Gujarat Ayurveda
University.
Dr GS Gaur, Professor of Physiology, JIPMER attended
the reorientation programme for doctors conducted by
MDNIY, New Delhi from 6 to 12 September. Dr
Madanmohan, Programme Director ACYTER was the
Chief Guest at the valedictory function.
From To
Advanced Centre for Yoga Therapy,
Education and research (ACYTER)
Department of Physiology,
JIPMER,
Puducherry – 605 006
Bulletin of ACYTER- January 2010 1
WORKSHOP ON CHAKRA HEALING
ACYTER organized a workshop on Chakra Meditation for Healing on
1st January 2010 by Sri Bala Ratnam, founder of Vibrational Breath
Therapy from Melbourne, Australia. The workshop conducted at
Bernard Theatre, JIPMER was chaired by Dr. Madanmohan,
Programme Director ACYTER. More than fifty members of the staff,
students, residents and invited guests from Pondicherry and Chennai
participated actively. Sri Bala explained in detail the stages of
consciousness and the pancha kosha and guided the participants
through the self healing techniques visualizing the chakras with the
chanting of akara, ukara, makara and omkara nada. He conveyed many
of his personal experiences through his intensive yoga sadhana and also
in dealing with patients of various ailments. Sri Bala is a dedicated
disciple of Swami Gitananda Giri and has codified the Vibrational
Breath Therapy based on Rishiculture teachings of his Guru. Sri Bala at
87 years of age is a living example of the beneficial effects of yoga and
Prana are the basis of all causation and creation. We are
in essence self consciousness, a part and parcel of
Divine / Cosmic Consciousness, which the Christians
call Christ Consciousness, Buddhists call Buddha
Consciousness, Hindus call Krishna Consciousness,
and Moslems call Allah Consciousness.
In our worldly existence we live in three states of
consciousness – wakeful, dream, and deep sleep
associated with the three planes of existence: physical,
astral and causal, all manifestations of cosmic energy or
prana. These three planes of existence are in fact the
physical, astral, and causal energy bodies, created and sustained by the cosmic vibratory energy of
Pranava AUM. To regenerate, rejuvenate and rehabilitate, the physical, astral and causal energy
bodies have to be energized, magnetized and integrated; and their wakeful, dream and deep sleep
states of consciousness transcended. To do so, the student/patient has to be assisted to rise above
both body and conscious mind, negate ego-consciousness and move into turiya, the fourth state, a
state beyond conceptualization. This state of causal silence is the abode of peace, happiness, tranquility, creativity, intuition, health, knowledge and
freedom – the source of everything, where renewal,
repair and healing take place.
These energy bodies need daily sustenance by the
cosmic vibratory energy of AUM to experience a state
of well being. Breathing over 70% of the lung capacity
in mahat yoga pranayama (the complete yogic breath) absorbs prana from the cosmos, which energizes and
magnetizes these energy bodies, while the chanting of
AUM provides the vibratory resonant frequency
component needed to create a state of well being.
The flow of prana is inhibited by traumas and tensions of this and previous births stored at the
manipura, vishuddha and ajna chakras (navel, throat and brow centres) associated with the
physical, astral and causal planes of existence respectively. These are neutralized by the divinely
inspired Chakra Meditation practice, which activates these centres and enhances their psychic
qualities to transform the personality and character of the student / patient to combat the illness /
disharmony in the body-mind complex. Practising these techniques initiates a process of healing at
the physical, astral and causal planes of existence.
Then, the psychic passage (shushumna nadi) is cleansed to allow a free flow of prana through it.
Using the chant AUM, all the three planes of existence are integrated to create a state of well
being. The awareness is then taken to the seat of
the problem. This could be in the physical body or in the mind. If there is a particular physical
condition, by using highly focused
concentration, the cosmic vibratory energy of
AUM is allowed to vibrate and resonate at the
seat of the problem to initiate the process of
healing. The session concludes with a meditation
at anahata chakra, the heart centre, the seat of the soul with a focused personal affirmation
(sankalpa).
Bulletin of ACYTER- January 2010 3
17th
INTERNATIONAL YOGA FESTIVAL AT PUDUCHERRY
The 17th International Yoga Festival was conducted at Puducherry by the Department of Tourism
from 4-7 January 2010. More than a thousand participants took part in the festival. ACYTER staff
actively participated in the festival and provided free consultation on yoga and healthy lifestyle for
the participants and the general public. Dr. Madanmohan, Programme Director chaired the session
on “Role of Yoga in Health Care – Hypertension” and described important yoga practices for
patients of hypertension. Shri G Dayanidy, Yoga Instructor, ACYTER won first place in the 20-25
male category yogasana competition and participated in the champion of champions final event. Dr
Ananda Balayogi Bhavanani, Programme Co-ordinator ACYTER coordinated theoretical aspects in the competition and moderated the workshops on different traditions. He chaired a session on
yoga for respiratory disorders and gave a presentation on the Gitananda tradition.
YOGA THERAPY OPD AT SUPER SPECIALTY BLOCK
ACYTER’s Yoga therapy OPD is functioning on a regular basis in Super Specialty Block. During
October to December, 1173 patients (new 420 and old 753 cases) of various conditions attended
consultation in the OPD with Dr Ananda Balayogi Bhavanani and Dr Zeena Sanjay. Patients who
attended consultation were prescribed individualized and generalized yoga therapy for diabetes
mellitus, hypertension, musculoskeletal disorders, respiratory disorders, stress and psychological
disorders, endocrine disorders, coronary artery disease, GIT, neurology, and other complaints.
Patients have reported benefits and expressed their thanks to ACYTER, JIPMER and MDNIY for
this facility.
YOGA THERAPY SESSIONS
Yoga therapy sessions are being conducted on Mondays, Wednesdays and Fridays from 10– 11 am
for patients of diabetes, 11 am – 12 noon for patients of cardiovascular diseases and 12 noon – 1 pm for patients of other disorders. The yoga instructors, Shri G Dayanidy and Selvi L
Vithiyalakshmi are conducting the sessions both individually and in groups as per directions of the
therapists given in the OPD. Patients have reported satisfaction with the therapy sessions and are
attending regularly. 389 patients of diabetes, 225 of hypertension and 405 of other conditions
attended the sessions between Oct-Dec 2009.
PILOT STUDIES AT ACYTER
Staff members of ACYTER have conducted short term pilot studies on different applications of
yoga in the past quarter. The studies that have been conducted are:
1. Acute effects of yoga nidra on normal subjects – Shri E Jayasettiaseelon, SRF
2. Acute effects of chandranadi pranayama in hypertension - Dr. Zeena Sanjay, SRF
3. Acute effects of shavasana and pranava pranayama in hypertension - Selvi L
Vithiyalakshmi, Yoga instructor
4. Immediate effect of yoga practices on blood pressure– Shri G Dayanidy, Yoga instructor
Bulletin of ACYTER- January 2010 4
YOGA AWARENESS AT JIPMER NURSING COLLEGE
Dr Madanmohan, Programme Director, Dr Ananda Balayogi Bhavanani, Programme Co-ordinator, Shri E Jayasettiaseelon, SRF & Dr Zeena Sanjay, SRF presented seven talks at the JIPMER
Nursing College for participants of the Nursing Workshops on AIDS/HIV conducted in Oct-Dec
2009. More than 150 participants were sensitized to the benefits of Yoga and other alternative and
complementary therapies though the talks as well as demonstrations by Shri G Dayanidy and Selvi
L Vithiyalakshmi, yoga instructors.
REGULAR ACTIVITES OF ACYTER
Academic programmes by staff of ACYTER as well as invited faculty are conducted at ACYTER
Hall every Saturday. Staff and students of JIPMER as well as Yoga enthusiasts from Puducherry
have been attending the talks. Group discussions on various topics pertaining to yoga therapy and
yoga research were also conducted with active participation of the residents of the department of
physiology.
A delegation of yoga teachers and students
from Berlin, Germany under the leadership of Yogacharya Ananda Leone visited
ACYTER in November and expressed
admiration for the programme and its
activities. They were especially appreciative
that the Indian Government has brought
Yoga into the mainstream health care system
though advanced centers in JIPMER,
NIMHANS, DIPAS and Gujarat Ayurveda
University.
Regular yoga classes are being conducted on
Mondays, Wednesdays and Fridays in both
mornings and evenings. 45 participants
attended the classes in the last quarter.
Suryanamaskar, basic asanas, pranayamas and relaxation techniques are being taught in the general classes. Senior Citizen’s Clinic is being conducted every Thursday and 40 participants attended
classes with Mrs. Meena Ramanathan, coordinator yoga courses, PUCC.
ANNOUNCEMENT:
ACYTER is organizing a National Workshop-Cum-Seminar on “Role of Yoga in Prevention and
Management of Hypertension” in collaboration with Morarji Desai National Institute of Yoga,
(MDNIY) New Delhi on March 18-19, 2010 at JIPMER. 300 medical and paramedical
professionals as well as yoga therapists are expected to participate in the deliberations on
the role of yoga in the prevention and management of hypertension. Lectures, panel
discussions and practical sessions will be conducted by eminent medical and yoga experts.
Bulletin of ACYTER, April 2010 1
NATIONAL WORKSHOP-CUM-SEMINAR ON ROLE OF YOGA IN PREVENTION AND MANAGEMENT OF HYPERTENSION
A National Workshop-cum- Seminar on “Role of Yoga in Prevention and Management of Hypertension” was held at JIPMER on March 18-19, 2010. The workshop was organized by the Advanced Centre for Yoga Therapy, Education & Research (ACYTER) and Department of Physiology, JIPMER in collaboration with Morarji Desai National Institute of Yoga (MDNIY) an Autonomous organisation under Dept of AYUSH, Ministry of Health, Govt of India, New Delhi.
The Workshop-cum- Seminar was inaugurated by Dr KSVK Subba Rao, Director JIPMER in the presence of Dr AK Das, Medical Superientendent, JIPMER. Senior faculty members from various departments of JIPMER as well as eminent yoga and medical experts from all over the country participated in the inaugural function.
The academic proceedings were conducted at the Bernard Theatre while the practice sessions were held at the JIPMER Community Hall. 133 medical and paramedical professionals and Yoga therapists from all over the country participated in the deliberations along with 40 faculty, residents and staff members of the department of physiology and ACYTER.
Lectures, lecture-demonstrations, panel discussions and practice sessions were conducted by 27 eminent medical and yoga experts from all over the country representing JIPMER; DIPAS, New Delhi; Krishnamacharya Yoga Mandiram, Chennai; Iyengar Yogashraya, Mumbai; Kaivalyadhama, Lonavla; Viniyoga Healing Foundation of India, Chennai and the International Centre for Yoga Education and Research (ICYER), Pondicherry.
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EDUCATION & RESEARCH (ACYTER) (A collaborative venture between JIPMER, Puducherry & MDNIY, New Delhi)
Bulletin of ACYTER- April 2010
Published by the
Advanced Centre for Yoga Therapy, Education & Research (ACYTER),
JIPMER, Puducherry, India 605 006
Patrons:
Dr. KSVK Subba Rao Director, JIPMER Dr. I V Basavaraddi Director, MDNIY, New Delhi Dr. Ashok Kumar Das Med. Superintendent, JIPMER. Dr. S Badrinath Project Co-ordinator, JIPMER Dr. KS Reddy Dean, JIPMER Editor:
Dr. Madanmohan Professor & Head, Dept. of Physiology, JIPMER & Programme Director, ACYTER Editorial board:
Dr. GK Pal Addl. Prof. of Physiology, JIPMER Dr. Ananda Balayogi Bhavanani Programme Co-ordinator, ACYTER, JIPMER Correspondence to:
The Editor, Bulletin of ACYTER, JIPMER, Puducherry- 605 006, India E-mail: [email protected]
Bulletin of ACYTER, April 2010 2
The key note talk on “Lifestyle modifications in diabetes mellitus” was given by Dr. AK Das, Medical Superintendent, JIPMER while the keynote by Yogacharini Meenakshi Devi Bhavanani, ICYER dealt with the importance of developing a yogic attitude in preventing and managing hypertension.
The following invited talks were given by eminent faculty during the workshop:
1. Stress and the relaxation response. Lt. Col. Dr. G Himashree, DIPAS, New Delhi
2. Pathophysiology of hypertension: a yogic perspective. Dr. Madanmohan, Professor and Head, Department of Physiology, and Programme Director ACYTER, JIPMER.
3. Yogic management of hypertension. Dr. Ananda Balayogi Bhavanani, Programme Coordinator, ACYTER, JIPMER and Chairman, ICYER, Pondicherry.
4. Meditation and its therapeutic potential. Dr. MR Kotwal, Medical Consultant, Govt. of Sikkim.
5. Psychological assessment in hypertension: yogic perspectives. Dr. Latha Satish, Psychologist and Managing Trustee, Krishnamacharya Yoga Mandiram, Chennai
6. Hypertension-Management and monitoring for complications: A physician’s perspective. Dr. Aparna Agrawal, Professor of Medicine, JIPMER
A excelent lecture-demonstration of yogasanas for hypertension was conducted by Dr. Rajvi Mehta, Editor Yoga Rahasya from the Iyengar Yogashraya, Mumbai. Dr. RS Bhogal, Principal GS College of Yoga and Cultural synthesis, Kaivalyadhama, Lonavla gave an enlightening and invigorating lecture-cum-practical session on Holistic Meditation.
Forenoon and afternoon practice sessions were conducted for the participants on both days at the JIPMER Community Hall. The Pranayama sessions were conducted by Dr. Madanmohan who was assisted by Shri R Murugesan, Dr Nalini Devi, Dr. Zeena Sanjay, Shri E Jayasettiaseelon and Smt. Lalitha Shanmugam. The Asana sessions were conducted by Dr Ananda Balayogi Bhavanani who was assited by Smt. Devasena Bhavanani, Smt. Meena Ramanathan and Shri G Dayanidy.
On the first day a panel discussion on the “Role of Yoga in prevention of hypertension” was chaired by Dr. AK Das in his inimitable manner while Dr GK Pal was the moderator. The panellists were Dr. RS Bhogal, Dr. G Himashree, Dr. N Chandrasekaran, Dr Nalini Devi and Dr. Ananda Balayogi Bhavanani.
On the second day a panel discussion was held on the “Role of yoga in management of hypertension”. The discussion was chaired in an amiable manner by Dr. TK Datta and moderated by Dr. Vivek Sharma. The panelists were Dr. G Himashree, Dr. Geetha Shankar, Dr. Nalini Devi and Dr. Ananda Balayogi Bhavanani.
Bulletin of ACYTER, April 2010 3
The delegates were treated to a spectacular cultural programme on the evening of the first day with a fusion of Yoga, Bharatanatyam and Music that was presented by Yoganjali Natyalayam, premier institute of Pondicherry. The cultural programme was directed by Yogacharini Meenakshi Devi Bhavanani, Director of the institute.
The workshop ended with the valedictory function that witrnessed excellent feedback and appreciation from all faculty and participants. The efforts of Dr Madanmoahn, the organising chariman were appreciated deeply and all complimented MDNIY and JIPMER for their efforts towards integrating Yoga and modern medicine. The workshop declaration was adopted un-ianimously and the programme concuded with a vote of thanks by Dr G K Pal, the Organising Secreatary of the workshop.
