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COMPILATION OF ACYTER BULLETINS

April 2009 - February 2012

Editor: Dr. MADANMOHAN Programme Director, ACYTER, JIPMER

Editorial board: Dr. GK PAL Professor and Head, Dept. of Physiology, JIPMER and Dr. ANANDA BALAYOGI BHAVANANI Programme Co-ordinator, ACYTER, JIPMER

ADVANCED CENTRE FOR YOGA THERAPY, EDUCATION AND RESEARCH (ACYTER) (A collaborative venture between Morarji Desai National Institute of Yoga (MDNIY), New Delhi and Jawaharlal Institute of Post Graduate Medical Education and Research (JIPMER), Pondicherry)

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QUARTERLY BULLETIN OF THE ADVANCED CENTRE FOR YOGA THERAPY, EDUCATION & RESEARCH (ACYTER)
(A collaborative venture between JIPMER, Puducherry & MDNIY, Delhi)

April 2009
Patrons: Dr. KSVK Subba Rao Director, JIPMER Dr. I V Basavaraddi Director, MDNIY, New Delhi Dr. Ashok Kumar Das Med. Superintendent, JIPMER Dr. S Badrinath Project Co-ordinator, JIPMER Dr. KS Reddy Dean, JIPMER. Editor: Dr. Madanmohan Director-Professor & Head, Dept. of Physiology, JIPMER & Programme Director, ACYTER Editorial board: Dr. GK Pal Prof. of Physiology, JIPMER Dr Ananda Balayogi Bhavanani Programme Coordinator, ACYTER, JIPMER Correspondence to: The Editor, Bulletin of ACYTER, JIPMER, Puducherry, India-605 006 E-mail: acyter.jipmer@gmail.com

S.No 1 2 3 4

Contents

Introduction to ACYTER Report on National Workshop on Introducing Yoga in Medical Curriculum Report on Mass Yoga Awareness Programme in Schools of Puducherry Report on Introducing Yoga to Medical Students: the JIPMER Experience
INTRODUCTION TO ACYTER

Page No. 1 2 3 4

The Advanced Centre for Yoga Therapy, Education and Research (ACYTER), a collaborative venture between JIPMER, Puducherry and Morarji Desai National Institute of Yoga (MDNIY), New Delhi was established by a MOU between JIPMER and MDNIY on 7th June 2008. This advanced centre will focus primarily on the role of yoga in the prevention and management of cardiovascular disorders and diabetes mellitus. MDNIY will be providing financial assistance and necessary academic input related to yoga and take steps to initiate collaborative research projects on yoga and its applications related to cardiovascular diseases and diabetes mellitus. JIPMER will be offering its infrastructure and faculty for purposes of collaborative ventures with MDNIY in the field of yoga and its applications to cardiovascular diseases and diabetes mellitus. JIPMER will also provide adequate space to establish ACYTER effectively and efficiently. The monitoring committee of ACYTER is constituted as follows: Dr. K.S.V.K. Subba Rao, Director, JIPMER Chairperson Dr. Ishwar V. Basavaraddi, Director, MDNIY - Vice-Chairperson Dr. A. K. Das, Medical Supdt., JIPMER - Member Dr. S. Badrinath Project Coordinator, JIPMER - Member Dr. K. S. Reddy Dean, JIPMER - Member Dr. J. Balachander, Dir-Prof & Head, Cardiology, JIPMER- Member Dr. I. N. Acharya Prog Officer (Yoga Therapy), MDNIY- Member Programme Coordinator ACYTER, JIPMER - Member Dr. Madanmohan Trakroo - Dir-Prof & Head, Physiology & Programme Director ACYTER - Member-Secretary ACYTER has been active in conducting yoga training for medical students, organizing a mass awareness programme in 48 schools of Puducherry and organized a national workshop on Introducing yoga in medical curriculum. Patient care and research work will be initiated soon.

Published by the Advanced Centre for Yoga Therapy, Education & Research (ACYTER), JIPMER, Puducherry, India-605 006

Quarterly Bulletin of ACYTER- April 2009

WORKSHOP ON INTRODUCING YOGA IN MEDICAL CURRICULUM


ACYTER and Department of Physiology, JIPMER organized a two day National Workshop on Introducing Yoga in the medical curriculum on 19th and 20th March 2009 at JIPMER. The workshop was organized in collaboration with Morarji Desai National Institute of Yoga (MDNIY), New Delhi under auspices of Department of AYUSH, Govt of India. The workshop was inaugurated by Dr KSVK Subba Rao, Director JIPMER. Dr Ishwar V Basavaraddi, Director, MDNIY, New Delhi and Dr AK Das, Medical Superintendent, JIPMER were guests of honour. The national workshop deliberated on the need, feasibility and modality of introducing yoga science in the medical curriculum for medical students in particular and medical professionals in general. 20 resource persons from MDNIY, DIPAS, sVYASA, Karuna Trust, Iyengar Yoga Institute, Mumbai Yoga Institute, Kaivalyadhama, ICYER and JIPMER as well as 150 participants from all over the country participated in the workshop that covered the theory, practicals and therapeutic aspects of yoga and evaluation methods for such a course. The following are the recommendations of the workshop: 1. The workshop appreciated the Department of AYUSH and Morarji Desai National Institute of Yoga, New Delhi for making efforts to integrate yoga science in the medical curriculum and create awareness of yoga amongst the medical students in particular and medical professionals in general. 2. It was recommended to introduce yoga science to medical students in particular and medical professionals in general through a Foundation Course in Yoga Science. 3. It is recommended that 14 hours of yoga theory be included in theory lectures for 1st, 2nd and 3rd professionals and 32 hours practicals be included in the 2nd professional. 4. It was also recommended that a 48 hour foundation course be conducted after class hours for interested professionals through the yoga units of the institutions as per the syllabus that has been prepared by the MDNIY in consultation with eminent yoga and medical experts.

Quarterly Bulletin of ACYTER- April 2009

MASS YOGA AWARENESS PROGRAMME IN SCHOOLS OF PUDUCHERRY DURING THE NATIONAL YOGA WEEK 2009
The Ministry of Health and Family Welfare sponsored the NATIONAL YOGA WEEK 2009 from 16 to 22 of February 2009 and Morarji Desai National Institute of Yoga (MDNIY), New Delhi organised a mass awareness programme for health, happiness and harmony through yoga with the theme of Role of Yoga in School Health. As part of the National Yoga Week, a MASS YOGA AWARENESS PROGRAMME was conducted in schools in different parts of the country through the active participation of leading and eminent yoga institutes who have come together under the banner of the Indian Yoga Association, a self regulatory body for yoga sponsored by the Department of AYUSH, Ministry of Health and Family Welfare, Government of India. ACYTER organized the mass yoga awareness programme in 48 schools of Puducherry with the cooperation of the Education Department, Government of Puducherry. The inaugural ceremony for the yoga week in Puducherry was held at Kendriya Vidyalaya, JIPMER campus on 16 February 2009 and the valedictory function at the Indira Nagar Government Higher Secondary School on 20 February. Shri MA Fathimaraj, Deputy Director Education (Sports and Youth Services) was the Chief Guest at the valedictory function. Daily yoga camps of 1 hours duration on the theme of the national yoga week were conducted in 48 government and private schools of Puducherry by 28 yoga teachers under the direction of Prof Dr. MADANMOHAN, Director-Professor & Head, Dept of Physiology, JIPMER, and Programme Director, ACYTER and coordinated by Mrs. Meena Ramanathan, Coordinator Yoga courses, Pondicherry University Community College. The International Centre for Yoga Education and Research (ICYER) and Pondicherry Yogasana Association extended active cooperation for the conduct of the yoga classes. More than 5,000 students as well as their teachers and parents were sensitized to the importance of yoga for school health during this programme. Yoga is the best means to improve the psychosomatic health of everyone, especially children. Regular yoga practice enhances the personality of children, improves concentration and memory power, helps endure stressful situation during examinations, increases immunity and improves overall health. The main objective of the programme was to increase awareness about the benefits of yoga among the children and there was much awakening as evidenced by feedback from the schools.
Quarterly Bulletin of ACYTER- April 2009

INTRODUCING YOGA TO MEDICAL STUDENTS: THE JIPMER EXPERIENCE


The holistic science of yoga has a great future as it has the potential to prevent as well as manage a number of stress-induced chronic diseases that defy allopathic medicine. A holistic physician and practitioner of yoga will be able to render better medicare and will be a boon to the society. It was my hearts desire to introduce yoga to medical students as a branch of physiology & contemporary medicine. The opportunity came with the active collaboration and financial support from MDNIY. The objectives of the programme were: To promote awareness among medical students about the effectiveness of yoga as an inexpensive means for achieving holistic health. To impart knowledge, skill & attitude about theoretical & practical aspects of yogic science. To motivate medical students to take up further studies, therapy & research in yoga. To introduce yoga in medical curriculum as a branch of physiology & contemporary medicine.

I designed a 60 hour programme that included i) lectures (12 h), ii) lecture-demonstrations (3 h) iii) practice sessions (36 h) iv) students seminar on yoga therapy modules (6 h) and v) pre-test, post-test, administration of questionnaires & programme evaluation by the students (3 h). The programme had an overwhelming response with excellent co-operation from the medical undergraduates. In light of the encouraging student feedback, the following are the suggestions: Yoga should be made an integral part of medical curriculum, as a branch of physiology and contemporary medicine. Complementary and alternative health systems are already being taught in many standard modern medical schools in different parts of the world. The ideal time in an undergraduate medical programme where yoga can be incorporated is during the first semester and again during the sixth and / seventh semesters. The former will help them in combating and adapting to the totally new and extremely stressful first year undergraduate medical curriculum. The latter will help in better understanding of the science of yoga and its applications in clinical practice. It is suggested that there should be a space fully furnished, having the right ambience and comfort that will facilitate the teaching and practice of yoga. The space should be exclusively devoted to the yoga training programme. From the students standpoint, practice sessions with integrated theory, morning practice sessions and training schedule within college hours are among the major recommendations. Students also wanted a facility to continue yoga practice on a regular basis even after the completion of the introductory programme.

Quarterly Bulletin of ACYTER- April 2009

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ADVANCED CENTRE FOR YOGA THERAPY, EDUCATION & RESEARCH (ACYTER)
(A collaborative venture between JIPMER, Puducherry & MDNIY, New Delhi)

Bulletin of ACYTER- July 2009


Patrons: Dr.KSVK Subba Rao Director, JIPMER Dr. I V Basavaraddi Director, MIDNIY, New Delhi Dr. Ashok Kumar Das Med. Superintendent, JIPMER. Dr. S Badrinath Project Co-ordinator, JIPMER Dr. KS Reddy Project Co-ordinator, JIPMER Editor: Dr. Madanmohan Director- Professor & Head, Dept. of Physiology, JIPMER & Programme Director, ACYTER Editorial board: Dr. GK Pal Prof. of Physiology, JIPMER Dr. Ananda Balayogi Bhavanani Programme Co-ordinator, ACYTER, JIPMER

S.No 1 2 3 4

Contents

Introduction to ACYTER Pranayam: a Vedic and physiological perspective by Dr Madanmohan Report on staff recruitment, yoga therapy OPD, yoga therapy sessions and regular yoga classes Report on weekly academic programme, senior citizen clinic, re-orientation programme for doctors and upcoming activities

Page No. 1 2 3 4

The Advanced Centre for Yoga Therapy, Education and Research (ACYTER), a collaborative venture between JIPMER, Puducherry and Morarji Desai National Institute of Yoga (MDNIY), New Delhi was established by a MOU between JIPMER and MDNIY on 7th June 2008. This advanced centre will focus on the role of yoga in the prevention and management of cardiovascular disorders and diabetes mellitus. The centre will also popularize the science of yoga amongst medical professionals and general public.

Correspondence to: The Editor, Bulletin of ACYTER, JIPMER, Puducherry- 605 006. India. E-mail: acyter.jipmer@gmail.com

Published by the Advanced Centre for Yoga Therapy, Education & Research (ACYTER), JIPMER, Puducherry, India-605 006

MDNIY will be providing financial assistance and necessary academic input related to yoga and take steps to initiate collaborative research projects on yoga and its applications related to cardiovascular diseases and diabetes mellitus. JIPMER will be offering its infrastructure and faculty for purposes of collaborative ventures with MDNIY in the field of yoga and its applications to cardiovascular diseases and diabetes mellitus.
Bulletin of ACYTER- July 2009

PRANAYAM: A VEDIC AND PHYSIOLOGICAL PERSPECTIVE


Dr. Madanmohan Director- Professor & Head, Department of Physiology & Programme Director, ACYTER Yog (and the English word yoke derived from it) means union and harmony. Vedic philosophy emphasizes oneness, unity and universality. Vedic concepts of i) one omnipresent God as the universal divine being (Ekam sadvipra bahudha vadanti. Rigved, 1: 164: 46; Ishavasyam idam sarvam. Yajurved, 40: 1), ii) world man (Vishwa manusho. Rigved, 8: 45: 42), iii) world as one family (Vasudhaiv kutumbakam) and iv) the ultimate goal of yog being the union of our individual soul with the one Universal Soul can be the basis of unity of humanity and the modern concept of global village. From the yogic and spiritual point of view, the Vedic concept of pran, the omnipresent and universal divine force is very important. Ken Upanishad (1: 2) describes the supreme God as Pranasya pranah, i.e. the very source of pran, the giver of life to pran. In our body, pran manifests as life energy or ki (as in reiki or qigong) and in Samskrit, living beings are called as prani. Pran improves the quality of vegetation and herbs and thereby the quality of our life (Atharva Ved, 11: 4: 6). This whole world vibrates with pran (Kath Upanishad, 6: 2). Our nerve currents, bio-rhythms and the very life are expressions of pran. From the Vedic point of view, the goal of pranayam is conscious unification with the universal vital life force or pran. Breathing is the most tangible expression of pran and pranayam is the ingenious technique for recharging our batteries and enhancing vitality by drawing pran from the omnipresent and inexhaustible universal source of pran. Pranayam means control and expansion of pran. Since life, breathing and mind are closely interrelated and act on each other, pranayam has significant influence on our psychosomatic health. According to Patanjali (Yog Darshan, 2: 52-53), pranayam removes the covering of inner light and our mind gains the power of concentration. According to manusmriti (6: 71), pranayam purifies the senses and mind even as fire removes the impurities of metals. Thus, the breathing techniques of pranayam are psychosomatic techniques that purify, balance and energize the practioner. From the physiological point of view, pranayam is of great significance. Deep and complete yog breathing (mahat yog pranayam) i) strengthens the diaphragm and intercostal muscles, ii) massages abdominal viscera, iii) stretches all parts of thorax and lungs and iv) improves venous return. Breathing meditatively with full concentration improves mind-body coordination. During slow, deep and rhythmic breathing, there is a conscious alteration of activity of medullary neurons and a definite pattern of proprioceptive inputs from thorax and abdomen. This may modulate the activity of central neuronal circuits. We have found that slow, rhythmic pranayam produces deep psychosomatic relaxation (Madanmohan et al. The Yoga Review, 1983, 3: 25-34). In an another study, we have found that bellows type of pranayam produces immediate and significant reduction in auditory and visual reaction times indicating an improved sensorimotor performance and enhanced processing ability of the central nervous system (Bhavanani et al. Ind J Physiol Pharmacol, 2003, 47: 297-300). In a study on patients with premature ventricular complexes (PVC) and episodes of palpitations, we have found that pranayam produces an immediate relief of palpitations and PVC (Ravindra et al. International J Cardiology, 2006, 108: 124-125). It is clear that pranayama has significant spiritual, physiological and therapeutic potential.
Bulletin of ACYTER- July 2009

STAFF RECRUITMENT COMPLETED ACYTER has started functioning with full staff with effect from 1 June 2009 when following staff members joined: Dr Zeena Sanjay (Senior Research Fellow), Sri G Dayanidy (Yoga Instructor), Selvi L Vithiyalakshmi (Yoga Instructor) and Sri P Munisamy (General Duty Attendant). This completes the full ACYTER team along with Dr Ananda Balayogi Bhavanani (Programme Co-ordinator), Sri E Jayasettiaseelon (Senior Research Fellow) and Sri S Mourthy (DEO-cum-clerk). Orientation programme was conducted for ACYTER staff by Dr. Madanmohan, Programme Director from 1 to 15 June 2009. Research methods as well as yoga teaching methods were finalized in this period with a special workshop on HRV methods conducted by Dr ES Prakash from Asian Institute of Medical Studies, Malaysia. YOGA THERAPY OPD AT SUPER SPECIALTY BLOCK Yoga therapy OPD started functioning from 15 June in Super Specialty block of JIPMER. During second half of June, 154 patients (89 new and 65 old cases) of various conditions attended consultation in the OPD with Dr Ananda Balayogi Bhavanani and Dr Zeena Sanjay. Patients who attended consultation were prescribed individualized and generalized yoga therapy for diabetes mellitus (53), hypertension (27), coronary artery disease (8), respiratory disorders (9), endocrine disorders (8), stress (6), urology (2), GI disorders (3), neurology (1), musculoskeletal disorders (10) and non specific complaints (1). Many patients had more than one health problem. Patients have reported benefits and expressed their thanks to ACYTER, JIPMER and MDNIY for this faciltity. YOGA THERAPY SESSIONS Yoga therapy sessions were started on 15 June and are being conducted on Mondays, Wednesdays and Fridays from 10:00 am 11:00 am for patients of diabetes, 11:00 am 12:00 noon for patients of cardiovascular diseases and 12:00 noon 1:00 pm for patients of other disorders. The yoga instructors, G Dayanidy and L Vithiyalakshmi are conducting the sessions both individually and in groups as per directions of the therapists given in the OPD. Therapy schedule notes are being prepared for distribution to patients enabling them to practice more efficiently at home. Patients have reported satisfaction with the therapy sessions and are attending regularly. 77 patients of diabetes, 35 of hypertension and 70 of other conditions attended the sessions up to the end of June. REGULAR YOGA CLASSES Regular yoga classes for normal subjects were started on 15 June and are being conducted on Mondays, Wednesdays and Fridays between 6:30 7:30 am & 4:30 5:30 pm. 16 participants attended the classes regularly up to the end of June. Suryanamaskar, basic asanas, pranayamas and relaxation techniques are being taught in the general classes.
Bulletin of ACYTER- July 2009

WEEKLY ACADEMIC PROGRAMMES Weekly academic programmes are being conducted at ACYTER on every Saturday. Sri E Jayasettiaseelon, SRF, ACYTER presented a talk on Yogic Diet on 20th June and Dr Vivek Sharma, Assistant Professor, Department of Physiology presented a talk on Yoga Its applications in Health and Disease on 27th June. Residents and faculty members of Physiology were invited participants in the academic programmes that ended with a healthy group discussion. Dr Ananda Balayogi Bhavanani, and Sri G Dayanidy, also gave an informative lecture cum demonstration on Important Asanas for Health on 27th June following the talk by Dr Vivek Sharma. SENIOR CITIZENS CLINIC Senior Citizens Clinic is being conducted on every Tuesday from 11:00 am to 12:30 pm at ACYTER Yoga Hall and was attended by 41 patients up to end of June. Members of the Pondicherry Senior Citizens Welfare association headed by Sri SV Iyer participated enthusiastically in the programme. Mrs. Meena Ramanathan assisted in this programme as she has been associated with the senior citizens yoga programme at the Pondicherry University Community College. Basic yoga practices were taught to participants after consultation with the therapists. REORIENTATION PROGRAMME FOR DOCTORS Dr Vivek Sharma, assistant professor, Department of physiology attended the reorientation programme for doctors conducted by MDNIY at New Delhi in May 2009. He gave positive feedback on the content and conduct of the programme and presented a talk on his experiences at ACYTER. It is to be noted that he is the first member of JIPMER faculty to participate in such a programme at MDNIY. UPCOMING ACTIVITIES 1. Yoga awareness programme for medical professionals at JIPMER 2. CME on Therapeutic potential of yoga for medical professionals in association with IMA, Puducherry chapter. 3. Monthly yoga camps for diabetes and hypertension in urban and rural Puducherry. 4. Weekly academic programmes at ACYTER

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Advanced Centre for Yoga Therapy, Education and research (ACYTER) Department of Physiology, JIPMER, Puducherry 605 006

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Bulletin of ACYTER- July 2009

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ADVANCED CENTRE FOR YOGA THERAPY, EDUCATION & RESEARCH (ACYTER)
(A collaborative venture between JIPMER, Puducherry & MDNIY, New Delhi)

Bulletin of ACYTER- October 2009


Patrons: Dr.KSVK Subba Rao Director, JIPMER Dr. I V Basavaraddi Director, MDNIY, New Delhi Dr. Ashok Kumar Das Med. Superintendent, JIPMER. Dr. S Badrinath Project Co-ordinator, JIPMER Dr. KS Reddy Dean, JIPMER Editor: Dr. Madanmohan Director- Professor & Head, Dept. of Physiology, JIPMER & Programme Director, ACYTER Editorial board: Dr. GK Pal Prof. of Physiology, JIPMER Dr. Ananda Balayogi Bhavanani Programme Co-ordinator, ACYTER, JIPMER

YOGA AND HEALTHY LIFESTYLE CONSULTATION AT OFFICIAL LANGUAGE CONFERENCE A team from ACYTER under direction of Dr Madanmohan, Programme Director ACYTER conducted yoga and healthy lifestyle consultations for delegates attending the Regional Official Language Conference for South and South Western Zone, at JIPMER on 9 October 2009. 95 delegates benefited from consultations offered from 11am to 5pm by Programme Director Dr Madanmohan, Programme Co-ordinator Dr Ananda Balayogi Bhavanani and SRF Dr Zeena Sanjay and Shri S Jayasettiaseelon from ACYTER along with Dr Rajajeyakumar and Shri T Ramkumar from the Physiology department, JIPMER. Simultaneous yoga practice sessions were conducted by Shri G Dayanidy, YOGA Instructor, ACYTER. It was found that of the 95 delegates (30-60 yr) who attended the consultation, 32 had hypertension (of this only nine were on medical treatment!), 12 had diabetes while 8 gave history of syncope, insomnia, arthritis, allergic rhinitis, dislipidemia, and anxiety. 43 didnt have any serious health conditions and were given general counseling and lifestyle advice to maintain their health. All delegates were given advice on healthy lifestyle practices, diet counseling and specific yoga practices as per their individual condition. They were also given references to yoga centers in their respective hometowns to continue the practices at home. Organizers and delegates expressed their gratitude to ACYTER for conducting such a consultation enabling them to gain an insight into healthy lifestyle and yoga. 1
Bulletin of ACYTER- October 2009

Correspondence to: The Editor, Bulletin of ACYTER, JIPMER, Puducherry- 605 006. India. E-mail: acyter.jipmer@gmail.com

Published by the Advanced Centre for Yoga Therapy, Education & Research (ACYTER), JIPMER, Puducherry, India-605 006

ROLE OF YOGA IN CARDIOVASCULAR DISEASE Dr. Madanmohan Director- Professor & Head, Department of Physiology & Programme Director, ACYTER All over the world, cardiovascular disease imposes a significant morbidity and mortality. Inspite of greatly improved diagnostic and curative cardiology, millions die of heart disease every year. It is a matter of concern that relatively young Indian professionals who are at the peak of their career and productivity become victims of angina. The most important cause is stress and strain of modern life characterized by competition, great speed and greater greed. Good health and freedom from disease is the greatest achievement, a blessing indeed and both modern medicine as well as yoga aim at it. Both systems have sound scientific basis and universal outlook. They are complementary and bound to come together. It is gratifying that yoga has started using modern technology and scientific methods while science has started studying the effects of yogic techniques. The ancient marvel of yoga is the priceless gift of India to the world. Yoga is beneficial in health as well as disease as it is holistic and has promotive, preventive as well as curative potential. Our body, mind and spirit are intricately interrelated and constantly influence one another. The holistic science of yoga has been designed to have subtle effect on our whole being- body, mind as well as spirit. The all-pervasive stress and stress-induced disorders like hypertension and angina are fast growing epidemics and bane of "modern" society. The holistic science of yoga is the best method for prevention as well as management of stress and stress-induced disorders. The psycho-physiological responses to yoga are opposite to the stress response. Shavasan, yoganidra, meditation and slow, rhythmic pranayam breathing are very effective in calming the mind and promoting psychosomatic health. Cardiac patients are sensitive and reactive. Yoga relaxation techniques calm the mind and make one emotionally balanced. Consequently, minor disturbances do not cause emotional upsets and cardiovascular problems. Hypertension is prevalent throughout the world and many patients are on life-long medication as a way of life. Drugs are expensive and have many adverse side effects. Hence, non-drug management like yoga should be the first choice. If diagnosed early, majority of cases of essential hypertension can be managed effectively by yoga alone. In more advanced cases, yoga can decrease drug dosage and improve the overall quality of life. Besides being inexpensive, safe and effective, yoga improves overall health and can be combined with allopathic medication. For best results, yogic lifestyle should be adopted early in life as it has been demonstrated that atherosclerotic plaques in coronary arteries form early in life. Moreover, in a recent study, we have demonstrated that the levels of total and LDL cholesterol are higher in prehypertensive as compared to normotensive subjects. Hence, yogic relaxation and yogic diet should be adopted early in life to prevent progression of the condition and development of hypertension. The effectiveness of yoga in the management of hypertension has been demonstrated from our laboratories and also by earlier workers. Hence, it is recommended that yogic relaxation techniques should be adopted as the first line of treatment for pre-hypertension, borderline hypertension and mild hypertension. In an interesting study, we have recently demonstrated that yoga relaxation training is beneficial in patients with benign ventricular ectopics. Therapeutic effect of yoga may be due to i) management of stress ii) improvement of cardiorespiratory function and overall fitness and iii) modulation of autonomic function. Stress is an important causative factor in cardiovascular diseases like hypertension and angina. In an interesting work from our laboratories, we have demonstrated that subjects trained in yoga can achieve a state of deep psychosomatic relaxation associated with highly significant decrease in oxygen consumption within five minutes of practising savitri pranayam (a slow, rhythmic and deep breathing) and shavasan. These findings are consistent with the report that yoga training not only produces a significant decrease in basal anxiety level, but also attenuates the change in anxiety score in stressful situations such as examination. It has also been reported that yoga training helps in development of resistance against stress.

