Chronobiology and Health- Proceedings 2016

National Conference on Chronobiology and Health

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Chief Patron

Shri MK Rajagoplan Chairman, Sri Balaji Educational and Charitable Public Trust

Patrons

Prof. P Rajaram Prof. KR Sethuraman

Chancellor, Sri Balaji Vidyapeeth Vice-Chancellor, Sri Balaji Vidyapeeth

Prof. YM Jayaraj Prof. N Ananthakrishnan

Pro-Vice Chancellor, Sri Balaji Vidyapeeth Dean- Research and AHS

Sri Balaji Vidyapeeth

Prof. M Ravishankar

Dean, MGMC & RI

Resource Committee

Prof. S Ravichandran Prof. V Nirmal Coumare Additional Director (HS), MGMC&RI Medical Superintendent, MGMC&RI

Prof. N Seetharaman Dr. AN Uma Head, Department of Community Medicine Assistant Professor, Department of Anatomy

Organizing Chairman Organizing Secretary

Prof. Madanmohan Prof. K Jaiganesh Head, Department of Physiology Professor of Physiology

Core team

Prof. K Henri Balraj Dr. T Jeneth Berlin Raj

Dr. Suchitra Parkhad Dr. Nikhilesh Singh

Dr. Richa Gupta Dr. R Sobana

Dr. K Ramya Mr. S Vasanthan

Dr. S Selvakumar Mr. P Uthiravelu


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INDEX

CONTENT

PAGE NO.

Messages 3

From the desk of Organizing Chairman 12

From the desk of Organizing Secretary 13

Conference faculty 14

Scientific programme 16

Chronobiology – an overview Prof. KR Sethuraman

20

Fundamental properties of circadian clocks – their cellular and molecular basis Dr. Sheeba Vasu

23

Blood pressure variability as a risk factor for cardiovascular diseases Prof. Narsingh Verma

24

Circadian rhythm and bipolar disorder Dr. Biju Vishwanath

25

Nasal cycle and its therapeutic applications: a yogic perspective Dr. Ananda Balayogi Bhavanani, Dr. Meena Ramanathan

26

Chronobiology of ageing: role of telomere and lifestyle intervention Prof. Vivek Kumar Sharma

29

Circadian sleep disorders: are they lifestyle associated? Prof. PN Ravindra

30

Chronotherapeutics Prof. K Manimekalai

34

Therapeutic potential of music: chrono-biological and traditional perspectives Prof. Sumathy Sundar

36

Adaptive resilience exercises as envisioned in yoga Dr. Meena Ramanathan, Dr. Ananda Balayogi Bhavanani

37

Pranayam and its physiological basis Prof. Madanmohan

39

Melatonin and chronobiology Dr. Suchitra B Parkhad

41

Posters 46-62


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MESSAGES


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MESSAGE FROM THE HONORABLE CHAIRMAN

It gives me immense pleasure to note that the Department of Physiology of

Mahatma Gandhi Medical College and Research Institute has taken the lead in

organizing a national conference on “Chronobiology and health” on 18th and 19th

March 2016.

I am confident that this is a maiden effort by us in the field of chronobiology which

relates health with the passage of time.

The deliberations made in the conference will enlighten the new arena among the

faculty.

I wish the conference a grand success.

Shri MK Rajagopalan

Chairman - SBECT


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MESSAGE FROM THE CHANCELLOR

Chronobiology – A Physiologic Paradox

The study of biological rhythm, chronobiology, is attracting interest amongst the scientists around the world. It is, nevertheless, a difficult field for the scientists to understand and learn and then teach and educate others. Medical rhythm research is rather challenging for, it need interest and inquisitive mind on the part of the scientists to learn first.

I am glad that Department of Physiology, under the dynamic leadership of Prof. Madanmohan, who is not only a Physiologist but has been doing research in applied diversified fields like yoga and meditation that has been shown having scientific basis. The researchers in this field have shown that they are not to be treated as having a religious bias but has bearing towards social aspects of humanity. He is heading a team of devoted scientists promoting research and education in these fields in India. This center at Sri Balaji Vidyapeeth is unique in India.

Therefore, organizing chronobiology conference is timely and it is expected that scientists, clinicians, and interested strata of the society will and must come together to promote this interdisciplinary field.

The younger generation of the present era of globalization is at the verge of breakdown of their biological clock. The outcome of research in chronobiology might help maintain the performance and output of workforce and avoid errors while performing their duties and avoid mental and physical health problems.

Medical scientists must join the hands of basic science researchers and try to understand “Chronobiology” and solve the „Physiologic puzzle‟ that we are confronted with.

Prof. Rajaram Pagadala

Chancellor



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MESSAGE FROM THE VICE CHANCELLOR

Following the UGC directive to all the universities to stress on environmental issues

during collegiate education, SBV has undertaken to conduct Annual Faculty

Development Program on various aspects of environment and health. In 2015, it was

Climate Change and Health and in the current year we are focusing on

Chronobiology and Chronotherapeutics and Health.

It is gratifying that the Department of Physiology of MGMC&RI has undertaken to

organize this program as a national conference.

In addition, the unique strength of SBV- yoga therapy and music therapy also find a

prominent place in the conference.

On behalf of SBV, I wish the conference a successful outcome, which would motivate

us to conduct three more annual events in the years to come

Prof. KR Sethuraman

Vice-Chancellor



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MESSAGE FROM THE REGISTRAR

It gives me immense pleasure to felicitate the organizing committee of the national

conference on Chronobiology and Health. The Department of Physiology,MGMC&RI

needs to be complimented for their efforts that have culminated in this great endeavor.

The natural cycles of our body include physiological,mental and emotional facets that

are grossly governed by solar and lunar rhythms. Eminent researchers drawn from

various research areas would enthrall the discerning audience with their intellectually

stimulating talks on many a thrust area in chronobiology as related to health.

I wish the conference great success.

Prof. AR Srinivasan

Registrar Sri Balaji Vidyapeeth


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MESSAGE FROM THE DEAN RESEARCH AND AHS

Right from its inception, SBV has been in the forefront amongst peers, in the field of

innovations and newly emerging areas of medical sciences so that it becomes part of

the exploring group along the advancing borders of modern science – in the words

from the famous serial Star trek “to boldly go where no man has been before.”

Biology has undergone considerable change in recent times from description of gross

cellular function to molecular biology at the sub-cellular level and the description of

the new biology by Bruce Lipton in his book “The Biology of Belief”. One such

emerging area is “Chronobiology” and its implication in medicine particularly in the

area of therapeutics.

I am very glad that the Department of Physiology at MGMC&RI has taken the lead in

arranging a national program in this field wherein experts from different fields would

highlight salient features of chronobiology and its application to different disciplines of

medicine.

I am sure that the proceedings of the program would go a long way in promoting our

understanding of the subject. I wish the conference all success.

Prof. N Ananthakrishnan

Dean – Research and Allied Health sciences



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MESSAGE FROM THE DEAN

It gives me great pleasure and happiness to know that the Department of Physiology is

organizing a National Conference on Chronobiology and Health on 18th and 19th March

2016 under Sri Balaji Vidyapeeth Deemed University, Accredited by NAAC with „A‟

Grade.

Chronobiology as a focused theme to analyze the effect of changing environment on

human health is a novel idea and delegates attending this conference will have lot to

think about.

I am confident that this conference will contribute to this national vision.

I wish the function every success.

Prof. M Ravishankar

Dean

MGMC&RI


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MESSAGE FROM THE ADDITIONAL DIRECTOR

I am very happy to see the Department of Physiology is going to conduct anational

conference on an important topic that is “CHRONOBIOLOGY AND HEALTH”. I think

many of you agree that the knowledge on this topic among our medical fraternity is

very limited and unpopular, where as many of the western countries started doing

many research in the field of Chronophysiology, Chronopathology,

Chronopharmacology etc.

Chronobiology or circadian biology has come a long way since 1960‟s. What was once

a difficult science to promote and teach has now become a very important field that

encompasses molecular biology, endocrinology, physiology, psychiatry, genetics,

neurology, sleep studies, and even astronomy when dealing with the cosmic origins of

our biological clocks and lunar rhythms that have an impact on the earth.

I have no doubt that this conference is going to inspire many of us to understand the

details regarding the forces that control our inner clocks and to find better ways to

adapt.

Good initiative, please keep going.

Prof. S Ravichandran

Additional director – Hospital services

MGMC&RI


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MESSAGE FROM THE MEDICAL SUPERINTENDENT

I am glad that the Department of Physiology, Mahatma Gandhi Medical College and

Research Institute is organizing a 2 day national conference on “Chronobiology and

Health” in which scientists from diverse fields are taking part. I am sure that coming

together of scientists from such diverse fields will encourage inter-disciplinary

research which will be a boon to the society.

I wish the conference a grand success.

Prof. V Nirmal Coumare Medical Superintendent,

MGMC&RI


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FROM THE DESK OF THE ORGANIZING CHAIRMAN

At the outset, I wish to express my heart-felt gratitude to our honorable Chairman

Shri MK Rajagopalan for his constant support to organize conferences/workshops. We

have been organizing such events every year and the management has been graciously

supporting the same. The present conference on “Chronobiology and Health” is second

in a series of conferences on “Environment and Health” conceived by our honorable

Vice-Chancellor, Prof. KR Sethuraman.

I am grateful to Prof. P Rajaram, honorable Chancellor, Prof. YM Jayaraj, Pro-Vice

Chancellor, Prof. N Ananthakrishanan, Dean Research & AHS and Prof. M

Ravishankar, Dean MGMC & RI for their constant support and inspiration. I wish to

thank my colleagues and friends from the Department of Physiology without whose

support it would not have been possible to organize this conference.

Chronobiology is an interdisciplinary field and faculties of this conference arefrom

diverse fields of neuroscience, physiology, pharmacology, medicine, psychiatry,

cardiology, pulmonary medicine, endocrinology, gynecology,yoga therapy and music

therapy. I am sure that the scientific program will be an enlightening one and a

memorable experience for you and wish you all the best for the 2 day conference.

Prof. Madanmohan

Prof. and Head,

Department of Physiology,

MGMC&RI


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FROM THE DESK OF THE ORGANIZING SECRETARY

It is indeed my pleasure and privilege to invite you all to the National Conference on

“Chronobiology and Health”

We have made our fullest efforts to bring in potential resource persons from diverse

fields to enlighten our delegates.

The scientific sessions and workshop have been meticulously planned and executed

to make your participation a comfortable and fruitful experience.

I assure you that the conference will be an enriching academic experience to you in

the field of chronobiology.

Prof. K Jaiganesh

Professor of Physiology

MGMC&RI


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CONFERENCE FACULTY

Internal faculty:

KR Sethuraman, MD, PGDHE. Vice Chancellor, Sri Balaji Vidyapeeth.

Madanmohan, MD, DSc.

Professor & Head,


MGMC & RI &

Director, Center for Yoga Therapy, Education & Research (CYTER),

Sri Balaji Vidyapeeth.

K Manimekali, MD.

Professor & Head,

Department of Pharmacology,

MGMC & RI.

Sumathy Sundar, PhD.

Director,

Centre for Music Therapy Education & Research (CMTER),


B Amirtha Ganesh, MD, DM

Professor & Head,

Department of Cardiology,

MGMC & RI.

R Pajanivel, MD, FRCP.

Professor,

Department of Pulmonary medicine,

MGMC & RI

Ananda Balayogi Bhavanani, MBBS, MD (AM).

Deputy Director,

Centre for Yoga Therapy Education & Research (CYTER),


Meena Ramanathan, PhD (Yoga).