DECLARATION OF THE WORKSHOP
National Workshop-cum-Seminar on “Role of Yoga in Prevention & Management of Hypertension”, attended by 133 delegates, medical professionals, yoga experts and discernible persons from the local town of Pondicherry has been a grand success. The medical, psychological and metaphysical perspectives of prevention and management of hypertension were deliberated at length and futuristic ideas and plans have been put forth. We, the organizers, delegates and all the participants urge the State Government, Central Government, Medical Council of India & Department of AYUSH to evolve a concrete policy for promotion of yoga as an adjunct to modern medicine so that a mass movement for yoga awareness with a sound scientific footing can be initiated.
We jointly propose the following:
1. There is an alarming rise in the incidence of hypertension, even among the younger age groups. There is an urgent need to evolve a strategy to reduce the incidence, morbidity and mortality of the disease. Also, the comorbidity of hypertension namely obesity, impaired glucose tolerance and dyslipidemia need to be contained. All this can be achieved by including the holistic science of yoga practice as an adjunct to conventional treatment modalities. Yoga practice should be included in the school curriculum for reducing the incidence of childhood obesity, diabetes mellitus and hypertension.
2. For effective implementation of the above action plan, and to make yoga therapy readily available to the public, there is a need to have sufficient number of qualified yoga therapists and instructors. This capacity building should be done by designated institutes.
3. There is a need for designing specific yoga modules for prevention and management of hypertension and other lifestyle disorders.
Bulletin of ACYTER, April 2010 4
SEMINAR-CUM-WORKSHOP ON YOGA & COMPLEMENTARY THERAPIES FOR AIDS/HIV
ACYTER organized a seminar-cum-workshop on “Yoga and Complementary Therapies for AIDS/HIV” on 30 January 2010. More than 100 delegates participated in the sessions held from 9 am to 5 pm at the JIPMER Nursing College.
The seminar-cum-workshop aimed to introduce medical and paramedical professionals and yoga therapists to the potentialities of yoga and other complementary and alternative therapies in
the prevention and management of HIV/AIDS.
Dr KSVK Subba Rao, Director JIPMER inaugurated the workshop in the presence of Dr Subbarayalu Naidu, Project Director, Pondicherry AIDS Control Society. Yogacharini Meenakshi Devi Bhavanani, Director ICYER and Dr N Ardhanari, Eminent Social Activist offered felicitations.
The workshop was conducted by 12 resource persons from various medical and Yoga organisations of Pondicherry under the direction of Dr Madanmohan, Professor and Head, Department of Physiology and Programme Director ACYTER.
Dr Subbarayalu Naidu gave a talk on “HIV infection & AIDS” and Dr Madanmohan spoke on “Role of Yoga in HIV/AIDS”.
Practical sessions were conducted by Dr Ananda Balayogi Bhavanani and Shri E Jayasettiaseelon assisted by Smt. Meena Ramanathan, Shri G Dayanidy and Selvi L Vithiyalakshmi.
A panel discussion on “Yoga and CAM therapies for AIDS” was chaired by Dr Madanmohan and moderated by Dr Ananda Balayogi Bhavanani. Panelists included Dr Prakash Rao (homeopathy), Yogacharini Dr Nalini Devi (modern medicine and Yoga), Dr Rajalakshmi (siddha), Smt. Meena Ramanathan (yoga) and Dr Zeena Sanjay (naturopathy).
ROLE OF YOGA AND COMPLEMENTARY THERAPIES FOR AIDS/HIV: AN OVERVIEW
No other word engenders as much fear, revulsion, despair and helplessness as AIDS. It is in fact rewriting medical history as humankind`s deadliest scourge. With 40 million deaths forecast in this millennium, statistics tell their own sordid tale. The first cases of AIDS were reported in the United States in 1981 and within two decades, about 50 million have been infected globally with 22 million deaths. Worryingly, many people think there is a 'cure' for AIDS, which makes them feel safer and perhaps take risks that they otherwise
Bulletin of ACYTER, April 2010 5
wouldn’t. However, there is still no cure for AIDS. The only way to stay safe is to be aware of how HIV is transmitted and how to prevent HIV infection. Antiretroviral treatment can prolong the time between HIV infection and the onset of AIDS. Modern combination therapy is highly effective and someone with HIV who is taking treatment could live for the rest of their life without developing AIDS.
Alternative medicine has been variously called natural, complementary, `holistic` and by other terms, which refer to elements of a particular modality or tradition. The traditional ethno-medicinal systems are by nature holistic, meaning that they aim to treat the whole individual, rather than a specific disease / symptom. Each individual possesses an innate healing capacity (the "immune system" in the broadest sense), and the goal is to reinforce this capacity and restore strength and balance to the weakened systems using a variety of natural modalities like body work, detoxification, foods, herbs and other botanicals, tailored to the individual`s specific constitution and condition.
The use of alternative therapies for AIDS grew out of this same eclectic mix. The key to effective treatment is early detection and intervention. Treatment aims to strengthen the immune system, help patients reduce stress and maintain good nutritional practices and appropriate exercise regimens.
Alternative therapies place significant emphasis on these lifestyle issues. Taking an active role is an important adjunct to treatment. Consideration of alternative therapies in conjunction with conventional medicine may offer additional opportunities for persons living with HIV/AIDS to be proactively involved in their treatment.
The emerging field of psychoneuroimmunology examines the interaction between physiological functioning and memory, behaviour and thoughts. Psychoneuroimmunology stresses the connection between mind and body. Therefore, working on the body will affect the mind as well. By obtaining insight into one's hardiness level, community, and belief or value system, the possibility for experiencing better health is offered.
New research reveals that stress enables HIV to spread more quickly in infected persons and prevents antiretroviral drugs from restoring immune system function. The higher a person’s stress levels, the less they responded to the antiretroviral drugs.
Yoga is quickly gaining ground as an important complementary therapy in the treatment of HIV and AIDS
Bulletin of ACYTER, April 2010 6
because of its adaptability and its physiological and psychological benefits. Meditation can calm the mind and promote healing. The patients gain a sense of well-being and control over their bodies that carries over into their daily lives. Yoga postures promote strength, flexibility, endurance and improve circulation. Recent studies in the USA have shown that mindfulness meditation, defined as practicing an open and receptive awareness of the present moment, avoiding thinking of the past or worrying about the future can have a direct impact on slowing HIV disease progression by modulating the cell mediated immunity.
NATIONAL YOGA WEEK 2010 AT MDNIY, NEW DELHI
Dr Madanmohan, Programme director and Dr Ananda Balayogi Bhavanani, programme co-ordinator were invited speakers for the National Yoga Week 2010 organized by MDNIY at New Delhi from February 12 to 18. Dr Madanmohan gave an invited talk and chaired a session on “Yoga for Cardiovascular Health” and Dr Ananda conducted a workshop on “Yoga for Technostress” in collaboration with staff of MDNIY. Shri E Jayasettiaseelon, Shri G Dayanidy and Shri B Gopal, PAO, JIPMER participated in the conference, seminar and workshop organized during the week long programme.
During the Yoga Week, all advanced centers had put up poster presentations on their activities. ACYTER put up a poster presentation highlighting activities that have been organized and conducted at JIPMER in the past year as well as the research contributions through various studies done in the past three decades by Dr Madanmohan, Professor and Head, Department of Physiology and Programme Director, ACYTER.
Bulletin of ACYTER, April 2010 7
TALK ON MOTHER-CHILD HEALTH
Dr Ananda Balayogi Bhavanani, programme co-ordinator presented an invited talk on “Yoga: A boon for Maternal and Child Health” at Mother Teresa Institute of Health Science as part of the State Level Campaign for mother and child health organized by the Directorate of Indian Systems of Medicine and Homeopathy, Government of Pondicherry on 23 February 2010. All the participants and eminent experts of modern medicine and alternative medicine who were present on the occasion appreciated the presentation that highlighted the importance of yoga in both antenatal and postnatal care.
YOGA CLASSES FOR NURSING STUDENTS
A lecture on yoga, meditation and spiritual healing was conducted for final year students of BSc Nursing on 1 February while lectures and yoga practice sessions highlighting benefits of yoga for antenatal and postnatal health were conducted on 23 and 24 February at the JIPMER Nursing College. The classes were conducted by Selvi Vithiyalakshmi, yoga instructor while Dr Ananda Balayogi Bhavanani, programme co-ordinator gave a theory session highlighting important yoga practices for both antenatal and postnatal care. Shri E Jayasettiaseelon, SRF gave a theory session on yoga, meditation and spiritual healing. More than 50 nursing students enthusiastically participated in the classes and expressed the physical and mental benefits they felt after the yoga practice sessions. The authorities of the nursing college have been giving excellent support for all activities related to yoga and staff members of ACYTER have been conducting lectures and awareness programmes for the nursing staff from all over Tamil Nadu who are attending the Nursing Workshops on AIDS/HIV.
Bulletin of ACYTER, April 2010 8
YOGA FOR DOCTORS AT KAIVALYADHAMA AND WARDHA
Dr Ananda Balayogi Bhavanani, programme co-ordinator presented invited talks on “Bridging yoga and modern medicine” and “Yoga research-where are we?” during the Seminar on Yoga for Doctors organized and conducted at Kaivalyadhama, Lonavla, Maharashtra on 26 and 27 February 2010. Dr Ananda was also invited to conduct an intensive workshop on Yoga for Doctors on 30 March, 2010 at Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, Maharashtra. More than 60 participants from the constituent medical, dental, Ayurveda, physiotherapy and nursing colleges enthusiastically participated in the workshop. The workshop was part of the one month long (48 hr) yoga training for medical professionals organized by the Department of Physiology, JNMC in collaboration with MDNIY, New Delhi.
YOGA THERAPY OPD AT SUPER SPECIALTY BLOCK
ACYTER’s Yoga therapy OPD is functioning on a regular basis in Super Specialty Block. During January to March, 1011 patients (new 189 and old 822 cases) of various conditions attended consultation in the OPD with Dr Ananda Balayogi Bhavanani and Dr Zeena Sanjay. Patients who attended consultation were prescribed individualized and generalized yoga therapy for diabetes mellitus, hypertension, musculoskeletal disorders, respiratory disorders, stress and psychological disorders, endocrine disorders, coronary artery disease, GIT, neurology, and other complaints. Patients have reported benefits and expressed their thanks to ACYTER, JIPMER and MDNIY for this facility.
YOGA THERAPY SESSIONS
Yoga therapy sessions are being conducted on Mondays, Wednesdays and Fridays from 10– 11 AM for patients of diabetes, 11 Am – 12 noon for patients of cardiovascular diseases and 12 noon – 1 PM for patients of other disorders. The yoga instructors, Shri G Dayanidy and Selvi L Vithiyalakshmi are conducting the sessions both individually and in groups as per directions of the therapists given in the OPD. Patients have reported satisfaction with the therapy sessions and are attending regularly. 271 patients of diabetes, 135 of hypertension and 362 of other conditions attended the sessions between January and March 2010.
REGULAR ACTIVITES OF ACYTER
Regular yoga classes are being conducted on Mondays, Wednesdays and Fridays in both mornings and evenings. 171 participants attended the classes in the last quarter. Suryanamaskar, basic asanas, pranayamas and relaxation techniques are being taught in the general classes. Senior Citizen’s Clinic is being conducted every Thursday and 90 participants attended classes with Mrs. Meena Ramanathan, coordinator yoga courses, PUCC.
From To Advanced Centre for Yoga Therapy, Education and research (ACYTER) Department of Physiology, JIPMER, Puducherry – 605 006
Bulletin of ACYTER, July 2010 1
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;ksx fpfdRlk f’k{kk ,oa vuqla/kku mUUkr dsUnz ADVANCED CENTRE FOR YOGA THERAPY,
EDUCATION & RESEARCH (ACYTER) (A collaborative venture between JIPMER, Puducherry & MDNIY, New Delhi)
Bulletin of ACYTER- July 2010
Published by the
Advanced Centre for Yoga Therapy, Education & Research (ACYTER),
JIPMER, Puducherry, India 605 006
Patrons:
Dr. KSVK Subba Rao Director, JIPMER Dr. I V Basavaraddi Director, MDNIY, New Delhi Dr. Ashok Kumar Das Med. Superintendent, JIPMER. Dr. S Badrinath Project Co-ordinator, JIPMER Dr. KS Reddy Dean, JIPMER Editor:
Dr. Madanmohan Professor & Head, Dept. of Physiology, JIPMER & Programme Director, ACYTER Editorial board:
Dr. GK Pal Addl. Prof. of Physiology, JIPMER Dr. Ananda Balayogi Bhavanani Programme Co-ordinator, ACYTER, JIPMER Correspondence to:
The Editor, Bulletin of ACYTER, JIPMER, Puducherry- 605 006, India E-mail: [email protected]
REPORT ON FOUNDATION COURSE IN YOGA The 48 hour “Foundation course in yoga for medical professionals”
was conducted from 2 June to 17 July 2010. 15 medical and
paramedical professionals from JIPMER and the Government
Dental College registered for the course that was conducted at the
ACYTER yoga hall. Lectures were conducted in the evening
sessions by Dr Madanmohan, Programme Director, Dr Ananda
Balayogi Bhavanani, Programme Co-ordinator, Shri
Jayasettiaseelon, SRF and Dr Zeena Sanjay, SRF. A guest lecture
was given by Mrs. Meena Ramanathan, Co-ordinator Yoga
Courses, PUCC. Practice sessions were conducted in the mornings
and evenings by Shri G Dayanidy and Selvi Vithiyalakshmi, Yoga
Instructors ACYTER. Different topics were allotted to the
participants for self study and they presented seminars on yoga
therapy during the course. Valedictory function was held on 17 July
2010 and certificates issued to the participants based on attendance,
assignments and seminar presentation. Those who had not
completed the 48 hours were given the option of completing
remaining hours in regular sessions for certification.
Bulletin of ACYTER, July 2010 2
PHOTO REPORT ON FOUNDATION COURSE IN YOGA
Bulletin of ACYTER, July 2010 3
MONITORING COMMITTEE MEETING
Meeting of the monitoring committee of ACYTER was held in the office of the director, JIPMER on 22 July 2010 at 5 PM. The meeting was chaired by Dr. KSVK Subba Rao, Director, JIPMER and attended by :
• Dr. AK Das, Medical Superintendent, JIPMER – Member
• Dr. J Balachander, Professor & Head, Department of Cardiology, JIPMER- Member
• Dr. Satish RR Gaikwad, Research Officer (Scientific) & Incharge of Scientific Research Wing, MDNIY – Member
• Dr. Ananda Balayogi Bhavanani, Programme Co-ordinator ACYTER, JIPMER – Member
• Dr. Madanmohan - Professor & Head, Department of Physiology & Programme Director ACYTER - Member-Secretary
The meeting started with an introduction by the member secretary. The chairman suggested that minutes of the previous monitoring committee meetings be circulated to all members. The annual report of work done was discussed and it was suggested that a chronological pattern be followed and a new report be circulated to all members. It was decided to hold the national workshop on yoga and diabetes mellitus in February 2011 taking into consideration numerous conferences being held in March. The date is to be finalized in consultation and entered in the register maintained for the purpose by the Dean’s office. Audited accounts for the years 2008-09 and 2009-10 were discussed and approved. It was suggested by the chairman to have a single sheet statement of accounts maintained from the inception of ACYTER. Proposed budget for the year 2010-11 was discussed and approved. Research activities at ACYTER were discussed.