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Bulletin of ACYTER- October 2009

Practice of asans and pranayams results in overall improvement in physical fitness and cardiorespiratory functions. In a study conducted on medical students, we have demonstrated that yoga training of 12 weeks duration produces a significant increase in respiratory pressures, breath holding time and handgrip strength. This indicates an improved physical strength and cardio-respiratory function. We have also reported that after yoga training, exercise-induced stress to cardiovascular system is less severe. Yoga training promotes emotional and physiological balance. In an interesting study, it was found that a brief (15 min) yoga based relaxation training normalizes the function of autonomic nervous system by deviating both sympathetic and parasympathetic indices towards more normal middle region of the reference values. These studies show that yoga has a great potential to improve our physiological functions, psychosomatic health and overall performance. PROPOSALS SUBMITTED FOR NEW YOGA RESEARCH PROJECTS Dr Madanmohan, Programme Director ACYTER, has submitted two research proposals to the JIPMER Research Council. The first proposal entitled, Effect of yoga therapy on patients of type II diabetes mellitus with neuropathy plans to investigate the physiological, bio-chemical, psychological and clinical effects of 6 months yoga therapy in patients of diabetes mellitus with neuropathy. The second proposal entitled Effect of yoga therapy on autonomic function and biochemical profile of patients of essential hypertension plans to investigate the autonomic and biochemical effects of 6 months yoga therapy in patients of essential hypertension. YOGA THERAPY OPD AT SUPER SPECIALTY BLOCK Yoga therapy OPD is functioning in Super Specialty Block of JIPMER. From July to September 1080 patients (251 new and 829 old cases) of various conditions attended consultation in the OPD with Dr Ananda Balayogi Bhavanani and Dr Zeena Sanjay. Patients who attended consultation were prescribed individualized and generalized yoga therapy for diabetes mellitus (169), hypertension (94), musculoskeletal disorders (47), respiratory disorders (27), stress and psychological disorders (27), endocrine disorders (26), coronary artery disease (18), urology (9), gynecological disorders (9), neurology (9), ENT disorders (7) and other complaints (10). Patients have reported benefits and expressed thanks to ACYTER, JIPMER and MDNIY for this facility. YOGA THERAPY SESSIONS Yoga therapy sessions continue to be conducted on Mondays, Wednesdays and Fridays from 10:00 am 11:00 am for patients of diabetes, 11:00 am 12:00 noon for patients of cardiovascular diseases and 12:00 noon 1:00 pm for patients of other disorders. The yoga instructors, G Dayanidy and L Vithiyalakshmi are conducting the sessions both individually and in groups as per directions of the therapists given in the OPD. Patients have reported satisfaction with the therapy sessions and are attending regularly. 463 patients of diabetes, 295 of hypertension and 328 of other conditions attended the sessions between July-September. YOGA CLASSES FOR NORMAL SUBJECTS Yoga classes for normal subjects are being conducted on Mondays, Wednesdays and Fridays between 6:30 7:30 am & 4:30 5:30 pm. 61 participants attended the classes regularly in JulySeptember. Suryanamaskar, basic asanas, pranayamas and relaxation techniques are being taught in the general classes. The Senior Citizens Clinic is being conducted on every Thursday from 11:00 am to 12:30 pm and was attended by 117 patients from July to September. YOGA AWARENESS AT PUDUCHERRY GOVT DENTAL COLLEGE Dr Ananda Balayogi Bhavanani, Programme Co-ordinator ACYTER was invited to give a talk on Yoga for Positive Health at the first clinical society meeting held at the Mahatma Gandhi Post Graduate Institute for Dental Sciences, Puducherry on 12 August. The talk was attended by the Director, Dean, senior professors and about 100 UG and PG students of the college. G Dayanidy, yoga instructor ACYTER gave an excellent demonstration on the occasion. The Director Dr Shyam Singh expressed his willingness to have a yoga orientation programme for the staff and students of the institute and ACYTER plans to conduct such a programme in the near future.

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Bulletin of ACYTER- October 2009

YOGA AWARENESS AT JIPMER NURSING COLLEGE Dr Madanmohan, Programme Director ACYTER and Dr Ananda Balayogi Bhavanani, Programme Co-ordinator ACYTER presented a series of talks at the JIPMER Nursing College for participants of the Nursing Workshop on AIDS/HIV conducted in August and September. More than 150 participants were sensitized to the benefits of Yoga and other alternative and complementary therapies though the talks. Shri G Dayanidy, yoga instructor ACYTER gave excellent demonstration during the talks. ACADEMIC ACTIVITES Academic programmes by staff of ACYTER as well as invited faculty are being conducted at ACYTER Hall every Saturday from 11am to 1pm. Many staff and students of JIPMER as well as yoga enthusiasts from Puducherry have been attending the talks. The following talks were given in the period July to September. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. Naturopathy & its applications by Dr. Zeena Sanjay Yoga for diabetes by Selvi L Vithiyalakshmi Yoga for hypertension by Shri G Dayanidy Music therapy by music researchers from Belgium Introduction to siddha medicine by Dr. Rajalakshmi Benefits of herbal medicines by Shri Paramakethu Pranayama and its therapeutic benefits by Shri S. Jayasettiaseelon Yoga for positive health by Dr Zeena Sanjay Yoga for special children by Mrs. Meena Ramanathan Methods of yogic diagnosis by Dr Ananda Balayogi Yoga for sleeping disorders by Shri G Dayanidy Shatkriyas by Selvi L Vithiyalakshmi

A delegation of yoga teachers from Australia and New Zealand visited ACYTER on 9 September and expressed their admiration for the programme and its activities. They were especially appreciative that Indian Government was bringing yoga into the mainstream health care system through advanced centers at JIPMER, NIMHANS, DIPAS and Gujarat Ayurveda University. Dr GS Gaur, Professor of Physiology, JIPMER attended the reorientation programme for doctors conducted by MDNIY, New Delhi from 6 to 12 September. Dr Madanmohan, Programme Director ACYTER was the Chief Guest at the valedictory function.

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Advanced Centre for Yoga Therapy, Education and research (ACYTER) Department of Physiology, JIPMER, Puducherry 605 006

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Bulletin of ACYTER- October 2009

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ADVANCED CENTRE FOR YOGA THERAPY, EDUCATION & RESEARCH (ACYTER)
(A collaborative venture between JIPMER, Puducherry & MDNIY, New Delhi)

Bulletin of ACYTER- January 2010


Patrons: Dr. KSVK Subba Rao Director, JIPMER Dr. I V Basavaraddi Director, MDNIY, New Delhi Dr. Ashok Kumar Das Med. Superintendent, JIPMER. Dr. S Badrinath Project Co-ordinator, JIPMER Dr. KS Reddy Dean, JIPMER Editor: Dr. Madanmohan Professor & Head, Dept. of Physiology, JIPMER & Programme Director, ACYTER Editorial board: Dr. GK Pal Prof. of Physiology, JIPMER Dr. Ananda Balayogi Bhavanani Programme Co-ordinator, ACYTER, JIPMER

Contents Workshop on Chakra Healing by Sri Bala Ratnam Notes on Chakra Meditation for Healing 17 International Yoga Festival at Puducherry Report on Yoga Therapy OPD and Therapy Sessions Yoga Awareness at JIPMER Nursing College Regular Activities of ACYTER WORKSHOP ON CHAKRA HEALING
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ACYTER organized a workshop on Chakra Meditation for Healing on 1st January 2010 by Sri Bala Ratnam, founder of Vibrational Breath Therapy from Melbourne, Australia. The workshop conducted at Bernard Theatre, JIPMER was chaired by Dr. Madanmohan, Programme Director ACYTER. More than fifty members of the staff, students, residents and invited guests from Pondicherry and Chennai participated actively. Sri Bala explained in detail the stages of consciousness and the pancha kosha and guided the participants through the self healing techniques visualizing the chakras with the chanting of akara, ukara, makara and omkara nada. He conveyed many of his personal experiences through his intensive yoga sadhana and also in dealing with patients of various ailments. Sri Bala is a dedicated disciple of Swami Gitananda Giri and has codified the Vibrational Breath Therapy based on Rishiculture teachings of his Guru. Sri Bala at 87 years of age is a living example of the beneficial effects of yoga and is a role model for all sincere yoga sadhakas.

Correspondence to: The Editor, Bulletin of ACYTER, JIPMER, Puducherry- 605 006 India E-mail: acyter.jipmer@gmail.com

Published by the Advanced Centre for Yoga Therapy, Education & Research (ACYTER), JIPMER, Puducherry, India-605 006
Bulletin of ACYTER- January 2010

CHAKRA MEDITATION FOR HEALING


Yoga Bishmacharya Sri Bala Ratnam
Founder, Vibrational Breath Therapy, Melbourne, Australia. www.vbt.com.au Cosmic/Divine Consciousness and Cosmic Energy / Prana are the basis of all causation and creation. We are in essence self consciousness, a part and parcel of Divine / Cosmic Consciousness, which the Christians call Christ Consciousness, Buddhists call Buddha Consciousness, Hindus call Krishna Consciousness, and Moslems call Allah Consciousness. In our worldly existence we live in three states of consciousness wakeful, dream, and deep sleep associated with the three planes of existence: physical, astral and causal, all manifestations of cosmic energy or prana. These three planes of existence are in fact the physical, astral, and causal energy bodies, created and sustained by the cosmic vibratory energy of Pranava AUM. To regenerate, rejuvenate and rehabilitate, the physical, astral and causal energy bodies have to be energized, magnetized and integrated; and their wakeful, dream and deep sleep states of consciousness transcended. To do so, the student/patient has to be assisted to rise above both body and conscious mind, negate ego-consciousness and move into turiya, the fourth state, a state beyond conceptualization. This state of causal silence is the abode of peace, happiness, tranquility, creativity, intuition, health, knowledge and freedom the source of everything, where renewal, repair and healing take place. These energy bodies need daily sustenance by the cosmic vibratory energy of AUM to experience a state of well being. Breathing over 70% of the lung capacity in mahat yoga pranayama (the complete yogic breath) absorbs prana from the cosmos, which energizes and magnetizes these energy bodies, while the chanting of AUM provides the vibratory resonant frequency component needed to create a state of well being. The flow of prana is inhibited by traumas and tensions of this and previous births stored at the manipura, vishuddha and ajna chakras (navel, throat and brow centres) associated with the physical, astral and causal planes of existence respectively. These are neutralized by the divinely inspired Chakra Meditation practice, which activates these centres and enhances their psychic qualities to transform the personality and character of the student / patient to combat the illness / disharmony in the body-mind complex. Practising these techniques initiates a process of healing at the physical, astral and causal planes of existence. Then, the psychic passage (shushumna nadi) is cleansed to allow a free flow of prana through it. Using the chant AUM, all the three planes of existence are integrated to create a state of well being. The awareness is then taken to the seat of the problem. This could be in the physical body or in the mind. If there is a particular physical condition, by using highly focused concentration, the cosmic vibratory energy of AUM is allowed to vibrate and resonate at the seat of the problem to initiate the process of healing. The session concludes with a meditation at anahata chakra, the heart centre, the seat of the soul with a focused personal affirmation (sankalpa).

Bulletin of ACYTER- January 2010

17th INTERNATIONAL YOGA FESTIVAL AT PUDUCHERRY


The 17th International Yoga Festival was conducted at Puducherry by the Department of Tourism from 4-7 January 2010. More than a thousand participants took part in the festival. ACYTER staff actively participated in the festival and provided free consultation on yoga and healthy lifestyle for the participants and the general public. Dr. Madanmohan, Programme Director chaired the session on Role of Yoga in Health Care Hypertension and described important yoga practices for patients of hypertension. Shri G Dayanidy, Yoga Instructor, ACYTER won first place in the 20-25 male category yogasana competition and participated in the champion of champions final event. Dr Ananda Balayogi Bhavanani, Programme Co-ordinator ACYTER coordinated theoretical aspects in the competition and moderated the workshops on different traditions. He chaired a session on yoga for respiratory disorders and gave a presentation on the Gitananda tradition.

YOGA THERAPY OPD AT SUPER SPECIALTY BLOCK


ACYTERs Yoga therapy OPD is functioning on a regular basis in Super Specialty Block. During October to December, 1173 patients (new 420 and old 753 cases) of various conditions attended consultation in the OPD with Dr Ananda Balayogi Bhavanani and Dr Zeena Sanjay. Patients who attended consultation were prescribed individualized and generalized yoga therapy for diabetes mellitus, hypertension, musculoskeletal disorders, respiratory disorders, stress and psychological disorders, endocrine disorders, coronary artery disease, GIT, neurology, and other complaints. Patients have reported benefits and expressed their thanks to ACYTER, JIPMER and MDNIY for this facility.

YOGA THERAPY SESSIONS


Yoga therapy sessions are being conducted on Mondays, Wednesdays and Fridays from 10 11 am for patients of diabetes, 11 am 12 noon for patients of cardiovascular diseases and 12 noon 1 pm for patients of other disorders. The yoga instructors, Shri G Dayanidy and Selvi L Vithiyalakshmi are conducting the sessions both individually and in groups as per directions of the therapists given in the OPD. Patients have reported satisfaction with the therapy sessions and are attending regularly. 389 patients of diabetes, 225 of hypertension and 405 of other conditions attended the sessions between Oct-Dec 2009.

PILOT STUDIES AT ACYTER


Staff members of ACYTER have conducted short term pilot studies on different applications of yoga in the past quarter. The studies that have been conducted are: 1. Acute effects of yoga nidra on normal subjects Shri E Jayasettiaseelon, SRF 2. Acute effects of chandranadi pranayama in hypertension - Dr. Zeena Sanjay, SRF 3. Acute effects of shavasana and pranava pranayama in hypertension - Selvi L Vithiyalakshmi, Yoga instructor 4. Immediate effect of yoga practices on blood pressure Shri G Dayanidy, Yoga instructor
Bulletin of ACYTER- January 2010

YOGA AWARENESS AT JIPMER NURSING COLLEGE


Dr Madanmohan, Programme Director, Dr Ananda Balayogi Bhavanani, Programme Co-ordinator, Shri E Jayasettiaseelon, SRF & Dr Zeena Sanjay, SRF presented seven talks at the JIPMER Nursing College for participants of the Nursing Workshops on AIDS/HIV conducted in Oct-Dec 2009. More than 150 participants were sensitized to the benefits of Yoga and other alternative and complementary therapies though the talks as well as demonstrations by Shri G Dayanidy and Selvi L Vithiyalakshmi, yoga instructors.

REGULAR ACTIVITES OF ACYTER


Academic programmes by staff of ACYTER as well as invited faculty are conducted at ACYTER Hall every Saturday. Staff and students of JIPMER as well as Yoga enthusiasts from Puducherry have been attending the talks. Group discussions on various topics pertaining to yoga therapy and yoga research were also conducted with active participation of the residents of the department of physiology. A delegation of yoga teachers and students from Berlin, Germany under the leadership of Yogacharya Ananda Leone visited ACYTER in November and expressed admiration for the programme and its activities. They were especially appreciative that the Indian Government has brought Yoga into the mainstream health care system though advanced centers in JIPMER, NIMHANS, DIPAS and Gujarat Ayurveda University. Regular yoga classes are being conducted on Mondays, Wednesdays and Fridays in both mornings and evenings. 45 participants attended the classes in the last quarter. Suryanamaskar, basic asanas, pranayamas and relaxation techniques are being taught in the general classes. Senior Citizens Clinic is being conducted every Thursday and 40 participants attended classes with Mrs. Meena Ramanathan, coordinator yoga courses, PUCC.

ANNOUNCEMENT:
ACYTER is organizing a National Workshop-Cum-Seminar on Role of Yoga in Prevention and Management of Hypertension in collaboration with Morarji Desai National Institute of Yoga, (MDNIY) New Delhi on March 18-19, 2010 at JIPMER. 300 medical and paramedical professionals as well as yoga therapists are expected to participate in the deliberations on the role of yoga in the prevention and management of hypertension. Lectures, panel discussions and practical sessions will be conducted by eminent medical and yoga experts. Bulletin of ACYTER- January 2010

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ADVANCED CENTRE FOR YOGA THERAPY, EDUCATION & RESEARCH (ACYTER) Bulletin of ACYTER- April 2010

(A collaborative venture between JIPMER, Puducherry & MDNIY, New Delhi)

Patrons: Dr. KSVK Subba Rao Director, JIPMER Dr. I V Basavaraddi Director, MDNIY, New Delhi Dr. Ashok Kumar Das Med. Superintendent, JIPMER. Dr. S Badrinath Project Co-ordinator, JIPMER Dr. KS Reddy Dean, JIPMER Editor: Dr. Madanmohan Professor & Head, Dept. of Physiology, JIPMER & Programme Director, ACYTER Editorial board: Dr. GK Pal Addl. Prof. of Physiology, JIPMER Dr. Ananda Balayogi Bhavanani Programme Co-ordinator, ACYTER, JIPMER

NATIONAL WORKSHOP-CUM-SEMINAR ON ROLE OF YOGA IN PREVENTION AND MANAGEMENT OF HYPERTENSION

A National Workshop-cum- Seminar on Role of Yoga in Prevention and Management of Hypertension was held at JIPMER on March 1819, 2010. The workshop was organized by the Advanced Centre for Yoga Therapy, Education & Research (ACYTER) and Department of Physiology, JIPMER in collaboration with Morarji Desai National Institute of Yoga (MDNIY) an Autonomous organisation under Dept of AYUSH, Ministry of Health, Govt of India, New Delhi. The Workshop-cum- Seminar was inaugurated by Dr KSVK Subba Rao, Director JIPMER in the presence of Dr AK Das, Medical Superientendent, JIPMER. Senior faculty members from various departments of JIPMER as well as eminent yoga and medical experts from all over the country participated in the inaugural function. The academic proceedings were conducted at the Bernard Theatre while the practice sessions were held at the JIPMER Community Hall. 133 medical and paramedical professionals and Yoga therapists from all over the country participated in the deliberations along with 40 faculty, residents and staff members of the department of physiology and ACYTER. Lectures, lecture-demonstrations, panel discussions and practice sessions were conducted by 27 eminent medical and yoga experts from all over the country representing JIPMER; DIPAS, New Delhi; Krishnamacharya Yoga Mandiram, Chennai; Iyengar Yogashraya, Mumbai; Kaivalyadhama, Lonavla; Viniyoga Healing Foundation of India, Chennai and the International Centre for Yoga Education and Research (ICYER), Pondicherry.

Correspondence to: The Editor, Bulletin of ACYTER, JIPMER, Puducherry- 605 006, India E-mail: acyter.jipmer@gmail.com

Published by the Advanced Centre for Yoga Therapy, Education & Research (ACYTER), JIPMER, Puducherry, India 605 006
Bulletin of ACYTER, April 2010

The key note talk on Lifestyle modifications in diabetes mellitus was given by Dr. AK Das, Medical Superintendent, JIPMER while the keynote by Yogacharini Meenakshi Devi Bhavanani, ICYER dealt with the importance of developing a yogic attitude in preventing and managing hypertension. The following invited talks were given by eminent faculty during the workshop: 1. Stress and the relaxation response. Lt. Col. Dr. G Himashree, DIPAS, New Delhi 2. Pathophysiology of hypertension: a yogic perspective. Dr. Madanmohan, Professor and Head, Department of Physiology, and Programme Director ACYTER, JIPMER. 3. Yogic management of hypertension. Dr. Ananda Balayogi Bhavanani, Programme Coordinator, ACYTER, JIPMER and Chairman, ICYER, Pondicherry. 4. Meditation and its therapeutic potential. Dr. MR Kotwal, Medical Consultant, Govt. of Sikkim. 5. Psychological assessment in hypertension: yogic perspectives. Dr. Latha Satish, Psychologist and Managing Trustee, Krishnamacharya Yoga Mandiram, Chennai 6. Hypertension-Management and monitoring for complications: A physicians perspective. Dr. Aparna Agrawal, Professor of Medicine, JIPMER A excelent lecture-demonstration of yogasanas for hypertension was conducted by Dr. Rajvi Mehta, Editor Yoga Rahasya from the Iyengar Yogashraya, Mumbai. Dr. RS Bhogal, Principal GS College of Yoga and Cultural synthesis, Kaivalyadhama, Lonavla gave an enlightening and invigorating lecture-cumpractical session on Holistic Meditation. Forenoon and afternoon practice sessions were conducted for the participants on both days at the JIPMER Community Hall. The Pranayama sessions were conducted by Dr. Madanmohan who was assisted by Shri R Murugesan, Dr Nalini Devi, Dr. Zeena Sanjay, Shri E Jayasettiaseelon and Smt. Lalitha Shanmugam. The Asana sessions were conducted by Dr Ananda Balayogi Bhavanani who was assited by Smt. Devasena Bhavanani, Smt. Meena Ramanathan and Shri G Dayanidy. On the first day a panel discussion on the Role of Yoga in prevention of hypertension was chaired by Dr. AK Das in his inimitable manner while Dr GK Pal was the moderator. The panellists were Dr. RS Bhogal, Dr. G Himashree, Dr. N Chandrasekaran, Dr Nalini Devi and Dr. Ananda Balayogi Bhavanani. On the second day a panel discussion was held on the Role of yoga in management of hypertension. The discussion was chaired in an amiable manner by Dr. TK Datta and moderated by Dr. Vivek Sharma. The panelists were Dr. G Himashree, Dr. Geetha Shankar, Dr. Nalini Devi and Dr. Ananda Balayogi Bhavanani.
Bulletin of ACYTER, April 2010

The delegates were treated to a spectacular cultural programme on the evening of the first day with a fusion of Yoga, Bharatanatyam and Music that was presented by Yoganjali Natyalayam, premier institute of Pondicherry. The cultural programme was directed by Yogacharini Meenakshi Devi Bhavanani, Director of the institute. The workshop ended with the valedictory function that witrnessed excellent feedback and appreciation from all faculty and participants. The efforts of Dr Madanmoahn, the organising chariman were appreciated deeply and all complimented MDNIY and JIPMER for their efforts towards integrating Yoga and modern medicine. The workshop declaration was adopted un-ianimously and the programme concuded with a vote of thanks by Dr G K Pal, the Organising Secreatary of the workshop.

