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Chronobiology and Health- Proceedings 2016

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Proceedings of the National Conference on "Chronobiology and Health" organised at by Deptt of Physiology, MGMCRI, Sri Balaji Vidyapeeth at Pondicherry, India on 18-19 March 2016.

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Chronobiology and Health- Proceedings 2016

  1. 1. National Conference on Chronobiology and Health 1 Chief Patron Shri MK Rajagoplan Chairman, Sri Balaji Educational and Charitable Public Trust Patrons Prof. P Rajaram Prof. KR Sethuraman Chancellor, Sri Balaji Vidyapeeth Vice-Chancellor, Sri Balaji Vidyapeeth Prof. YM Jayaraj Prof. N Ananthakrishnan Pro-Vice Chancellor, Sri Balaji Vidyapeeth Dean- Research and AHS Sri Balaji Vidyapeeth Prof. M Ravishankar Dean, MGMC & RI Resource Committee Prof. S Ravichandran Prof. V Nirmal Coumare Additional Director (HS), MGMC&RI Medical Superintendent, MGMC&RI Prof. N Seetharaman Dr. AN Uma Head, Department of Community Medicine Assistant Professor, Department of Anatomy Organizing Chairman Organizing Secretary Prof. Madanmohan Prof. K Jaiganesh Head, Department of Physiology Professor of Physiology Core team Prof. K Henri Balraj Dr. T Jeneth Berlin Raj Dr. Suchitra Parkhad Dr. Nikhilesh Singh Dr. Richa Gupta Dr. R Sobana Dr. K Ramya Mr. S Vasanthan Dr. S Selvakumar Mr. P Uthiravelu
  2. 2. National Conference on Chronobiology and Health 2 INDEX CONTENT PAGE NO. Messages 3 From the desk of Organizing Chairman 12 From the desk of Organizing Secretary 13 Conference faculty 14 Scientific programme 16 Chronobiology – an overview Prof. KR Sethuraman 20 Fundamental properties of circadian clocks – their cellular and molecular basis Dr. Sheeba Vasu 23 Blood pressure variability as a risk factor for cardiovascular diseases Prof. Narsingh Verma 24 Circadian rhythm and bipolar disorder Dr. Biju Vishwanath 25 Nasal cycle and its therapeutic applications: a yogic perspective Dr. Ananda Balayogi Bhavanani, Dr. Meena Ramanathan 26 Chronobiology of ageing: role of telomere and lifestyle intervention Prof. Vivek Kumar Sharma 29 Circadian sleep disorders: are they lifestyle associated? Prof. PN Ravindra 30 Chronotherapeutics Prof. K Manimekalai 34 Therapeutic potential of music: chrono-biological and traditional perspectives Prof. Sumathy Sundar 36 Adaptive resilience exercises as envisioned in yoga Dr. Meena Ramanathan, Dr. Ananda Balayogi Bhavanani 37 Pranayam and its physiological basis Prof. Madanmohan 39 Melatonin and chronobiology Dr. Suchitra B Parkhad 41 Posters 46-62
  3. 3. National Conference on Chronobiology and Health 3 MESSAGES
  4. 4. National Conference on Chronobiology and Health 4 MESSAGE FROM THE HONORABLE CHAIRMAN It gives me immense pleasure to note that the Department of Physiology of Mahatma Gandhi Medical College and Research Institute has taken the lead in organizing a national conference on “Chronobiology and health” on 18th and 19th March 2016. I am confident that this is a maiden effort by us in the field of chronobiology which relates health with the passage of time. The deliberations made in the conference will enlighten the new arena among the faculty. I wish the conference a grand success. Shri MK Rajagopalan Chairman - SBECT
  5. 5. National Conference on Chronobiology and Health 5 MESSAGE FROM THE CHANCELLOR Chronobiology – A Physiologic Paradox The study of biological rhythm, chronobiology, is attracting interest amongst the scientists around the world. It is, nevertheless, a difficult field for the scientists to understand and learn and then teach and educate others. Medical rhythm research is rather challenging for, it need interest and inquisitive mind on the part of the scientists to learn first. I am glad that Department of Physiology, under the dynamic leadership of Prof. Madanmohan, who is not only a Physiologist but has been doing research in applied diversified fields like yoga and meditation that has been shown having scientific basis. The researchers in this field have shown that they are not to be treated as having a religious bias but has bearing towards social aspects of humanity. He is heading a team of devoted scientists promoting research and education in these fields in India. This center at Sri Balaji Vidyapeeth is unique in India. Therefore, organizing chronobiology conference is timely and it is expected that scientists, clinicians, and interested strata of the society will and must come together to promote this interdisciplinary field. The younger generation of the present era of globalization is at the verge of breakdown of their biological clock. The outcome of research in chronobiology might help maintain the performance and output of workforce and avoid errors while performing their duties and avoid mental and physical health problems. Medical scientists must join the hands of basic science researchers and try to understand “Chronobiology” and solve the „Physiologic puzzle‟ that we are confronted with. Prof. Rajaram Pagadala Chancellor Sri Balaji Vidyapeeth
  6. 6. National Conference on Chronobiology and Health 6 MESSAGE FROM THE VICE CHANCELLOR Following the UGC directive to all the universities to stress on environmental issues during collegiate education, SBV has undertaken to conduct Annual Faculty Development Program on various aspects of environment and health. In 2015, it was Climate Change and Health and in the current year we are focusing on Chronobiology and Chronotherapeutics and Health. It is gratifying that the Department of Physiology of MGMC&RI has undertaken to organize this program as a national conference. In addition, the unique strength of SBV- yoga therapy and music therapy also find a prominent place in the conference. On behalf of SBV, I wish the conference a successful outcome, which would motivate us to conduct three more annual events in the years to come Prof. KR Sethuraman Vice-Chancellor Sri Balaji Vidyapeeth
  7. 7. National Conference on Chronobiology and Health 7 MESSAGE FROM THE REGISTRAR It gives me immense pleasure to felicitate the organizing committee of the national conference on Chronobiology and Health. The Department of Physiology,MGMC&RI needs to be complimented for their efforts that have culminated in this great endeavor. The natural cycles of our body include physiological,mental and emotional facets that are grossly governed by solar and lunar rhythms. Eminent researchers drawn from various research areas would enthrall the discerning audience with their intellectually stimulating talks on many a thrust area in chronobiology as related to health. I wish the conference great success. Prof. AR Srinivasan Registrar Sri Balaji Vidyapeeth
  8. 8. National Conference on Chronobiology and Health 8 MESSAGE FROM THE DEAN RESEARCH AND AHS Right from its inception, SBV has been in the forefront amongst peers, in the field of innovations and newly emerging areas of medical sciences so that it becomes part of the exploring group along the advancing borders of modern science – in the words from the famous serial Star trek “to boldly go where no man has been before.” Biology has undergone considerable change in recent times from description of gross cellular function to molecular biology at the sub-cellular level and the description of the new biology by Bruce Lipton in his book “The Biology of Belief”. One such emerging area is “Chronobiology” and its implication in medicine particularly in the area of therapeutics. I am very glad that the Department of Physiology at MGMC&RI has taken the lead in arranging a national program in this field wherein experts from different fields would highlight salient features of chronobiology and its application to different disciplines of medicine. I am sure that the proceedings of the program would go a long way in promoting our understanding of the subject. I wish the conference all success. Prof. N Ananthakrishnan Dean – Research and Allied Health sciences Sri Balaji Vidyapeeth
  9. 9. National Conference on Chronobiology and Health 9 MESSAGE FROM THE DEAN It gives me great pleasure and happiness to know that the Department of Physiology is organizing a National Conference on Chronobiology and Health on 18th and 19th March 2016 under Sri Balaji Vidyapeeth Deemed University, Accredited by NAAC with „A‟ Grade. Chronobiology as a focused theme to analyze the effect of changing environment on human health is a novel idea and delegates attending this conference will have lot to think about. I am confident that this conference will contribute to this national vision. I wish the function every success. Prof. M Ravishankar Dean MGMC&RI
  10. 10. National Conference on Chronobiology and Health 10 MESSAGE FROM THE ADDITIONAL DIRECTOR I am very happy to see the Department of Physiology is going to conduct anational conference on an important topic that is “CHRONOBIOLOGY AND HEALTH”. I think many of you agree that the knowledge on this topic among our medical fraternity is very limited and unpopular, where as many of the western countries started doing many research in the field of Chronophysiology, Chronopathology, Chronopharmacology etc. Chronobiology or circadian biology has come a long way since 1960‟s. What was once a difficult science to promote and teach has now become a very important field that encompasses molecular biology, endocrinology, physiology, psychiatry, genetics, neurology, sleep studies, and even astronomy when dealing with the cosmic origins of our biological clocks and lunar rhythms that have an impact on the earth. I have no doubt that this conference is going to inspire many of us to understand the details regarding the forces that control our inner clocks and to find better ways to adapt. Good initiative, please keep going. Prof. S Ravichandran Additional director – Hospital services MGMC&RI
  11. 11. National Conference on Chronobiology and Health 11 MESSAGE FROM THE MEDICAL SUPERINTENDENT I am glad that the Department of Physiology, Mahatma Gandhi Medical College and Research Institute is organizing a 2 day national conference on “Chronobiology and Health” in which scientists from diverse fields are taking part. I am sure that coming together of scientists from such diverse fields will encourage inter-disciplinary research which will be a boon to the society. I wish the conference a grand success. Prof. V Nirmal Coumare Medical Superintendent, MGMC&RI
  12. 12. National Conference on Chronobiology and Health 12 FROM THE DESK OF THE ORGANIZING CHAIRMAN At the outset, I wish to express my heart-felt gratitude to our honorable Chairman Shri MK Rajagopalan for his constant support to organize conferences/workshops. We have been organizing such events every year and the management has been graciously supporting the same. The present conference on “Chronobiology and Health” is second in a series of conferences on “Environment and Health” conceived by our honorable Vice-Chancellor, Prof. KR Sethuraman. I am grateful to Prof. P Rajaram, honorable Chancellor, Prof. YM Jayaraj, Pro-Vice Chancellor, Prof. N Ananthakrishanan, Dean Research & AHS and Prof. M Ravishankar, Dean MGMC & RI for their constant support and inspiration. I wish to thank my colleagues and friends from the Department of Physiology without whose support it would not have been possible to organize this conference. Chronobiology is an interdisciplinary field and faculties of this conference arefrom diverse fields of neuroscience, physiology, pharmacology, medicine, psychiatry, cardiology, pulmonary medicine, endocrinology, gynecology,yoga therapy and music therapy. I am sure that the scientific program will be an enlightening one and a memorable experience for you and wish you all the best for the 2 day conference. Prof. Madanmohan Prof. and Head, Department of Physiology, MGMC&RI
  13. 13. National Conference on Chronobiology and Health 13 FROM THE DESK OF THE ORGANIZING SECRETARY It is indeed my pleasure and privilege to invite you all to the National Conference on “Chronobiology and Health” We have made our fullest efforts to bring in potential resource persons from diverse fields to enlighten our delegates. The scientific sessions and workshop have been meticulously planned and executed to make your participation a comfortable and fruitful experience. I assure you that the conference will be an enriching academic experience to you in the field of chronobiology. Prof. K Jaiganesh Professor of Physiology MGMC&RI
  14. 14. National Conference on Chronobiology and Health 14 CONFERENCE FACULTY Internal faculty: KR Sethuraman, MD, PGDHE. Vice Chancellor, Sri Balaji Vidyapeeth. Madanmohan, MD, DSc. Professor & Head, Department of Physiology, MGMC & RI & Director, Center for Yoga Therapy, Education & Research (CYTER), Sri Balaji Vidyapeeth. K Manimekali, MD. Professor & Head, Department of Pharmacology, MGMC & RI. Sumathy Sundar, PhD. Director, Centre for Music Therapy Education & Research (CMTER), Sri Balaji Vidyapeeth. B Amirtha Ganesh, MD, DM Professor & Head, Department of Cardiology, MGMC & RI. R Pajanivel, MD, FRCP. Professor, Department of Pulmonary medicine, MGMC & RI Ananda Balayogi Bhavanani, MBBS, MD (AM). Deputy Director, Centre for Yoga Therapy Education & Research (CYTER), Sri Balaji Vidyapeeth. Meena Ramanathan, PhD (Yoga). Coordinator-cum-Yoga Therapist, Centre of Yoga Therapy Education Research (CYTER), Sri Balaji Vidyapeeth.