The member secretary explained the present situation with regards to the two major proposals and the 7 pilot studies that have been completed till date. Dr Satish Gaikward, Scientific officer, MDNIY, put forth the view of the director MDNIY regarding importance of research activities at ACYTER. He also gave an overview of the activities at the other Advanced Centres in NIMHANS, DIPAS and Gujarat Ayurved University.
Lack of adequate space for yoga practice sessions at ACYTER was discussed and the programme director was advised to write officially to get permission sanctioned for the use of Banting hall. The meeting ended with a vote of thanks by the member secretary.
After the meeting, Dr Satish Gaikward, Research Officer (Scientific) & Incharge of Scientific Research Wing, MDNIY inspected the facilities and work done at ACYTER.
Bulletin of ACYTER, July 2010 4
REPORT ON PILOT STUDIES AT ACYTER Various pilot studies have been done by ACYTER staff under the direction of Dr Madanmohan, Programme Director ACYTER. The following studies have been conducted by Shri Jayasettiaseelon SRF, Dr Zeena Sanjay SRF, Shri G Dayanidy, Yoga Instructor and Selvi Vithiyalakshmi Yoga Instructor and coordinated by Dr Ananda Balayogi Bhavanani, Programme Co-ordinator.
1. IMMEDIATE EFFECT OF SUKHA PRANAYAMA ON HEART RATE AND BLOOD PRESSURE OF PATIENTS WITH HYPERTENSION
Introduction: Hypertension is one of the most common health disorders and yoga has been shown to be an effective adjunct therapy in its management. Earlier two studies from our laboratories have demonstrated heart rate (HR) and blood pressure (BP) lowering effects of slow, deep breathing after 3 weeks and 3 months of training. Beneficial effects of deep breathing in reducing premature ventricular complexes have also been reported by us. With this background, the present study was undertaken to determine the immediate effects of sukha pranayama on cardiovascular parameters in hypertensive patients.
Methods: 23 hypertensive patients attending the Yoga OPD at JIPMER were instructed to perform sukha pranayama for five minutes at the rate of 6 breaths / minute. Sukha pranayama is a slow and deep pattern of breathing where inhalation and exhalation are of equal duration. HR and BP were recorded before and immediately after the intervention. Rate-pressure product (RPP) and double product (Do P) were derived by formulae.
Results: Sukha pranayama produced a significant (p<0.05) reduction in HR from 79.5 ± 3.09 to 78 ± 3.24 beats/min and a highly significant (p< 0.001) reduction in systolic pressure from 132.5 ± 5.45 to 123 ± 3.83 mmHg. Pulse pressure decreased from 61.5 ± 3.39 to 52.5 ± 2.21 mm Hg, mean arterial pressure from 91.5 ± 3.19 to 88 ± 2.35 mm Hg, RPP from 107.28 ± 8.43 to 97.37 ± 6.97 units and Do P from 73.88 ± 53.72 to 69.52 ± 46.94 units, all these changes being statistically significant (P<0.001).
Discussion and conclusion: It is concluded that sukha pranayama breathing at the rate of 6 breaths / minute can reduce HR and BP in hypertensive patients within five minutes of the practice. This may be due to normalization of autonomic cardiovascular rhythms as a result of increased vagal modulation and /or decreased sympathetic activity. Further studies are required to understand the possible mechanisms underlying this beneficial effect in hypertensive patients.
2. IMMEDIATE CARDIOVASCULAR EFFECTS OF KAYA KRIYA IN NORMAL HEALTHY VOLUNTEERS
Introduction: Kaya kriya is a dynamic hatha yoga relaxation practice. It may have psycho-somatic harmonizing potential as it combines movement of different parts of the body with deep breathing in the supine position. The present study was undertaken to determine immediate effects of kaya kriya on cardiovascular parameters in normal subjects.
Methods: 12 normal subjects were instructed to perform kaya kriya for 10 minutes. Heart rate (HR) and blood pressure (BP) were measured with non-invasive semi-automatic BP monitor before and immediately after the practice. Rate-pressure product (RPP) and double product (Do P) were derived by formulae.
Results: There was significant (p< 0.01) reduction in systolic pressure from 112.25±2.91 to 108.83±2.69 mmHg, diastolic pressure from 71.25 ± 1.72 to 68.17± 1.29 mmHg and
Bulletin of ACYTER, July 2010 5
mean pressure from 84.92±1.93 to 81.72±1.57 mmHg and an appreciable fall in HR from 72.33 ± 3.62 to 69.67 ± 3.29 beats/min. RPP decreased from 81.29 ± 4.97 to 75.84 ± 4.17 units and Do P from 61.55 ± 3.80 to 56.95 ± 2.97 units (p=0.06).
Discussion and conclusion: It is concluded that 10 minutes of kaya kriya relaxation produces a significant reduction in BP. This may be due to a normalization of autonomic cardiovascular rhythms as a result of increased vagal modulation, and /or decreased sympathetic activity. Further studies with more subjects with control group and in different health conditions are required to understand the possible mechanisms underlying this beneficial effect.
3. IMMEDIATE EFFECT OF SHAVASANA AND SAVITRI PRANAYAMA ON HEART RATE AND BLOOD PRESSURE OF HYPERTENSIVE PATIENTS
Introduction: Yoga has been shown to be an effective adjunct therapy in the management of hypertension. Earlier studies from our laboratories have shown beneficial effects of savitri pranayama in normal subjects. Savitri pranayama involves slow and deep breathing in the ratio 2:1:2:1 and has been studied in combination with other practices in hypertensive patients. The present study was undertaken to determine immediate effects of savitri pranayama and shavasana on cardiovascular parameters in hypertensive patients.
Methods: 6 hypertensive patients attending Yoga therapy sessions at ACYTER were recruited for this study. They were instructed to lie down in shavasana and perform savitri pranayam for 10 minutes. Heart rate (HR) and blood pressure (BP) were recorded before and immediately after the intervention. Rate-pressure product (RPP) and double product (Do P) were derived by formulae.
Results: Statistical analysis revealed a highly significant (p < 0.001) reduction in mean pressure from 90.33 ± 1.77 to 85.11 ± 1.67 mmHg and Do P from 73.91 ±6.23 to 65.35 ± 5.69 units. There was a significant (p < 0.01) reduction in HR from 81.50 ± 5.84 to 76.50 ± 5.78 beats/min, systolic pressure from 125.67 ± 4.42 to 117 ± 3.89 mmHg and RPP from 102.24 ± 7.58 to 89.20 ± 6.46 units. Diastolic pressure decreased from 72.67 ± 2.74 to 69.17 ± 2.74 mmHg, the decrease being statistically significant (p < 0.05).
Discussion and conclusion: It is concluded that 10 minutes of shavasana with savitri pranayama reduces HR and BP implying normalization of the cardiovascular autonomic regulatory mechanisms with increased vagal modulation and / or decreased sympathetic activity. Reduction in RPP and Do P signifies reduction in oxygen consumption and work done by the heart. Further studies with more subjects and control groups are required to understand possible mechanisms underlying this immediate and beneficial effect in hypertensive patients.
4. IMMEDIATE EFFECT OF CHANDRA NADI PRANAYAMA ON HEART RATE AND BLOOD PRESSURE OF HYPERTENSIVE PATIENTS
Introduction: Yoga therapists routinely use chandra nadi pranayama to help reduce blood pressure (BP) in hypertensive patients. This is attributed to its stress lowering effects that have been documented by previous studies. Though there are some studies on the long term effect of chandra nadi pranayama, there are no studies on its immediate effect on cardiovascular parameters in hypertensive patients.
Methods: 26 hypertensive patients attending yoga OPD at JIPMER were recruited for the study. They were taught chandra nadi pranayama and instructed to perform the same for five minutes in sitting position. Heart rate (HR) and BP were recorded with non-invasive automatic BP apparatus before and immediately after the practice of chandra nadi
Bulletin of ACYTER, July 2010 6
pranayama. Rate-pressure product (RPP) and double product (Do P) were derived by formulae.
Results: There was a significant (p < 0.001) reduction in HR from 75.5 ± 2.78 to 70 ± 2.72 beats/min, RPP from 106.15 ±4.53 to 96.06 ± 4.24 units and Do P from 76.36 ± 33.90 to 72.66 ± 33.36 units. A significant reduction (p < 0.01) occurred in systolic pressure (SP) from 140 ± 3.26 to 137 ± 3.12 mmHg and pulse pressure from 58.5 ± 2.78 to 50 ± 2.39 mmHg. There was a statistically insignificant rise in mean arterial pressure (MAP) from 101 ± 1.97 to 103.67 ± 2.01 mmHg and diastolic pressure (DP) from 81.5 ± 1.76 to 87 ± 1.76 mm Hg
Discussion and conclusion: Chandra nadi pranayama produced a significant decrease in HR and SP signifying a normalization of cardiovascular reflex mechanisms within 5 minutes. It also produced a significant fall in RPP and Do P signifying a reduction in oxygen consumption and work done by the heart. However the rise in DP and MAP is difficult to explain. Further studies with more subjects and control groups are required to understand the possible mechanisms underlying this immediate effect of chandra nadi pranayama in hypertensive patients.
5. IMMEDIATE CARDIOVASCULAR EFFECTS OF SHAVASANA AND PRANAVA PRANAYAMA ON HEART RATE AND BLOOD PRESSURE OF HYPERTENSIVE PATIENTS
Introduction: The use of sound vibrations as part of relaxation in shavasana is taught in some yoga schools. The present study was planned to determine the cardiovascular effects of performing shavasana with pranava pranayama involving making akara, ukara, makara and omkara nada.
Methods: 19 hypertensive patients attending yoga therapy sessions at ACYTER were taught shavasana with pranava pranayama and instructed to perform the same for 15 minutes. Heart rate (HR) and blood pressure (BP) were measured with non-invasive semi-automatic BP monitor before and immediately after. Rate-pressure product (RPP) and double product (Do P) were derived by formulae.
Results: There was a highly significant (p < 0.001) reduction in systolic pressure from 135.94 ± 3.51 to 126.21 ± 2.88 mmHg, pulse pressure from 57.26 ± 3.02 to 50.15 ± 2.35 mmHg, RPP from 106.45 ± 5.36 to 97.35 ± 4.91 units and Do P from 121.41 ± 63.17 to 110.21 ± 56.35 units. Diastolic pressure reduced significantly (p< 0.01) from 78.68 ± 1.74 to 76.05 ± 1.59 mmHg. There was statistically insignificant reduction in HR from 78.05 ± 2.91 to 76.78 ± 2.89.
Discussion and conclusion: It is concluded that 15 minutes of shavasana with pranava pranayama can reduce BP in hypertensives. This may be due to a normalization of autonomic cardiovascular rhythms as a result of increased vagal modulation, and /or decreased sympathetic activity. It also produced a significant fall in RPP and Do P signifying a reduction in oxygen consumption and work done by the heart. Further studies are required to understand the possible mechanisms underlying this beneficial effect in hypertensive patients.
6. IMMEDIATE EFFECTS OF YOGA NIDRA ON HEART RATE AND BLOOD PRESSURE
Introduction: Yoga nidra is one of the special relaxation techniques of yoga. Previous studies have shown beneficial effects after different periods of training. The present study
Bulletin of ACYTER, July 2010 7
was undertaken to study the immediate cardiovascular effects of yoga nidra on 20 normal subjects.
Methods: 20 healthy volunteers attended 20 minutes of yoga nidra sessions during a one month period. They were instructed to mentally observe the body part by part in association with breath. Heart rate (HR) and blood pressure (BP) were measured before and after a single session. Pulse pressure (PP), mean arterial pressure (MAP), rate-pressure product (RPP) and double product (Do P) were calculated by formulae.
Results: Statistical analysis showed significant (p < 0.05) reduction in HR from 79.3 ± 2.45 to 75.2 ± 1.84 beats/min, RPP from 88.21 ± 3.33 to 81.89 ± 2.38 units and Do P from 66.84 ± 2.60 to 62.52 ± 1.89 units immediately after the yoga nidra session. There was insignificant reduction in SP from 111.2 ± 2.21 to 109 ± 2.05 mmHg, PP from 40.6 ± 1.42 to 38.9 ± 1.50 mmHg, DP from 70.6 ± 1.36 to 70 ± 1.25 mmHg and MAP from 84.08 ± 1.55 to 83.15 ± 1.40 mmHg.
Discussion and conclusion: It is concluded that 20 minutes of yoga nidra practice can reduce HR, RPP and Do P in normal subjects. This may be due to a normalization of autonomic cardiovascular rhythms as a result of increased vagal modulation, and /or decreased sympathetic activity. The reduction in RPP and Do P signifies reduction in oxygen consumption and work done by the heart. Further studies are required to understand possible mechanisms underlying this beneficial effect of yoga nidra.
SYNERGIES IN HEALING: INTERNATIONAL CONFERENCE ORGANIZED BY KRISHNAMACHARYA YOGA MANDIRAM AT CHENNAI
Dr Ananda Balayogi Bhavanani, Programme Co-ordinator ACYTER presented a talk on “Rheumatological and immunological aspects of aging and importance of an integrated approach of yoga in senior citizens” during “SYNERGIES IN HEALING” organized by Krishnamacharya Yoga Mandiram at GRT Convention Centre, Chennai on 18 July 2010.
This international conference aimed at an integrative approach of yoga and modern medicine and was attended by more than 300 delegates from all over the country and abroad.
The eminent cardiologist Dr. S Thanikachalam from Sri Ramachandra Medical College was chief guest. Keynote was presented by Dr Ishwar V Basavaraddi, Director MDNIY and chaired by Yogashri TKV Desikachar, founder of KYM.
The inauguration was followed by invited talks by Dr. Arjun Rajagopal, Dr. Kausthub Desikachar, Dr. Prithika Chari, Dr. Uma Krishnaswami, Dr. Latha Satish, Dr. Michael Steinbrecher, Dr. AV Balasubramaniam, Dr. VD Swaminathan, and Mr. S Sridharan. The event received wide publicity in the local press and all delegates expressed their desire that such integrative conferences must be held more often.
Bulletin of ACYTER, July 2010 8
YOGA CLASSES FOR NURSING STUDENTS
A lecture-cum-practice session on yoga, meditation and spiritual healing was conducted by Shri E Jayasettiaseelon, SRF for 90 students of BSc Nursing (final year) on 30 July. The students participated enthusiastically in the session and expressed the physical and mental benefits they felt after the session. He also gave talks on “Yoga and Complementary Medicine” on 2 and 23 July at the JIPMER Nursing College for the GFATM Nursing Workshop on AIDS / HIV while Dr Ananda Balayogi Bhavanani gave the talk for the participants on 9 July. The authorities of the nursing college have been giving excellent support for all activities related to yoga.
