1 726 78 EFFECT OF LAUGHTER YOGA ON SALIVARY CORTISOL AND DEHYDROEPIANDROSTERONE AMONG HEALTHY UNIVERSITY STUDENTS: A RANDOMIZED CONTROLLED TRIAL. OBJECTIVE: TO EXAMINE WHETHER LAUGHTER YOGA (LY), I.E., SIMULATED LAUGHTER, ALTERS CORTISOL AND DEHYDROEPIANDROSTERONE (DHEA) LEVELS AND CORTISOL/DHEA (C/D) RATIOS. METHODS: IN A RANDOMIZED CONTROLLED TRIAL, 120 HEALTHY UNIVERSITY STUDENTS WERE ALLOCATED TO EXPERIENCING LY, WATCHING A COMEDY MOVIE (SPONTANEOUS LAUGHTER), OR READING A BOOK. SALIVARY CORTISOL AND DHEA LEVELS WERE MEASURED IMMEDIATELY BEFORE, IMMEDIATELY AFTER, AND 30MIN AFTER THE INTERVENTION. RESULTS: CORTISOL LEVELS AND C/D RATIOS SIGNIFICANTLY DECREASED BY TIME IN THE LY AND COMEDY MOVIE GROUPS. SIGNIFICANT GROUP*TIME INTERACTIONS WERE FOUND BETWEEN THESE TWO GROUPS FOR CORTISOL LEVELS AND C/D RATIOS. DHEA LEVELS DID NOT CHANGE BY TIME IN THE LY GROUP. CONCLUSIONS: LY DECREASED CORTISOL LEVELS AND C/D RATIOS BUT DID NOT AFFECT DHEA LEVELS. SIMULATED AND SPONTANEOUS LAUGHTER DIFFERENTLY AFFECTED THE DYNAMICS OF CORTISOL LEVELS AND C/D RATIOS. EFFECT OF SPONTANEOUS LAUGHTER ON THE CORTISOL DYNAMICS LASTED LONGER THAN THAT OF SIMULATED LAUGHTER. (UMIN000019409). 2018 2 1548 18 LAUGHTER YOGA ACTIVITIES FOR OLDER PEOPLE LIVING IN RESIDENTIAL AGED CARE HOMES: A FEASIBILITY STUDY. OBJECTIVE: TO EVALUATE THE EFFECTS OF A LAUGHTER YOGA ACTIVITIES (LY) PROGRAM FOR OLDER PEOPLE LIVING IN RESIDENTIAL AGED CARE HOMES (RACHS). METHODS: A 6-WEEK LY PROGRAM WAS IMPLEMENTED AT THREE RACHS WITH TWENTY-EIGHT RESIDENTS. A PRE-POST DESIGN WAS USED TO MEASURE POSITIVE AND NEGATIVE AFFECT, HAPPINESS, BLOOD PRESSURE AND PULSE. RESULTS: POST-SESSION MEAN SCORES FOR POSITIVE MOOD, AND HAPPINESS WERE SIGNIFICANTLY HIGHER THAN PRE-SESSION SCORES IN WEEKS 1, 3 AND 6, AND THE POST-SESSION MEAN NEGATIVE MOOD SCORES WERE SIGNIFICANTLY LOWER THAN PRE-SESSION SCORES IN WEEKS 3 AND 6. POST-SESSION READINGS FOR MEAN SYSTOLIC BLOOD PRESSURE WERE SIGNIFICANTLY LOWER THAN PRE-SESSION READINGS IN WEEKS 1 AND 6. CONCLUSION: THIS STUDY DEMONSTRATES THE POTENTIAL FOR USING LY TO IMPROVE MOOD AND LOWER BLOOD PRESSURE OF OLDER PEOPLE LIVING IN RACHS. 2017 3 830 30 EFFECT OF YOGA ON MENTAL HEALTH: COMPARATIVE STUDY BETWEEN YOUNG AND SENIOR SUBJECTS IN JAPAN. BACKGROUND: JAPAN HAS A LARGE NUMBER OF SENIOR CITIZENS. YOGA CAN BE WISELY APPLIED IN OLD AGE CARE. THERE IS NO ANY AGE RESTRICTION TO PRACTICE YOGA. THE EFFECT MAY DIFFER BY AGE. THERE IS A NEED TO STUDY THE MECHANISM OF ACTION OF YOGA WITH RESPECT TO AGE. AIM: THIS STUDY WAS CONDUCTED IN JAPAN TO FIND THE EFFECT OF YOGA ON MENTAL HEALTH BETWEEN YOUNG AND SENIOR PEOPLE. MATERIALS AND METHODS: TWENTY-FIVE NORMAL HEALTHY VOLUNTEERS OF BOTH SEXES WERE DIVIDED INTO TWO GROUPS ACCORDING TO AGE. FIFTEEN PARTICIPANTS OF THE AGE GROUP BETWEEN 65 TO 75 YEARS AND 10 PARTICIPANTS OF THE AGE GROUP BETWEEN 20 TO 30 YEARS WERE SELECTED. THIS STUDY WAS APPROVED BY THE ETHICAL COMMITTEE OF KAWASAKI UNIVERSITY OF MEDICAL WELFARE. SELECTED INDIVIDUALS WERE SUBJECTED TO 90 MIN OF YOGA CLASSES ONCE OR TWICE A WEEK FOR A MONTH. SALIVARY AMYLASE ACTIVITY WAS ASSESSED BEFORE AND AFTER YOGA PRACTICE. STATE TRAIT ANXIETY INVENTORY (STAI) WAS GIVEN BEFORE YOGA ON THE FIRST DAY AND AFTER ONE MONTH OF PRACTICE TO ASSESS THE CHANGE IN STATE ANXIETY AND TRAIT ANXIETY. RESULTS: SENIOR GROUP - SALIVARY AMYLASE ACTIVITY DECREASED FROM 111.2+/-42.7 TO 83.48+/-39.5 KU/L [AVERAGE+/-STANDARD DEVIATION]. YOUNGER GROUP - SALIVARY AMYLASE ACTIVITY REDUCED FROM 60.74+/-31.8 TO 42.39+/-24 KU/L. SENIOR GROUP - STATE ANXIETY SCORE DECREASED FROM 41.13 +/-8.43 TO 30.8+/-6.49, TRAIT ANXIETY SCORE REDUCED FROM 45.66+/-7.5 TO 40.73+/-8.3. YOUNGER GROUP - STATE ANXIETY SCORE REDUCED FROM 38.7+/-4.8 TO 30.8+/-4.1,TRAIT ANXIETY SCORE REDUCED FROM 46.2+/-7.9 TO 42.9+/-9.1. CHANGES WERE STATISTICALLY SIGNIFICANT WITH P<0.05. CONCLUSION: DECREASE IN SALIVARY AMYLASE ACTIVITY MAY BE DUE TO REDUCTION IN SYMPATHETIC RESPONSE. REDUCTION IN STATE AND TRAIT ANXIETY SCORE SIGNIFIES THAT YOGA HAS BOTH IMMEDIATE AS WELL AS LONG-TERM EFFECT ON ANXIETY REDUCTION. THUS YOGA HELPS TO IMPROVE THE MENTAL HEALTH IN BOTH THE GROUPS. 