  15. 15. National Conference on Chronobiology and Health 15 External faculty: PN Ravindra, MD, PhD. Professor & Head, Department of Physiology, Akash Institute of Medical Sciences & Research Centre, Bangalore. Narsingh Verma, MD. Professor of Physiology & Vice Dean, KG Medical College, Lucknow. Gowri Dorairajan, MD Professor of Gynecology, JIPMER Vivek Sharma, MD. Additional Professor, Department of Physiology, JIPMER. Sadish Kumar, MD, DM Associate professor, Department of Endocrinology, JIPMER. Biju Vishwanath, MD, PhD. Assistant Professor, Department of Psychiatry, NIMHANS, Bangalore. Sheeba Vasu, PhD. Faculty Fellow, Neuroscience unit, Jawaharlal Nehru Centre for Advanced Scientific Research, Bangalore.
  16. 16. National Conference on Chronobiology and Health 16 SCIENTIFIC PROGRAMME Day1: 18 March 2016 (Friday) Venue: Ground Floor Lecture Hall, College Block 8.00 to 9.00 AM Registration 9.00 to 9.30 AM Pre- test 9.30 to 10.00 AM Fundamental properties of circadian clocks – their cellular and molecular basis. Sheeba Vasu, PhD. JNCASR, Bangalore 10.00 to 11.00 AM Inaugural function and lead talk by KR Sethuraman Vice Chancellor, Sri Balaji Vidyapeeth. 11.00 to 11.30 AM High tea 11.30 to 12.00 Noon Blood pressure variability as a risk factor for cardiovascular diseases: chronobiological perspective. Narsingh Verma, MD. Professor of Physiology & Vice Dean, KG Medical College, Lucknow. 12.00 to 12.30 PM Circadian rhythm and bipolar disorder Biju Vishwanath, MD. Assistant Professor, Department of Psychiatry, NIMHANS, Bangalore. 12.30 to 1.00 PM Nasal cycle and its therapeutic applications: a yogic perspective. Ananda Balayogi Bhavanani, MBBS, MD (AM). Deputy Director, CYTER, Sri Balaji Vidyapeeth. 1.00 to 2.30 PM Poster session and lunch 2.30 to 3.00 PM Chronobiology of ageing: role of telomere and lifestyle intervention. Vivek Sharma, MD. Additional Professor, Department of Physiology, JIPMER, Pondicherry. 3.00 to 3.30 PM Circadian sleep disorders: are they lifestyle associated? PN Ravindra, MD, PhD. Professor & Head, Department of Physiology, Akash Institute of Medical Sciences & Research Centre, Bangalore. 3.30 to 3.45 PM Tea 3.45 to 4.15 PM Therapeutic potential of music: chronobiological and traditional perspectives. Sumathy Sundar, PhD. Director, CMTER, Sri Balaji Vidyapeeth. 4.15 to 4.45 PM Question / answer session.
  17. 17. National Conference on Chronobiology and Health 17 SCIENTIFIC PROGRAMME Day 2: 19 March 2016 (Saturday) Venue: Ground Floor Lecture Hall, College Block 9.00 to 10.15 AM Panel discussion on chronotherapeutics: Chairperson: K Manimekalai Panelists: B Amirtha Ganesh R Pajanivel Gowri Dorairajan Sadish Kumar 10.15 to 10.30 AM Tea 10.30 to 11.00 AM Post test 11.00 AM to 12.30 PM Practice sessions at CYTER, I Block, First floor Practice sessions on adaptive resilience cyclic exercises and pranayam. Meena Ramanathan, Ananda Balayogi Bhavanani, Madanmohan 12.30 to 1.00 PM Valedictory 1.00 PM Lunch
  18. 18. National Conference on Chronobiology and Health 18
  19. 19. National Conference on Chronobiology and Health 19 ABSTRACTS
  20. 20. National Conference on Chronobiology and Health 20 Chronobiology – an overview Prof. KR Sethuraman. MD, PGDHE. Vice Chancellor, Sri Balaji Vidyapeeth (A Deemed University) Biological Rhythms are cyclical changes at the level of body chemistry or function. They can be i) internal or endogenous controlled by the internal biological clock e.g. body temperature cycle) or ii) external or exogenous (controlled by synchronizing internal cycles with external stimuli, e.g., sleep/wakefulness synchronizing with day/night. Such stimuli are called zeitgebers (German word meaning “time givers”). Zeitgebers include environmental time cues such as sunlight, food, noise, or social interaction and they help to reset the biological clock to a 24-hour day- night cycle. The circadian clock is genetic transcription-translation feedback machinery. It exists in most organs and cells, termed the peripheral clock, which is orchestrated by the central clock in the supra-chiasmatic nucleus. Depending on the duration, biological rhythms are:  Circadian rhythms – endogenously generated rhythms with a period close to 24 hours.  Diurnal rhythms – a circadian rhythm that is synchronized with the day/night cycle.  Ultradian rhythms – biological rhythms (e.g. feeding cycles) with a period much shorter (i.e., frequency much higher) than that of a circadian rhythm.  Infradian rhythms – biological rhythms with a cycle of more than 24 hours (e.g. the human menstrual cycle). Circadian is derived from a Latin phrase meaning “about a day”. Circadian rhythms have a period of approximately 24 to 25 hours. When the rhythm is synchronized with the day-night cycle, it is termed a diurnal rhythm. Physiological and behavioural rhythms of the circadian type include:  sleep/wakefulness cycle  body temperature
  21. 21. National Conference on Chronobiology and Health 21  hormone secretion patterns  blood pressure variation  digestive secretions  alertness level  reaction time Variations of circadian rhythm (the morning-evening types): “morningness” and “Eveningness” describe a person‟s individual circadian profile.  Most people fall somewhere between these two types.  Morning people usually prefer to rise between 5 a.m. and 7 a.m., and retire between 9 p.m.and 11 p.m.  Evening people tend to prefer both a later wake up (9 a.m. to 11 a.m.) and a later bed time (11 p.m. to 3 a.m.).  Morning people also tend to be more rigid in their circadian rhythms.  Evening people find adjustment to new schedules somewhat easier. Post-lunch dip effect: The "post-lunch dip" is a period of decreased alertness that strikes between 1 p.m. and 4 p.m. Most of us would have experienced this, especially after a heavy lunch. Between 1 pm and 4 pm:  work performance suffers  people in dimly lit meeting rooms are apt to nod off  The likelihood of getting into a car accident increases.  The body temperature, hormone levels and other physiological cycles place us at low ebb in the early afternoon, in contrast to periods of peak alertness we experience in the morning and early evening.  The post-lunch dip occurs even if we skip the lunch, but a heavy lunch exaggerates the effect. Strategies for coping with the post-lunch dip:  a brief power nap (no longer than 10-15 minutes)  a brisk walk outside  drinking tea, coffee or ice-cold juice  doing work that requires moderate physical exertion.  If possible, the most mentally demanding work should be done in the morning or evening, depending on a person‟s rhythm. Human errors and time-of-day:  Disasters caused by human errors, such as 3-Mile Island, Bhopal and Chernobyl, occurred at middle of the night.  The majority of single-vehicle driving accidents occur in the hours near dawn.
  22. 22. National Conference on Chronobiology and Health 22  Compared to nocturnal predatory animals, we humans have relatively poor night vision, hearing and smell. Therefore, our circadian rhythms put us to sleep at night for our own protection.  The biological imperative to sleep creates problems for shift work.  Studies revealed that performance of visual search is better in the morning than the evening.  Performance on thinking tests is better around lunchtime than in the morning or evening Caution: The above findings on time-of-day (TOD) effects are highly variable in any given individual and we should not generalize. Biorhythms theory - a myth A pseudoscientific theory claims that our lives are affected by 3 rhythmic cycles: – Physical – 23 days cycle; Emotional – 28 days cycle; Intellectual – 33 days cycle. A systematic review of 134 biorhythm studies found that there is no scientific evidence to support the theory. Chronotherapeutics Coordinating biological rhythms with medical treatment is called chronotherapy. It considers a person‟s biological rhythms in determining the timing and sometimes the amount of medication to optimize a drug‟s desired effects and minimize the undesired ones. Recent studies linking circadian rhythms with blood pressure control and type-2 diabetes have forced the scientists to look for the ways to set the clock right. The risks of myocardial infarction, cardiac arrest and of stroke are higher by 40%, 29% and 49% respectively, between 06:00 am and noon. Therefore, our focus has shifted towards chrono-therapeutics i.e., dosing of the medications at 10 pm with novel drug delivery systems to keep the drug levels high at 6 am and for 6 to 8 hours thereafter. A clinical study of 1995 has shown that administration of an HMG-CoA reductase inhibitor in the evening was more effective at lowering serum cholesterol levels than the same dose given in the morning, because higher rates of cholesterol synthesis occur during the evening hours. Another study in 2009 has revealed that the proportion of patients with controlled ambulatory blood pressure increased from 43% to 65% with single bedtime dose of angiotensin converting enzyme inhibitor, ramipril. To sum up, the physicians of 21st Century, who practise salutogenesis (promoting wellness) need to be aware of chronobiology and chronotherapeutics.
