Narsingh Verma

Effect of yogic practices on lipid profile and body fat composition in patients of coronary artery disease

OBJECTIVES To observe the effect of regular yogic practices and self-discipline in reducing body fat and elevated lipids in CAD patients. METHOD In this study one hundred seventy (170) subjects, of both sexes having coronary artery disease were randomly selected form Department of Cardiology. Subjects were divided in to two groups randomly in yoga group and in non-yoga group, eighty five (85) in each group. Out of these (170 subjects), one hundred fifty four (154) completed the study protocol. TIME LINE: The yogic intervention consisted of 35-40 min/day, five days in a week till six months in the Department of Physiology CSMMU UP Lucknow. Body fat testing and estimation of lipid profile were done of the both groups at zero time and after six months of yogic intervention in yoga group and without yogic intervention in non yoga group. RESULTS In present study, BMI (p<0.04), fat % (p<0.0002), fat free mass (p<0.04), SBP (p<0.002), DBP (p<0.009), heart rate (p<0.0001), total cholesterol (p<0.0001), triglycerides (p<0.0001), HDL (p<0.0001) and low density lipoprotein (p<0.04) were changed significantly. CONCLUSION Reduction of SBP, DBP, heart rate, body fat%, total cholesterol, triglycerides and LDL after regular yogic practices is beneficial for cardiac and hypertensive patients. Therefore yogic practices included in this study are helpful for the patients of coronary artery disease.

Increased parasympathetic tone as the underlying cause of asthma: A hypothesis

Asthma is a chronic inflammatory disease of airways that is characterized by increased responsiveness of the tracheo-bronchial tree to multiple number of stimuli. Immunological theory does not explain all features in asthma, for example hyper-reactivity of the airways. Neurogenic theory also fails to explain the pathogenesis of asthma comprehensively. Higher parasympathetic tone has been reported in asthmatics but has never been suggested as a major underlying cause of asthma. This article attempts to explain the occurrence of hyper-responsiveness, inflammatory/allergic reactions and broncho-constriction in asthma on a common basis of inherent higher parasympathetic tone in asthmatics. The higher background parasympathetic firing leads to increased nitric oxide (NO) production owing to its co-localization with acetylcholine (ACh) in inhibitory non-adrenergic and non-cholinergic (i-NANC) nerves. NO is a neurotransmitter of i-NANC system and it mediates bronchodilation. Increased NO release has been found to be responsible for hyper-responsiveness and increased inflammation in the airways. The authors suggest that an inherently higher background parasympathetic tone in concert with inflammation or a specific genetic background could modify the effects of NO on lung homeostasis in humans leading to increased susceptibility to an asthmatic state.

A multicenter clinical study to determine the efficacy of a novel fenugreek seed (Trigonella foenum-graecum) extract (Fenfuro™) in patients with type 2 diabetes

Background Trigonella foenum-graecum (fenugreek) seeds are known to exhibit potent antioxidant, hypoglycemic, and nephroprotective activities, as well as serve as excellent membrane stabilizers especially because of their content of novel furostanolic saponins. Our previous studies exhibited the broad spectrum safety and efficacy of Fenfuro, a novel T. foenum-graecum seed extract enriched in furostanolic saponins, in type 2 diabetes (T2D) in rats. Design This multicenter, randomized, placebo-controlled, double-blind, add-on clinical study evaluated over a period of 90 consecutive days the efficacy of Fenfuro (daily dosage: 500 mg bid) in 154 subjects (male: 108; female: 46; age: 25–60 years) with T2D. Methods This study examined the body weight, blood pressure, and pulse rate, as well as the efficacy of Fenfuro on fasting and post-prandial plasma sugar (mg/dL), glycosylated hemoglobin (HbA1c), and fasting and post-prandial C-peptide levels. Results Fenfuro caused significant reduction in both fasting plasma and post-prandial blood sugar levels. Approximately 83% of the subjects reported decreases in fasting plasma sugar levels in the Fenfuro-treated group as compared to 62% in the placebo group, while 89% of the subjects demonstrated reduction in post-prandial plasma sugar levels in the Fenfuro-treated group as compared to 72% in the placebo group. HbA1c levels were reduced in both placebo and treatment groups. The decrease in HbA1c levels was significant in both groups as compared to respective baseline values. A significant increase in fasting and post-prandial C-peptide levels compared to the respective baseline values was observed, while no significant changes in fasting and post-prandial C-peptide levels were observed between the two groups. No significant adverse effects were observed by blood chemistry analyses. Furthermore, 48.8% of the subjects reported reduced dosage of anti-diabetic therapy in the Fenfuro-treated group, whereas 18.05% reported reduced dosage of anti-diabetic therapy in the placebo group. Conclusion In summary, Fenfuro proved safe and efficacious in ameliorating the symptoms of T2D in humans.