2011 4 2220 24 THE IMPACT OF LAUGHTER YOGA ON DEPRESSION AND ANXIETY AMONG RETIRED WOMEN: A RANDOMIZED CONTROLLED CLINICAL TRIAL. RECENTLY, LAUGHTER YOGA (LY) HAS BEEN INTRODUCED FOR MANAGING DEPRESSION AND ANXIETY. THIS STUDY AIMED TO INVESTIGATE THE IMPACT OF LY ON DEPRESSION AND ANXIETY AMONG RETIRED WOMEN IN CITY OF BOJNURD, IRAN, 2018. SIXTY-SIX RETIRED WOMEN WERE RANDOMLY ASSIGNED TO INTERVENTION AND CONTROL GROUPS. INTERVENTION GROUP RECEIVED LY TWICE WEEKLY FOR 8 WEEKS; CONTROL GROUP HAD THEIR ROUTINE DAILY ACTIVITIES. DEPRESSION AND ANXIETY LEVELS WERE MEASURED AT STUDY INITIATION, WEEK 4, AND WEEK 8 IN BOTH GROUPS. RESULTS SHOWED SIGNIFICANT DIFFERENCE IN THE PATTERN OF DEPRESSION (P <.001) AND ANXIETY (P <.001) SCORES WITHIN AND BETWEEN GROUPS. LY COULD BE AN EFFECTIVE INTERVENTION IN REDUCING DEPRESSION AND ANXIETY AMONG RETIRED WOMEN. 2022 5 1549 29 LAUGHTER YOGA REDUCES THE CORTISOL RESPONSE TO ACUTE STRESS IN HEALTHY INDIVIDUALS. STRESS IS ONE OF THE FOREMOST CONTRIBUTORS TO THE DEVELOPMENT OF PSYCHIATRIC DISEASES. SINCE THE PREVALENCE OF STRESS-RELATED COMPLAINTS IS INCREASING, WE ARE IN NEED FOR AFFORDABLE AND EFFECTIVE TREATMENT ALTERNATIVES. LAUGHTER YOGA (LY), A POPULAR METHOD ENCOURAGING PARTICIPANTS TO SIMULATE LAUGHTER AND PARTICIPATE IN YOGIC BREATHING EXERCISES, IS HYPOTHESIZED TO BUFFER NEGATIVE EFFECTS OF STRESS. ALTHOUGH WIDELY PRACTICED, EMPIRICAL EVIDENCE FOR BENEFICIAL EFFECTS OF LY IS SCARCE. WE INVESTIGATED THE ACUTE EFFECTS OF A SINGLE 30-MIN LY SESSION ON THE AUTONOMIC, ENDOCRINE AND PSYCHOLOGICAL RESPONSE TO A STANDARDIZED PSYCHOSOCIAL STRESSOR. THIRTY-FIVE HEALTHY SUBJECTS (51% FEMALE) WERE RANDOMLY ASSIGNED TO EXPERIENCE EITHER A LY (N = 11), A RELAXATION BREATHING (N = 12) OR A (NON-INTERVENTION) CONTROL (N = 12) SESSION PRIOR TO THEIR EXPOSURE TO THE TRIER SOCIAL STRESS TEST FOR GROUPS (TSST-G). SALIVARY CORTISOL, SALIVARY ALPHA AMYLASE, AND SUBJECTIVE STRESS WERE ASSESSED REPEATEDLY THROUGHOUT THE EXPERIMENT. WE EXPECTED THAT LY AND RELAXATION BREATHING GROUP EACH SHOW A DOWNREGULATION OF STRESS RESPONSE INDICES COMPARED TO THE CONTROL GROUP. FURTHER, WE EXPECTED THAT LY HAS BENEFICIAL EFFECTS COMPARED TO RELAXATION BREATHING. THE GROUPS DID NOT DIFFER IN SALIVARY CORTISOL, ALPHA AMYLASE OR SUBJECTIVE STRESS REACTIVITY DURING THE 30-MIN INTERVENTION. HOWEVER, IN RESPONSE TO THE TSST-G, THE LY, BUT NEITHER THE RELAXATION BREATHING, NOR THE CONTROL CONDITION, SHOWED AN ATTENUATED CORTISOL STRESS RESPONSE. THESE FINDINGS HIGHLIGHT THE POTENTIAL OF LY TO BUFFER THE ENDOCRINE STRESS RESPONSE. THEREFORE, LY COULD BE USED AS A CHEAP AND EASILY-TO-IMPLEMENT ADD-ON TO MORE TRADITIONAL STRESS INTERVENTIONS. LAY SUMMARY IN RECENT YEARS, MORE AND MORE PEOPLE HAVE REPORTED TO FEEL STRESSED. ALTHOUGH OUR BODY IS WELL EQUIPPED TO DEAL WITH ACUTE STRESS, CHRONIC STRESS CAN TIRE OUR SYSTEM AND CONTRIBUTE TO ILLNESS IN THE LONG RUN. THEREFORE, WE NEED AFFORDABLE AND EFFECTIVE MEASURES TO REDUCE STRESS. IN THIS STUDY WE HAVE INVESTIGATED WHETHER A SINGLE LAUGHTER YOGA SESSION CAN HELP US TO DEAL WITH ACUTE STRESS. ALTHOUGH LAUGHTER YOGA DID NOT CHANGE HOW STRESSFUL A SITUATION WAS PERCEIVED, IT REDUCED THE AMOUNT OF STRESS HORMONES THAT WERE RELEASED IN RESPONSE TO THE SITUATION. AS SUCH, LAUGHTER YOGA MIGHT BE A CHEAP AND EASILY-TO-IMPLEMENT ADD-ON TO MORE TRADITIONAL STRESS REDUCTION INTERVENTIONS. 