R L Bijlani

All India Institute of Medical Sciences, New Dilli, NCT, India

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Publications (52)32.05 Total impact

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    ABSTRACT: Amitriptyline (10-50mg) is the most common drug prescribed for the treatment of fibromyalgia. Amitriptyline influences the autonomic nervous system, as is well known; fibromyalgia is also associated with dysautonomia. The present preliminary study was designed to observe the effects of amitriptyline prescribed in a low dose (10mg) on the autonomic function tests and blood flow measurements in well-diagnosed patients with fibromyalgia. Amitriptyline (10mg) was prescribed for 3 months to 21 female patients with fibromyalgia. A standard battery of noninvasive autonomic function tests comprising of lying to standing test, hand grip test, cold pressor test, deep breathing test, and Valsalva maneuver was performed both before and after amitriptyline therapy to study the autonomic reactivity of the patients with fibromyalgia. Heart rate variability analysis was done to quantify autonomic tone (activity). Blood flow measurement around the knee joint was performed using impedance plethysmography technique. The patients were also assessed for 10 major clinical symptoms of primary fibromyalgia and state and trait anxiety (state and trait anxiety inventory) at both instances. No significant changes in autonomic activity (tone) and reactivity were observed after amitriptyline therapy. Clinical symptom score and anxiety scores (both state and trait) decreased significantly from the pretreatment values. Blood flow measurement showed significant improvement in blood flow index values at the affected sites after amitriptyline therapy. Amitriptyline therapy (10mg for 3 months) increases blood flow to the affected sites. It does not affect autonomic tone and reactivity in the patients with fibromyalgia.
    No preview · Article · Dec 2011 · Pain Medicine
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    ABSTRACT: The hypothesis of autonomic nervous system involvement in pathophysiology in the patients with fibromyalgia has been addressed and tested time and again but the existing reports are both contradictory and inconclusive. A complete knowledge of the degree of autonomic dysfunction in fibromyalgia patients would be more substantial. We conducted a comprehensive non-invasive study to investigate the complete autonomic profile of female patients with fibromyalgia. An autonomic function test using a standard battery and heart rate variability analysis in the 42 fibromyalgia patients as well as 42 age matched healthy controls was performed. Both autonomic activity (tone) and reactivity were measured. Autonomic tone (both time and frequency domain parameters) was measured using heart rate variability (HRV) analysis. Autonomic reactivity was measured using a standard battery of autonomic function tests. Resting blood pressure (both systolic and diastolic) was significantly higher in the fibromyalgia patients than controls. The time domain variables and HF% as recorded by HRV were significantly lower in the patients than the controls. The autonomic reactivity for sympathetic and parasympathetic nervous system was found to be within normal limits. The cardiac autonomic function is normal and the autonomic reflex arc seems to be intact in the patients with fibromyalgia.
    No preview · Article · Oct 2011 · Clinical Autonomic Research
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    Amit Mohan · Ratna Sharma · Ramesh L Bijlani
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    ABSTRACT: The objective of this study was to study the effects of meditation on stress-induced changes in cognitive functions. The study was conducted on 32 healthy adult male student volunteers who had never practiced meditation before the study. The study consisted of practicing 20 minutes of guided meditation and administration of psychologic stress to the subjects. The psychologic stress was administered to the subjects by asking them to play a (preselected) stressful computer game. The subjects were asked to meditate either before or after the administration of psychologic stress. For the control group measurements, the subjects were asked to wait quietly for an equivalent period of meditation time. The outcome measures were galvanic skin response (GSR), heart rate (HR), electromyography (EMG), sympathetic reactivity (QTc/QS2 ratio), cortisol, and acute psychologic stress scores. The central nervous system functions were assessed using Wechsler memory scale and visual-choice reaction time (VCRT). These parameters were measured both at the beginning and at the end of the intervention, using a pre-post experimental test design. Computer game stress was associated with a significant increase in physiologic (GSR, EMG, HR, QTc/QS2) and psychologic (acute stress questionnaire scores) markers of stress. Meditation was associated with relaxation (significant decrease in GSR, EMG, QTc/QS2, and acute stress questionnaire scores). Meditation, if practiced before the stressful event, reduced the adverse effects of stress. Memory quotient significantly increased, whereas cortisol level decreased after both stress and meditation. VCRT showed no significant change. Practice of meditation produced a relaxation response even in the young adult subjects who had never practiced meditation before. The practice of meditation reduced the physiologic stress responses without taking away the beneficial effect of stress, namely, improved memory scores.