Coordinator-cum-Yoga Therapist,

Centre of Yoga Therapy Education Research (CYTER),



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External faculty:

PN Ravindra, MD, PhD.

Professor & Head,


Akash Institute of Medical Sciences & Research Centre,

Bangalore.

Narsingh Verma, MD.

Professor of Physiology & Vice Dean,

KG Medical College,

Lucknow.

Gowri Dorairajan, MD

Professor of Gynecology,

JIPMER

Vivek Sharma, MD.

Additional Professor,


JIPMER.

Sadish Kumar, MD, DM

Associate professor,

Department of Endocrinology,

JIPMER.

Biju Vishwanath, MD, PhD.

Assistant Professor,

Department of Psychiatry,

NIMHANS,

Bangalore.

Sheeba Vasu, PhD.

Faculty Fellow,

Neuroscience unit,

Jawaharlal Nehru Centre for Advanced Scientific Research,

Bangalore.


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SCIENTIFIC PROGRAMME

Day1: 18 March 2016 (Friday)

Venue: Ground Floor Lecture Hall, College Block

8.00 to 9.00 AM Registration

9.00 to 9.30 AM Pre- test

9.30 to 10.00 AM Fundamental properties of circadian clocks – their cellular and molecular basis. Sheeba Vasu, PhD. JNCASR, Bangalore

10.00 to 11.00 AM Inaugural function and

lead talk by KR Sethuraman Vice Chancellor, Sri Balaji Vidyapeeth.

11.00 to 11.30 AM High tea

11.30 to 12.00

Noon

Blood pressure variability as a risk factor for cardiovascular diseases: chronobiological perspective. Narsingh Verma, MD. Professor of Physiology & Vice Dean,

KG Medical College, Lucknow.

12.00 to 12.30 PM

Circadian rhythm and bipolar disorder

Biju Vishwanath, MD. Assistant Professor, Department of

Psychiatry, NIMHANS, Bangalore.

12.30 to 1.00 PM

Nasal cycle and its therapeutic applications: a yogic perspective.

Ananda Balayogi Bhavanani, MBBS, MD (AM).

Deputy Director, CYTER, Sri Balaji Vidyapeeth.

1.00 to 2.30 PM Poster session and lunch

2.30 to 3.00 PM

Chronobiology of ageing: role of telomere and lifestyle intervention. Vivek Sharma, MD. Additional Professor, Department of Physiology,

JIPMER, Pondicherry.

3.00 to 3.30 PM

Circadian sleep disorders: are they lifestyle associated?

PN Ravindra, MD, PhD. Professor & Head, Department of

Physiology, Akash Institute of Medical Sciences & Research Centre,

Bangalore.

3.30 to 3.45 PM Tea

3.45 to 4.15 PM Therapeutic potential of music: chronobiological and traditional perspectives. Sumathy Sundar, PhD. Director, CMTER, Sri Balaji Vidyapeeth.

4.15 to 4.45 PM Question / answer session.


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SCIENTIFIC PROGRAMME

Day 2: 19 March 2016 (Saturday)

Venue: Ground Floor Lecture Hall, College Block

9.00 to 10.15 AM

Panel discussion on chronotherapeutics:

Chairperson: K Manimekalai

Panelists: B Amirtha Ganesh

R Pajanivel

Gowri Dorairajan

Sadish Kumar

10.15 to 10.30 AM

Tea

10.30 to 11.00 AM

Post test

11.00 AM to 12.30 PM

Practice sessions at CYTER, I Block, First floor

Practice sessions on adaptive resilience cyclic exercises and

pranayam.

Meena Ramanathan, Ananda Balayogi Bhavanani,

Madanmohan

12.30 to 1.00 PM

Valedictory

1.00 PM

Lunch


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ABSTRACTS


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Chronobiology – an overview

Prof. KR Sethuraman. MD, PGDHE.

Vice Chancellor, Sri Balaji Vidyapeeth (A Deemed University)

Biological Rhythms are cyclical changes at the level of body chemistry or function.

They can be i) internal or endogenous controlled by the internal biological clock e.g.

body temperature cycle) or ii) external or exogenous (controlled by synchronizing

internal cycles with external stimuli, e.g., sleep/wakefulness synchronizing with

day/night.

Such stimuli are called zeitgebers (German word meaning “time givers”). Zeitgebers

include environmental time cues such as sunlight, food, noise, or social interaction

and they help to reset the biological clock to a 24-hour day- night cycle. The circadian

clock is genetic transcription-translation feedback machinery. It exists in most organs

and cells, termed the peripheral clock, which is orchestrated by the central clock in

the supra-chiasmatic nucleus.

Depending on the duration, biological rhythms are:

Circadian rhythms – endogenously generated rhythms with a period close to 24

hours.

Diurnal rhythms – a circadian rhythm that is synchronized with the day/night

cycle.

Ultradian rhythms – biological rhythms (e.g. feeding cycles) with a period much

shorter (i.e., frequency much higher) than that of a circadian rhythm.

Infradian rhythms – biological rhythms with a cycle of more than 24 hours (e.g.

the human menstrual cycle).

Circadian is derived from a Latin phrase meaning “about a day”. Circadian rhythms

have a period of approximately 24 to 25 hours. When the rhythm is synchronized with

the day-night cycle, it is termed a diurnal rhythm.

Physiological and behavioural rhythms of the circadian type include:

sleep/wakefulness cycle

body temperature


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hormone secretion patterns

blood pressure variation

digestive secretions

alertness level

reaction time

Variations of circadian rhythm (the morning-evening types): “morningness” and

“Eveningness” describe a person‟s individual circadian profile.

Most people fall somewhere between these two types.

Morning people usually prefer to rise between 5 a.m. and 7 a.m., and retire

between 9 p.m.and 11 p.m.

Evening people tend to prefer both a later wake up (9 a.m. to 11 a.m.) and a

later bed time (11 p.m. to 3 a.m.).

Morning people also tend to be more rigid in their circadian rhythms.

Evening people find adjustment to new schedules somewhat easier.

Post-lunch dip effect: The "post-lunch dip" is a period of decreased alertness that

strikes between 1 p.m. and 4 p.m. Most of us would have experienced this, especially

after a heavy lunch.

Between 1 pm and 4 pm:

work performance suffers

people in dimly lit meeting rooms are apt to nod off

The likelihood of getting into a car accident increases.

The body temperature, hormone levels and other physiological cycles place us

at low ebb in the early afternoon, in contrast to periods of peak alertness we

experience in the morning and early evening.

The post-lunch dip occurs even if we skip the lunch, but a heavy lunch

exaggerates the effect.

Strategies for coping with the post-lunch dip:

a brief power nap (no longer than 10-15 minutes)

a brisk walk outside

drinking tea, coffee or ice-cold juice

doing work that requires moderate physical exertion.

If possible, the most mentally demanding work should be done in the morning

or evening, depending on a person‟s rhythm.

Human errors and time-of-day:

Disasters caused by human errors, such as 3-Mile Island, Bhopal and

Chernobyl, occurred at middle of the night.

The majority of single-vehicle driving accidents occur in the hours near dawn.


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Compared to nocturnal predatory animals, we humans have relatively poor

night vision, hearing and smell. Therefore, our circadian rhythms put us to

sleep at night for our own protection.

The biological imperative to sleep creates problems for shift work.

Studies revealed that performance of visual search is better in the morning than

the evening.

Performance on thinking tests is better around lunchtime than in the morning

or evening

Caution: The above findings on time-of-day (TOD) effects are highly variable in any

given individual and we should not generalize.

Biorhythms theory - a myth

A pseudoscientific theory claims that our lives are affected by 3 rhythmic cycles:

– Physical – 23 days cycle; Emotional – 28 days cycle; Intellectual – 33 days cycle.

A systematic review of 134 biorhythm studies found that there is no scientific evidence

to support the theory.

Chronotherapeutics

Coordinating biological rhythms with medical treatment is called chronotherapy. It

considers a person‟s biological rhythms in determining the timing and sometimes the

amount of medication to optimize a drug‟s desired effects and minimize the undesired

ones.

Recent studies linking circadian rhythms with blood pressure control and type-2

diabetes have forced the scientists to look for the ways to set the clock right. The risks

of myocardial infarction, cardiac arrest and of stroke are higher by 40%, 29% and 49%

respectively, between 06:00 am and noon. Therefore, our focus has shifted towards

chrono-therapeutics i.e., dosing of the medications at 10 pm with novel drug delivery

systems to keep the drug levels high at 6 am and for 6 to 8 hours thereafter.

A clinical study of 1995 has shown that administration of an HMG-CoA reductase

inhibitor in the evening was more effective at lowering serum cholesterol levels than

the same dose given in the morning, because higher rates of cholesterol synthesis

occur during the evening hours.

Another study in 2009 has revealed that the proportion of patients with controlled

ambulatory blood pressure increased from 43% to 65% with single bedtime dose of

angiotensin converting enzyme inhibitor, ramipril.

To sum up, the physicians of 21st Century, who practise salutogenesis (promoting

wellness) need to be aware of chronobiology and chronotherapeutics.


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Fundamental properties of circadian clocks – their cellular and

molecular basis.

Dr. Sheeba Vasu. PhD.

Faculty Fellow, Neuroscience Unit,

Jawaharlal Nehru Centre for Advanced Scientific Research,

Bangalore, INDIA.

E-mail: [email protected]

I will introduce the basic features of rhythms that would allow us to consider them as

being driven by endogenous circadian clocks. The underlying genetic basis of

circadian clocks was unraveled by researchers using classic genetic approaches and

many critical genes that are involved in the functioning of the circadian clock were

first discovered in fruit flies. These findings paved the way for studies in mammals

and several other organisms. The anatomical and cellular identities of the circadian

pacemakers were also investigated in parallel in many organisms. I will describe some

studies from our own research group and that of others which showed that behavior of

animals in more natural settings can reveal features not detected in standard

laboratory studies. The characteristic features of circadian rhythms and their

molecular, genetic and cellular basis will be discussed. Rhythms under natural

conditions and behaviors underlying molecular clock will be explained.


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Blood pressure variability as a risk factor for cardiovascular

diseases: chronobiological perspective

Dr. Narsingh Verma. MD

Professor of Physiology & Vice Dean, KGMU, Lucknow

Blood pressure measurement by sphygmomanometer or automated devices is the

routine approach for diagnosing hypertension in clinics, but patients may be

misclassified due to masked hypertension or “white coat” hypertension. The addition

of ambulatory blood pressure monitoring (ABPM), has helped in improving the

diagnosis and treatment decisions. ABPM is not new as more than 50 years have

passed since first attempt for ABPM was made by Hinman et al. in 1962. The potential

of this technique was not recognized that time and nobody expected that it will soon

become indispensable tool in day to day practice. Its recognition and acceptance in

clinical practice took little time and now there is overflow of data using ABPM from

different groups around the world. Study of circadian pattern of blood pressure has

provided several insights into the patho-physiology of target organ damage in

hypertensives. With identification of dipping and non dipping patterns among

hypertensives the treatment goals have observed a paradigm shift from correcting the

average blood pressure values to restoring the dipping pattern. Chronomics now

guiding the drug therapy in such patients have made ABPM indispensible tool not only

in diagnosing but overall management of hypertension. Recently several studies have

increasingly demonstrated its application in identifying risk of target organ damage in

Type 2 Diabetes and Kidney transplant patients. In this context our group is working

on investigating circadian pattern of Blood Pressures among normal subjects,

hypertensive patients, Type-2 Diabetes Patients and pregnancy induced hypertension.

Some of the interesting findings from our group will be discussed during the meeting.