  23. 23. National Conference on Chronobiology and Health 23 Fundamental properties of circadian clocks – their cellular and molecular basis. Dr. Sheeba Vasu. PhD. Faculty Fellow, Neuroscience Unit, Jawaharlal Nehru Centre for Advanced Scientific Research, Bangalore, INDIA. E-mail: sheeba@jncasr.ac.in I will introduce the basic features of rhythms that would allow us to consider them as being driven by endogenous circadian clocks. The underlying genetic basis of circadian clocks was unraveled by researchers using classic genetic approaches and many critical genes that are involved in the functioning of the circadian clock were first discovered in fruit flies. These findings paved the way for studies in mammals and several other organisms. The anatomical and cellular identities of the circadian pacemakers were also investigated in parallel in many organisms. I will describe some studies from our own research group and that of others which showed that behavior of animals in more natural settings can reveal features not detected in standard laboratory studies. The characteristic features of circadian rhythms and their molecular, genetic and cellular basis will be discussed. Rhythms under natural conditions and behaviors underlying molecular clock will be explained.
  24. 24. National Conference on Chronobiology and Health 24 Blood pressure variability as a risk factor for cardiovascular diseases: chronobiological perspective Dr. Narsingh Verma. MD Professor of Physiology & Vice Dean, KGMU, Lucknow Blood pressure measurement by sphygmomanometer or automated devices is the routine approach for diagnosing hypertension in clinics, but patients may be misclassified due to masked hypertension or “white coat” hypertension. The addition of ambulatory blood pressure monitoring (ABPM), has helped in improving the diagnosis and treatment decisions. ABPM is not new as more than 50 years have passed since first attempt for ABPM was made by Hinman et al. in 1962. The potential of this technique was not recognized that time and nobody expected that it will soon become indispensable tool in day to day practice. Its recognition and acceptance in clinical practice took little time and now there is overflow of data using ABPM from different groups around the world. Study of circadian pattern of blood pressure has provided several insights into the patho-physiology of target organ damage in hypertensives. With identification of dipping and non dipping patterns among hypertensives the treatment goals have observed a paradigm shift from correcting the average blood pressure values to restoring the dipping pattern. Chronomics now guiding the drug therapy in such patients have made ABPM indispensible tool not only in diagnosing but overall management of hypertension. Recently several studies have increasingly demonstrated its application in identifying risk of target organ damage in Type 2 Diabetes and Kidney transplant patients. In this context our group is working on investigating circadian pattern of Blood Pressures among normal subjects, hypertensive patients, Type-2 Diabetes Patients and pregnancy induced hypertension. Some of the interesting findings from our group will be discussed during the meeting.
  25. 25. National Conference on Chronobiology and Health 25 Circadian rhythm and bipolar disorder Dr. Biju Vishwanath. MD, PhD Assistant Professor (DST INSPIRE), Dept. of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore. Bipolar disorder is a chronic severe neuropsychiatric illness with high rate of suicide. The exact biological basis of bipolar disorder or its pharmacological treatment is unknown. Over the last decade, circadian rhythm abnormalities in this disorder have been studied increasingly. Clinical, neuro-endo-phenotype and genetic studies in the field need to be highlighted. Recent studies of cell models offer exciting avenues to integrate the biology of this complex disorder along these lines of research.
  26. 26. National Conference on Chronobiology and Health 26 Nasal cycle and its therapeutic applications: a yogic perspective Yogacharya Dr Ananda Balayogi Bhavanani. MBBS, MD (AM). Deputy Director, Centre for Yoga Therapy, Education and Research (CYTER), Sri Balaji Vidyapeeth University, MGMC&RI Campus, Pondicherry. Yogachemmal Dr Meena Ramanathan. PhD (Yoga). Coordinator-cum-Yoga therapist, Centre for Yoga Therapy, Education and Research (CYTER), Sri Balaji Vidyapeeth University, MGMC&RI Campus, Pondicherry. Introduction: The nasal cycle is an ultradian rhythm of nasal congestion and decongestion with a quasi-periodicity of 60 to 240 minutes.(1) Keyser made the first formal description and the use of the term nasal cycle in 1895.(2) However the concept of the nasal cycle and an understanding of its role in our life had existed for long in Indian thought. The Vedic science of understanding the function of the nasal cycle was known as Swarodaya Vigjnan (swara = sonorous sound produced by the airflow through the nostrils in the nasal cycle, udaya = functioning state, and vigjnan = knowledge).(3) The Shivaswarodaya, an ancient treatise in Sanskrit literature advises the Yogi to undertake quieter, passive activities (soumyakarya) when the left nostril flow is dominant (ida / chandraswara), to engage in challenging and exertional activities (roudrakarya) when right nostril is dominant (pingala / suryaswara) and to relax or meditate when the bilateral nasal flow is operational (sushumnaswara) as it was considered to be unsuitable for performance of worldly activities. Ida swara (left nostril dominance) was described as feminine, Shakti and moon-like (chandra) while the pingalaswara (right nostril dominance) was described as masculine, Shiva and sun-like (surya). Traditional Indian description of Ardhanarishwara consists of Shakti (the female element) being depicted on the left and Shiva (the male element) on the right side of the body. Such a notion of left-right, female-male duality was common in oriental traditional medicine as also in western alchemy. (1) Postulated mechanisms: Various mechanisms were postulated for the occurrence of the nasal cycle and a great amount of research work has been done in this field. It has been seen that the use of Yoga Danda (T-shaped wooden implement used by the Yogis to regulate differential breathing patterns), pressure of a crutch in the axilla,
  27. 27. National Conference on Chronobiology and Health 27 pressure on the thorax while sitting and also the act of lying down on the side, can affect pattern of nasal dominance. (4-7)The nasal cycle is dependent upon the tonic activity of the limbic autonomic nervous system, the levels of circulating catecholamines and other neuro-hormones. Nasal congestion correlates with low sympathetic-high parasympathetic activity whereas decongestion is directly related to high sympathetic-low parasympathetic activity mode.(8) Compression of the hemi thorax from any surface lateral, anterior, posterior or superior leads to congestion of the ipsilateral nostril with simultaneous decongestion of the opposite nostril. (9) Eccles proposed that the hypothalamus was the centre for the sympathetic effects on the nasal mucosa and the nasal cycle.(10) Therapeutic applications: A group of pranayama, namely chandra and suryanadi (CN and SN, respectively) and chandrabhedana and suryabhedana (CB and SB, respectively) have uninostril breathing (UNB) and alternate nostril breathing (ANB) patterns using left and/or right nostrils, respectively. This type of yogic nostril manipulation is also furthered in nadishuddhi (NS), a specific technique involving alternate use of both nostrils in a specific pattern. It has been previously suggested that right nostril dominance in the nasal cycle as well as right UNB may be correlated with the “activity phase” of the basic rest-activity cycle, the time during which sympathetic activity in general exceeds parasympathetic activity throughout the body. (11) These yogic UNB and ANB techniques have captured the imagination of researchers worldwide and recent studies have reported their differential physiological and psychological effects including effects on O2 consumption, metabolism and body weight,(12) blood glucose,(11)involuntary blink rates(11) and intraocular pressure, (13) heart rate (HR), stroke volume and end diastolic volume(14)as well as skin resistance, digit pulse volume, and blood pressure (BP).(15)ANB (as done in NS pattern) has been reported to rapidly alter cardiopulmonary responses and improve simple problem solving. (16)Yogic breathing through right, left, or through both nostrils alternately produce distinct autonomic changes: right UNB increased systolic pressure (SP) and diastolic pressure (DP), whereas left UNB resulted in significant reduction in SP and mean pressure (MP).(17) Shannahoff-Khalsa suggested that mechanical receptors in the nasal mucosa register flow of air across membranes (unilaterally) and transmit this signal ipsilaterally to the hypothalamus, the highest center for autonomic regulation. (11) Even alternating left- right levels of catecholamines have been found to occur in peripheral circulation of resting humans with rhythms coupled to the nasal cycle. (18)It is possible that the right nostril initiated techniques are producing such a state of autonomic arousal, whereas left nostril initiated techniques are inducing autonomic relaxation/balance in our subjects.