Variations in 7‐day/24‐h circadian pattern of ambulatory blood pressure and heart rate of type 2 diabetes patients

Diabetes has profound consequences on the cardiovascular system leading to cardiovascular morbidity and mortality in diabetic patients. Blood pressure (BP) has a characteristic and reproducible circadian pattern, with high values during the day and low values at night. A 7‐day timed analysis of BP through ambulatory blood pressure monitoring has been used not only to diagnose day and night dipping patterns of blood pressure, but also to measure day‐to‐day variability and the circadian hyper‐amplitude‐tension, a condition in which excessive circadian BP amplitude precedes the chronic established hypertension. Our objective was to assess the 7‐day/24‐h circadian pattern of BP and heart rate in diabetic patients, as it could be helpful in the diagnosis and prevention of cardiovascular morbidity.

Efficacy of FurosapTM, a novel Trigonella foenum-graecum seed extract, in Enhancing Testosterone Level and Improving Sperm Profile in Male Volunteers

Background: Dietary fiber rich fenugreek (Trigonella foenum-graecum) seeds have exhibited cardioprotective, hypolipidemic and other health benefits. Furosap (FS), an innovative, patented, 20% protodioscin-enriched extract was developed in our laboratory from fenugreek seeds. This study examined the free and total testosterone levels, sperm profile and morphology, sexual health, mood and mental alertness, and broad spectrum safety parameters of FS in 50 male volunteers following supplementation over a period of 12 weeks. Methods: Institutional Review Board (IRB) and other regulatory approvals were obtained for our study. This one-arm, open-labelled, multi-center study was conducted in 50 male volunteers (age: 35 to 65 years) over a period of 12 weeks to determine the efficacy of FS (500 mg/day/subject) on free and total testosterone levels, sperm profile, sperm morphology, libido and sexual health, mood and mental alertness, and broad spectrum safety parameters. Results: Free testosterone levels were improved up to 46% in 90% of the study population. 85.4% of the study population showed improvements in sperm counts. Sperm morphology improved in 14.6% of volunteers. Majority of the subjects enrolled in the study demonstrated improvements in mental alertness and mood. Furthermore, cardiovascular health and libido were significantly improved. Extensive safety parameters were evaluated which included blood chemistry data. No significant changes were observed in serum lipid function, cholesterol, triglyceride, HDL and LDL levels, hemogram (CBC), hepatotoxicity and nephrotoxicity. Conclusion: Overall, the results demonstrate that FS, enriched in 20% protodioscin, is safe and effective in attenuating testosterone levels, healthy sperm profile, mental alertness, cardiovascular health and overall performance in human subjects.

Evaluating relationship in cytokines level, Fibromyalgia Impact Questionnaire and Body Mass Index in women with Fibromyalgia syndrome

Cytokines (TNF-α and IL-6) levels are reported to be perturbed in Fibromyalgia syndrome (FMS) patients. Moreover, Body Mass Index (BMI) may also be related to disturbed cytokines level. Therefore, the present study was planned to evaluate the levels of cytokines and to correlate them with BMI and Fibromyalgia Impact Questionnaire Revised (FIQR) in female FMS patients (n= 60) and control group (n= 60). 4 ml of blood samples were taken from both the group of patients and controls to measure the levels of IL-6 and TNF-α . Symptoms of FMS were assessed by FIQR. BMI was calculated by a standard formula of weight in kilograms divided by height in meter square. There were significant differences in BMI levels in FMS patients than in control group. However, no significant association was found between BMI and TNF-α levels, and BMI and IL-6 levels in patient and control groups. However, a significant association was found between FIQR and BMI in patients group. On the basis of the results we conclude that the levels of IL-6 and TNF-alpha are not associated with BMI in FMS patients. Furthermore, patients with higher BMI may fall at the risk of FMS. Therefore, weight management may be an important aspect for treatment of FMS patients.

