1 443 158 CERVICAL ARTERIAL DISSECTION AND TRAUMATIC MYELOPATHY FOLLOWING YOGA: SURGICAL CASE REPORT. INTRODUCTION: CERVICAL SPONDYLOSIS CAN PREDISPOSE PATIENTS TO CENTRAL CANAL STENOSIS. IN THIS SETTING, MYELOPATHY THROUGH FURTHER FLATTENING OF THE CORD FROM EXTRINSIC COMPRESSION CAN BE PRECIPITATED BY RELATIVELY MINOR TRAUMAS. ARTERIAL DISSECTION IS SIMILARLY CONSIDERED A RESULT OF HIGH VELOCITY OR MOMENTUM DURING TRAUMA, COMMONLY ASSOCIATED WITH FRACTURES, CERVICAL HYPERFLEXION, OR DIRECT BLUNT FORCE TO THE NECK. OVERALL, PRECAUTIONS FOR BOTH ARTERIAL DISSECTION AND MYELOPATHY ARE RARELY CONSIDERED IN LOW-VELOCITY, STATIC ACTIVITIES SUCH AS YOGA. CASE PRESENTATION: THE AUTHORS REPORT THE CASE OF A 63-YEAR-OLD MAN WHO SUFFERED CONCURRENT CERVICAL MYELOPATHY FROM MULTILEVEL SPONDYLOPATHY, RIGHT VERTEBRAL ARTERY DISSECTION, AND LEFT CERVICAL CAROTID ARTERY DISSECTION FOLLOWING A YOGA SESSION. SYMPTOMATOLOGY CONSISTED OF ACUTE ONSET NECK PAIN, UPPER EXTREMITY SENSORY PARESTHESIA, WORSENING GAIT AND BALANCE, AND IMPAIRED DEXTERITY FOR SEVERAL WEEKS. CERVICAL MRI WAS OBTAINED GIVEN MYELOPATHIC SYMPTOMS AND REVEALED SPONDYLOSIS WITH COMPRESSION AND T2 SIGNAL CHANGE AT C3-C4. CT ANGIOGRAPHY OF THE NECK REVEALED AFOREMENTIONED DISSECTIONS WITHOUT FLOW LIMITING STENOSIS OR OCCLUSION. A THERAPEUTIC HEPARIN INFUSION WAS STARTED PREOPERATIVELY UNTIL THE PATIENT UNDERWENT C3-C4 ANTERIOR CERVICAL DISCECTOMY AND FUSION. ASPIRIN AND PLAVIX WERE THEN STARTED WITHOUT INCIDENCE AND THE PATIENT HAD SIGNIFICANT BUT GRADUAL IMPROVEMENT IN MYELOPATHIC SYMPTOMS AT 6-WEEK FOLLOW-UP. DISCUSSION: THE STATIC YET INTENSIVE POSES ASSOCIATED WITH YOGA PRESENT A RARE ETIOLOGY FOR ARTERIAL DISSECTION AND MYELOPATHY, BUT PATIENTS WITH PERSISTENT AND PROGRESSIVE SYMPTOMS SHOULD BE SCREENED WITH THE APPROPRIATE IMAGING MODALITY. CERVICAL DECOMPRESSION SHOULD BE EXPEDITED BEFORE INITIATING AN ANTIPLATELET MEDICATION. 2022 2 2288 20 THE YOGA MAT TECHNIQUE IN POSTLESS HIP ARTHROSCOPY. HIP ARTHROSCOPY FOR THE TREATMENT OF FEMOROACETABULAR IMPINGEMENT SYNDROME WITH ANTI-SLIDING TECHNIQUES AND WITHOUT THE USE OF A PERINEAL POST TO ACHIEVE HIP DISTRACTION HAS INCREASED GREATLY IN THE PAST 5 TO 10 YEARS. TO ACCESS THE HIP JOINT, DISTRACTION IS MANDATORY TO TREAT INTRA-ARTICULAR DISORDERS SUCH AS LABRAL TEARS, ACETABULAR CARTILAGE DEFECTS, LOOSE BODIES, LIGAMENTUM TERES