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Circadian rhythm and bipolar disorder

Dr. Biju Vishwanath. MD, PhD

Assistant Professor (DST INSPIRE),

Dept. of Psychiatry,

National Institute of Mental Health and Neuro Sciences

(NIMHANS), Bangalore.

Bipolar disorder is a chronic severe neuropsychiatric illness with high rate of suicide.

The exact biological basis of bipolar disorder or its pharmacological treatment is

unknown. Over the last decade, circadian rhythm abnormalities in this disorder have

been studied increasingly. Clinical, neuro-endo-phenotype and genetic studies in the

field need to be highlighted. Recent studies of cell models offer exciting avenues to

integrate the biology of this complex disorder along these lines of research.


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Nasal cycle and its therapeutic applications: a yogic perspective

Yogacharya Dr Ananda Balayogi Bhavanani. MBBS, MD (AM).

Deputy Director,

Centre for Yoga Therapy, Education and Research (CYTER),

Sri Balaji Vidyapeeth University,

MGMC&RI Campus, Pondicherry.

Yogachemmal Dr Meena Ramanathan. PhD (Yoga).

Coordinator-cum-Yoga therapist,




Introduction: The nasal cycle is an ultradian rhythm of nasal congestion and

decongestion with a quasi-periodicity of 60 to 240 minutes.(1) Keyser made the first

formal description and the use of the term nasal cycle in 1895.(2) However the concept

of the nasal cycle and an understanding of its role in our life had existed for long in

Indian thought. The Vedic science of understanding the function of the nasal cycle

was known as Swarodaya Vigjnan (swara = sonorous sound produced by the airflow

through the nostrils in the nasal cycle, udaya = functioning state, and vigjnan =

knowledge).(3) The Shivaswarodaya, an ancient treatise in Sanskrit literature advises

the Yogi to undertake quieter, passive activities (soumyakarya) when the left nostril

flow is dominant (ida / chandraswara), to engage in challenging and exertional

activities (roudrakarya) when right nostril is dominant (pingala / suryaswara) and to

relax or meditate when the bilateral nasal flow is operational (sushumnaswara) as it

was considered to be unsuitable for performance of worldly activities. Ida swara (left

nostril dominance) was described as feminine, Shakti and moon-like (chandra) while

the pingalaswara (right nostril dominance) was described as masculine, Shiva and

sun-like (surya). Traditional Indian description of Ardhanarishwara consists

of Shakti (the female element) being depicted on the left and Shiva (the male element)

on the right side of the body. Such a notion of left-right, female-male duality was

common in oriental traditional medicine as also in western alchemy. (1)

Postulated mechanisms: Various mechanisms were postulated for the occurrence of

the nasal cycle and a great amount of research work has been done in this field. It has

been seen that the use of Yoga Danda (T-shaped wooden implement used by

the Yogis to regulate differential breathing patterns), pressure of a crutch in the axilla,


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pressure on the thorax while sitting and also the act of lying down on the side, can

affect pattern of nasal dominance. (4-7)The nasal cycle is dependent upon the tonic

activity of the limbic autonomic nervous system, the levels of circulating

catecholamines and other neuro-hormones. Nasal congestion correlates with low

sympathetic-high parasympathetic activity whereas decongestion is directly related

to high sympathetic-low parasympathetic activity mode.(8) Compression of the hemi

thorax from any surface lateral, anterior, posterior or superior leads to congestion of

the ipsilateral nostril with simultaneous decongestion of the opposite nostril. (9) Eccles

proposed that the hypothalamus was the centre for the sympathetic effects on the

nasal mucosa and the nasal cycle.(10)

Therapeutic applications: A group of pranayama, namely chandra and suryanadi

(CN and SN, respectively) and chandrabhedana and suryabhedana (CB and SB,

respectively) have uninostril breathing (UNB) and alternate nostril breathing (ANB)

patterns using left and/or right nostrils, respectively. This type of yogic nostril

manipulation is also furthered in nadishuddhi (NS), a specific technique involving

alternate use of both nostrils in a specific pattern. It has been previously suggested

that right nostril dominance in the nasal cycle as well as right UNB may be correlated

with the “activity phase” of the basic rest-activity cycle, the time during which

sympathetic activity in general exceeds parasympathetic activity throughout the body. (11)

These yogic UNB and ANB techniques have captured the imagination of researchers

worldwide and recent studies have reported their differential physiological and

psychological effects including effects on O2 consumption, metabolism and body

weight,(12) blood glucose,(11)involuntary blink rates(11) and intraocular pressure, (13) heart

rate (HR), stroke volume and end diastolic volume(14)as well as skin resistance, digit

pulse volume, and blood pressure (BP).(15)ANB (as done in NS pattern) has been

reported to rapidly alter cardiopulmonary responses and improve simple problem

solving. (16)Yogic breathing through right, left, or through both nostrils alternately

produce distinct autonomic changes: right UNB increased systolic pressure (SP) and

diastolic pressure (DP), whereas left UNB resulted in significant reduction in SP and

mean pressure (MP).(17)

Shannahoff-Khalsa suggested that mechanical receptors in the nasal mucosa register

flow of air across membranes (unilaterally) and transmit this signal ipsilaterally to the

hypothalamus, the highest center for autonomic regulation. (11) Even alternating left-

right levels of catecholamines have been found to occur in peripheral circulation of

resting humans with rhythms coupled to the nasal cycle. (18)It is possible that the right

nostril initiated techniques are producing such a state of autonomic arousal, whereas

left nostril initiated techniques are inducing autonomic relaxation/balance in our

subjects.


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Research studies at CYTER: Our studies at CYTER have demonstrated that right and

left yogic UNB and ANB techniques have differential physiological effects.(19-21) Right

nostril initiated UNB and ANB techniques (SB and SN) induce a state of arousal

through sympathetic activation and/through increased ascending reticular activity

and/or by central action at the primary thalamo-cortical level. On the other hand, left

nostril initiated UNB and ANB techniques (CB, CN, NS) delay reactivity of the subjects

by inducing a sense of inert lethargy and may induce a state of parasympathetic

dominance as seen in CV parameters. This finding is in tune with the traditional

swara yoga concept that air flow through right nostril (SN and pingalaswara) is

activatory in nature, whereas the flow through left nostril (chandranadi and idaswara)

is relaxatory. Further studies in different populations and in patients of different

conditions, as well as over different periods of time, may provide a more detailed

understanding of the therapeutic potential of these simple and effective pranayama

techniques.

References:

1. Bhavanani AB. Swarodaya vigjnan. A scientific study of the nasal cycle. Yoga Mimamsa.2007; 39: 32–38.

2. Kayser R. Die exakte Messung der Luftdurchgängigkeit der Nase. Arch. Laryng. Rhinol (Berl.) 1895; 3: 101-210.

3. Giri R, Shankar G. Swara Yoga - an introduction and its applications. Nisargopachar Varta 2001; 1: 18-20.

4. Rao S, Potdar A. Nasal airflow with body in various positions. J Appl Physiol 1970; 28:162-65.

5. Block RA, Arnott DP, Quigley B, Lynch WC. Unilateral nostril breathing influences lateralised cognitive

performance. Brain Cognit 1989; 9:181-90.

6. Davies AM, Eccles R. Reciprocal changes in nasal resistance to air flow caused by pressure applied to the axilla. Acta Otolaryngol (Stockh) 1985; 99:154-59.

7. Mitti Mohan S. Reflex reversal of nostril dominance by application of pressure to the axilla by a crutch. Indian J of

Physiol Pharmacol 1993; 37: 147-50.

8. Deshmukh VD. Limbic autonomic arousal: its physiological classification and review of the literature. Clinical Electroencephalography 1991; 22: 46-60.

9. Singh V. Thoracic pressure and nasal patency. J Appl Physiol 1987; 62: 91-94.

10. Eccles R. The Central Rhythm of the Nasal Cycle. Acta Oto-Laryngologica 1978; 86: 464-68.

11. Shannahoff-Khalsa DS. Unilateral forced nostril breathing: Basic science, clinical trials, and selected advanced techniques. Subtle Energies and Energy Med J. 2002; 12: 79–106.

12. Telles S, Nagarathna R, Nagendra HR. Breathing through a particular nostril can alter metabolism and autonomic

activities. Indian J Physiol Pharmacol 1994; 38: 133–37.

13. Mohan SM, Reddy SC, Wei LY. Modulation of intraocular pressure by unilateral and forced unilateral nostril breathing in young healthy human subjects. Int Ophthalmol 2001;24: 305–11.

14. Shannahoff-Khalsa DS, Kennedy B. The effects of unilateral forced nostril breathing on the heart. Int J Neurosci

1993; 73: 47–60.

15. Telles S, Nagarathna R, Nagendra HR. Physiological measures of right nostril breathing. J Altern Complement Med 1996; 2: 479–84.

16. Subbalakshmi NK, Saxena SK, Urmimala, D'Souza UJ. Immediate effect of „Nadi-shodhana Pranayama‟ on

selected parameters of cardiovascular, pulmonary, and higher functions of brain. Thai J Physiol Sci 2005; 18: 10–16.

17. Raghuraj P, Telles S. Immediate effect of specific nostril manipulating yoga breathing practices on autonomic and respiratory variables. Appl Psychophysiol Biofeedback 2008; 33: 65–75.

18. Kennedy B, Ziegler MG, Shannahoff-Khalsa DS. Alternating lateralization of plasma catecholamines and nasal patency in humans. Life Sci 1986; 38: 1203–14.

19. Bhavanani AB, Ramanathan M, Balaji R, Pushpa D. Differential effects of uninostril and alternate nostril

pranayamas on cardiovascular parameters and reaction time. Int J Yoga 2014; 7: 60-65.

20. Bhavanani AB, Ramanathan M, Madanmohan. Immediate effect of alternate nostril breathing on cardiovascular parameters and reaction time. Online International Interdisciplinary Research Journal 2014; 4: 297-302.

21. Ramanathan M and Bhavanani AB. Immediate effect of chandra and suryanadi pranayamas on cardiovascular

parameters and reaction time in a geriatric population. International Journal of Physiology 2014; 2: 59-63.


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Chronobiology of ageing: role of telomere and lifestyle intervention

Dr. Vivek Kumar Sharma. MD

Additional Professor of Physiology,

Jawaharlal Institute of Postgraduate Medical Education &

Research,Pondicherry-605006

Contact No: 04132296849; 9442529673.

Email: [email protected]

Recent studies document that telomere length and telomerase cellular are not only associated with chronobiology of ageing but also accelerated ageing in various cardio-metabolic disorders like coronary artery disease, diabetes, hypertension etc and their associated complications. Telomeres are “expendable” repetitive (TTAGGG) sequences at the end of chromosomes. Telomere length-telomerase enzyme activities are affected by oxidative stress,

inflammation and cellular proliferation, and thus form an association with

chronobiology of ageing and related diseases. Recent research in the field of telomere

length dynamics documents that chronobiology of ageing and age-related diseases

have a synergistic effect on telomere length-telomerase activity and as well as effect

telomere length independently also. Reports suggest decreased telomerase activity that

reflects greater tissue ageing and prevalence of senescent phenotypes in various

tissues marking the progression of the accelerated chronobiology of aging.

There has been an alarming increase in non-communicable diseases worldwide

including India in recent decades due to the adoption of modern lifestyle, unplanned

urbanization, dietary changes, physical inactivity, socio-economic changes and

accompanied stress. By 2015, 50-60 % of deaths in India will be attributed to lifestyle

related disorders including obesity, coronary artery disease and diabetes mellitus.