YOGA THERAPY OPD AT SUPER SPECIALTY BLOCK
Yoga therapy OPD of ACYTER is functioning on a regular basis in Super Specialty Block. During April to June, 967 patients (new 193 and old 774 cases) of various conditions attended consultation in the OPD with Dr Ananda Balayogi Bhavanani and Dr Zeena Sanjay. Patients who attended consultation were prescribed individualized and generalized yoga therapy for diabetes mellitus, hypertension, musculoskeletal disorders, respiratory disorders, stress and psychological disorders, endocrine disorders, coronary artery disease, GIT, neurology, and other complaints. Patients have reported benefits and expressed their thanks to ACYTER, JIPMER and MDNIY for this facility.
YOGA THERAPY SESSIONS
Yoga therapy sessions are being conducted on Mondays, Wednesdays and Fridays from 10 – 11 AM for patients of diabetes, 11 AM – 12 noon for patients of cardiovascular diseases and 12 noon – 1 PM for patients of other disorders. The yoga instructors, Shri G Dayanidy and Selvi L Vithiyalakshmi are conducting the sessions both individually and in groups as per directions of the therapists given in the OPD. Patients have reported satisfaction with the therapy sessions and are attending regularly. 194 patients of diabetes, 129 of hypertension and 436 of other conditions attended the sessions between April and June 2010.
REGULAR ACTIVITES OF ACYTER
Regular yoga classes are being conducted on Mondays, Wednesdays and Fridays in both mornings and evenings. 157 participants attended the classes in the last quarter. Suryanamaskar, basic asanas, pranayamas and relaxation techniques are being taught in the general classes. Senior Citizen’s Clinic is being conducted every Thursday and 65 participants attended classes with Mrs. Meena Ramanathan, coordinator yoga courses, Pondicherry University Community College.
From To Advanced Centre for Yoga Therapy, Education and research (ACYTER) Department of Physiology, JIPMER, Puducherry – 605 006
Bulletin of ACYTER, Oct 2010 1
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;ksx fpfdRlk f’k{kk ,oa vuqla/kku mUUkr dsUnz ADVANCED CENTRE FOR YOGA THERAPY,
EDUCATION & RESEARCH (ACYTER) (A collaborative venture between JIPMER, Puducherry & MDNIY, New Delhi)
Bulletin of ACYTER - October 2010
Published by the
Advanced Centre for Yoga Therapy, Education & Research (ACYTER),
JIPMER, Puducherry, India 605 006
Patrons:
Dr. KSVK Subba Rao Director, JIPMER Dr. I V Basavaraddi Director, MDNIY, New Delhi Dr. Ashok Kumar Das Med. Superintendent, JIPMER Dr. S Badrinath Project Co-ordinator, JIPMER Dr. KS Reddy Dean, JIPMER Editor:
Dr. Madanmohan Professor & Head, Dept. of Physiology, JIPMER & Programme Director, ACYTER Editorial board:
Dr. GK Pal Professor, Dept. of Physiology, JIPMER Dr. Ananda Balayogi Bhavanani Programme Co-ordinator, ACYTER, JIPMER Correspondence to:
The Editor, Bulletin of ACYTER, JIPMER, Puducherry- 605 006, India E-mail: [email protected]
ARE WE PRACTICING YOGA THERAPY OR YOGOPATHY?
Modern Yoga therapy seems to have lost touch with the real essence of Yoga. The art and science of Yoga aims to help us regain our psycho-physiological balance by removing the root cause of the disharmony (duhkha samyoga viyogam yoga samjnitam. Bhagavadgita VI: 23).
Yoga understands health and well being as a dynamic continuum of human nature and not a mere ‘state’ to be attained and maintained. The lowest point on the continuum with the lowest speed of vibration is that of death whereas the highest point with the highest vibration is that of immortality. In between these two extremes lie the states of normal health and disease. For many, their state of health is defined as that ‘state’ in which they are able to function without hindrance whereas in reality, health is part of our evolutionary process towards Divinity.
Yoga aims at enabling the individual to attain and maintain a dynamic sukha sthanam that may be defined as a dynamic sense of physical, mental and spiritual well being. The Bhagavadgita defines Yoga as samatvam meaning thereby that Yoga is equanimity at all levels. (yogasthah kuru karmani sangam tyaktva dhananjaya siddhiasiddhyoh samo bhutva samatvam yoga uchyate. Bhagavadgita ii: 48) this may be also be understood as a perfect state of health wherein physical homeostasis and mental equanimity occur in a balanced and healthy harmony.
Tiruvalluvar the great Dravidian mystic says in his 1330 versed Tirukkural, a treatise on right living, “Look for the disease, look for the primary cause of it and then treat it” (noinaadi noimudhal naadi athuthanikkum vaai naadi vaippach cheyal.Tirukkural 948). Most modern doctors and even Yoga therapists seem to have lost their way in the maze and are content managing the manifest symptoms without understanding the real cause.
Maharishi Patanjali has explained the primary causation of stress based disorders through the concept of pancha klesha (psychological afflictions). These are avidya (ignorance of the ultimate reality), asmita (a false sense of identification), raga-dwesha (addiction and aversion) and abhinivesha (clinging on to life for fear of death) (avidya asmita raga dwesha abhinivesha kleshah. Yoga Darshan II: 3).
Bulletin of ACYTER, Oct 2010 2
Avidya as the root cause enables other kleshas to manifest in different forms from time to time. They may be dormant, attenuated, manifest or overpowering in their causation of pain and suffering (avidya kshetram uttaresham prasupta tanu vicchinna udaranam. Yoga Darshan II: 4).
Dwaitam or the misplaced sense of duality due to avidya, the mother klesha is the main initial cause of the imbalance at the higher level that may then manifest into the lower through psycho-somatic stress mechanisms. This occurs through the various Koshas (aspects of the human existence) as various disorders depending upon the propensity due to sanchita karma of the individual.
Yoga Vasishtha, one of the great classical Yoga texts describes the causation and manifestation of disease (vyadhi) in an admirable manner. I often joke with my students that this text is the first recorded counseling session in human history- Bhagavadgita being the second! In the dialogue between the great sage Vasishtha and Prince Rama, it describes both psychosomatic (adhija vyadhi) as well as non-psychosomatic ailments (anadhija vyadhi). Samanya adhija vyadhi are described as those arising from day-to-day causes while sara adhija vyadhi is the essential disease of being caught in the birth –rebirth cycle that may be also understood in modern terms as congenital diseases (caused due to sanchita karma). The former can be corrected by day-to-day remedial measures such as medicines and surgery whereas the sara adhija vyadhi doesn’t cease until knowledge of the self (atma jnana) is attained.
Guru Stotra from the Vishvasaratantra also takes a similar line in saying that the ultimate ‘wisdom of the self’ gained through the Guru destroys karmic bondages from many births (Anekajanma samprapta karma bandha vidhahine atmajnana pradanena tasmai srigurave namah.Guru Stotra, verse 9). It is interesting to note that traditional Indian thought views the very occurrence of birth on this planet as a disease and a source of suffering! Tiruvalluvar reiterates this when he says, “It is knowledge of the ultimate truth that removes the folly of birth” (pirappu ennum pedaimai neenga chirappu ennum chem porul kaanbadhu arivu- Tirukkural 358)
From the Yogic viewpoint of disease it can be seen that psychosomatic, stress related disorders appear to progress through four distinct phases. These can be described as follows:
1. Psychic Phase: This phase is marked by mild but persistent psychological and behavioural symptoms of stress like irritability, disturbed sleep and other minor symptoms. This phase can be correlated with vijnanamaya and manomaya koshas. Yoga as a therapy is very effective in this phase.
2. Psychosomatic Phase: If the stress continues there is an increase in symptoms, along with the appearance of generalized physiological symptoms such as occasional hypertension and tremors. This phase can be correlated with manomaya and pranamaya koshas. Yoga as a therapy is very effective in this phase
3. Somatic Phase: This phase is marked by disturbed function of organs, particularly the target, or involved organ. At this stage one begins to identify the diseased state. This phase can be correlated with pranamaya and annamaya koshas. Yoga as a therapy is less effective in this phase and may need to be used in conjunction with other methods of treatment.
4. Organic Phase: This phase is marked by full manifestation of the diseased state, with pathological changes such as an ulcerated stomach or chronic hypertension, becoming manifest in their totality with their resultant complications. This phase
Bulletin of ACYTER, Oct 2010 3
can be correlated with the annamaya kosha as the disease has become fixed in the physical body. Yoga as a therapy has a palliative and quality of life improving effect in this phase. It does also produce positive emotional and psychological effects even in terminal and end of life situations.
As Yoga therapists, unless we aim to correct the manifest psycho-somatic disassociation as well as the underlying ignorant, jaundiced perception of reality in the individual, we are not practicing Yoga Chikitsa (Yoga as a therapy).
Managing and suppressing the manifest symptoms with Yoga techniques is just as good or bad as modern Allopathic medicine that focuses primarily on symptomatic management without ever getting close to the “real” cause of most disorders. How many doctors look at the emotional and psychological issues that are the primary cause of the problem in so many of their patients? Remember, the concept of psychosomatics is not older than a hundred years in modern medicine. A hundred years ago any doctor talking about ‘mind affecting bodily disease’ risked getting labeled a quack for sure!
When today we find our Yoga therapists making the same mistake in merely treating manifesting symptoms without remedying the ‘real’ cause, it can only be termed as YOGOPATHY!
An example of this Yogopathy trend is when we use Shavasana to manage patients of hypertension quoting research that has shown that Shavasana reduces blood pressure. We seem happy just to bring the blood pressure down for the time being! Real Yoga Chikitsa would try to look for the primary cause of the patient’s hypertension and try to tackle that along with Shavasana for symptomatic management. Without an attempt to do so, it is merely Yogopathy.
Another common example is of using the left nostril Chandra Nadi Pranayama to lower the blood sugar or using the right nostril Surya Nadi Pranayama to relieve brochospasm without looking for the real cause of the patient’s diabetes or asthma. When we do this, how are we any different than the modern doctors who prescribe anti diabetic and sympathomimetic agents for these patients? Where is the real Yoga in this type of therapy? Where is the effort to find and deal with the primary cause?
When we remember to inculcate the principles of Yoga in our day to day life, and help our patients to understand them thus assimilating them in their own lives, we are practicing Yoga. If not, it is merely Yogopathy, the symptomatic management of conditions using techniques of Yoga!
The art and science of Yoga has infinite possibilities for providing answers to most health problems troubling modern humankind. However we often misunderstand this science and want it to be a miracle pill. A pill that we take only once, and want all the problems to vanish into thin air! Yoga is a wholistic science and must be learnt and practiced with a holistic view. The dedicated practice of Yoga as a way of life is no doubt a panacea for problems related to psychosomatic, stress related disorders helping us to regain our birthright of health and happiness.
* By Yogacharya Dr Ananda Balayogi Bhavanani, Programme Co-ordinator ACYTER, JIPMER. This article first appeared in the Integral Yoga Magazine, Yogaville, USA. Fall 2009.
Bulletin of ACYTER, Oct 2010 4
CASE REPORTS FROM ACYTER YOGA THERAPY OPD
Yoga therapy OPD is functioning in Super Specialty Block of JIPMER. Yoga therapy and lifestyle consultation is given by Dr Ananda Balayogi Bhavanani, Programme co-ordinator and Dr Zeena Sanjay, SRF from 10 AM to 1 PM on Monday, Wednesday and Friday and 10 AM to 4 PM on Tuesday and Thursday. 283 patients (new 205 and old 78) of various disorders attended the OPD between July and September 2010. The yoga therapy sessions are being conducted at ACYTER yoga hall on Mondays, Wednesdays and Fridays from 10 – 11 AM for patients of diabetes, 11 AM – 12 noon for patients of cardiovascular diseases and 12 noon – 1 PM for patients of other disorders. The yoga instructors, Shri G Dayanidy and Selvi L Vithiyalakshmi are conducting the sessions both individually and in groups as per directions of the therapists given in the OPD. Patients have reported satisfaction with the therapy sessions and are attending regularly. 417 patients of diabetes, 293 of hypertension and 489 of other conditions attended these sessions in July - September 2010. A total of 4036 patients of various psychosomatic ailments including diabetes mellitus, hypertension, musculoskeletal disorders, respiratory disorders, stress and psychological disorders, endocrine disorders, coronary artery disease, urology, gynecological disorders and ENT disorders have attended consultations and therapy sessions between June 2009 and June 2010.
We give below a few case reports compiled from our patients over the past year.
1. Effect of yoga on subclinical hypothyroidism: Complementary and Alternative Medical (CAM) therapies such as yoga are being increasingly used as adjuncts to modern medicine. Though it has been suggested that yoga may have a role in revitalizing thyroid function, there are few studies on the effects of yoga on thyroid disorders. A 36 year old female with elevated TSH level (9.39 IU/ml) and low normal T4 levels (12.57 pmol/L) was diagnosed as having primary subclinical hypothyroidism and advised to start replacement therapy. She came for consultation to the ACYTER Yoga OPD and was given appropriate yogic counseling and taught a series of techniques potentially beneficial to patients of thyroid conditions. This included suryanamaskar, sarvangasana, viparita karani mudra, surya nadi pranayama, bhramari pranayama and relaxation practices. She continued the practices for a year and reported back at the end of the year with her biochemical investigations. After one year of therapy, there was a fall in TSH (2.66 mIU/L) and a normalization of free T4 values (8.98 pmol/L). A third biochemical analysis three months later showed that TSH further stabilized 2 mIU/L and FT4 at 9.78 pmol/L. As the anti TPO antibodies were positive both before and after the yoga intervention, the patient was advised to continue the yoga practices on a regular basis as long as possible with regular six-monthly follow up. It is suggested that yoga can be an effective adjunct therapy in thyroid conditions and further studies in larger samples are needed to confirm these findings and to better understand the mechanisms behind such beneficial effects in patients of thyroid disorders.
2. Effect of yoga in newly diagnosed hypertension: A 21 year old male working as an executive in Chennai presented to his clinician with complaints of headache and giddiness. There were no other major symptoms though he was anxious about his condition. As his blood pressure was 160/100 he was advised to start antihypertensive medication. He took the medicines for a week and on a visit to Pondicherry the following week, came for consultation at the ACYTER Yoga OPD where his blood pressure was recorded as 130/90 mm Hg. He was given appropriate yogic counselling and dietary advice and taught a series of techniques
Bulletin of ACYTER, Oct 2010 5
that are potentially beneficial to patients of hypertension. This included jathis and asanas such as tala, hastakona, trikona, meru, vakra, bhujanga, uttanpada and pawanmukta. Pranayamas such as sukha, vyagraha, pranava, nasarga mukha bhastrika, chandra nadi and bhramari were also taught. Relaxation practices included shavasana with savitri pranayama and yoga nidra. He continued the practices for 10 days and his blood pressure were monitored daily. He continued doing these practises at ACYTER as well as at home. His BP averaged 128/86 for the first three days and reduced to 122/84 by the 4th day. It normalised at 124/80 during the last few days. The patient expressed a sense of relaxation and felt a decrease in his anxiety levels.