TEARS, AND AVASCULAR NECROSIS OF THE HIP. IN HIP DISTRACTION, COUNTER-DISTRACTION IS NEEDED, AND THIS IS ACHIEVED WITH A BULKY AND CUSHIONED PERINEAL POST. MOST OF THE DESCRIBED TECHNIQUES IN HIP ARTHROSCOPY WORLDWIDE USE A PERINEAL POST, BUT IATROGENIC PUDENDAL NERVE, GENITAL LACERATIONS, HEMATOMAS, AND GROIN COMPLICATIONS HAVE BEEN REPORTED TO OCCUR. IN LATIN AMERICAN COUNTRIES, DISPOSABLE HIP PAD DEVICES ARE EXPENSIVE, AND NOT ALL THE ARTHROSCOPIC COMPANIES PROVIDE THEM. OUR YOGA MAT TECHNIQUE PROVIDES ENOUGH COUNTERTRACTION TO ACHIEVE ADEQUATE HIP DISTRACTION. LABRAL REPAIR, LABRAL RECONSTRUCTION, AND DECOMPRESSION OF FEMOROACETABULAR IMPINGEMENT SYNDROME HAVE BEEN ACHIEVED PROPERLY, RELIABLY, AND REPRODUCIBLY, AND NO TRENDELENBURG POSITION IS NEEDED. POSTLESS HIP ARTHROSCOPY IS MADE SIMPLE, AND POSITIONING THE PATIENT IS NOT DIFFICULT. HIP SURGEONS CAN ADAPT THIS TECHNIQUE TO A FRACTURE TABLE, A HIP DISTRACTOR, AND A STANDARD OPERATING ROOM TABLE. 2021 3 197 32 A RARE CASE OF QUADRATUS FEMORIS MUSCLE RUPTURE AFTER YOGA EXERCISES. WE PRESENT A CASE OF A FEMALE PATIENT WITH LEFT GROIN PAIN AFTER INTENSE YOGA EXERCISES. THE PATIENT PRESENTED ABNORMAL PATTERN OF GAIT WITH NO SWELLING OVER THE GROIN, THIGH, OR BUTTOCK. MAGNETIC RESONANCE IMAGING DEMONSTRATED A TEAR OF THE QUADRATUS FEMORIS MUSCLE WITH AN ASSOCIATED EXTENSIVE HEMATOMA FORMATION. PATIENT WAS TREATED WITH A REHABILITATION PROGRAM CONSISTING OF NONSTEROIDAL ANTI-INFLAMMATORY DRUGS AND PHYSIOTHERAPY. AT THE FOLLOW-UP CONTROL, THE PATIENT HAD IMPROVED HER PAIN AND FLEXIBILITY OF THE HIP, AND GRADUALLY SHE RETURNED TO DAILY ACTIVITIES AND YOGA EXERCISES. SUCH AN ENTITY IS A RARE CAUSE OF HIP PAIN AFTER EXERCISE AND SHOULD BE KEPT IN MIND BY THE ORTHOPEDIC SURGEON, IN CASES OF GLUTEAL PAIN AFTER INTENSE PHYSICAL ACTIVITY. MOREOVER, SUCH A CONDITION SHOULD BE INCLUDED IN THE DIAGNOSTIC ALGORITHM OF UNKNOWN ORIGIN HIP PAIN. 2016 4 1396 26 IMPACT OF YOGA IN A CASE OF VOCAL CORD DYSFUNCTION WITH DYSAUTONOMIA. A 23-YEAR-OLD FEMALE WITH A PAST MEDICAL HISTORY OF GASTROESOPHAGEAL REFLUX DISEASE PRESENTED WITH SHORTNESS OF BREATH INDUCED BY EXERCISE AND CERTAIN ODORS. SHE REPORTED THE SYMPTOMS OF AUTONOMIC DYSFUNCTION INCLUDING FATIGUE, CHEST PAIN, LIGHTHEADEDNESS, HEADACHES, NUMBNESS/TINGLING IN THE ARMS AND LEGS, AND EXERCISE INTOLERANCE. VITAL SIGNS WERE SIGNIFICANT FOR