DECLARATION OF THE WORKSHOP National Workshop-cum-Seminar on Role of Yoga in Prevention & Management of Hypertension, attended by 133 delegates, medical professionals, yoga experts and discernible persons from the local town of Pondicherry has been a grand success. The medical, psychological and metaphysical perspectives of prevention and management of hypertension were deliberated at length and futuristic ideas and plans have been put forth. We, the organizers, delegates and all the participants urge the State Government, Central Government, Medical Council of India & Department of AYUSH to evolve a concrete policy for promotion of yoga as an adjunct to modern medicine so that a mass movement for yoga awareness with a sound scientific footing can be initiated. We jointly propose the following: 1. There is an alarming rise in the incidence of hypertension, even among the younger age groups. There is an urgent need to evolve a strategy to reduce the incidence, morbidity and mortality of the disease. Also, the comorbidity of hypertension namely obesity, impaired glucose tolerance and dyslipidemia need to be contained. All this can be achieved by including the holistic science of yoga practice as an adjunct to conventional treatment modalities. Yoga practice should be included in the school curriculum for reducing the incidence of childhood obesity, diabetes mellitus and hypertension. 2. For effective implementation of the above action plan, and to make yoga therapy readily available to the public, there is a need to have sufficient number of qualified yoga therapists and instructors. This capacity building should be done by designated institutes. 3. There is a need for designing specific yoga modules for prevention and management of hypertension and other lifestyle disorders.
Bulletin of ACYTER, April 2010

SEMINAR-CUM-WORKSHOP ON YOGA & COMPLEMENTARY THERAPIES FOR AIDS/HIV ACYTER organized a seminar-cumworkshop on Yoga and Complementary Therapies for AIDS/HIV on 30 January 2010. More than 100 delegates participated in the sessions held from 9 am to 5 pm at the JIPMER Nursing College. The seminar-cum-workshop aimed to introduce medical and paramedical professionals and yoga therapists to the potentialities of yoga and other complementary and alternative therapies in the prevention and management of HIV/AIDS. Dr KSVK Subba Rao, Director JIPMER inaugurated the workshop in the presence of Dr Subbarayalu Naidu, Project Director, Pondicherry AIDS Control Society. Yogacharini Meenakshi Devi Bhavanani, Director ICYER and Dr N Ardhanari, Eminent Social Activist offered felicitations. The workshop was conducted by 12 resource persons from various medical and Yoga organisations of Pondicherry under the direction of Dr Madanmohan, Professor and Head, Department of Physiology and Programme Director ACYTER. Dr Subbarayalu Naidu gave a talk on HIV infection & AIDS and Dr Madanmohan spoke on Role of Yoga in HIV/AIDS. Practical sessions were conducted by Dr Ananda Balayogi Bhavanani and Shri E Jayasettiaseelon assisted by Smt. Meena Ramanathan, Shri G Dayanidy and Selvi L Vithiyalakshmi. A panel discussion on Yoga and CAM therapies for AIDS was chaired by Dr Madanmohan and moderated by Dr Ananda Balayogi Bhavanani. Panelists included Dr Prakash Rao (homeopathy), Yogacharini Dr Nalini Devi (modern medicine and Yoga), Dr Rajalakshmi (siddha), Smt. Meena Ramanathan (yoga) and Dr Zeena Sanjay (naturopathy). ROLE OF YOGA AND COMPLEMENTARY THERAPIES FOR AIDS/HIV: AN OVERVIEW No other word engenders as much fear, revulsion, despair and helplessness as AIDS. It is in fact rewriting medical history as humankind`s deadliest scourge. With 40 million deaths forecast in this millennium, statistics tell their own sordid tale. The first cases of AIDS were reported in the United States in 1981 and within two decades, about 50 million have been infected globally with 22 million deaths. Worryingly, many people think there is a 'cure' for AIDS, which makes them feel safer and perhaps take risks that they otherwise

Bulletin of ACYTER, April 2010

wouldnt. However, there is still no cure for AIDS. The only way to stay safe is to be aware of how HIV is transmitted and how to prevent HIV infection. Antiretroviral treatment can prolong the time between HIV infection and the onset of AIDS. Modern combination therapy is highly effective and someone with HIV who is taking treatment could live for the rest of their life without developing AIDS. Alternative medicine has been variously called natural, complementary, `holistic` and by other terms, which refer to elements of a particular modality or tradition. The traditional ethno-medicinal systems are by nature holistic, meaning that they aim to treat the whole individual, rather than a specific disease / symptom. Each individual possesses an innate healing capacity (the "immune system" in the broadest sense), and the goal is to reinforce this capacity and restore strength and balance to the weakened systems using a variety of natural modalities like body work, detoxification, foods, herbs and other botanicals, tailored to the individual`s specific constitution and condition. The use of alternative therapies for AIDS grew out of this same eclectic mix. The key to effective treatment is early detection and intervention. Treatment aims to strengthen the immune system, help patients reduce stress and maintain good nutritional practices and appropriate exercise regimens. Alternative therapies place significant emphasis on these lifestyle issues. Taking an active role is an important adjunct to treatment. Consideration of alternative therapies in conjunction with conventional medicine may offer additional opportunities for persons living with HIV/AIDS to be proactively involved in their treatment. The emerging field of psychoneuroimmunology examines the interaction between physiological functioning and memory, behaviour and thoughts. Psychoneuroimmunology stresses the connection between mind and body. Therefore, working on the body will affect the mind as well. By obtaining insight into one's hardiness level, community, and belief or value system, the possibility for experiencing better health is offered. New research reveals that stress enables HIV to spread more quickly in infected persons and prevents antiretroviral drugs from restoring immune system function. The higher a persons stress levels, the less they responded to the antiretroviral drugs. Yoga is quickly gaining ground as an important complementary therapy in the treatment of HIV and AIDS
Bulletin of ACYTER, April 2010

because of its adaptability and its physiological and psychological benefits. Meditation can calm the mind and promote healing. The patients gain a sense of well-being and control over their bodies that carries over into their daily lives. Yoga postures promote strength, flexibility, endurance and improve circulation. Recent studies in the USA have shown that mindfulness meditation, defined as practicing an open and receptive awareness of the present moment, avoiding thinking of the past or worrying about the future can have a direct impact on slowing HIV disease progression by modulating the cell mediated immunity. NATIONAL YOGA WEEK 2010 AT MDNIY, NEW DELHI Dr Madanmohan, Programme director and Dr Ananda Balayogi Bhavanani, programme co-ordinator were invited speakers for the National Yoga Week 2010 organized by MDNIY at New Delhi from February 12 to 18. Dr Madanmohan gave an invited talk and chaired a session on Yoga for Cardiovascular Health and Dr Ananda conducted a workshop on Yoga for Technostress in collaboration with staff of MDNIY. Shri E Jayasettiaseelon, Shri G Dayanidy and Shri B Gopal, PAO, JIPMER participated in the conference, seminar and workshop organized during the week long programme.

During the Yoga Week, all advanced centers had put up poster presentations on their activities. ACYTER put up a poster presentation highlighting activities that have been organized and conducted at JIPMER in the past year as well as the research contributions through various studies done in the past three decades by Dr Madanmohan, Professor and Head, Department of Physiology and Programme Director, ACYTER.

Bulletin of ACYTER, April 2010

TALK ON MOTHER-CHILD HEALTH Dr Ananda Balayogi Bhavanani, programme co-ordinator presented an invited talk on Yoga: A boon for Maternal and Child Health at Mother Teresa Institute of Health Science as part of the State Level Campaign for mother and child health organized by the Directorate of Indian Systems of Medicine and Homeopathy, Government of Pondicherry on 23 February 2010. All the participants and eminent experts of modern medicine and alternative medicine who were present on the occasion appreciated the presentation that highlighted the importance of yoga in both antenatal and postnatal care. YOGA CLASSES FOR NURSING STUDENTS A lecture on yoga, meditation and spiritual healing was conducted for final year students of BSc Nursing on 1 February while lectures and yoga practice sessions highlighting benefits of yoga for antenatal and postnatal health were conducted on 23 and 24 February at the JIPMER Nursing College. The classes were conducted by Selvi Vithiyalakshmi, yoga instructor while Dr Ananda Balayogi Bhavanani, programme co-ordinator gave a theory session highlighting important yoga practices for both antenatal and postnatal care. Shri E Jayasettiaseelon, SRF gave a theory session on yoga, meditation and spiritual healing. More than 50 nursing students enthusiastically participated in the classes and expressed the physical and mental benefits they felt after the yoga practice sessions. The authorities of the nursing college have been giving excellent support for all activities related to yoga and staff members of ACYTER have been conducting lectures and awareness programmes for the nursing staff from all over Tamil Nadu who are attending the Nursing Workshops on AIDS/HIV.

Bulletin of ACYTER, April 2010

YOGA FOR DOCTORS AT KAIVALYADHAMA AND WARDHA Dr Ananda Balayogi Bhavanani, programme co-ordinator presented invited talks on Bridging yoga and modern medicine and Yoga research-where are we? during the Seminar on Yoga for Doctors organized and conducted at Kaivalyadhama, Lonavla, Maharashtra on 26 and 27 February 2010. Dr Ananda was also invited to conduct an intensive workshop on Yoga for Doctors on 30 March, 2010 at Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, Maharashtra. More than 60 participants from the constituent medical, dental, Ayurveda, physiotherapy and nursing colleges enthusiastically participated in the workshop. The workshop was part of the one month long (48 hr) yoga training for medical professionals organized by the Department of Physiology, JNMC in collaboration with MDNIY, New Delhi. YOGA THERAPY OPD AT SUPER SPECIALTY BLOCK ACYTERs Yoga therapy OPD is functioning on a regular basis in Super Specialty Block. During January to March, 1011 patients (new 189 and old 822 cases) of various conditions attended consultation in the OPD with Dr Ananda Balayogi Bhavanani and Dr Zeena Sanjay. Patients who attended consultation were prescribed individualized and generalized yoga therapy for diabetes mellitus, hypertension, musculoskeletal disorders, respiratory disorders, stress and psychological disorders, endocrine disorders, coronary artery disease, GIT, neurology, and other complaints. Patients have reported benefits and expressed their thanks to ACYTER, JIPMER and MDNIY for this facility. YOGA THERAPY SESSIONS Yoga therapy sessions are being conducted on Mondays, Wednesdays and Fridays from 10 11 AM for patients of diabetes, 11 Am 12 noon for patients of cardiovascular diseases and 12 noon 1 PM for patients of other disorders. The yoga instructors, Shri G Dayanidy and Selvi L Vithiyalakshmi are conducting the sessions both individually and in groups as per directions of the therapists given in the OPD. Patients have reported satisfaction with the therapy sessions and are attending regularly. 271 patients of diabetes, 135 of hypertension and 362 of other conditions attended the sessions between January and March 2010. REGULAR ACTIVITES OF ACYTER Regular yoga classes are being conducted on Mondays, Wednesdays and Fridays in both mornings and evenings. 171 participants attended the classes in the last quarter. Suryanamaskar, basic asanas, pranayamas and relaxation techniques are being taught in the general classes. Senior Citizens Clinic is being conducted every Thursday and 90 participants attended classes with Mrs. Meena Ramanathan, coordinator yoga courses, PUCC.

From
Advanced Centre for Yoga Therapy, Education and research (ACYTER) Department of Physiology, JIPMER, Puducherry 605 006

To

Bulletin of ACYTER, April 2010

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ADVANCED CENTRE FOR YOGA THERAPY, EDUCATION & RESEARCH (ACYTER) Bulletin of ACYTER- July 2010

(A collaborative venture between JIPMER, Puducherry & MDNIY, New Delhi)

Patrons: Dr. KSVK Subba Rao Director, JIPMER Dr. I V Basavaraddi Director, MDNIY, New Delhi Dr. Ashok Kumar Das Med. Superintendent, JIPMER. Dr. S Badrinath Project Co-ordinator, JIPMER Dr. KS Reddy Dean, JIPMER Editor: Dr. Madanmohan Professor & Head, Dept. of Physiology, JIPMER & Programme Director, ACYTER Editorial board: Dr. GK Pal Addl. Prof. of Physiology, JIPMER Dr. Ananda Balayogi Bhavanani Programme Co-ordinator, ACYTER, JIPMER

REPORT ON FOUNDATION COURSE IN YOGA The 48 hour Foundation course in yoga for medical professionals was conducted from 2 June to 17 July 2010. 15 medical and paramedical professionals from JIPMER and the Government Dental College registered for the course that was conducted at the ACYTER yoga hall. Lectures were conducted in the evening sessions by Dr Madanmohan, Programme Director, Dr Ananda Balayogi Bhavanani, Programme Co-ordinator, Shri

Jayasettiaseelon, SRF and Dr Zeena Sanjay, SRF. A guest lecture was given by Mrs. Meena Ramanathan, Co-ordinator Yoga Courses, PUCC. Practice sessions were conducted in the mornings and evenings by Shri G Dayanidy and Selvi Vithiyalakshmi, Yoga Instructors ACYTER. Different topics were allotted to the participants for self study and they presented seminars on yoga therapy during the course. Valedictory function was held on 17 July 2010 and certificates issued to the participants based on attendance, assignments and seminar presentation. Those who had not completed the 48 hours were given the option of completing remaining hours in regular sessions for certification.

Correspondence to: The Editor, Bulletin of ACYTER, JIPMER, Puducherry- 605 006, India E-mail: acyter.jipmer@gmail.com

Published by the Advanced Centre for Yoga Therapy, Education & Research (ACYTER), JIPMER, Puducherry, India 605 006

Bulletin of ACYTER, July 2010

PHOTO REPORT ON FOUNDATION COURSE IN YOGA

Bulletin of ACYTER, July 2010

MONITORING COMMITTEE MEETING Meeting of the monitoring committee of ACYTER was held in the office of the director, JIPMER on 22 July 2010 at 5 PM. The meeting was chaired by Dr. KSVK Subba Rao, Director, JIPMER and attended by : Dr. AK Das, Medical Superintendent, JIPMER Member Dr. J Balachander, Professor & Head, Department of Cardiology, JIPMER- Member Dr. Satish RR Gaikwad, Research Officer (Scientific) & Incharge of Scientific Research Wing, MDNIY Member Dr. Ananda Balayogi Bhavanani, Programme Co-ordinator ACYTER, JIPMER Member Dr. Madanmohan - Professor & Head, Department of Physiology & Programme Director ACYTER - Member-Secretary

The meeting started with an introduction by the member secretary. The chairman suggested that minutes of the previous monitoring committee meetings be circulated to all members. The annual report of work done was discussed and it was suggested that a chronological pattern be followed and a new report be circulated to all members. It was decided to hold the national workshop on yoga and diabetes mellitus in February 2011 taking into consideration numerous conferences being held in March. The date is to be finalized in consultation and entered in the register maintained for the purpose by the Deans office. Audited accounts for the years 2008-09 and 2009-10 were discussed and approved. It was suggested by the chairman to have a single sheet statement of accounts maintained from the inception of ACYTER. Proposed budget for the year 2010-11 was discussed and approved. Research activities at ACYTER were discussed. The member secretary explained the present situation with regards to the two major proposals and the 7 pilot studies that have been completed till date. Dr Satish Gaikward, Scientific officer, MDNIY, put forth the view of the director MDNIY regarding importance of research activities at ACYTER. He also gave an overview of the activities at the other Advanced Centres in NIMHANS, DIPAS and Gujarat Ayurved University. Lack of adequate space for yoga practice sessions at ACYTER was discussed and the programme director was advised to write officially to get permission sanctioned for the use of Banting hall. The meeting ended with a vote of thanks by the member secretary. After the meeting, Dr Satish Gaikward, Research Officer (Scientific) & Incharge of Scientific Research Wing, MDNIY inspected the facilities and work done at ACYTER.
Bulletin of ACYTER, July 2010

REPORT ON PILOT STUDIES AT ACYTER


Various pilot studies have been done by ACYTER staff under the direction of Dr Madanmohan, Programme Director ACYTER. The following studies have been conducted by Shri Jayasettiaseelon SRF, Dr Zeena Sanjay SRF, Shri G Dayanidy, Yoga Instructor and Selvi Vithiyalakshmi Yoga Instructor and coordinated by Dr Ananda Balayogi Bhavanani, Programme Co-ordinator. 1. IMMEDIATE EFFECT OF SUKHA PRANAYAMA ON HEART RATE AND BLOOD PRESSURE OF PATIENTS WITH HYPERTENSION Introduction: Hypertension is one of the most common health disorders and yoga has been shown to be an effective adjunct therapy in its management. Earlier two studies from our laboratories have demonstrated heart rate (HR) and blood pressure (BP) lowering effects of slow, deep breathing after 3 weeks and 3 months of training. Beneficial effects of deep breathing in reducing premature ventricular complexes have also been reported by us. With this background, the present study was undertaken to determine the immediate effects of sukha pranayama on cardiovascular parameters in hypertensive patients. Methods: 23 hypertensive patients attending the Yoga OPD at JIPMER were instructed to perform sukha pranayama for five minutes at the rate of 6 breaths / minute. Sukha pranayama is a slow and deep pattern of breathing where inhalation and exhalation are of equal duration. HR and BP were recorded before and immediately after the intervention. Rate-pressure product (RPP) and double product (Do P) were derived by formulae. Results: Sukha pranayama produced a significant (p<0.05) reduction in HR from 79.5 3.09 to 78 3.24 beats/min and a highly significant (p< 0.001) reduction in systolic pressure from 132.5 5.45 to 123 3.83 mmHg. Pulse pressure decreased from 61.5 3.39 to 52.5 2.21 mm Hg, mean arterial pressure from 91.5 3.19 to 88 2.35 mm Hg, RPP from 107.28 8.43 to 97.37 6.97 units and Do P from 73.88 53.72 to 69.52 46.94 units, all these changes being statistically significant (P<0.001). Discussion and conclusion: It is concluded that sukha pranayama breathing at the rate of 6 breaths / minute can reduce HR and BP in hypertensive patients within five minutes of the practice. This may be due to normalization of autonomic cardiovascular rhythms as a result of increased vagal modulation and /or decreased sympathetic activity. Further studies are required to understand the possible mechanisms underlying this beneficial effect in hypertensive patients. 2. IMMEDIATE CARDIOVASCULAR EFFECTS OF KAYA KRIYA IN NORMAL HEALTHY VOLUNTEERS Introduction: Kaya kriya is a dynamic hatha yoga relaxation practice. It may have psycho-somatic harmonizing potential as it combines movement of different parts of the body with deep breathing in the supine position. The present study was undertaken to determine immediate effects of kaya kriya on cardiovascular parameters in normal subjects. Methods: 12 normal subjects were instructed to perform kaya kriya for 10 minutes. Heart rate (HR) and blood pressure (BP) were measured with non-invasive semi-automatic BP monitor before and immediately after the practice. Rate-pressure product (RPP) and double product (Do P) were derived by formulae. Results: There was significant (p< 0.01) reduction in systolic pressure from 112.252.91 to 108.832.69 mmHg, diastolic pressure from 71.25 1.72 to 68.17 1.29 mmHg and
Bulletin of ACYTER, July 2010

mean pressure from 84.921.93 to 81.721.57 mmHg and an appreciable fall in HR from 72.33 3.62 to 69.67 3.29 beats/min. RPP decreased from 81.29 4.97 to 75.84 4.17 units and Do P from 61.55 3.80 to 56.95 2.97 units (p=0.06). Discussion and conclusion: It is concluded that 10 minutes of kaya kriya relaxation produces a significant reduction in BP. This may be due to a normalization of autonomic cardiovascular rhythms as a result of increased vagal modulation, and /or decreased sympathetic activity. Further studies with more subjects with control group and in different health conditions are required to understand the possible mechanisms underlying this beneficial effect. 3. IMMEDIATE EFFECT OF SHAVASANA AND SAVITRI PRANAYAMA ON HEART RATE AND BLOOD PRESSURE OF HYPERTENSIVE PATIENTS Introduction: Yoga has been shown to be an effective adjunct therapy in the management of hypertension. Earlier studies from our laboratories have shown beneficial effects of savitri pranayama in normal subjects. Savitri pranayama involves slow and deep breathing in the ratio 2:1:2:1 and has been studied in combination with other practices in hypertensive patients. The present study was undertaken to determine immediate effects of savitri pranayama and shavasana on cardiovascular parameters in hypertensive patients. Methods: 6 hypertensive patients attending Yoga therapy sessions at ACYTER were recruited for this study. They were instructed to lie down in shavasana and perform savitri pranayam for 10 minutes. Heart rate (HR) and blood pressure (BP) were recorded before and immediately after the intervention. Rate-pressure product (RPP) and double product (Do P) were derived by formulae. Results: Statistical analysis revealed a highly significant (p < 0.001) reduction in mean pressure from 90.33 1.77 to 85.11 1.67 mmHg and Do P from 73.91 6.23 to 65.35 5.69 units. There was a significant (p < 0.01) reduction in HR from 81.50 5.84 to 76.50 5.78 beats/min, systolic pressure from 125.67 4.42 to 117 3.89 mmHg and RPP from 102.24 7.58 to 89.20 6.46 units. Diastolic pressure decreased from 72.67 2.74 to 69.17 2.74 mmHg, the decrease being statistically significant (p < 0.05). Discussion and conclusion: It is concluded that 10 minutes of shavasana with savitri pranayama reduces HR and BP implying normalization of the cardiovascular autonomic regulatory mechanisms with increased vagal modulation and / or decreased sympathetic activity. Reduction in RPP and Do P signifies reduction in oxygen consumption and work done by the heart. Further studies with more subjects and control groups are required to understand possible mechanisms underlying this immediate and beneficial effect in hypertensive patients. 4. IMMEDIATE EFFECT OF CHANDRA NADI PRANAYAMA ON HEART RATE AND BLOOD PRESSURE OF HYPERTENSIVE PATIENTS Introduction: Yoga therapists routinely use chandra nadi pranayama to help reduce blood pressure (BP) in hypertensive patients. This is attributed to its stress lowering effects that have been documented by previous studies. Though there are some studies on the long term effect of chandra nadi pranayama, there are no studies on its immediate effect on cardiovascular parameters in hypertensive patients. Methods: 26 hypertensive patients attending yoga OPD at JIPMER were recruited for the study. They were taught chandra nadi pranayama and instructed to perform the same for five minutes in sitting position. Heart rate (HR) and BP were recorded with non-invasive automatic BP apparatus before and immediately after the practice of chandra nadi
Bulletin of ACYTER, July 2010

pranayama. Rate-pressure product (RPP) and double product (Do P) were derived by formulae. Results: There was a significant (p < 0.001) reduction in HR from 75.5 2.78 to 70 2.72 beats/min, RPP from 106.15 4.53 to 96.06 4.24 units and Do P from 76.36 33.90 to 72.66 33.36 units. A significant reduction (p < 0.01) occurred in systolic pressure (SP) from 140 3.26 to 137 3.12 mmHg and pulse pressure from 58.5 2.78 to 50 2.39 mmHg. There was a statistically insignificant rise in mean arterial pressure (MAP) from 101 1.97 to 103.67 2.01 mmHg and diastolic pressure (DP) from 81.5 1.76 to 87 1.76 mm Hg Discussion and conclusion: Chandra nadi pranayama produced a significant decrease in HR and SP signifying a normalization of cardiovascular reflex mechanisms within 5 minutes. It also produced a significant fall in RPP and Do P signifying a reduction in oxygen consumption and work done by the heart. However the rise in DP and MAP is difficult to explain. Further studies with more subjects and control groups are required to understand the possible mechanisms underlying this immediate effect of chandra nadi pranayama in hypertensive patients. 5. IMMEDIATE CARDIOVASCULAR EFFECTS OF SHAVASANA AND PRANAVA PRANAYAMA ON HEART RATE AND BLOOD PRESSURE OF HYPERTENSIVE PATIENTS Introduction: The use of sound vibrations as part of relaxation in shavasana is taught in some yoga schools. The present study was planned to determine the cardiovascular effects of performing shavasana with pranava pranayama involving making akara, ukara, makara and omkara nada. Methods: 19 hypertensive patients attending yoga therapy sessions at ACYTER were taught shavasana with pranava pranayama and instructed to perform the same for 15 minutes. Heart rate (HR) and blood pressure (BP) were measured with non-invasive semiautomatic BP monitor before and immediately after. Rate-pressure product (RPP) and double product (Do P) were derived by formulae. Results: There was a highly significant (p < 0.001) reduction in systolic pressure from 135.94 3.51 to 126.21 2.88 mmHg, pulse pressure from 57.26 3.02 to 50.15 2.35 mmHg, RPP from 106.45 5.36 to 97.35 4.91 units and Do P from 121.41 63.17 to 110.21 56.35 units. Diastolic pressure reduced significantly (p< 0.01) from 78.68 1.74 to 76.05 1.59 mmHg. There was statistically insignificant reduction in HR from 78.05 2.91 to 76.78 2.89. Discussion and conclusion: It is concluded that 15 minutes of shavasana with pranava pranayama can reduce BP in hypertensives. This may be due to a normalization of autonomic cardiovascular rhythms as a result of increased vagal modulation, and /or decreased sympathetic activity. It also produced a significant fall in RPP and Do P signifying a reduction in oxygen consumption and work done by the heart. Further studies are required to understand the possible mechanisms underlying this beneficial effect in hypertensive patients. 6. IMMEDIATE EFFECTS OF YOGA NIDRA ON HEART RATE AND BLOOD PRESSURE Introduction: Yoga nidra is one of the special relaxation techniques of yoga. Previous studies have shown beneficial effects after different periods of training. The present study

Bulletin of ACYTER, July 2010

was undertaken to study the immediate cardiovascular effects of yoga nidra on 20 normal subjects. Methods: 20 healthy volunteers attended 20 minutes of yoga nidra sessions during a one month period. They were instructed to mentally observe the body part by part in association with breath. Heart rate (HR) and blood pressure (BP) were measured before and after a single session. Pulse pressure (PP), mean arterial pressure (MAP), rate-pressure product (RPP) and double product (Do P) were calculated by formulae. Results: Statistical analysis showed significant (p < 0.05) reduction in HR from 79.3 2.45 to 75.2 1.84 beats/min, RPP from 88.21 3.33 to 81.89 2.38 units and Do P from 66.84 2.60 to 62.52 1.89 units immediately after the yoga nidra session. There was insignificant reduction in SP from 111.2 2.21 to 109 2.05 mmHg, PP from 40.6 1.42 to 38.9 1.50 mmHg, DP from 70.6 1.36 to 70 1.25 mmHg and MAP from 84.08 1.55 to 83.15 1.40 mmHg. Discussion and conclusion: It is concluded that 20 minutes of yoga nidra practice can reduce HR, RPP and Do P in normal subjects. This may be due to a normalization of autonomic cardiovascular rhythms as a result of increased vagal modulation, and /or decreased sympathetic activity. The reduction in RPP and Do P signifies reduction in oxygen consumption and work done by the heart. Further studies are required to understand possible mechanisms underlying this beneficial effect of yoga nidra. SYNERGIES IN HEALING: INTERNATIONAL CONFERENCE ORGANIZED BY KRISHNAMACHARYA YOGA MANDIRAM AT CHENNAI Dr Ananda Balayogi Bhavanani, Programme Co-ordinator ACYTER presented a talk on Rheumatological and immunological aspects of aging and importance of an integrated approach of yoga in senior citizens during SYNERGIES IN HEALING organized by Krishnamacharya Yoga Mandiram at GRT Convention Centre, Chennai on 18 July 2010. This international conference aimed at an integrative approach of yoga and modern medicine and was attended by more than 300 delegates from all over the country and abroad. The eminent cardiologist Dr. S Thanikachalam from Sri Ramachandra Medical College was chief guest. Keynote was presented by Dr Ishwar V Basavaraddi, Director MDNIY and chaired by Yogashri TKV Desikachar, founder of KYM. The inauguration was followed by invited talks by Dr. Arjun Rajagopal, Dr. Kausthub Desikachar, Dr. Prithika Chari, Dr. Uma Krishnaswami, Dr. Latha Satish, Dr. Michael Steinbrecher, Dr. AV Balasubramaniam, Dr. VD Swaminathan, and Mr. S Sridharan. The event received wide publicity in the local press and all delegates expressed their desire that such integrative conferences must be held more often.