    Full-text · Article · Mar 2011 · Journal of alternative and complementary medicine (New York, N.Y.)
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    Punita Puri · S. C. Mahapatra · R. L. Bijlani · H. K. Prasad · I. Nath
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    ABSTRACT: Weight gain, feed efficiency and proliferation response of splenic lymphocytes were studied in mice fed either a yogurt or a milk-based diet. The yogurt contained live Lactobacillus bulgaricus and Streptococcus thermophilus. The feeding trial lasted for 10 months. Proliferation response of lymphocytes was measured by the uptake of tritiated thymidine into the cells when stimulated with the mitogens phytohaemagglutinin (PHA), concanavalin A (Con A) and Escherichia coli lipopolysaccharide (LPS). There was no significant difference between the average body weight of mice belonging to the two dietary groups. But yogurt diet showed a higher feed efficiency ratio when compared to the milk diet for the first 8 weeks of the study while the mice were growing. After the period of growth was over, yogurt-fed mice maintained a constant body weight like the milk-fed mice but on a lower energy intake. The proliferation of splenic lymphocytes, expressed as Stimulation Index, was significantly higher in response to the T-lymphocyte mitogens Con A and PHA. Results suggest that yogurt has better feed efficiency and its long term inclusion in diets primes the splenic T-lymphocytes for a higher mitogenic response.
    Full-text · Article · Aug 2009 · International Journal of Food Sciences and Nutrition
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    Ramaprabhu Vempati · Ramesh Lal Bijlani · Kishore Kumar Deepak
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    ABSTRACT: There is a substantial body of evidence on the efficacy of yoga in the management of bronchial asthma. Many studies have reported, as the effects of yoga on bronchial asthma, significant improvements in pulmonary functions, quality of life and reduction in airway hyper-reactivity, frequency of attacks and medication use. In addition, a few studies have attempted to understand the effects of yoga on exercise-induced bronchoconstriction (EIB) or exercise tolerance capacity. However, none of these studies has investigated any immunological mechanisms by which yoga improves these variables in bronchial asthma. The present randomized controlled trial (RCT) was conducted on 57 adult subjects with mild or moderate bronchial asthma who were allocated randomly to either the yoga (intervention) group (n = 29) or the wait-listed control group (n = 28). The control group received only conventional care and the yoga group received an intervention based on yoga, in addition to the conventional care. The intervention consisted of 2-wk supervised training in lifestyle modification and stress management based on yoga followed by closely monitored continuation of the practices at home for 6-wk. The outcome measures were assessed in both the groups at 0 wk (baseline), 2, 4 and 8 wk by using Generalized Linear Model (GLM) repeated measures followed by post-hoc analysis. In the yoga group, there was a steady and progressive improvement in pulmonary function, the change being statistically significant in case of the first second of forced expiratory volume (FEV1) at 8 wk, and peak expiratory flow rate (PEFR) at 2, 4 and 8 wk as compared to the corresponding baseline values. There was a significant reduction in EIB in the yoga group. However, there was no corresponding reduction in the urinary prostaglandin D2 metabolite (11beta prostaglandin F2alpha) levels in response to the exercise challenge. There was also no significant change in serum eosinophilic cationic protein levels during the 8-wk study period in either group. There was a significant improvement in Asthma Quality of Life (AQOL) scores in both groups over the 8-wk study period. But the improvement was achieved earlier and was more complete in the yoga group. The number-needed-to-treat worked out to be 1.82 for the total AQOL score. An improvement in total AQOL score was greater than the minimal important difference and the same outcome was achieved for the sub-domains of the AQOL. The frequency of rescue medication use showed a significant decrease over the study period in both the groups. However, the decrease was achieved relatively earlier and was more marked in the yoga group than in the control group. The present RCT has demonstrated that adding the mind-body approach of yoga to the predominantly physical approach of conventional care results in measurable improvement in subjective as well as objective outcomes in bronchial asthma. The trial supports the efficacy of yoga in the management of bronchial asthma. However, the preliminary efforts made towards working out the mechanism of action of the intervention have not thrown much light on how yoga works in bronchial asthma. Current Controlled Trials ISRCTN00815962.
