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INTEGRATIVE NEUROLOGY YOGA AND MEDIATION’S ROLE IN HEALTH

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  1. INTEGRATIVE NEUROLOGYYOGA AND MEDIATION’S ROLE IN HEALTH SHRI KANT MISHRA, ABMS, MD, MS (ADMIN. MEDICINE) PROFESSOR OF NEUROLOGY /COORDINATOR INTEGRATIVE MEDICINE KECK USC SCHOOL OF MEDICINE, LOS ANGELES, CALIF DIRECTOR NEUROMUSCULAR PROGRAM VA GLA AND OLIVE VIEW UCLA MEDICAL CENTER

  2. HISTORICAL BACKGROUND • VARIOUS NATURAL MEDICINE REMEDIES IN EXISTENCE SINCE THE BEGINNING OF THE CIVILIZATION • VARIOUS ETHNIC MEDICINE HAS BEEN PRACTICED FOR AT LEAST 2,000-5,000 YRS • LIKE CHINESE, KOREAN, AYURVEDA (INDIAN SYSTEM OF MEDICINE) AMERICAN INDIAN MEDICINE

  3. HISTORICAL BACKGROUND • MANY OF THESE SYSTEMS OF MEDICINE ARE WELL ORGANIZED WITH RELATIVELY GOOD PHARMACOPEA BASIC PRINCIPLES AND TRETMENT MODALITIES. • MANY MODERN MEDICINES HAVE ORIGINATED FROM PLANT SOURCES AND FROM ETHENIC MEDS • EXAMPLE - RESERPINE, EPHEDRINE, ETC.

  4. FACTS AND FIGURES • CAM VISITS 1993 425 MILLION VISITS(NEJM) THIS WILL DOUBLE BY 2010. 1997 625 MILLION VISITS(JAMA) • EXPENDIETURE 1997 $27 BILLION 2004 $35 BILLION 2010 $ DOUBLE“ David Isenberg, M.D.” • EDUCATIONAL PROGRAMS 90% MEDICAL SCHOOLS OFFER INTRODUCTORY COURSES. HARVARD,UCSF, UCLA , UCI , ETC. • RESEARCH NCCAM STARTED IN 1994 - $5 MILLION BUDGET BUDGET FY 2006 $200 MILLION

  5. NCCAM /CLASSIFICATION • MASSAGE THERAPY • AROMATHERAPY • HOMEOPATHY • BIOLOGICAL BASED MEDICINE • DIET NUTRITION • LIFE STYLE CHANGES • SYSTEMS OF MEDICINE • MIND BODY MEDICINE • HERBAL MEDICINE • ELECTRO MAGNETIC MEDICINE • MANIPULATION

  6. CLASSIFICATION MIND/BODY MEDICINE • TECHNIQUES INVOLVE EXPLORING THE MIND’S ABILITY TO AFFECT THE BODY. • BASED ON TRADITIONAL PRINCIPLES ON HOW THE MIND AND BODY ARE INTERLINKED. ART THERAPY BIOFEEDBACK RELAXATION TECHNIQUES DANCE THERAPY GUIDED IMAGERY HUMOR THERAPY SUPPORT GROUPS YOGA MEDITATION MUSIC THERAPY PRAYER THERAPY PSYCHOTHERAPY COUNSELING HYNOTHERAPY SPIRITUALITY

  7. AYURVEDA YOGA HOMEOPATHIC MEDICINE TRANSCUTANEOUS ELECTRICAL NERVE STIMULATION (TENS) VAGAL /TRIGEMINAL NERVE STIMULATION CHINESE MEDICINE ACUPUNCTURE ACCUPRESSURE ELECTRO ACUPUNCTURE (EA) CHIROPRACTIC TRAGER THERAPY MASSAGE THERAPY AROMATHERAPY HERBAL THERAPY CAM MODALITIES USED IN NEUROLOGICAL DISORDERS