ORTHOSTATIC INTOLERANCE. VOLUME FLOW LOOP IN THE PULMONARY FUNCTION TESTS SHOWED A FLATTENING OF THE INSPIRATORY PORTION CHARACTERISTIC OF VOCAL CORD DYSFUNCTION. LARYNGOSCOPY SHOWED DYSKINESIA OF THE LEFT VOCAL CORD, ESPECIALLY AFTER EXERCISE. MULTIFACTORIAL APPROACH WAS USED INCLUDING INCREASED FLUID INTAKE AND BREATHING EXERCISES. AFTER 6 WEEKS OF BREATHING AND ISOMETRIC EXERCISES, THE PATIENT REPORTED IMPROVEMENT IN DYSPNEA AFTER EXERCISE. THIS CASE REPORT DEMONSTRATES THE THERAPEUTIC ROLE OF BREATHING AND ISOMETRIC EXERCISES IN THE MANAGEMENT OF VOCAL CORD AND AUTONOMIC DYSFUNCTION. 2017 5 1522 20 ISOLATED RUPTURE OF THE LATERAL COLLATERAL LIGAMENT DURING YOGA PRACTICE: A CASE REPORT. WE REPORT A CASE OF ISOLATED RUPTURE OF THE LATERAL COLLATERAL LIGAMENT (LCL) OF THE KNEE WHILE ATTEMPTING TO PLACE THE LEFT FOOT BEHIND THE HEAD DURING YOGA PRACTICE. THE 34-YEAR-OLD MAN HAD DISCOMFORT OF THE LATERAL ASPECT OF THE KNEE PARTICULARLY WITH VARUS STRAIN. A MAGNETIC RESONANCE IMAGE REVEALED RUPTURE OF THE LCL AT THE INSERTION ONTO THE FIBULA. THE PATIENT HAD GRADE-II LAXITY OF THE LCL AND WAS TREATED NON-OPERATIVELY. AT THE 12-MONTH FOLLOW-UP, GRADE-I LAXITY OF THE LCL REMAINED CLINICALLY EVIDENT, BUT FUNCTION WAS NOT IMPAIRED. 2008 6 79 24 A LOW-ENERGY FEMORAL SHAFT FRACTURE FROM PERFORMING A YOGA POSTURE. THE FEMORAL SHAFT IS RARELY THE SITE OF A LOW-ENERGY FRACTURE IN A HEALTHY INDIVIDUAL. THE VAST MAJORITY OF THESE FRACTURES ARE DUE TO MAJOR TRAUMA SUCH AS MOTOR VEHICLE ACCIDENTS. ALTHOUGH LOW-ENERGY FEMORAL SHAFT FRACTURES DO OCCUR, THEY ARE TYPICALLY IN PATIENTS WITH OSTEOPOROTIC BONE, OR PROSTHESIS RELATED. IN THIS CASE REPORT, WE PRESENT A MAN IN HIS LATE 30S WHO WAS PRACTISING A SPECIFIC YOGA STANCE WHEN HE EXPERIENCED A FEMORAL SHAFT FRACTURE. 2015 7 379 20 BASILAR ARTERY OCCLUSION FOLLOWING YOGA EXERCISE: A CASE REPORT. BASILAR ARTERY OCCLUSION DEVELOPED IN A 34 YEAR OLD WOMAN 2 MONTHS AFTER ADOPTING UNUSUAL NECK POSTURES DURING YOGA PRACTICE. ON ANGIOGRAPHY, HER BASILAR ARTERY WAS FILLED WITH INTRALUMINAL CLOT WHILE THE VERTEBRAL ARTERIES WERE NORMAL. WE POSTULATE THAT A SEVERE REDUCTION IN BLOOD FLOW AND POSSIBLY AN INTIMAL TEAR TRIGGERED THROMBOSIS OF THE VERTEBRAL ARTERY AND THAT THE FINAL STROKE MECHANISM WAS ARTERY-TO-ARTERY EMBOLISM. 