  28. 28. National Conference on Chronobiology and Health 28 Research studies at CYTER: Our studies at CYTER have demonstrated that right and left yogic UNB and ANB techniques have differential physiological effects.(19-21) Right nostril initiated UNB and ANB techniques (SB and SN) induce a state of arousal through sympathetic activation and/through increased ascending reticular activity and/or by central action at the primary thalamo-cortical level. On the other hand, left nostril initiated UNB and ANB techniques (CB, CN, NS) delay reactivity of the subjects by inducing a sense of inert lethargy and may induce a state of parasympathetic dominance as seen in CV parameters. This finding is in tune with the traditional swara yoga concept that air flow through right nostril (SN and pingalaswara) is activatory in nature, whereas the flow through left nostril (chandranadi and idaswara) is relaxatory. Further studies in different populations and in patients of different conditions, as well as over different periods of time, may provide a more detailed understanding of the therapeutic potential of these simple and effective pranayama techniques. References: 1. Bhavanani AB. Swarodaya vigjnan. A scientific study of the nasal cycle. Yoga Mimamsa.2007; 39: 32–38. 2. Kayser R. Die exakte Messung der Luftdurchgängigkeit der Nase. Arch. Laryng. Rhinol (Berl.) 1895; 3: 101-210. 3. Giri R, Shankar G. Swara Yoga - an introduction and its applications. Nisargopachar Varta 2001; 1: 18-20. 4. Rao S, Potdar A. Nasal airflow with body in various positions. J Appl Physiol 1970; 28:162-65. 5. Block RA, Arnott DP, Quigley B, Lynch WC. Unilateral nostril breathing influences lateralised cognitive performance. Brain Cognit 1989; 9:181-90. 6. Davies AM, Eccles R. Reciprocal changes in nasal resistance to air flow caused by pressure applied to the axilla. Acta Otolaryngol (Stockh) 1985; 99:154-59. 7. Mitti Mohan S. Reflex reversal of nostril dominance by application of pressure to the axilla by a crutch. Indian J of Physiol Pharmacol 1993; 37: 147-50. 8. Deshmukh VD. Limbic autonomic arousal: its physiological classification and review of the literature. Clinical Electroencephalography 1991; 22: 46-60. 9. Singh V. Thoracic pressure and nasal patency. J Appl Physiol 1987; 62: 91-94. 10. Eccles R. The Central Rhythm of the Nasal Cycle. Acta Oto-Laryngologica 1978; 86: 464-68. 11. Shannahoff-Khalsa DS. Unilateral forced nostril breathing: Basic science, clinical trials, and selected advanced techniques. Subtle Energies and Energy Med J. 2002; 12: 79–106. 12. Telles S, Nagarathna R, Nagendra HR. Breathing through a particular nostril can alter metabolism and autonomic activities. Indian J Physiol Pharmacol 1994; 38: 133–37. 13. Mohan SM, Reddy SC, Wei LY. Modulation of intraocular pressure by unilateral and forced unilateral nostril breathing in young healthy human subjects. Int Ophthalmol 2001;24: 305–11. 14. Shannahoff-Khalsa DS, Kennedy B. The effects of unilateral forced nostril breathing on the heart. Int J Neurosci 1993; 73: 47–60. 15. Telles S, Nagarathna R, Nagendra HR. Physiological measures of right nostril breathing. J Altern Complement Med 1996; 2: 479–84. 16. Subbalakshmi NK, Saxena SK, Urmimala, D'Souza UJ. Immediate effect of „Nadi-shodhana Pranayama‟ on selected parameters of cardiovascular, pulmonary, and higher functions of brain. Thai J Physiol Sci 2005; 18: 10– 16. 17. Raghuraj P, Telles S. Immediate effect of specific nostril manipulating yoga breathing practices on autonomic and respiratory variables. Appl Psychophysiol Biofeedback 2008; 33: 65–75. 18. Kennedy B, Ziegler MG, Shannahoff-Khalsa DS. Alternating lateralization of plasma catecholamines and nasal patency in humans. Life Sci 1986; 38: 1203–14. 19. Bhavanani AB, Ramanathan M, Balaji R, Pushpa D. Differential effects of uninostril and alternate nostril pranayamas on cardiovascular parameters and reaction time. Int J Yoga 2014; 7: 60-65. 20. Bhavanani AB, Ramanathan M, Madanmohan. Immediate effect of alternate nostril breathing on cardiovascular parameters and reaction time. Online International Interdisciplinary Research Journal 2014; 4: 297-302. 21. Ramanathan M and Bhavanani AB. Immediate effect of chandra and suryanadi pranayamas on cardiovascular parameters and reaction time in a geriatric population. International Journal of Physiology 2014; 2: 59-63.
  29. 29. National Conference on Chronobiology and Health 29 Chronobiology of ageing: role of telomere and lifestyle intervention Dr. Vivek Kumar Sharma. MD Additional Professor of Physiology, Jawaharlal Institute of Postgraduate Medical Education & Research,Pondicherry-605006 Contact No: 04132296849; 9442529673. Email: drviveksharma@yahoo.com Recent studies document that telomere length and telomerase cellular are not only associated with chronobiology of ageing but also accelerated ageing in various cardio- metabolic disorders like coronary artery disease, diabetes, hypertension etc and their associated complications. Telomeres are “expendable” repetitive (TTAGGG) sequences at the end of chromosomes. Telomere length-telomerase enzyme activities are affected by oxidative stress, inflammation and cellular proliferation, and thus form an association with chronobiology of ageing and related diseases. Recent research in the field of telomere length dynamics documents that chronobiology of ageing and age-related diseases have a synergistic effect on telomere length-telomerase activity and as well as effect telomere length independently also. Reports suggest decreased telomerase activity that reflects greater tissue ageing and prevalence of senescent phenotypes in various tissues marking the progression of the accelerated chronobiology of aging. There has been an alarming increase in non-communicable diseases worldwide including India in recent decades due to the adoption of modern lifestyle, unplanned urbanization, dietary changes, physical inactivity, socio-economic changes and accompanied stress. By 2015, 50-60 % of deaths in India will be attributed to lifestyle related disorders including obesity, coronary artery disease and diabetes mellitus. Benefits of life-style intervention including yoga, meditation and increased physical activity are universally known and recent studies indicate higher levels of telomere- telomerase system activity in subjects participating in these interventions thereby, suggesting subcellular changes and delayed chronobiology of aging in the practicants. Therefore, Telomere-Telomerase system may be considered as a potential therapeutic target for life-style modification related interventions in studying the chronobiology of accelerated aging conditions. Two recent western studies have documented that 12 weeks of intensive meditation and lifestyle changes significantly increased peripheral blood telomerase activity, immune function, reduced stress parameters and promoted more meaningful life in the participants. There is paucity of data on studying the relationship of life-style interventions with chronobiology of aging in healthy and diseased Indian population and this can be contemplated by the scientific community.
  30. 30. National Conference on Chronobiology and Health 30 Circadian sleep disorders: are they lifestyle associated? Prof. PN Ravindra. MD, PhD (Neurophysiology) Professor and Head, Dept of Physiology Akash Institute of Medical Sciences and Research Centre, Bangalore. Melatonin is evolutionarily highly conserved molecule present in a spectrum of plant and animal species that play a major role in circadian rhythm regulation. Melatonin is a central time keeper (Zeitgeber) synthesized and secreted by pineal gland, a central structure in the circadian system. Pineal gland was considered as a functionless rudimentary organ until 1958 when Aaron Lerner and colleagues (Lerner, 1958) isolated pineal active substance . They (Lerner, 1959) named this compound as melatonin, a „hormone of darkness‟ and described its chemical structure as N-acetyl- 5-methoxytryptamine. Light is the most dominant powerful environmental source that regulates melatonin synthesis. Photic stimuli through retina are transmitted to suprachiasmatic nucleus (SCN), the master circadian clock. SCN in turn conveys the signal to pineal gland for melatonin synthesis. In this process, noradrenergic fibers of cervical ganglion, is the one that ensures proper translation of photic information into melatonin synthesis. Therefore, in addition to light, the levels of noradrenalin in these neurons also play important role in synthesis of melatonin. It is to be noted that the photoreceptors (melanospin containing retinal ganglion cells) that are sensitive to light in the range between 446-484 nm (blue light) are primarily involved in stimulating melatonin synthesis (Lewy and Sack, 1989). Therefore, visual blindness doesn‟t necessarily cause circadian misalignment but for the absence of melanospin or its connection to SCN if not intact. However, with development of cataract and constriction of pupil with age, the transmission of light waves of shorter wave length may be impeded, thereby, causing alteration in melatonin rhythm and ensuing sleep problems. The most striking feature of melatonin is its daily variations that are sensitive to light– dark cycle and its release is at peak towards darkness. These circadian variations in melatonin play major role in bringing about normal daily rhythms in hormonal secretion, temperature variations, sleep-wake cycle etc. Melatonin peak is followed by drop in the core body temperature; these two factors play important role in inducing sleep (Karasek and Winczyk, 2006). This relationship between melatonin and core body temperature follows even during therapeutic administration of melatonin
  31. 31. National Conference on Chronobiology and Health 31 agonists, wherein, temperature drops down within 2-3 hours after administration (Verster, 2009). Alterations in normal circadian variations of melatonin either due to exposure to bright light during biological night (as in shift work, late night work etc) or pathological conditions tends to misalign the circadian rhythm thereby bringing various sleep related problems. The classical circadian rhythm disorders include delayed sleep phase syndrome, advanced sleep phase syndrome, jet lag, shift work, and free running type as seen in the visually challenged people (Martinez and Lenz, 2010). However, there can be circadian disorder due to genetic mutations of circadian genes, medical conditions (insulin resistance, parkinsonism, cirrhosis, renal failure etc.), medications and drug abuse as well. Few common circadian sleep disorders are explained briefly here (Phyllis et al 2013, L Sack et al, 2007). Delayed sleep phase disorder (DSPD): This is characterized by recurrent difficulty in falling asleep or wakeup in socially acceptable time. There will be a delay of more than two hours than conventional acceptable time to bed and waking up. However, the important characteristic of this disorder is that the circadian rhythm of the person will get persistently be delayed that brings about significant impairment in individuals social life. DPSD is most commonly observed in adolescent primarily due to socially enforced alterations in sleep-wake scheduled associated with late night social activities. The symptoms exacerbate with decreased light exposure in the morning and bright light exposure in late evening hours. However, genetic basis with polymorphism of circadian clock gene is also implicated in developing DPSD. It has been reported that DPSD patients have diminished ability to compensate for the sleep loss in spite of having high homeostatic drive. In managing DPSD, chronotherapy, secluding the timing of sleep, would synchronize circadian rhythm. Sleep scheduled is delayed gradually for several hours a day until the target time is reached. After reaching the target time patients are advised to keep the regular sleep-wake scheduled. In addition to this, bright light exposure during morning hours with evening melatonin administration is known to realign the circadian rhythm in DPSD patients. Advanced sleep phase disorder (ASPD): characterized with early sleep time than the conventional socially acceptable timings i.e. feeling extremely sleepy in late afternoon and evening hours and earlier wake up time (between 2 - 5 am) than desired. This is generally found with aging. Shortened circadian time due to mutation of circadian clock gene is one of the causes for ASPD. The most reported complications of this are alcoholism, sedative and other drug abuse. The usual treatment is exposure to light in evening so as to suppress their melatonin secretion and postpone the sleep. Patients are encouraged to take melatonin supplements in early morning hours so that sleep is continued and wake up after sunrise.