  8. THE ROLE OF CAM IN NEUROLOGICAL DISORDERS • CNS • DEMENTIA, INCLUDING ALZHEIMERS DISEASE • PARKINSON’S DISEASE • EPILEPSY • STROKE • HEADACHE • MULTIPLE SCLEROSIS • PNS • PERIPHERAL NEUROPATHY, CARPAL TUNNEL SYNDROME CHRONIC PAIN • MUSCLE DISORDERS • FIBROMYALGIA

  9. AYURVEDA • ANCIENT MEDICAL DISCIPLINE OF INDIA • LITERAL MEANING: “SCIENCE OF LIFE” • DATES BACK THOUSANDS OF YEARS COMPREHENSIVE APPROACH TO HEALING PRINCIPAL GOAL: • PRESERVATION AND PROMOTION OF HEALTH • EMPHASIS ON ENHANCEMENT OF NATURAL IMMUNITY • BASED ON 4 ELEMENTS, 3 HUMORS AND TISSUES • INDIVIDUAL CONSTITUTIONAL PROFILE. SIMILARITIES WITH TCM

  10. YOGA • PRACTICED IN INDIA FOR THOUSANDS OF YEARS • BY FAR THE BEST KNOWN AND MOST POPULAR EXERCISE REGIMEN. • 1.69 MILLION PRACTICE IT REGULARLY. • COMES FROM SANSKRIT ROOT “YUJ” • DEFINITION • TO YOKE, TO JOIN AND TO DIRECT AND CONCENTRATE ONE’S ATTENTION. • BASIC PRINCIPLES • FOCUSES ON THE BODY’S MUSCULATURE POSTURE, BREATHING MECHANISMS(PRANAYAMA) AND CONSCIOUSNESS. • EFFECTS ON NERVOUS SYSTEM • REDUCTION IN CHRONIC PAIN AND BACK PAIN • CARPAL TUNNEL SYNDROME

  11. TYPES OF YOGA • KARMA Yoga • YOGA OF ACTION • BHAKTI YOGA • THE PATH OF DEVOTION • RAJ YOGA • THE MOST COMPREHENSIVE YOGA • IT HAS 8 PARTS INCLUDING • ASANAS • MORAL ETHICAL • PRANAYAMA • MEDITATION

  12. PRANAYAMA • PRANAYAMAS ARE SPECIALLY DEVELOPED BREATHING TECHNIQUES. • ALSO IMPROVES BRAIN FUNCTION (INTELLIGENCE AND MEMORY) INCREASING THE ELIMINATION OF TOXINS FROM THE SYSTEM. • THE TOTAL EFFECT OF YOGA ASANAS AND BREATHING IS TO PRODUCE A STATE OF HIGH VITALITY AND REJUVENATION • STUDIES HAVE SHOWN THAT IT INCREASES THE SEROTONIN LEVEL IN THE BRAIN WITH REGULAR PRANAYAMA

  13. MEDITATION • IT IS A SELF-DIRECTED PRACTICE FOR RELAXING THE BODY AND CALMING THE MIND. • MEDITATION IS A SAFE AND SIMPLE WAY TO BALANCE A PERSON'S PHYSICAL, EMOTIONAL, AND MENTAL STATES. • IT IS SIMPLE, BUT CAN BENEFIT EVERYONE

  14. PROVEN SCIENTIFIC/SOCIAL STUDIESEFFECTS CAN BE DIVIDED INTO THREE PARTS • HEALTH PROMOTION AND DISEASE PREVENTION • PHYSICAL ILLNESS • MENTAL ILLNESS

  15. HEALTH PROMOTION AND DISEASE PREVENTIONEFFECTS OF YOGA • IMPROVES RESPIRATORY ENDURANCE, MUSCLE STRENGTH, AND OVERALL PHYSICAL FITNESS. • GENERAL EFFECT MEDITATION AND BREATHING EXERCISES INCREASE PHYSICAL AND MENTAL WELL BEING. • ENDOCRINE FUNCTION BLOOD CORTISOL LEVELS LOWER AFTER MEDITATION. • CARDIOVASCULAR • STRESS MANAGEMENT • EFFECTS ON NERVOUS SYSTEM • MUSCLE TENSION