1993 8 1775 21 PRACTICE OF YOGA MAY CAUSE DAMAGE OF BOTH SCIATIC NERVES: A CASE REPORT. SCIATIC NERVE TRAUMATIC DAMAGE VERY RARELY OCCURS BILATERALLY. WE DESCRIBE THE CASE OF A 67-YEAR-OLD WOMAN WHO REPORTED A BILATERAL TRAUMATIC LESION OF THE SCIATIC NERVE DURING PRACTICE OF YOGA. NERVE CONDUCTION STUDIES SHOWED A BILATERAL SCIATIC NERVE NEUROPATHY, MOSTLY AFFECTING THE PERONEAL COMPONENT. LUMBAR PLEXUS MRI DOCUMENTED REGULAR ANATOMICAL FEATURES OF THE MAIN PRINCIPAL NERVE ROOTS WITH BILATERAL T2 SIGNAL ALTERATION OF ROOTS L4, L5 AND S1 THAT EXTENDED INTO THE SCIATIC NERVES SHOWING BOTH INCREASE IN SIZE, PROBABLY RELATED TO CHRONIC INJURY OF NERVES, AND AN ALTERATION IN DIFFUSION SIGNAL THAT SUGGESTED A RECENT ACUTE OVERLAPPED PROCESS. 2013 9 2694 28 YOGA INDUCED ACUTE ULNAR NERVE COMPRESSION BY A GANGLION CYST IN GUYON'S CANAL. ACUTE ULNAR NEUROPATHY AT THE WRIST CAN BE DIFFICULT TO DIAGNOSE, AS IT IS AN UNCOMMON NEUROPATHY WITH VARIABLE CLINICAL PRESENTATIONS AND NUMEROUS ETIOLOGIES. WE PRESENT A CASE OF ACUTE ULNAR NEUROPATHY OF THE DEEP MOTOR BRANCH CAUSED BY A GANGLION CYST IN GUYON'S CANAL. INTERESTINGLY, THIS CASE OF ACUTE LOSS OF MOTOR FUNCTION OCCURRED AFTER THE PATIENT PARTICIPATED IN YOGA (SPECIFICALLY THE DOWNWARD DOG POSITION), AND RESOLVED SPONTANEOUSLY OVER TIME AFTER STOPPING YOGA, WITHOUT SURGICAL EXCISION OF THE GANGLION, SUGGESTING EXACERBATION OR PROTRUSION OF AN OCCULT GANGLION CYST DUE TO INCREASED ACTIVITY AND COMPRESSION OF THE HYPOTHENAR EMINENCE. 2013 10 1546 20 LATE ANTERIOR PROSTHETIC HIP DISLOCATION DUE TO YOGA. THE POPULARITY OF YOGA AND THE PREVALENCE OF TOTAL HIP ARTHROPLASTY (THA) HAVE SIMULTANEOUSLY INCREASED IN THE UNITED STATES. ACCORDINGLY, ONE CAN ASSUME THAT THE NUMBER OF THA PATIENTS PRACTICING YOGA HAS INCREASED. CERTAIN YOGA POSES REACH THE EXTREMES OF HIP RANGE OF MOTION, POTENTIALLY LEAVING PATIENTS VULNERABLE TO DISLOCATION. TO DATE, 2 CASES OF LATE POSTERIOR PROSTHETIC HIP DISLOCATIONS DURING YOGA HAVE BEEN REPORTED; HOWEVER, THERE HAVE BEEN NO REPORTS OF ANTERIOR PROSTHETIC HIP DISLOCATIONS. WE PRESENT ONE CASE OF LATE ANTERIOR PROSTHETIC HIP DISLOCATION DURING YOGA IN A PATIENT WHO UNDERWENT THA VIA THE DIRECT ANTERIOR APPROACH. PROSTHETIC HIP DISLOCATION DURING YOGA MAY BE A GROWING CONCERN. WE PROVIDE ADDITIONAL EVIDENCE IN SUPPORT OF RECOMMENDATIONS FOR THA PATIENTS TO SAFELY PRACTICE YOGA. 2021 11 2873 37 YOGA-INDUCED MYOSITIS OSSIFICANS TRAUMATICA