  32. 32. National Conference on Chronobiology and Health 32 Jet lag disorder: Is a temporary misalignment of circadian clock due to travel across at least two different time zones. The symptoms like disturbed sleep, generalized weakness, decreased day time attention, mood disturbance etc occurs with one or two days of travel. The severity of symptoms depends on the number of time zones and the direction of travel. Travelling from east to west is less severe than travelling from west to east ward. The sleep problems parse with eastward travel include difficulty in falling asleep and awakening next day, whereas, with west bound travel individual experiences excessive sleepiness in evening and early morning awakening. The treatment of jet lag syndromes is focused bringing desired sleep and wake time in accordance to destination travelled with improving nocturnal sleep and increasing day time alertness. However, if the stay in the destination is for 2 days and less, then measures taken for circadian adaptation will be counterproductive. In the measures to be taken, planned exposure or avoidance to light is advised. Travelers towards east, are advised to avoid light exposure in early morning (enhance melatonin secretion) and expose to bright light in late morning and afternoon (decrease melatonin secretion). In west ward travel, expose to light during afternoon and early evening, not to go to sleep till nighttime of the place. However, with melatonin (0.5 to 10mg) administration during early evening hours well in advance before the travel towards east and during night time at the destination, the severity of jet lag syndromes can be minimized. Shift work disorder: Characterized by history of excessive sleepiness during the day and insomnia during sleep period at least for one month due to unconventional work secludes. This will bring impaired work performance, decreased alertness and cognition there by increasing the risk of accidents in the work place. This is associated with higher incidence of cardiovascular comorbid conditions, metabolic syndromes, endometrial and breast cancer etc., Exposure to intense light during night work and avoiding light during day respectively will help to reduce sleepiness during work and to induce sleep in the day. Exposure to light during night works hours should be to 1000 -10,000 lux until 2 hours prior to end of the shift. Melatonin consumption before bed will enable good sleep, but, do not improve the alertness during work. Therefore, melatonin and light therapy should be combined in individuals with shift work disorder. In addition to these circadian rhythm disorders, melatonin administration in old age aids in preventing many neurodegenerative conditions, insomnia, neuropsychiatric conditions like depression as mentioned above, in schizophrenia, eating disorders, intractable epilepsy etc., Interestingly, meditation (Vipassana) is known to enhance endogenous melatonin levels across age groups in experienced practitioners (Ravindra et al, 2012). Apart from therapeutic potential, melatonin role as an antioxidant, immune enhancing, oncostatic; hence, its supplement has positive role in maintaining general health and wellbeing as well.
  33. 33. National Conference on Chronobiology and Health 33 References: 1. Lerner. Isolation of melatonin,pinalfactorthat lightens melanocytes. J Am Chem Soc.1958; 80:2587. 2. Lerner. Structure of mealtonin. J Am Chem Soc.1959; 81:6084. 3. Lewy AJ, Sack RL. The dim light melatonin onset as a marker for circadian phase position. Chronobiol Int. 1989; 6:93-102. 4. Karasek M, Winczyk K (2006) Melatonin in humans. J Physiol Pharmacol.2006; 57 Suppl 5:19-39. 5. GC Verster .Melatonin and its Agonists, Circadian Rhythms and Psychiatry. Afr J Psychiatry.2009;12:42-46,. 6. Denis Martinez & Maria do CarmoSfreddo Lenz. Circadian rhythm sleep disorders. Indian J Med Res.2010; February 131, pp 141-149, 7. Phyllis C. Zee,HrayrAttarian,AleksandarVidenovic. Circadian Rhythm Abnormalities. Continuum (MinneapMinn).2013;19(1):132–147. 8. Robert L Sack, Robert L Sack, Dennis Auckley, R. Robert Auger, Mary A. Carskadon, Kenneth P. Wright Jr, Michael V. Vitiello, Irina V. Zhdanova.An American Academy of Sleep Medicine Review Circadian Rhythm Sleep Disorders: Part I, Basic Principles, Shift Work and Jet Lag Disorders. SLEEP.2007; 30( 11): 1460-1483. 9. Robert L Sack, Robert L Sack, Dennis Auckley, R. Robert Auger, Mary A. Carskadon, Kenneth P. Wright Jr, Michael V. Vitiello, Irina V. Zhdanova.An American Academy of Sleep Medicine Review Circadian Rhythm Sleep Disorders: Part II, Advanced Sleep Phase Disorder, Delayed Sleep Phase Disorder, Free-Running Disorder, and Irregular Sleep-Wake Rhythm SLEEP.2007a; 30( 11):1484-1501. 10. Ravindra P.N, NirmalaMathurai,Bindu M Kutty „ Meditation its regulatory effect on sleep‟ Frontiers in Neurology. April 2012; 3(54): 1-3.
  34. 34. National Conference on Chronobiology and Health 34 Chronotherapeutics Prof. K Manimekalai. MD Professor Head, Department of Pharmacology, Mahatma Gandhi Medical College & Research Institute, Sri Balaji Vidyapeeth Deemed University, Pondicherry Chronotherapeutics is the delivery of medications in the right concentration to the right targeted tissues at the right time to meet biological rhythm-determined needs, e.g., rhythms in the mechanisms of disease, symptom intensity, and/ or patient tolerance, to optimize desired and minimize and avert adverse effects. The following are the diseases with established oscillatory rhythm in their pathogenesis 1. Asthma Symptoms of asthma occur 50 to 100 times more often at night than during the day. Cortisol levels were highest at the time of awakening and lowest in the middle of the night, and histamine (a mediator of broncho constriction) concentrations peaked at a level that coincided with the greatest degree of bronchoconstriction at 4:00 am. 2. Pain The sensitivity threshold of the gingiva to a cold stimulus was maximal at 18:00 h and reached a peak at 03:00 h (35% difference). Tooth sensitivity was lowest between 15:00 and 18:00 h; with a peak in pain intensity at 08:00 h (160% increase).The peak of morphine use occurred at 09:00 h and was the least at 15:00 h in patients undergoing elective surgery. The peak demand for morphine or hydromorphone occurred in the early morning and was lowest during the night in postoperative gynecologic patients. 3. Arthritis Patients with osteoarthritis tend to have less pain in the morning and more at night; while those with rheumatoid arthritis, have pain that usually peaks in the morning and decreases throughout the day. Chronotherapy for all forms of arthritis using NSAID‟s such as ibuprofen should be timed to ensure that the highest blood levels of the drug coincide with peak pain. For osteoarthritis sufferers, the optimal time for a non-steroidal anti-inflammatory drug such as ibuprofen would be around noon or mid-afternoon. The same drug would be more effective for people with rheumatoid arthritis when taken after the evening meal.
  35. 35. National Conference on Chronobiology and Health 35 4. Cardiovascular diseases Several functions (e.g. BP, heart rate, stroke volume, cardiac output, blood flow) of the cardiovascular system are subject to circadian rhythms. For instance, capillary resistance and vascular reactivity are higher in the morning and decrease later in the day. Platelet aggregability is increased and fibrinolytic activity is decreased in the morning, leading to a state of relative hypercoagulability of the blood. Numerous studies have shown an increase in the incidence of early-morning myocardial infarction, sudden cardiac death, stroke, and episodes of ischemia. BP is at its lowest during the sleep cycle and rises steeply during the early morning awakening period. 5. Duodenal ulcer In peptic ulcer patients, gastric acid secretion is highest during the night. Suppression of nocturnal acid is an important factor in duodenal ulcer healing. Therefore, for active duodenal ulcer, once daily at bed time is the recommended dosage regimen for H2antagonists. At nighttime, when gastric motility and emptying are slower, drug disintegration, dissolution, and absorption may be slower. 6. Hypercholesterolemia Cholesterol is synthesized during the night as well as during daylight; however the maximal production occurs early in the morning, i.e. 12 h after the last meal. Studies with HMG CoA reductase inhibitors have suggested that evening dosing was more effective than morning dosing. 7. Diabetes The goal of insulin therapy is to mimic the normal physiologic pattern of endogenous insulin secretion in healthy individuals, with continuous basal secretion as well as meal-stimulated secretion. Providing basal insulin exogenously to patients with Type 1 diabetes inhibits hepatic glucose production. Exogenous administration of mealtime doses promotes peripheral glucose uptake (i.e. it prevents postprandial increases in blood glucose concentration) as well as reducing hepatic glucose release.
  36. 36. National Conference on Chronobiology and Health 36 Therapeutic potential of music: chrono-biological and traditional perspectives Prof. Sumathy Sundar. PhD Director, Centre for Music Therapy Education and Research (CMTER), Mahatma Gandhi Medical College and Research Institute, Pondicherry Chronobiology is the science of understanding of biological rhythms in respect of life, health and disease observing the cyclical repeated variation in a biological function that gives a time sense to every living organism. However the roots of chronobiology can be traced back even in the Vedic traditions in Indian culture roughly 4000 to 4500 years ago. Ayurvedic physicians of the Vedic period indicated three phases in which the activation of certain bodily functions is sometimes stronger, sometimes weaker and coined the terms vata, pitta and kapha to express this phenomenon. Evidences have also been documented linking cycles of time with musical performances in ancient times and recorded relation between scales and the different bodily functions. Time theory of ragas prescribes specific time to perform specific Indian ragas according to the tonal characteristics corresponding to vata, pitta and kapha biological cycles in the human body. This presentation deals in detail with the ancient wisdom or the art of understanding the biological rhythms, entraining and resetting them through music as an external stimulus and how far these ideas are explored and integrated in the modern music therapy, clinical practice and research and integrative medicine. This paves way for deep understanding of the patterns of biological rhythms and the mutual relationships between music, health and illness and also preserve the health and promote healing under integrative medicine.
