Context : Breast cancer patients awaiting surgery experience heightened distress that could affect postoperative outcomes. Aims : The aim of our study was to evaluate the effects of yoga intervention on mood states, treatment-related symptoms, quality of life and immune outcomes in breast cancer patients undergoing surgery. Settings and Design : Ninety-eight recently diagnosed stage II and III breast cancer patients were recruited for a randomized controlled trial comparing the effects of a yoga program with supportive therapy plus exercise rehabilitation on postoperative outcomes following surgery. Materials and Methods : Subjects were assessed prior to surgery and four weeks thereafter. Psychometric instruments were used to assess self-reported anxiety, depression, treatment-related distress and quality of life. Blood samples were collected for enumeration of T lymphocyte subsets (CD4 %, CD8 % and natural killer (NK) cell % counts) and serum immunoglobulins (IgG, IgA and IgM). Statistical Analysis Used : We used analysis of covariance to compare interventions postoperatively. Results : Sixty-nine patients contributed data to the current analysis (yoga n = 33, control n = 36). The results suggest a significant decrease in the state ( P = 0.04) and trait ( P = 0.004) of anxiety, depression ( P = 0.01), symptom severity ( P = 0.01), distress ( P < 0.01) and improvement in quality of life ( P = 0.01) in the yoga group as compared to the controls. There was also a significantly lesser decrease in CD 56% ( P = 0.02) and lower levels of serum IgA ( P = 0.001) in the yoga group as compared to controls following surgery. Conclusions : The results suggest possible benefits for yoga in reducing postoperative distress and preventing immune suppression following surgery.

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Objective : To study the efficacy of yoga on Guna (yogic personality measure) and general health in normal adults. Methods : Of the 1228 persons who attended introductory lectures, 226 subjects aged 18-71 years, of both sexes, who satisfied the inclusion and exclusion criteria and who consented to participate in the study were randomly allocated into two groups. The Yoga(Y) group practised an integrated yoga module that included asanas , pranayama , meditation, notional correction and devotional sessions. The control group practised mild to moderate physical exercises (PE). Both groups had supervised practice sessions (by trained experts) for one hour daily, six days a week for eight weeks. Guna (yogic personality) was assessed before and after eight weeks using the self-administered Vedic Personality Inventory (VPI) which assesses Sattva (gentle and controlled), Rajas (violent and uncontrolled) and Tamas (dull and uncontrolled). The general health status (total health), which includes four domains namely somatic symptoms (SS), anxiety and insomnia (AI), social dysfunction (SF) and severe depression (SP), was assessed using a General Health Questionnaire (GHQ). Results : Baseline scores for all the domains for both the groups did not differ significantly ( P > 0.05, independent samples t test). Sattva showed a significant difference within the groups and the effect size was more in the Y than in the PE group. Rajas showed a significant decrease within and between the groups with a higher effect size in the PE group. Tamas showed significant reduction within the PE group only. The GHQ revealed that there was significant decrease in SS, AI, SF and SP in both Y and PE groups (Wilcoxcon Singed Rank t test). SS showed a significant difference between the groups (Mann Whitney U Test). Conclusions : There was an improvement in Sattva in both the Yoga and control groups with a trend of higher effect size in Yoga; Rajas reduced in both but significantly better in PE than in Yoga and Tamas reduced in PE. The general health status improved in both the Yoga and control groups.