2021 6 277 24 ADDITIONAL PRACTICE OF YOGA BREATHING WITH INTERMITTENT BREATH HOLDING ENHANCES PSYCHOLOGICAL FUNCTIONS IN YOGA PRACTITIONERS: A RANDOMIZED CONTROLLED TRIAL. BACKGROUND AND OBJECTIVE: THE PRACTICE OF YOGA IS ASSOCIATED WITH ENHANCED PSYCHOLOGICAL WELLBEING. THE CURRENT STUDY ASSESSED THE CORRELATION BETWEEN THE DURATION OF YOGA PRACTICE WITH STATE MINDFULNESS, MIND-WANDERING AND STATE ANXIETY. ALSO, WE EXAMINED IF AN ADDITIONAL 20 MIN OF YOGA BREATHING WITH INTERMITTENT BREATH HOLDING (EXPERIMENTAL GROUP) FOR 8 WEEKS WOULD AFFECT THESE PSYCHOLOGICAL VARIABLES MORE THAN REGULAR YOGA PRACTICE (CONTROL GROUP) ALONE. METHODS: ONE HUNDRED SIXTEEN SUBJECTS WERE RANDOMLY ASSIGNED TO EXPERIMENTAL (N = 60) AND CONTROL (N = 56) GROUPS. STATE MINDFULNESS ATTENTION AWARENESS SCALE (SMAAS), MIND-WANDERING QUESTIONNAIRE (MWQ) AND STATE ANXIETY INVENTORY WERE ADMINISTERED AT BASELINE AND AT THE END OF 8 WEEKS. RESULTS: BASELINE ASSESSMENT REVEALED A POSITIVE CORRELATION BETWEEN DURATION OF YOGA PRACTICE WITH SMAAS SCORES AND NEGATIVE CORRELATION WITH MWQ AND STATE ANXIETY SCORES. AT THE END OF 8 WEEKS, BOTH GROUPS DEMONSTRATED ENHANCED PSYCHOLOGICAL FUNCTIONS, BUT THE EXPERIMENTAL GROUP RECEIVING ADDITIONAL YOGA BREATHING PERFORMED BETTER THAN THE GROUP PRACTICING YOGA ALONE. CONCLUSION: AN ADDITIONAL PRACTICE OF YOGA BREATHING WITH INTERMITTENT BREATH HOLDING WAS FOUND TO ENHANCE THE PSYCHOLOGICAL FUNCTIONS IN YOUNG ADULT YOGA PRACTITIONERS. 2018 7 2319 30 TREATING THE CLIMACTERIC SYMPTOMS IN INDIAN WOMEN WITH AN INTEGRATED APPROACH TO YOGA THERAPY: A RANDOMIZED CONTROL STUDY. OBJECTIVE: TO STUDY THE EFFECT OF YOGA ON THE CLIMACTERIC SYMPTOMS, PERCEIVED STRESS, AND PERSONALITY IN PERIMENOPAUSAL WOMEN. DESIGN: ONE HUNDRED TWENTY PARTICIPANTS (AGES 40-55 Y) WERE RANDOMLY DIVIDED INTO TWO STUDY ARMS, IE, YOGA AND CONTROL. THE YOGA GROUP PRACTICED AN INTEGRATED APPROACH TO YOGA THERAPY COMPRISING SURYA NAMASKARA (SUN SALUTATION) WITH 12 POSTURES, PRANAYAMA (BREATHING PRACTICES), AND AVARTAN DHYAN (CYCLIC MEDITATION), WHEREAS THE CONTROL GROUP PRACTICED A SET OF SIMPLE PHYSICAL EXERCISES UNDER SUPERVISION OF TRAINED TEACHERS FOR 8 WEEKS (1 H DAILY, 5 DAYS PER WEEK). THE ASSESSMENTS WERE MADE BY GREENE CLIMACTERIC SCALE, PERCEIVED STRESS SCALE, AND EYSENCK'S PERSONALITY INVENTORY BEFORE AND AFTER THE INTERVENTION. RESULTS: OF THE THREE FACTORS OF THE GREENE CLIMACTERIC SCALE, THE MANN-WHITNEY TEST SHOWED A SIGNIFICANT DIFFERENCE BETWEEN GROUPS (P < 0.05) IN THE VASOMOTOR SYMPTOMS, A MARGINALLY SIGNIFICANT DIFFERENCE (P = 0.06) IN PSYCHOLOGICAL FACTORS BUT NOT IN THE SOMATIC COMPONENT. EFFECT SIZES WERE HIGHER IN THE YOGA GROUP FOR ALL FACTORS. THERE WAS A SIGNIFICANTLY GREATER DEGREE OF DECREASE IN PERCEIVED STRESS SCALE SCORES (P < 0.001, INDEPENDENT SAMPLES T TEST) IN THE YOGA GROUP COMPARED WITH CONTROLS (BETWEEN-GROUP ANALYSIS) WITH A HIGHER EFFECT SIZE IN THE YOGA GROUP (1.10) THAN THE CONTROL (0.27). ON THE EYSENCK'S PERSONALITY INVENTORY, THE DECREASE IN NEUROTICISM WAS GREATER (P < 0.05) IN THE YOGA GROUP (EFFECT SIZE = 0.43) THAN THE CONTROL GROUP (EFFECT SIZE = 0.21) WITH NO CHANGE IN EXTROVERSION IN EITHER THE YOGA OR CONTROL GROUP. CONCLUSIONS: EIGHT WEEKS OF AN INTEGRATED APPROACH TO YOGA THERAPY DECREASES CLIMACTERIC SYMPTOMS, PERCEIVED STRESS, AND NEUROTICISM IN PERIMENOPAUSAL WOMEN BETTER THAN PHYSICAL EXERCISE. 