  16. PHYSICAL ILLNESSEFFECTS OF YOGA • NERVOUS SYSTEM • REDUCTION IN CHRONIC PAIN AND BACK PAIN. • QUALITY OF LIFE IMPROVED. • SEIZURE DISORDERS IMPROVE QUALITY OF LIFE AND BETTER SEIZURE CONTROL • CARDIOVASCULAR DISEASE • IMPROVES HYPERTENSION . • IMPROVES HYPERCHOLESTEROLEMIA. • CANCER • RHEUMATOLOGICAL DISORDERS • RESPIRATORY DISORDERS (INCLUDING ASTHMA)

  17. MENTAL ILLNESS/ PSYCHIATRIC DISORDERSEFFECTS OF YOGA • HELPS COGNITIVE FUNCTION IN MENTALLY RETARDED CHILDREN. • REDUCE ANXIETY LEVELS. • BIPOLAR SYNDROME IS IMPROVED. • FOUND TO BE HELPFUL IN HEROIN AND OTHER DRUG ADDICTIONS.

  18. BENEFITS OF MEDITATION • REDUCE HEALTH CARE USE • INCREASES LONGEVITY AND QUALITY OF LIFE • REDUCES CHRONIC PAIN • REDUCES ANXIETY • REDUCES HIGH BLOOD PRESSURE • REDUCES POST-TRAUMATIC STRESS SYNDROME IN VIETNAM VETERANS • LOWERS BLOOD CORTISOL LEVELS INITIALLY BROUGHT ON BY STRESS.

  19. STATISTICS • PHYSICIANS, PSYCHOTHERAPISTS, AND OTHER PROFESSIONALS ARE INCREASINGLY ADDING MEDITATIVE TECHNIQUES TO THEIR PRACTICE. • OVER SIX THOUSAND PHYSICIANS HAVE BEGUN THE PRACTICE OF TRANSCENDENTAL MEDITATION AND REGULARLY RECOMMEND THE TM TECHNIQUE TO THEIR PATIENTS. • MANY PHYSICIANS CONSIDER MEDITATION A KEY ELEMENT OF AN INTEGRATED HEALTH PROGRAM.

  20. CHINESE MEDICINE • 3,-4000 YEARS OLD HEALTH CARE SYSTEM • REQUIRES • BALANCE OF BODY’S DIFFERENT ENERGIES (YIN AND YANG) • PROPER FLOW OF ENERGY • CAN BE CORRECTED BY STIMULATING RELATED CHANNELS BY HERBAL REMEDIES, ACUPUNCTURE, ACUPRESSURE

  21. HOMEOPATHIC MEDICINE • SPECIALIZED, SCIENTIFIC FIELD OF ALTERNATIVE MEDICINE • STARTED IN LATE 18TH CENTURY BY PHYSICIAN SAMUEL HAHNEMANN. • BASED ON PRINCIPAL OF SIMILARS • HIGHLY DILUTED PREPARATIONS OF SUBSTANCES • STIMULATES HEALING IN PTS WHO HAVE SIMILAR SX’S WHEN ILL • USED IN HEADACHE,DEMENTIA,CHRONIC PAIN

  22. AROMA THERAPY • ORIGINS • TRACED BACK TO ANCIENT EGYPT AND INDIA • 3,000 YEARS AGO, ESSENTIAL OILS WERE UTILIZED FOR HEALING, COSMETICS, PERFUMERY, AND RELIGIOUS RITES. • BENEFITS • REDUCES STRESS, ENHANCES RELAXATION, RELIEVE ANXIETY AND OTHER EMOTIONAL DISORDERS.