  37. 37. National Conference on Chronobiology and Health 37 Adaptive resilience exercises as envisioned in yoga Yogachemmal Dr Meena Ramanathan. PhD (Yoga). Coordinator-cum-Yoga therapist, Centre for Yoga Therapy, Education and Research (CYTER), Sri Balaji Vidyapeeth University, MGMC&RI Campus, Pondicherry. Yogacharya Dr Ananda Balayogi Bhavanani. MBBS, MD (AM). Deputy Director, Centre for Yoga Therapy, Education and Research (CYTER), Sri Balaji Vidyapeeth University, MGMC&RI Campus, Pondicherry. The tree that bends doesn’t break! As human beings, it is inevitable that we have our share of ups and downs. Something always pushes us down, throws us off-balance and makes us uneasy. During such moments, it is imperative that we stop, take a step back and observe ourselves objectively to understand how long it takes us to bounce back to normalcy once again. The faster we can disentangle ourselves from events of the past, the faster we begin experiencing freedom in the present. This is where Yoga comes in, to rescue us from this vicious negative spiral of mental and emotional whirlpools that suck us down into the depths of despair. Yoga may be understood as a conscious and evolutionary path that enables us to break free from our conditioned patterns (samskara) that take us nowhere. Yoga teaches us that we need to make conscious choices to do the following: 1. Let go of the negativities beseeching us (doshanivarana), 2. Regain our balance, equipoise (samatvam) at the earliest, 3. Relax ourselves so that we can rebuild and replenish our resources (nishpanda kaya kalpaanukrama). 4. Empower ourselves to efficiently face „repeat challenges‟ by: a. Adopting healthy attitudes (pratipakshabhavanam, maitri-karuna et al),
  38. 38. National Conference on Chronobiology and Health 38 b. Enhancing flexibility of body, mind, emotions and spirit (hatha yoga), c. Developing objective self-awareness (vairagya, swadhyaya) d. Creating positive relationships through acceptance (samabhavabhavana). Mind, body and emotions of the individual are harmonised and brought into a state of balance by the various Yoga techniques. The practice of jathis and kriyas helps loosen up inherent tensions, stresses, and regressed emotions. They can be then thrown out through conscious breath-body-mind workouts such as nasargamukhabhastrika and the pawanmukta series. Nada Yoga techniques that utilise sound power like the hakarakriya, brahma mudra and bhramari pranayama are efficient methods to release pent-up tensions. These practices produce psycho-somatic energisation and create a beautiful mind-body harmony, stabilising emotions thus teaching us to „let go and be free‟. Through Yogic relaxation techniques such as shavasana, we consciously overcome our self-defeating tendencies and re-invigorate ourselves physically, mentally, and emotionally. Many studies have reported that Yoga reduces allostatic load and induces balance of autonomic nervous system. This is the keystone in developing adaptive resilience. The very sound of the word resilience captures its bouncy, rubbery quality. Yoga enables an alignment of panchakosha, the five sheaths of existence - the body, breath, emotions, intellect and spirit. Jnana yoga kriya-s and prakriya-s enable inherent healing energies to integrate, reunite and bring together fragmented parts of the individual thereby enhancing such adaptive resilience. Yoga also empowers the spirit, developing a deep and subtle adaptive resilience that promotes the skilful stepping beyond of one‟s limitations, enabling self-transformation (atmabhavabhavana). This facilitates insight, empathy and an ability to calm and focus the mind, thus ultimately transcending all limiting traits of the individual. Such a transformation of the individual until they manifest their fullest potential, and live life as it is meant to be, is truly the goal of Yoga itself.
  39. 39. National Conference on Chronobiology and Health 39 Pranayam and its physiological basis Prof. Madanmohan. MD, DSc, FIAY Professor & Head, Department of Physiology, MGMC& RI & Director, Center for Yoga Therapy, Education & Research (CYTER), Sri Balaji Vidyapeeth. Vedic concept of universal, divine pran occurs in many ancient scriptures. Pran is the omnipresent energy whose Divine source Paramatma is called as pranasyapranah (Ken Upanishad, 1:2). On the physical plane, pran manifests as physical energy like light and heat and this whole universe vibrates with pran (Kath Upanishad, 6:2). On the biological plane, pran manifests as life energy (“ki” in reiki) and acts as a catalyst in our all activities. In Bhagavadgita (15:14), YogeshwarKrishn says that “Pran manifested as digestive power, it is I who digests the food”. Being superior, holy and higher power (Brhdaranyak Upanishad, 6:1:1), pran should be used only for higher, noble purposes and never for lower pursuits. Breathing is the most tangible expression of pran and pranayam is an ingenious method for enhancing our vitality by drawing pran from inexhaustible and omnipresent universal source. Pranayam means conscious expansion of pran (the life force) and is the 4th limb of Patanjali‟sashtang (8-limbed) yoga. Yoga is holistic and pranayam is best practiced as a component of full, holistic yoga discipline. There are many types of pranayams. Some involve rapid breathing whereas others involve slow, uniform breathing, with or without ratio between the phases of respiration. Yoga is a psychosomatic technique. Pranayam breathing should be uniform and with meditative awareness. Thus performed, pranayam enhances one‟s ability to combat physical as well as psychological stress. From the physiological point of view, pranayam is of great significance. Deep breathing with maximum contraction of diaphragm and intercostal muscles results in: 1. Massage of abdominal viscera and improved venous return. 2. Stretching of all parts of thorax and lungs with resultant increase in compliance and vital capacity. 3. A definite pattern of proprioceptive input from thorax and abdomen. This, along with a pattern of activity in respiratory center may modulate the neuronal activity of other medullary centers/brain areas.
  40. 40. National Conference on Chronobiology and Health 40 4. Fluctuations in blood gas content and altered proprioceptive input may alter the sensitivity and activity of chemo reflex and other neuronal circuits. 5. Breathing meditatively with full concentration results in conscious alteration of cerebral activity and improves mind-body coordination, the goal of yoga. Rhythmic breathing in a relaxed state of mind (e.g. savitri pranayam) can produce deep psychosomatic relaxation and significant decrease in oxygen consumption within a few minutes. (Madanmohan et al. The Yoga Review, 3: 25-34, 1983).
  41. 41. National Conference on Chronobiology and Health 41 Melatonin & chronobiology Dr. Suchitra B Parkhad Assistant Professor, Department of Physiology Mahatma Gandhi Medical College & Research Institute Melatonin, also known as the “mother hormone of chronobiology,” is a hormone made in the pineal gland due to cues from the supra-chiasmatic nucleus of the hypothalamus, which regulates the circadian rhythm. When the retinas stop sensing as much blue wavelength light, the supra-chiasmatic nucleus senses this and induces the pineal gland to begin making melatonin. When early morning light is sensed by the retinas, melatonin production is ceased and hormones associated with wakefulness are made instead. This cycle helps to create a circadian rhythm, or 24-hour sleep- wake cycle. Melatonin has a very short half-life of about 30 minutes. Because it breaks down so quickly, it must be made continuously throughout the night in order to sustain restful sleep. In people with a healthy circadian rhythm, melatonin levels rise rapidly after dark and plateau throughout the night until early morning. These high levels are essential not just for falling asleep, but for sleeping deeply and restfully. Melatonin levels then drop sharply in the early morning to allow people to wake up in response to increasing light levels. The dangers of sleep disturbances & melatonin deficiencies Chronic sleep disturbance in an average of three out of seven nights raises the likelihood of heart attack, stroke, diabetes, vascular disease, and medically problematic obesity considerably. A team at the University of Pennsylvania is analyzing the huge data collection from more than 130,000 people (average age of 46) for the first time, and was able to draw the following conclusion: Even minimal interference with sleeping in, sleeping soundly, as well as sleeping too much can make a big difference. The risk for obesity increased by 35%, for diabetes by 54%, and for cardiovascular illness by 98%, and the risk for stroke doubled. Researchers of the Harvard Medical School are concentrating on the 90 to 120 minutes every night that provide healthy people with actual deep sleep. They recruited 784 men with normal blood pressure who allowed their sleep cycles to be monitored at home with the help of a small machine. This was done for 42 months.
  42. 42. National Conference on Chronobiology and Health 42 Normally deep sleep makes up about 25 percent of one night. In this phase brain activity is weakened and the heartbeat and the disbursement of stress hormones are reduced. Blood pressure readings during this time are typically 10 points lower than normal. Nightly pressure decline is seen as very positive. However, a condition in which the pressure stays low is seen as a risk factor for heart conditions. The results were, that those men who had a noticeably shorter regeneration phase, reacted with increased blood pressure of dangerous proportions (several of those monitored only reached four percent of deep sleep, or fifteen minutes). Most of these generally had interrupted and shortened sleep. As mother hormone of chronobiology, melatonin not only directs sleep patterns, but also the activity of all organs. One consequence is that with age the frequent lack of melatonin affects the liver negatively by leaving it without a sense of direction at night, which in turn impacts the glycol-metabolism. Aging &melatonin production Not only are modern humans the only living creatures who diverge from their rhythms and turn night into day – the older we get, the lower the nightly production of melatonin becomes, and the shorter the signal it transmits to the other glands becomes. Often, it does not become active until well after midnight. At daybreak, however, the secretion of this hormone continues to stop on time. The result is that older people are exposed to the sleep hormone for a time span that is much too short, and the hormone becomes available less and less overall. For the older pineal gland sufficient nighttime production of melatonin is no longer possible, even when the body is exposed to complete darkness. The pineal gland is heavily supplied with blood and like other areas with vessels, it is predestined to suffer from calcification–this leads to pronounced insomnia. Melatonin deficiency is also reflected in the disrupted rhythmicity of the downstream hormone systems. A decrease in female sex hormones may be a factor in the early onset of menopause. It also threatens to slow down the production of the growth hormone HGH, also called the “vitality hormone.” Insufficient melatonin also affects the liver, when it is not effectively programmed at night. This can cause insulin resistance, which can lead to diabetes. In addition, the urge to urinate at night remains at a daytime level when a special anti-hormone (ADH) is missing due to a lack of melatonin. Melatonin deficiency has particular effects directly on the brain. All nightly repair mechanisms become diminished. The storing of information into long-term memory, which takes place at night, is impeded. This increases the susceptibility to early-onset dementia and neurodegenerative processes. The British Journal of Ophthalmology recently published an alarming connection between aging eyes and the production of melatonin. Measurements demonstrate that after 45 years of age less rays of sunlight reach the inner eye. This is a result of subtle yellowing of the ocular lens and narrowing of the pupil. Because of this, less light particles reach the key cells of the retina which are dependent on the day and night
  43. 43. National Conference on Chronobiology and Health 43 rhythm to regulate our internal clocks. Studies show that the changes in the aging eye lead to a number of typical eye ailments, for which the cause is not searched for in the eye itself. Consequences of the deterioration of eye performance include cognitive deficiencies (especially memory capacity), sleeplessness, depression, and lengthened reaction times. Our internal clocks react to the changes in light and dark, and manage our circadian rhythms. They give each organ an impulse for daily and nightly tasks. The brain, for example, saves the information gathered during the day as long-term memory, or deletes it entirely. These trigger signals are transferred especially through the mother hormone of chronobiology, melatonin. Older people, however, only have a fraction of this neurotransmitter available. This leads not only to widespread problems of staying asleep in the morning and throughout the night, but also to impairment of the correct daytime activities of major organs, for example the liver or nerves, in the course of a 24 hour day. Melatonin supplements Recent studies in chronobiology have indicated that melatonin supplements can help treat circadian sleep disorders as well as a variety of sleep-related issues. However, not all melatonin supplements are created equal. The way melatonin supplements are metabolized can have a huge effect on physiological levels and effects of this hormone. Studies in circadian biology have shown how important melatonin levels are to maintaining a natural human sleep-wake pattern. In fact, studies have found that many sleep disorders improve significantly with melatonin supplementation. However, some people find that melatonin doesn‟t work as dramatically as they expected. They may assume that melatonin is not a useful treatment for their sleep issues when, in fact, they could be simply taking the wrong kind of melatonin supplement. The most common types of melatonin supplements are fast release and slow release. Fast release melatonin causes a sharp spike in melatonin levels that drops off after an hour. People who use this type of melatonin supplement may find that they are immediately sleepy but have trouble remaining asleep or do not get high quality sleep. Slow-release melatonin, on the other hand, takes hours to build up to sleep-inducing levels and then does not wear off in the early morning. People who take slow release melatonin may have trouble falling asleep due to low melatonin levels, followed by difficulty waking up because the levels are unnaturally high.