OF THE SCAPHOLUNATE LIGAMENT. BACKGROUND MYOSITIS OSSIFICANS TRAUMATICA (MOT) INVOLVES THE HETEROTOPIC DEVELOPMENT OF LAMELLAR BONE AFTER A TRAUMATIC INJURY. DESPITE BEING TERMED "MYOSITIS," MOT IS NOT LIMITED TO MUSCLE BUT RATHER CAN INVOLVE TENDONS, FAT, AND FASCIA. "TRAUMATICA" REFLECTS THAT LESIONS ARE USUALLY ASSOCIATED WITH A HISTORY OF SIGNIFICANT TRAUMA, THAT IS, FRACTURES OR SURGERY; HOWEVER, MANY REPORTS SUGGEST THEY CAN ALSO BE LINKED TO REPETITIVE LOW-ENERGY INSULTS. IN BOTH CASES, THE INFLAMMATORY RESPONSE SECONDARY TO TISSUE INJURY GENERATES A PROLIFERATIVE OSTEOBLASTIC CASCADE. CASE DESCRIPTION WE PRESENT A CASE OF PERSISTENT WRIST PAIN IN A 43-YEAR-OLD WOMAN ASSOCIATED WITH YOGA ACTIVITIES. HER RADIOGRAPHIC STUDIES DEMONSTRATED PARTIAL SCAPHOLUNATE (SL) LIGAMENT TEAR AND AN ASSOCIATED MASS LESION. SURGICAL PATHOLOGY REVEALED MOT INVOLVING THE SL LIGAMENT. LITERATURE REVIEW MOT LESIONS IN THE UPPER EXTREMITY ARE USUALLY LOCALIZED AROUND THE ELBOW, AND CASES IN THE HAND ARE RELATIVELY RARE. THERE ARE NO PRIOR REPORTS OF OCCURRENCES WITHIN THE WRIST JOINT OR IN ASSOCIATION WITH THE SL LIGAMENT. HOWEVER, BIOMECHANICAL STUDIES HAVE QUANTIFIED SIGNIFICANT MECHANICAL STRAINS ACROSS THE SL INTERVAL DURING VARIOUS YOGA POSES. THIS PATTERN OF MICROTRAUMA IS CAPABLE OF GENERATING MOT. CLINICAL RELEVANCE UPPER EXTREMITY WEIGHT-BEARING POSITIONS ARE COMMON IN YOGA AND SUBJECT THE WRIST, ESPECIALLY THE SL INTERVAL, TO HIGH MECHANICAL STRAINS. THIS PATTERN OF MICROTRAUMA SHOULD LEAD THE CLINICIAN TO SUSPECT MOT WHEN ENCOUNTERING A MASS IN THE WRIST, BUT MALIGNANCY AND INFECTION MUST BE RULED OUT. 2019 12 2724 17 YOGA NEUROPATHY. A SNOOZER. SCIATIC NERVE COMPRESSION VERY RARELY OCCURS BILATERALLY. THE AUTHORS PRESENT A WOMAN WITH PROFOUND LOWER EXTREMITY WEAKNESS AND SENSORY ABNORMALITY AFTER FALLING ASLEEP IN THE HEAD-TO-KNEES YOGA POSITION (ALSO CALLED "PASCHIMOTTANASANA"). CLINICAL AND ELECTRODIAGNOSTIC FINDINGS ARE DISCUSSED IN DETAIL AND A BRIEF REVIEW OF THE LITERATURE IS PRESENTED. 