336 Alka Gupta et al. / International Journal of Biological & Pharmaceutical Research. 2015; 6(5): 336-344.

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RELEVANCE OF ON TYPE 2 DIABETES MELLITUS, OBESITY AND IBS-AN APPROACH THROUGH MANIPURA : A REVIEW DISCUSSION

Alka Gupta1, H.H.Awasthi2, J.S.Tripathi3

1Junior Resident, 2Professor & Head, Department of Rachana Sharira, IMS, BHU, Varanasi-221005, Uttar Pradesh, India. 3Professor, Department of Kaya Chikitsa, IMS, BHU, Varanasi-221005, Uttar Pradesh, India.

ABSTRACT After exhausted review of available literature related to manipura chakra, it is concluded that all the abdominal organs share a close relation with manipura chakra and the yoga technique like uddiyana , bhastrika , pawanmuktasana etc affect directly on manipura chakra thereby affecting abdominal organ‟s physiology and pathology i.e.Type2DM, Obesity, IBS. Thus manipura chakra is the basic anatomical entity which is affected by these yoga practices and further improves the function of all the neurovascular channels in its vicinity. The purpose of this article is to provide a scholarly review of the literature and regarding research studies related with the effects of yoga in the manipura chakra vicinity on a variety of health outcomes and in diabetes/IBS/obesity and healthy conditions. Using different research database with the key word „„yoga and type2 DM/ Obesity/IBS” a comprehensive search of the research literature from core scientific and nursing journals yielded 20 studies that met inclusion criteria. These studies subsequently were classified as uncontrolled (n-4), wait list controlled (n-3), or comparison (n-7). The most common comparison intervention (n-6) involved exercise. These studies were included in this review. Manipura chakra and it‟s relation with abdominal organ related disease searched through ancient Indian literature (veda, upnishad and ) cleared the aim of this article. In the studies reviewed, yoga interventions affecting manipura chakra appeared to be superior to only medical treatment in nearly every outcome measured in abdominal organ related diseases i.e.Type2DM, Obesity, IBS except those involving emergency management in physical condition. The studies comparing the effects of yoga on manipura chakra and only medical treatment seems to indicate that, in both healthy and diseased populations, yoga may be as effective as or better at improving a variety of health-related outcome measures. Future clinical trials are needed to examine the distinctions among yoga on different , particularly how these modalities may differ in their effects. Additional studies using rigorous methodologies are needed to examine the health benefits of the various types of yoga on manipura chakras. uddiyana bandha, bhastrika.

Key Words: Manipura chakra, Yoga, , Pranayama, Pawanmuktasana.

INTRODUCTION Yoga is power to achieve the supreme state of life means “The science of life” has become recognized today for living being. connects yoga to different for its wonderful dietary, herbal; lifestyle and yogic pathological conditions in human being. Ayurveda- which therapy that help us live longer happier, wiser and more in harmony. Ayurveda mainly emphasizes on mind body Corresponding Author balance which is the main key of being healthy. Ayurvedic ancient literature although very rich didn‟t described Alka Gupta anatomy and physiology of nervous system in a elaborative Email: [email protected] manner. The nervous system in ayurveda is mostly the 337 Alka Gupta et al. / International Journal of Biological & Pharmaceutical Research. 2015; 6(5): 336-344. contribution of system that comprises trinadi outer margin venous arcade can be seen so the colour sidhhant, sadchakra sidhhant etc. The sadchakra system is symptomatology can be understood by anatomical directly responsible for our physical, emotional and correlation. This anatomical concept is the base for spiritual health. According to many tantric texts, the understanding functions of manipura chakra. human body contains nadis that channel to every In hath yoga pradipika many asana, pranayama, cell. Some are wide and rushing; others are a mere trickle. bandhaa and mudra are mentioned with chakra as point of When this system flows freely, we are vital and healthy; action. Uddiyana bandha is only bandha which directly when it becomes weak or congested, we struggle with poor affect nabhi chakra (manipura chakra) so the name given mental and physical health. The practices of are to it. Bhastika pranayama exerts the action on umbilical extremely effective because they strengthen the flow of region and affect. (Hath Yoga Pradipika, 1914) besides prana in our bodies, invigorating the current so that it these many asana e.g. pavanamuktasana, carries away obstructions that block the free flow of paschimottanasana, mandukasana etc and energy. perform their action through umbilical vicinity, seat of Between these nadis one nadi is considered