    Full-text · Article · Aug 2009 · BMC Pulmonary Medicine
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    ABSTRACT: The study was conducted to evaluate the acute postprandial and long-term metabolic response to a traditional mixture of barley (Hordeum vulgare), Bengal gram (Cicer arietinum) and wheat (Triticum aestivum). The acute study was performed on eight healthy subjects (five male, three female) and six subjects with non-insulin dependent diabetes mellitus (NIDDM) (four male, two female). Each subject underwent two 50g carbohydrate meal tolerance tests (MTT), one with white bread (reference meal) and another with chapaties made from the cereal-pulse mixture (CP). The postprandial glycaemic and insulinaemic responses to CP were attenuated compared to those to white bread, the glycaemic index being 68.6 and 64.9 in healthy and NIDDM subjects, respectively, and the insulinaemic index being 88.1 and 66.0 in healthy and NIDDM subjects, respectively.
    No preview · Article · Jul 2009 · International Journal of Food Sciences and Nutrition
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    ABSTRACT: Metabolic responses to barley (Hordeum vulgare) were studied in six healthy human subjects (five male, one female). The trial comprised two dietary periods, control and experimental, of four weeks each, separated by a washout period of one week. The control diet was one to which the subject was normally accustomed. In the experimental diet, part of the daily cereal intake was replaced by 100 g of whole barley flour. The control and experimental dietary periods were random in sequence and a cross-over design was used. A meal tolerance test using a 50g carbohydrate portion of white bread was performed at the beginning and end of each dietary period. Fasting blood samples were collected for estimation of glycosylated haemoglobin, total cholesterol and triglycerides at the beginning and end of each dietary period. No measured variable changed significantly during the control period. At the end of the experimental period, the MTT incremental area under the 3h glucose curve decreased from 107.9 ± 54.8 to 91.5 ± 30.8 (mean ± s.d., mg/dl/3h; P < 0.05) and HDL cholesterol increased from 50.7 ± 9.2 to 65.5 ± 15.4 (mean ± s.d., mg/dl; P < 0.05). The observed changes are possibly mediated by the water soluble β-glucan fraction of barley dietary fibre and are favourable in relation to prevention and treatment of diabetes mellitus and atherosclerosis.
    No preview · Article · Jul 2009 · International Journal of Food Sciences and Nutrition
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    Ratna Sharma · Nidhi Gupta · R L Bijlani
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    ABSTRACT: Yoga is assuming importance in improving mental health and quality of life in the treatment of a number of psychiatric and psychosomatic disorders. The present study was a prospective controlled study to explore the short-term impact of a comprehensive but brief lifestyle intervention, based on yoga, on subjective well being levels in normal and diseased subjects. Normal healthy individuals and subjects having hypertension, coronary artery disease, diabetes mellitus or a variety of other illnesses were included in the study. The outcome measures were 'subjective well being inventory' (SUBI) scores, taken on the first and last day of the course. The inventory consists of questions related to one's feelings and attitude about various areas of life, such as happiness, achievement and interpersonal relationship. There was significant improvement in the subjective well being scores of the 77 subjects within a period of 10 days as compared to controls. These observations suggest that a short lifestyle modification and stress management educational program leads to remarkable improvement in the subjective well being scores of the subjects and can therefore make an appreciable contribution to primary prevention as well as management of lifestyle diseases.
    Preview · Article · Apr 2008 · Indian journal of physiology and pharmacology
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    ABSTRACT: The role of central versus peripheral mechanisms has always been questioned while explaining the etiopathogenesis of chronic tension type headache (CTTH). The following study was done to study the role of muscle spasm in CTTH. 15 patients of CTTH and 7 age matched controls were included in the study and their m. temporalis EMG was recorded for one minute each during rest, mental activity and maximal voluntary contraction and subjective pain scoring was done by visual analogue scale. The results revealed significant overactivity of m.temporalis in CTTH patients at rest when compared with control subjects (P = 0.01 and 0.03 left and right side respectively). After respective interventions namely non steroidal anti inflammatory drugs, botulinum toxin injections and yogic life style course, the EMG records revealed decrease in the mean EMG amplitude of m. temporalis during rest and mental activity more significantly after yoga based interventions (P = 0.03) and subjective pain scores decreased from 7.00 +/- 2.10 to 2.00 +/- 1.26 (P = 0.02) supporting the beneficial effect of such non invasive techniques.