  44. 44. National Conference on Chronobiology and Health 44 Timed-Release Melatonin: A Better Option for Maintaining Natural Circadian Rhythms Timed-release melatonin is a supplement that is formulated to be released in amounts that mimic healthy, natural melatonin levels. It is metabolized so that levels rise sharply after the supplement is taken and then remain at a high plateau for several hours. Levels then drop sharply to allow for waking. This mimics the healthy, normal circadian rhythm cycles that are linked to restful sleep. Research in chronobiology has shown that maintaining melatonin cycles is important not just to restful sleep but also to overall health. For this reason, an increasing number of health experts are recommending timed-release melatonin as the ideal melatonin supplement. It more closely correlates to the natural levels of melatonin in a healthy brain. Maintaining a healthy circadian rhythm is important to health, so timed-release melatonin supplements are usually the best option.
  45. 45. National Conference on Chronobiology and Health 45 POSTERS
  46. 46. National Conference on Chronobiology and Health 46 Physiological significance of retinal melatonin Qurratul Ain Sayeed Dept. of Physiology, DCMS, Hyderabad The circadian signaling molecule, melatonin, is secreted into the circulation from the pineal gland, and is also produced within specific ocular cells such as retinal photoreceptors, ciliary epithelial cells, and perhaps cells of the lens.In addition many ocular tissues themselves exhibit circadian rhythm activity to optimize specific processes which require coordination with the light-dark cycle.Melatonin receptors have been identified in many ocular tissues, including the neural retina, retinal pigment epithelium, ciliary body, cornea, sclera, and lens. This mini paper tries to review physiological significance of ocular melatonin in a very brief manner including following points. 1. Melatonin causes aggregation of melanin in RPE and clumping of pigment granules in the chromatophores in choroid. It activates disc shedding in rod photoreceptors, and elongation of cone photoreceptors. Melatonin blocks apoptosis after experimentally induced RPE cell ischemia. 2. Synthesis and diurnal rhythm of retinal melatonin are independent of the pineal gland. Pinealectomy had no effect on ocular melatonin levels and a diurnal rhythm continued. 3. Retinal melatonin synthesis is elevated at night and decreased during day as a result of rhythmic regulation by a circadian oscillator, or clock 4. Retinal dopamine appears to act through D2 receptors to suppress melatonin synthesis and to entrain ocular circadian oscillator. 5. Light inhibits melatonin synthesis and entrains circadian rhythms. 6. Pineal melatonin (but not retinal) has an important role in the control of circadian rhythms. 7. Retinal melatonin may be a modulator of intraocular pressure and melatonergic mechanisms in the eye could be responsible for the diurnal rhythm in IOP. 8. Studies show an Inhibitory effect of melatonin on cataract formation in newborn rats and may be an evidence for anti-oxidative role for melatonin.
  47. 47. National Conference on Chronobiology and Health 47 Virgin olive oil reduces dental plaque formation Mahantayya V Math1, Rohit B Gadda 2, PradnyaJadhav 3, NehaPatil 4, Yashoda R Kattimani 5, RS Inamdar 6 1, 5, 6 Department of Physiology, MGM Medical College, 2, 3, 4 Department of Oral Medicine and Radiology, MGM Dental College, Navi Mumbai Introduction: Oral cavity has a complex and changing environment. Dental diseases are affecting a large number of people in both the developed and developing countries. Diurnal variation is seen in salivary osmolality. Salivary secretion is reduced at night and salivary osmolality is highest at 7 am in the morning. Mild dehydration is a risk factor for dental disease. Virgin olive oil has low surface tension and is rich in monounsaturated fatty acids, phenolics and antioxidants. Objectives: This study was done to determine the plaque inhibitory action of virgin olive oil using a plaque re-growth model and compare the effect of virgin olive oil with distilled water on plaque index Materials and methods: 17 healthy young volunteers participated in this study A randomized, controlled, cross-over design was used. The subjects were asked to swish thoroughly for 5 minutes with 3 ml of virgin olive oil or distilled water in the morning and at night before going to sleep and then swallow. They were told to use water or olive oil from Monday to Friday twice daily (10 swishing in total), and were instructed not to use any other oral hygiene product during this period. Dental plaque was assessed with plaque disclosing agent (Alphaplac).at the beginning and end of the study. Results: The mean plaque index with virgin olive oil use was (mean ± SD) 1.476 ± 0.36 and with use of distilled water 2.3±0.386 (p<0.001) Conclusion: Use of virgin olive oil twice a day (in the morning and at night) is effective in decreasing dental plaque compared to that observed with distilled water.
  48. 48. National Conference on Chronobiology and Health 48 Comparative study of pulmonary function tests in early smokers, chronic smokers and non-smokers Manjushree R, Suresh Y, Bondade, Smilee Johncy S Department of Physiology, JJM Medical College, Davangere Introduction: Smoking is the malicious curse of world today. Smoking related diseases kill one in ten adults globally. Smoking is the main risk factor in the development of Chronic obstructive pulmonary disease (COPD), and smoking cessation is the only effective treatment for avoiding or reducing the progression of this disease. Objective: To study the differences in pulmonary function test values in early- smokers, chronic-smokers and non-smokers. Materials and methods: In cross sectional study, spirometry data were collected by RMS Helios 401 computerized spirometer. Expiratory flow volume curves were recorded and FVC, FEV1, FEV1/FVC ratio, PEFR, FEF25-75%were obtained. The data were compared between early smokers, chronic smokers and non-smokers group &statistically analyzed usingSPSS software and ANOVAtest Results: Pulmonary function test(PFT) parameters FVC,FEV1, PEFR, FEF25-75% and MVV were significantly reduced in chronic smokers group compared to non-smokers group (p<0.05).FEV1was the initial parameter to be declined in early smokers. The PFT parameters markedly decrease with increase number of cigarette smoked per day as well as increase duration of smoking. Conclusion: The present study brings out substantial variation in most of the parameters of PFTs between early smokers, chronic smokers and non-smokers confirming PFT values are less in chronic smokers due to toxic effects of tobacco smoking on respiratory system & is the major cause of obstructive lung disease in Indian population. It also reveals that smoking cessation improves the accelerated decline in FEV1which indicates that smoking cessation positively influences remodeling processes in lungs. These results can be used to convince people to quit smoking.
  49. 49. National Conference on Chronobiology and Health 49 Depression, anxiety and stress among junior science college students Sanghamitra Panda, Ashok Kumar Dash Shadan Institute of Medical Sciences, Hyderabad Introduction:Adolescence is a transitional stage marked by rapid changes in physical, cognitive and emotionaldevelopment. Presence of conditions like depression, anxiety and stress at this age is a matter of concern. Teen stress is an important health issue. Objective: To study the depression, anxiety and stress among adolescent junior college girls. Material and method: A cross sectional study was conducted in a junior science college, 240 girl students belonging to class 11th and 12th were recruited for the study. Among them 87 students were day scholars and 153 students were staying in the hostel. DASS 21 questionnaire was used to assess depression, anxiety and stress among the students. Sleep pattern of all the students were sought and it was found that average sleep duration was less than 7 hours per day. Results: The scores in the three domains were found to be remarkably high. It was found that depression and anxiety was more in students in comparison to stress. DASS score was found to be more in students residing in the hostel viz. depression (77.125%), anxiety (75.164%), stress (45.099%) in comparison to day scholars viz. depression (72.414%), anxiety (67.817%), stress (40.230%). Conclusion: Depression, anxiety and stress among the students were found to be quite high. Educational institutions need to identify the prevalence of negative mental health states among students especially high risk students and preventive measures should be undertaken to reduce the mental stress.
  50. 50. National Conference on Chronobiology and Health 50 Chronobiology and irritable bowel syndrome Prabhavathi K, Hemamalini RV, Thamaraiselvi K, Christy A, Saravanan A SRM MCH & RC, Potheri Chronobiology is one of most studied topics in modern medicine as it links between the body‟s internal clock and health almost every day. Studies in circadian biology showed a link between disrupted sleep cycles and irritable bowel syndrome (IBS). Supra-chiasmatic nucleus the central pacemaker of our brain is known to dictate a variety of hormonal processes and physiological activities of GIT explaining the fact “We are what and when we eat”. Around 10% of our genes fluctuate in activity according to the time of day which is involved in the health and function of the digestive tract. Research has found that Non-REM sleep enhances the parasympathetic nervous system to aid in the digestion of food and sympathetic nervous system slows the digestion during REM sleep. This balance is crucial for sustaining good gut health. Also hormones associated with digestion like ghrelin, insulin, leptin, orexins, neuropeptide Y, VIP, serotonins are released periodically throughout the day. Thus the molecular basis for circadian timing in GIT involves transcriptional /translational feedback loop which culminate in rhythmic expression and activity of a set of clock genes and related hormones which is responsible for periodic activity of various segments and transit along GIT. In IBS there may be a lack of hormonal regulation along with the alternating cycles of autonomic activity. People with diarrhea predominant type of IBS, have very different autonomic activity from the normal people during sleep. Also melatonin produced by neuroendocrine cells of GIT mucosa, plays an important role in the internal biological clock. Clinical studies have demonstrated that administration of melatonin improve symptoms with IBS. Thus Mind-brain-body-gene frame work, including the role of chrono-nutrition is probably implicated in the genesis of IBS, which may further help in diagnosis and treatment of IBS in shift duty workers with impaired circadian rhythm.