as the manipura chakra (Light of yoga, 1979) centre of all nadis and body‟s pranik energy that is Coeliac plexus is the largest major autonomic susumna nadi. The sushumna (most gracious) nadi is plexus and sited at the level of 12th thoracic and 1st lumbar running from the base of the spine to the crown of the vertebra. It is dense network uniting two large coeliac head, passing through each of the seven chakras in its ganglia and surrounds the coeliac artery and root of the course. (The serpent power 1919, Thesis by Dr. Tirath Raj superior mesenteric artery. The plexus and ganglia are 2011) joined by greater and lesser splanchnic nerve and branches of vagus and phrenic nerve. The plexus extends as Chakra description- numerous secondary plexuses along adjacent arteries and Chakra verbally means “Wheels of light”. These give rise to phrenic, splenic, superior mesenteric, hepatic, chakras included the centre of electromagnetic energy that suprarenal, renal, gonadal, superior and inferior hypo are located throughout the body, they provide a way for gastric, pelvic and many small plexuses. Every petal can be energy to enter and exit our body and help to regulate all considered as small plexus in that area i. e. mesenteric type of energy flow i.e. physical, mental, emotional and plexus, pancreatic plexus, renal plexus, adrenal plexus, spiritual. Our body has 7 major and many minor chakras. splenic plexus etc (Gray‟s anatomy-39th edition, 2005) (Shiv Samhita, 2012) These 7 chakras are situated from Site of coeliac plexus and lumbar plexus may be base of spine to the top of head. These are psychic centre said as the site of Manipura Chakra because this is not of the astral body governing a group of functions. (The only the region where nerves form coalition but arteries serpent power, 1919) and veins also form plexuses and these all in collaboration Anatomically these chakras are wheels of regulate whole digestive system which is actually the base neurovascular circulatory channels attached to the of wholesome body and brain. connective tissue of human body in various shape and size, Beyond the spiritual effect of yoga therapeutic where from different branches spring up and are effect on materialistic body is also an important concern. communicated with or distributed to various organs and Effect of any yoga practice is two types physical and structure of the body. These wheels of nerves are called psychological, physical affect is through chakra either plexuses which are an intricate inner communication major or minor. If the major chakra is stimulated wider between the funiculi of adjacent nerve.1In many scriptures range of reaction is seen while minor chakras situated in chakras are considered as mere electromagnetic waves but all joints and between major chakra produce a short term then a question arise if an electromagnetic current can flow effect. Thus yoga according to tantric anatomy effect on without a media in such a polar atmosphere of human chakras and mana, they further stimulate nervous and body? In our understanding spinal cord and sympathetic hormonal reaction on the concerning viscera as well as chains are these main nadis in which energy travel and generalized effect on whole body. chakras are the neurovascular plexuses through which this Several article and literature review has been energy is radiated in the concerning areas. conducted all over the world for the evaluation of the effect In satchakra nirupana, manipura chakra is of yoga in different specific medical conditions e.g. defined as it have triangular fire region in centre Diabetes, pulmonary disorders, obesity, Irritable bowel surrounded by morning sun like hue and in periphery it is syndrome, metabolic syndrome, menopause, radiates as bluish black cloudy colour which can be disorder, cancer etc. Most of the studies have concluded directly correlated with vessels and nervous arrangement in that yoga either directly beneficial in disease prognosis or abdominal region as coeliac plexus and lumbar plexus lies enhance the quality of life. The effect of yoga on the in centre surrounded by emerging superior mesenteric, psycho-physiological system through the chakra can be inferior mesenteric and coeliac vessels and in periphery on schematically presented as below. 338 Alka Gupta et al. / International Journal of Biological & Pharmaceutical Research. 2015; 6(5): 336-344.

heamoglobin, HR- heart rate, HRV- Heart rate variability, BMI- Body mass index, SBP- Systolic blood pressure, BP- Blood pressure, CT- computed tomography SOD- Superoxide dismutase 20 experimental articles and 5 review studies met the inclusion criteria and were available at the NLM. Of these, more than half were published in Indian journals. These 25 studies examined a wide range of outcome measures and included numerous healthy and diseased populations. Among these 12 studies with intervention related with umbilical region was elaborated which is focus of this article.