3. Effect of yoga in a patient of long standing diabetes and hypertension: A 55 year old male, with history of diabetes since 16 yr and hypertension since 7yr and on medication at JIPMER medicine OPD attended consultation in ACYTER Yoga OPD. His blood pressure was BP 130/90 mm Hg and blood sugar levels were 140 mg% (AC) and 173 mg% (PC). The patient was highly stressed out and quite fed up with life. He was given appropriate yogic counseling and dietary advice and taught a series of techniques that are potentially beneficial to patients of both diabetes and hypertension. This included surya namaskar, talasana, trikonasana, vakrasana, pawan muktasana, viparita karani, chandra nadi pranayama, pranava pranayama and relaxation techniques. He has continued the practices regularly for the past 14 months both at ACYTER as well as at home. He reports a feeling of rejuvenation and energy and his outlook towards life has changed dramatically. His blood pressure has stabilized around 110/70 with 50% decrease in antihypertensive medications. His blood sugar levels have also stabilized at 120 mg% (AC) and 167 mg% (PC) with no change in medications. This patient has felt the benefits of yoga in changing his life for the better and has brought more than two dozen patients to ACYTER to experience the benefits of yoga that he feels have come in his life.
4. Case report on COAD in an adult: A 33 year old female, suffering from chronic obstructive airway disease (COAD) for the past five years came to the yoga OPD. She was on regular medication and had complaints of uncontrolled wheezing despite using various inhalers. Her FEV1 was 57%. She was given appropriate yogic counselling and dietary advice and taught a series of techniques potentially beneficial to patients of COAD. She was taught breath body co-ordination practices and suryanamaskar as well as asanas such as ushtra, gomukha, vakra, bhujanga and matsya and the jala neti cleaning technique. She was also taught sectional breathing and pranayamas such as vyaghrah, mukha bhastrika, suryanadi and nadi shuddhi. Relaxation techniques used were kaya kriya and yoga nidra. She continued the practices for 2 months at ACYTER and at home and reported that she was feeling a sense of ease and comfort that wasn’t there earlier. The frequency of her wheezing attacks had also reduced. Repeat PFT showed that her FEV1 had increased to 68%.
5. Case report on bronchial asthma in a 4 year old child: A 4 year old female child, with complaints of respiratory difficulties since birth was on regular treatment for bronchial asthma with oral medication and inhaler. She came for consultation to the ACYTER Yoga OPD with complaints of wheezing, breathlessness and the mother expressed a desire to try out the yoga practices. The mother was given appropriate yogic counseling and dietary advice and then the child was taught in a playful manner a series of techniques that are potentially beneficial to patients of bronchial asthma. She was taught breath body co-
Bulletin of ACYTER, Oct 2010 6
ordination practices and suryanamaskar as well as asanas such as ushtra, gomukha, vakra, bhujanga and matsya. She was also introduced to the jala neti nasal cleaning technique. She was then taught sectional breathing and pranayamas such as vyaghra, mukha bhastrika and suryanadi. She continued the practices for nearly one year and her complaints reduced slowly. She continued doing these practices at ACYTER as well as home and the frequency and severity of her wheezing attacks reduced. After the practice of 4 months she was able to stop the oral medications and usage of inhaler was also lesser. The consulting pediatrician advised her to stop the inhaler too as she was able to be comfortable without it. There were no episodes of wheezing reported till the end of the year even though she was not taking any medicines.
REPORT ON RESEARCH ACTIVITIES AT ACYTER
1. Effect of yoga therapy in patients of essential hypertension: A study is being conducted on the effect of yoga therapy in patients of hypertension. The study has a proposed sample size of 72 (36 in yoga and 36 in control group). Autonomic function tests have been completed in 50 patients and 23 have been randomised to the yoga therapy sessions being conducted at ACYTER on Monday, Wednesday and Friday. 15 of the patients have been attending the sessions regularly and 8 have attended more than 10 sessions till date.
2. Effect of yoga therapy in patients of type 2 diabetes mellitus: A study is being conducted on the effect of yoga therapy in patients of diabetes with peripheral neuropathy. The study has a proposed sample size of 60 (30 in yoga group; 30 in control group). Patients are being recruited from diabetic clinic and staff clinic. Cardiac autonomic function testing, nerve conduction studies and biochemical assessment are being done for each patient recruited into the study. So far pre-values of 25 patients in control group and 15 patients in yoga group have been taken. Of the 15 patients recruited into yoga group, 10 are regularly attending classes.
REGULAR ACTIVITES OF ACYTER
Regular yoga classes are being conducted on Mondays, Wednesdays and Fridays in both mornings and evenings. 341 participants attended the classes in the last quarter. Suryanamaskar, basic asanas, pranayamas and relaxation techniques are being taught in the general classes. Senior Citizen’s Clinic is being conducted every Thursday and 116 participants attended classes with Mrs. Meena Ramanathan, coordinator yoga courses, Pondicherry University Community College.
From To Advanced Centre for Yoga Therapy, Education and Research (ACYTER) Department of Physiology, JIPMER, Puducherry – 605 006
Bulletin of ACYTER – Jan 2011 1
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;ksx fpfdRlk f’k{kk ,oa vuqla/kku mUUkr dsUnz ADVANCED CENTRE FOR YOGA THERAPY,
EDUCATION & RESEARCH (ACYTER) (A collaborative venture between JIPMER, Puducherry & MDNIY, New Delhi)
Bulletin of ACYTER – January 2011
Published by the
Advanced Centre for Yoga Therapy, Education & Research (ACYTER),
JIPMER, Puducherry, India 605 006
Patrons:
Dr. KSVK Subba Rao Director, JIPMER Dr. I V Basavaraddi Director, MDNIY, New Delhi Dr. Ashok Kumar Das Med. Superintendent, JIPMER Dr. S Badrinath Project Co-ordinator, JIPMER Dr. KS Reddy Dean, JIPMER Editor:
Dr. Madanmohan Professor & Head, Dept. of Physiology, JIPMER & Programme Director, ACYTER Editorial board:
Dr. GK Pal Professor, Dept. of Physiology, JIPMER Dr. Ananda Balayogi Bhavanani Programme Co-ordinator, ACYTER, JIPMER Correspondence to:
The Editor, Bulletin of ACYTER, JIPMER, Puducherry- 605 006, India E-mail: [email protected]
NATIONAL WORKSHOP-CUM-SEMINAR ON ROLE OF YOGA IN PREVENTION AND MANAGEMENT OF
DIABETES MELLITUS
Announcement
The Advanced Centre for Yoga Therapy, Education & Research (ACYTER) and Department of Physiology JIPMER are jointly organizing a National Workshop-cum-Seminar on “Role of Yoga in Prevention and Management of Diabetes Mellitus” in collaboration with Morarji Desai National Institute of Yoga, (MDNIY) New Delhi.
The workshop will be conducted on March 1 & 2, 2011 at JIPMER. More than 200 medical and paramedical professionals and yoga therapists are expected to participate.
The Workshop-cum-Seminar will deliberate on the role of yoga in the prevention and management of diabetes mellitus. Lectures, lecture-demonstrations, panel discussion and practice sessions will be conducted by eminent medical and yoga experts.
Registration fee is Rs. 800 for delegates and Rs. 300 for student delegates and includes registration, kit, lunch and refreshments. Certificate of participation will be issued to all delegates. Assistance will be provided to arrange accommodation if required but hotel/guest house charges are to be borne by delegates.
The Advanced Centre for Yoga Therapy, Education and Research (ACYTER), a collaborative venture between JIPMER, Puducherry and Morarji Desai National Institute of Yoga (MDNIY), New Delhi was established by a MOU between JIPMER and MDNIY in June 2008. The centre is focusing on the role of yoga in the prevention and management of cardiovascular disorders and diabetes mellitus. More than 6000 patients have benefited from the yoga therapy consultations and practical sessions till date. The centre also aims to popularize the science of yoga among medical professionals and general public and has conducted workshops and awareness programmes to this effect.
For more details please contact:
Dr Madanmohan Professor & Head, Dept. of Physiology, & Programme Director, ACYTER, JIPMER [email protected]
Bulletin of ACYTER – Jan 2011 2
FOUNDATION COURSE IN YOGA FOR MEDICAL AND PARAMEDICAL PROFESSIONALS AND STUDENTS OF JIPMER
One month Foundation Course in yoga for Medical and Paramedical Professionals and Students was conducted at JIPMER from 18 October to 20 November 2010. 63 medical doctors, paramedical professionals, students and staff members of JIPMER participated in the training programme. The theory lectures were conducted in Bernard Theatre and practice sessions in the auditorium of the Nursing College under the direction of Dr. Madanmohan, Professor and Head, Department of Physiology, JIPMER and Programme Director ACYTER.
Modern man is the victim of all-pervading stress. Yoga is the best means for managing this stress of our daily life. Medical and paramedical professionals have to face great stress in their professional career and the regular practice of yoga will improve their psychosomatic health and enable them to face the situation.
The holistic science of yoga has a great future as it has the potential to prevent as well as manage a number of stress-induced chronic diseases that defy allopathic medicine. A holistic physician who is a practitioner of yoga will be able to render better medicare to the masses and will be a boon to the society.
ACYTER and Department of Physiology, JIPMER had also previously organized a two day National Workshop on “Introducing Yoga in the medical curriculum” in March 2009 at JIPMER. The workshop was organized in collaboration with Morarji Desai National Institute of Yoga (MDNIY), New Delhi under auspices of Department of AYUSH, Govt of India. The national workshop deliberated on the need, feasibility and modality of introducing yoga science in the medical curriculum for medical students in particular and medical professionals in general. 20 resource persons from eminent Yoga Centers and 150 participants from all over the country participated in the workshop that included theory, practice sessions and therapeutic aspects of yoga and evaluation methods for such a course.
The workshop had recommended the introduction of yoga to medical students in particular and medical professionals in general through a “Foundation Course in Yoga Science”. It was also recommended that a 48 hour foundation course be conducted after class hours for interested professionals through the yoga units of the institutions as per the syllabus that has
been prepared by the MDNIY in consultation with eminent yoga and medical experts.
To achieve this aim, the Advanced Centre for Yoga Therapy, Education, and Research (ACYTER) under the direction of Dr. Madanmohan conducted a month long foundation course in yoga for medical and paramedical professionals and students at JIPMER. It is noteworthy that ACYTER has previously conducted two such foundation courses for nearly 130 medical and paramedical professionals and students.
Bulletin of ACYTER – Jan 2011 3
The objectives of this 48 hour (one month) introductory course were:
1. To promote awareness among medical students about the effectiveness of yoga as an inexpensive means for achieving holistic health.
2. To impart knowledge, skill & attitude about the theoretical and practical aspects of yogic science.
3. To motivate medical professionals and students to take up further studies, therapy and research in yoga.
The 48 hour course was conducted over a period of one month and included lectures, lecture-demonstrations and practice sessions. Lecture topics included: What is yoga?, Healthy lifestyle: a yogic perspective, Effect of yoga training on physiological functions, Dhyana and its psycho-physiological correlates, Pranayam and its physiological benefits, Stress and its management: a yogic perspective, Spiritual health and healing: a yogic perspective, Diet for health and healing: a yogic perspective, Therapeutic potential of yoga, Benefits of yoga
practices and traditional basis of yoga. Group discussion and assignments were given on yoga therapy modules on stress, yogic diet, anxiety, hypertension, diabetes mellitus, bronchial asthma, obesity, arthritis, GI disorders, cardiovascular diseases and menstrual disorders. Practical sessions were guided by Shri G Dayanidy and Selvi L Vithiyalakshmi with assistance from Selvi Shyamaladevi and Mrs. Karpagam Ramanan. Pre-test and post-test were given to all participants at the beginning and end of the course and there was a 60 percent improvement in scores.
Valedictory function was held 19 November with Dr. KVSK Subba Rao, Director, JIPMER as chief guest and Dr. S Revathi, Principal Nursing College and Coordinator GFATM as special guest. Dr. Ananda Balayogi Bhavanani welcomed all to the concluding session and Dr. Madanmohan gave an overview of the aims and objectives of the course that were successfully met during the month-long training programme. In his valedictory address Director, JIPMER appreciated the efforts of Dr. Madanmohan to spread the message of yoga effectively and assured his cooperation for the activities of ACYTER. Positive feedback was given by all the participants with special inputs from Dr. Nalini, former Professor of Pediatrics at JIPMER who is a regular visitor to the ACYTER. Certificates were distributed to all participants who had completed the course and vote of thanks proposed by Shri E Jayasettiaseelon.
Bulletin of ACYTER – Jan 2011 4
ACYTER PARTICIPATION IN YOGA AWARENESS PROGRAMMES
Dr Ananda Balayogi, Programme Coordinator ACYTER was invited to present a lecture on “Yoga for women” in the 8th National Conference hosted by Puducherry Chapter of Society of Midwives on 13th November 2010. He was invited to present another lecture on “Principles & Practice of Yoga Therapy for Geriatric Psychiatric Disorders" in the one day workshop on "Yoga Therapy for Psychiatric Disorders" held at the Advanced Centre for Yoga, NIMHANS, Bangalore on 5 December 2010. The event was organized jointly by the Advanced Centre and Morarji Desai National Institute of Yoga, New Delhi. The workshop aimed at improving the awareness and imparting brief training for yoga therapists and mental health professionals in therapeutic application of yoga for psychiatric disorders. It had lectures and demonstrations by experts from both Psychiatry and Yoga Therapy.
A delegation of yoga teachers from Italy visited ACYTER on 11th December and expressed their admiration for the programme and its activities. They were especially appreciative that Indian Government was bringing yoga into the mainstream health care system through advanced centers at JIPMER, NIMHANS, DIPAS, Gujarat Ayurveda University & at Government medical college, Jammu.
Staff of ACYTER also participated in the 18th International Yoga Festival Conducted by the Government of Pondicherry from 4-7 January2011. Invited talks were given by Dr Ananda Balayogi, Programme Coordinator ACYTER and free consultation on yoga and healthy living was provided to 102 delegates and members of the public in the ACYTER stall. Sri G Dayanidy, Yoga Instructor ACYTER won first place in the 25-35 age category and was selected to participate in the Final Championship Round.
YOGA THERAPY OPD AT SUPERSPECIALITY BLOCK
Yoga therapy OPD is functioning in Super Specialty Block of JIPMER. Yoga therapy and lifestyle consultation is given by Dr Ananda Balayogi Bhavanani, Programme co-ordinator and Dr Zeena Sanjay, SRF from 10 AM to 1 PM on Monday, Wednesday and Friday and 10 AM to 4 PM on Tuesday and Thursday. 234 patients (new 169 and old 65) of various disorders attended the OPD between October and December 2010.
YOGA THERAPY SESSIONS AT ACYTER
The yoga therapy sessions are being conducted at ACYTER yoga hall on Mondays, Wednesdays and Fridays from 10 – 11 AM for patients of diabetes, 11 AM – 12 noon for patients of cardiovascular diseases and 12 noon – 1 PM for patients of other disorders. The yoga instructors, Shri G Dayanidy and Selvi L Vithiyalakshmi are conducting the sessions both individually and in groups as per directions of the therapists given in the OPD. Patients have reported satisfaction with the therapy sessions and are attending regularly. 593 patients of diabetes, 320 of hypertension and 591 of other conditions attended these sessions in October - December 2010.