2005 13 573 22 DELAYED UNION OF STRESS FRACTURE OF THE FIRST RIB IN A YOGA INSTRUCTOR: A CASE REPORT. CASE: WE DESCRIBE THE CASE OF A 38-YEAR-OLD WOMAN, A YOGA INSTRUCTOR, WHO HAD PAIN IN THE RIGHT SHOULDER AND SCAPULAR REGION OF 4 MONTHS' DURATION WHILE PERFORMING YOGA. RADIOGRAPHY AND COMPUTED TOMOGRAPHY DIAGNOSED DELAYED UNION OF A FIRST RIB STRESS FRACTURE. THE DELAYED UNION OF STRESS FRACTURE OF THE FIRST RIB WAS SUCCESSFULLY TREATED WITH THE LIMITING OF YOGA ACTIVITY AND LOW-INTENSITY PULSED ULTRASOUND (LIPUS). CONCLUSIONS: PHYSICIANS SHOULD BE AWARE THAT EVEN YOGA POSING CAN CAUSE STRESS FRACTURES OF THE FIRST RIB. LIPUS THERAPY MAY BE EFFECTIVE FOR DELAYED UNION IN ADDITION TO REST. 2021 14 1656 14 MUSCULOSKELETAL INJURIES RELATED TO YOGA: IMAGING OBSERVATIONS. OBJECTIVE: THE PURPOSE OF THIS ARTICLE IS TO DESCRIBE THE IMAGING APPEARANCES OF MUSCULOSKELETAL INJURIES RELATED TO YOGA. WE PERFORMED AN AUTOMATED SEARCH IN THE DATABASE OF A LARGE TERTIARY CARE CENTER AND CONDUCTED A RETROSPECTIVE ANALYSIS OF THE IMAGING FINDINGS IN 38 PATIENTS OVER A 9-YEAR PERIOD. CONCLUSION: THE MOST FREQUENTLY ENCOUNTERED MUSCULOSKELETAL INJURIES WERE TENDINOUS LESIONS, INCLUDING TEARS OF THE SUPRASPINATUS, ACHILLES, AND PERONEUS BREVIS TENDONS AND FIBROCARTILAGINOUS TEARS INVOLVING THE MEDIAL MENISCUS, ACETABULAR LABRUM, GLENOID LABRUM, AND LUMBAR DISK WITH EXTRUSION. 2012 15 2911 33 [PSEUDOARTHROSIS OF THE FIRST RIB IN A PATIENT WHO PRACTICES YOGA. A CASE REPORT]. INTRODUCTION: PSEUDOARTHROSIS OF THE FIRST RIB IS A RARE CONDITION THAT MAY OCCUR IN ATHLETES AS A RESULT OF REPETITIVE ACTIVITIES, MAINLY OVERHEAD. THE USUAL CLINICAL PRESENTATION IS PAIN IN THE NECK OR THE IPSILATERAL SHOULDER. CASE REPORT: THIS IS THE CASE OF A 19-YEAR-OLD FEMALE PATIENT WHO HAD SUDDEN PAIN OF THE BASE OF THE NECK WHILE DOING YOGA. PSEUDOARTHROSIS OF THE FIRST RIB WAS DIAGNOSED WITH X-RAYS AND CAT SCAN. TREATMENT CONSISTED OF A REHABILITATION AND PHYSICAL THERAPY PROGRAM THAT WAS SUCCESSFUL DESPITE THE PERSISTENCE OF THE PSEUDOARTHROSIS. DISCUSSION: CASES OF FIRST RIB FRACTURES HAVE BEEN REPORTED IN ATHLETES PRACTICING MULTIPLE ACTIVITIES; HOWEVER, PSEUDOARTHROSIS CASES ARE RARE SINCE MOST OF THEM PROGRESS TO BONE HEALING. THIS IS THE FIRST REPORTED CASE OF A FRACTURE OR PSEUDOARTHROSIS IN A PATIENT PRACTICING YOGA. AS IN MOST REPORTED CASES, CONSERVATIVE TREATMENT WAS SUCCESSFUL. CONCLUSION: FRACTURES AND PSEUDOARTHROSIS OF THE FIRST RIB ARE RARE IN ATHLETES AND SHOULD BE INCLUDED IN THE DIFFERENTIAL DIAGNOSIS OF ATHLETES PRESENTING WITH SHOULDER AND NECK PAIN. CONSERVATIVE TREATMENT IS SUCCESSFUL IN MOST CASES. 