RESULTS Table 1 detail the populations, study methodology, and outcome measures of the 12 studies Method: A empirical search has been done for diseases comparing the effects of yoga and exercise evaluated in affected by yogic practices specially originating in vicinity this article. 2 out of the 12 studies were conducted in the of manipura chakra (i.e. diabetes, IBS, obesity etc) and a United States, 8 in India, and 1 each was completed in comprehensive search for articles showing effect of yoga England, Neatherland. Seven of the studies (58.88%) were in these abdominal organ related disorder until 2013 randomized controlled trials. four studies focused on December. healthy populations, and the remainder focused on subjects The articles were identified using PubMed , the with abdominal organ related diseases conditions. Nearly online database of biomedical journal citations produced every study utilized a yoga intervention that combined by the United States National Library of Medicine (NLM). physical (seated, or lying) and restorative or Using the key word “yoga on manipura chakra” and relaxation poses. Seven (7) of the 12 studies also „„yoga on diabetes/IBS/obesity” limiting the search to core incorporated and pranayama (breath work). clinical and nursing journals published in English, 136 Two (2) studies did not specify the type of yoga articles published, in which article published after year intervention used. The remaining studies utilized hatha 2000 were identified. Articles clearly specifying yoga yoga (N-2), iyengar yoga (N-1). While three of the studies intervention in diabetes, IBS, obesity were included. provided specific sequences of yoga poses used in the intervention, the remaining offered few details. Total 808 Exclusion criteria: Articles were eliminated if they were patients examined under these 12 studies, in which 269 for editorials, anecdotal or single case studies, or of extremely diabetes, 67 for IBS and 373 for obesity. poor quality. Although meditation, one of the eight limbs of yoga, and yoga intervention such as cleansing exercises Yoga affecting manipura chakra in diabetes arguably could be included in a scholarly review of yoga Studies show a dignified data proving beneficial literature, studies solely focusing on these modalities were effect asana and pranayama in improving blood sugar and excluded. insulin level in type 2 DM. Inclusion criteria: Studies were included in the review if Some studies have taken only asanas as they were of reasonably good quality and involved yoga intervention. Malhotra V et al., selected 20 NIDDM asana as the primary intervention modality. Quality of subjects (mild to moderate diabetics) in the age group of studies was determined using the criteria outlined by 30-60 years to practice 13 specific Yoga asanas for 40 days Greenhalgh (Greenhalgh, 1997) Much of the research including pashimottanasana, pawanmuktasana. The results regarding yoga interventions have been done all over the indicate that there was significant decrease in fasting world with the majority of those studies, not surprisingly, glucose levels from basal 208.3 +/- 20.0 to 171.7 +/- 19.5 done in India. Many of the early studies published in mg/dl and one hour postprandial blood glucose levels journals prior to 1990 were of questionable quality, with decreased from 295.3 +/- 22.0 to 269.7 +/- 19.9 mg/dl inadequate descriptions of methodology and few (Malhotra V et al., 2005) According to Chaya MS et al., randomized, controlled trials. However, the quality of more yoga also increase insulin sensitivity in type 2 DM recent studies has improved noticeably. Studies completed significantly (yoga 7.82 [2.29] control 4.86 [11.97] abroad were considered if they met the inclusion criteria (mg/[kg.min])/(micro/ml), p less than 0.001). (Chaya MS and were available at the NLM. et al., 2008) This could be justified as an important step in Note: DM-Diabetes mellitus, RCT- Randomise control whole mechanism. In another article Manjunatha S used trial, IBS-Irritable bowel syndrome, OGTT- Oral glucose sets of asanas in diabetes patient to specify more tolerance test, FBS- Fasting blood sugar, PPBS- influential posture in diabetic patients, and found OGTT Postprandial blood sugar, Hb1Ac- Glycosylated test and serum insulin level more significantly changed in 339 Alka Gupta et al. / International Journal of Biological & Pharmaceutical Research. 