  23. ACUPUNCTURE • ACUPUNCTURE (THE USE OF NEEDLES) • ELECTRO ACUPUNCTURE (EA) • TRANSCUTANEOUS ELECTRICAL NERVE STIMULATION (TENS) • ACUPRESSURE • THE USE OF PRESSURE ON SPECIFIC POINTS

  24. DEMENTIA • FIFTY-FIVE PERCENT OF CAREGIVERS REPORTED THAT THEY HAD TRIED AT LEAST ONE ALTERNATIVE THERAPY TO IMPROVE THE PATIENT'S MEMORY. • TWENTY PERCENT OF CAREGIVERS TRIED THREE OR MORE UNPROVEN THERAPIES • VITAMINS WERE USED MOST FREQUENTLY (84%) HEALTH FOODS (27%) HERBAL MEDICINES (11%) "SMART PILLS" (9%) AND HOME REMEDIES (7%) COLEMAN LM, FOWLER LL, WILLIAMS ME.AM GERIATR SOC. 1995 JUL;43(7):747-50

  25. DEMENTIA • AYURVEDIC HERBAL TREATMENTS • MEDHYA(MEMORY ENHANCER) • BRAHMI (BACOPA ) • SANKHPUSPI CONVOLULUS PLURICALIS • GOTUKOLA • CURCUMIN • WITHANIA SEMNIFORA ETC

  26. DEMENTIA • GINKGO CONTROVERSIAL STUDIES SHOW: • SLOWS DEVELOPMENT OF 20% OF DEMENTIA BY 6-12 MONTHS • META ANALYSIS BARRY OKEN 1998, ARCHIVES OF NEUROLOGY • OVERALL THERE WAS A SIGNIFICANT EFFECT SIZE OF 0.40 (P<.0001). THIS MODEST EFFECT SIZE TRANSLATED INTO A 3% DIFFERENCE IN THE ALZHEIMER DISEASE ASSESSMENT SCALE-COGNITIVE SUBTEST. • SOLOMON JAMA 2002 NEGATIVE STUDY: TOTAL 26 TRIAL MAJORITY OF STUDIES NEGATIVE?

  27. MIGRAINE HEADACHE • HOMEOPATHIC TREATMENT • IN A DOUBLE-BLIND, PLACEBO-CONTROLLED TRIAL ON 60 PTS SHOWED THAT 93% OF PATIENTS GIVEN AN INDIVIDUALIZED HOMEOPATHIC MEDICINE EXPERIENCED GOOD RESULTS. • ISOMETRIC NECK EXERCISE / BIOFEEDBACK A COMBINATION PRODUCT CONTAINING MAGNESIUM, RIBOFLAVIN, AND FEVERFEW; MELETONIN, GINGER AND GINKO • TRAGER THERAPY

  28. TREATMENT OF PATIENTS WITH CHRONIC HEADACHES IN A HOSPITAL FOR TRADITIONAL CHINESE MEDICINE IN GERMANY • A RANDOMISED, WAITING LIST CONTROLLED TRIAL SHOWED PATIENTS WITH MIGRAINE AND A COMBINATION OF MIGRAINE AND EPISODIC TENSION-TYPE HEADACHES HAD LASTING IMPROVEMENTS MORE THAN PATIENTS WITH OTHER HEADACHES, WITH TREATMENT OF TRADITIONAL CHINESE MEDICINE IN KOTZTING MELCHART D, HAGER S, MUNICH, GERMANY.

  29. ACUPUNCTURE FOR PATIENTS WITH MIGRAINE • ACUPUNCTURE IS WIDELY USED TO PREVENT MIGRAINE ATTACKS. • THE PROPORTION OF RESPONDERS (REDUCTION IN HEADACHE DAYS BY AT LEAST 50%) WAS 51% IN THE ACUPUNCTURE GROUP, 53% IN THE SHAM ACUPUNCTURE GROUP, AND 15% IN THE WAITING LIST GROUP. • ACUPUNCTURE AND SHAM ACUPUNCTURE IN REDUCING MIGRAINE HEADACHES ALTHOUGH BOTH INTERVENTIONS WERE MORE EFFECTIVE IN REDUCING MIGRAINE HEADACHES THAN A WAITING LIST CONTROL. LINDE K, STRENG A, MUNICH, GERMANY

  30. MULTIPLE SCLEROSIS • ACUPUNCTURE MAIL SURVEY INCLUDED 217 PATIENTS • RESULT • 37 HAD REDUCED PAIN • 34 DECREASED SPASTICITY • 14 IMPROVED BLADDER AND BOWEL DYSFUNCTION • 34 IMPROVED WALKING AND MOBILITY • 48 EXPERIENCED ELEVATED ENERGY LEVEL AND REDUCED FATIGUE • YOGA AND MS >MEDITATION

