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Introduction: A multitude of modalities are available for the treatment of chronic rhinosinusitis, however, each has its side effects and compliance issues. Bhramari pranayama, which is a breathing exercise in the practice of yoga, offers an inexpensive and free from side effect modality in this regard.Objective: The objective of this study was to evaluate the efficacy of Bhramari pranayama in relieving the symptoms of chronic sinusitis. Methodology: A total of 60 patients with chronic sinusitis were randomly divided into two groups, one received conventional treatment of chronic sinusitis and the other group was in addition taught to practice yogic breathing exercise Bhramari pranayama. The patients were advised to practice this breathing exercise twice a day and were followed up at 1, 4, and 12 weeks using the Sino-Nasal Outcome Test (SNOT-22 score). Results: The mean SNOT-22 score in the group following the Bhramari pranayama breathing exercise using the ANOVA test improved from 39.13 ± 9.10 to 24.79 ± 8.31 (P = 0.0002), this improvement was seen by the end of 4 weeks itself and continued until the 12th week of assessment. Conclusion: Integrating regular practice of Bhramari pranayama along with the conventional management of chronic rhinosinusitis is more effective than conventional management alone.

Slow, deep, pranayama - based breathing training has been shown to be effective in reducing blood pressure (BP). The present study was undertaken to determine immediate effects of performing pranava pranayama on cardiovascular parameters in hypertensive patients. 29 hypertensive patients who were on medical treatment and also attending yoga sessions were recruited for the present study. Supine heart rate (HR) and BP were recorded before and after performance of pranava pranayama for five minutes. Post intervention statistical analysis revealed a significant (P<0.05) reduction in systolic pressure (SP) and a more significant (P<0.01) reduction in HR, pulse pressure and double product (Do P). The reduction in rate-pressure product (RPP) was highly significant (P<0.001). Pranava pranayama is effective in reducing HR and SP in hypertensive patients within five minutes of the 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 along with an augmentation of endogenous nitric oxide production. Our findings have potential therapeutic applications in day-to-day as well as clinical situations where blood pressure needs to be brought down at the earliest. The significant fall in RPP and Do P signifies a reduction in oxygen consumption and work done by the heart. It is concluded that pranava pranayama, a simple and cost effective technique can be used in the management of hypertensive patients in addition to the regular medical management. Further studies are required to enable a deeper understanding of the mechanisms involved and its usefulness in the long- term management of hypertension.

Mentally challenged individuals are known to have slower speed of reaction. As a previous study has shown immediate improvement in reaction time (RT) following mukha bhastrika, a bellows type of pranayama, we planned to study the effect of this pranayama in mentally challenged adolescents. 34 mentally challenged adolescents (15.1±0.806 y) studying in a school for Special Needs were recruited as they have been receiving yoga training once a week for more than 3 years. Exclusion criteria were inability to either perform mukha bhastrika or to understand procedure for testing RT. Visual (VRT) and auditory reaction time (ART) was measured using RT apparatus before and after nine rounds of mukha bhastrika and a control period of ten minutes of normal activities to rule out any test-retest practice effect. Analysis of non-intervention period values showed that the reliability in terms of reproducibility of the observation for both VRT (r=0.87) and ART (r=0.95) was excellent. Mukha bhastrika produced an immediate and significant decrease in both VRT and ART. There was a statistically significant decrease in VRT (P<0.0001) from 296.15 ms±13.49 to 263.59 ms±12.53 and ART (P<0.0001) from 247.88 ms±14.33 to 217.35 ms±11.36 following mukha bhastrika. Decrease in RT signifies improved central neuronal processing ability. This may be due to greater arousal and faster rate of information processing, improved concentration and/or ability to ignore or inhibit extraneous stimuli. Mukha bhastrika may be altering afferent inputs from abdominal and thoracic regions, in turn modulating activity at ascending reticular activating system and thalamo-cortical levels. It is suggested that yogic breathing techniques like mukha bhastrika be used as an effective means of improving neuromuscular abilities in special children.

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 < .05) reduction in HR and a highly significant (p < .001) reduction in systolic pressure, pulse pressure, mean arterial pressure, rate-pressure product, and double product with an 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.

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 < .05) reduction in HR and a highly significant (p < .001) reduction in systolic pressure, pulse pressure, mean arterial pressure, rate-pressure product, and double product with an 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.

<b>Aim:</b> This pilot study was done to evaluate the immediate effect of Sukha Pranayama, a slow and deep breathing technique on maternal and fetal cardiovascular parameters.<b>Subjects and Methods:</b> Single session pre-post comparison was done for 10 min of Sukha Pranayama in 12 pregnant women in their 3<sup>rd</sup> trimester. The study participants were guided to breathe in and out in a slow and regular manner for a count of 4 s each. Maternal cardiovascular parameters, namely mean heart rate (MHR), systolic pressure (SP), and diastolic pressure (DP), were measured before and after the session and rate-pressure product (RPP) derived with the formulae. Fetal heart rate (FHR) was derived from the nonstress test tracing. <b>Results:</b> SP, MHR, FHR, and RPP reduced significantly after single session of Sukha Pranayama. The mothers reported that they felt more relaxed and also sensed active fetal movement while performing the pranayama. <b>Discussion:</b> Reduction in maternal cardiovascular parameters may be attributed to reduced sympathetic activity coupled with enhanced vagal parasympathetic tone. Reduction in RPP signifies reduced myocardial oxygen consumption and load on the heart as evidenced by previous studies. These changes in cardiac autonomic status may enhance placental circulation, leading to healthier fetal development. <b>Conclusion:</b> The present study reiterates the importance of yoga for the psychosomatic health of maternal-fetal unit as an add-on relaxation technique. We plan to develop this pilot study into a full-fledged evaluation of maternal and fetal wellbeing through yoga.