2009 16 1332 11 HOT YOGA AND PREGNANCY: FITNESS AND HYPERTHERMIA. QUESTION: ONE OF MY PREGNANT PATIENTS WISHES TO CONTINUE HER HOT YOGA EXERCISES DURING PREGNANCY. IS THIS PRACTICE SAFE? ANSWER: WITH THE INCREASED RISK OF NEURAL TUBE DEFECTS AND POSSIBLY OF OTHER MALFORMATIONS AMONG FETUSES EXPOSED TO EXCESSIVE HEAT, PREGNANT WOMEN SHOULD AVOID PRACTISING HOT YOGA DURING PREGNANCY. 2014 17 1472 20 INSULAR CORTEX MEDIATES INCREASED PAIN TOLERANCE IN YOGA PRACTITIONERS. YOGA, AN INCREASINGLY POPULAR DISCIPLINE AMONG WESTERNERS, IS FREQUENTLY USED TO IMPROVE PAINFUL CONDITIONS. WE INVESTIGATED POSSIBLE NEUROANATOMICAL UNDERPINNINGS OF THE BENEFICIAL EFFECTS OF YOGA USING SENSORY TESTING AND MAGNETIC RESONANCE IMAGING TECHNIQUES. NORTH AMERICAN YOGIS TOLERATED PAIN MORE THAN TWICE AS LONG AS INDIVIDUALLY MATCHED CONTROLS AND HAD MORE GRAY MATTER (GM) IN MULTIPLE BRAIN REGIONS. ACROSS SUBJECTS, INSULAR GM UNIQUELY CORRELATED WITH PAIN TOLERANCE. INSULAR GM VOLUME IN YOGIS POSITIVELY CORRELATED WITH YOGA EXPERIENCE, SUGGESTING A CAUSAL RELATIONSHIP BETWEEN YOGA AND INSULAR SIZE. YOGIS ALSO HAD INCREASED LEFT INTRAINSULAR WHITE MATTER INTEGRITY, CONSISTENT WITH A STRENGTHENED INSULAR INTEGRATION OF NOCICEPTIVE INPUT AND PARASYMPATHETIC AUTONOMIC REGULATION. YOGIS, AS OPPOSED TO CONTROLS, USED COGNITIVE STRATEGIES INVOLVING PARASYMPATHETIC ACTIVATION AND INTEROCEPTIVE AWARENESS TO TOLERATE PAIN, WHICH COULD HAVE LED TO USE-DEPENDENT HYPERTROPHY OF INSULAR CORTEX. TOGETHER, THESE FINDINGS SUGGEST THAT REGULAR AND LONG-TERM YOGA PRACTICE IMPROVES PAIN TOLERANCE IN TYPICAL NORTH AMERICANS BY TEACHING DIFFERENT WAYS TO DEAL WITH SENSORY INPUTS AND THE POTENTIAL EMOTIONAL REACTIONS ATTACHED TO THOSE INPUTS LEADING TO A CHANGE IN INSULAR BRAIN ANATOMY AND CONNECTIVITY. 2014 18 43 24 A CASE REPORT OF PATIENT PRACTISING YOGA LEADING TO DENTAL EROSION. THE ARTICLE PRESENTS THE CASE OF A PATIENT WHO WAS PRACTISING YOGA (KUNJAL KRIYA) WHICH LED TO DENTAL EROSION. DENTAL EROSION CAN BE DUE TO EXTRINSIC OR INTRINSIC CAUSES. THE INTRINSIC CAUSES INCLUDE VOMITING DUE TO ANOREXIA NERVOSA, REGURGITATION DUE TO ABNORMALITY IN GASTRO-INTESTINAL TRACT OR RUMINATION. A 38-YEAR-OLD MALE PATIENT PRESENTED WITH A RARE AETIOLOGY OF DENTAL EROSION. HE HAD PRACTICED KUNJAL KRIYA ONE OF THE YOGIC EXERCISES DESCRIBED IN ANCIENT INDIA. IN KUNJAL KRIYA THE PATIENT VOMITS ON AN EMPTY STOMACH IN ORDER TO CLEAN HIS OR HER GASTRO-INTESTINAL TRACT. THE