2008 8 412 24 BLOOD PRESSURE EFFECTS OF YOGA, ALONE OR IN COMBINATION WITH LIFESTYLE MEASURES: RESULTS OF THE LIFESTYLE MODIFICATION AND BLOOD PRESSURE STUDY (LIMBS). THE AUTHORS CONDUCTED A STUDY TO ASSESS THE EFFECTS OF YOGA ON BLOOD PRESSURE (BP). PATIENTS WERE RANDOMIZED TO YOGA (BLOOD PRESSURE EDUCATION PROGRAM [BPEP]), OR A COMBINED PROGRAM (COMBO). AMBULATORY BP WAS MEASURED AT BASELINE AND AT 12 AND 24 WEEKS. DATA ARE PRESENTED FOR ALL ENROLLED PATIENTS (N=137) AND FOR COMPLETERS ONLY (N=90). SYSTOLIC BP (SBP) AND DIASTOLIC BP (DBP) WERE SIGNIFICANTLY DECREASED WITHIN ALL GROUPS AT 12 AND 24 WEEKS (P<.001) FOR ENROLLED PATIENTS AND COMPLETERS. SBP WAS SIGNIFICANTLY REDUCED IN THE YOGA AND COMBO GROUPS AS COMPARED WITH THE BPEP GROUP AT 12 WEEKS IN ALL ENROLLED AND COMPLETERS. SBP DIFFERENCES WERE NO LONGER SIGNIFICANT AT 24 WEEKS BETWEEN GROUPS IN ALL ENROLLED PATIENTS; HOWEVER, THERE WAS A GREATER REDUCTION IN SBP AT 24 WEEKS IN COMPLETERS FAVORING BPEP OVER YOGA. NO DIFFERENCES IN DBP BETWEEN GROUPS OR IN BP BETWEEN THE YOGA AND COMBO GROUPS WERE PRESENT. THE AUTHORS DID NOT OBSERVE AN ADDITIVE BENEFIT FROM COMBINING YOGA WITH BPEP MEASURES. REASONS FOR THIS ARE UNCLEAR AT THIS TIME. BP LOWERING WITH YOGA, HOWEVER, WAS SIMILAR TO THAT ACHIEVED WITH LIFESTYLE MEASURES. 2016 9 1826 23 PSYCHOLOGICAL AND PHYSIOLOGICAL EFFECTS OF LAUGHTER YOGA SESSIONS IN JAPAN: A PILOT STUDY. THE PURPOSE OF THIS PILOT STUDY WAS TO EXAMINE AND EVALUATE THE PSYCHOLOGICAL AND PHYSIOLOGICAL EFFECTS OF MULTIPLE SESSIONS OF LAUGHTER YOGA ON COMMUNITY MEMBERS. PARTICIPANTS TOOK PART IN A 45 MIN LAUGHTER YOGA SESSION ONCE PER MONTH FOR 6 MONTHS. BEFORE AND AFTER ALL SESSIONS, PARTICIPANTS COMPLETED THE PROFILE OF MOOD STATES-BRIEF JAPANESE VERSION (J-POMS-B) QUESTIONNAIRE TO ASSESS THEIR MOOD, AND HAD BLOOD DRAWN FOR THE MEASUREMENT OF STRESS INDICATORS AND IMMUNE FUNCTION. SERIAL CHANGES IN J-POMS-B SCORES WERE TESTED BY THREE WAY ANALYSIS OF VARIANCE, AND CHANGES IN LABORATORY RESULTS PER SESSION WERE EVALUATED WITH A PAIRED T-TEST. THE RESULTS SHOWED THAT REPEATED SESSIONS OF LAUGHTER YOGA HAD PSYCHOLOGICALLY BENEFICIAL EFFECTS, ESPECIALLY ON THE ASPECTS OF TENSION-ANXIETY, AND VIGOR. ADRENOCORTICOTROPIC HORMONE AND CORTISOL VALUES RELATED TO THE PARTICIPANTS' STRESS LEVELS WERE SIGNIFICANTLY DECREASED AFTER THE FOURTH LAUGHTER YOGA SESSION. THESE RESULTS INDICATED THAT MULTIPLE LAUGHTER YOGA SESSIONS APPEARED TO BE EFFECTIVE IN IMPROVING THE PSYCHOLOGICAL AND PHYSIOLOGICAL STATUS OF HEALTHY ADULTS. 2018 10 1003 24 EFFECTS OF MATERNITY YOGA ON THE AUTONOMIC NERVOUS SYSTEM DURING PREGNANCY. AIM: TO ELUCIDATE THE CHANGES IN THE DAILY VARIATION SEEN IN THE AUTONOMIC NERVOUS SYSTEM DURING PREGNANCY BROUGHT ABOUT BY MATERNITY YOGA AND TO EVALUATE HOW MATERNAL YOGA AFFECTS STRESS AND SLEEP. METHODS: A PROSPECTIVE, LONGITUDINAL STUDY WAS CONDUCTED BETWEEN JANUARY 2013 AND DECEMBER 2014. PREGNANT WOMEN WHO WERE ATTENDING MATERNITY YOGA CLASSES AT PALMORE HOSPITAL BETWEEN 20 AND 23 WEEKS' GESTATION WERE ENROLLED AS THE YOGA GROUP, AND A MATCHED CONTROL GROUP WAS ALSO ENROLLED. STUDY PARTICIPANTS COMPLETED QUESTIONNAIRES, INCLUDING A PERCEIVED STRESS SCALE AND SLEEP LOGS, DURING THEIR SECOND AND THIRD TRIMESTERS. HEART RATE VARIABILITY AND SALIVARY ALPHA-AMYLASE LEVELS WERE EVALUATED AS STRESS INDICES AT 20-23 WEEKS' GESTATION, 28-31 WEEKS' GESTATION AND 36-40 WEEKS' GESTATION. RESULTS: A TOTAL OF 38 WOMEN WERE IN THE YOGA GROUP, WITH 53 IN THE CONTROL GROUP. AT 28-31 WEEKS' GESTATION, HEART RATE VARIABILITY DURING NIGHT AND LATE-NIGHT PERIODS WAS SIGNIFICANTLY HIGHER IN THE YOGA GROUP THAN IN THE CONTROL GROUP. AT 36-40 WEEKS' GESTATION, VARIABILITY BETWEEN THE MORNING, AFTERNOON AND LATE NIGHT WAS SIGNIFICANTLY HIGHER IN THE YOGA GROUP. SALIVARY ALPHA-AMYLASE LEVELS DECREASED SIGNIFICANTLY IMMEDIATELY AFTER PRACTICING YOGA DURING ALL EVALUATION PERIODS IN THE YOGA GROUP. NIGHT-TIME SLEEP DURATION WAS SIGNIFICANTLY LONGER IN THE YOGA GROUP. CONCLUSION: OUR RESULTS SUGGEST THAT PRACTICING YOGA ACTIVATES THE PARASYMPATHETIC NERVOUS SYSTEM DURING THE THIRD TRIMESTER OF PREGNANCY, CONSOLIDATING SLEEP DURING THE NIGHT AND DECREASING ALPHA-AMYLASE LEVELS, WHICH INDICATES REDUCED STRESS. 