  31. AYURVEDIC HERBS IN NEURODEGENERATIVE DISEASES • AYURVEDIC PLANTS USED FOR THE MANAGEMENT OF NEURODEGENERATIVE DISEASES SUCH AS: • PARKINSON'S, ALZHEIMER'S, LOSS OF MEMORY • DEGENERATION OF NERVES AND OTHER NEURONAL DISORDERS • GENERALLY POSSESSES STRONG ANTIOXIDANT ACTIVITY.

  32. AYURVEDA IN PARKINSON'S DISEASE. • CLINICAL PROSPECTIVE STUDY, OF AYURVEDA TREATMENT (A CONCOCTION IN COW'S MILK OF POWDERED MUCUNA PRURIENS AND HYOSCYAMUS RETICULATUS SEEDS WITHANIA SOMNIFERA AND SIDA CORDIFOLIA ROOTS) • IN 18 CLINICALLY DIAGNOSED (WITH A MEAN HOEN AND YAHR VALUE OF 2.22) PARKINSONIAN PATIENTS SHOWED:

  33. PARKINSON’S DISEASE • HP - 200 • DERIVED FROM MUCUNA PRURIENT(AYURVEDIC HERB) • A CLINICAL TRIAL OF 60 PATIENTS SHOWED THAT HP-200 MAY HAVE SOME BENEFITS. (BALA MANYAM PI)

  34. AYURVEDA IN PARKINSON'S DISEASE. • RESULTS • SIGNIFICANT IMPROVEMENT IN ACTIVITIES OF DAILY LIVING (ADL) AND ON MOTOR EXAMINATION AS PER UPDRS RATING. SYMPTOMATICALLY, THEY EXHIBITED GOOD RESPONSE IN TREMOR, BRADYKINESIA, STIFFNESS AND CRAMPS.

  35. CURCUMIN AND ALZHEIMER DISEASE • CURCUMIN, IN VITRO, INCUBATED WITH ABETA 40 AND A BETA42, SIGNIFICANTLY DECREASES AMYLOID AGGREGATION (GREG COLE ET AL). • CAPABLE OF INDUCING THE DISAGGREGATION OF PRE-AGGREGATED AMYLOID. • SIGNIFICANTLY REDUCES ABETA OLIGOMERS FORMATION. • INHIBITED THE CELL TOXICITY OF AMYLOID OLIGOMERS. • POSSESSES POTENT ANTI-AMYLOIDOGENIC ACTIVITY, IN ALZHEIMER AGED APP TRANSGENIC MICE TG2576. • RATIONALE FOR CURCUMIN USE IN CLINICAL TRIALS PREVENTING OR TREATING IN AD ,WHICH IS UNDERWAY AT UCLA • EPIDEMEOLOGICAL STUDY IN INDIA GANGULI ETAL

  36. CURCUMIN AND ALZHEIMER DISEASE • THE INHIBITION OF EGR-1 DNA-BINDING ACTIVITY BY CURCUMIN WAS DEMONSTRATED, IN VITRO, IN HUMAN THP-1 MONOCYTES AND HUMAN PERIPHERAL BLOOD MONOCYTES. • INHIBITION RESULTED IN A DECREASE IN MRNA EXPRESSION OF CYTOKINES (TNFALPHA AND IL-1BETA) AND CHEMOKINES (MCP-1, IL-8 AND MIP-1BETA). • CURCUMIN COULD THUS AMELIORATE INFLAMMATION. • CURCUMIN DID NOT AFFECT THE VIABILITY OF CELLS.

  37. MEDITATION IN NEUROLOGICAL DISORDERS • ACCORDING TO STUDIES CONDUCTED BY HERBERT BENSON, M.D., [HARVARD MEDICAL SCHOOL] • MEDITATION PROCESS COUNTERACTED THE EFFECTS OF THE SYMPATHETIC NERVOUS SYSTEM. • WHEREAS THE SYMPATHETIC SYSTEM DILATES THE PUPILS AND GETS THE HEART RATE, RESPIRATION, AND BLOOD PRESSURE UP, THE PARASYMPATHETIC SYSTEM, ACTIVATED WHEN WE MEDITATE, DOES JUST THE OPPOSITE.