Benefits of life-style intervention including yoga, meditation and increased physical

activity are universally known and recent studies indicate higher levels of telomere-

telomerase system activity in subjects participating in these interventions thereby,

suggesting subcellular changes and delayed chronobiology of aging in the practicants.

Therefore, Telomere-Telomerase system may be considered as a potential therapeutic

target for life-style modification related interventions in studying the chronobiology of

accelerated aging conditions.

Two recent western studies have documented that 12 weeks of intensive meditation

and lifestyle changes significantly increased peripheral blood telomerase activity,

immune function, reduced stress parameters and promoted more meaningful life in

the participants. There is paucity of data on studying the relationship of life-style

interventions with chronobiology of aging in healthy and diseased Indian population

and this can be contemplated by the scientific community.


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Circadian sleep disorders: are they lifestyle associated?

Prof. PN Ravindra. MD, PhD (Neurophysiology) Professor and Head, Dept of Physiology Akash Institute of Medical Sciences and Research Centre,

Bangalore.

Melatonin is evolutionarily highly conserved molecule present in a spectrum of plant

and animal species that play a major role in circadian rhythm regulation. Melatonin is

a central time keeper (Zeitgeber) synthesized and secreted by pineal gland, a central

structure in the circadian system. Pineal gland was considered as a functionless

rudimentary organ until 1958 when Aaron Lerner and colleagues (Lerner, 1958)

isolated pineal active substance . They (Lerner, 1959) named this compound as

melatonin, a „hormone of darkness‟ and described its chemical structure as N-acetyl-

5-methoxytryptamine. Light is the most dominant powerful environmental source that

regulates melatonin synthesis. Photic stimuli through retina are transmitted to

suprachiasmatic nucleus (SCN), the master circadian clock. SCN in turn conveys the

signal to pineal gland for melatonin synthesis. In this process, noradrenergic fibers of

cervical ganglion, is the one that ensures proper translation of photic information into

melatonin synthesis. Therefore, in addition to light, the levels of noradrenalin in these

neurons also play important role in synthesis of melatonin. It is to be noted that the

photoreceptors (melanospin containing retinal ganglion cells) that are sensitive to light

in the range between 446-484 nm (blue light) are primarily involved in stimulating

melatonin synthesis (Lewy and Sack, 1989). Therefore, visual blindness doesn‟t

necessarily cause circadian misalignment but for the absence of melanospin or its

connection to SCN if not intact. However, with development of cataract and

constriction of pupil with age, the transmission of light waves of shorter wave length

may be impeded, thereby, causing alteration in melatonin rhythm and ensuing sleep

problems.

The most striking feature of melatonin is its daily variations that are sensitive to light–

dark cycle and its release is at peak towards darkness. These circadian variations in

melatonin play major role in bringing about normal daily rhythms in hormonal

secretion, temperature variations, sleep-wake cycle etc. Melatonin peak is followed by

drop in the core body temperature; these two factors play important role in inducing

sleep (Karasek and Winczyk, 2006). This relationship between melatonin and core

body temperature follows even during therapeutic administration of melatonin


31

agonists, wherein, temperature drops down within 2-3 hours after administration

(Verster, 2009). Alterations in normal circadian variations of melatonin either due to

exposure to bright light during biological night (as in shift work, late night work etc) or

pathological conditions tends to misalign the circadian rhythm thereby bringing

various sleep related problems. The classical circadian rhythm disorders include

delayed sleep phase syndrome, advanced sleep phase syndrome, jet lag, shift work,

and free running type as seen in the visually challenged people (Martinez and Lenz,

2010). However, there can be circadian disorder due to genetic mutations of circadian

genes, medical conditions (insulin resistance, parkinsonism, cirrhosis, renal failure

etc.), medications and drug abuse as well. Few common circadian sleep disorders are

explained briefly here (Phyllis et al 2013, L Sack et al, 2007).

Delayed sleep phase disorder (DSPD): This is characterized by recurrent difficulty in

falling asleep or wakeup in socially acceptable time. There will be a delay of more than

two hours than conventional acceptable time to bed and waking up. However, the

important characteristic of this disorder is that the circadian rhythm of the person will

get persistently be delayed that brings about significant impairment in individuals

social life. DPSD is most commonly observed in adolescent primarily due to socially

enforced alterations in sleep-wake scheduled associated with late night social

activities. The symptoms exacerbate with decreased light exposure in the morning and

bright light exposure in late evening hours. However, genetic basis with polymorphism

of circadian clock gene is also implicated in developing DPSD. It has been reported

that DPSD patients have diminished ability to compensate for the sleep loss in spite of

having high homeostatic drive.

In managing DPSD, chronotherapy, secluding the timing of sleep, would

synchronize circadian rhythm. Sleep scheduled is delayed gradually for several hours

a day until the target time is reached. After reaching the target time patients are

advised to keep the regular sleep-wake scheduled. In addition to this, bright light

exposure during morning hours with evening melatonin administration is known to

realign the circadian rhythm in DPSD patients.

Advanced sleep phase disorder (ASPD): characterized with early sleep time than the

conventional socially acceptable timings i.e. feeling extremely sleepy in late afternoon

and evening hours and earlier wake up time (between 2 - 5 am) than desired. This is

generally found with aging. Shortened circadian time due to mutation of circadian

clock gene is one of the causes for ASPD. The most reported complications of this are

alcoholism, sedative and other drug abuse. The usual treatment is exposure to light in

evening so as to suppress their melatonin secretion and postpone the sleep. Patients

are encouraged to take melatonin supplements in early morning hours so that sleep is

continued and wake up after sunrise.


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Jet lag disorder: Is a temporary misalignment of circadian clock due to travel across

at least two different time zones. The symptoms like disturbed sleep, generalized

weakness, decreased day time attention, mood disturbance etc occurs with one or two

days of travel. The severity of symptoms depends on the number of time zones and the

direction of travel. Travelling from east to west is less severe than travelling from west

to east ward. The sleep problems parse with eastward travel include difficulty in falling

asleep and awakening next day, whereas, with west bound travel individual

experiences excessive sleepiness in evening and early morning awakening. The

treatment of jet lag syndromes is focused bringing desired sleep and wake time in

accordance to destination travelled with improving nocturnal sleep and increasing day

time alertness. However, if the stay in the destination is for 2 days and less, then

measures taken for circadian adaptation will be counterproductive. In the measures to

be taken, planned exposure or avoidance to light is advised. Travelers towards east,

are advised to avoid light exposure in early morning (enhance melatonin secretion) and

expose to bright light in late morning and afternoon (decrease melatonin secretion). In

west ward travel, expose to light during afternoon and early evening, not to go to sleep

till nighttime of the place. However, with melatonin (0.5 to 10mg) administration

during early evening hours well in advance before the travel towards east and during

night time at the destination, the severity of jet lag syndromes can be minimized.

Shift work disorder: Characterized by history of excessive sleepiness during the day

and insomnia during sleep period at least for one month due to unconventional work

secludes. This will bring impaired work performance, decreased alertness and

cognition there by increasing the risk of accidents in the work place. This is associated

with higher incidence of cardiovascular comorbid conditions, metabolic syndromes,

endometrial and breast cancer etc., Exposure to intense light during night work and

avoiding light during day respectively will help to reduce sleepiness during work and

to induce sleep in the day. Exposure to light during night works hours should be to

1000 -10,000 lux until 2 hours prior to end of the shift. Melatonin consumption before

bed will enable good sleep, but, do not improve the alertness during work. Therefore,

melatonin and light therapy should be combined in individuals with shift work

disorder.

In addition to these circadian rhythm disorders, melatonin administration in old

age aids in preventing many neurodegenerative conditions, insomnia, neuropsychiatric

conditions like depression as mentioned above, in schizophrenia, eating disorders,

intractable epilepsy etc., Interestingly, meditation (Vipassana) is known to enhance

endogenous melatonin levels across age groups in experienced practitioners (Ravindra

et al, 2012). Apart from therapeutic potential, melatonin role as an antioxidant,

immune enhancing, oncostatic; hence, its supplement has positive role in maintaining

general health and wellbeing as well.


33

References:

1. Lerner. Isolation of melatonin,pinalfactorthat lightens melanocytes. J Am

Chem Soc.1958; 80:2587.

2. Lerner. Structure of mealtonin. J Am Chem Soc.1959; 81:6084.

3. Lewy AJ, Sack RL. The dim light melatonin onset as a marker for circadian

phase position. Chronobiol Int. 1989; 6:93-102.

4. Karasek M, Winczyk K (2006) Melatonin in humans. J Physiol

Pharmacol.2006; 57 Suppl 5:19-39.

5. GC Verster .Melatonin and its Agonists, Circadian Rhythms and Psychiatry.

Afr J Psychiatry.2009;12:42-46,.

6. Denis Martinez & Maria do CarmoSfreddo Lenz. Circadian rhythm

sleep disorders. Indian J Med Res.2010; February 131, pp 141-149,

7. Phyllis C. Zee,HrayrAttarian,AleksandarVidenovic. Circadian

Rhythm Abnormalities. Continuum (MinneapMinn).2013;19(1):132–147.

8. Robert L Sack, Robert L Sack, Dennis Auckley, R. Robert Auger,

Mary A. Carskadon, Kenneth P. Wright Jr, Michael V. Vitiello,

Irina V. Zhdanova.An American Academy of Sleep Medicine Review

Circadian Rhythm Sleep Disorders: Part I, Basic Principles, Shift Work

and Jet Lag Disorders. SLEEP.2007; 30( 11): 1460-1483.

9. Robert L Sack, Robert L Sack, Dennis Auckley, R. Robert Auger,

Mary A. Carskadon, Kenneth P. Wright Jr, Michael V. Vitiello,

Irina V. Zhdanova.An American Academy of Sleep Medicine Review

Circadian Rhythm Sleep Disorders: Part II, Advanced Sleep Phase

Disorder, Delayed Sleep Phase Disorder, Free-Running Disorder, and

Irregular Sleep-Wake Rhythm SLEEP.2007a; 30( 11):1484-1501.

10. Ravindra P.N, NirmalaMathurai,Bindu M Kutty „ Meditation

its regulatory effect on sleep‟ Frontiers in Neurology.

April 2012; 3(54): 1-3.


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Chronotherapeutics

Prof. K Manimekalai. MD Professor Head, Department of Pharmacology, Mahatma Gandhi Medical College & Research Institute, Sri Balaji Vidyapeeth Deemed University, Pondicherry

Chronotherapeutics is the delivery of medications in the right concentration to the

right targeted tissues at the right time to meet biological rhythm-determined needs,

e.g., rhythms in the mechanisms of disease, symptom intensity, and/ or patient

tolerance, to optimize desired and minimize and avert adverse effects. The following

are the diseases with established oscillatory rhythm in their pathogenesis

1. Asthma

Symptoms of asthma occur 50 to 100 times more often at night than during the day.

Cortisol levels were highest at the time of awakening and lowest in the middle of the

night, and histamine (a mediator of broncho constriction) concentrations peaked at a

level that coincided with the greatest degree of bronchoconstriction at 4:00 am.

2. Pain

The sensitivity threshold of the gingiva to a cold stimulus was maximal at 18:00 h and

reached a peak at 03:00 h (35% difference). Tooth sensitivity was lowest between

15:00 and 18:00 h; with a peak in pain intensity at 08:00 h (160% increase).The peak

of morphine use occurred at 09:00 h and was the least at 15:00 h in patients

undergoing elective surgery. The peak demand for morphine or hydromorphone

occurred in the early morning and was lowest during the night in postoperative

gynecologic patients.