Bulletin of ACYTER, July 2010

YOGA CLASSES FOR NURSING STUDENTS A lecture-cum-practice session on yoga, meditation and spiritual healing was conducted by Shri E Jayasettiaseelon, SRF for 90 students of BSc Nursing (final year) on 30 July. The students participated enthusiastically in the session and expressed the physical and mental benefits they felt after the session. He also gave talks on Yoga and Complementary Medicine on 2 and 23 July at the JIPMER Nursing College for the GFATM Nursing Workshop on AIDS / HIV while Dr Ananda Balayogi Bhavanani gave the talk for the participants on 9 July. The authorities of the nursing college have been giving excellent support for all activities related to yoga. YOGA THERAPY OPD AT SUPER SPECIALTY BLOCK Yoga therapy OPD of ACYTER is functioning on a regular basis in Super Specialty Block. During April to June, 967 patients (new 193 and old 774 cases) of various conditions attended consultation in the OPD with Dr Ananda Balayogi Bhavanani and Dr Zeena Sanjay. Patients who attended consultation were prescribed individualized and generalized yoga therapy for diabetes mellitus, hypertension, musculoskeletal disorders, respiratory disorders, stress and psychological disorders, endocrine disorders, coronary artery disease, GIT, neurology, and other complaints. Patients have reported benefits and expressed their thanks to ACYTER, JIPMER and MDNIY for this facility. YOGA THERAPY SESSIONS Yoga therapy sessions are being conducted on Mondays, Wednesdays and Fridays from 10 11 AM for patients of diabetes, 11 AM 12 noon for patients of cardiovascular diseases and 12 noon 1 PM for patients of other disorders. The yoga instructors, Shri G Dayanidy and Selvi L Vithiyalakshmi are conducting the sessions both individually and in groups as per directions of the therapists given in the OPD. Patients have reported satisfaction with the therapy sessions and are attending regularly. 194 patients of diabetes, 129 of hypertension and 436 of other conditions attended the sessions between April and June 2010. REGULAR ACTIVITES OF ACYTER Regular yoga classes are being conducted on Mondays, Wednesdays and Fridays in both mornings and evenings. 157 participants attended the classes in the last quarter. Suryanamaskar, basic asanas, pranayamas and relaxation techniques are being taught in the general classes. Senior Citizens Clinic is being conducted every Thursday and 65 participants attended classes with Mrs. Meena Ramanathan, coordinator yoga courses, Pondicherry University Community College.

From
Advanced Centre for Yoga Therapy, Education and research (ACYTER) Department of Physiology, JIPMER, Puducherry 605 006

To

Bulletin of ACYTER, July 2010

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ADVANCED CENTRE FOR YOGA THERAPY, EDUCATION & RESEARCH (ACYTER) Bulletin of ACYTER - October 2010

(A collaborative venture between JIPMER, Puducherry & MDNIY, New Delhi)

Patrons: Dr. KSVK Subba Rao Director, JIPMER Dr. I V Basavaraddi Director, MDNIY, New Delhi Dr. Ashok Kumar Das Med. Superintendent, JIPMER Dr. S Badrinath Project Co-ordinator, JIPMER Dr. KS Reddy Dean, JIPMER Editor: Dr. Madanmohan Professor & Head, Dept. of Physiology, JIPMER & Programme Director, ACYTER Editorial board: Dr. GK Pal Professor, Dept. of Physiology, JIPMER Dr. Ananda Balayogi Bhavanani Programme Co-ordinator, ACYTER, JIPMER

ARE WE PRACTICING YOGA THERAPY OR YOGOPATHY?


Modern Yoga therapy seems to have lost touch with the real essence of Yoga. The art and science of Yoga aims to help us regain our psycho-physiological balance by removing the root cause of the disharmony (duhkha samyoga viyogam yoga samjnitam. Bhagavadgita VI: 23). Yoga understands health and well being as a dynamic continuum of human nature and not a mere state to be attained and maintained. The lowest point on the continuum with the lowest speed of vibration is that of death whereas the highest point with the highest vibration is that of immortality. In between these two extremes lie the states of normal health and disease. For many, their state of health is defined as that state in which they are able to function without hindrance whereas in reality, health is part of our evolutionary process towards Divinity. Yoga aims at enabling the individual to attain and maintain a dynamic sukha sthanam that may be defined as a dynamic sense of physical, mental and spiritual well being. The Bhagavadgita defines Yoga as samatvam meaning thereby that Yoga is equanimity at all levels. (yogasthah kuru karmani sangam tyaktva dhananjaya siddhiasiddhyoh samo bhutva samatvam yoga uchyate. Bhagavadgita ii: 48) this may be also be understood as a perfect state of health wherein physical homeostasis and mental equanimity occur in a balanced and healthy harmony. Tiruvalluvar the great Dravidian mystic says in his 1330 versed Tirukkural, a treatise on right living, Look for the disease, look for the primary cause of it and then treat it (noinaadi noimudhal naadi athuthanikkum vaai naadi vaippach cheyal.Tirukkural 948). Most modern doctors and even Yoga therapists seem to have lost their way in the maze and are content managing the manifest symptoms without understanding the real cause. Maharishi Patanjali has explained the primary causation of stress based disorders through the concept of pancha klesha (psychological afflictions). These are avidya (ignorance of the ultimate reality), asmita (a false sense of identification), ragadwesha (addiction and aversion) and abhinivesha (clinging on to life for fear of death) (avidya asmita raga dwesha abhinivesha kleshah. Yoga Darshan II: 3).

Correspondence to: The Editor, Bulletin of ACYTER, JIPMER, Puducherry- 605 006, India E-mail: acyter.jipmer@gmail.com

Published by the Advanced Centre for Yoga Therapy, Education & Research (ACYTER), JIPMER, Puducherry, India 605 006

Bulletin of ACYTER, Oct 2010

Avidya as the root cause enables other kleshas to manifest in different forms from time to time. They may be dormant, attenuated, manifest or overpowering in their causation of pain and suffering (avidya kshetram uttaresham prasupta tanu vicchinna udaranam. Yoga Darshan II: 4). Dwaitam or the misplaced sense of duality due to avidya, the mother klesha is the main initial cause of the imbalance at the higher level that may then manifest into the lower through psycho-somatic stress mechanisms. This occurs through the various Koshas (aspects of the human existence) as various disorders depending upon the propensity due to sanchita karma of the individual. Yoga Vasishtha, one of the great classical Yoga texts describes the causation and manifestation of disease (vyadhi) in an admirable manner. I often joke with my students that this text is the first recorded counseling session in human history- Bhagavadgita being the second! In the dialogue between the great sage Vasishtha and Prince Rama, it describes both psychosomatic (adhija vyadhi) as well as non-psychosomatic ailments (anadhija vyadhi). Samanya adhija vyadhi are described as those arising from day-to-day causes while sara adhija vyadhi is the essential disease of being caught in the birth rebirth cycle that may be also understood in modern terms as congenital diseases (caused due to sanchita karma). The former can be corrected by day-to-day remedial measures such as medicines and surgery whereas the sara adhija vyadhi doesnt cease until knowledge of the self (atma jnana) is attained. Guru Stotra from the Vishvasaratantra also takes a similar line in saying that the ultimate wisdom of the self gained through the Guru destroys karmic bondages from many births (Anekajanma samprapta karma bandha vidhahine atmajnana pradanena tasmai srigurave namah.Guru Stotra, verse 9). It is interesting to note that traditional Indian thought views the very occurrence of birth on this planet as a disease and a source of suffering! Tiruvalluvar reiterates this when he says, It is knowledge of the ultimate truth that removes the folly of birth (pirappu ennum pedaimai neenga chirappu ennum chem porul kaanbadhu arivu- Tirukkural 358) From the Yogic viewpoint of disease it can be seen that psychosomatic, stress related disorders appear to progress through four distinct phases. These can be described as follows: 1. Psychic Phase: This phase is marked by mild but persistent psychological and behavioural symptoms of stress like irritability, disturbed sleep and other minor symptoms. This phase can be correlated with vijnanamaya and manomaya koshas. Yoga as a therapy is very effective in this phase. 2. Psychosomatic Phase: If the stress continues there is an increase in symptoms, along with the appearance of generalized physiological symptoms such as occasional hypertension and tremors. This phase can be correlated with manomaya and pranamaya koshas. Yoga as a therapy is very effective in this phase 3. Somatic Phase: This phase is marked by disturbed function of organs, particularly the target, or involved organ. At this stage one begins to identify the diseased state. This phase can be correlated with pranamaya and annamaya koshas. Yoga as a therapy is less effective in this phase and may need to be used in conjunction with other methods of treatment. 4. Organic Phase: This phase is marked by full manifestation of the diseased state, with pathological changes such as an ulcerated stomach or chronic hypertension, becoming manifest in their totality with their resultant complications. This phase
Bulletin of ACYTER, Oct 2010

can be correlated with the annamaya kosha as the disease has become fixed in the physical body. Yoga as a therapy has a palliative and quality of life improving effect in this phase. It does also produce positive emotional and psychological effects even in terminal and end of life situations. As Yoga therapists, unless we aim to correct the manifest psycho-somatic disassociation as well as the underlying ignorant, jaundiced perception of reality in the individual, we are not practicing Yoga Chikitsa (Yoga as a therapy). Managing and suppressing the manifest symptoms with Yoga techniques is just as good or bad as modern Allopathic medicine that focuses primarily on symptomatic management without ever getting close to the real cause of most disorders. How many doctors look at the emotional and psychological issues that are the primary cause of the problem in so many of their patients? Remember, the concept of psychosomatics is not older than a hundred years in modern medicine. A hundred years ago any doctor talking about mind affecting bodily disease risked getting labeled a quack for sure! When today we find our Yoga therapists making the same mistake in merely treating manifesting symptoms without remedying the real cause, it can only be termed as YOGOPATHY! An example of this Yogopathy trend is when we use Shavasana to manage patients of hypertension quoting research that has shown that Shavasana reduces blood pressure. We seem happy just to bring the blood pressure down for the time being! Real Yoga Chikitsa would try to look for the primary cause of the patients hypertension and try to tackle that along with Shavasana for symptomatic management. Without an attempt to do so, it is merely Yogopathy. Another common example is of using the left nostril Chandra Nadi Pranayama to lower the blood sugar or using the right nostril Surya Nadi Pranayama to relieve brochospasm without looking for the real cause of the patients diabetes or asthma. When we do this, how are we any different than the modern doctors who prescribe anti diabetic and sympathomimetic agents for these patients? Where is the real Yoga in this type of therapy? Where is the effort to find and deal with the primary cause? When we remember to inculcate the principles of Yoga in our day to day life, and help our patients to understand them thus assimilating them in their own lives, we are practicing Yoga. If not, it is merely Yogopathy, the symptomatic management of conditions using techniques of Yoga! The art and science of Yoga has infinite possibilities for providing answers to most health problems troubling modern humankind. However we often misunderstand this science and want it to be a miracle pill. A pill that we take only once, and want all the problems to vanish into thin air! Yoga is a wholistic science and must be learnt and practiced with a holistic view. The dedicated practice of Yoga as a way of life is no doubt a panacea for problems related to psychosomatic, stress related disorders helping us to regain our birthright of health and happiness.

* By Yogacharya Dr Ananda Balayogi Bhavanani, Programme Co-ordinator ACYTER, JIPMER. This article first appeared in the Integral Yoga Magazine, Yogaville, USA. Fall 2009.

Bulletin of ACYTER, Oct 2010

CASE REPORTS FROM ACYTER YOGA THERAPY OPD Yoga therapy OPD is functioning in Super Specialty Block of JIPMER. Yoga therapy and lifestyle consultation is given by Dr Ananda Balayogi Bhavanani, Programme co-ordinator and Dr Zeena Sanjay, SRF from 10 AM to 1 PM on Monday, Wednesday and Friday and 10 AM to 4 PM on Tuesday and Thursday. 283 patients (new 205 and old 78) of various disorders attended the OPD between July and September 2010. The yoga therapy sessions are being conducted at ACYTER yoga hall on Mondays, Wednesdays and Fridays from 10 11 AM for patients of diabetes, 11 AM 12 noon for patients of cardiovascular diseases and 12 noon 1 PM for patients of other disorders. The yoga instructors, Shri G Dayanidy and Selvi L Vithiyalakshmi are conducting the sessions both individually and in groups as per directions of the therapists given in the OPD. Patients have reported satisfaction with the therapy sessions and are attending regularly. 417 patients of diabetes, 293 of hypertension and 489 of other conditions attended these sessions in July - September 2010. A total of 4036 patients of various psychosomatic ailments including diabetes mellitus, hypertension, musculoskeletal disorders, respiratory disorders, stress and psychological disorders, endocrine disorders, coronary artery disease, urology, gynecological disorders and ENT disorders have attended consultations and therapy sessions between June 2009 and June 2010. We give below a few case reports compiled from our patients over the past year. 1. Effect of yoga on subclinical hypothyroidism: Complementary and Alternative Medical (CAM) therapies such as yoga are being increasingly used as adjuncts to modern medicine. Though it has been suggested that yoga may have a role in revitalizing thyroid function, there are few studies on the effects of yoga on thyroid disorders. A 36 year old female with elevated TSH level (9.39 IU/ml) and low normal T4 levels (12.57 pmol/L) was diagnosed as having primary subclinical hypothyroidism and advised to start replacement therapy. She came for consultation to the ACYTER Yoga OPD and was given appropriate yogic counseling and taught a series of techniques potentially beneficial to patients of thyroid conditions. This included suryanamaskar, sarvangasana, viparita karani mudra, surya nadi pranayama, bhramari pranayama and relaxation practices. She continued the practices for a year and reported back at the end of the year with her biochemical investigations. After one year of therapy, there was a fall in TSH (2.66 mIU/L) and a normalization of free T4 values (8.98 pmol/L). A third biochemical analysis three months later showed that TSH further stabilized 2 mIU/L and FT4 at 9.78 pmol/L. As the anti TPO antibodies were positive both before and after the yoga intervention, the patient was advised to continue the yoga practices on a regular basis as long as possible with regular six-monthly follow up. It is suggested that yoga can be an effective adjunct therapy in thyroid conditions and further studies in larger samples are needed to confirm these findings and to better understand the mechanisms behind such beneficial effects in patients of thyroid disorders. 2. Effect of yoga in newly diagnosed hypertension: A 21 year old male working as an executive in Chennai presented to his clinician with complaints of headache and giddiness. There were no other major symptoms though he was anxious about his condition. As his blood pressure was 160/100 he was advised to start antihypertensive medication. He took the medicines for a week and on a visit to Pondicherry the following week, came for consultation at the ACYTER Yoga OPD where his blood pressure was recorded as 130/90 mm Hg. He was given appropriate yogic counselling and dietary advice and taught a series of techniques
Bulletin of ACYTER, Oct 2010

that are potentially beneficial to patients of hypertension. This included jathis and asanas such as tala, hastakona, trikona, meru, vakra, bhujanga, uttanpada and pawanmukta. Pranayamas such as sukha, vyagraha, pranava, nasarga mukha bhastrika, chandra nadi and bhramari were also taught. Relaxation practices included shavasana with savitri pranayama and yoga nidra. He continued the practices for 10 days and his blood pressure were monitored daily. He continued doing these practises at ACYTER as well as at home. His BP averaged 128/86 for the first three days and reduced to 122/84 by the 4th day. It normalised at 124/80 during the last few days. The patient expressed a sense of relaxation and felt a decrease in his anxiety levels. 3. Effect of yoga in a patient of long standing diabetes and hypertension: A 55 year old male, with history of diabetes since 16 yr and hypertension since 7yr and on medication at JIPMER medicine OPD attended consultation in ACYTER Yoga OPD. His blood pressure was BP 130/90 mm Hg and blood sugar levels were 140 mg% (AC) and 173 mg% (PC). The patient was highly stressed out and quite fed up with life. He was given appropriate yogic counseling and dietary advice and taught a series of techniques that are potentially beneficial to patients of both diabetes and hypertension. This included surya namaskar, talasana, trikonasana, vakrasana, pawan muktasana, viparita karani, chandra nadi pranayama, pranava pranayama and relaxation techniques. He has continued the practices regularly for the past 14 months both at ACYTER as well as at home. He reports a feeling of rejuvenation and energy and his outlook towards life has changed dramatically. His blood pressure has stabilized around 110/70 with 50% decrease in antihypertensive medications. His blood sugar levels have also stabilized at 120 mg% (AC) and 167 mg% (PC) with no change in medications. This patient has felt the benefits of yoga in changing his life for the better and has brought more than two dozen patients to ACYTER to experience the benefits of yoga that he feels have come in his life. 4. Case report on COAD in an adult: A 33 year old female, suffering from chronic obstructive airway disease (COAD) for the past five years came to the yoga OPD. She was on regular medication and had complaints of uncontrolled wheezing despite using various inhalers. Her FEV1 was 57%. She was given appropriate yogic counselling and dietary advice and taught a series of techniques potentially beneficial to patients of COAD. She was taught breath body co-ordination practices and suryanamaskar as well as asanas such as ushtra, gomukha, vakra, bhujanga and matsya and the jala neti cleaning technique. She was also taught sectional breathing and pranayamas such as vyaghrah, mukha bhastrika, suryanadi and nadi shuddhi. Relaxation techniques used were kaya kriya and yoga nidra. She continued the practices for 2 months at ACYTER and at home and reported that she was feeling a sense of ease and comfort that wasnt there earlier. The frequency of her wheezing attacks had also reduced. Repeat PFT showed that her FEV1 had increased to 68%. 5. Case report on bronchial asthma in a 4 year old child: A 4 year old female child, with complaints of respiratory difficulties since birth was on regular treatment for bronchial asthma with oral medication and inhaler. She came for consultation to the ACYTER Yoga OPD with complaints of wheezing, breathlessness and the mother expressed a desire to try out the yoga practices. The mother was given appropriate yogic counseling and dietary advice and then the child was taught in a playful manner a series of techniques that are potentially beneficial to patients of bronchial asthma. She was taught breath body co-

Bulletin of ACYTER, Oct 2010

ordination practices and suryanamaskar as well as asanas such as ushtra, gomukha, vakra, bhujanga and matsya. She was also introduced to the jala neti nasal cleaning technique. She was then taught sectional breathing and pranayamas such as vyaghra, mukha bhastrika and suryanadi. She continued the practices for nearly one year and her complaints reduced slowly. She continued doing these practices at ACYTER as well as home and the frequency and severity of her wheezing attacks reduced. After the practice of 4 months she was able to stop the oral medications and usage of inhaler was also lesser. The consulting pediatrician advised her to stop the inhaler too as she was able to be comfortable without it. There were no episodes of wheezing reported till the end of the year even though she was not taking any medicines. REPORT ON RESEARCH ACTIVITIES AT ACYTER 1. Effect of yoga therapy in patients of essential hypertension: A study is being conducted on the effect of yoga therapy in patients of hypertension. The study has a proposed sample size of 72 (36 in yoga and 36 in control group). Autonomic function tests have been completed in 50 patients and 23 have been randomised to the yoga therapy sessions being conducted at ACYTER on Monday, Wednesday and Friday. 15 of the patients have been attending the sessions regularly and 8 have attended more than 10 sessions till date. 2. Effect of yoga therapy in patients of type 2 diabetes mellitus: A study is being conducted on the effect of yoga therapy in patients of diabetes with peripheral neuropathy. The study has a proposed sample size of 60 (30 in yoga group; 30 in control group). Patients are being recruited from diabetic clinic and staff clinic. Cardiac autonomic function testing, nerve conduction studies and biochemical assessment are being done for each patient recruited into the study. So far prevalues of 25 patients in control group and 15 patients in yoga group have been taken. Of the 15 patients recruited into yoga group, 10 are regularly attending classes. REGULAR ACTIVITES OF ACYTER Regular yoga classes are being conducted on Mondays, Wednesdays and Fridays in both mornings and evenings. 341 participants attended the classes in the last quarter. Suryanamaskar, basic asanas, pranayamas and relaxation techniques are being taught in the general classes. Senior Citizens Clinic is being conducted every Thursday and 116 participants attended classes with Mrs. Meena Ramanathan, coordinator yoga courses, Pondicherry University Community College.