  38. ALS AND CURCUMIN • FAMILIAL FORMS OF ALS DEMONSTRATE UP-REGULATION OF TUMOR NECROSIS FACTOR ALPHA (TNFALPHA). • CURCUMIN ANTAGONIZED TNF ALPHA, IN VITRO, IN THE MICROGLIAL CELL LINE, DERIVED FROM MOUSE WALKER EOC-20 CELLS. • ANTAGONISM WAS POSSIBLY DUE TO THE INHIBITION OF 5LOX. • CURCUMIN COULD THUS BE USED FOR CLINICAL BENEFIT IN ALS. (WEST ET AL )

  39. EPILEPSY ALTERNATIVE TREATMENTS • VAGUS NERVE STIMULATION • DEEP BRAIN STIMULATION • CORTICAL STIMULATION • TRIGEMINAL NERVE STIMULATION • FISH OIL

  40. BACKGROUND • THE TRIGEMINAL NERVE PROJECTS TO THE NUCLEUS TRACTUS SOLITARIUS (NTS), THE LOCUS CERULEUS, AND THE VAGUS NERVE. • Stimulation of NTS reduces seizures induced by amygdala stimulation. • STIMULATION OF LC SUPPRESSES COBALT AND PENICILLIN INDUCED EPILEPTIC DISCHARGES. • Lesioning the LC blocks the effect of vagus nerve stimulation. • TRIGEMINAL NERVE STIMULATION BLOCKS PTZ INDUCED SPIKES AND SEIZURES IN RATS Fanselow, Nicolelis, et al 2000

  41. SUDDEN DEATH IS A MAJOR PROBLEM IN EPILEPSY • SUDDEN DEATH RATES ARE SIGNIFICANTLY HIGHER IN EPILEPSY THAN AGE MATCHED POPULATION • SPERLING • ANNEGERS

  42. STROKE • AYURVEDIC SPICE: TURMERIC • INHIBITS PLATELET AGGREGATION AND MODULATES EICOSANOID BIOSYNTHESIS • AYURVEDIC OIL MASSAGE • ACUPUNCTURE • A CLINICAL TRIAL ON 118 PTS: SHORTER DURATIONS OF HOSPITAL STAY FOR REHAB • YOGA • MASSAGE THERAPY

  43. SUB ACUTE LOW-BACK PAIN • PROTOCOL RANDOMIZED CONTROLLED TRIAL COMPARED COMPREHENSIVE MASSAGE THERAPY(CMT) TO SOFT-TISSUE MANIPULATION (STM), REMEDIAL EXERCISE, AND PLACEBO. • RESULTS (1 MONTH FOLLOW-UP) • % OF PATIENTS WHO REPORTEDNO PAIN • CMT: 63% • STM: 27% • PLACEBO: 0% • CHIROPRACTIC MANUPULATION AND ACUPUNCTURE USEFUL IN NIH CONCENSOUS PANEL REPORT

  44. CHRONIC PAIN • TENS • STUDY OF 482 PATIENTS WITH CHRONIC PAIN OF VARIOUS ORIGINS. GOOD RESPONSE • PROBLEMS WITH STUDY • INDIVIDUAL DIFFERENCES IN PTS RESPONSE • HIGH DROP OUT RATE IN LONG-TERM TREATMENT

  45. PERIPHERAL NEUROPATHY • YOGA / CARPAL TUNNEL SYNDROME • RANDOMIZED SINGLE-BLIND CONTROLLED TRIAL 42 PTS WITH CTS • RESULT: YOGA-BASED REGIMENMORE EFFECTIVE THAN WRIST SPLINTING OR NO TX IN RELIEVING SOME S/SXS OF CTS • PHALEN SIGN IMPROVEMENT IN 12 PTS WITH YOGA TX VS. 2 PTS IN CONTROL