3. Arthritis

Patients with osteoarthritis tend to have less pain in the morning and more at night;

while those with rheumatoid arthritis, have pain that usually peaks in the morning

and decreases throughout the day. Chronotherapy for all forms of arthritis using

NSAID‟s such as ibuprofen should be timed to ensure that the highest blood levels of

the drug coincide with peak pain. For osteoarthritis sufferers, the optimal time for a

non-steroidal anti-inflammatory drug such as ibuprofen would be around noon or

mid-afternoon. The same drug would be more effective for people with rheumatoid

arthritis when taken after the evening meal.


35

4. Cardiovascular diseases

Several functions (e.g. BP, heart rate, stroke volume, cardiac output, blood flow) of the

cardiovascular system are subject to circadian rhythms. For instance, capillary

resistance and vascular reactivity are higher in the morning and decrease later in the

day. Platelet aggregability is increased and fibrinolytic activity is decreased in the

morning, leading to a state of relative hypercoagulability of the blood. Numerous

studies have shown an increase in the incidence of early-morning myocardial

infarction, sudden cardiac death, stroke, and episodes of ischemia. BP is at its lowest

during the sleep cycle and rises steeply during the early morning awakening period.

5. Duodenal ulcer

In peptic ulcer patients, gastric acid secretion is highest during the night. Suppression

of nocturnal acid is an important factor in duodenal ulcer healing. Therefore, for active

duodenal ulcer, once daily at bed time is the recommended dosage regimen for

H2antagonists. At nighttime, when gastric motility and emptying are slower, drug

disintegration, dissolution, and absorption may be slower.

6. Hypercholesterolemia

Cholesterol is synthesized during the night as well as during daylight; however the

maximal production occurs early in the morning, i.e. 12 h after the last meal. Studies

with HMG CoA reductase inhibitors have suggested that evening dosing was more

effective than morning dosing.

7. Diabetes

The goal of insulin therapy is to mimic the normal physiologic pattern of endogenous

insulin secretion in healthy individuals, with continuous basal secretion as well as

meal-stimulated secretion. Providing basal insulin exogenously to patients with Type 1

diabetes inhibits hepatic glucose production. Exogenous administration of mealtime

doses promotes peripheral glucose uptake (i.e. it prevents postprandial increases in

blood glucose concentration) as well as reducing hepatic glucose release.


36

Therapeutic potential of music: chrono-biological and traditional

perspectives

Prof. Sumathy Sundar. PhD

Director, Centre for Music Therapy Education and Research

(CMTER),

Mahatma Gandhi Medical College and Research Institute,

Pondicherry

Chronobiology is the science of understanding of biological rhythms in respect of life,

health and disease observing the cyclical repeated variation in a biological function

that gives a time sense to every living organism. However the roots of chronobiology

can be traced back even in the Vedic traditions in Indian culture roughly 4000 to 4500

years ago. Ayurvedic physicians of the Vedic period indicated three phases in which

the activation of certain bodily functions is sometimes stronger, sometimes weaker

and coined the terms vata, pitta and kapha to express this phenomenon. Evidences

have also been documented linking cycles of time with musical performances in

ancient times and recorded relation between scales and the different bodily functions.

Time theory of ragas prescribes specific time to perform specific Indian ragas

according to the tonal characteristics corresponding to vata, pitta and kapha biological

cycles in the human body. This presentation deals in detail with the ancient wisdom

or the art of understanding the biological rhythms, entraining and resetting them

through music as an external stimulus and how far these ideas are explored and

integrated in the modern music therapy, clinical practice and research and integrative

medicine. This paves way for deep understanding of the patterns of biological rhythms

and the mutual relationships between music, health and illness and also preserve the

health and promote healing under integrative medicine.


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Adaptive resilience exercises as envisioned in yoga

Yogachemmal Dr Meena Ramanathan. PhD (Yoga).

Coordinator-cum-Yoga therapist,




Yogacharya Dr Ananda Balayogi Bhavanani. MBBS, MD (AM).

Deputy Director,




The tree that bends doesn’t break!

As human beings, it is inevitable that we have our share of ups and downs. Something

always pushes us down, throws us off-balance and makes us uneasy. During such

moments, it is imperative that we stop, take a step back and observe ourselves

objectively to understand how long it takes us to bounce back to normalcy once again.

The faster we can disentangle ourselves from events of the past, the faster we begin

experiencing freedom in the present.

This is where Yoga comes in, to rescue us from this vicious negative spiral of mental

and emotional whirlpools that suck us down into the depths of despair. Yoga may be

understood as a conscious and evolutionary path that enables us to break free from

our conditioned patterns (samskara) that take us nowhere.

Yoga teaches us that we need to make conscious choices to do the following:

1. Let go of the negativities beseeching us (doshanivarana),

2. Regain our balance, equipoise (samatvam) at the earliest,

3. Relax ourselves so that we can rebuild and replenish our resources (nishpanda

kaya kalpaanukrama).

4. Empower ourselves to efficiently face „repeat challenges‟ by:

a. Adopting healthy attitudes (pratipakshabhavanam, maitri-karuna et al),


38

b. Enhancing flexibility of body, mind, emotions and spirit (hatha yoga),

c. Developing objective self-awareness (vairagya, swadhyaya)

d. Creating positive relationships through acceptance (samabhavabhavana).

Mind, body and emotions of the individual are harmonised and brought into a state of

balance by the various Yoga techniques. The practice of jathis and kriyas helps loosen

up inherent tensions, stresses, and regressed emotions. They can be then thrown out

through conscious breath-body-mind workouts such as nasargamukhabhastrika and

the pawanmukta series. Nada Yoga techniques that utilise sound power like the

hakarakriya, brahma mudra and bhramari pranayama are efficient methods to release

pent-up tensions. These practices produce psycho-somatic energisation and create a

beautiful mind-body harmony, stabilising emotions thus teaching us to „let go and be

free‟. Through Yogic relaxation techniques such as shavasana, we consciously

overcome our self-defeating tendencies and re-invigorate ourselves physically,

mentally, and emotionally.

Many studies have reported that Yoga reduces allostatic load and induces balance of

autonomic nervous system. This is the keystone in developing adaptive resilience. The

very sound of the word resilience captures its bouncy, rubbery quality. Yoga enables

an alignment of panchakosha, the five sheaths of existence - the body, breath,

emotions, intellect and spirit. Jnana yoga kriya-s and prakriya-s enable inherent

healing energies to integrate, reunite and bring together fragmented parts of the

individual thereby enhancing such adaptive resilience.

Yoga also empowers the spirit, developing a deep and subtle adaptive resilience that

promotes the skilful stepping beyond of one‟s limitations, enabling self-transformation

(atmabhavabhavana). This facilitates insight, empathy and an ability to calm and

focus the mind, thus ultimately transcending all limiting traits of the individual. Such

a transformation of the individual until they manifest their fullest potential, and live

life as it is meant to be, is truly the goal of Yoga itself.


39

Pranayam and its physiological basis

Prof. Madanmohan. MD, DSc, FIAY Professor & Head, Department of Physiology, MGMC& RI

& Director, Center for Yoga Therapy, Education & Research (CYTER), Sri Balaji Vidyapeeth.

Vedic concept of universal, divine pran occurs in many ancient scriptures. Pran is the

omnipresent energy whose Divine source Paramatma is called as pranasyapranah

(Ken Upanishad, 1:2). On the physical plane, pran manifests as physical energy like

light and heat and this whole universe vibrates with pran (Kath Upanishad, 6:2). On

the biological plane, pran manifests as life energy (“ki” in reiki) and acts as a catalyst

in our all activities. In Bhagavadgita (15:14), YogeshwarKrishn says that “Pran

manifested as digestive power, it is I who digests the food”. Being superior, holy and

higher power (Brhdaranyak Upanishad, 6:1:1), pran should be used only for higher,

noble purposes and never for lower pursuits.

Breathing is the most tangible expression of pran and pranayam is an ingenious

method for enhancing our vitality by drawing pran from inexhaustible and

omnipresent universal source. Pranayam means conscious expansion of pran (the life

force) and is the 4th limb of Patanjali‟sashtang (8-limbed) yoga. Yoga is holistic and

pranayam is best practiced as a component of full, holistic yoga discipline. There are

many types of pranayams. Some involve rapid breathing whereas others involve slow,

uniform breathing, with or without ratio between the phases of respiration. Yoga is a

psychosomatic technique. Pranayam breathing should be uniform and with meditative

awareness. Thus performed, pranayam enhances one‟s ability to combat physical as

well as psychological stress.

From the physiological point of view, pranayam is of great significance. Deep breathing

with maximum contraction of diaphragm and intercostal muscles results in:

1. Massage of abdominal viscera and improved venous return.

2. Stretching of all parts of thorax and lungs with resultant increase in compliance

and vital capacity.

3. A definite pattern of proprioceptive input from thorax and abdomen. This, along

with a pattern of activity in respiratory center may modulate the neuronal

activity of other medullary centers/brain areas.


40

4. Fluctuations in blood gas content and altered proprioceptive input may alter

the sensitivity and activity of chemo reflex and other neuronal circuits.

5. Breathing meditatively with full concentration results in conscious alteration of

cerebral activity and improves mind-body coordination, the goal of yoga.

Rhythmic breathing in a relaxed state of mind (e.g. savitri pranayam) can produce

deep psychosomatic relaxation and significant decrease in oxygen consumption within

a few minutes. (Madanmohan et al. The Yoga Review, 3: 25-34, 1983).


41

Melatonin & chronobiology

Dr. Suchitra B Parkhad Assistant Professor, Department of Physiology Mahatma Gandhi Medical College & Research Institute

Melatonin, also known as the “mother hormone of chronobiology,” is a hormone made

in the pineal gland due to cues from the supra-chiasmatic nucleus of the

hypothalamus, which regulates the circadian rhythm. When the retinas stop sensing

as much blue wavelength light, the supra-chiasmatic nucleus senses this and induces

the pineal gland to begin making melatonin. When early morning light is sensed by the

retinas, melatonin production is ceased and hormones associated with wakefulness

are made instead. This cycle helps to create a circadian rhythm, or 24-hour sleep-

wake cycle.

Melatonin has a very short half-life of about 30 minutes. Because it breaks down so

quickly, it must be made continuously throughout the night in order to sustain restful

sleep. In people with a healthy circadian rhythm, melatonin levels rise rapidly after

dark and plateau throughout the night until early morning. These high levels are

essential not just for falling asleep, but for sleeping deeply and restfully. Melatonin

levels then drop sharply in the early morning to allow people to wake up in response to

increasing light levels.

The dangers of sleep disturbances & melatonin deficiencies

Chronic sleep disturbance in an average of three out of seven nights raises the

likelihood of heart attack, stroke, diabetes, vascular disease, and medically

problematic obesity considerably.

A team at the University of Pennsylvania is analyzing the huge data collection from

more than 130,000 people (average age of 46) for the first time, and was able to draw

the following conclusion: Even minimal interference with sleeping in, sleeping soundly,

as well as sleeping too much can make a big difference. The risk for obesity increased

by 35%, for diabetes by 54%, and for cardiovascular illness by 98%, and the risk for

stroke doubled.

Researchers of the Harvard Medical School are concentrating on the 90 to 120

minutes every night that provide healthy people with actual deep sleep. They recruited

784 men with normal blood pressure who allowed their sleep cycles to be monitored at

home with the help of a small machine. This was done for 42 months.


42

Normally deep sleep makes up about 25 percent of one night. In this phase brain

activity is weakened and the heartbeat and the disbursement of stress hormones are

reduced. Blood pressure readings during this time are typically 10 points lower than

normal. Nightly pressure decline is seen as very positive. However, a condition in

which the pressure stays low is seen as a risk factor for heart conditions.