From
Advanced Centre for Yoga Therapy, Education and Research (ACYTER) Department of Physiology, JIPMER, Puducherry 605 006

To

Bulletin of ACYTER, Oct 2010

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ADVANCED CENTRE FOR YOGA THERAPY, EDUCATION & RESEARCH (ACYTER) Bulletin of ACYTER January 2011

(A collaborative venture between JIPMER, Puducherry & MDNIY, New Delhi)

Patrons: Dr. KSVK Subba Rao Director, JIPMER Dr. I V Basavaraddi Director, MDNIY, New Delhi Dr. Ashok Kumar Das Med. Superintendent, JIPMER Dr. S Badrinath Project Co-ordinator, JIPMER Dr. KS Reddy Dean, JIPMER Editor: Dr. Madanmohan Professor & Head, Dept. of Physiology, JIPMER & Programme Director, ACYTER Editorial board: Dr. GK Pal Professor, Dept. of Physiology, JIPMER Dr. Ananda Balayogi Bhavanani Programme Co-ordinator, ACYTER, JIPMER

NATIONAL WORKSHOP-CUM-SEMINAR ON ROLE OF YOGA IN PREVENTION AND MANAGEMENT OF DIABETES MELLITUS Announcement The Advanced Centre for Yoga Therapy, Education & Research (ACYTER) and Department of Physiology JIPMER are jointly organizing a National Workshop-cum-Seminar on Role of Yoga in Prevention and Management of Diabetes Mellitus in collaboration with Morarji Desai National Institute of Yoga, (MDNIY) New Delhi. The workshop will be conducted on March 1 & 2, 2011 at JIPMER. More than 200 medical and paramedical professionals and yoga therapists are expected to participate. The Workshop-cum-Seminar will deliberate on the role of yoga in the prevention and management of diabetes mellitus. Lectures, lecture-demonstrations, panel discussion and practice sessions will be conducted by eminent medical and yoga experts. Registration fee is Rs. 800 for delegates and Rs. 300 for student delegates and includes registration, kit, lunch and refreshments. Certificate of participation will be issued to all delegates. Assistance will be provided to arrange accommodation if required but hotel/guest house charges are to be borne by delegates. The Advanced Centre for Yoga Therapy, Education and Research (ACYTER), a collaborative venture between JIPMER, Puducherry and Morarji Desai National Institute of Yoga (MDNIY), New Delhi was established by a MOU between JIPMER and MDNIY in June 2008. The centre is focusing on the role of yoga in the prevention and management of cardiovascular disorders and diabetes mellitus. More than 6000 patients have benefited from the yoga therapy consultations and practical sessions till date. The centre also aims to popularize the science of yoga among medical professionals and general public and has conducted workshops and awareness programmes to this effect. For more details please contact: Dr Madanmohan Professor & Head, Dept. of Physiology, & Programme Director, ACYTER, JIPMER acyter.jipmer@gmail.com

Correspondence to: The Editor, Bulletin of ACYTER, JIPMER, Puducherry- 605 006, India E-mail: acyter.jipmer@gmail.com

Published by the Advanced Centre for Yoga Therapy, Education & Research (ACYTER), JIPMER, Puducherry, India 605 006

Bulletin of ACYTER Jan 2011

FOUNDATION COURSE IN YOGA FOR MEDICAL AND PARAMEDICAL PROFESSIONALS AND STUDENTS OF JIPMER One month Foundation Course in yoga for Medical and Paramedical Professionals and Students was conducted at JIPMER from 18 October to 20 November 2010. 63 medical doctors, paramedical professionals, students and staff members of JIPMER participated in the training programme. The theory lectures were conducted in Bernard Theatre and practice sessions in the auditorium of the Nursing College under the direction of Dr. Madanmohan, Professor and Head, Department of Physiology, JIPMER and Programme Director ACYTER. Modern man is the victim of all-pervading stress. Yoga is the best means for managing this stress of our daily life. Medical and paramedical professionals have to face great stress in their professional career and the regular practice of yoga will improve their psychosomatic health and enable them to face the situation. The holistic science of yoga has a great future as it has the potential to prevent as well as manage a number of stress-induced chronic diseases that defy allopathic medicine. A holistic physician who is a practitioner of yoga will be able to render better medicare to the masses and will be a boon to the society. ACYTER and Department of Physiology, JIPMER had also previously organized a two day National Workshop on Introducing Yoga in the medical curriculum in March 2009 at JIPMER. The workshop was organized in collaboration with Morarji Desai National Institute of Yoga (MDNIY), New Delhi under auspices of Department of AYUSH, Govt of India. The national workshop deliberated on the need, feasibility and modality of introducing yoga science in the medical curriculum for medical students in particular and medical professionals in general. 20 resource persons from eminent Yoga Centers and 150 participants from all over the country participated in the workshop that included theory, practice sessions and therapeutic aspects of yoga and evaluation methods for such a course. The workshop had recommended the introduction of yoga to medical students in particular and medical professionals in general through a Foundation Course in Yoga Science. It was also recommended that a 48 hour foundation course be conducted after class hours for interested professionals through the yoga units of the institutions as per the syllabus that has been prepared by the MDNIY in consultation with eminent yoga and medical experts. To achieve this aim, the Advanced Centre for Yoga Therapy, Education, and Research (ACYTER) under the direction of Dr. Madanmohan conducted a month long foundation course in yoga for medical and paramedical professionals and students at JIPMER. It is noteworthy that ACYTER has previously conducted two such foundation courses for nearly 130 medical and paramedical professionals and students.

Bulletin of ACYTER Jan 2011

The objectives of this 48 hour (one month) introductory course were: 1. To promote awareness among medical students about the effectiveness of yoga as an inexpensive means for achieving holistic health. 2. To impart knowledge, skill & attitude about the theoretical and practical aspects of yogic science. 3. To motivate medical professionals and students to take up further studies, therapy and research in yoga. The 48 hour course was conducted over a period of one month and included lectures, lecture-demonstrations and practice sessions. Lecture topics included: What is yoga?, Healthy lifestyle: a yogic perspective, Effect of yoga training on physiological functions, Dhyana and its psycho-physiological correlates, Pranayam and its physiological benefits, Stress and its management: a yogic perspective, Spiritual health and healing: a yogic perspective, Diet for health and healing: a yogic perspective, Therapeutic potential of yoga, Benefits of yoga practices and traditional basis of yoga. Group discussion and assignments were given on yoga therapy modules on stress, yogic diet, anxiety, hypertension, diabetes mellitus, bronchial asthma, obesity, arthritis, GI disorders, cardiovascular diseases and menstrual disorders. Practical sessions were guided by Shri G Dayanidy and Selvi L Vithiyalakshmi with assistance from Selvi Shyamaladevi and Mrs. Karpagam Ramanan. Pre-test and post-test were given to all participants at the beginning and end of the course and there was a 60 percent improvement in scores. Valedictory function was held 19 November with Dr. KVSK Subba Rao, Director, JIPMER as chief guest and Dr. S Revathi, Principal Nursing College and Coordinator GFATM as special guest. Dr. Ananda Balayogi Bhavanani welcomed all to the concluding session and Dr. Madanmohan gave an overview of the aims and objectives of the course that were successfully met during the month-long training programme. In his valedictory address Director, JIPMER appreciated the efforts of Dr. Madanmohan to spread the message of yoga effectively and assured his cooperation for the activities of ACYTER. Positive feedback was given by all the participants with special inputs from Dr. Nalini, former Professor of Pediatrics at JIPMER who is a regular visitor to the ACYTER. Certificates were distributed to all participants who had completed the course and vote of thanks proposed by Shri E Jayasettiaseelon.

Bulletin of ACYTER Jan 2011

ACYTER PARTICIPATION IN YOGA AWARENESS PROGRAMMES Dr Ananda Balayogi, Programme Coordinator ACYTER was invited to present a lecture on Yoga for women in the 8th National Conference hosted by Puducherry Chapter of Society of Midwives on 13th November 2010. He was invited to present another lecture on Principles & Practice of Yoga Therapy for Geriatric Psychiatric Disorders" in the one day workshop on "Yoga Therapy for Psychiatric Disorders" held at the Advanced Centre for Yoga, NIMHANS, Bangalore on 5 December 2010. The event was organized jointly by the Advanced Centre and Morarji Desai National Institute of Yoga, New Delhi. The workshop aimed at improving the awareness and imparting brief training for yoga therapists and mental health professionals in therapeutic application of yoga for psychiatric disorders. It had lectures and demonstrations by experts from both Psychiatry and Yoga Therapy. A delegation of yoga teachers from Italy visited ACYTER on 11th December and expressed their admiration for the programme and its activities. They were especially appreciative that Indian Government was bringing yoga into the mainstream health care system through advanced centers at JIPMER, NIMHANS, DIPAS, Gujarat Ayurveda University & at Government medical college, Jammu. Staff of ACYTER also participated in the 18th International Yoga Festival Conducted by the Government of Pondicherry from 4-7 January2011. Invited talks were given by Dr Ananda Balayogi, Programme Coordinator ACYTER and free consultation on yoga and healthy living was provided to 102 delegates and members of the public in the ACYTER stall. Sri G Dayanidy, Yoga Instructor ACYTER won first place in the 25-35 age category and was selected to participate in the Final Championship Round. YOGA THERAPY OPD AT SUPERSPECIALITY BLOCK Yoga therapy OPD is functioning in Super Specialty Block of JIPMER. Yoga therapy and lifestyle consultation is given by Dr Ananda Balayogi Bhavanani, Programme co-ordinator and Dr Zeena Sanjay, SRF from 10 AM to 1 PM on Monday, Wednesday and Friday and 10 AM to 4 PM on Tuesday and Thursday. 234 patients (new 169 and old 65) of various disorders attended the OPD between October and December 2010. YOGA THERAPY SESSIONS AT ACYTER The yoga therapy sessions are being conducted at ACYTER yoga hall on Mondays, Wednesdays and Fridays from 10 11 AM for patients of diabetes, 11 AM 12 noon for patients of cardiovascular diseases and 12 noon 1 PM for patients of other disorders. The yoga instructors, Shri G Dayanidy and Selvi L Vithiyalakshmi are conducting the sessions both individually and in groups as per directions of the therapists given in the OPD. Patients have reported satisfaction with the therapy sessions and are attending regularly. 593 patients of diabetes, 320 of hypertension and 591 of other conditions attended these sessions in October - December 2010. REGULAR ACTIVITES OF ACYTER Regular yoga classes are being conducted on Mondays, Wednesdays and Fridays in both mornings and evenings. 164 participants attended the classes in the last quarter. Suryanamaskar, basic asanas, pranayamas and relaxation techniques are being taught in the general classes. Senior Citizens Clinic is being conducted every Thursday and 112 participants attended classes with Mrs. Meena Ramanathan, Coordinator Yoga Centre, Mahatma Gandhi Medical College and Research Institute.

Bulletin of ACYTER Jan 2011

ADVANCED CENTRE FOR YOGA THERAPY, EDUCATION & RESEARCH (ACYTER)


(A collaborative venture between JIPMER, Puducherry & MDNIY, New Delhi)

Bulletin of ACYTER- April 2011


Patrons: Dr. KSVK Subba Rao Director, JIPMER Dr. I V Basavaraddi Director, MDNIY, New Delhi Dr. Ashok Kumar Das Med. Superintendent, JIPMER. Dr. S Badrinath Project Co-ordinator, JIPMER Dr. KS Reddy Dean, JIPMER Editor: Dr. Madanmohan Professor & Head, Dept. of Physiology, JIPMER & Programme Director, ACYTER Editorial board: Dr. GK Pal Prof. of Physiology, JIPMER Dr. Ananda Balayogi Bhavanani Programme Co-ordinator, ACYTER, JIPMER Correspondence to: The Editor, Bulletin of ACYTER, III floor Institute Block, JIPMER, D Nagar, Puducherry- 605 006, India E-mail: acyter.jipmer@gmail.com

REPORT ON NATIONAL WORKSHOP-CUMSEMINAR ON ROLE OF YOGA IN PREVENTION AND MANAGEMENT OF DIABETES MELLITUS

The Advanced Centre for Yoga Therapy, Education and Research (ACYTER) and the Department of Physiology, JIPMER organized a two day National Workshop-cum-Seminar on Role of Yoga in Prevention and Management of Diabetes Mellitus on 1 & 2 March 2011 at JIPMER. The workshop was organized in collaboration with Morarji Desai National Institute of Yoga (MDNIY), New Delhi, an autonomous organization under the Department of AYUSH, Ministry of Health and Family Welfare, Govt. of India. More than 200 medical, paramedical and yoga professionals and yoga enthusiasts from all over the country participated along with 100 medical students of JIPMER and 30 faculty, residents and staff members of the Department of Physiology and ACYTER, JIPMER. The workshop was inaugurated by Dr KSVK Subba Rao, Director JIPMER and Dr BK Sahay, eminent diabetologist was the guest of honour. Senior faculty members from various departments of JIPMER as well as eminent yoga and medical experts from all over the country participated. The workshop deliberated on the role of yoga in the prevention and management of diabetes with keynote lecture, invited talks, lecturedemonstrations, panel discussions and practice sessions that were given by a team of 30 resource persons from JIPMER, DIPAS, NIMHANS, Viniyoga Healing Foundation, Chennai; The Yoga Institute, Mumbai; Iyengar Yogashraya, Pune; Antar Praksh Yoga Centre, Haridwar; KMC Mangalore, Vinayaka Mission's Medical College, Salem; Vivekananda Institute of Yoga Therapy, Karur; PGIBMS, Taramani, Chennai; and the International Centre for Yoga Education and Research, Pondicherry.

Published by the Advanced Centre for Yoga Therapy, Education & Research (ACYTER), JIPMER, Puducherry, India 605 006

Bulletin of ACYTER- April 2011

Faculty from JIPMER included Dr AK Das, Medical Superintendent, Dr Madanmohan, Professor and Head, Department of Physiology and Programme Director ACYTER (Organizing Chairman of the workshop) and Dr GK Pal, Professor, Department of Physiology (organizing secretary of the workshop). Dr Zeena Sanjay, Shri E Jayasettiaseelon, Shri G Dayanidy and Selvi L Vithiyalakshmi from ACYTER and Smt Lalitha Shanmugam, Smt Devasena Bhavanani and Smt Meena Ramanathan of Yoganjali Natyalayam assisted in the conduct of the practice sessions under guidance of Dr Madanmohan and Dr Ananda Balayogi Bhavanani, (Coordinator of the workshop). On the evening of the first day, the delegates were treated to a spectacular cultural programme that was a fusion of yogasana tableaux, Bharatanatyam compositions and instrumental music that was presented by Yoganjali Natyalayam under the dynamic direction of Kalaimamani Yogacharini Meenakshi Devi Bhavanani, Director of the institute. Dr Ananda Balayogi actively coordinated the performance along with Smt Devasena Bhavanani. Dr IV Basavaraddi, Director MDNIY was guest of honour for the valedictory function and expressed his appreciation of work at ACYTER, JIPMER. In his special address he extolled the medical community to research yoga in depth with proper adherence to the correct textual basis and proper practice of yoga techniques so that the results were of international quality and acceptable to the modern scientific community. At the conclusion, Yogacharya Dr Ananda Balayogi Bhavanani, Programme Coordinator ACYTER proposed the vote of thanks. DECLARATION OF THE WORKSHOP National workshop-cum-seminar on Role of Yoga in Prevention & Management of Diabetes Mellitus, attended by more than 200 delegates, medical professionals and students, yoga experts and discernible persons from the local town of Pondicherry, has been a grand success.

Bulletin of ACYTER- April 2011

The physiological, pathological, psychological and metaphysical perspectives of prevention and management of diabetes have been deliberated at length and futuristic ideas and plans have also been put forth. We, the organizers, patrons, delegates and all the participants, urge the State Government, Central Government, MCI & Department of AYUSH to evolve a concrete policy for promotion of yoga as an adjunct to modern medicine so that a mass movement for yoga awareness with a sound scientific footing can be initiated. The workshop proposes the following recommendations with regard to the prevention and management of diabetes mellitus through yoga: 1. The inculcation of yoga has to be not only at the medical level but at the school level if we want to prevent diabetes. We need to concentrate our energies on working at the school level itself and catch them young. 2. Screening for pre-diabetes needs to be intensified and yoga introduced to the prediabetics to prevent them from going into full blown diabetes. 3. We need to bring out effective and consensus-based diet guidelines keeping yogic principles in mind. 4. A universal standardized yoga package needs to be evolved for diabetes so that the diabetic patients all over the world can be benefited in a rational manner. 5. A universal standardized research protocol to scientifically evaluate the effect of yoga on diabetes needs to be evolved with inputs from physicians, researchers and statisticians. 6. Scientific evaluation and standardization of various recommended individual techniques of yoga should be done and documented with publications so that the benefits of the individual practices as well as their combination can be understood in a scientific and rational manner.

Bulletin of ACYTER- April 2011

Bulletin of ACYTER- April 2011

Bulletin of ACYTER- April 2011

CME PROGRAMME AT SRI SATYA SAI MEDICAL COLLEGE AND RESEARCH INSTITUTE, KANCHEEPURAM Staff of ACYTER presented talks and lecture demonstrations during the CME on Physiological Effects of Yoga on January 17th 2011, organized by the Department of Physiology, Sri Satya Sai Medical College and Research Institute, near Chennai. Dr Madanmohan, Programme Director presented an overview of Yoga and Physiology while Dr Ananda Balayogi, Programme Coordinator gave a talk on Therapeutic Potential of Yoga. Dr Zeena Sanjay, SRF gave a talk on Yoga research that also highlighted the activities of ACYTER. Sri G Dayanidy gave a spectacular demonstration of various yogasanas with commentary by Dr Ananda. The CME was attended by more than a hundred members of the management, faculty, staff and students who gave positive feedback and expressed appreciation for the entire programme.

Bulletin of ACYTER- April 2011

ACYTER PARTICIPATION IN YOGA AWARENESS PROGRAMMES Dr Madanmohan, Programme Director and Dr Ananda Balayogi, Programme Coordinator were invited to give talks and workshops on January 20 and 21, during the Golden Jubilee National Seminar-cum-Workshop on Role of Yoga in Respiratory Tract Disorders organized by the Advanced Centre for Yoga Education and Research, Gujarat Ayurved University, Jamnagar, Gujarat, in collaboration with Morarji Desai National Institute of Yoga (MDNIY), New Delhi. Dr Ananda Balayogi, Programme Coordinator was invited to give a talk on Physiological perspective on recent trends in yoga therapy during the Yoga Update at Kaivalyadhama, Mumbai on January 2930, 2011. Dr Madanmohan, Programme Director, Dr Ananda Balayogi Bhavanani, Programme Co-ordinator and Dr Zeena Sanjay, SRF attended the Yoga Week which held from February 12-18 at MDNIY, New Delhi. Dr. Ananda Balayogi Bhavanani presented a talk on yoga for general well being at the yoga week. Dr Madanmohan chaired a session and gave a talk in the valedictory session. RECENT ACTIVITIES AT ACYTER As part of the pre-hypertension research project, yoga therapy sessions are being conducted for staff members of Kendriya Vidyalaya from the second week of January. Screening of the participants for prehypertension was done by Mr Ram Kumar, PhD scholar, Dept of Physiology while Shri G Dayanidy is conducting the sessions on Tuesday, Thursday and Saturday from 3 4 PM at the school premises. Yoga therapy sessions are being conducted for pregnant ladies as part of a preeclampsia prevention study since the end of March. Screening of the patients is being done by Dr Manikandan, Asst Professor in OBG, JIPMER and Selvi L Vithiyalakshmi is conducting the sessions on Tuesdays and Thursdays from 3- 4 PM at the ACYTER yoga hall.
Bulletin of ACYTER- April 2011

YOGA THERAPY OPD AT SUPERSPECIALITY BLOCK Yoga therapy OPD is functioning in Super Specialty Block of JIPMER. Yoga therapy and lifestyle consultation is given by Dr Ananda Balayogi Bhavanani and Dr Zeena Sanjay from 10 AM to 1 PM on Monday, Wednesday and Friday and 10 AM to 4 PM on Tuesday and Thursday. 436 patients (new 358 and old 78) of various disorders attended the OPD between January and March 2011. YOGA THERAPY SESSIONS The yoga therapy sessions are being conducted at ACYTER yoga hall on Mondays, Wednesdays and Fridays from 10 11 AM for patients of diabetes, 11 AM 12 noon for patients of cardiovascular diseases and 12 noon 1 PM for patients of other disorders. The yoga instructors, Shri G Dayanidy and Selvi L Vithiyalakshmi are conducting the sessions both individually and in groups as per directions of the therapists. Patients have reported satisfaction with the therapy sessions and are attending regularly. 747 patients of diabetes, 424 of hypertension and 770 of other conditions attended these sessions in January - March 2011. YOGA CLASSES FOR NORMAL SUBJECTS Yoga classes are being conducted on Mondays, Wednesdays and Fridays at 6.30 AM and 4.30 PM. 415 participants attended the classes in the last quarter. Suryanamaskar, basic asanas, pranayamas and relaxation techniques are being taught in the classes. YOGA CLASSES FOR SENIOR CITIZENS Classes for senior citizens are being conducted every Thursday between 11 AM and 12 noon. 95 participants attended classes with Mrs. Meena Ramanathan, Coordinator, Yoga Centre, Mahatma Gandhi Medical College and Research Institute.

From
Advanced Centre for Yoga Therapy, Education and Resea rch (ACYTER) III floor Institute Block, JIPMER, Puducherry 605 006

To

Bulletin of ACYTER- April 2011

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ADVANCED CENTRE FOR YOGA THERAPY, EDUCATION & RESEARCH (ACYTER) Bulletin of ACYTER July 2011

(A collaborative venture between JIPMER, Puducherry & MDNIY, New Delhi)

Patrons: Dr. KSVK Subba Rao Director, JIPMER Dr. I V Basavaraddi Director, MDNIY, New Delhi Dr. Ashok Kumar Das Med. Superintendent, JIPMER Dr. S Badrinath Project Co-ordinator, JIPMER Dr. KS Reddy Dean, JIPMER Editor: Dr. Madanmohan Professor & Head, Dept. of Physiology, JIPMER & Programme Director, ACYTER Editorial board: Dr. GK Pal Professor, Dept. of Physiology, JIPMER Dr. Ananda Balayogi Bhavanani Programme Co-ordinator, ACYTER, JIPMER

INAUGURAL CEREMONY OF ACYTER YOGA RESEARCH LAB AT SUPER SPECIALTY BLOCK, JIPMER The ACYTER Yoga Research Lab was inaugurated by Dr. KSVK Subba Rao, Director, JIPMER at 9.30am on 6 July 2011 in the Super Specialty Block. The lab is situated next to the ACYTER Yoga Therapy OPD. Dr. AK Das, Medical Superintendent and Dr. Balachander, Professor and Head, Dept. of Cardiology were special invitees. Dr. Madanmohan, Professor & Head, Dept. of Physiology and Program Director of ACYTER welcomed the gathering and explained the work being done at ACYTER since the past 2 years. The inaugural was attended by faculty, residents, research scholars and staff of the Department of physiology along with staff of ACYTER. The Research lab is equipped with BioHarness and CMCdaq to monitor HRV (heart rate variability), computerized Audio-Visual Reaction Time apparatus, computerized Spirometer and 12 channel ECG machine. The Director JIPMER suggested that the work of ACYTER be given due publicity to enable more patients to be benefited and for standardized research to be done in cardiovascular disease and diabetes. He also suggested that ACYTER conduct awareness programs for the general public of Puducherry to enable them to know about the functioning of ACYTER. The function concluded on 10.30 am with refreshment and high tea.