REGULAR ACTIVITES OF ACYTER
Regular yoga classes are being conducted on Mondays, Wednesdays and Fridays in both mornings and evenings. 164 participants attended the classes in the last quarter. Suryanamaskar, basic asanas, pranayamas and relaxation techniques are being taught in the general classes. Senior Citizen’s Clinic is being conducted every Thursday and 112 participants attended classes with Mrs. Meena Ramanathan, Coordinator Yoga Centre, Mahatma Gandhi Medical College and Research Institute.
Bulletin of ACYTER- April 2011 1
ADVANCED CENTRE FOR YOGA THERAPY, EDUCATION & RESEARCH (ACYTER)
(A collaborative venture between JIPMER, Puducherry & MDNIY, New Delhi)
Bulletin of ACYTER- April 2011
REPORT ON NATIONAL WORKSHOP-CUM-SEMINAR ON ROLE OF YOGA IN PREVENTION AND MANAGEMENT OF DIABETES MELLITUS
The Advanced Centre for Yoga Therapy, Education and Research (ACYTER) and the Department of Physiology, JIPMER organized a two day National Workshop-cum-Seminar on “Role of Yoga in Prevention and Management of Diabetes Mellitus” on 1 & 2 March 2011 at JIPMER.
The workshop was organized in collaboration with Morarji Desai National Institute of Yoga (MDNIY), New Delhi, an autonomous organization under the Department of AYUSH, Ministry of Health and Family Welfare, Govt. of India. More than 200 medical, paramedical and yoga professionals and yoga enthusiasts from all over the country participated along with 100 medical students of JIPMER and 30 faculty, residents and staff members of the Department of Physiology and ACYTER, JIPMER.
The workshop was inaugurated by Dr KSVK Subba Rao, Director JIPMER and Dr BK Sahay, eminent diabetologist was the guest of honour. Senior faculty members from various departments of JIPMER as well as eminent yoga and medical experts from all over the country participated.
The workshop deliberated on the role of yoga in the prevention and management of diabetes with keynote lecture, invited talks, lecture-demonstrations, panel discussions and practice sessions that were given by a team of 30 resource persons from JIPMER, DIPAS, NIMHANS, Viniyoga Healing Foundation, Chennai; The Yoga Institute, Mumbai; Iyengar Yogashraya, Pune; Antar Praksh Yoga Centre, Haridwar; KMC Mangalore, Vinayaka Mission's Medical College, Salem; Vivekananda Institute of Yoga Therapy, Karur; PGIBMS, Taramani, Chennai; and the International Centre for Yoga Education and Research, Pondicherry.
Patrons:Dr. KSVK Subba RaoDirector, JIPMER
Dr. I V BasavaraddiDirector, MDNIY, New Delhi
Dr. Ashok Kumar DasMed. Superintendent, JIPMER.
Dr. S BadrinathProject Co-ordinator, JIPMER
Dr. KS ReddyDean, JIPMER
Editor:Dr. Madanmohan Professor & Head,Dept. of Physiology, JIPMER & Programme Director, ACYTER
Editorial board:Dr. GK PalProf. of Physiology, JIPMER
Dr. Ananda Balayogi BhavananiProgramme Co-ordinator,ACYTER, JIPMER
Correspondence to:The Editor,Bulletin of ACYTER, III floor Institute Block, JIPMER, D Nagar, Puducherry- 605 006, India
Physiology (organizing secretary of the workshop).
Dr Zeena Sanjay, Shri E Jayasettiaseelon, Shri G
Dayanidy and Selvi L Vithiyalakshmi from
ACYTER and Smt Lalitha Shanmugam, Smt
Devasena Bhavanani and Smt Meena Ramanathan of
Yoganjali Natyalayam assisted in the conduct of the practice sessions under guidance of Dr Madanmohan and
Dr Ananda Balayogi Bhavanani, (Coordinator of the workshop).
On the evening of the first day, the delegates were
treated to a spectacular cultural programme that was
a fusion of yogasana tableaux, Bharatanatyam
compositions and instrumental music that was
presented by Yoganjali Natyalayam under the
dynamic direction of Kalaimamani Yogacharini
Meenakshi Devi Bhavanani, Director of the institute.
Dr Ananda Balayogi actively coordinated the
performance along with Smt Devasena Bhavanani.
Dr IV Basavaraddi, Director MDNIY was guest of
honour for the valedictory function and expressed his appreciation of work at ACYTER, JIPMER. In his
special address he extolled the medical community to research yoga in depth with proper adherence to the
correct textual basis and proper practice of yoga techniques so that the results were of international quality and
acceptable to the modern scientific community. At the conclusion, Yogacharya Dr Ananda Balayogi
Bhavanani, Programme Coordinator ACYTER
proposed the vote of thanks.
DECLARATION OF THE WORKSHOP
National workshop-cum-seminar on “Role of Yoga in
Prevention & Management of Diabetes Mellitus”,
attended by more than 200 delegates, medical
professionals and students, yoga experts and
discernible persons from the local town of
Pondicherry, has been a grand success.
Bulletin of ACYTER- April 2011
3
The physiological, pathological, psychological and
metaphysical perspectives of prevention and
management of diabetes have been deliberated at
length and futuristic ideas and plans have also been
put forth. We, the organizers, patrons, delegates
and all the participants, urge the State Government,
Central Government, MCI & Department of
AYUSH to evolve a concrete policy for promotion
of yoga as an adjunct to modern medicine so that a
mass movement for yoga awareness with a sound
scientific footing can be initiated.
The workshop proposes the following
recommendations with regard to the prevention
and management of diabetes mellitus through
yoga:
1. The inculcation of yoga has to be not only
at the medical level but at the school level
if we want to prevent diabetes. We need to
concentrate our energies on working at the
school level itself and catch them young.
2. Screening for pre-diabetes needs to be
intensified and yoga introduced to the pre-
diabetics to prevent them from going into full blown diabetes.
3. We need to bring out effective and consensus-based diet guidelines keeping yogic principles in mind.
4. A universal standardized yoga package needs to be evolved for diabetes so that the diabetic patients all
over the world can be benefited in a rational manner.
5. A universal standardized research protocol to scientifically evaluate the effect of yoga on diabetes
needs to be evolved with inputs from
physicians, researchers and statisticians.
6. Scientific evaluation and standardization of
various recommended individual techniques
of yoga should be done and documented with
publications so that the benefits of the
individual practices as well as their
combination can be understood in a scientific
and rational manner.
Bulletin of ACYTER- April 2011
4 Bulletin of ACYTER- April 2011
5 Bulletin of ACYTER- April 2011
6 Bulletin of ACYTER- April 2011
CME PROGRAMME AT SRI SATYA SAI MEDICAL COLLEGE AND RESEARCH INSTITUTE,
KANCHEEPURAM
Staff of ACYTER presented talks and lecture
d e m o n s t r a t i o n s d u r i n g t h e C M E o n th“Physiological Effects of Yoga” on January 17
2011, organized by the Department of Physiology,
Sri Satya Sai Medical College and Research
Institute, near Chennai.
Dr Madanmohan, Programme Director presented
an overview of “Yoga and Physiology” while
Dr Ananda Balayogi, Programme Coordinator
gave a talk on “Therapeutic Potential of Yoga”.
Dr Zeena Sanjay, SRF gave a talk on “Yoga
research” that also highlighted the activities of
ACYTER. Sri G Dayanidy gave a spectacular
demonstration of various yogasanas with
commentary by Dr Ananda.
The CME was attended by more than a hundred
members of the management, faculty, staff and
students who gave positive feedback and
expressed appreciation for the entire programme.
7Bulletin of ACYTER- April 2011
ACYTER PARTICIPATION IN YOGA AWARENESS PROGRAMMES
Dr Madanmohan, Programme Director and Dr Ananda
Balayogi, Programme Coordinator were invited to give
talks and workshops on January 20 and 21, during the
Golden Jubilee National Seminar-cum-Workshop on
“Role of Yoga in Respiratory Tract Disorders”
organized by the Advanced Centre for Yoga Education
and Research, Gujarat Ayurved University, Jamnagar,
Gujarat,
Dr Ananda Balayogi, Programme Coordinator was
invited to give a talk on “Physiological perspective on
recent trends in yoga therapy” during the “Yoga
Update” at Kaivalyadhama, Mumbai on January 29-
30, 2011.
Dr Madanmohan, Programme Director, Dr Ananda
Balayogi Bhavanani, Programme Co-ordinator and Dr
Zeena Sanjay, SRF attended the Yoga Week which held
from February 12-18 at MDNIY, New Delhi. Dr.
Ananda Balayogi Bhavanani presented a talk on yoga
for general well being at the yoga week. Dr
Madanmohan chaired a session and gave a talk in the
valedictory session.
RECENT ACTIVITIES AT ACYTER
As part of the pre-hypertension research project, yoga
therapy sessions are being conducted for staff members
of Kendriya Vidyalaya from the second week of
January. Screening of the participants for pre-
hypertension was done by Mr Ram Kumar, PhD
scholar, Dept of Physiology while Shri G Dayanidy is
conducting the sessions on Tuesday, Thursday and
Saturday from 3 – 4 PM at the school premises. Yoga
therapy sessions are being conducted for pregnant
ladies as part of a pre–eclampsia prevention study since the end of March. Screening of the patients is being
done by Dr Manikandan, Asst Professor in OBG, JIPMER and Selvi L Vithiyalakshmi is conducting the
sessions on Tuesdays and Thursdays from 3- 4 PM at the ACYTER yoga hall.
in collaboration with Morarji Desai National
Institute of Yoga (MDNIY), New Delhi.
8Bulletin of ACYTER- April 2011
From To
Advanced Centre for Yoga Therapy, Education and Research (ACYTER) III floor Institute Block, JIPMER, Puducherry – 605 006
YOGA THERAPY OPD AT SUPERSPECIALITY BLOCK
Yoga therapy OPD is functioning in Super Specialty Block of JIPMER. Yoga therapy and lifestyle
consultation is given by Dr Ananda Balayogi Bhavanani and Dr Zeena Sanjay from 10 AM to 1 PM on
Monday, Wednesday and Friday and 10 AM to 4 PM on Tuesday and Thursday. 436 patients (new 358
and old 78) of various disorders attended the OPD between January and March 2011.
YOGA THERAPY SESSIONS
The yoga therapy sessions are being conducted at ACYTER yoga hall on Mondays, Wednesdays and
Fridays from 10 – 11 AM for patients of diabetes, 11 AM – 12 noon for patients of cardiovascular
diseases and 12 noon – 1 PM for patients of other disorders. The yoga instructors, Shri G Dayanidy
and Selvi L Vithiyalakshmi are conducting the sessions both individually and in groups as per
directions of the therapists. Patients have reported satisfaction with the therapy sessions and are
attending regularly. 747 patients of diabetes, 424 of hypertension and 770 of other conditions attended
these sessions in January - March 2011.
YOGA CLASSES FOR NORMAL SUBJECTS
Yoga classes are being conducted on Mondays, Wednesdays and Fridays at 6.30 AM and 4.30 PM.
415 participants attended the classes in the last quarter. Suryanamaskar, basic asanas, pranayamas and
relaxation techniques are being taught in the classes.
YOGA CLASSES FOR SENIOR CITIZENS
Classes for senior citizens are being conducted every Thursday between 11 AM and 12 noon. 95
participants attended classes with Mrs. Meena Ramanathan, Coordinator, Yoga Centre, Mahatma
Gandhi Medical College and Research Institute.
Bulletin of ACYTER – July 2011 1
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;ksx fpfdRlk f’k{kk ,oa vuqla/kku mUUkr dsUnz ADVANCED CENTRE FOR YOGA THERAPY,
EDUCATION & RESEARCH (ACYTER) (A collaborative venture between JIPMER, Puducherry & MDNIY, New Delhi)
Bulletin of ACYTER – July 2011
Published by the
Advanced Centre for Yoga Therapy, Education & Research (ACYTER),
JIPMER, Puducherry, India 605 006
Patrons:
Dr. KSVK Subba Rao Director, JIPMER Dr. I V Basavaraddi Director, MDNIY, New Delhi Dr. Ashok Kumar Das Med. Superintendent, JIPMER Dr. S Badrinath Project Co-ordinator, JIPMER Dr. KS Reddy Dean, JIPMER Editor:
Dr. Madanmohan Professor & Head, Dept. of Physiology, JIPMER & Programme Director, ACYTER Editorial board:
Dr. GK Pal Professor, Dept. of Physiology, JIPMER Dr. Ananda Balayogi Bhavanani Programme Co-ordinator, ACYTER, JIPMER Correspondence to:
The Editor, Bulletin of ACYTER, III floor Institute Block, JIPMER, D Nagar, Puducherry- 605 006, India E-mail: [email protected]
INAUGURAL CEREMONY OF ACYTER YOGA RESEARCH
LAB AT SUPER SPECIALTY BLOCK, JIPMER
The ACYTER Yoga Research Lab was inaugurated by Dr. KSVK Subba Rao, Director, JIPMER at 9.30am on 6 July 2011 in the Super Specialty Block. The lab is situated next to the ACYTER Yoga Therapy OPD. Dr. AK Das, Medical Superintendent and Dr. Balachander, Professor and Head, Dept. of Cardiology were special invitees. Dr. Madanmohan, Professor & Head, Dept. of Physiology and Program Director of ACYTER welcomed the gathering and explained the work being done at ACYTER since the past 2 years. The inaugural was attended by faculty, residents, research scholars and staff of the Department of physiology along with staff of ACYTER.
The Research lab is equipped with BioHarness and CMCdaq to monitor HRV (heart rate variability), computerized Audio-Visual Reaction Time apparatus, computerized Spirometer and 12 channel ECG machine.
The Director JIPMER suggested that the work of ACYTER be given due publicity to enable more patients to be benefited and for standardized research to be done in cardiovascular disease and diabetes. He also suggested that ACYTER conduct awareness programs for the general public of Puducherry to enable them to know about the functioning of ACYTER. The function concluded on 10.30 am with refreshment and high tea.
Bulletin of ACYTER – July 2011 2
INAUGURAL CEREMONY OF ACYTER YOGA RESEARCH LAB
PRANAYAM TRAINING SESSIONS FOR RESIDENTS OF PHYSIOLOGY
Bulletin of ACYTER – July 2011 3
RESULTS OF A SURVEY OF PARTICIPANT FEEDBACK AT ACYTER, JIPMER, PONDICHERRY
From March to June 2011, a survey was conducted on 100 patients who were regularly attending yoga therapy sessions at ACYTER and had completed a minimum of one month of the regular programme.
A questionnaire was given to them consisting of questions related to their age, gender and demographic characteristic in addition to their main health complaints, attendance at the yoga sessions, home practice as well as their physical and mental condition and changes in dosage of medication.
Results of the survey are given in number of participants except for those questions where all 100 participants had not replied, in which case % values are reported instead.
• AGE: Age of the participants ranged from 16 to 77 years with an average age of 47.04 ± 4.85 years (SEM). The maximum participants (39) were in the age group of 40-60 y while 25 were above 60 and 24 in the age group 30-40. There were 11 in the age group 20-30 and 2 were below 20 y ears of age.
• GENDER: 49 participants were male and 51 female.