    Full-text · Article · Nov 2006 · Indian journal of physiology and pharmacology
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    ABSTRACT: Considerable evidence exists for the place of mind body medicine in the treatment of anxiety disorders. Excessive anxiety is maladaptive. It is often considered to be the major component of unhealthy lifestyle that contributes significantly to the pathogenesis of not only psychiatric but also many other systemic disorders. Among the approaches to reduce the level of anxiety has been the search for healthy lifestyles. The aim of the study was to study the short-term impact of a comprehensive but brief lifestyle intervention, based on yoga, on anxiety levels in normal and diseased subjects. The study was the result of operational research carried out in the Integral Health Clinic (IHC) at the Department of Physiology of All India Institute of Medical Sciences. The subjects had history of hypertension, coronary artery disease, diabetes mellitus, obesity, psychiatric disorders (depression, anxiety, 'stress'), gastrointestinal problems (non ulcer dyspepsia, duodenal ulcers, irritable bowel disease, Crohn's disease, chronic constipation) and thyroid disorders (hyperthyroidism and hypothyroidism). The intervention consisted of asanas, pranayama, relaxation techniques, group support, individualized advice, and lectures and films on philosophy of yoga, the place of yoga in daily life, meditation, stress management, nutrition, and knowledge about the illness. The outcome measures were anxiety scores, taken on the first and last day of the course. Anxiety scores, both state and trait anxiety were significantly reduced. Among the diseased subjects significant improvement was seen in the anxiety levels of patients of hypertension, coronary artery disease, obesity, cervical spondylitis and those with psychiatric disorders. The observations suggest that a short educational programme for lifestyle modification and stress management leads to remarkable reduction in the anxiety scores within a period of 10 days.
    Full-text · Article · Nov 2005 · Indian journal of physiology and pharmacology
  • W. Kanan · R.L. Bijlani · U. Sachdeva · S.C. Mahapatra
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    ABSTRACT: Objective: To study the effect of composition of food and overnight refrigeration on the glycaemic response in NIDDM. Methods: NIDDM patients attending Endocrinology OPD of AIIMS under different management regime were taken for the study. Each volunteer underwent 7 (seven) Meal Tolerance Test (MTT) at intervals of one week each. Their glycaemic response to the above mentioned meals were recorded. Results: The glycaemic; response at 3hr to freshly cooked meals (141.8±59.4) was higher than that of corresponding refrigerated and rewarmed meals (129.8±65.2) which was statistically significant (P<0.05). The glycaemic response at 2hr to freshly cooked meals (154.2±54.9) was higher than that of freshly cooked laboratory equivalent meals (134±57.66) which was statistically significant (P<0.01). Conclusion: The glycaemic response to natural foods was higher than those of their laboratory equivalents having an identical macronutrient and fibre content. Also, freshly cooked meals showed higher glycaemic response than that to the same meals refrigerated and rewarmed.
    No preview · Article · Sep 2005
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    Raj Kumar Yadav · Rooma Basu Ray · Ramaprabhu Vempati · Ramesh Lal Bijlani
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    ABSTRACT: Oxidative stress contributes to the process of aging as well as a variety of chronic degenerative diseases. There are indications that psychological stress increases oxidative stress whereas relaxation decreases it. We have measured the concentration of thiobarbituric acid reactive substances (TBARS) in blood as an indicator of oxidative stress at the beginning and at the end of a comprehensive yoga-based lifestyle modification program (YLMP). The data was collected from 104 subjects (59 male, 45 female), 19-71 years of age (mean +/- SD, 41.2 +/- 14.6 years). The YLMP consisted of a nine-day educational out-patient course on the theory and practice of yoga and included, besides a daily one-hour practice of physical postures (asanas) and breathing exercises (pranayama), lecture and films on yoga, stress management and nutrition, practice of meditation and shavasana (a relaxation technique), and individual counseling. Venous blood samples were collected on the first and last day of the course. The serum concentration of TBARS decreased significantly from 1.72 +/- 0.72 nmoles/ml on day 1 to 1.57 +/- 0.72 nmoles/ml on day 10 (P<0.05). The study suggests that a brief low cost lifestyle intervention based on yoga reduces oxidative stress.