2015; 6(5): 336-344. manipura chakra affecting yoga (pawanamuktasana) improve with these yoga practice (Singh S et al., 2004, group (Manjunatha S, 2005). Malhotra V et al., 2002). Many other authors used asana and pranayama A controlled clinical trial by Shreelaxmi V. Hegde both in DM2 patient, and compare the effect with control et al., screened yoga with the most important causetive group, registered them together more promising (Savita factor of diabetes that is oxidative stress and after three singh et al., 2008) Viveka P et al., applied on group months yoga including pawanamuktasana and pranayama patients a comprehensive yogic breathing program for 3 practice, yoga practitioners achieved significant days. This course included yogic movements and postures improvements in BMI, FPG, PPPG, HbA1c, (asanas), relaxation practices, meditation. Patients malondialdehyde, glutathione, and vitamin C at 3 months underwent 1 h of long group breathing technique, which compared with the standard care group. In the yoga group, included three stages of pranayama, three rounds of 20 the mean percentage reduction in malondialdehyde was each of bhastrika, three times Om chanting and sudarshan 20% (−10.8 ± 1.4 μmol/L) and in HbA1c1.4% (−0.1 ± kriya followed by rest in supine position. There was a 0.2%). Significant reductions in glutathione and vitamin C decrease of mean FBS by 3.5 ± 33.27 mg/dL in the yoga were seen in control subjects (Shreelaxmi V. Hegde et al., group (P = 0.85). The mean post-prandial blood sugar 2011). (PPBS) decreased by 9.65 ± 42.72 mg/dL in the yoga Lorenzo A Gordon et al., compared hath yoga group (P = 0.40). There was a decrease of 0.026 ± 1.43% with exercise in diabetic patients and reported that in the in the mean glycated hemoglobin (HbA1c) in the yoga hatha yoga and conventional PT exercise groups there group (P = 0.79). Although there was a trend toward were significantly decreased concentrations of FBG at the improvement in glycemic control in patients practicing third (P < 0.0001) and sixth months of exercise (P < 0.001) yoga and taking standard treatment compared with those compared to baseline values. A study also evaluated the taking standard treatment alone, this improvement was not effect of yoga-nidra on blood glucose level in diabetic statistically significant (Viveka P et al., 2012). patients (Lorenzo A Gordon et al., 2008). Rani K Beena et al., concluded in their research In a interesting study Markerman vizcaino et al.,, paper that yoga (pranayama and asana) may improve risk however stated that hatha yoga shown no significant profiles induced by stress in geriatric patients with type change in glucose control or physiological stress, but found 2diabetes and may be promising for the prevention or significant change in perceived stress, state anxiety and delay in diabetes complications. Yoga group in this study self-care behaviour (Markerman vizcaino et al., 2013). showed statistically significant (P < 0.001) decrease in Diabetes is a growing worldwide problem so conventional glucose[179.7 ± 6.23 to 140 ± 6.02 mg/dl (20 %)], but in and accessible treatment is demand of time, specific yoga control group significant increase (P = 0.005) from 148 ± practices showing promising effect could be a good 2.08 to 150.97 ± 2.28 mg/dl was observed , decrease in alternative for diabetes patients. Some population survey HbA1c, lipids, cortisol, ferritin, MDA level and significant also dignified beneficial effect of yoga in diabetic patients increase in catalase activity after yogic practices (Rani. K. (Gina K Alexender et al., 2008, Aswathy Sreedevi, 2013). Beena et al., 2013). Yoga affecting manipura chakra not only Yoga affecting manipura chakra in IBS improves all glycemic indexes but also increase the quality Irritable bowel syndrome (IBS) is a common yet of life in all aspect. Various studies have been done in poorly understood functional bowel disorder. Comparision associated disorder and health aspects in diabetic patients. between studies which may provide further information is Yoga training including bhastrika pranayama in 15 peri often difficult due to inconsistencies in the experimental and post-menopausal patients receiving standard medical protocol and the nonstandard ways in which data have treatment for type 2 DM has shown significant (P<0.01) been presented. Therefore, only few studies meet the decrease in fasting and postprandial blood glucose levels inclusion criteria. Yoga affecting manipura chakra in IBS [FBG (P=0.0035) by 20.62% from 160.07 ± 15.65 to is well complimented on both physical and psychological 127.07 ± 10.24 mg/dl, PPBG (P=0.0012) by 14.52% from level. 244.20 ± 17.12 to 208.73 ± 16.07 mg/dl] as well as low Taneja I et al., study indicates a beneficial effect density lipoprotein. of yogic intervention over conventional treatment in The decrease in total cholesterol, triglycerides, diarrhoea-predominant IBS. The conventional group was and very low density lipoprotein and increase in high given symptomatic treatment with loperamide 2-6 mg/day density lipoprotein was also statistically significant for 2 months, and the yogic intervention group consisted of (P<0.05) (Madanmohan et al., 2012) In another study a set of 12 asanas (yogic poses including pawanmuktasana intervention with yoga for a period of 3 months the and paschimottanasana) along with surya nadi pranayama diabetic patient study group showed a decrease in total (right-nostril breathing) two times a day for 2 months. Two cholesterol, triglycerides and LDL, with an improvement months of both conventional and yogic intervention in HDL (Shantakumari et al., 2013) In patients of diabetes showed a significant decrease of bowel symptoms and state pulmonary function and cardiovascular function also anxiety. This was accompanied by an increase in 340 Alka Gupta et al. / International Journal of Biological & Pharmaceutical Research. 