2018 11 725 22 EFFECT OF LAUGHTER YOGA ON PSYCHOLOGICAL WELL-BEING AND PHYSIOLOGICAL MEASURES. CONTEXT: IN 2014, LAUGHTER YOGA (LY) ACHIEVED THE INTERMEDIATE LEVEL, TIER 2, UNDER THE TITLE III-D EVIDENCE-BASED DISEASE PREVENTION AND HEALTH PROMOTION PROGRAM THROUGH THE ADMINISTRATION ON AGING (AOA). FURTHER RESEARCH IS NEEDED TO QUALIFY LY UNDER THE CRITERIA FOR THE HIGHEST TIER, TIER 3, TO ASSURE CONTINUED FUNDING FOR LY CLASSES AT SENIOR CENTERS. OBJECTIVES: THE STUDY INTENDED TO DEMONSTRATE FURTHER THE BENEFITS OF LY AND TO QUALIFY LY AS TIER 3 UNDER TITLE III-D. DESIGN: USING A QUASI-EXPERIMENTAL DESIGN, THE RESEARCH TEAM CONDUCTED A PREINTERVENTION/POSTINTERVENTION STUDY IN 3 PHASES. SETTING: THE STUDY WAS DONE IN A VARIETY OF COMMUNITY CENTERS. PHASE 1, A PILOT PHASE, WAS LIMITED TO NORTH CAROLINA, AND PHASE 2 WAS CONDUCTED IN MULTIPLE STATES. PHASE 3 WAS HELD AT THE NORTH CAROLINA AREA AGENCY ON AGING'S ANNUAL VOLUNTEER APPRECIATION MEETING. PARTICIPANTS: PARTICIPANTS IN PHASES 1 (N = 109) AND 2 (N = 247) ENROLLED IN LY CLASSES. CLASSES WERE ADVERTISED BY FLIERS POSTED IN COMMUNITY AND IN RETIREMENT CENTERS. THE ABILITY OF PARTICIPANTS TO PARTICIPATE IN A CLASS WAS BASED SOLELY ON THEIR DESIRE TO PARTICIPATE, REGARDLESS OF AGE, ABILITY, HEALTH STATUS, OR PHYSICAL IMPAIRMENT. PHASE 3 (N = 23) WAS A CONVENIENCE SAMPLE ONLY. ALL PHASES WERE VOLUNTARY. OUTCOME MEASURE: THE PRE- AND POSTTESTS FOR ALL 3 PHASES WERE LIKERT-SCALE SURVEYS, 10 QUESTIONS ON THE PSYCHOLOGICAL OUTCOMES OF WELL-BEING (POWB) SURVEY. PULSE AND OTHER PHYSIOLOGICAL MEASUREMENTS WERE ALSO ASSESSED PRE- AND POSTINTERVENTION. ANALYSIS INCLUDED A T TEST ON EACH OF THE 10 POWB AND PHYSIOLOGICAL MEASURES FOR ALL PHASES. RESULTS: ALL 10 POWB MEASURES FOR PHASES 1 AND 2 SHOWED SIGNIFICANT IMPROVEMENTS BETWEEN THE PRE- AND POSTINTERVENTION TESTING (P < .001). PHASE 3, THE CONTROL, SHOWED NO SIGNIFICANT IMPROVEMENT. CONCLUSIONS: THE INITIAL STUDY DEMONSTRATED THAT LY MEETS THE CRITERIA TO QUALIFY FOR TIER 3 UNDER THE TITLE III-D EVIDENCE-BASED DISEASE PREVENTION AND HEALTH PROMOTION PROGRAM AND THAT A LARGE NUMBER OF AMERICANS, REGARDLESS OF AGE AND PHYSICAL ABILITY, COULD BENEFIT FROM LY. 2016 12 1361 23 IMMEDIATE STRESS REDUCTION EFFECTS OF YOGA DURING PREGNANCY: ONE GROUP PRE-POST TEST. BACKGROUND: EXCESSIVE STRESS DURING PREGNANCY MAY CAUSE MENTAL DISORDERS IN PREGNANT WOMEN AND INHIBIT FETAL GROWTH. YOGA MAY ALLEVIATE STRESS DURING PREGNANCY. AIM: TO VERIFY THE IMMEDIATE EFFECTS OF YOGA ON STRESS RESPONSE DURING PREGNANCY. METHODS: ONE GROUP PRE-POST TEST WAS CONDUCTED AT A HOSPITAL IN JAPAN. WE RECRUITED 60 HEALTHY PRIMIPARAS WITHOUT COMPLICATIONS AND ASKED THEM TO ATTEND YOGA CLASSES TWICE A MONTH AND TO PRACTICE YOGA AT THEIR HOMES USING DVD 3 TIMES A WEEK FROM 20 GESTATIONAL WEEKS UNTIL CHILDBIRTH. SALIVARY CORTISOL AND ALPHA-AMYLASE CONCENTRATION WERE MEASURED BEFORE AND AFTER YOGA CLASSES AT TIME 1 (27-32 GESTATIONAL WEEKS) AND TIME 2 (34-37 GESTATIONAL WEEKS). SUBJECTIVE MOOD WAS ASSESSED USING THE PROFILE OF MOOD STATES. SALIVA VALUES AND MOOD SCORES BEFORE AND AFTER EACH YOGA CLASS WERE COMPARED USING PAIRED T-TEST AND WILCOXON RANK-SUM TEST, RESPECTIVELY. FINDINGS: WE ANALYZED 44 AND 35 WOMEN AT TIME 1 AND TIME 2, RESPECTIVELY. THE MEAN SALIVARY CORTISOL CONCENTRATION DECLINED SIGNIFICANTLY AFTER EACH YOGA CLASS [TIME 1: 0.36-0.26MUG/DL (P<0.001), TIME 2: 0.32-0.26MUG/DL (P=0.001)]. THE MEAN SALIVARY ALPHA-AMYLASE CONCENTRATION ALSO DECREASED SIGNIFICANTLY FOLLOWING EACH CLASS [TIME 1: 72.2-50.8KU/L (P=0.001), TIME 2: 70.6-52.7KU/L (P=0.006)]. THE SCORES FOR NEGATIVE DIMENSIONS OF MOOD (TRAIT-ANXIETY, DEPRESSION, ANGER-HOSTILITY, FATIGUE, AND CONFUSION) DECREASED SIGNIFICANTLY. THE SCORES OF VIGOR FOR A POSITIVE DIMENSION OF MOOD SIGNIFICANTLY INCREASED. CONCLUSION: THIS STUDY INDICATED THE IMMEDIATE STRESS REDUCTION EFFECTS OF YOGA DURING PREGNANCY. 