Diurnal Variation in Peak Expiratory Flow and Forced Expiratory Volume

INTRODUCTION Diurnal variability in airways has most commonly been reported using peak expiratory flow (PEF) and forced expiratory volume in one second (FEV1). Characteristics of variability in small, mid and large airways caliber are expected to be different but have not been studied. AIM The aim of the study was to assess diurnal variation in small mid and large airways caliber using FEF25, FEF50, FEF75 and FEF25-75 along with PEF and FEV1 in healthy subjects. MATERIALS AND METHODS Spirometry was performed in 161 healthy subjects twice in a day. Diurnal variability in FEF25, FEF50, FEF75, FEF25-75, PEF and FEV1 were determined and compared. RESULTS It revealed that all parameters exhibit significant diurnal variability. Diurnal variability is highest in large airways and lowest in smaller airways. CONCLUSION Proximal airways show greater diurnal variation in their caliber than distal airways as reflected by greater variability in PEF as compared to FEV1.

Effects of pulmonary rehabilitation on secondary polycythemia in stable chronic obstructive pulmonary disease: A pilot study

Chronic obstructive pulmonary disease (COPD) is a major health issue worldwide. Secondary polycythemia is common in COPD. There are reports of improvement in pulmonary functions by various rehabilitatory pulmonary exercise programs. However, the effect of pulmonary rehabilitation on secondary polycythemia has not yet been fully assessed. Therefore, in the present study, we investigated the effect of a short course (10 weeks) of pulmonary rehabilitation program (PRP) on secondary polycythemia in 26 subjects, divided into cases ( n = 14) and controls ( n = 12). In cases (those who received PRP), the percentage decrease in hematocrit was significant compared to the controls (who did not receive PRP). This pilot study suggests that PRP could be beneficial in the treatment of COPD especially for decreasing hematocrit.

Glycemic Variability and Its Clinical Implications

Abstract The prevalence of diabetes is rising at a very fast pace in both developed and developing countries. The burden is becoming a threat to health in the Southeast Asia region. The complications of diabetes are manyfold and some of them begin even before the diagnosis of the disease. These complications have been responsible for the morbidity and mortality of disease, and have been linked to the extent and duration of hyperglycemia and dyslipedemia produced by them. For some time, hyperglycemia has been measured in terms of fasting blood sugar, prandial sugar, and A1c. It has been seen that even within the normal range of A1c the complications still occur. Scientists have been interested in a new entity of glycemic variability to address this issue. It is postulated that the excursions that occur in blood sugar levels due to nutrition, activity, and other circadian factors is very important. Recently, new methods have evolved for the measurement of this variation in terms of continuous glucose monitoring and ambulatory glucose profile to further improve the management of diabetes and glycemic control. This has also improved dysglycemia and has been found instrumental in decreasing the complications of diabetes. This variability can be short-term variability, which reflects as intraday variability, or it can be variability over weeks and months. This variability in blood sugar level is also emerging as a factor to decide on the type of therapy and various issues of nutrition and exercise related to the management of type 2 diabetes mellitus.

Association of Higher Omega-6/Omega-3 Fatty Acids in the Diet with Higher Prevalence of Metabolic Syndrome in North India

The epidemic of obesity and hypertension over the last two decades, in the middle and high income countries is associated with marked rise in the incidence of metabolic syndrome (MS), CAD, type 2 diabetes, myocardial infarction and stroke and the total burden of cardiovascular disease (CVD) [1-4]. The metabolic syndrome is associated with constellation of metabolic disturbances, of all the risk factors for CVD, [4]. MS appears to be a major cause of mortality and morbidity due to CVD and diabetes [5-9]. In the 1920s, Kylin, a Swedish physician, described MS, as the clustering of hypertension, hyperglycemia, and gout [10]. However, the concept of the MS has existed for at least 80 years [4]. In 1947, Vague [11], drew attention to upper body adiposity (android or male-type obesity) as the obesity phenotype that was commonly associated with metabolic abnormalities characterized with type 2 diabetes and CVD. There is urgent need for strategies to prevent the emerging global epidemic, as this syndrome appears to be a master of disguise since it can present in various ways according to the various components that constitute the syndrome [3-9]. Reaven [12], described the MS as syndrome X, De Fronzo et al. [13], as the insulin resistance syndrome, and Kaplan [14], the deadly quartet. The MS represents a constellation of metabolic abnormalities including glucose intolerance (type 2 diabetes, impaired glucose tolerance, or impaired fasting glycaemia), insulin resistance, central obesity, dyslipidemia, and hypertension, which are well known risk factors for CAD [2,3]. Epidemiological studies suggest that primary risk factors such as physical inactivity and unbalanced nutritional consumption of excess calories, simple refined carbohydrates with a high glycemic index and load of high saturated fat (SF), trans fatty acids (TFA), and high w-6/w-3 ratio and lower monounsaturated fatty acids, in the diet are pro-inflammatory [8-15], and contribute to the escalating rates of obesity, MS and mortality due to CVD [1-16].