• DEMOGRAPHIC DATA: 91 of the participants were from Pondicherry town and surrounding rural areas while 9 were from adjoining areas of Tamil Nadu.
• MAIN HEALTH COMPLAINTS: The system wise break up of main health complaints was: diabetes mellitus (41), hypertension and other cardiovascular disorders (39), musculoskeletal disorders (13), respiratory disorders (13), endocrine (12), neurological disorders (5), gastro intestinal disorders (3), obstetrics and gynecological disorders (3), dermatological disorders (1) psychiatric disorders (1) and others (11). Some of the participants had multiple complaints.
• REGULARITY OF ATTENDANCE AT ACYTER: 50 had attended yoga therapy sessions for 1-3 months, 26 for 3-6 months, 16 for 6-12 months and 8 for more than a year. 60 participants were attending the sessions 3 days/week, 21 of them 4 days/week while 8 were attending once/week, 7 twice /week, 2 five days/week and 2 six days/week. The regularity was attributed to a feeling of physical and mental betterment (58%), regularity of the sessions (23%) and symptomatic relief (12%). Inability to be more regular was attributed to work pressure and examinations (7%).
• REGULARITY OF HOME PRACTICE: 21 were practising at home on 3 days/week, 18 on 2 days, 11 on 5 days, 10 on all 7 days, 10 on 4 days, 9 on 6 days and 3 were practising at home only once/week. 14 reported that they were not practicing at home at all. The regularity of home practice was attributed by the participants to a feeling of physical and mental betterment (49%) while inability to be more regular was attributed to lack of time (18%), work and education (18 %), laziness (9%) and other home circumstances (6%). 46% of the participants reported a home practice of 30 min, 17% for 40 min, 16% for 20 min, 15% for 60 min and 6% reported that they practised for more than an hour at home. This regularity was attributed to a feeling of wellbeing (47%) while the irregularity was attributed to lack of time (29%), work pressure (18%) and other factors (6%).
• HEALTH STATUS: 56 participants reported that their health status was better than when they started the yoga practice. 36 reported that it was much better than before
Bulletin of ACYTER – July 2011 4
while 7 said that it was the same as before. One participant reported total relief from his health complaints after starting the yoga programme.
• DOSAGE OF MEDICATION: 56 participants reported no change in their medication, 29 reported a decrease while 2 reported an increase in the dosage of their medication. 13 of the participants were not on any medication.
• GENERAL SUGGESTIONS: The majority of participants reported satisfaction with the programme as well as the teaching methods of the instructors. General suggestions included the need for more space for practice sessions, an increase in the number of sessions as well as duration of sessions and possibility of sessions being conducted after office hours. The participants thanked the Director JIPMER and MDNIY for starting ACYTER thus enabling so many persons to benefit from the excellent yoga programmes conducted free of cost.
POST INTERVENTION, RETROSPECTIVE WELLNESS QUESTIONNAIRE
A post intervention, retrospective wellness questionnaire compiled by ACYTER was used to evaluate the comparative feelings of the patients after the therapy programme. Five different responses ranging from ‘worse than before’ to “complete relief / total satisfaction’ were utilized to evaluate various physical and psychological aspects of the patient’s condition. The questionnaire was finalized in consultation with a 12 member team consisting of 3 eminent medical practitioners, 2 psychologists, 2 yoga experts, 2 eminent yoga therapy consultants, 2 educationalists and one legal anthropologist.
The post intervention overall wellness scores of the participants are given below in fig.1 and the detailed breakup of % responses to each question is given in table.1. Results of the retrospective wellness scores indicates that 11% attained complete relief from their condition while 35% felt much better than before. 38 % were better than before while 15% had no change in their condition. The condition of 1% was worse than before.
Fig 1: Post intervention total well being score of participants
Worse than before1%
Same as before15%
Better than before38%
Much better than before35%
Complete relief 11%
Bulletin of ACYTER – July 2011 5
Table 1: Responses of the participants to retrospective wellness questionnaire
Worse than
before
Same as before
Better than
before
Much better than before
Complete relief / Totally
satisfied
Ability to concentrate - 12% 56% 30% 2%
Control of anger / loss of temper
- 15% 51% 26% 8%
Appetite 1% 26% 37% 24% 12%
Confidence level 2% 12% 41% 37% 8%
Ease of breathing - 14% 33% 41% 12%
Energy levels - 18% 39% 39% 4%
Enjoyment of life - 18% 41% 28% 13%
Feeling calm & fresh - 14% 32% 40% 14%
Feeling of hopelessness 1% 19% 36% 30% 14%
Feeling of loneliness 1% 15% 40% 30% 14%
General flexibility - 11% 37% 42% 10%
General mood - 7% 38% 47% 8%
General sense of relaxation
- 12% 37% 43% 8%
General wellbeing - 10% 36% 39% 15%
Joint mobility - 12% 36% 41% 11%
Nervousness - 14% 45% 34% 7%
Normality of menstrual cycles
4% 29% 21% 25% 21%
Pain levels - 14% 41% 30% 15%
Performance of day-to-day activities
- 12% 41% 38% 9%
Sleep quality / duration 1% 19% 26% 39% 15%
Stress levels - 17% 38% 33% 12%
Total well being score 0.48 % 15.24 % 38.19 % 35.05 % 11.05 %
Bulletin of ACYTER – July 2011 6
RESEARCH ACTIVITIES
Final reports are being prepared on studies conducted on effects of yoga therapy programmes on diabetes mellitus and hypertension. Pre-hypertension screening programme was organized by PhD scholars and residents from the department of Physiology. Baseline recordings are in progress for studies on the effect of different pranayamas and effect of yoga on premenstrual tension. Yoga therapy sessions are being conducted for pregnant ladies as part of a pre–eclampsia prevention study since the end of March. Screening of patients is done by Dr Manikandan, Asst Professor in OBG, JIPMER and Selvi L Vithiyalakshmi is conducting sessions on Tuesdays and Thursdays from 3- 4 PM at ACYTER. Two papers on the effects of yoga therapy have been accepted for publication in Yoga Mimamsa and the International Journal of Yoga therapy.
YOGA THERAPY OPD AT SUPERSPECIALITY BLOCK
Yoga therapy OPD is functioning regularly in Super Specialty Block of JIPMER. Yoga therapy and lifestyle consultation is given by Dr Ananda Balayogi Bhavanani and Dr Zeena Sanjay from 10 AM to 1 PM on Monday, Wednesday and Friday and 10 AM to 4 PM on Tuesday and Thursday. 309 patients (new 213 and old 96) of various disorders attended the OPD between April and June 2011.
YOGA THERAPY SESSIONS
The yoga therapy sessions are being conducted at ACYTER yoga hall on Mondays, Wednesdays and Fridays from 10 – 11 AM for patients of diabetes, 11 AM – 12 noon for patients of cardiovascular diseases and 12 noon – 1 PM for patients of other disorders. The yoga instructors, Shri G Dayanidy and Selvi L Vithiyalakshmi are conducting the sessions both individually and in groups as per directions of the therapists. Patients have reported satisfaction with the therapy sessions and are attending regularly. 778 patients of diabetes, 513 of hypertension and 742 of other conditions attended these sessions in April and June 2011.
YOGA CLASSES FOR NORMAL SUBJECTS
Yoga classes are being conducted on Mondays, Wednesdays and Fridays at 6.30 AM and 4.30 PM. 332 participants attended the classes in the last quarter. Suryanamaskar, basic asanas, pranayamas and relaxation techniques are being taught in the classes.
YOGA CLASSES FOR SENIOR CITIZENS
Yoga classes for senior citizens are being conducted every Thursday between 11 AM and 12 noon. 126 participants attended classes with Mrs. Meena Ramanathan, Coordinator, Yoga Centre, Mahatma Gandhi Medical College and Research Institute.
From To Advanced Centre for Yoga Therapy, Education and research (ACYTER) Department of Physiology, JIPMER, Puducherry – 605 006
Bulletin of ACYTER – October 2011 1
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;ksx fpfdRlk f’k{kk ,oa vuqla/kku mUUkr dsUnz ADVANCED CENTRE FOR YOGA THERAPY,
EDUCATION & RESEARCH (ACYTER) (A collaborative venture between JIPMER, Puducherry & MDNIY, New Delhi)
Bulletin of ACYTER – October 2011
Published by the Advanced Centre for Yoga
Therapy, Education & Research (ACYTER),
JIPMER, D Nagar, Puducherry, India
605 006
Patrons:
Dr. KSVK Subba Rao Director, JIPMER Dr. I V Basavaraddi Director, MDNIY, New Delhi Dr. Ashok Kumar Das Med. Superintendent, JIPMER Dr. S Badrinath Project Co-ordinator, JIPMER Dr. KS Reddy Dean, JIPMER Editor:
Dr. Madanmohan Professor & Head, Dept. of Physiology, JIPMER & Programme Director, ACYTER Editorial board:
Dr. GK Pal Professor, Dept. of Physiology, JIPMER Dr. Ananda Balayogi Bhavanani Programme Co-ordinator, ACYTER, JIPMER Correspondence to:
The Editor, Bulletin of ACYTER, III floor Institute Block, JIPMER, D Nagar, Puducherry- 605 006, India E-mail: [email protected]
SOME THOUGHTS ON YOGA RESEARCH# Yoga research is now a global phenomenon with an increased number of blinded, randomized and controlled trials. There is ample evidence of improved planning and implementation with a better understanding of the mechanisms by which various yoga practices cause their effects. More research studies are being published in indexed journals with peer review, indicating a better standard of research at least at the physical level. Greater funding is also available nowadays both nationally and internationally.
Today, however, we are really at the crossroads with important questions such as “How do we really look into the deeper aspects of yoga” cropping up more and more often. We are confronted with the stark reality that we really don’t have the equipment, techniques and expertise to study the yogic phenomena as most of them are beyond the physical realm. To conclude that shavasana has only the physical effect of lowering heart rate and blood pressure is to sight merely the iceberg’s tip, missing the other 90%. The real effects of shavasana as the ultimate relaxation and true renunciation may have far-reaching effects than we are led to believe.
Many excellent papers are published from a scientific perspective, but are limited from a yogic perspective. There has to be a symbiotic relationship between yoga and modern science. For this, bridges combining the best of both worlds need to be cultivated. Youngsters who have a good grounding in yoga from childhood and those who are living a life of yoga need to take up scientific studies to actualize their potential of being the perfect yoga researchers. Similarly scientists who study yoga, need to remember that yoga is not a subject to be merely ‘studied’ but is a way of life to be observed as implied by “Atha yoganushasanam”, the very first sutra in the Yoga Darshan of Maharishi Patanjali.
In this issue we take a look at the extensive work done at JIPMER in the past few decades under the direction of Prof Dr Madanmohan and an update on studies being conducted by ACYTER at JIPMER as a collaborative venture with MDNIY, New Delhi.
We hope that this issue of the ACYTER bulletin will stimulate many like minded scientists to explore yoga in a wholistic manner and provide a scientific understanding of its great preventive and therapeutic potential.
Dr Ananda Balayogi Bhavanani Programme Coordinator ACYTER
# Bhavanani AB. IJYT 2011; 21: 21
Bulletin of ACYTER – October 2011 2
ROLE OF YOGA IN PREVENTION AND MANAGEMENT OF CARDIO-VASCULAR DISEASE: THE JIPMER EXPERIENCE∗
Dr MADANMOHAN MBBS, MD, MSc (Yoga), FIAY
Professor& Head, Dept of Physiology and Programme Director ACYTER, JIPMER, Pondicherry Email: [email protected]
Non-communicable diseases, including cardiovascular diseases comprise more than 60% of health problems and are a major burden on our health care delivery system. In developed countries, cardiovascular disease accounts for 30% of all cause mortality and the incidence is more among the elderly.
India is catching fast with an alarming increase in the incidence of hypertension and coronary artery disease. It is a matter of great concern that young Indian professionals who are at the peak of their life and career are becoming victims of cardiovascular diseases. In spite of awesome advances in modern medicine, globally millions die of cardiovascular diseases every year. Allopathy depends on powerful drugs that have many undesirable
side effects, especially when administered over a period of time. Many hypertensives and heart patients have to take prolonged drug treatment with the consequent financial burden and undesirable side effects.
It needs to be emphasized that Allopathy does not have all the answers for chronic, degenerative disorders whose incidence is rising by the day. Being high-tech and expensive, modern medicine has not been able to deliver health care to large sections of our population. State of-the-art technology and expensive medicine automatically limits the reach of modern medicine. Allopathy has not been able to prevent and cure lifestyle-based chronic degenerative disorders that are the bane of modern society and impose significant morbidity and mortality.
It is clear that there is a pressing need for introducing yoga as an add-on, complimentary system to augment modern medicare. Modern medicine as well as yoga have sound scientific basis and are, therefore, natural allies. Their merger will give us an enlightened, holistic and highly effective health care delivery system that will be a boon to our society.
Cardiovascular disease is basically a lifestyle disorder. Hence, lifestyle modification along with usual medicare should be adopted as the strategy for its prevention and management. The goal of lifestyle modification should be to modify risk factors and improve quality of life so that the need for drugs and interventional procedures is significantly reduced. Holistic science of yoga is the best lifestyle ever designed. Yoga is holistic because it has preventive, promotive as well as curative potential and is an ideal means to improve our physical, mental as well as spiritual health.
The ancient marvel of yoga is the eternal and priceless gift of India to the world. Yoga means union. Union between our body, mind and soul and the ultimate union of our individual consciousness with the universal Divine Consciousness in a super-conscious state called Samadhi. Yoga is a scientific – spiritual discipline and the most precious gem of Indian cultural heritage and Vedic thought. It has non-sectarian approach and is for the whole humanity. Indian yogic tradition is pre-historic. The first book of humankind, Rigved, ∗ Published invited talk. Souvenir and Abstracts. 24th Annual Conference, Indian Society for Atherosclerosis Research & International CME on Atherosclerosis 2011, p 7-10.
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mentions about yogic meditation by the wise (5:81:1). Yajurved exhorts us to practice yoga for enhancing mental health, physical strength and prosperity (11:14). That is an ideal recipe against stress and chronic disorders including cardiovascular disease. Upanishads are replete with yogic concepts and Bhagavadgita (~3000BC) mentions the term yoga 105 times in its 700 verses. In unequivocal turns, yogeshwar (lord of yoga) Krishna emphasizes the superiority of a yogi (Bhagavadgita 6:46).
Scientific literature on the role of yoga in prevention and management of cardiovascular diseases is scanty. Yoga has preventive, curative as well as rehabilitative potential. This holistic action of yoga can be explained on the basis of its ability to modulate autonomic functions, relieve stress, improve physiological functions including cardio-respiratory fitness and improve quality of life.
Hypertension and coronary artery disease are common disorders and many patients are on life-long medication as a way of life. To reduce the drug dosage and improve general health and quality of life, yoga should be introduced along with usual medical care. If diagnosed early, most of the patients having essential hypertension/pre-hypertension can be managed effectively by yoga alone. Even in advanced cases, yoga can improve quality of life and decrease drug dosage. Yoga is safe, effective, inexpensive and it improves overall health.