2016 13 713 23 EFFECT OF INTEGRATED YOGA ON ANXIETY, DEPRESSION & WELL BEING IN NORMAL PREGNANCY. OBJECTIVE: TO STUDY THE EFFECT OF INTEGRATED YOGA ON PREGNANCY EXPERIENCE, ANXIETY, AND DEPRESSION IN NORMAL PREGNANCY. METHODS: THIS PROSPECTIVE RANDOMIZED CONTROL STUDY RECRUITED 96 WOMEN IN 20TH WEEK OF NORMAL PREGNANCY. YOGA GROUP (N = 51) PRACTICED INTEGRATED YOGA AND CONTROL GROUP (N = 45) DID STANDARD ANTENATAL EXERCISES, ONE HOUR DAILY, FROM 20TH TO 36TH WEEK OF GESTATION. MANN-WHITNEY AND WILCOXON'S TESTS WERE USED FOR STATISTICAL ANALYSIS. RESULTS: THERE WAS SIGNIFICANT DIFFERENCE BETWEEN GROUPS (MANN-WHITNEY P < 0.001) IN ALL VARIABLES. THERE WERE SIGNIFICANT CHANGES WITHIN GROUPS (WILCOXON'S P < 0.001) IN BOTH GROUPS. PREGNANCY RELATED EXPERIENCE (PEQ) REDUCED IN YOGA BY 26.86%, STATE (STAI I) ANXIETY (DECREASED 15.65% IN YOGA, INCREASED 13.76% IN CONTROL), TRAIT (STAI II) ANXIETY (DECREASED 8.97% IN YOGA, INCREASED 5.02% IN CONTROL) AND DEPRESSION (HADS) (DECREASED 30.67% IN YOGA, INCREASED 3.57% IN CONTROL). CONCLUSION: YOGA REDUCES ANXIETY, DEPRESSION AND PREGNANCY RELATED UNCOMFORTABLE EXPERIENCES. 2013 14 735 23 EFFECT OF POSTPARTUM YOGA ON BREASTFEEDING SELF-EFFICACY AND MATERNAL ATTACHMENT IN PRIMIPAROUS MOTHERS. OBJECTIVE: THIS STUDY WAS CONDUCTED TO DETERMINE THE EFFECT OF YOGA PRACTICE ON THE BREASTFEEDING SELF-EFFICACY AND MATERNAL ATTACHMENT OF PRIMIPAROUS MOTHERS IN THE POSTPARTUM PERIOD. METHODS: THIS STUDY WAS PERFORMED IN A QUASI-EXPERIMENTAL MODEL WITH PRETEST AND POSTTEST CONTROL GROUPS. THE DOMAIN OF THE STUDY WAS FORMED WITH WOMEN WITH 20-40-DAY-OLD BABIES ENROLLED IN TWO FAMILY HEALTH CENTERS. ONE HUNDRED AND TWENTY-FOUR WOMEN PARTICIPATED IN THE STUDY. THE INDIVIDUAL IDENTIFICATION FORM, BREASTFEEDING SELF-EFFICACY SCALE, AND MATERNAL ATTACHMENT SCALE WERE COMPLETED BY THE EXPERIMENTAL AND CONTROL GROUPS. THE EXPERIMENTAL GROUP ENGAGED IN 60 MINUTES OF POSTPARTUM YOGA PRACTICE 2 DAYS A WEEK FOR 8 WEEKS IN THE COMPANY OF THE RESEARCHER. RESULTS: AFTER YOGA PRACTICE, THERE WAS A STATISTICALLY SIGNIFICANT INCREASE IN THE BREASTFEEDING SELF-EFFICACY AND IMPROVEMENT IN THE MATERNAL ATTACHMENT OF THE EXPERIMENTAL GROUP (P < 0.05). THE CORRESPONDING INCREASE AND IMPROVEMENT OF THE MOTHERS IN THE CONTROL GROUP WERE LESS THAN THOSE OF THE MOTHERS IN THE EXPERIMENTAL GROUP (P < 0.05). CONCLUSION: THIS STUDY FINDS THAT IT IS BENEFICIAL FOR BOTH THE MOTHER'S AND THE BABY'S PHYSICAL AND PSYCHOLOGICAL HEALTH FOR HEALTH PROFESSIONALS TO TEACH MOTHERS TO PRACTICE YOGA, WHICH POSITIVELY AFFECTS BREASTFEEDING AND MATERNAL ATTACHMENT IN THE POSTPARTUM PERIOD. 2022 15 2444 19 YOGA AND SOCIAL SUPPORT REDUCE PRENATAL DEPRESSION, ANXIETY AND CORTISOL. THE PURPOSE OF THIS STUDY WAS TO COMPARE THE EFFECTS OF YOGA (PHYSICAL ACTIVITY) VERSUS SOCIAL SUPPORT (VERBAL ACTIVITY) ON PRENATAL AND POSTPARTUM DEPRESSION. NINETY-TWO PRENATALLY DEPRESSED WOMEN WERE RANDOMLY ASSIGNED TO A YOGA OR A SOCIAL SUPPORT CONTROL GROUP AT 22 WEEKS GESTATION. THE YOGA GROUP PARTICIPATED IN A 20-MIN GROUP SESSION (ONLY PHYSICAL POSES) ONCE PER WEEK FOR 12 WEEKS. THE SOCIAL SUPPORT GROUP (A LEADERLESS DISCUSSION GROUP) MET ON THE SAME SCHEDULE. AT THE END OF THE FIRST AND LAST SESSIONS THE YOGA GROUP REPORTED LESS DEPRESSION, ANXIETY, ANGER, BACK AND LEG PAIN AS COMPARED TO THE SOCIAL SUPPORT GROUP. AT THE END OF THE LAST SESSION THE YOGA GROUP AND THE SUPPORT GROUP DID NOT DIFFER. THEY BOTH HAD LOWER DEPRESSION (CES-D), ANXIETY (STAI), AND ANGER (STAXI) SCORES AND IMPROVED RELATIONSHIP SCORES. IN ADDITION, CORTISOL LEVELS DECREASED FOR BOTH GROUPS FOLLOWING EACH SESSION. ESTRIOL AND PROGESTERONE LEVELS DECREASED AFTER THE LAST SESSION. AT THE POSTPARTUM FOLLOW-UP ASSESSMENT DEPRESSION AND ANXIETY LEVELS WERE LOWER FOR BOTH GROUPS. 