    Full-text · Article · Jul 2005 · Indian journal of physiology and pharmacology
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    ABSTRACT: The objective of the study was to study the short-term impact of a brief lifestyle intervention based on yoga on some of the biochemical indicators of risk for cardiovascular disease and diabetes mellitus. The variables of interest were measured at the beginning (day 1) and end (day 10) of the intervention using a pre-post design. The study is the result of operational research carried out in our Integral Health Clinic (IHC). The IHC is an outpatient facility which conducts 8-day lifestyle modification programs based on yoga for prevention and management of chronic disease. A new course begins every alternate week of the year. The study is based on data collected on 98 subjects (67 male, 31 female), ages 20-74 years, who attended one of our programs. The subjects were a heterogeneous group of patients with hypertension, coronary artery disease, diabetes mellitus, and a variety of other illnesses. The intervention consisted of asanas (postures), pranayama (breathing exercises), relaxation techniques, group support, individualized advice, lectures and films on the philosophy of yoga and the place of yoga in daily life, meditation, stress management, nutrition, and knowledge about the illness. The outcome measures were fasting plasma glucose and serum lipoprotein profile. These variables were determined in fasting blood samples, taken on the first and last day of the course. Fasting plasma glucose, serum total cholesterol, low-density lipoprotein (LDL) cholesterol, very- LDL cholesterol, the ratio of total cholesterol to high density lipoprotein (HDL) cholesterol, and total triglycerides were significantly lower, and HDL cholesterol significantly higher, on the last day of the course compared to the first day of the course. The changes were more marked in subjects with hyperglycemia or hypercholesterolemia. The observations suggest that a short lifestyle modification and stress management education program leads to favorable metabolic effects within a period of 9 days.
    Full-text · Article · May 2005 · The Journal of Alternative and Complementary Medicine
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    ABSTRACT: Ghee (clarified butter) has generally been assumed to be hypercholesterolaemic on the basis of its composition but there is hardly any study to support or refute the assumption. The present study was conducted on sixty-three healthy, young, physically active adult volunteers (52 male, 11 female). The study design was that of a randomized controlled trial with a parallel design. After a lead-in period of 2 wk, the subjects were randomly divided into two groups, Group A (n = 30; 25 male, 5 female) and Group B (n = 33; 27 male, 6 female). Group A (experimental) consumed for 8 wk a diet in which ghee provided 10% of the energy intake. The only other visible fat in the diet was mustard oil, and total energy from fats was 25% of the energy intake. Group B (control) consumed for 8 wk a similar diet except that all visible fat came from mustard oil. The serum total cholesterol level showed a significant rise in the experimental group at 4 wk; the rise persisted at 8 wk. A similar rise was also seen in HDL cholesterol. Hence the total cholesterol/HDL cholesterol ratio did not show any significant change. In the control group, there was a trend towards a fall in LDL cholesterol but the change was not significant. The study does not indicate any adverse effect of ghee on lipoprotein profile. However, more studies are needed on older subjects, hyperlipidaemic subjects, and on subjects following less healthy lifestyles before the results of this study can be extrapolated to the general population.