The results were, that those men who had a noticeably shorter regeneration phase,

reacted with increased blood pressure of dangerous proportions (several of those

monitored only reached four percent of deep sleep, or fifteen minutes). Most of these

generally had interrupted and shortened sleep.

As mother hormone of chronobiology, melatonin not only directs sleep patterns, but

also the activity of all organs. One consequence is that with age the frequent lack of

melatonin affects the liver negatively by leaving it without a sense of direction at night,

which in turn impacts the glycol-metabolism.

Aging &melatonin production

Not only are modern humans the only living creatures who diverge from their rhythms

and turn night into day – the older we get, the lower the nightly production of

melatonin becomes, and the shorter the signal it transmits to the other glands

becomes. Often, it does not become active until well after midnight. At daybreak,

however, the secretion of this hormone continues to stop on time. The result is that

older people are exposed to the sleep hormone for a time span that is much too short,

and the hormone becomes available less and less overall.

For the older pineal gland sufficient nighttime production of melatonin is no longer

possible, even when the body is exposed to complete darkness. The pineal gland is

heavily supplied with blood and like other areas with vessels, it is predestined to suffer

from calcification–this leads to pronounced insomnia.

Melatonin deficiency is also reflected in the disrupted rhythmicity of the downstream

hormone systems. A decrease in female sex hormones may be a factor in the early

onset of menopause. It also threatens to slow down the production of the growth

hormone HGH, also called the “vitality hormone.” Insufficient melatonin also affects

the liver, when it is not effectively programmed at night. This can cause insulin

resistance, which can lead to diabetes. In addition, the urge to urinate at night

remains at a daytime level when a special anti-hormone (ADH) is missing due to a lack

of melatonin.

Melatonin deficiency has particular effects directly on the brain. All nightly repair

mechanisms become diminished. The storing of information into long-term memory,

which takes place at night, is impeded. This increases the susceptibility to early-onset

dementia and neurodegenerative processes.

The British Journal of Ophthalmology recently published an alarming connection

between aging eyes and the production of melatonin. Measurements demonstrate that

after 45 years of age less rays of sunlight reach the inner eye. This is a result of subtle

yellowing of the ocular lens and narrowing of the pupil. Because of this, less light

particles reach the key cells of the retina which are dependent on the day and night


43

rhythm to regulate our internal clocks. Studies show that the changes in the aging eye

lead to a number of typical eye ailments, for which the cause is not searched for in the

eye itself. Consequences of the deterioration of eye performance include cognitive

deficiencies (especially memory capacity), sleeplessness, depression, and lengthened

reaction times.

Our internal clocks react to the changes in light and dark, and manage our circadian

rhythms. They give each organ an impulse for daily and nightly tasks. The brain, for

example, saves the information gathered during the day as long-term memory, or

deletes it entirely. These trigger signals are transferred especially through the mother

hormone of chronobiology, melatonin. Older people, however, only have a fraction of

this neurotransmitter available. This leads not only to widespread problems of staying

asleep in the morning and throughout the night, but also to impairment of the correct

daytime activities of major organs, for example the liver or nerves, in the course of a

24 hour day.

Melatonin supplements

Recent studies in chronobiology have indicated that melatonin supplements can help

treat circadian sleep disorders as well as a variety of sleep-related issues. However, not

all melatonin supplements are created equal. The way melatonin supplements are

metabolized can have a huge effect on physiological levels and effects of this hormone.

Studies in circadian biology have shown how important melatonin levels are to

maintaining a natural human sleep-wake pattern. In fact, studies have found that

many sleep disorders improve significantly with melatonin supplementation. However,

some people find that melatonin doesn‟t work as dramatically as they expected. They

may assume that melatonin is not a useful treatment for their sleep issues when, in

fact, they could be simply taking the wrong kind of melatonin supplement.

The most common types of melatonin supplements are fast release and slow release.

Fast release melatonin causes a sharp spike in melatonin levels that drops off after an

hour. People who use this type of melatonin supplement may find that they are

immediately sleepy but have trouble remaining asleep or do not get high quality sleep.

Slow-release melatonin, on the other hand, takes hours to build up to sleep-inducing

levels and then does not wear off in the early morning. People who take slow release

melatonin may have trouble falling asleep due to low melatonin levels, followed by

difficulty waking up because the levels are unnaturally high.


44

Timed-Release Melatonin: A Better Option for Maintaining Natural Circadian

Rhythms

Timed-release melatonin is a supplement that is formulated to be released in amounts

that mimic healthy, natural melatonin levels. It is metabolized so that levels rise

sharply after the supplement is taken and then remain at a high plateau for several

hours. Levels then drop sharply to allow for waking. This mimics the healthy, normal

circadian rhythm cycles that are linked to restful sleep.

Research in chronobiology has shown that maintaining melatonin cycles is important

not just to restful sleep but also to overall health. For this reason, an increasing

number of health experts are recommending timed-release melatonin as the ideal

melatonin supplement. It more closely correlates to the natural levels of melatonin in a

healthy brain. Maintaining a healthy circadian rhythm is important to health, so

timed-release melatonin supplements are usually the best option.

http://www.chronobiology.com/wp-content/uploads/2015/04/melatonin-chronobiology.jpg


45

POSTERS


46

Physiological significance of retinal melatonin

Qurratul Ain Sayeed Dept. of Physiology, DCMS, Hyderabad

The circadian signaling molecule, melatonin, is secreted into the circulation from the

pineal gland, and is also produced within specific ocular cells such as retinal

photoreceptors, ciliary epithelial cells, and perhaps cells of the lens.In addition many

ocular tissues themselves exhibit circadian rhythm activity to optimize specific

processes which require coordination with the light-dark cycle.Melatonin receptors

have been identified in many ocular tissues, including the neural retina, retinal

pigment epithelium, ciliary body, cornea, sclera, and lens.

This mini paper tries to review physiological significance of ocular melatonin in a very

brief manner including following points.

1. Melatonin causes aggregation of melanin in RPE and clumping of pigment granules

in the chromatophores in choroid. It activates disc shedding in rod photoreceptors,

and elongation of cone photoreceptors. Melatonin blocks apoptosis after

experimentally induced RPE cell ischemia.

2. Synthesis and diurnal rhythm of retinal melatonin are independent of the pineal

gland. Pinealectomy had no effect on ocular melatonin levels and a diurnal rhythm

continued.

3. Retinal melatonin synthesis is elevated at night and decreased during day as a

result of rhythmic regulation by a circadian oscillator, or clock

4. Retinal dopamine appears to act through D2 receptors to suppress melatonin

synthesis and to entrain ocular circadian oscillator.

5. Light inhibits melatonin synthesis and entrains circadian rhythms.

6. Pineal melatonin (but not retinal) has an important role in the control of circadian

rhythms.

7. Retinal melatonin may be a modulator of intraocular pressure and melatonergic

mechanisms in the eye could be responsible for the diurnal rhythm in IOP.

8. Studies show an Inhibitory effect of melatonin on cataract formation in newborn

rats and may be an evidence for anti-oxidative role for melatonin.


47

Virgin olive oil reduces dental plaque formation

Mahantayya V Math1, Rohit B Gadda 2, PradnyaJadhav 3, NehaPatil 4, Yashoda

R Kattimani 5, RS Inamdar 6

1, 5, 6 Department of Physiology, MGM Medical College, 2, 3, 4 Department of Oral Medicine and Radiology, MGM Dental College, Navi Mumbai Introduction: Oral cavity has a complex and changing environment. Dental diseases

are affecting a large number of people in both the developed and developing countries.

Diurnal variation is seen in salivary osmolality. Salivary secretion is reduced at night

and salivary osmolality is highest at 7 am in the morning. Mild dehydration is a risk

factor for dental disease. Virgin olive oil has low surface tension and is rich in

monounsaturated fatty acids, phenolics and antioxidants.

Objectives: This study was done to determine the plaque inhibitory action of virgin

olive oil using a plaque re-growth model and compare the effect of virgin olive oil with

distilled water on plaque index

Materials and methods: 17 healthy young volunteers participated in this study A

randomized, controlled, cross-over design was used. The subjects were asked to swish

thoroughly for 5 minutes with 3 ml of virgin olive oil or distilled water in the morning

and at night before going to sleep and then swallow. They were told to use water or

olive oil from Monday to Friday twice daily (10 swishing in total), and were instructed

not to use any other oral hygiene product during this period. Dental plaque was

assessed with plaque disclosing agent (Alphaplac).at the beginning and end of the

study.

Results: The mean plaque index with virgin olive oil use was (mean ± SD) 1.476 ± 0.36

and with use of distilled water 2.3±0.386 (p<0.001)

Conclusion: Use of virgin olive oil twice a day (in the morning and at night) is effective

in decreasing dental plaque compared to that observed with distilled water.


48

Comparative study of pulmonary function tests in early smokers,

chronic smokers and non-smokers

Manjushree R, Suresh Y, Bondade, Smilee Johncy S

Department of Physiology, JJM Medical College, Davangere Introduction: Smoking is the malicious curse of world today. Smoking related

diseases kill one in ten adults globally. Smoking is the main risk factor in the

development of Chronic obstructive pulmonary disease (COPD), and smoking

cessation is the only effective treatment for avoiding or reducing the progression of this

disease.

Objective: To study the differences in pulmonary function test values in early-

smokers, chronic-smokers and non-smokers.

Materials and methods: In cross sectional study, spirometry data were collected by

RMS Helios 401 computerized spirometer. Expiratory flow volume curves were

recorded and FVC, FEV1, FEV1/FVC ratio, PEFR, FEF25-75%were obtained. The data

were compared between early smokers, chronic smokers and non-smokers group

&statistically analyzed usingSPSS software and ANOVAtest

Results: Pulmonary function test(PFT) parameters FVC,FEV1, PEFR, FEF25-75% and

MVV were significantly reduced in chronic smokers group compared to non-smokers

group (p<0.05).FEV1was the initial parameter to be declined in early smokers. The PFT

parameters markedly decrease with increase number of cigarette smoked per day as

well as increase duration of smoking.

Conclusion: The present study brings out substantial variation in most of the

parameters of PFTs between early smokers, chronic smokers and non-smokers

confirming PFT values are less in chronic smokers due to toxic effects of tobacco

smoking on respiratory system & is the major cause of obstructive lung disease in

Indian population. It also reveals that smoking cessation improves the accelerated

decline in FEV1which indicates that smoking cessation positively influences

remodeling processes in lungs. These results can be used to convince people to quit

smoking.


49

Depression, anxiety and stress among junior science college

students

Sanghamitra Panda, Ashok Kumar Dash Shadan Institute of Medical Sciences, Hyderabad Introduction:Adolescence is a transitional stage marked by rapid changes in physical,

cognitive and emotionaldevelopment. Presence of conditions like depression, anxiety

and stress at this age is a matter of concern. Teen stress is an important health issue.

Objective: To study the depression, anxiety and stress among adolescent junior

college girls.

Material and method: A cross sectional study was conducted in a junior science

college, 240 girl students belonging to class 11th and 12th were recruited for the study.

Among them 87 students were day scholars and 153 students were staying in the

hostel. DASS 21 questionnaire was used to assess depression, anxiety and stress

among the students. Sleep pattern of all the students were sought and it was found

that average sleep duration was less than 7 hours per day.

Results: The scores in the three domains were found to be remarkably high. It was

found that depression and anxiety was more in students in comparison to stress.