Correspondence to: The Editor, Bulletin of ACYTER, III floor Institute Block, JIPMER, D Nagar, Puducherry- 605 006, India E-mail: acyter.jipmer@gmail.com

Published by the Advanced Centre for Yoga Therapy, Education & Research (ACYTER), JIPMER, Puducherry, India 605 006
Bulletin of ACYTER July 2011

INAUGURAL CEREMONY OF ACYTER YOGA RESEARCH LAB

PRANAYAM TRAINING SESSIONS FOR RESIDENTS OF PHYSIOLOGY

Bulletin of ACYTER July 2011

RESULTS OF A SURVEY OF PARTICIPANT FEEDBACK AT ACYTER, JIPMER, PONDICHERRY


From March to June 2011, a survey was conducted on 100 patients who were regularly attending yoga therapy sessions at ACYTER and had completed a minimum of one month of the regular programme. A questionnaire was given to them consisting of questions related to their age, gender and demographic characteristic in addition to their main health complaints, attendance at the yoga sessions, home practice as well as their physical and mental condition and changes in dosage of medication. Results of the survey are given in number of participants except for those questions where all 100 participants had not replied, in which case % values are reported instead. AGE: Age of the participants ranged from 16 to 77 years with an average age of 47.04 4.85 years (SEM). The maximum participants (39) were in the age group of 40-60 y while 25 were above 60 and 24 in the age group 30-40. There were 11 in the age group 20-30 and 2 were below 20 y ears of age. GENDER: 49 participants were male and 51 female. DEMOGRAPHIC DATA: 91 of the participants were from Pondicherry town and surrounding rural areas while 9 were from adjoining areas of Tamil Nadu. MAIN HEALTH COMPLAINTS: The system wise break up of main health complaints was: diabetes mellitus (41), hypertension and other cardiovascular disorders (39), musculoskeletal disorders (13), respiratory disorders (13), endocrine (12), neurological disorders (5), gastro intestinal disorders (3), obstetrics and gynecological disorders (3), dermatological disorders (1) psychiatric disorders (1) and others (11). Some of the participants had multiple complaints. REGULARITY OF ATTENDANCE AT ACYTER: 50 had attended yoga therapy sessions for 1-3 months, 26 for 3-6 months, 16 for 6-12 months and 8 for more than a year. 60 participants were attending the sessions 3 days/week, 21 of them 4 days/week while 8 were attending once/week, 7 twice /week, 2 five days/week and 2 six days/week. The regularity was attributed to a feeling of physical and mental betterment (58%), regularity of the sessions (23%) and symptomatic relief (12%). Inability to be more regular was attributed to work pressure and examinations (7%). REGULARITY OF HOME PRACTICE: 21 were practising at home on 3 days/week, 18 on 2 days, 11 on 5 days, 10 on all 7 days, 10 on 4 days, 9 on 6 days and 3 were practising at home only once/week. 14 reported that they were not practicing at home at all. The regularity of home practice was attributed by the participants to a feeling of physical and mental betterment (49%) while inability to be more regular was attributed to lack of time (18%), work and education (18 %), laziness (9%) and other home circumstances (6%). 46% of the participants reported a home practice of 30 min, 17% for 40 min, 16% for 20 min, 15% for 60 min and 6% reported that they practised for more than an hour at home. This regularity was attributed to a feeling of wellbeing (47%) while the irregularity was attributed to lack of time (29%), work pressure (18%) and other factors (6%). HEALTH STATUS: 56 participants reported that their health status was better than when they started the yoga practice. 36 reported that it was much better than before

Bulletin of ACYTER July 2011

while 7 said that it was the same as before. One participant reported total relief from his health complaints after starting the yoga programme. DOSAGE OF MEDICATION: 56 participants reported no change in their medication, 29 reported a decrease while 2 reported an increase in the dosage of their medication. 13 of the participants were not on any medication. GENERAL SUGGESTIONS: The majority of participants reported satisfaction with the programme as well as the teaching methods of the instructors. General suggestions included the need for more space for practice sessions, an increase in the number of sessions as well as duration of sessions and possibility of sessions being conducted after office hours. The participants thanked the Director JIPMER and MDNIY for starting ACYTER thus enabling so many persons to benefit from the excellent yoga programmes conducted free of cost.

POST INTERVENTION, RETROSPECTIVE WELLNESS QUESTIONNAIRE A post intervention, retrospective wellness questionnaire compiled by ACYTER was used to evaluate the comparative feelings of the patients after the therapy programme. Five different responses ranging from worse than before to complete relief / total satisfaction were utilized to evaluate various physical and psychological aspects of the patients condition. The questionnaire was finalized in consultation with a 12 member team consisting of 3 eminent medical practitioners, 2 psychologists, 2 yoga experts, 2 eminent yoga therapy consultants, 2 educationalists and one legal anthropologist. The post intervention overall wellness scores of the participants are given below in fig.1 and the detailed breakup of % responses to each question is given in table.1. Results of the retrospective wellness scores indicates that 11% attained complete relief from their condition while 35% felt much better than before. 38 % were better than before while 15% had no change in their condition. The condition of 1% was worse than before.

Worse thanbefore 1% Complete relief11%

Same asbefore 15%

Muchbetter than before 35%

Better than before 38%

Fig 1: Post intervention total well being score of participants


Bulletin of ACYTER July 2011

Table 1: Responses of the participants to retrospective wellness questionnaire Worse than before Ability to concentrate Control of anger / loss of temper Appetite Confidence level Ease of breathing Energy levels Enjoyment of life Feeling calm & fresh Feeling of hopelessness Feeling of loneliness General flexibility General mood General sense of relaxation General wellbeing Joint mobility Nervousness Normality of menstrual cycles Pain levels Performance of day-today activities Sleep quality / duration Stress levels Total well being score 1% 2% 1% 1% 4% 1% 0.48 % Same as before 12% 15% 26% 12% 14% 18% 18% 14% 19% 15% 11% 7% 12% 10% 12% 14% 29% 14% 12% 19% 17% 15.24 % Better than before 56% 51% 37% 41% 33% 39% 41% 32% 36% 40% 37% 38% 37% 36% 36% 45% 21% 41% 41% 26% 38% 38.19 % Much better than before 30% 26% 24% 37% 41% 39% 28% 40% 30% 30% 42% 47% 43% 39% 41% 34% 25% 30% 38% 39% 33% 35.05 % Complete relief / Totally satisfied 2% 8% 12% 8% 12% 4% 13% 14% 14% 14% 10% 8% 8% 15% 11% 7% 21% 15% 9% 15% 12% 11.05 % 5

Bulletin of ACYTER July 2011

RESEARCH ACTIVITIES Final reports are being prepared on studies conducted on effects of yoga therapy programmes on diabetes mellitus and hypertension. Pre-hypertension screening programme was organized by PhD scholars and residents from the department of Physiology. Baseline recordings are in progress for studies on the effect of different pranayamas and effect of yoga on premenstrual tension. Yoga therapy sessions are being conducted for pregnant ladies as part of a pre eclampsia prevention study since the end of March. Screening of patients is done by Dr Manikandan, Asst Professor in OBG, JIPMER and Selvi L Vithiyalakshmi is conducting sessions on Tuesdays and Thursdays from 3- 4 PM at ACYTER. Two papers on the effects of yoga therapy have been accepted for publication in Yoga Mimamsa and the International Journal of Yoga therapy. YOGA THERAPY OPD AT SUPERSPECIALITY BLOCK Yoga therapy OPD is functioning regularly in Super Specialty Block of JIPMER. Yoga therapy and lifestyle consultation is given by Dr Ananda Balayogi Bhavanani and Dr Zeena Sanjay from 10 AM to 1 PM on Monday, Wednesday and Friday and 10 AM to 4 PM on Tuesday and Thursday. 309 patients (new 213 and old 96) of various disorders attended the OPD between April and June 2011. YOGA THERAPY SESSIONS The yoga therapy sessions are being conducted at ACYTER yoga hall on Mondays, Wednesdays and Fridays from 10 11 AM for patients of diabetes, 11 AM 12 noon for patients of cardiovascular diseases and 12 noon 1 PM for patients of other disorders. The yoga instructors, Shri G Dayanidy and Selvi L Vithiyalakshmi are conducting the sessions both individually and in groups as per directions of the therapists. Patients have reported satisfaction with the therapy sessions and are attending regularly. 778 patients of diabetes, 513 of hypertension and 742 of other conditions attended these sessions in April and June 2011. YOGA CLASSES FOR NORMAL SUBJECTS Yoga classes are being conducted on Mondays, Wednesdays and Fridays at 6.30 AM and 4.30 PM. 332 participants attended the classes in the last quarter. Suryanamaskar, basic asanas, pranayamas and relaxation techniques are being taught in the classes. YOGA CLASSES FOR SENIOR CITIZENS Yoga classes for senior citizens are being conducted every Thursday between 11 AM and 12 noon. 126 participants attended classes with Mrs. Meena Ramanathan, Coordinator, Yoga Centre, Mahatma Gandhi Medical College and Research Institute.

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Advanced Centre for Yoga Therapy, Education and research (ACYTER) Department of Physiology, JIPMER, Puducherry 605 006

To

Bulletin of ACYTER July 2011

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ADVANCED CENTRE FOR YOGA THERAPY, EDUCATION & RESEARCH (ACYTER) Bulletin of ACYTER October 2011

(A collaborative venture between JIPMER, Puducherry & MDNIY, New Delhi)

Patrons: Dr. KSVK Subba Rao Director, JIPMER Dr. I V Basavaraddi Director, MDNIY, New Delhi Dr. Ashok Kumar Das Med. Superintendent, JIPMER Dr. S Badrinath Project Co-ordinator, JIPMER Dr. KS Reddy Dean, JIPMER Editor: Dr. Madanmohan Professor & Head, Dept. of Physiology, JIPMER & Programme Director, ACYTER Editorial board: Dr. GK Pal Professor, Dept. of Physiology, JIPMER Dr. Ananda Balayogi Bhavanani Programme Co-ordinator, ACYTER, JIPMER

SOME THOUGHTS ON YOGA RESEARCH# Yoga research is now a global phenomenon with an increased number of blinded, randomized and controlled trials. There is ample evidence of improved planning and implementation with a better understanding of the mechanisms by which various yoga practices cause their effects. More research studies are being published in indexed journals with peer review, indicating a better standard of research at least at the physical level. Greater funding is also available nowadays both nationally and internationally. Today, however, we are really at the crossroads with important questions such as How do we really look into the deeper aspects of yoga cropping up more and more often. We are confronted with the stark reality that we really dont have the equipment, techniques and expertise to study the yogic phenomena as most of them are beyond the physical realm. To conclude that shavasana has only the physical effect of lowering heart rate and blood pressure is to sight merely the icebergs tip, missing the other 90%. The real effects of shavasana as the ultimate relaxation and true renunciation may have far-reaching effects than we are led to believe. Many excellent papers are published from a scientific perspective, but are limited from a yogic perspective. There has to be a symbiotic relationship between yoga and modern science. For this, bridges combining the best of both worlds need to be cultivated. Youngsters who have a good grounding in yoga from childhood and those who are living a life of yoga need to take up scientific studies to actualize their potential of being the perfect yoga researchers. Similarly scientists who study yoga, need to remember that yoga is not a subject to be merely studied but is a way of life to be observed as implied by Atha yoganushasanam, the very first sutra in the Yoga Darshan of Maharishi Patanjali. In this issue we take a look at the extensive work done at JIPMER in the past few decades under the direction of Prof Dr Madanmohan and an update on studies being conducted by ACYTER at JIPMER as a collaborative venture with MDNIY, New Delhi. We hope that this issue of the ACYTER bulletin will stimulate many like minded scientists to explore yoga in a wholistic manner and provide a scientific understanding of its great preventive and therapeutic potential. Dr Ananda Balayogi Bhavanani Programme Coordinator ACYTER
# Bhavanani AB. IJYT 2011; 21: 21

Correspondence to: The Editor, Bulletin of ACYTER, III floor Institute Block, JIPMER, D Nagar, Puducherry- 605 006, India E-mail: acyter.jipmer@gmail.com

Published by the Advanced Centre for Yoga Therapy, Education & Research (ACYTER), JIPMER, D Nagar, Puducherry, India 605 006

Bulletin of ACYTER October 2011

ROLE OF YOGA IN PREVENTION AND MANAGEMENT OF CARDIOVASCULAR DISEASE: THE JIPMER EXPERIENCE Dr MADANMOHAN MBBS, MD, MSc (Yoga), FIAY Professor& Head, Dept of Physiology and Programme Director ACYTER, JIPMER, Pondicherry Email: drmadanmohan999@rediffmail.com Non-communicable diseases, including cardiovascular diseases comprise more than 60% of health problems and are a major burden on our health care delivery system. In developed countries, cardiovascular disease accounts for 30% of all cause mortality and the incidence is more among the elderly. India is catching fast with an alarming increase in the incidence of hypertension and coronary artery disease. It is a matter of great concern that young Indian professionals who are at the peak of their life and career are becoming victims of cardiovascular diseases. In spite of awesome advances in modern medicine, globally millions die of cardiovascular diseases every year. Allopathy depends on powerful drugs that have many undesirable side effects, especially when administered over a period of time. Many hypertensives and heart patients have to take prolonged drug treatment with the consequent financial burden and undesirable side effects. It needs to be emphasized that Allopathy does not have all the answers for chronic, degenerative disorders whose incidence is rising by the day. Being high-tech and expensive, modern medicine has not been able to deliver health care to large sections of our population. State of-the-art technology and expensive medicine automatically limits the reach of modern medicine. Allopathy has not been able to prevent and cure lifestyle-based chronic degenerative disorders that are the bane of modern society and impose significant morbidity and mortality. It is clear that there is a pressing need for introducing yoga as an add-on, complimentary system to augment modern medicare. Modern medicine as well as yoga have sound scientific basis and are, therefore, natural allies. Their merger will give us an enlightened, holistic and highly effective health care delivery system that will be a boon to our society. Cardiovascular disease is basically a lifestyle disorder. Hence, lifestyle modification along with usual medicare should be adopted as the strategy for its prevention and management. The goal of lifestyle modification should be to modify risk factors and improve quality of life so that the need for drugs and interventional procedures is significantly reduced. Holistic science of yoga is the best lifestyle ever designed. Yoga is holistic because it has preventive, promotive as well as curative potential and is an ideal means to improve our physical, mental as well as spiritual health. The ancient marvel of yoga is the eternal and priceless gift of India to the world. Yoga means union. Union between our body, mind and soul and the ultimate union of our individual consciousness with the universal Divine Consciousness in a super-conscious state called Samadhi. Yoga is a scientific spiritual discipline and the most precious gem of Indian cultural heritage and Vedic thought. It has non-sectarian approach and is for the whole humanity. Indian yogic tradition is pre-historic. The first book of humankind, Rigved,

Published invited talk. Souvenir and Abstracts. 24th Annual Conference, Indian Society for Atherosclerosis Research & International CME on Atherosclerosis 2011, p 7-10.
Bulletin of ACYTER October 2011

mentions about yogic meditation by the wise (5:81:1). Yajurved exhorts us to practice yoga for enhancing mental health, physical strength and prosperity (11:14). That is an ideal recipe against stress and chronic disorders including cardiovascular disease. Upanishads are replete with yogic concepts and Bhagavadgita (~3000BC) mentions the term yoga 105 times in its 700 verses. In unequivocal turns, yogeshwar (lord of yoga) Krishna emphasizes the superiority of a yogi (Bhagavadgita 6:46). Scientific literature on the role of yoga in prevention and management of cardiovascular diseases is scanty. Yoga has preventive, curative as well as rehabilitative potential. This holistic action of yoga can be explained on the basis of its ability to modulate autonomic functions, relieve stress, improve physiological functions including cardio-respiratory fitness and improve quality of life. Hypertension and coronary artery disease are common disorders and many patients are on life-long medication as a way of life. To reduce the drug dosage and improve general health and quality of life, yoga should be introduced along with usual medical care. If diagnosed early, most of the patients having essential hypertension/pre-hypertension can be managed effectively by yoga alone. Even in advanced cases, yoga can improve quality of life and decrease drug dosage. Yoga is safe, effective, inexpensive and it improves overall health. In a study on patients having essential hypertension, we have demonstrated that yoga training produces a significant decrease in blood pressure and heart rate within 3 weeks of the training (Vijayalakshmi et al, Ind J Physiol Pharmacol 2004, 48: 59-64). In this study, we have also found that yoga training optimizes the sympathetic response to stressful stimuli like isometric handgrip test. Other workers (Patel and North, lancet 1975, 19: 93-95; Datey et al, Angiology 1969, 20: 325-333) also have reported blood pressure lowering ability of yoga training. For best results, yogic lifestyle should be adopted early in life since atherosclerotic plaques in coronary arteries start forming early in life. Moreover, in a recent report, we have found that the levels of LDL and total cholesterol are higher in prehypertensive patients as compared to normal subjects (Pavithran et al, Indian J Physiol Pharmacol 2007, 51: 96-98). Breathing exercises and relaxation training have beneficial effects in patients with previous myocardial infarction (van Dixhoom, Biol Psycol 1998, 49: 123-135). This supports our earlier finding that shavasan (yoga relaxation training) and pranayam (yoga breathing) is beneficial in patients having premature ventricular complexes and palpitations (Ravindra et al, International J Cardiology 2006, 108:124-125). In a recent work, we have demonstrated that pranayam breathing at 6 breaths/min can reduce heart rate and blood pressure of hypertensive patients within 5 mins of starting the practice (Bhavanani et al, International J Yoga Therapy 2011, 21: 73-76). This novel finding has potential therapeutic application in day-to-day as well as clinical situations where blood pressure needs to be brought down quickly. We recommend that this simple to perform and inexpensive technique be added to the management protocol of hypertensive patients as an add-on to the routine medical care. Therapeutic potential of yoga may be due to, at least partly, its ability to modulate autonomic function. In a study on the effect of pranayam on school children, we have demonstrated that three month pranayam training produce a decrease in basal sympathetic tone, an increase in basal parasympathetic activity and a significant decrease in rate pressure product (Udupa et al, Indian J Physiol Pharmacol 2003, 47: 27-33). Rate-pressure product is an index of load on heart and myocardial oxygen consumption. These findings indicate that pranayam has potential benefit in health and disease. In another study, we have demonstrated that six week yoga training improves thermoregulatory efficiency as measured by weight loss response to step test (Madanmohan et al, Indian J Physiol Pharmacol 2008, 52: 164-170). This yoga training induced attenuation of
Bulletin of ACYTER October 2011

sweating response to muscular exercise is of physiological significance and indicates improved autonomic regulation and exercise tolerance. Our findings support those of Michalsen et al (Am Heart J 2006, 151: 870-877) who have reported that comprehensive lifestyle modification improves autonomic function, angina and quality of life of patients with established coronary artery disease. Stress is an important factor in the etiology as well as progression of chronic diseases including hypertension and coronary artery disease. For prevention as well as management of stress, there is no method as effective and far-reaching as yoga. Shavasan, meditation and mantra chanting are very effective in controlling stress. Yogic postures, when performed with awareness and synchronized with breathing as well as slow, rhythmic pranayams are effective stress busters. In a study on subjects who were well trained in yoga, we have demonstrated that savitri pranayam (slow rhythmic and deep breathing with a ratio of 2:1:2:1 between inspiration, hold-in, expiration and hold-out phases) and shavasan produce a significant decrease in oxygen consumption and a deep psychosomatic relaxation within 5 minutes of starting the practice (Madanmohan et al, The Yoga Review 1983, 3: 25-34). In another study, we have demonstrated that shavasan improves ones ability to withstand stress as measured by response to cold-pressor test and this ability can be achieved within 7 days of training (Madanmohan et al, Indian J Physiol Pharmacol 2002, 46: 307-312). Our findings are consistent with the report that yoga training not only produces a significant decrease in basal anxiety level, but also attenuates the increase in stress scores during stressful situations like examinations (Malathi and Damodaran, Indian J Physiol Pharmacol 1999, 43:218). It is clear that yoga is very effective in combating stress and stress disorders like hypertension and coronary artery disease. The beneficial health-promoting and therapeutic effects of yoga training can also be due to improvement of physiological functions. Practice of pranayam and asan results in improvement of physical fitness and cardio-respiratory endurance. In a work on normal school going boys, we have found that yoga training blunts the exercise-induced increase in heart rate and blood pressure (Madanmohan et al, Indian J Physiol Pharmacol 2004, 48: 461465). This suggests that yoga training improves exercise tolerance. In an another work conducted on medical students, we have found that 12 week yoga training produces a significant increase in respiratory pressures, handgrip strength and breath holding time, suggesting an improved physical strength and cardio-respiratory function. Yoga training also improves respiratory endurance, muscle strength and reaction time (Madanmohan et al, Indian J Physiol Pharmacol 1992, 36: 229-233). Improvement of pulmonary functions by yoga training has also been reported by us (Madanmohan et al, Indian J Physiol Pharmacol 2003, 47: 387-392). We have also reported that training in slow breathing pranayams (e.g. savitri pranayam) reduces the basal heart rate and rate-pressure product while training in fast breathing pranayams (e.g. bhastrika) produces an increase in these parameters. Thus, it is possible that slow and fast pranayams may have different therapeutic effects. Our studies demonstrate the health promoting and therapeutic potential of yoga. Yoga can play a significant role in prevention as well as management of cardiovascular disease, especially essential hypertension and coronary artery disease, whose incidence is increasing alarmingly. Yoga is the mantra for avoidable attributes of ageing.

Bulletin of ACYTER October 2011

CURRENT YOGA RESEARCH ACTIVITIES AT JIPMER Various studies are being conducted at JIPMER as collaborative efforts between ACYTER and the Departments of Physiology, Medicine, Biochemistry, Cardiology, Obstetrics and Gynecology. Papers and abstracts have been published on the completed studies and also submitted for publication. Details of the various studies that have been completed / in progress are given below along with details of the papers published and those in press. PhD theses: In Progress: 1. Effect of yoga therapy on cardiac autonomic functions and oxidative stress in prehypertensive subjects: a randomized controlled study. 2. Effect of yoga therapy on cardiac function, response to exercise, oxidative stress and quality of life in heart failure patients: a randomized controlled trial. MD dissertations: Completed: 1. Effect of 12 week yoga therapy as a lifestyle intervention in patients of type 2 diabetes mellitus with distal symmetric polyneuropathy A randomized controlled study. Dissertation submitted. 2. Effect of yoga therapy on cardiac autonomic function in patients of essential hypertension A randomized controlled study. Dissertation submitted In Progress: 1. Effects of slow and fast pranayams on pulmonary function, handgrip strength and endurance in young healthy volunteers A randomized controlled trial. 2. Effect of yoga training on autonomic functions and reaction time in young healthy females during different phases of menstrual cycle. 3. Effect of pranayam on maximal exercise performance, pulmonary function, recovery heart rate and blood pressure in healthy adults. MSc dissertations: Completed: 1. Effect of yoga training on heart rate, blood pressure and lipid profile of patients with essential hypertension. Paper has been submitted for publication 2. Effect of yoga training on reaction time, blood glucose and lipid profile of female diabetes mellitus patients. Paper has been accepted for publication 3. Effect of yogic training on physical and biochemical variables of type 2 diabetes mellitus patients. Dissertation submitted. PILOT STUDIES: Completed: 1. Immediate effect of sukha pranayama on heart rate and blood pressure of patients with hypertension. Paper has been published in International Journal of Yoga therapy 2011; 21: 73-76. 2. Immediate cardiovascular effects of kaya kriya in normal healthy volunteers. Abstract of the study published in ACYTER bulletin, workshop proceedings and compilations.
Bulletin of ACYTER October 2011

3. Immediate effect of shavasana and savitri pranayama on heart rate and blood pressure of hypertensive patients. Abstract of the study published in ACYTER bulletin, workshop proceedings and compilations. 4. Immediate effect of chandra nadi pranayama on heart rate and blood pressure of hypertensive patients. Abstract of the study published in ACYTER bulletin, workshop proceedings and compilations. Full paper has been submitted for publication 5. Immediate cardiovascular effects of shavasana and pranava pranayama on heart rate and blood pressure of hypertensive patients. Abstract of the study published in ACYTER bulletin, workshop proceedings and compilations. 6. Immediate effects of yoga nidra on heart rate and blood pressure. Abstract of the study published in ACYTER bulletin, workshop proceedings and compilations. 7. Immediate effect of yoga practices on blood pressure. Work and data analysis completed. 8. Immediate cardiovascular effects of pranava pranayama in hypertensive patients. Paper has been submitted for publication. 9. Immediate effect of suryanadi pranayam on heart rate and blood pressure of hypertensive patients. Work and data analysis completed 10. Immediate effect of suryanadi and chandranadi on short term heart rate variability in healthy volunteers. Data analysis completed and abstract of the study sent for publication and presentation at APPICON 2011. In Progress: 1. A pilot study on acute effect of anulom vilom pranayam on heart rate variability in healthy volunteers. Work and data analysis completed and more patients are being recruited 2. Immediate effect of 5 minutes chandranadi pranayam on heart rate variability in hypertensive patients. Work and data analysis completed and more patients are being recruited 3. Immediate effect of 5 minutes chandranadi pranayam on heart rate variability in Diabetes mellitus patients. Work and data analysis completed and more patients are being recruited 4. Acute effect of 5 minutes chandranadi pranayam on heart rate variability in patients with diabetes mellitus and hypertension. Work and data analysis completed and more patients are being recruited 5. Immediate effect of 5 minutes chandranadi pranayam on heart rate variability in patients of heart failure. Work and data analysis completed and more patients are being recruited 6. A pilot study on effect of respiratory rate on heart rate variability in healthy volunteers. 7. Effect of yoganidra on short term HRV in heart failure patients. CASE STUDIES: Completed: Effect of yoga on subclinical hypothyroidism. Full paper was published in Yoga Mimamsa 2011; 43: 102-107. Effect of yoga in newly diagnosed hypertension. Abstract of the study published in ACYTER bulletin.
Bulletin of ACYTER October 2011

Effect of yoga in a patient of long standing diabetes and hypertension. Abstract of the study published in ACYTER bulletin. Case report on COAD in an adult. Abstract of the study published in ACYTER bulletin. Case report on bronchial asthma in a 4 year old child. Abstract of the study published in ACYTER bulletin.