    Full-text · Article · Feb 2005 · Indian journal of physiology and pharmacology
  • Ramaprabhu Vempati · Bijlani RL · Deepak KK

    No preview · Article · Jan 2005 · Allergy & Clinical Immunology International - Journal of the World Allergy Organization
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    S Manjunatha · R P Vempati · D Ghosh · R L Bijlani
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    ABSTRACT: The study was conducted to examine the hypothesis that yogasanas help in the treatment of diabetes mellitus by releasing insulin from the pancreas. Twenty healthy young voluntees (17 male, 3 female; age 19-31 years) participated in the study. Each volunteer performed four sets of asanas in random order for 5 consecutive days each with a 2-day gap between consecutive sets of asanas. The four sets of asanas were: (I) dhanurasana + matsyendrasana, (II) halasana + vajrasana, (III) naukasana + bhujangasana, and (IV) setubandhasana + pavanamuktasana. Blood samples were collected on days 4 and 5 of each set of asanas for measurement of glucose and insulin levels before the asanas, within 10 min after performing the asanas, and 30 min after ingestion of 75 g glucose, which in turn was ingested immediately after the second blood sample. A standard 75 g oral glucose tolerance test (OGTT) was also done before and after the study. On the days of the pre-study or post-study OGTT, no asanas were done. The serum insulin levels after the asanas were lower (P<0.05) than those before the asanas. However, the serum insulin level 0.5 h after the post-asana oral 75 g-glucose challenge was higher (P<0.05) in Set IV than the 0.5 h postprandial insulin level in the pre-study OGTT; the same trend was observed in other sets as well although statistically not significant. The observations suggest that the performance of asanas led to increased sensitivity of the B cells of pancreas to the glucose signal. The increased sensitivity seems to be a sustained change resulting from a progressive long-term effect of asanas. The study is significant in that it has for the first time attempted to probe the mechanism by which yogasanas help diabetes mellitus.
    Full-text · Article · Nov 2004 · Indian journal of physiology and pharmacology
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    ABSTRACT: Thirty four healthy young volunteers (22 men, 12 women; age 25.7 +/- 5.8 years; BMI 20.8 +/- 2.3 kg/m2) participated in a randomized controlled cross-over trial on the effect of consuming one boiled egg every day for 8 wk on the serum lipid profile. The only significant change after 8 wk of egg consumption was an elevation of the total cholesterol/HDL cholesterol ratio. However, scrutiny of individual responses revealed that twelve of the subjects (10 men, 2 women) had a greater than 15% rise in the LDL cholesterol level after 8 wk of egg consumption. These subjects, considered hyperresponders, showed significant increases (P < 0.025) at both 4 wk and 8 wk after egg consumption in total cholesterol and LDL cholesterol levels, and at 8 wk in total cholesterol/HDL cholesterol ratio. The remaining 22 hyporesponders showed no change in any of the variables measured at 4 wk or 8 wk after egg consumption. In view of the high nutritional value of eggs, a blanket ban on eggs is not justified. However, since up to one-third of the population may be hyperresponders, knowing the response of an individual is important before making the egg a regular item of the diet.
    Full-text · Article · Jul 2004 · Indian journal of physiology and pharmacology
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    Rajesh K Sharma · K K Deepak · R L Bijlani · P S Rao
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    ABSTRACT: This study reports the results of 15 days of exercise training in 25 adult males on cardiovascular autonomic response amplitude and latencies. A standard battery of autonomic function tests including both activity (tone) and reactivity was used. Parasympathetic activity as evaluated from Heart rate variability (HRV) showed no statistically significant change in both time and frequency domain measures, similarly Sympathetic activity as measured by QT/QS2 ratio showed no statistically significant change, but there was a trend of a decrease in sympathetic activity and an increase in parasympathetic activity. There were no changes in the parameters measuring parasympathetic reactivity. Sympathetic reactivity as evaluated by diastolic blood pressure responses to hand grip test (HGT) and cold pressor test (CPT) showed significant decreases. Time domain assessment of autonomic responses was done by measuring tachycardia and bradycardia latencies during Valsalva maneuver (VM) and lying to standing test (LST). Physical training resulted in a decrease in tachycardia latency during LST and a decrease in bradycardia latency during VM. We conclude from the present study that 15 days of physical training is not enough to alter autonomic activity and PNS reactivity but can result in changes in SNS reactivity and latency parameters. We hypothesize that a decrease in bradycardia latency during VM signifies a faster recovery of heart rate during VM and a decrease in tachycardia latency during LST denotes a delayed activation of the system both of which are favorable cardiovascular responses.
    Preview · Article · May 2004 · Indian journal of physiology and pharmacology
  • K Yadav Raj · R P Vempati · B Ray Rooma · KK Deepak · RL Bijlani

    No preview · Article · Jan 2004 · Indian journal of physiology and pharmacology
  • R P Vempati · S Manjunatha · RL Bijlani

    No preview · Article · Jan 2004 · Indian journal of physiology and pharmacology