DASS score was found to be more in students residing in the hostel viz. depression

(77.125%), anxiety (75.164%), stress (45.099%) in comparison to day scholars viz.

depression (72.414%), anxiety (67.817%), stress (40.230%).

Conclusion: Depression, anxiety and stress among the students were found to be

quite high. Educational institutions need to identify the prevalence of negative mental

health states among students especially high risk students and preventive measures

should be undertaken to reduce the mental stress.

https://en.wikipedia.org/wiki/Human_development_(biology)


50

Chronobiology and irritable bowel syndrome

Prabhavathi K, Hemamalini RV, Thamaraiselvi K, Christy A, Saravanan A

SRM MCH & RC, Potheri

Chronobiology is one of most studied topics in modern medicine as it links between

the body‟s internal clock and health almost every day. Studies in circadian biology

showed a link between disrupted sleep cycles and irritable bowel syndrome (IBS).

Supra-chiasmatic nucleus the central pacemaker of our brain is known to dictate a

variety of hormonal processes and physiological activities of GIT explaining the fact

“We are what and when we eat”. Around 10% of our genes fluctuate in activity

according to the time of day which is involved in the health and function of the

digestive tract. Research has found that Non-REM sleep enhances the

parasympathetic nervous system to aid in the digestion of food and sympathetic

nervous system slows the digestion during REM sleep. This balance is crucial for

sustaining good gut health. Also hormones associated with digestion like ghrelin,

insulin, leptin, orexins, neuropeptide Y, VIP, serotonins are released periodically

throughout the day. Thus the molecular basis for circadian timing in GIT involves

transcriptional /translational feedback loop which culminate in rhythmic expression

and activity of a set of clock genes and related hormones which is responsible for

periodic activity of various segments and transit along GIT. In IBS there may be a lack

of hormonal regulation along with the alternating cycles of autonomic activity. People

with diarrhea predominant type of IBS, have very different autonomic activity from the

normal people during sleep. Also melatonin produced by neuroendocrine cells of GIT

mucosa, plays an important role in the internal biological clock. Clinical studies have

demonstrated that administration of melatonin improve symptoms with IBS.

Thus Mind-brain-body-gene frame work, including the role of chrono-nutrition is

probably implicated in the genesis of IBS, which may further help in diagnosis and

treatment of IBS in shift duty workers with impaired circadian rhythm.


51

Sleep deprivation and disruption of bio-clock in medical students

Madhuri Taranikanti, Sanghamitra Panda, Nikhat Yasmeem, Siddique A R O

Department of Physiology, Shadan Institute of Medical Sciences, Hyderabad

Introduction: One of the major problems in today‟s modern world is the component of

artificial light and working hours during the night time. Also, urban lifestyle involves

sleeping late in the night and exposure to bright lights contributing to derangement of

the normal bio-clock. Medical students are faced with the problem of managing time

with the hectic schedule in order to cover the vast syllabus and are often under stress

to reach their targets with changes in their lifestyle acting against the normal

circadian rhythm. The aim of the present study is to look for pathophysiology of

diseases if any caused by sleep deprivation in medical students as understanding this

mechanism seems to be the present major challenge. The objectives of the study are to

see the association between duration of sleep and levels of blood pressure and blood

sugar.

Material and Methods: I MBBS students, both male and female were included in the

study. They were asked to fill out a form about their sleep pattern like time of sleeping

and waking up and the reason for sleeping late. Anthropometric measurements, blood

pressure and blood sugar were recorded twice in the day.

Results: Students with reduced hours of sleep had changes in BP and blood sugars

from morning to evening and their BMI was higher. The values were close to pre-

hypertensive and pre-diabetic ranges. Students who maintained regular timings for

sleep and waking up had less or no changes.

Discussion: It is seen that sleep deprivation can lead to a variety of metabolic

derangements including fluctuation in blood pressure and blood sugar levels. Medical

students who slept late in the night were exposed to artificial light for a longer

duration which may cause suppression of melatonin and disruption of bio-clock of the

body. Also, there is scope for eating late into the night causing weight gain and obesity

which further causes sleep disruption forming a vicious cycle.

Conclusion: There is a need to intervene and sensitize medical students about the

need to maintain a disciplined lifestyle by including techniques that relieve stress into

the hectic curriculum.


52

Therapeutic implications of the circadian clock on skin function

Amal Philip, Ashwini Dhandayutham

Government Villupuram Medical College,Villupuram

Introduction: Circadian rhythm is any biological process that displays an

endogenous oscillation of about 24 hours. The human circadian clock ensures that

biochemical and physiological processes occur at the optimal time of day.

Circadian pacemaker in skin: Like the central circadian pacemaker, some rhythmic

oscillations are there for the functioning for peripheral tissues like skin. The skin's

chronobiologic functioning influences i) skin aging ii) cell repair (iii) development of

skin cancers iv) DNA repair and copying

Circadian rhythm in skin:The skin is uniquely positioned at the interface between

body and external environment. Predictable daily periodicity has been reported in i)

skin cell proliferation rates ii) hydration and trans-epidermal water loss iii) capillary

blood flow iv) temperature v) surface pH

Therapeutic implications:

Skin Cancer: Stem cells in epidermis reproduce mainly at night. Hence skin cancer

treatments involving chemotherapy is most effective when planned to coincide with

skin cell cycle.

Role of melatonin: Melatonin acts as a potent antioxidant and anti-aging substance

and plays a role in controlling hair growth, development of melanoma, suppression of

UV light induced damage. Lower melatonin levels during the day may inhibit the skins

ability to repair UV rays induced DNA damage and the harmful effects of reactive

oxygen species.

Conclusion: Chronobiology is an emerging field that is proving to be more and more

important in human health. Understanding CLOCK (Circadian Loco motor Output

Cycles Kaput) genes and their effects on skin cells may be an important way of

preventing skin cancer, premature aging, and a variety of skin disorders.


53

Effect of work shift timings and sleep pattern on circadian rhythm

in urban population of Hyderabad

Anuradha G, Joya Rani D

Gandhi Medical College, Secunderabad Introduction: Sleep is an important regulator of circadian rhythm. Changes in

working timings of individuals may affect the normal sleep pattern. Reaction time is an

important aspect of circadian rhythm. Reaction time plays important role in our day to

day activities like driving, crossing a road, working in industries etc.

Materials and methods: A total 40 subjects are divided in to two groups of 20 each.

Group A includes day shift and Group B includes night shift workers. Test for simple

visual reaction time was conducted at 9 am and 9 pm for both the groups using

garydar computer software. Females between 20-25 years of age were included in the

study. Participants with hypertension, diabetes mellitus, visual and hearing problems,

alcoholics, smokers, yoga practitioners & regular sports persons were excluded.

Results: Mean simple visual reaction time for group A and group B (mean ± SD) are

0.32±0.08 and 0.44±0.14 which was statistically significant.

Conclusion: Simple visual reaction time is prolonged in night shift workers than day

shift workers. There is more sleepiness in night shift workers at the end of the work

shift than day shift workers.


54

Assessment of cardiac sympatho-vagal activity of sedentary

overweight and obese young females

Latha Ramalingam1, Rajalakshmi R2 1.Department of Physiology, Shri Sathya Sai Medical College and Research Institute, Kanchipuram2.Department of Physiology, Indira Gandhi Medical College and Research Institute, Puducherry Introduction: Heart rate variability (HRV), also known as R-R interval variability,

represents the cardiac autonomic status of the individual. Several factors are known

to affect the HRV and reduced HRV is associated with increased risk of cardiovascular

morbidity and mortality. In today‟s world, increase in the standard of living,

consumption of junk food and sedentary lifestyle are emerging as major risk factors for

cardiovascular disorders among the young population. Several studies have shown

that young sedentary obese males have reduced HRV. However, there are not many

studies which have explored the changes in HRV indices in young sedentary females

with BMI above the normal range.

Objective: The aim of this study was to assess the cardiac sympatho-vagal status of

young sedentary overweight and obese females.

Materials and methods: A total of forty females aged 18 to 25 years were recruited in

the study. Categorization of sedentary behavior was done using the IPAQ

questionnaire. Based on the BMI (WHO guidelines for Asian population), subjects were

divided into test group (BMI >23 Kg/m2 & W/H ratio>0.8, N=20) and control group

(BMI = 18 to 23 Kg/m2, W/H ratio<0.8 N=20). Subjects were asked to rest in supine

posture for 10 minutes after which a 5 minute ECG was acquired in lead II

configuration. R-R intervals were acquired from the ECG data and were fed into the

Kubios HRV analysis software to obtain the time domain and frequency domain

indices of HRV.

Results: There was no significant difference between the test and control group with

respect to time domain indices. With respect to frequency domain indices, LF power,

HF power and total power did not show significant differences. However, LF nu was

significantly high (p=0.043), HF nu was significantly low (0.043) and LF/HF ratio was

significantly high (p=0.05) among the test group individuals.

Conclusion: Apparently healthy young sedentary overweight and obese females have

increased cardiac sympathetic activity and reduced cardiac parasympathetic activity.

This will lead to reduced HRV in these individuals which in turn may predispose them

to the risk of various cardiovascular disorders at an earlier age. Hence, appropriate

lifestyle modifications need to be adopted to prevent the progress of impending

alterations in the cardiovascular status of these young women.


55

Global warming and its effect on health

Thamaraiselvi K1, S.Jayaraman S2, Saravanan A1

1Department of Physiology, SRM Medical College Hospital & Research Centre, Kattankulathur, 2Department of Economics, Presidency College, Chennai

In the theory of evolution Darwin said that nature selects only the fittest. But human

through their economic activities and indiscriminate use of natural resources have

endangered many species of animals, flora and fauna by destroying their habitats and

consuming them. These activities have created a kind of situations unacceptable to

the nature. This situation is collectively called global warming. This is unsuitable to

the very survival of the human being. Many of the human activities have created non

conducive atmosphere for the survival of the human being itself. The globe which

includes the atmosphere, lithosphere and hydrosphere has been polluted by the gases

and particles either by their presence or excess quantity. Since the industrial

revolution, atmospheric pollution have increased many fold and in faster rate than

which the nature can handle. There is an excess quantity of CO2, CO, Methane,

sulphur, nitrogen, water particles, dust particles in the atmosphere and the

hydrosphere. The causes have been overexploitation of natural resources,

deforestation, and excessive use of fossil fuels, industrial wastages and domestic

wastages both non-biodegradable and excessive biodegradable. In the past fifty years

the atmospheric temperature has increased by 0.75°degree Celsius. This has

increased sea level by melting of the glaciers in the Polar Regions and many climatic

and seasonal changes like abnormal rain fall and cyclones. The ocean‟s surface

temperature has increased by 0.50° C in the last fifty years. By 2100 this may be

increased to 1°C to 3.5° C, the highest increase will result in the increase of sea level

by 7 meters and cause the inundation of many low lying areas.

The health effect of the global warming is very severe in widespread sparing nobody.

Global warming have created conducive atmosphere for host of vectors that carry

disease causing bacteria, viruses, parasites etc. There are frequent outbreaks of

Malaria, yellow fever, dengue, chickengunya etc. There is decrease in productivity,

mental health and above all the reproductive capacity and ability. This has rendered

many infertile and impotent. The future of human being is at the mercy of nature and

technology advancement.

Unless due care is taken to correct the past mistakes and steps taken to prevent

further degradation. Not only the economic sustainability but also the very survival

and the affordability of survival will be at stake, which is in the hands of human

beings.


56

Peripheral blood mononuclear cells: an immune marker

Ihsan V P, Balanaga Nandhini D

Department of Physiology, Government Villupuram Medical College, Villupuram

Introduction: In humans, most physiological and behavioral functions are expressed

rhythmically across days and nights.