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Context : Pre- and postoperative distress in breast cancer patients can cause complications and delay recovery from surgery. Objective : The aim of our study was to evaluate the effects of yoga intervention on postoperative outcomes and wound healing in early operable breast cancer patients undergoing surgery. Methods : Ninety-eight recently diagnosed stage II and III breast cancer patients were recruited in a randomized controlled trial comparing the effects of a yoga program with supportive therapy and exercise rehabilitation on postoperative outcomes and wound healing following surgery. Subjects were assessed at the baseline prior to surgery and four weeks later. Sociodemographic, clinical and investigative notes were ascertained in the beginning of the study. Blood samples were collected for estimation of plasma cytokines-soluble Interleukin (IL)-2 receptor (IL-2R), tumor necrosis factor (TNF)-alpha and interferon (IFN)-gamma. Postoperative outcomes such as the duration of hospital stay and drain retention, time of suture removal and postoperative complications were ascertained. We used independent samples t test and nonparametric Mann Whitney U tests to compare groups for postoperative outcomes and plasma cytokines. Regression analysis was done to determine predictors for postoperative outcomes. Results : Sixty-nine patients contributed data to the current analysis (yoga: n = 33, control: n = 36). The results suggest a significant decrease in the duration of hospital stay ( P = 0.003), days of drain retention ( P = 0.001) and days for suture removal ( P = 0.03) in the yoga group as compared to the controls. There was also a significant decrease in plasma TNF alpha levels following surgery in the yoga group ( P < 0.001), as compared to the controls. Regression analysis on postoperative outcomes showed that the yoga intervention affected the duration of drain retention and hospital stay as well as TNF alpha levels. Conclusion : The results suggest possible benefits of yoga in reducing postoperative complications in breast cancer patients.

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Context : Reactive oxygen species are known to aggravate disease progression. To counteract their harmful effects, the body produces various antioxidant enzymes, viz , superoxide dismutase, glutathione reductase etc. Literature reviews revealed that exercises help to enhance antioxidant enzyme systems; hence, yogic exercises may be useful to combat various diseases. Aims : This study aims to record the efficacy of yoga on superoxide dismutase, glycosylated hemoglobin (Hb) and fasting blood glucose levels in diabetics. Settings and Design: Forty diabetics aged 40-55 years were assigned to experimental (30) and control (10) groups. The experimental subjects underwent a Yoga program comprising of various Asanas (isometric type exercises) and Pranayamas (breathing exercises) along with regular anti-diabetic therapy whereas the control group received anti-diabetic therapy only. Materials and Methods : Heparinized blood samples were used to determine erythrocyte superoxide dismutase (SOD) activity and glycosylated Hb levels and fasting blood specimens collected in fluoride Vacutainers were used for assessing blood glucose. Statistical Analysis Used : Data were analyzed by using 2 x 2 x 3 Factorial ANOVA followed by Scheffe's posthoc test. Results : The results revealed that Yogic exercise enhanced the levels of Superoxide dismutase and reduced glycosylated Hb and glucose levels in the experimental group as compared to the control group. Conclusion : The findings conclude that Yogic exercises have enhanced the antioxidant defence mechanism in diabetics by reducing oxidative stress.

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Background : The metabolic rate is an indicator of autonomic activity. Reduced sympathetic arousal probably resulting in hypometabolic states has been reported in several yogic studies. Aim : The main objective of this study was to assess the effect of yoga training on diurnal metabolic rates in yoga practitioners at two different times of the day (at 6 a.m. and 9 p.m.). Materials and Methods : Eighty eight healthy volunteers were selected and their metabolic rates assessed at 6 a.m. and 9 p.m. using an indirect calorimeter at a yoga school in Bangalore, India. Results and conclusions: The results show that the average metabolic rate of the yoga group was 12% lower than that of the non-yoga group ( P < 0.001) measured at 9 p.m. and 16% lower at 6 a.m. ( P < 0.001). The 9 p.m. metabolic rates of the yoga group were almost equal to their predicted basal metabolic rates (BMRs) whereas the metabolic rate was significantly higher than the predicted BMR for the non-yoga group. The 6 a.m. metabolic rate was comparable to their predicted BMR in the non-yoga group whereas it was much lower in the yoga group ( P < 0.001). The lower metabolic rates in the yoga group at 6 a.m. and 9 p.m. may be due to coping strategies for day-to-day stress, decreased sympathetic nervous system activity and probably, a stable autonomic nervous system response (to different stressors) achieved due to training in yoga.

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