PATIENT HAD PRACTICED THIS FORM OF EXERCISE FOR OVER 12 YEARS WHICH HAD LED TO SEVERE DENTAL EROSION. A PROPER CASE HISTORY SHOULD BE EVALUATED FOR EVERY PATIENT SO THAT THEY CAN BE COUNSELLED FOR ANY FACTORS THAT COULD BE DETRIMENTAL TO DENTAL HEALTH. EARLY DIAGNOSIS IS PARAMOUNT IN RECOGNISING THE AETIOLOGY OF DENTAL EROSION SO THAT DETRIMENTAL EFFECTS ON THE DENTITION CAN BE PREVENTED. 2007 19 426 22 CAN YOGA BE USED TO TREAT GASTROESOPHAGEAL REFLUX DISEASE? YOGA METHODS INCLUDING PRANAYAMA ARE THE BEST WAYS TO PREVENT MANY DISEASES AND THEIR PROGRESSION. EVEN THOUGH, YOGA IS WIDELY PRACTICED, ITS EFFECTS ON CERTAIN MEDICAL CONDITIONS HAVE NOT BEEN STUDIED OR REPORTED. GASTROESOPHAGEAL REFLUX DISEASE (GERD) IS ONE OF THEM. GERD IS EXTREMELY COMMON CONDITION REQUIRING FREQUENT CONSUMPTION OF OVER-THE-COUNTER OR PRESCRIBED PROTON PUMP INHIBITORS (PPI). IN SEVERE SYMPTOMS OF GERD AND IN THE PRESENCE OF MULTIPLE ETIOLOGIES, PPIS ARE INSUFFICIENT TO RELIEVE THE SYMPTOMS OF GASTRIC REFLUX. REGULAR AND PROPER USE OF THE YOGA ALONG WITH PPI CAN CONTROL THE SEVERE SYMPTOMS OF GERD AND CAN AVOID OR DELAY THE NECESSITY OF INVASIVE PROCEDURES. THIS EVIDENCE-BASED CASE REPORT FOCUSES ON THE EFFECTS OF YOGA ON GERD. OUR CASE REPORT SHOWED THAT REGULAR PRACTICE OF KAPALBHATI AND AGNISAR KRIYA ALONG WITH PPI, PATIENTS WITH HIATAL HERNIA HAD IMPROVEMENT IN SEVERE SYMPTOMS OF GERD, WHICH WERE INITIALLY REFRACTORY TO PPI ALONE. 2013 20 1813 22 PROGRESSION OF GLAUCOMA ASSOCIATED WITH THE SIRSASANA (HEADSTAND) YOGA POSTURE. THIS ARTICLE REPORTS A CASE OF PROGRESSIVE GLAUCOMATOUS OPTIC NEUROPATHY AND VISUAL FIELD LOSS THAT OCCURRED IN A PATIENT WHO PRACTICED THE SIRSASANA (HEADSTAND) YOGA POSTURE ON A DAILY BASIS FOR MANY YEARS. VISUAL FIELD ANALYSIS WAS PERFORMED THROUGH STANDARD AUTOMATED PERIMETRY. INTRAOCULAR PRESSURE (IOP) WAS MEASURED THROUGH PNEUMOTONOMETRY IN THE SITTING POSITION AND IN THE HEAD-DOWN POSITION. STEREO-OPTIC DISC PHOTOGRAPHS WERE OBTAINED. IOP INCREASED SIGNIFICANTLY IN THE HEAD-DOWN POSITION. OPTIC DISC EVALUATION REVEALED A NEW DISC HEMORRHAGE IN THE LEFT EYE. VISUAL FIELD ANALYSIS OVER A PERIOD OF 2 Y SHOWED PROGRESSION OF A SUPERIOR ARCUATE DEFECT IN THE LEFT EYE. TRANSIENT INCREASES IN IOP ASSOCIATED WITH THE YOGA HEADSTAND POSTURE MAY LEAD TO PROGRESSIVE GLAUCOMATOUS OPTIC NERVE DAMAGE AND VISUAL FIELD LOSS. 2006