2015; 6(5): 336-344. electrophysiologically recorded gastric activity in the groups (i.e., between periods), all parameters in Yoga conventional intervention group and enhanced group showed significant (P < 0.001) decrease from day 30 parasympathetic reactivity, as measured by heart rate while Aerobic group showed improvement from day 90. parameters, in yogic intervention group (Taneja I et al., Similarly, comparing the levels between the groups, the 2004). weight, WC, HC and depression decreased more In a article Kuttner L et al., tested yoga in the significantly (P < 0.01 or P < 0.001) at day 90 and day 180 adolescents group for IBS, adolescents found the yoga to in yoga group than Aerobic group. The depression also be helpful to manage their IBS When the pre- and post decreased significantly (P < 0.01) in yoga group than in intervention data for the two groups were combined, there Aerobic group at day (S Dhananjai et al., 2013, Janice K. was a significant reduction in reports of gastrointestinal Kiecolt-glaser, 2012). symptoms (t[1,24]=3.15, P<0.01) and a trend for lower Janice K. Kiecolt-Glaser et al., analyse the levels of emotion-focused avoidance (t[1,24]=2.82, adiponectin and leptin in yoga practitioner and novice, P=0.10) following participation in the yoga intervention revealed a borderline effect of yoga expertise, P = .08; (Kuttner L et al., 2006). experts average adiponectin levels were 28% higher than Brand MM et al., in their study on functional pain novices across the three visits. Frequency of self-reported related to IBS stated that in the 8-11 year old group and the yoga practice showed significant negative relationships 11-18 year old group pain frequency was significantly with leptin; more weeks of yoga practice over the last year, decreased at the end of therapy (asanas) (p=0.031 and more lifetime yoga sessions, and more years of yoga p=0.004) compared to baseline. In the 8-11 year group pain practice were all significantly associated with lower leptin, intensity was also significantly decreased at this time point with similar findings for the adiponectin to leptin ratio (p=0.015) (Brand MM et al., 2011). (Janice K. Kiecolt-glaser, 2012). Some other studies has been done with Yoga appears to be an appropriate and potentially complementary and alternative medicine in IBS but didn‟t successful intervention for weight maintenance, prevention mention the exact yoga practice. of obesity. In their study Sarvottam K et al., for investigating Yoga affecting manipura chakra in obesity the effect of a short-term yoga-based lifestyle intervention Abdominal obesity has been suggested to be on risk factors for cardiovascular disease (CVD) and associated with overstimulation of the hypothalamic markers of inflammation and endothelial function in pituitary-adrenal (HPA) axis (Rosemond et al., 1998, overweight and obese men implemented, yoga practices Bjorntorp P et al., 1997) due to chronic stress and altering including asanas and pranayama in subjects. There was a diurnal cortisol secretion. Abnormal regulation of the HPA significant reduction in weight from Baseline to Day 10 axis and perceived stress-dependent cortisol levels are (p<0.001), BMI (p<0.001), and systolic BP (p=0.042, strongly related to perturbations of the endocrine axis as respectively). There was a significant reduction in plasma well as abdominal obesity with metabolic abnormalities. IL-6 from Baseline to Day 10 (p=0.012). There was a A growing number of research studies have significant increase in the plasma adiponectin from shown that hatha yoga can improve strength and Baseline to Day 10 (respectively, p=0.014). These findings flexibility, and may help control physiological variables suggest that even a short-term yoga-based lifestyle such as blood pressure, lipids, respiration, heart rate and intervention may be an important modality to reduce the metabolic rate to improve overall exercise capacity (Ray risk for CVD as indicated by weight loss, reduction in US et al., 2001, Tran MD et al., 2001). systolic blood pressure, an increase in adiponectin, and In their research paper S Dhananjai et al., have decrease in IL-6 in overweight and obese men (Sarvottam documented effect of implementation of a set of yoga K et al., 2013). techniques daily in healthy subjects [in the form of asana Yoga in community is very much sought for (postures), deep relaxation technique, pranayama weight reducing benefit but documented data with specific (breathing techniques) and meditation] and also compared yoga practices are very few. This is a big lacuna in with aerobic exercise. On comparing the levels within the establishing the theory in regard to this function of yoga.