  46. YOGA • YOGA'S ROLE IN THE MANAGEMENT OF DEPRESSION HAS BEEN INVESTIGATED AND REPORTED TO BE BENEFICIAL FOR COLLEGE STUDENTS WHO EXHIBIT A HIGH LEVEL OF DEPRESSIVE SYMPTOMS. • CASE REPORT DESCRIBING AN APPLICATION OF YOGA THERAPEUTICS TO A PATIENT WITH PARKINSON DISEASE. • RELAXATION MAY PROMOTE POSITIVE EFFECTS ON CAROTID ATHEROSCLEROSIS, HYPERTENSION, DIABETES, AND CORONARY ARTERY DISEASE, WHICH ARE IDENTIFIED AS RISK FACTORS ASSOCIATED WITH STROKE OCCURRENCE OR REOCCURRENCE

  47. YOGA AND MS • DR. OKEN HYPOTHESIS: • YOGA MIGHT BE BENEFICIAL IN TERMS OF COGNITIVE FUNCTION IN MULTIPLE SCLEROSIS, WHERE THERE ARE SIGNIFICANT COGNITIVE PROBLEMS, SUCH AS DIFFICULTY CONCENTRATING. • COGNITIVE FUNCTION WAS THE PRIMARY OUTCOME MEASURE IN THE STUDY, AND ALL THE QUALITY OF LIFE MEASURES SUCH AS FATIGUE AND MOOD WERE SECONDARY OUTCOME MEASURES

  48. FUTURE INVESTIGATIVE POTENTIALS • YOGA CAN BE USED TO PREVENT AND CURE VARIOUS INDIVIDUAL, COMMUNITY, AND SOCIETAL ILLNESSES. • INDIVIDUAL DEVELOPMENT TO UPLIFT ONESELF IS CRUCIAL AND NEEDS TO BE STUDIED. • YOGA WITH AYURVEDA AND MODERN MEDICINE CAN BE APPLIED TO AGING, DEMENTIA, STRESS ADAPTATION, G.I. DISORDERS, HIV/AIDS, AUTOIMMUNE DISORDERS, AND MANY OTHER AILMENTS.

  49. W. SOMNIFERA IN MUSCLE SARCOPENIA • PRELIMINARY TRIAL ON 28 HEALTHY VOLUNTEERS (22 MALES) AND (6 FEMALES) BETWEEN 60 TO 75 YEARS WAS CONDUCTED. • THE HERB W. SOMNIFERA MAY HAVE THE POTENTIAL TO IMPROVE MUSCLE STRENGTH AND ENDURANCE FOR THE AGED SUBJECTS. • SHOWED POTENTIAL EFFECT IN IMPROVING MUSCLE FUNCTIONING AND MUSCLE STRENGTH TESTING • FUNCTIONAL MEASUREMENT UP AND GO TEST • NO SIDE EFFECT WAS OBSERVED FOR THE HERB AT 500 MG (BID) FOR THE AGED SUBJECTS FOR CONTINUOUS PERIOD OF 3 MONTHS. MISHRA ETAL 2002

  50. FIBROMYALGIA • CLINICAL SURVEY SHOWS 98% PERCENT OF THE PATIENTS USE SOME TYPE OF CAM THERAPY. • MOST FREQUENTLY USED CAM TREATMENTS: • EXERCISE FOR A SPECIFIC MEDICAL PROBLEM (48%), • SPIRITUAL HEALING (PRAYERS) (45%), • MASSAGE THERAPY (44%), • CHIROPRACTIC TREATMENTS (37%), • VITAMIN C (35%), VITAMIN E (31%), MAGNESIUM (29%), VITAMIN B COMPLEX (25%), GREEN TEA (24%), AND • WEIGHT-LOSS PROGRAMS (20%). • ACUPUNCTURE 20% • CONCLUSION: CAM USE IS COMMON IN PATIENTS REFERRED TO A FIBROMYALGIA TREATMENT PROGRAM.. WAHNER-ROEDLER DL, MAYO CLINIC COLLEGE OF MEDICINE, ROCHESTER, MINN 55905, USA