OTHER RESEARCH PROJECTS: Completed: Patient Feedback Survey and Retrospective Wellness Questionnaire was completed for 100 patients in June 2011 and published in ACYTER bulletin of July 2011. In progress: 1. Effect of slow and fast pranayams on cognitive and autonomic parameters in young healthy subjects. 2. Effect of mid trimester yoga on the incidence of preeclampsia in high risk women. The clinical trial is being conducted in collaboration with the Department of Obstetrics and Gynecology with Dr K Manikandan, Asst Professor as Principal Investigator. The trial has been registered as CTRI/2011/10/002064 with Clinical Trials Registry- India (CTRI), hosted at the ICMR's National Institute of Medical Statistics (NIMS). PUBLICATIONS: 1. Effect of yoga on subclinical hypothyroidism: a case report. Yoga Mimamsa 2011; 43: 102-107. 2. Immediate effect of sukha pranayama on cardiovascular variables in patients of hypertension. International Journal of Yoga therapy 2011; 21: 73-76. 3. Dont put yoga in a small box: The challenges of scientifically studying yoga. Perspective by Ananda Balayogi Bhavanani. International Journal of Yoga therapy 2011; 21: 21. 4. A comparative study of slow and fast suryanamaskar on physiological function. International Journal of Yoga 2011: 4 (2); 71-76 5. Effects of a comprehensive six week yoga therapy programme on reaction time and biochemical parameters and wellness score of peri and post menopausal diabetic patients. Accepted for publication in the International Journal of Yoga. 6. Role of yoga in managing bronchitis. Accepted for publication in Journal of Alternative and Complementary Medicine. 7. Immediate effect of mukha bhastrika (a bellows type of pranayama) on reaction time in special children. Accepted for publication in Indian Journal of Physiology and Pharmacology. 8. Immediate cardiovascular effects of pranava pranayama in hypertensive patients. Submitted to the Indian Journal of Physiology and Pharmacology. 9. Effects of a comprehensive eight week yoga therapy programme on cardiovascular health in patients of essential hypertension. Submitted to the International Journal of Yoga therapy.
Bulletin of ACYTER October 2011

10. Immediate effect of chandra nadi pranayama (left unilateral forced nostril breathing) on cardiovascular parameters in hypertensive patients. Submitted to the International Journal of Yoga. YOGA THERAPY OPD AT SUPERSPECIALITY BLOCK Yoga therapy OPD is functioning regularly in Super Specialty Block of JIPMER. Yoga therapy and lifestyle consultation is given by Dr Ananda Balayogi Bhavanani and Dr Zeena Sanjay from 10 AM to 1 PM on Monday, Wednesday and Friday and 10 AM to 4 PM on Tuesday and Thursday. 441 patients (new 334 and old 107) of various disorders attended the OPD between July and October 2011. YOGA RESEARCH LAB AT SUPERSPECIALITY BLOCK ACYTER Yoga Research Lab is functioning in SS Block since 6 July 2011 and regular studies are being done on patients of diabetes, hypertension and heart failure along with the administration of questionnaires. Various pilot studies on patients as well as normal volunteers are being conducted by Sri E Jayasettiaseelon, SRF in coordination with Sri Harikrishna, PhD Scholar and Dr M Rajajeyakumar, SR, Department of Physiology. YOGA THERAPY SESSIONS The yoga therapy sessions are being conducted at ACYTER yoga hall on Mondays, Wednesdays and Fridays from 10 11 AM for patients of diabetes, 11 AM 12 noon for patients of cardiovascular diseases and 12 noon 1 PM for patients of other disorders. Additional sessions are being conducted on Tuesday, Thursday and Saturday from 10 11 AM for patients of diabetes. The yoga instructors, Shri G Dayanidy and Selvi L Vithiyalakshmi are conducting the sessions both individually and in groups as per directions of the therapists. Patients have reported satisfaction with the therapy sessions and are attending regularly. 654 patients of diabetes, 514 of hypertension and 635 of other conditions attended these sessions between July and October 2011. YOGA CLASSES FOR NORMAL SUBJECTS Yoga classes are being conducted on Mondays, Wednesdays and Fridays at 6.30 AM and 4.30 PM. 637 participants attended the classes in the last quarter. Suryanamaskar, basic asanas, pranayamas and relaxation techniques are being taught in the classes. YOGA CLASSES FOR SENIOR CITIZENS Yoga classes for senior citizens are being conducted every Thursday between 11 AM and 12 noon. 138 participants attended classes with Mrs. Meena Ramanathan, Guest faculty who is Coordinator, Yoga Centre, Mahatma Gandhi Medical College and Research Institute.

From
Advanced Centre for Yoga Therapy, Education and Research (ACYTER) III floor Institute Block, JIPMER, D Nagar Puducherry 605 006

To

Bulletin of ACYTER October 2011

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ADVANCED CENTRE FOR YOGA THERAPY, EDUCATION & RESEARCH (ACYTER)
(A collaborative venture between JIPMER, Puducherry & MDNIY, New Delhi)

Bulletin of ACYTER February 2012


(A special issue on the activities of ACYTER from June 2008 to February 2012)
Patrons: Dr. TS Ravikumar Director, JIPMER Dr. KSVK Subba Rao Former Director, JIPMER Dr. I V Basavaraddi Director, MDNIY, New Delhi Dr. Ashok Kumar Das Med. Superintendent, JIPMER Dr. S Badrinath Project Co-ordinator, JIPMER Dr. KS Reddy Dean, JIPMER Editor: Dr. Madanmohan Professor & Head, Dept. of Physiology, JIPMER & Programme Director, ACYTER Editorial board: Dr. GK Pal Professor, Dept. of Physiology, JIPMER Dr. Ananda Balayogi Bhavanani Programme Co-ordinator, ACYTER, JIPMER Correspondence to: The Editor, Bulletin of ACYTER, III floor Institute Block, JIPMER, D Nagar, Puducherry- 605 006 E-mail: acyter.jipmer@gmail.com Website:www.jipmer.edu/ACYTE R/main.html

ACYTER extends a hearty welcome to the new Director of JIPMER, Dr TS Ravikumar. We are confident that he will guide and motivate us to achieve greater heights. We express our heartfelt gratitude to Dr KSVK Subba Rao during whose tenure as director, ACYTER came into being. His constant guidance and support has enabled us to undertake many activities in the past three years. This issue of the bulletin gives a report on the activities of ACYTER since its inception in June 2008. CONTENTS 1 2 3 4 5 6 Dr Madanmohan awarded DSc (Yoga) Attendance at Yoga OPD and practice sessions Report on foundation course in yoga for paramedical students at Mother Theresa Post Graduate and Research Institute of Health Sciences Seminars, conferences, workshops and IEC activities Research works Publications 2 3 4 5 7 9 1

Published by the Advanced Centre for Yoga Therapy, Education & Research (ACYTER), JIPMER, D Nagar, Puducherry, India 605 006

Bulletin of ACYTER February 2012

Dr MADANMOHAN AWARDED DSc (YOGA) Dr Madanmohan, Professor and Head, Department of Physiology, and Programme Director, Advanced Centre for Yoga Therapy, Education and Research (ACYTER) was honoured with DSc (Yoga) by SVYASA University, Bengaluru on January 12, 2012. This prestigious award was bestowed upon him in recognition of his yeoman service towards the cause of scientific validation of yoga. Dr Madanmohan was awarded MBBS in Dr Madanmohan receiving DSc during 9th Convocation 1968 from Jammu & Kashmir University of SVYASA. From left to right Dr HR Nagendra, VC, and MD Physiology in1974 from Delhi SVYASA; Dr SC Sharma, VC, Tumkur University; Dr University. He joined Maulana Azad SL Goel, representative to SVYASA from the Ministry of medical College in October 1970 and HRD and Dr Madanmohan. JIPMER in March 1977. He completed PG Diploma in Yoga in 2005 and MSc Yoga in 2010 from Annamalai University. His vast teaching and research experience spanning more than four decades has resulted in 90 research papers (including original research work in Physiology and Yoga) in national and international journals and 73 abstracts and 28 magazine articles. He was honored as a Fellow of the Indian Academy of Yoga (FIAY) and has personally given yoga training to hundreds of medical students, school children, police personnel and general public. He was awarded with Karma Yoga Shiromani by Yoganjali Natyalayam (2003) for his work in yoga. He has guided 30 PG (MD, MS, MSc, and PhD) students in their thesis work, 14 medical students in their ICMR Research Studentship and been chief investigator / co-investigator in 26 research projects. He has participated in 63 national and international conferences/workshops and chaired many scientific sessions and delivered invited talks. He has served as an expert in many selection committees and is Officer-in-Overall Charge, Hindi Teaching Scheme, Pondicherry. He was awarded Gold medal and Scroll of Honor when he delivered the Annual Internal Oration (2009-10) of the JIPMER Scientific Society. He is on the Editorial / Advisory boards of many journals.

Bulletin of ACYTER February 2012

ATTENDANCE AT YOGA OPD AND PRACTICE SESSIONS


Yoga therapy OPD is functioning in the Super Specialty Block of JIPMER daily from 9 AM to 1 PM and yoga therapy sessions are being conducted at ACYTER yoga hall for diabetes everyday from 10 11 AM, for cardiovascular diseases from 11 AM 12 noon on Mondays, Wednesdays and Fridays and from 12 noon 1 PM everyday for other disorders. Sessions are conducted individually and in groups as per requirements of the patients and directions of therapists. Yoga classes for normal subjects are being conducted on Mondays, Wednesdays and Fridays at 6.30 AM and 4.30 PM and for senior citizens on Thursdays between 11 AM and 12 noon.

2009
Jan OPD attendance Therapy sessions Diabetes Hypertension Other disorders 77 35 70 41 16 Total 331 150 100 77 57 29 529 176 116 117 30 23 557 137 79 134 30 9 501 166 105 157 18 14 643 141 77 151 8 16 490 72 43 97 38 50 391 919 555 803 222 157 3442 Feb Mar Apr May Jun 92 Jul 116 Aug 95 Sep 112 Oct 183 Nov 97 Dec 91 Grand total 786

Senior citizens Normal subjects

2010
Jan OPD attendance Therapy sessions Diabetes Hypertension Other disorders 47 29 58 17 73 Total 306 116 49 162 38 57 499 108 57 142 35 41 451 73 43 133 29 44 393 53 34 155 17 36 382 68 52 148 19 77 460 113 75 204 42 134 677 171 101 150 35 88 657 133 117 135 39 119 605 192 110 213 36 59 695 159 82 162 32 35 544 242 128 216 44 70 775 1475 877 1878 383 833 6444 82 Feb 77 Mar 68 Apr 71 May 87 Jun 96 Jul 109 Aug 112 Sep 62 Oct 85 Nov 74 Dec 75 Grand total 998

Senior citizens Normal subjects

2011
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Grand total 1506

OPD attendance Therapy sessions Diabetes Hypertension Other disorders

214

74

148

81

118

110

104

190

113

111

150

93

224 120 186 21 146 Total 911

258 118 232 29 150 861

265 186 352 45 119 1115

246 186 245 28 98 884

300 176 243 45 142 1024

232 151 254 53 92 892

236 133 269 40 140 922

167 199 181 49 105 891

251 182 185 49 392 1172

148 134 163 16 541 1113

143 146 147 25 425 1036

146 158 148 50 192 787

2616 1889 2605 450 2542 11608

Senior citizens Normal subjects

Bulletin of ACYTER February 2012

REPORT ON FOUNDATION COURSE IN YOGA FOR PARAMEDICAL STUDENTS AT MOTHER THERESA POST GRADUATE AND RESEARCH INSTITUTE OF HEALTH SCIENCES ACYTER staff conducted 40 hour Foundation Course in Yoga for Paramedical Students at the department of Physiotherapy, Mother Theresa Post Graduate and Research Institute of Health Sciences, Pondicherry in November 2011. 16 students of BPT course participated in the training programme that included 20 hours of lectures and lecture-demonstrations and 20 hours of practice sessions. The sessions were conducted by Sri G Dayanidy and Selvi L Vithiyalakshmi. All participants had 100% attendance. 15 participants reported that they were practising at home daily for an average of 30 minutes. A post intervention, retrospective wellness questionnaire compiled by ACYTER was used to evaluate the comparative feelings of the participants after the training programme. Five different responses ranging from worse than before to complete relief / total satisfaction were utilized to evaluate the physical and psychological aspects and results are given below. Worse than before Ability to concentrate Control of anger / loss of temper Appetite Confidence level Ease of breathing Energy level Enjoyment of life Feeling calm & fresh Feeling of hopelessness Feeling of loneliness General flexibility General mood General sense of relaxation General wellbeing Joint mobility Nervousness Pain levels Performance of dayto-day activities Normality of menstrual cycle Sleep quality / duration Stress levels Total wellbeing score Same as before 12.5% 6.25% 6.25% 12.5% 43.75% 18.75% 18.75% 18.75% 37.5% 25% 25% 43.75% 6.25% 25% 33.33% 33.33% 13.33% 18.75% 43.75% 37.5% 53.84% 6.25% 6.25% 3.63 % 37.5% 37.5% 28.40 % Better than before 62.5% 37.5% 12.5% 31.25% 56.25% 50% 18.75% 31.5% 25% 12.5% 37.5% 50% 33.33% 33.33% 31.25% 43.75% 25% 37.5% 23.07% 37.5% 31.25% 34.34 % Much better than before 25% 37.5% 25% 37.5% 18.75% 18.75% 18.75% 37.5% 18.75% 6.25% 43.75% 18.75% 26.67% 6.25% 37.5% 25% 12.5% 12.5% 7.69% 12.5% 18.75% 22.17 % 6.25% 6.25% 12.5% 6.25% 6.25% 25% 6.25% 18.75% 12.5% 12.5% 6.25% 6.25% 26.67% 18.75% 12.5% 12.5% 15.38% 6.25% 6.25% 10.63 % Complete relief / Totally satisfied

12.5% 20%

12.5% 6.25%

Bulletin of ACYTER February 2012

SEMINARS, CONFERENCES, WORKSHOPS AND IEC ACTIVITIES


2008 September & October: 60 hour Foundation Course in Yoga conducted by Dr Madanmohan, Programme Director ACYTER for 100 undergraduate medical students of JIPMER. 2009 February 16 to 20: ACYTER organized mass yoga awareness programme in 48 schools of Puducherry with cooperation of Education Department, Government of Puducherry during the National Yoga Week 2009. More than 5,000 students, teachers and parents were sensitized to the importance of yoga for school health. March 18: Release of a booklet Introducing Yog to Medical students: The JIPMER experience by Dr Madanmohan, Programme Director ACYTER. A report on this was also published in Yoga Vijnana, Journal of MDNIY. March 18 to 20: ACYTER and Department of Physiology, JIPMER organized a three day National Workshop on Introducing Yoga in the Medical Curriculum June 1 to 15: Orientation programme was conducted for ACYTER staff by Dr. Madanmohan, Programme Director. Workshop on HRV methods was conducted by Dr ES Prakash, Asian institute of Medicine, Science and Technology. July 15: First edition of ACYTER Bulletin published. October 9: ACYTER conducted Yoga and Healthy Lifestyle consultations for delegates attending the Regional Official Language Conference for South and South Western Zone, at JIPMER Auditorium. December: Compilation and publication of Tamil translations of MDNIY IEC materials on Asana, Pranayama, Yoga for Diabetes, Yoga for Hypertension and Yoga for Cardiovascular Diseases for free distribution. 3000 copies of each booklet were distributed 2010 January 1: Workshop on Chakra Healing by Sri Bala Ratnam, founder Vibrational Breath Therapy, Melbourne, Australia. January 4 to 7: ACYTER participated in 17th International Yoga Festival conducted by Department of Tourism, Govt of Puducherry. January 12 & 13: ACYTER actively participated in Workshop on yoga for stress management and personality development organized by Anandita Trust, at Hotel Surguru at Pondicherry. January 30: Workshopcum-seminar on Role of Yoga and CAM therapies in HIV/AIDS organized at JIPMER Nursing College in collaboration with Pondicherry AIDS control society. February 12 to 18: ACYTER participated in National Yoga Week 2010 organized by MDNIY at New Delhi. Programme Director, Programme Co-ordinator, Shri E Jayasettiaseelon, SRF and Shri G Dayanidy, Yoga instructor attended. Poster presentation was given on ACYTER activities. March 18 to 20: National Workshop on Role of Yoga in Prevention and Management of Hypertension organized at JIPMER.
Bulletin of ACYTER February 2012

April : Compilations by ACYTER on Yoga and Diabetes and Yoga and Hypertension were circulated amongst JIPMER doctors. June 2 to 30: 48 hour Foundation Course in Yoga conducted for 15 medical and paramedical staff of JIPMER. October18 November 20: 48 hour Foundation Course in Yoga conducted for 63 medical doctors, paramedical professionals, students and staff members of JIPMER. November 13: Dr Ananda Balayogi Bhavanani, Programme Coordinator ACYTER delivered a lecture on Yoga for Women during 8th National Conference, Puducherry Chapter of Society of Midwives. November 27 28: ACYTER staff participated as jury in 25th Pondicherry State Yogasana competition. IEC materials were distributed and free consultation given to general public. December 5: Dr Ananda Balayogi Bhavanani, Programme Coordinator ACYTER was a guest speaker at the one day workshop on Yoga therapy for Psychiatric Disorders held at the Advanced Centre for Yoga, NIMHANS, Bangalore. 2011 January 4-7: Staff of ACYTER participated in 18th International Yoga Festival Conducted by Government of Pondicherry from 4-7 January 2011. Invited talks were given by Programme Coordinator and free consultation on yoga and healthy living was provided to delegates and members of the public. Sri G Dayanidy, Yoga Instructor ACYTER won first place and was selected to participate in the Final Championship Round. January 17: Staff of ACYTER presented talks and lecture demonstrations during the CME on Physiological Effects of Yoga, organized by Department of Physiology, Sri Satya Sai Medical College and Research Institute, near Chennai. The CME was attended by more than hundred participants from management, faculty, staff and students who gave positive feedback and expressed appreciation for the entire programme. January 20-21: Programme Director and Programme Coordinator were invited to give invited talks and conduct workshops during Golden Jubilee National Seminar-cum-Workshop on Role of Yoga in Respiratory Tract Disorders organized by the Advanced Centre for Yoga Education and Research, Gujarat Ayurved University, Jamnagar. January - March: As part of the pre-hypertension research project, yoga therapy sessions were conducted for staff members of Kendriya Vidyalaya. Screening of the participants for pre-hypertension was done and then sessions conducted thrice weekly at the school premises. February 12-18: Dr Madanmohan, Programme Director, Dr Ananda Balayogi, Programme Coordinator and Dr Zeena Sanjay, SRF participated in the National Yoga Week conducted by MDNIY, New Delhi. March 1: Released proceedings of previous national workshop-cum-seminar on Role of Yoga in Prevention and Management of Hypertension. Also released Tamil books on Yogic Management of Diabetes Mellitus and Yogic Management of Cardio Vascular Disorders. Tamil translation of MDNIY booklet on Normal healthy diet was also released. March 1-2: ACYTER conducted National Workshop-cum-Seminar on Role of Yoga in Prevention and Management of Diabetes Mellitus. May 20-June 20: Pranayam classes were conducted for 20 senior and junior residents and research scholars of Physiology Department.

Bulletin of ACYTER February 2012

July 6: The ACYTER Yoga Research Lab was inaugurated by Dr. KSVK Subba Rao, Director, JIPMER in the Super Specialty Block. Dr. AK Das, Medical Superintendent and Dr. Balachander, Professor and Head, Dept. of Cardiology were special invitees. August 6: Free hypertension screening and yoga consultation programme conducted in Lawspet, Pondicherry. Residents and PhD scholars of the Department of Physiology and staff members of ACYTER conducted the programme in coordination with the local MLA Sri Vaithiyanathan and his colleagues. August 7: Programme Co-ordinator presented an invited talk on Dealing with obesity the Yoga way during the CME on obesity organized by Woman Doctors Association (TN) at Sri Lakshminarayana Institute of Medical Sciences, Pondicherry. Mr. G Dayanidy, Yoga Instructor gave an excellent yoga demonstration to complement the talk. August 20: Yoga instructors started taking yoga sessions for physiotherapy students at Mother Theresa Institute of Health Sciences, Pondicherry. October 15: Eleventh edition of ACYTER bulletin published December 10-11: IEC materials were distributed and free consultation given for general public by the ACYTER team during the 26th Pondicherry State Yogasana competition. December 21: Dr Ananda Balayogi Bhavanani, Programme Coordinator ACYTER was invited to present a lecture on Yoga and Education in the 19th International Yoga conference at SVYASA, Bangalore. 2012 January 21: Staff of ACYTER conducted a special Yoga Awareness programme for more than 50 corporate executives and invitees of the Harmoney Company at Hotel Athiti. February 4: Programme Director presented an Invited talk on My work in yoga at Golden Jubilee Celebrations of Kashmir Medicos Association and CME, New Delhi. February 10: Programme Director presented an Invited talk on Integrating naturopathy and yoga in conventional medical education and chaired a session in the International Conference on Yoga, Naturopathy and AROGYA Expo 2012, Bangalore. February 12-18: Dr Madanmohan, Programme Director and Dr Ananda Balayogi Bhavanani, Programme Coordinator presented Key Note addresses and chaired scientific sessions during National Yoga Week at MDNIY, New Delhi. Poster presentation of ACYTER activities was exhibited by Sri E Jayasettiaseelon, SRF and Miss L Vithiyalakshmi.