2013 16 2221 20 THE IMPACT OF LAUGHTER YOGA ON THE STRESS OF CANCER PATIENTS BEFORE CHEMOTHERAPY. BACKGROUND: CANCER IS USUALLY ACCOMPANIED BY CONSIDERABLE STRESS FOR THE SUFFERER, AND THE STRESS HAS DESTRUCTIVE EFFECTS ON CHEMOTHERAPY TREATMENT PROCESS. THEREFORE, THE CURRENT RESEARCH DEALS WITH THE EFFECT OF YOGA LAUGHTER ON THE CANCER PATIENTS' STRESS BEFORE CHEMOTHERAPY. METHODS: IN THIS RESEARCH, AS THE FIRST STEP, 37 CANCER SUFFERERS , WHO HAD BEEN HOSPITALIZED IN SHOHADA TAJRISH HOSPITAL (BEHNAM DANESHPOOR CHARITY ORGANIZATION) AND HAD THE REQUIREMENTS NECESSARY FOR BEING TAKEN AS RESEARCH SAMPLES, WERE SELECTED FOR DATA COLLECTION. THE MENTIONED PATIENTS WERE CLASSIFIED RANDOMLY IN EXPERIMENTAL AND CONTROL GROUPS. COLLECTED DATA WERE ANALYZED BY THE MULTI-VARIABLE COVARIANCE ANALYSIS TEST. RESULTS: THE RESULTS SHOW THERE IS A MEANINGFUL DIFFERENCE IN THE STRESS AVERAGE BEFORE AND AFTER INTERFERENCE IN THE TEST GROUP (P<0.05). CONCLUSION: LAUGHTER YOGA CAN DECREASE THE STRESS IN CANCER SUFFERERS BEFORE CHEMOTHERAPY. 2014 17 843 29 EFFECT OF YOGA ON PSYCHOLOGICAL FUNCTIONING OF NURSING STUDENTS: A RANDOMIZED WAIT LIST CONTROL TRIAL. INTRODUCTION: NURSING STUDENTS EXPERIENCE CONSIDERABLE AMOUNT OF STRESS TO MEET THEIR PROFESSIONAL DEMANDS. YOGA IS AN EFFECTIVE PRACTICE TO REDUCE STRESS AND IMPROVE PSYCHOLOGICAL WELL BEING. HOWEVER, IMPROVEMENT IN PSYCHOLOGICAL WELL BEING AIDS IN STRESS MANAGEMENT. AIM: TO EVALUATE THE EFFECTIVENESS OF EIGHT WEEK YOGA INTERVENTION ON PSYCHOLOGICAL FUNCTIONING OF NURSING STUDENTS. MATERIALS AND METHODS: THIS WAS A RANDOMISED WAIT LIST CONTROL (WLC) TRIAL, WE RECRUITED TOTAL 100 STUDENTS FROM KEMPEGOWDA INSTITUTE OF NURSING, BENGALURU, KARNATAKA, INDIA AND RANDOMIZED THEM INTO TWO GROUPS (YOGA=50 AND WLC=50 STUDENTS). THE FOLLOWING INSTRUMENTS WERE USED TO COLLECT THE DATA, FREIBURG MINDFULNESS INVENTORY (FMI), SELF-COMPASSION SCALE- SHORT FORM (SCS-SF), CONNOR-DAVIDSON RESILIENCE SCALE (CD-RISC), SATISFACTION WITH LIFE SCALE (SWLS), JEFFERSON SCALE OF EMPATHY HPS-VERSION (JSE-HPS), AND PERCEIVED STRESS SCALE (PSS). DATA WAS ANALYSED USING REPEATED MEASURES ANALYSIS OF VARIANCE (RM-ANOVA) FOLLOWED BY POST-HOC BONFERRONI CORRECTION FOR ALL PSYCHOLOGICAL VARIABLES. RESULTS: THE RESULTS OF OUR STUDY REPORT THAT EIGHT WEEK YOGA INTERVENTION WAS SIGNIFICANTLY EFFECTIVE IN IMPROVING SELF COMPASSION AND MINDFULNESS AMONG NURSING STUDENTS IN EXPERIMENTAL GROUP THAN COMPARED TO WLC GROUP. EVEN THOUGH THERE WERE IMPROVEMENTS IN RESILIENCE, SATISFACTION IN LIFE AND PERCEIVED STRESS, RESULTS WERE NOT STATISTICALLY SIGNIFICANT. CONCLUSION: OVERALL, RESULTS OF THE PRESENT STUDY HAVE DEMONSTRATED IMPACT OF EIGHT WEEK YOGA INTERVENTION ON THE PSYCHOLOGICAL FUNCTIONING OF NURSING STUDENTS. YOGA INTERVENTION CAN BE INCULCATED IN THE NURSING EDUCATION TO MEET DEMANDS OF THE PROFESSION. 2017 18 1046 26 EFFECTS OF YOGA ON ANXIETY AND DEPRESSION FOR HIGH RISK MOTHERS ON HOSPITAL BEDREST. BACKGROUND: AND PURPOSE: IN RECENT YEARS, YOGA PRACTITIONERS HAVE JOINED FORCES WITH MEDICAL PROGRAMS TO APPROACH PATIENTS' WELL-BEING HOLISTICALLY. THIS STUDY IS A RANDOMIZED CONTROLLED TRIAL TO ASSESS THE EFFECTS OF A SPECIALIZED ADAPTED YOGA PROGRAM ON ANXIETY AND DEPRESSION FOR HIGH-RISK EXPECTANT MOTHERS ON BEDREST IN A HOSPITAL SETTING. MATERIALS AND METHODS: SEVENTY-NINE PREGNANT SUBJECTS ON PHYSICIAN ORDERED HOSPITALIZED BEDREST WERE RANDOMIZED INTO TWO GROUPS: RECEIVING BIWEEKLY YOGA SESSIONS (INTERVENTION GROUP) OR RECEIVING NO YOGA (CONTROL GROUP). DATA COLLECTION TOOL WAS THE HOSPITAL ANXIETY AND DEPRESSION SCALE (HADS) TO ASSESS OUTCOMES AFTER DELIVERY. RESULTS: YOGA, EVEN AS LITTLE AS THREE SESSIONS, SHOWED SIGNIFICANT IMPACT IN REDUCING ANXIETY AND DEPRESSION HIGH-RISK PREGNANT WOMEN ON HOSPITALIZED BEDREST. PERCEIVED ANXIETY AND DEPRESSION OVERALL SCORES WERE LOWER IN THE INTERVENTION GROUP THAN IN THE CONTROL GROUP (P < 0.001). CONCLUSION: RESULTS DEMONSTRATED THAT YOGA IS AN EFFECTIVE INTERVENTION TO DECREASE ANXIETY AND DEPRESSION IN HIGH-RISK ANTEPARTUM WOMEN ON HOSPITALIZED BEDREST. 2020 19 1550 30 LAUGHTER YOGA VERSUS GROUP EXERCISE PROGRAM IN ELDERLY DEPRESSED WOMEN: A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: LAUGHTER YOGA FOUNDED BY M. KATARIA IS A COMBINATION OF UNCONDITIONED LAUGHTER AND YOGIC BREATHING. ITS EFFECT ON MENTAL AND PHYSICAL ASPECTS OF HEALTHY INDIVIDUALS WAS SHOWN TO BE BENEFICIAL. OBJECTIVE: THE OBJECTIVE OF THIS STUDY WAS TO COMPARE THE EFFECTIVENESS OF KATARIA'S LAUGHTER YOGA AND GROUP EXERCISE THERAPY IN DECREASING DEPRESSION AND INCREASING LIFE SATISFACTION IN OLDER ADULT WOMEN OF A CULTURAL COMMUNITY OF TEHRAN, IRAN. METHODS: SEVENTY DEPRESSED OLD WOMEN WHO WERE MEMBERS OF A CULTURAL COMMUNITY OF TEHRAN WERE CHOSEN BY GERIATRIC DEPRESSION SCALE (SCORE>10). AFTER COMPLETION OF LIFE SATISFACTION SCALE PRE-TEST AND DEMOGRAPHIC QUESTIONNAIRE, SUBJECTS WERE RANDOMIZED INTO THREE GROUPS OF LAUGHTER THERAPY, EXERCISE THERAPY, AND CONTROL. SUBSEQUENTLY, DEPRESSION POST-TEST AND LIFE SATISFACTION POST-TEST WERE DONE FOR ALL THREE GROUPS. THE DATA WERE ANALYZED USING ANALYSIS OF COVARIANCE AND BONFERRONI'S CORRECTION. RESULTS: SIXTY SUBJECTS COMPLETED THE STUDY. THE ANALYSIS REVEALED A SIGNIFICANT DIFFERENCE IN DECREASE IN DEPRESSION SCORES OF BOTH LAUGHTER YOGA AND EXERCISE THERAPY GROUP IN COMPARISON TO CONTROL GROUP (P<0.001 AND P<0.01, RESPECTIVELY). THERE WAS NO SIGNIFICANT DIFFERENCE BETWEEN LAUGHTER YOGA AND EXERCISE THERAPY GROUPS. THE INCREASE IN LIFE SATISFACTION OF LAUGHTER YOGA GROUP SHOWED A SIGNIFICANT DIFFERENCE IN COMPARISON WITH CONTROL GROUP (P<0.001). NO SIGNIFICANT DIFFERENCE WAS FOUND BETWEEN EXERCISE THERAPY AND EITHER CONTROL OR LAUGHTER YOGA GROUP. CONCLUSION: OUR FINDINGS SHOWED THAT LAUGHTER YOGA IS AT LEAST AS EFFECTIVE AS GROUP EXERCISE PROGRAM IN IMPROVEMENT OF DEPRESSION AND LIFE SATISFACTION OF ELDERLY DEPRESSED WOMEN. 2011 20 755 21 EFFECT OF SHORT-TERM YOGA-BASED-BREATHING ON PERI-OPERATIVE ANXIETY IN PATIENTS UNDERGOING CARDIAC SURGERY. BACKGROUND: PERI-OPERATIVE ANXIETY IN PATIENTS SCHEDULED FOR CARDIAC SURGERY IS DETRIMENTAL. THIS STUDY EVALUATED THE EFFECT OF SHORT-TERM YOGA BASED-BREATHING WITH DIFFERENT VARIATIONS ON PERI-OPERATIVE ANXIETY. MATERIALS AND METHODS: A PROSPECTIVE RANDOMIZED CONTROLLED STUDY WAS CONDUCTED IN PATIENTS AGED 20-60 YEARS SCHEDULED FOR MAJOR CARDIAC SURGERY. PATIENTS IN YOGA GROUP WERE TRAINED FOR YOGA BASED-BREATHING WITH DIFFERENT VARIATIONS FOR 5 DAYS; NO INTERVENTION WAS DONE IN CONTROLS. RESULTS: WE ANALYZED TWENTY PATIENTS IN EACH GROUP. ANXIETY SCORES MEASURED AT BASELINE, PRESURGERY, AND POSTSURGERY WERE ENTERED AS THE WITHIN-SUBJECTS FACTOR; GROUP STATUS WAS ENTERED AS THE BETWEEN-SUBJECTS FACTOR IN THE RMANOVA. BASELINE DEMOGRAPHICS AND ANXIETY SCORES WERE COMPARABLE. THE SHORT-TERM YOGA-BASED BREATHING EXERCISE-TRAINING PROGRAM HAD A STATISTICALLY SIGNIFICANT EFFECT ON STATE (F = 13.45, P < 0.0001), TRAIT (F = 13.29, P < 0.0001) AND TOTAL ANXIETY SCORES (F = 29.44, P < 0.0001) AT DIFFERENT TIME POINTS FOR YOGA OVER CONTROL GROUP. CONCLUSION: SHORT-TERM YOGA-BASED BREATHING FOR 5 DAYS LOWERS PRESURGERY AND POSTSURGERY ANXIETY IN PATIENTS UNDERGOING CARDIAC SURGERY. 2021