Table 1. Showing studies concerned in article Name of first Durat Year Population Type of yoga Design Assessment technique author ion Healthy 4-5 Uncontrolled, 1 Manjunath S 2005 4 set of asanas OGTT, S.insulin individual days repeated measure Patients of 13 specific 40 FBS, PPBS, HbAc1, 2 Malhotra V 2002 Comparision RCT DM2 asanas days Pulmonary function test Asana, FBS, PPBS, HbAc1, Patients of 3 3 Viveka P 2012 Pranayama, RCT, comparision WHOQOL BREF DM2 Days Meditation Questionnire 341 Alka Gupta et al. / International Journal of Biological & Pharmaceutical Research. 2015; 6(5): 336-344.

3 Reena K Healthy Asana , Repeated FBS, PPBS, HbAc1, lipid 4 2013 Mont Beena individual Pranayama measures profile hs FBS, PPBS, HbiAc, BMI, 3 Shreelaxmi V. Patients of Asana and waist-hip ratio, SOD, 5 2011 month Comparison RCT Hegde DM2 pranayama VitC, VitE, Glutathion, s BP FBS, PPBS, HbAc1, 6 Summery of diabeties self Markermen Patients of Repeated 6 2013 Hatha Yoga Week care activities vizoin DM2 measures s Questionnier, Precised stress scale Electrophysiolosically Diarrhoea 12 asanas 2 Repeated gastric activity, HR, 7 Taneja I 2004 dominent with suryanadi month measures HRV, parasympathetic IBS patients pranayama s activity Children 10 Yoga Kidscreen quality of life 8 Brand MM 2011 - Pilot study with IBS lesson questionnier Pain coping questionnier, Revised child manifest 44 IBS 2 9 Leara Kuttner 2006 Iyanger Yoga RCT anxiety scale, Children patients weeks depression inventory- short form Nonrandomized BMI, SBP, IL-6, Over weight Asana and 10 prospective 10 Sarvottank 2013 Adiponectin, Endothelin patients pranayama days lifestyle 1 intervention study 6 Obesity Asana and Repeated BMI, HR, Depression – 11 S Dhananjai 2013 month patient Pranayama measures anxiety scale s Sagittal abdominal Janice K. Healthy 2 diameter, Axial CT, Dual 12 2012 Asana RCT Kiecolt-Glaser Patients years energy x Ray Absorbtiometry

DISCUSSION The review of these 12 studies address the yoga glucose level by about 20% and increase in serum insulin intervention specially concern with manipura chakra in level (Manjunath S, 2005) with yoga practices while abdominal organ related disease i.e. type2 diabetes markerman vizoin shown no significant change in blood mellitus, IBS and obesity. Despite an extensive review of glucose level by absolute hatha yoga practice. (Markerman different literature via different methods we could only Vizcaino 2013)One study magnified that yoga asanas include these 12 studies in the main review. Even than we (posture) affecting manipura chakra (pawanmuktasana) is could not find any research work done on specific bandha more effective in diabetes patients than other asanas. as on any pathological disorder in all our review collection (Manjunath S, 2005) 2 studies specify about manipura criteria. chakra related pranayama (bhastrika). (Vivek aP Jyotsana The asanas, pranayama and bandhas practiced in et al., 2012, Madanmohan et al., 2012). the vicinity of umbilicus are found to be effective more on This article dignify that specific yoga practice these diseases than other yoga practices and umbilicus is should be practiced in specific diseases because all yoga the site of manipura chakra which control, govern and practices doesn‟t affect all diseases. Although all yoga regulate physiology of all abdominal viscera. practices effect on mana through psychological component All these 12 studies suggested beneficial effect of so have a generalized decrease in health markers and yoga (concern with manipura chakra), on type 2 diabetes, stress. IBS and obesity comparing biochemical markers and According to ayurveda and modern sciences, different questionner. sthoulya (obesity) is the main causative factor for type 2 In case of type 2 diabetes all studies except diabetes, so Yoga affecting manipura chakra by markermen vizoin et al., depicted decrease in blood beneficially effecting on obesity also regress the pathology 342 Alka Gupta et al. / International Journal of Biological & Pharmaceutical Research. 