RESEARCH WORKS
Many research projects are being conducted at JIPMER as collaborative efforts between ACYTER and the Departments of Physiology, Medicine, Biochemistry, Cardiology and Obstetrics & Gynecology. Papers and abstracts have been published and also submitted for publication. Details of various studies completed / in progress are given below: PhD theses: (in progress): 1. Effect of yoga therapy on cardiac autonomic functions and oxidative stress in prehypertensive subjects: a randomized controlled study. 2. Effect of yoga therapy on cardiac function, response to exercise, oxidative stress and quality of life in heart failure patients: a randomized controlled trial.
Bulletin of ACYTER February 2012

MD dissertations: Completed: 1. Effect of 12 week yoga therapy as a lifestyle intervention in patients of type 2 diabetes mellitus with distal symmetric polyneuropathy a randomized controlled study. 2. Effect of yoga therapy on cardiac autonomic function in patients of essential hypertension a randomized controlled study. In Progress: 1. Effects of slow and fast pranayams on pulmonary function, handgrip strength and endurance in young healthy volunteers a randomized controlled trial. 2. Effect of yoga training on autonomic functions and reaction time in young healthy females during different phases of menstrual cycle. 3. Effect of pranayam on maximal exercise performance, pulmonary function, recovery heart rate and blood pressure in healthy adults. MSc dissertations (completed): 1. Effect of yoga training on cardiorespiratory functions of normal young volunteers 2. Effect of yoga therapy on reaction time, biochemical parameters and wellness score of peri and post menopausal diabetic patients. 3. Effect of yoga training on heart rate, blood pressure and lipid profile of patients with essential hypertension. 4. Effect of yogic training on physical and biochemical variables of type 2 diabetes mellitus patients. OTHER RESEARCH PROJECTS: Completed: Patient feedback survey and retrospective wellness questionnaire was completed for 100 patients in June 2011. In progress: 1. Effect of slow and fast pranayams on cognitive and autonomic parameters in young healthy subjects. 2. Effect of mid trimester yoga on the incidence of pre-eclampsia in high risk women. PILOT STUDIES: Completed: 1. Immediate effect of sukha pranayama on heart rate and blood pressure of patients with hypertension. 2. Immediate cardiovascular effects of kaya kriya in normal healthy volunteers. 3. Immediate effect of shavasana and savitri pranayama on heart rate and blood pressure of hypertensive patients. 4. Immediate effect of chandra nadi pranayama on heart rate and blood pressure of hypertensive patients. 5. Immediate cardiovascular effects of shavasana and pranava pranayama on heart rate and blood pressure of hypertensive patients. 6. Immediate effects of yoga nidra on heart rate and blood pressure.
Bulletin of ACYTER February 2012

7. Immediate effect of suryanadi and chandranadi on short term heart rate variability in healthy volunteers. 8. Immediate cardiovascular effects of pranava pranayama in hypertensive patients. 9. Immediate effect of yoga practices on blood pressure. 10. Immediate effect of suryanadi pranayam on heart rate and blood pressure of hypertensive patients. In Progress: 1. Acute effect of anulom vilom pranayam on heart rate variability in healthy volunteers. 2. Immediate effect of 5 minutes chandranadi pranayam on heart rate variability in hypertensive patients. 3. Immediate effect of 5 minutes chandranadi pranayam on heart rate variability in Diabetes mellitus patients. 4. Acute effect of 5 minutes chandranadi pranayam on heart rate variability in patients with diabetes mellitus and hypertension. 5. Immediate effect of 5 minutes chandranadi pranayam on heart rate variability in patients of heart failure. 6. Effect of respiratory rate on heart rate variability in healthy volunteers. 7. Effect of yoganidra on short term HRV in heart failure patients. 8. Acute biochemical and physiological effects of unilateral and bilateral nostril breathing in patients of diabetes. 9. A controlled trial of immediate effects of pranava pranayama in shavasana on patients having both diabetes and hypertension. CASE STUDIES (completed): 1. 2. 3. 4. 5. Effect of yoga on subclinical hypothyroidism. Effect of yoga in newly diagnosed hypertension. Effect of yoga in a patient of long standing diabetes and hypertension. Case report on COAD in an adult. Case report on bronchial asthma in a 4 year old child. PUBLICATIONS Published papers: 1. Effect of yoga therapy on reaction time, biochemical parameters and wellness score of peri and post menopausal diabetic patients. Madanmohan, Ananda Balayogi Bhavanani, Dayanidy G, Zeena Sanjay, Basavaraddi IV. International J Yoga 2012; 5: 10-15. 2. Immediate effect of sukha pranayama on cardiovascular variables in patients of hypertension. Ananda Balayogi Bhavanani, Zeena Sanjay, Madanmohan. International J Yoga Therapy 2011; 21: 4-7. 3. Dont put yoga in a small box: the challenges of scientifically studying yoga. Ananda Balayogi Bhavanani. International J of Yoga Therapy 2011; 21 ; 21. 4. A comparative study of slow and fast suryanamaskar on physiological functions. Ananda Balayogi Bhavanani, Kaviraja Udupa, Madanmohan, Ravindra PN. International J Yoga 2011; 4: 72-77.
Bulletin of ACYTER February 2012

5. Effect of yoga on subclinical hypothyroidism: a case report. Ananda Balayogi Bhavanani, Zeena Sanjay, Madanmohan. Yoga Mimamsa 2011; 43: 102-107. 6. Yogic perspective on depression and mental health. Ananda Balayogi Bhavanani. Yoga Mimamsa 2011; 43: 254-264. 7. Results of a survey of participant feedback at ACYTER, JIPMER Pondicherry. Madanmohan, Ananda Balayogi Bhavanani, Zeena Sanjay, G Dayanidy, L Vithiyalakshmi, E Jayasettiaseelon. Yoga Life 2011; 42 (Nov): 11-13. 8. Are we practicing yoga therapy or yogopathy? Ananda Balayogi Bhavanani. Yoga Therapy Today 2011; 7 (2): 26-28 9. Introducing yoga to medical students: the JIPMER experience. Madanmohan. Yoga Vijnana 2008; 2: 71- 78. Published abstracts 1. Role of yoga in prevention and management of cardiovascular disease: the JIPMER experience. (Published invited talk) Madanmohan. Souvenir & Abstract. 24th Annual Conference, Indian Society for Atherosclerosis Research & International CME on Atherosclerosis 2011, p 7-10. 2. Immediate effect of suryanadi and chandranadi on short term heart rate variability in healthy volunteers. Rajajeyakumar M, Madanmohan, Amudharaj D, Bandi Harikrishna, Jeyasettiseloune, Bhavanani AB. Indian J Physiol Pharmacol 2011; 55 (5 supplement): 43-44. 3. Yoga and the educational process. Ananda Balayogi Bhavanani. Souvenir 19th International Conference on Yoga. SVYASA, Bengaluru. December 2011. p 122. Papers in press 1. Role of yoga in managing bronchitis. Ananda Balayogi Bhavanani and Zeena Sanjay (Journal of Alternative and Complementary Medicine). 2. Immediate effect of chandra nadi pranayama (left unilateral forced nostril breathing) on cardiovascular parameters in hypertensive patients. Ananda Balayogi Bhavanani, Madanmohan, Zeena Sanjay (International Journal of Yoga). 3. Yoga is not an intervention, but maybe yogopathy is. Ananda Balayogi Bhavanani (International Journal of Yoga). 4. Immediate cardiovascular effects of pranava pranayama in hypertensive patients. Ananda Balayogi Bhavanani, Madanmohan, Zeena Sanjay, Basavaraddi IV (Indian Journal of Physiology and Pharmacology). 5. Immediate effect of mukha bhastrika (a bellows type of pranayama) on reaction time in special children. Ananda Balayogi Bhavanani, Meena Ramanathan, Harichandrakumar KT (Indian Journal of Physiology and Pharmacology). 6. Effects of a comprehensive eight week yoga therapy programme on cardiovascular health in patients of essential hypertension. Madanmohan, Ananda Balayogi Bhavanani, Zeena Sanjay, Vithiyalakshmi L, Dayanidy G (Indian Journal of Traditional Knowledge). 7. Immediate cardiovascular effects of pranava relaxation in patients of hypertension and diabetes. Ananda Balayogi Bhavanani, Madanmohan, Zeena Sanjay, Vithiyalakshmi L (National Medical Journal of India)
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SUMMARY OF PUBLISHED PAPERS AND ABSTRACTS


1. Effect of yoga therapy on reaction time, biochemical parameters and wellness score of peri and post menopausal diabetic patients. Madanmohan, Ananda Balayogi Bhavanani, Dayanidy G, Zeena Sanjay, Basavaraddi IV. International J Yoga 2012; 5: 10-15. Background: Yogic practices may aid in the prevention and management of diabetes mellitus (DM) and reduce cardiovascular complications in the population. The present study was undertaken to evaluate the effect of yoga therapy on reaction time, biochemical parameters and wellness score of peri and post menopausal diabetic patients. Materials and methods: 15 peri and post menopausal patients receiving standard medical treatment for type 2 DM were recruited and reaction time and biochemical investigations were done before and after a comprehensive yoga therapy programme comprising of three times a week sessions for 6 weeks. A post intervention, retrospective wellness questionnaire compiled by ACYTER was used to evaluate the comparative feelings of the patients after the therapy programme. Results: Yoga training reduced auditory reaction time (ART) from right as well as left hand, the decrease being statistically significant (p < 0.05) for ART from the right hand. There was a significant (p < 0.01) decrease in fasting and postprandial blood glucose levels as well as low density lipoprotein. The decrease in total cholesterol, triglycerides, and very low density lipoprotein and increase in high density lipoprotein was also statistically significant (p< 0.05). All the lipid ratios showed desirable improvement with a decrease (p<0.01) of TC/HDL and LDL/HDL ratios and increase (p<0.05) in the HDL/LDL ratio. Discussion: Shortening of RT implies an improvement in the information processing and reflexes and is the first such report in diabetic patients. This has clinical significance and is worth further exploration with wider, well controlled, randomized studies in the diabetic population. Changes in blood glucose levels may be due to improved insulin sensitivity, decline in insulin resistance and increased sensitivity of the pancreatic cells to glucose signals. Yoga improved the heart friendly status of lipid profile in our subjects and as our participants were peri and post menopausal, the decrease in cardiovascular risk profile is of greater significance. A comprehensive yoga therapy programme has the potential to enhance the beneficial effects of standard medical management of diabetes mellitus and can be used as an effective complementary or integrative therapy programme. 2. Immediate effect of sukha pranayama on cardiovascular variables in patients of hypertension. Ananda Balayogi Bhavanani, Zeena Sanjay, Madanmohan. International J Yoga Therapy 2011; 21: 4-7. Hypertension is one of the most common health disorders, and yoga has been shown to be an effective adjunct therapy in its management. Earlier studies have reported blood pressure (BP)-lowering effects of slow, deep breathing after 3 weeks and 3 months of training and beneficial immediate effects of slow, deep breathing in reducing premature ventricular complexes and lowering blood pressure. None of these immediate studies used the concept of pranayama, involving conscious internal awareness of the whole breathing process. This study was undertaken to determine the immediate cardiovascular effects of sukha pranayama in hypertensive patients. Methods: Twenty-three hypertensive patients attending the Yoga OPD at JIPMER were recruited for the study and instructed to perform sukha pranayama for 5 minutes at the rate of 6 breaths/min. This pranayama involves conscious, slow and deep breathing with equal duration for inhalation and exhalation. Heart rate (HR) and BP were recorded before and immediately after the intervention. Results: Post- intervention statistical analysis revealed a significant (p <0 .05) reduction in HR and a highly significant (p < 0.001) reduction in systolic pressure, pulse pressure, mean arterial pressure, rate-pressure product, and double product with an
Bulletin of ACYTER February 2012

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insignificant fall in diastolic pressure. Discussion: It is concluded that sukha pranayama at the rate of 6 breaths/minute can reduce HR and BP in hypertensive patients within 5 minutes of practice. This may be due to a normalization of autonomic cardiovascular rhythms as a result of increased vagal modulation and/or decreased sympathetic activity and improved baroreflex sensitivity. Further studies are required to understand possible mechanisms underlying this beneficial immediate effect and to determine how long such a beneficial effect persists. 3. Dont put yoga in a small box: the challenges of scientifically studying yoga. Ananda Balayogi Bhavanani. International Journal of Yoga Therapy 2011; 21: 21. It is clearly important to legitimize yoga practices in the eyes of the scientific community. However, we need to move away from the current model of yoga research that resembles pharmaceutical companies trying to find wonder drugs for newer diseases. Most modern yoga researchers seem to be trying to find a single yoga pill for each ill. We need to focus more attention on the core concepts of yoga. This requires extensive basic research that is lacking in modern times, as there isnt much money available for such an approach. We must not allow yoga to be made small as modern science tries to make yoga fit the demands of science. Putting yoga in a small box is as absurd as trying to put the ocean in a tea cup. We must remember that the origin of research in yoga dates back to the prehistoric origin of yoga itself. Our ancient seers, the rishis, were truly searching and researching the all important question, Who am I? One of the dangers in modern times is that many excellent scientists are researching yoga, but because their understanding of yoga is so limited, they end up missing the bus completely, in my opinion. Excellent papers are published from a scientific perspective, but they are truly very limited from a yogic perspective. There has to be a symbiotic relationship between yoga and modern science, and for this, human bridges combining the best of both worlds need to be cultivated. It is important that more scientists take up yoga and more yogis go into the study of science, so that we can build a bridge between these two great aspects of our civilization. 4. A comparative study of slow and fast suryanamaskar on physiological functions. Ananda Balayogi Bhavanani, Kaviraja Udupa, Madanmohan, Ravindra PN. International J Yoga 2011; 4: 72-77. Background: Numerous scientific studies have reported beneficial physiological changes after short- and long-term yoga training. Suryanamaskar (SN) is an integral part of modern yoga training and may be performed either in a slow or rapid manner. As there are few studies on SN, we conducted this study to determine the differential effect of 6 months training in the fast and slow versions. Materials and Methods: 42 school children in the age group of 12-16 years were randomly divided into two groups of 21 each. Group I and Group II received 6 months training in performance of slow suryanamaskar (SSN) and fast suryanamaskar (FSN), respectively. Results: Training in SSN produced a significant decrease in diastolic pressure. In contrast, training in FSN produced a significant increase in systolic pressure. Although there was a highly significant increase in isometric hand grip (IHG) strength and hand grip endurance (HGE) in both the groups, the increase in HGE in FSN group was significantly more than in SSN group. Pulmonary function tests showed improvements in both the groups though intergroup comparison showed no significance difference. Maximum inspiratory pressure (MIP) and maximum expiratory pressure increased significantly in both the groups with increase of MIP in FSN group being more significant than in SSN. Conclusion: The present study reports that SN has positive physiological benefits as evidenced by improvement of pulmonary function, respiratory pressures, hand grip strength and endurance, and resting cardiovascular parameters. It also demonstrates the differences between SN training when
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performed in a slow and fast manner, concluding that the effects of FSN are similar to physical aerobic exercises, whereas the effects of SSN are similar to those of yoga training. 5. Effect of yoga on subclinical hypothyroidism: a case report. Ananda Balayogi Bhavanani, Zeena Sanjay, Madanmohan. Yoga Mimamsa 2011; 43: 102-107. Introduction: Complementary and Alternative Medical (CAM) therapies such as yoga are being increasingly used as adjuncts to modern medicine. Though it has been suggested that yoga may have a role in revitalizing thyroid function there are few studies on the effects of yoga on thyroid disorders. Case history: A 36 year old female with elevated TSH level (9.39 IU/ml) and low normal T4 levels (12.57 pmol/L) was diagnosed as having primary subclinical hypothyroidism and advised to start replacement therapy. She came for consultation to the ACYTER Yoga OPD at JIPMER, Pondicherry and was given appropriate yogic counseling and taught a series of techniques potentially beneficial to patients of thyroid conditions. She continued the practices for a year and reported back at the end of the year with her biochemical investigations. Results: After one year of therapy, there was a fall in TSH (2.66 mIU/L) and a normalization of free T4 values (8.98 pmol/L). A third biochemical analysis three months later showed that TSH further stabilized 2 mIU/L and FT4 at 9.78 pmol/L. As the anti TPO antibodies were positive both before and after the yoga intervention, the patient was advised to continue the yoga practices on a regular basis as long as possible with regular six-monthly follow up. Conclusion: it is suggested that yoga can be an effective adjunct therapy in thyroid conditions and further studies in larger samples are needed to confirm these findings and to better understand the mechanisms behind such beneficial effects in patients of thyroid disorders. 6. Yogic perspective on depression and mental health. Ananda Balayogi Bhavanani. Yoga Mimamsa 2011; 43: 254-64. The dedicated practice of Yoga as a way of life is no doubt a panacea for problems related to psychosomatic, stress related physical, emotional and mental disorders and helps us regain our birthright of health and happiness. It is only when we are healthy and happy that we can fulfill our destiny. According to the Yoga Darshan codified by Maharishi Patanjali, depression or rather daurmanasya is one of the four vikshepa sahabhuvah that are the manifestations that accompany the obstacles to yoga sadhana, the nava antaraya. The other sahabhuvah are duhkha or suffering, angamejayatva or tremors and shvasaprasvasa or irregular respiration (duhkhadaurmanasya angamejayatva shvasaprasvasa vikshepa sahabhuvah -Yoga Darshan -1:31). When we analyze this sutra deeply we find that they are very true reflections of our inner state. The central theme of Yoga is the golden mean, finding the middle path, a constant search for moderation and a harmonious homoeostatic balance. Yoga is the unitive impulse of life, which always seeks to unite diverse streams into a single powerful force. Proper practice produces an inner balance of mind that remains stable and serene even in the midst of chaos. This ancient science shows its adherents a clear path to the eye of the storm and ensures a stability that endures within, even as the cyclone rages externally. 7. Results of a survey of participant feedback at ACYTER, JIPMER Pondicherry. Madanmohan, Ananda Balayogi Bhavanani, Zeena Sanjay, Dayanidy G, Vithiyalakshmi L, Jayasettiaseelon E. Yoga Life 2011; 42 (Nov): 11-13. The Advanced Centre for Yoga Therapy Education and Research (ACYTER), a collaborative venture between JIPMER, Puducherry and Morarji Desai National Institute of Yoga (MDNIY), New Delhi was established by MOU between JIPMER and MDNIY in 2008. This advanced centre is focusing primarily on the role of yoga in the prevention
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and management of cardiovascular disorders and diabetes mellitus. In the period from March to June 2011, a survey was done on 100 patients who were regularly attending yoga therapy sessions at ACYTER and had completed a minimum of one month of the regular programme. A questionnaire was given to them consisting of questions related to their age, gender and demographic characteristic in addition to their main health complaints, attendance at the yoga sessions, home practice as well as their physical and mental condition and changes in dosage of medication. 8. Are we practicing yoga therapy or yogopathy? Ananda Balayogi Bhavanani. Yoga Therapy Today 2011; 7 (2): 26-28 Unless we aim to correct the manifest psycho-somatic disassociation as well as the underlying ignorant jaundiced perception of reality in the individual, we are not practicing Yoga Chikitsa (Yoga therapy). Managing and suppressing the manifest symptoms with Yoga techniques is just as good or bad as modern Allopathy that focuses on symptomatic management without ever getting close to the real cause of most disorders. How many doctors look at the emotional and psychological issues that are the primary cause of the problem in so many of their patients? When Yoga therapists make the same mistake of merely treating the manifesting symptoms without remedying the cause, it is better referred to as yogopathy. 9. Introducing yoga to medical students: the JIPMER experience. Madanmohan. Yoga Vijnana 2008; 2: 71- 78. I have given yoga training to many batches of medical students, school children, police personnel and hospital patients with the aim of determining the effectiveness of yoga as a health-promoting and therapeutic intervention. The results have been gratifying and many papers have been published in indexed journals. It was my hearts desire to introduce yoga to medical students as a branch of physiology and contemporary medicine. The opportunity came with financial support from Morarji Desai National Institute of Yoga, New Delhi. With the aim of motivating 30 students to join the initial programme, I took introductory lecture for the MBBS batch of 2008. However, after the introductory lecture, many students wanted to join and I enlisted the entire batch (n=100) for the programme. The objectives of the programme were: 1) To promote awareness among medical students about the effectiveness of yoga as an inexpensive means for achieving holistic health, 2 ) To impart knowledge, skill & attitude about the theoretical & practical aspects of yogic science, 3)To motivate medical students to take up further studies, therapy & research in yoga and 4) To introduce yoga in medical curriculum as a branch of physiology & contemporary medicine. I designed a 60 hour programme that included lectures, lecturedemonstrations, practice sessions, students seminar on yoga therapy modules and pretest, post-test, administration of questionnaires to students and programme evaluation by the students. The programme had an overwhelming response with excellent co-operation from the medical undergraduates. In light of the encouraging student feedback it is suggested that yoga should be made an integral part of medical curriculum, as a branch of physiology and contemporary medicine. Complementary and alternative health systems are already being taught in many standard modern medical schools in different parts of the world. Yoga has a stronger scientific and philosophical basis. The ideal time in an undergraduate medical programme where yoga can be incorporated is during the first semester and again during sixth and / seventh semesters. The former will help them in combating and adapting to the totally new and stressful first year undergraduate medical curriculum. The latter will help in better understanding of the science of yoga and its applications in clinical practice. This will also enable them to shape themselves as holistic physicians and help them in their personal development as well as to become more efficient physicians. The present programme was constrained by lack of a space with
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proper ambience which is very essential for yoga training. It is suggested that there should be a space fully furnished, having the right ambience and comfort that will facilitate the teaching and practice of yoga. The space should be exclusively devoted to the yoga training programme. From the students standpoint, practice sessions with integrated theory, morning practice sessions and training schedule within the college hours are among major recommendations. Students also wanted a facility to continue yoga practice on a regular basis even after the completion of the introductory programme.

SUMMARY OF PUBLISHED ABSTRACTS 1. Role of yoga in prevention and management of cardiovascular disease: the JIPMER experience. (Published invited talk) Madanmohan. Souvenir & Abstract. 24th Annual Conference, Indian Society for Atherosclerosis Research & International CME on Atherosclerosis 2011, p 7-10. This article discusses some of the important research findings from JIPMER related to the role of yoga in prevention and management of cardiovascular diseases that demonstrate the health promoting and therapeutic potential of yoga. Yoga can play a significant role in prevention as well as management of cardiovascular disease, especially essential hypertension and coronary artery disease, whose incidence is increasing alarmingly. In the words of Dr Madanmohan, Yoga is the mantra for avoidable attributes of ageing". 2. Immediate effect of suryanadi and chandranadi on short term heart rate variability in healthy volunteers. Rajajeyakumar M, Madanmohan, Amudharaj D, Bandi Harikrishna, Jeyasettiseloune, Bhavanani AB. Indian J Physiol Pharmacol 2011; 55 (5 supplement): 43-44. Background: Yoga is a science practiced in India over thousands of years. It produces consistent physiological changes and have sound scientific basis. Pranayam or the control of prana or the life force yields control over bodily functions and the mind. Heart rate variability has come to be widely used as a non-invasive tool to assess autonomic function in a variety of physiologic as well as disease states. Different types of pranayams are known to improve autonomic function by changing sympathetic or parasympathetic activity. In view of this, the present study was aimed to study the effect of suryanadi and chandranadi pranayams on HRV in healthy young volunteers. Methods: The present study was conducted on 11male volunteers 20-30yrs. Their height, weight were recorded and BMI was calculated. Volunteers were assigned to a sequence randomly. Each volunteer was taught both suryanadi (SNP) and chandranadi pranayam (CNP) by trained yoga teacher and made to practice under direct supervision until they were familiar. The procedures and recordings were carried out in lying down posture for all volunteers between 4-6.30 pm in ACYTER lab, JIPMER. Heart rate variability (HRV) was recorded by using BIOHARNESS AcqKnowledge 4.1 version and analyzed by Kubios HRV 2.00 software. Basal resting parameters and HRV were recorded for 5 minutes after that. SNP (only right nostril breathing) was performed in six cycles per minute (each cycle consists of 5 seconds for each inspiration and expiration) for 5 minutes followed by 5 min rest. Three such sessions (before, during and after) HRV were recorded. The same procedure and recording ware followed for CNP (left nostril breathing only). Appropriate statistical analysis was done using SPSS version 16(Repeated measures of ANOVA followed by post hoc analysis with Benferroni adjustment) and the level of statistical significance is considered at a p value < 0.05. Results: The results of our study were much in accordance with the previous studies. The time domain analysis of SNP revealed an increased heart rate with a decreased RMSSD, the index of short term HRV. However the SDNN which is considered the index
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of long term HRV increased. Also, in the frequency domain analysis there is an increased LF power and decreased HF power. The index of sympathovagal balance as reflected by LF/HF ratio increased i.e from 1.8 to 2.2 after the intervention. All the observation showed that SNP is sympathomimetic. In CNP, the time domain analysis of HRV revealed a decreased heart rate and an increased pNN50. The frequency domain analysis revealed an increased HF power with decreased LF/HF ratio i.e. from 2.1 to 1.5. The observations of CNP clearly indicated that CNP is an activator of the parasympathetic activity. Conclusion: SNP increase the sympathetic activity and CNP increases the parasympathetic activity and these can be appropriately advocated in many chronic cardiovascular diseases where the autonomic imbalance is one of the primary derangements. The beneficial effect of SNP and CNP can be applied to all school children to improve the physical health and sports activities of the students. 3. Yoga and the educational process. Ananda Balayogi Bhavanani. Souvenir 19 th International Conference on Yoga. SVYASA, Bengaluru. December 2011. p 122. Each individual has different inherent potentialities that need to be cultivated for their ultimate manifest expression. There is no, One size fits all in the Indian approach to either education or health care. The Indian system of education was centred on the Guru Kula, a mentor centric process similar to that seen in higher education with possibilities of one-to-one interaction on a regular basis. This was based on the principle of stimulating a yearning for the higher concepts of being, while learning the norms of natural living. The students developed themselves physically, emotionally, mentally and spiritually during this period of intense study at the feet of the Master. The emphasis was on the development of a purna purusha, a complete human being through all round development of physical, mental, emotional and spiritual qualities. Indian scriptures give us a deep understanding of the process of learning through shravana (attentive listening), manana (introspectional analysis) and nidhidhyaasana (embodiment of the wisdom) as also different levels of students such as mridu (dull), madhya (average), adimatra (excellent) and adimatratma (supreme) samvegins. once the type of student and their nature is understood the teacher must judiciously apply the methods of teaching to maximize the inherent potential. The biggest challenge facing teachers today is how to deal with their students as they have been robbed of most of their authority. The traditional indian approach to dealing with students is four-fold: sama (treating as an equal), dana (giving of gifts), bheda (separation) and danda (punitive correction). Of course this requires great viveka (discernment) and karuna (empathy) on the part of the teacher as also safety precautions as how many teachers today have these necessary qualities of wisdom and empathy?

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