Introduction: The prevalence of coronary artery disease (CAD) has progressively -increased in India and is the major cause of morbidity and mortality burden in the world. Several strategies are available to reduce morbidity and mortality, including the interventional approach (eg, early revascularization with PCI and stenting) and the pharmacologic approach (eg, thrombolytic and anticoagulant therapies) and yoga 1,2 The various psychological responses to experiencing myocardial infarction are anxiety reactions, depression , agoraphobia , exhaustion, hostility , sadness , anger , disgust and social withdrawal. 3 Yoga has reported to decrease these incidences. Methodology: The study included 200 patients diagnosed as MI who were divided into two groups 100 cases of control group subjected to conventional treatment and lifestyle counseling while 100 cases in test group were treated with yoga in addition to conventional treatment and lifestyle modification. The primary outcome included change in risk factors from baseline to end of study. Secondary outcome included change in Depression score and MACE at the end of the study. Result -After 24 weeks of intervention, the difference among yoga and control group was found to be significant for following parameters- weight, BMI, waist circumference, post prandial blood sugar, HBA1c, HDL cholesterol, triglyceride, total cholesterol and depression score. A significant difference was not seen for mean CIMT. Conclusion: Yoga may be a cost-effective technique to target multiple risk factors of myocardial infarction. It can be recommended along with conventional treatment for prevention and improvement of outcome in MI patients
Objective: To study the effect of yoga on risk factors and Beck's Depression Inventory score after myocardial infarction Design and method: Our study that comprised of 300 patients were randomized into test group (n = 150) who were subjected to conventional treatment and yoga and control group (n = 150) subjected to conventional treatment only. The study included patients diagnosed as myocardial infarction above 18 years with their consent to participate. Patients with hemodynamic instability, heart failure, pregnancy, prior yoga practice, arrhythmia, cardiac pacemaker, autonomic neuropathy and musculoskeletal disease were excluded. Initially, assessment of clinical & biochemical parameters and routine investigations were performed. Beck's depression score was calculated. Yoga was started on 4th day after MI (test group) and there were sessions of 10 minutes of pranayam, 15 minutes of shavasan and 15 minutes of transcendental meditation. The patients were followed after 24 weeks for assessment of clinical & biochemical parameters. Carotid doppler & depression score was evaluated. Results: After 24 weeks of intervention, a significant improvement was noted among yoga group in comparison to control group for BMI (p = 0.04), heart rate (p = 0.01), systolic & diastolic blood pressure (p<0.05), fasting & post prandial blood sugar (p<0.05), HbA1c (p = 0.03), Beck's depression score (p = 0.001) and lipid profile (p<0.05). In contrast, no improvement was seen for carotid intima media thickness. Conclusions: On the basis of the study, it was concluded that conventional therapy with yoga has a positive impact on risk factors of MI and psychosocial stress including blood pressure. Therefore, yoga can be recommended to reduce morbidity and mortality after MI. Large trials with more number of cases and long term follow up are needed so that yoga as an intervention, can be added for secondary prevention and rehabilitation in myocardial infarction cases.
Aim- The aim of the study was to find out value of CRP in COPD patients and its correlation with the predictors of outcome. Method- We studied 100 COPD patients (80 stable and 20 unstable) with spirometry, body mass index, MMRDC dyspnoea scale, 6-minute walk distance and BODE index. The CRP values were measured in these patients and compared with 50 sex and age matched controls. CRP was subjected to evaluation for any correlation with the predictors of outcomes in COPD patients. Results- Serum CRP levels were significantly higher in COPD patients than in healthy subjects (Mean 13.55+10.83 vs.2.07+ 0.82 mg/lit, p<0.001). CRP levels were significantly higher in unstable than stable patients (mean 33.78+7.74 mg/lit vs. 8.50+1.81 mg/lit, p<0.001). Severity of dyspnoea as measured by MMRC dyspnoea scale was significantly higher in unstable patients than in stable patients (mean 3.60+0.5 vs. 1.84+0.86, p<0.001). The exercise capacity of the patients as measured by 6 MWD was significantly lower in un stable patients than in stable patients (mean 180.5+53.26m vs. 219.58+67m, p=0.017). The BODE index was found to be significantly higher among unstable patients than stable patients (mean 7.30+1.66 vs. 4.94+1.94, p<0.001). A significant negative correlation was found between CRP and FEV1 (r=-0.284, p=0.004) and FEV1/FVC (r=-0.305, p=0.002). CRP levels were independent of FVC (r=-0.162, p=0.107). A significant positive correlation was found bet ween CRP and severity of dyspnoea according to MMRC dyspnoea scale (r=0.638, p<0.001). The CRP levels negatively correlated with the exercise capacity of the patient (6MWD) which was statistically significant (r= -0.364, p<0.001). A significant positive correlation was foun d between CRP with BODE index (r=0.780, p<0.001) and BODE stage (r=0.726, p<0.001). Conclusion- We conclude that systemic inflammation is present in COPD patients and CRP is important biomarker in COPD in means of reflecting severity of disease and prognosis of patients.
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