2015; 6(5): 336-344. of diabetes and also separately reduce obesity and related effects in elderly type 2 diabetic patients by reducing disorder (Inne KE et al., 2007; Agnivesha Charak Samhita stress, oxidative stress and by improving the antioxidant 1994). defense system and from the group analysis they concluded Most of the yoga in IBS related article were that at all stages of the disease a significant improvement public study only 3 studies fall under inclusion criteria can be achieved by yogic practice in geriatric diabetes also with controlled study. IBS is widely accepted as (Rani k Beena et al., 2013). Exercise stimulates the SNS, psychosomatic disorder so mostly biochemical marker raising plasma epinephrine and norepinephrine (Peronnet F does not show any significant changes but questionner and et al., 1981) Yoga on the other hand, has been shown to anxiety scale shown significant beneficial changes in lower sympathetic stimulation, significantly lowering symptoms of IBS with yogic practices especially levels of plasma norepinephrine and epinephrine concerned with manipura chakra. A study also stated (Selvamurthy W et al., 1998, Upadhaya AK et al., 2008). significant changes in electrogastrography and autonomic When we are using yogic intervention we must symptoms in IBS patient signify that organic effect is also consider the philosophy of yoga tantras which support present with yoga intervention (Taneja I et al., 2004). manipura chakra hypothesis. Manipura chakra is primary For mechanism of action of these yoga most of afferent and efferent entity for all the abdominal organs the researcher keep silent, but some articles given a brief considering that its petals form visceral plexuses in the description of mechanism, although none have tested facts . This is a potentially rich area for research for a according to tantric philosophy point of view. Vincent variety of reasons (Hath yoga pradipika, 1914). have suggested that yoga reduces this risk profile by decreasing activation of the sympatho-adrenal system and CONCLUSION the hypothalamic-pituitary-adrenal axis and also by Overall, the studies on the effects of yoga promoting a feeling of wellbeing along with direct (concerned with manipura chakra) seems to indicate that, enhancement of parasympathetic activity via vagus nerve in both healthy and diseased populations, yoga may be as (Inne KE, 2007) Manjunatha et al., stated that the effective or better at improving a variety of health-related performance of asanas led to increased sensitivity of the B outcome measures including blood glucose, blood cells of to the glucose signal. The increased lipids,oxidative stress, Pulmonary functions and sensitivity seems to be a sustained change resulting from a electrogastrography in type 2 diabetes, IBS and obesity. progressive long-term effect of asanas. (Manjunatha et al., Furthermore, yoga appears to improve subjective measures 2005) Malhotra V given a different view and emphasis that of fatigue, pain and sleep in healthy and ill populations. somatoendocrine mechanism affecting insulin kinetics However, future clinical trials are needed to further worked out (Malhotra V et al., 2005). examine specific Yoga affecting manipura chakra, One hypothesis points out to the role of stress and particularly how these modalities effects on physical level relaxation, while others suggest that the non-invasive both for ayurvedic and modern point of view. Additional nature of yoga provides excellent support. (Surwit RS studies are needed to distinguish between the different 1993, Jablon SL, 1997, Da Silva GD, 2007) Michalsen et types of yoga for different diseases and their various al.,., found out that Iyengar Yoga reduces stress-related techniques. These studies need to use rigorous study diseases and it shows that yogic practice has an effect on methodologies, including the use of larger sample sizes, hypothalamic - pituitary-adrenal (HPA) axis. It may randomized samples, and blinding of researchers and also alleviate the effects of stress and foster multiple positive to specify the anatomical structure effected. These studies downstream effects on the neuroendocrine system. need to be replicated in a variety of populations, both sick (Michelsen A et al., 2005) Rani k Beena point out that and well, as the effects may vary depending upon the yogic exercise has therapeutic, preventive and protective health status of the population.

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