In a study on patients having essential hypertension, we have demonstrated that yoga training produces a significant decrease in blood pressure and heart rate within 3 weeks of the training (Vijayalakshmi et al, Ind J Physiol Pharmacol 2004, 48: 59-64). In this study, we have also found that yoga training optimizes the sympathetic response to stressful stimuli like isometric handgrip test. Other workers (Patel and North, lancet 1975, 19: 93-95; Datey et al, Angiology 1969, 20: 325-333) also have reported blood pressure lowering ability of yoga training.
For best results, yogic lifestyle should be adopted early in life since atherosclerotic plaques in coronary arteries start forming early in life. Moreover, in a recent report, we have found that the levels of LDL and total cholesterol are higher in prehypertensive patients as compared to normal subjects (Pavithran et al, Indian J Physiol Pharmacol 2007, 51: 96-98).
Breathing exercises and relaxation training have beneficial effects in patients with previous myocardial infarction (van Dixhoom, Biol Psycol 1998, 49: 123-135). This supports our earlier finding that shavasan (yoga relaxation training) and pranayam (yoga breathing) is beneficial in patients having premature ventricular complexes and palpitations (Ravindra et al, International J Cardiology 2006, 108:124-125).
In a recent work, we have demonstrated that pranayam breathing at 6 breaths/min can reduce heart rate and blood pressure of hypertensive patients within 5 mins of starting the practice (Bhavanani et al, International J Yoga Therapy 2011, 21: 73-76). This novel finding has potential therapeutic application in day-to-day as well as clinical situations where blood pressure needs to be brought down quickly. We recommend that this simple to perform and inexpensive technique be added to the management protocol of hypertensive patients as an add-on to the routine medical care.
Therapeutic potential of yoga may be due to, at least partly, its ability to modulate autonomic function. In a study on the effect of pranayam on school children, we have demonstrated that three month pranayam training produce a decrease in basal sympathetic tone, an increase in basal parasympathetic activity and a significant decrease in rate pressure product (Udupa et al, Indian J Physiol Pharmacol 2003, 47: 27-33). Rate-pressure product is an index of load on heart and myocardial oxygen consumption. These findings indicate that pranayam has potential benefit in health and disease.
In another study, we have demonstrated that six week yoga training improves thermo-regulatory efficiency as measured by weight loss response to step test (Madanmohan et al, Indian J Physiol Pharmacol 2008, 52: 164-170). This yoga training induced attenuation of
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sweating response to muscular exercise is of physiological significance and indicates improved autonomic regulation and exercise tolerance. Our findings support those of Michalsen et al (Am Heart J 2006, 151: 870-877) who have reported that comprehensive lifestyle modification improves autonomic function, angina and quality of life of patients with established coronary artery disease.
Stress is an important factor in the etiology as well as progression of chronic diseases including hypertension and coronary artery disease. For prevention as well as management of stress, there is no method as effective and far-reaching as yoga. Shavasan, meditation and mantra chanting are very effective in controlling stress.
Yogic postures, when performed with awareness and synchronized with breathing as well as slow, rhythmic pranayams are effective stress busters. In a study on subjects who were well trained in yoga, we have demonstrated that savitri pranayam (slow rhythmic and deep breathing with a ratio of 2:1:2:1 between inspiration, hold-in, expiration and hold-out phases) and shavasan produce a significant decrease in oxygen consumption and a deep psychosomatic relaxation within 5 minutes of starting the practice (Madanmohan et al, The Yoga Review 1983, 3: 25-34).
In another study, we have demonstrated that shavasan improves one’s ability to withstand stress as measured by response to cold-pressor test and this ability can be achieved within 7 days of training (Madanmohan et al, Indian J Physiol Pharmacol 2002, 46: 307-312). Our findings are consistent with the report that yoga training not only produces a significant decrease in basal anxiety level, but also attenuates the increase in stress scores during stressful situations like examinations (Malathi and Damodaran, Indian J Physiol Pharmacol 1999, 43:218). It is clear that yoga is very effective in combating stress and stress disorders like hypertension and coronary artery disease.
The beneficial health-promoting and therapeutic effects of yoga training can also be due to improvement of physiological functions. Practice of pranayam and asan results in improvement of physical fitness and cardio-respiratory endurance. In a work on normal school going boys, we have found that yoga training blunts the exercise-induced increase in heart rate and blood pressure (Madanmohan et al, Indian J Physiol Pharmacol 2004, 48: 461-465). This suggests that yoga training improves exercise tolerance. In an another work conducted on medical students, we have found that 12 week yoga training produces a significant increase in respiratory pressures, handgrip strength and breath holding time, suggesting an improved physical strength and cardio-respiratory function.
Yoga training also improves respiratory endurance, muscle strength and reaction time (Madanmohan et al, Indian J Physiol Pharmacol 1992, 36: 229-233). Improvement of pulmonary functions by yoga training has also been reported by us (Madanmohan et al, Indian J Physiol Pharmacol 2003, 47: 387-392).
We have also reported that training in slow breathing pranayams (e.g. savitri pranayam) reduces the basal heart rate and rate-pressure product while training in fast breathing pranayams (e.g. bhastrika) produces an increase in these parameters. Thus, it is possible that slow and fast pranayams may have different therapeutic effects.
Our studies demonstrate the health promoting and therapeutic potential of yoga. Yoga can play a significant role in prevention as well as management of cardiovascular disease, especially essential hypertension and coronary artery disease, whose incidence is increasing alarmingly. Yoga is the mantra for “avoidable attributes” of ageing.
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CURRENT YOGA RESEARCH ACTIVITIES AT JIPMER Various studies are being conducted at JIPMER as collaborative efforts between ACYTER and the Departments of Physiology, Medicine, Biochemistry, Cardiology, Obstetrics and Gynecology. Papers and abstracts have been published on the completed studies and also submitted for publication. Details of the various studies that have been completed / in progress are given below along with details of the papers published and those in press.
PhD theses:
In Progress: 1. Effect of yoga therapy on cardiac autonomic functions and oxidative stress in
prehypertensive subjects: a randomized controlled study.
2. Effect of yoga therapy on cardiac function, response to exercise, oxidative stress and quality of life in heart failure patients: a randomized controlled trial.
MD dissertations:
Completed: 1. Effect of 12 week yoga therapy as a lifestyle intervention in patients of type 2
diabetes mellitus with distal symmetric polyneuropathy – A randomized controlled study. Dissertation submitted.
2. Effect of yoga therapy on cardiac autonomic function in patients of essential hypertension – A randomized controlled study. Dissertation submitted
In Progress: 1. Effects of slow and fast pranayams on pulmonary function, handgrip strength and
endurance in young healthy volunteers – A randomized controlled trial.
2. Effect of yoga training on autonomic functions and reaction time in young healthy females during different phases of menstrual cycle.
3. Effect of pranayam on maximal exercise performance, pulmonary function, recovery heart rate and blood pressure in healthy adults.
MSc dissertations:
Completed: 1. Effect of yoga training on heart rate, blood pressure and lipid profile of patients with
essential hypertension. Paper has been submitted for publication
2. Effect of yoga training on reaction time, blood glucose and lipid profile of female diabetes mellitus patients. Paper has been accepted for publication
3. Effect of yogic training on physical and biochemical variables of type 2 diabetes mellitus patients. Dissertation submitted.
PILOT STUDIES:
Completed: 1. Immediate effect of sukha pranayama on heart rate and blood pressure of patients
with hypertension. Paper has been published in International Journal of Yoga therapy 2011; 21: 73-76.
2. Immediate cardiovascular effects of kaya kriya in normal healthy volunteers. Abstract of the study published in ACYTER bulletin, workshop proceedings and compilations.
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3. Immediate effect of shavasana and savitri pranayama on heart rate and blood pressure of hypertensive patients. Abstract of the study published in ACYTER bulletin, workshop proceedings and compilations.
4. Immediate effect of chandra nadi pranayama on heart rate and blood pressure of hypertensive patients. Abstract of the study published in ACYTER bulletin, workshop proceedings and compilations. Full paper has been submitted for publication
5. Immediate cardiovascular effects of shavasana and pranava pranayama on heart rate and blood pressure of hypertensive patients. Abstract of the study published in ACYTER bulletin, workshop proceedings and compilations.
6. Immediate effects of yoga nidra on heart rate and blood pressure. Abstract of the study published in ACYTER bulletin, workshop proceedings and compilations.
7. Immediate effect of yoga practices on blood pressure. Work and data analysis completed.
8. Immediate cardiovascular effects of pranava pranayama in hypertensive patients. Paper has been submitted for publication.
9. Immediate effect of suryanadi pranayam on heart rate and blood pressure of hypertensive patients. Work and data analysis completed
10. Immediate effect of suryanadi and chandranadi on short term heart rate variability in healthy volunteers. Data analysis completed and abstract of the study sent for publication and presentation at APPICON 2011.
In Progress: 1. A pilot study on acute effect of anulom vilom pranayam on heart rate variability in
healthy volunteers. Work and data analysis completed and more patients are being recruited
2. Immediate effect of 5 minutes chandranadi pranayam on heart rate variability in hypertensive patients. Work and data analysis completed and more patients are being recruited
3. Immediate effect of 5 minutes chandranadi pranayam on heart rate variability in Diabetes mellitus patients. Work and data analysis completed and more patients are being recruited
4. Acute effect of 5 minutes chandranadi pranayam on heart rate variability in patients with diabetes mellitus and hypertension. Work and data analysis completed and more patients are being recruited
5. Immediate effect of 5 minutes chandranadi pranayam on heart rate variability in patients of heart failure. Work and data analysis completed and more patients are being recruited
6. A pilot study on effect of respiratory rate on heart rate variability in healthy volunteers.
7. Effect of yoganidra on short term HRV in heart failure patients.
CASE STUDIES:
Completed:
• Effect of yoga on subclinical hypothyroidism. Full paper was published in Yoga Mimamsa 2011; 43: 102-107.
• Effect of yoga in newly diagnosed hypertension. Abstract of the study published in ACYTER bulletin.
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• Effect of yoga in a patient of long standing diabetes and hypertension. Abstract of the study published in ACYTER bulletin.
• Case report on COAD in an adult. Abstract of the study published in ACYTER bulletin.
• Case report on bronchial asthma in a 4 year old child. Abstract of the study published in ACYTER bulletin.
OTHER RESEARCH PROJECTS:
Completed: Patient Feedback Survey and Retrospective Wellness Questionnaire was completed for 100 patients in June 2011 and published in ACYTER bulletin of July 2011.
In progress: 1. Effect of slow and fast pranayams on cognitive and autonomic parameters in young
healthy subjects.
2. Effect of mid trimester yoga on the incidence of preeclampsia in high risk women. The clinical trial is being conducted in collaboration with the Department of Obstetrics and Gynecology with Dr K Manikandan, Asst Professor as Principal Investigator. The trial has been registered as CTRI/2011/10/002064 with Clinical Trials Registry- India (CTRI), hosted at the ICMR's National Institute of Medical Statistics (NIMS).
PUBLICATIONS: 1. Effect of yoga on subclinical hypothyroidism: a case report. Yoga Mimamsa 2011;
43: 102-107.
2. Immediate effect of sukha pranayama on cardiovascular variables in patients of hypertension. International Journal of Yoga therapy 2011; 21: 73-76.
3. Don’t put yoga in a small box: The challenges of scientifically studying yoga. Perspective by Ananda Balayogi Bhavanani. International Journal of Yoga therapy 2011; 21: 21.
4. A comparative study of slow and fast suryanamaskar on physiological function. International Journal of Yoga 2011: 4 (2); 71-76
5. Effects of a comprehensive six week yoga therapy programme on reaction time and biochemical parameters and wellness score of peri and post menopausal diabetic patients. Accepted for publication in the International Journal of Yoga.
6. Role of yoga in managing bronchitis. Accepted for publication in Journal of Alternative and Complementary Medicine.
7. Immediate effect of mukha bhastrika (a bellows type of pranayama) on reaction time in special children. Accepted for publication in Indian Journal of Physiology and Pharmacology.
8. Immediate cardiovascular effects of pranava pranayama in hypertensive patients. Submitted to the Indian Journal of Physiology and Pharmacology.
9. Effects of a comprehensive eight week yoga therapy programme on cardiovascular health in patients of essential hypertension. Submitted to the International Journal of Yoga therapy.
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10. Immediate effect of chandra nadi pranayama (left unilateral forced nostril breathing) on cardiovascular parameters in hypertensive patients. Submitted to the International Journal of Yoga.
YOGA THERAPY OPD AT SUPERSPECIALITY BLOCK Yoga therapy OPD is functioning regularly in Super Specialty Block of JIPMER. Yoga therapy and lifestyle consultation is given by Dr Ananda Balayogi Bhavanani and Dr Zeena Sanjay from 10 AM to 1 PM on Monday, Wednesday and Friday and 10 AM to 4 PM on Tuesday and Thursday. 441 patients (new 334 and old 107) of various disorders attended the OPD between July and October 2011.
YOGA RESEARCH LAB AT SUPERSPECIALITY BLOCK ACYTER Yoga Research Lab is functioning in SS Block since 6 July 2011 and regular studies are being done on patients of diabetes, hypertension and heart failure along with the administration of questionnaires. Various pilot studies on patients as well as normal volunteers are being conducted by Sri E Jayasettiaseelon, SRF in coordination with Sri Harikrishna, PhD Scholar and Dr M Rajajeyakumar, SR, Department of Physiology.
YOGA THERAPY SESSIONS The yoga therapy sessions are being conducted at ACYTER yoga hall on Mondays, Wednesdays and Fridays from 10 – 11 AM for patients of diabetes, 11 AM – 12 noon for patients of cardiovascular diseases and 12 noon – 1 PM for patients of other disorders. Additional sessions are being conducted on Tuesday, Thursday and Saturday from 10 – 11 AM for patients of diabetes. The yoga instructors, Shri G Dayanidy and Selvi L Vithiyalakshmi are conducting the sessions both individually and in groups as per directions of the therapists. Patients have reported satisfaction with the therapy sessions and are attending regularly. 654 patients of diabetes, 514 of hypertension and 635 of other conditions attended these sessions between July and October 2011.
YOGA CLASSES FOR NORMAL SUBJECTS Yoga classes are being conducted on Mondays, Wednesdays and Fridays at 6.30 AM and 4.30 PM. 637 participants attended the classes in the last quarter. Suryanamaskar, basic asanas, pranayamas and relaxation techniques are being taught in the classes.
YOGA CLASSES FOR SENIOR CITIZENS Yoga classes for senior citizens are being conducted every Thursday between 11 AM and 12 noon. 138 participants attended classes with Mrs. Meena Ramanathan, Guest faculty who is Coordinator, Yoga Centre, Mahatma Gandhi Medical College and Research Institute.
From To Advanced Centre for Yoga Therapy, Education and Research (ACYTER) III floor Institute Block, JIPMER, D Nagar Puducherry – 605 006
Bulletin of ACYTER – February 2012 1
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ADVANCED CENTRE FOR YOGA THERAPY,
EDUCATION & RESEARCH (ACYTER) (A collaborative venture between JIPMER, Puducherry & MDNIY, New Delhi)
Bulletin of ACYTER – February 2012 (A special issue on the activities of ACYTER from June 2008 to February 2012)