Central clock: The circadian rhythms are controlled by a central self-sustained

biological oscillator organized in transcriptional/translational feedback loops involving

several clock genes. Central component of this complex oscillatory system resides in

the suprachiasmatic nuclei (SCN) of the anterior hypothalamus.

Peripheral clock: Molecular clock mechanisms oscillate also in peripheral organs,

such as the liver, kidney, and fibroblast cells. Many immune parameters such as

cytokine synthesis and white blood cell counts fluctuate in a circadian fashion.

Peak clock expression: Peak clock gene expression was observed mostly during the

usual time of activity and light exposure. Peak melatonin concentration is followedby

peak clock gene expression. The oscillation of clock genes in peripheral tissues often

lags several hours behind oscillation of the supra-chiasmatic nuclei.

Immune clock: Circadian clock keeps immune system more active during day time.

The sympathetic autonomic nerves keep them activated during habitual time of

activity. Circadian clock genes are expressed in a circadian manner in human

peripheral blood mononuclear cells (PBMCs), with the peak level occurring during the

habitual time of activity. Oscillation of clock genes in PBMC takes place even in

absence of sleep/darkness which suggests an endogenous nature for this oscillation.

Hence PBMC is an accessible surrogate for the identification of rhythmic clock gene

expression in humans.

Conclusion: Functional circadian machinery in human PBMCs suggests that

peripheral blood cells may be useful for the investigation of human circadian rhythms

and their associated disorders.


57

Gut clock: the implications of circadian rhythm on GIT

Nandagopal S S, Senthilkumari K R

Department of Physiology, Government Villupuram Medical College, Villupuram

Introduction: Circadian and seasonal rhythms are a fundamental feature of all living

organisms and their organelles. Biological rhythms are responsible for daily food

intake. The period of hunger and satiety is controlled by the central pacemaker, which

resides in the supra-chiasmatic nucleus (SCN) of the hypothalamus. Clocks in the GIT

are responsible for the periodic activities which transit along the GIT. They are

localized in special interstitial cells.

Endocrine encoding: Melatonin, produced by neuro-endocrine cells of the

gastrointestinal mucosa, plays an important role in the internal biological clock,

related to food intake and the myoelectric rhythm. This appears to be an endocrine

encoding of the light-dark cycle, conveying photic information.

Effect of disruption of circadian physiology: i) irritable bowel syndrome (IBS) ii)

gastroesophageal reflux disease (GERD) and iii) peptic ulcer disease. It also accelerates

aging, and promotes tumor genesis in the liver and GIT. Disruption of circadian

regulation may also lead to obesity by shifting food intake schedules.

Role of melatonin: The role of melatonin in the regulation of circadian rhythm allows

researchers and clinicians to approach gastrointestinal diseases from a

chronobiological perspective. Clinical studies have demonstrated that the

administration of melatonin improves symptoms in patients with IBS and GERD.

Melatonin significantly protects gastrointestinal mucosa, and has strong protective

effects on the liver in patients with non-alcoholic steatohepatitis (NASH).

Conclusion: Hence the role of clock genes in the pathophysiology of the GIT and liver

is a probe to be discussed in this modern day scenario.


58

Inadequate sleep as a risk factor for neurodegenerative diseases

Hemamalini R V, Prabhavathi K, Thamaraiselvi K, Christy A, Saravanan A SRM Medical College Hospital & Research Center, Kattankulathur

Inadequate sleep refers to sleep of shorter duration than the average need of seven to

eight hours per night. The cumulative effects of sleep loss have been associated with a

wide range of deleterious health consequences including an increased risk of

hypertension, diabetes, obesity, depression, heart attack, and stroke. Recently it has

also been considered as serious risk factor for neurodegerative diseases like

Alzheimer‟s, Parkinsons disease, Lewy body dementia.

Studies have shown that in those who carried the APOE-E4 gene and who slept most

soundly showed the greatest preservation of memory and thinking skills. Among study

participants who died, the poor sleepers were more likely to exhibit the characteristic

brain plaques and tangles of Alzheimer‟s disease. It was found that those getting less

sleep or sleeping poorly was tied to an increase in brain levels of beta-amyloid, a toxic

protein that builds up and forms plaques in the brains of those with Alzheimer‟s.

Brain scans revealed that individual who slept less than five hours a night had higher

levels of beta-amyloid in the brain than those who slept over seven hours a night.

A SPECT study showed a trend towards decreased dopamine transporter density in

the nigrostriatal regions of the brain and Parkinsonism in the follow-up data of

patients with REM sleep disturbance who had no previous evidence of

neurodegenerative disease. A lack of tracer binding in these regions of the brain is

closely linked to neuronal degeneration and the development of dementia and

movement disorders.REM sleep disturbances also results in Lewy body dementia.

There is an increasing amount of research linking sleep disturbance resulting in

inadequate sleep with increased risk of dementia.

It is extremely important to identify the individuals at risk such as night shift workers

who are sleep deprived, those with sleep apnea which causes them to awaken several

times during the night and those with various sleep disorders. As early detection and

adequate treatment of their sleep problems may reduce the risk of developing neuro-

degenerative diseases.


59

A glow in night is a blow to health

Rohinikirupha R, Senthilkumari K R

Government Villupuram medical college, Villupuram.

Introduction: Continuous exposure to artificial light of short wave length such as

blue light from electronic devices like mobile phones, laptop screens and fluorescent

light affects the circadian rhythm.

Circadian rhythm: It is a 24-hour cycle that tells our body when to sleep and

regulates many other physiological processes.

Population affected: Night shift workers, healthcare professionals, people working in

IT sector and college students.

Mode of resetting: Short wavelength light rays sensitize melanopsin retinal ganglionic

cells in eye and stimulates supra-chiasmatic nucleus through retino hypothalamic

tract. They project to many other brain regions influencing myriad aspects of human

physiology.

Acute effect of resetting of biological clock are decreases 50% of melatonin secretion,

reduces sleep, increases body temperature, alters clock gene expression, increases

cortisol secretion and increases heart rate.

The decrease in melatonin release can lead to coronary heart disease, oxidative stress,

decreased immune function, cancer in humans especially breast cancer in women,

generates free radicals causing premature ageing.

On the other hand increased cortisol release can result in insulin resistance, diabetes,

obesity, metabolic syndrome, polycystic ovarian disease (PCOD)

Decreased sleep can contribute to EEG changes like delta brain waves and boosted

alpha waves.

Impact on clock gene expression may lead to the asynchronicity between central and

peripheral oscillators.

Prevention:

1. Wearing orange tinted lenses.

2. Use of dim red lights and LEDs.

3. Avoid looking at bright screen two to three hoursbefore bed.

4. Night shift workers wear glasses that blocks blue light.

5. Lots of bright light during day boost your ability to sleep at night.


60

Effect of meditation on sleep

Srikanth T, Joya Rani D

Department of Physiology, Gandhi Medical College, Secunderabad.

Introduction: Deep sleep meditation is much more than a relaxation technique which

immensely has profound effects on body‟s physiology, especially brain. The quality of

life improves tremendously with constant and regular meditation. All the studies

document this fact of improving the sleep quality and sleep efficiency. Mediators

experience a state of “restful altertness” which in our terms means more connectivity

in the centres of the brain. This also slow the aging process in the humans that is in

other words the sleep architecture reduces the activity of negative mechanisms that

which help in the process of graying

Objectives: To study the effect of meditation on sleep pattern.

Materials and methods: In this study, 25 meditators of age group 30 to 45 years of

pyaramid spiritual society, kadtal, Telangana were identified as subjects. None had

any history or diagnosis of Diabetes Mellitus or any other chronic diseases. None had

altered their lifestyle or were taking any medication for the same. Two months

duration was taken into consideration for an EEG evaluation of sleep pattern, pre and

post meditation for 45mins duration period of mindful meditation (Ana-Pana sati)

Results:

Slow wave pattern REM sleep

Pre meditation 0.8 0.8

Post meditation 0.96 0.96

Conclusion: The above studies indicate that a better pattern of sleep both efficiency

and quality of sleep has improved in the two months time, which is reflected in the

EEG taken.


61

Alterations in FBS levels in IT company employees

Farheen Fatima, Joya Rani D

Department of Physiology, Gandhi Medical College, Secunderabad

Introduction: IT companies are synonymous with altered sleep schedule, mental

stress, improper diet etc. In this context, it is important to see how the hematological

parameters change under the influence of disturbed sleep and mental stress. Fasting

Blood sugar (FBS) is one of the important parameters to indicate the carbohydrate

metabolism status in the body. Usually any change in FBS indicates a disturbed

metabolism.

Objectives: To study the alterations in FBS levels in IT company workers.

Materials and methods: In this study, 30 workers of an IT company were selected as

subjects. None had any previous history or diagnosis of Diabetes Mellitus or any other

chronic diseases. None had altered their lifestyle or were taking any medication for

the same. Two Fasting Blood samples were collected from each volunteer at an interval

of 6 months. The first sample was collected when they had newly joined the company

(PRE) and the second sample was collected after 6 months (POST). These workers had

a rotating night shift schedule ranging from 2 weeks to month long night shift. All the

workers were exposed to a disturbed sleeping pattern in this 6 month duration.

Results:

FBS Mean (mg/dl) SD SE

PRE 81.46 6.569 1.199

POST 95.4 20.441 3.732 p = 0.0016

Conclusion: In comparison of FBS levels between the pre and post values of IT group

a very significant rise was seen after working in a set up with high stress and

decreased sleep.


62

Chromosomal abnormalities in congenital anomalous fetuses & babies - a possible outcome of chemicals exposures associated with environmental

pollution.

AN Uma

Department of Anatomy, Genetic Division, Mahatma Gandhi Medical College and

Research Institute, Pondicherry.

Introduction

Exposure even to brief episodes of pollution at critical stages in the development of the

human embryo can cause a person to experience an increased likelihood of multiple

diseases and congenital defects including cancer. Exposure to intermittent air

pollution is associated with sperm DNA damage and consequent increase in the rates

of male infertility, miscarriages and other adverse reproductive outcomes. Pregnant

women exposed to more air pollution give birth to babies with significantly more

chromosomal aberrations, with congenital malformation and sometimes also undergo

spontaneous abortions.

Aims & objectives

To study the chromosomal aberrations in the congenital malformed fetuses and babies

in mothers exposed to industrial chemical air pollution.

Materials and methods: All the congenital malformed fetuses and babies

delivered/MTP at the OBGY Dept at MGMCRI were taken for cytogenetic assay

following standard Hungerford method (1963) with due consent.

Results and discussion

A cytogenetic study on congenital malformed / syndromal fetuses and babies at

MGMCRI from June 2009 to June 2015 revealed the following scenario. Out of 36

cases done so far, 24 cases belonged to mothers living in a chemical industrial area.

Thus the inhaled toxic chemicals could have possibly affected the developing embryo

giving rise to congenital malformed / syndromal fetuses and babies. This was further

confirmed through chromosomal analysis which showed structural and numerical

aberrations.

Conclusion

Environmental concerns should be incorporated into both pre-conceptional and

prenatal care. In order to prevent congenital anomalies, one must reduce exposure to

potential teratogens before pregnancy is recognized (i.e. pre-conceptionally and in the

first few weeks of pregnancy). This should be one part of the public health function in

primary care. Relevant prenatal services include prenatal screening and prenatal

counseling. Prenatal service providers and counselors need to be aware of the

uncertainties regarding environmental pollution when addressing parental concerns.

Chronobiology and Health- Proceedings 2016

Healthcare