  51. 51. National Conference on Chronobiology and Health 51 Sleep deprivation and disruption of bio-clock in medical students Madhuri Taranikanti, Sanghamitra Panda, Nikhat Yasmeem, Siddique A R O Department of Physiology, Shadan Institute of Medical Sciences, Hyderabad Introduction: One of the major problems in today‟s modern world is the component of artificial light and working hours during the night time. Also, urban lifestyle involves sleeping late in the night and exposure to bright lights contributing to derangement of the normal bio-clock. Medical students are faced with the problem of managing time with the hectic schedule in order to cover the vast syllabus and are often under stress to reach their targets with changes in their lifestyle acting against the normal circadian rhythm. The aim of the present study is to look for pathophysiology of diseases if any caused by sleep deprivation in medical students as understanding this mechanism seems to be the present major challenge. The objectives of the study are to see the association between duration of sleep and levels of blood pressure and blood sugar. Material and Methods: I MBBS students, both male and female were included in the study. They were asked to fill out a form about their sleep pattern like time of sleeping and waking up and the reason for sleeping late. Anthropometric measurements, blood pressure and blood sugar were recorded twice in the day. Results: Students with reduced hours of sleep had changes in BP and blood sugars from morning to evening and their BMI was higher. The values were close to pre- hypertensive and pre-diabetic ranges. Students who maintained regular timings for sleep and waking up had less or no changes. Discussion: It is seen that sleep deprivation can lead to a variety of metabolic derangements including fluctuation in blood pressure and blood sugar levels. Medical students who slept late in the night were exposed to artificial light for a longer duration which may cause suppression of melatonin and disruption of bio-clock of the body. Also, there is scope for eating late into the night causing weight gain and obesity which further causes sleep disruption forming a vicious cycle. Conclusion: There is a need to intervene and sensitize medical students about the need to maintain a disciplined lifestyle by including techniques that relieve stress into the hectic curriculum.
  52. 52. National Conference on Chronobiology and Health 52 Therapeutic implications of the circadian clock on skin function Amal Philip, Ashwini Dhandayutham Government Villupuram Medical College,Villupuram Introduction: Circadian rhythm is any biological process that displays an endogenous oscillation of about 24 hours. The human circadian clock ensures that biochemical and physiological processes occur at the optimal time of day. Circadian pacemaker in skin: Like the central circadian pacemaker, some rhythmic oscillations are there for the functioning for peripheral tissues like skin. The skin's chronobiologic functioning influences i) skin aging ii) cell repair (iii) development of skin cancers iv) DNA repair and copying Circadian rhythm in skin:The skin is uniquely positioned at the interface between body and external environment. Predictable daily periodicity has been reported in i) skin cell proliferation rates ii) hydration and trans-epidermal water loss iii) capillary blood flow iv) temperature v) surface pH Therapeutic implications: Skin Cancer: Stem cells in epidermis reproduce mainly at night. Hence skin cancer treatments involving chemotherapy is most effective when planned to coincide with skin cell cycle. Role of melatonin: Melatonin acts as a potent antioxidant and anti-aging substance and plays a role in controlling hair growth, development of melanoma, suppression of UV light induced damage. Lower melatonin levels during the day may inhibit the skins ability to repair UV rays induced DNA damage and the harmful effects of reactive oxygen species. Conclusion: Chronobiology is an emerging field that is proving to be more and more important in human health. Understanding CLOCK (Circadian Loco motor Output Cycles Kaput) genes and their effects on skin cells may be an important way of preventing skin cancer, premature aging, and a variety of skin disorders.
  53. 53. National Conference on Chronobiology and Health 53 Effect of work shift timings and sleep pattern on circadian rhythm in urban population of Hyderabad Anuradha G, Joya Rani D Gandhi Medical College, Secunderabad Introduction: Sleep is an important regulator of circadian rhythm. Changes in working timings of individuals may affect the normal sleep pattern. Reaction time is an important aspect of circadian rhythm. Reaction time plays important role in our day to day activities like driving, crossing a road, working in industries etc. Materials and methods: A total 40 subjects are divided in to two groups of 20 each. Group A includes day shift and Group B includes night shift workers. Test for simple visual reaction time was conducted at 9 am and 9 pm for both the groups using garydar computer software. Females between 20-25 years of age were included in the study. Participants with hypertension, diabetes mellitus, visual and hearing problems, alcoholics, smokers, yoga practitioners & regular sports persons were excluded. Results: Mean simple visual reaction time for group A and group B (mean ± SD) are 0.32±0.08 and 0.44±0.14 which was statistically significant. Conclusion: Simple visual reaction time is prolonged in night shift workers than day shift workers. There is more sleepiness in night shift workers at the end of the work shift than day shift workers.
  54. 54. National Conference on Chronobiology and Health 54 Assessment of cardiac sympatho-vagal activity of sedentary overweight and obese young females Latha Ramalingam1, Rajalakshmi R2 1.Department of Physiology, Shri Sathya Sai Medical College and Research Institute, Kanchipuram2.Department of Physiology, Indira Gandhi Medical College and Research Institute, Puducherry Introduction: Heart rate variability (HRV), also known as R-R interval variability, represents the cardiac autonomic status of the individual. Several factors are known to affect the HRV and reduced HRV is associated with increased risk of cardiovascular morbidity and mortality. In today‟s world, increase in the standard of living, consumption of junk food and sedentary lifestyle are emerging as major risk factors for cardiovascular disorders among the young population. Several studies have shown that young sedentary obese males have reduced HRV. However, there are not many studies which have explored the changes in HRV indices in young sedentary females with BMI above the normal range. Objective: The aim of this study was to assess the cardiac sympatho-vagal status of young sedentary overweight and obese females. Materials and methods: A total of forty females aged 18 to 25 years were recruited in the study. Categorization of sedentary behavior was done using the IPAQ questionnaire. Based on the BMI (WHO guidelines for Asian population), subjects were divided into test group (BMI >23 Kg/m2 & W/H ratio>0.8, N=20) and control group (BMI = 18 to 23 Kg/m2, W/H ratio<0.8 N=20). Subjects were asked to rest in supine posture for 10 minutes after which a 5 minute ECG was acquired in lead II configuration. R-R intervals were acquired from the ECG data and were fed into the Kubios HRV analysis software to obtain the time domain and frequency domain indices of HRV. Results: There was no significant difference between the test and control group with respect to time domain indices. With respect to frequency domain indices, LF power, HF power and total power did not show significant differences. However, LF nu was significantly high (p=0.043), HF nu was significantly low (0.043) and LF/HF ratio was significantly high (p=0.05) among the test group individuals. Conclusion: Apparently healthy young sedentary overweight and obese females have increased cardiac sympathetic activity and reduced cardiac parasympathetic activity. This will lead to reduced HRV in these individuals which in turn may predispose them to the risk of various cardiovascular disorders at an earlier age. Hence, appropriate lifestyle modifications need to be adopted to prevent the progress of impending alterations in the cardiovascular status of these young women.
  55. 55. National Conference on Chronobiology and Health 55 Global warming and its effect on health Thamaraiselvi K1, S.Jayaraman S2, Saravanan A1 1Department of Physiology, SRM Medical College Hospital & Research Centre, Kattankulathur, 2Department of Economics, Presidency College, Chennai In the theory of evolution Darwin said that nature selects only the fittest. But human through their economic activities and indiscriminate use of natural resources have endangered many species of animals, flora and fauna by destroying their habitats and consuming them. These activities have created a kind of situations unacceptable to the nature. This situation is collectively called global warming. This is unsuitable to the very survival of the human being. Many of the human activities have created non conducive atmosphere for the survival of the human being itself. The globe which includes the atmosphere, lithosphere and hydrosphere has been polluted by the gases and particles either by their presence or excess quantity. Since the industrial revolution, atmospheric pollution have increased many fold and in faster rate than which the nature can handle. There is an excess quantity of CO2, CO, Methane, sulphur, nitrogen, water particles, dust particles in the atmosphere and the hydrosphere. The causes have been overexploitation of natural resources, deforestation, and excessive use of fossil fuels, industrial wastages and domestic wastages both non-biodegradable and excessive biodegradable. In the past fifty years the atmospheric temperature has increased by 0.75°degree Celsius. This has increased sea level by melting of the glaciers in the Polar Regions and many climatic and seasonal changes like abnormal rain fall and cyclones. The ocean‟s surface temperature has increased by 0.50° C in the last fifty years. By 2100 this may be increased to 1°C to 3.5° C, the highest increase will result in the increase of sea level by 7 meters and cause the inundation of many low lying areas. The health effect of the global warming is very severe in widespread sparing nobody. Global warming have created conducive atmosphere for host of vectors that carry disease causing bacteria, viruses, parasites etc. There are frequent outbreaks of Malaria, yellow fever, dengue, chickengunya etc. There is decrease in productivity, mental health and above all the reproductive capacity and ability. This has rendered many infertile and impotent. The future of human being is at the mercy of nature and technology advancement. Unless due care is taken to correct the past mistakes and steps taken to prevent further degradation. Not only the economic sustainability but also the very survival and the affordability of survival will be at stake, which is in the hands of human beings.
  56. 56. National Conference on Chronobiology and Health 56 Peripheral blood mononuclear cells: an immune marker Ihsan V P, Balanaga Nandhini D Department of Physiology, Government Villupuram Medical College, Villupuram Introduction: In humans, most physiological and behavioral functions are expressed rhythmically across days and nights. Central clock: The circadian rhythms are controlled by a central self-sustained biological oscillator organized in transcriptional/translational feedback loops involving several clock genes. Central component of this complex oscillatory system resides in the suprachiasmatic nuclei (SCN) of the anterior hypothalamus. Peripheral clock: Molecular clock mechanisms oscillate also in peripheral organs, such as the liver, kidney, and fibroblast cells. Many immune parameters such as cytokine synthesis and white blood cell counts fluctuate in a circadian fashion. Peak clock expression: Peak clock gene expression was observed mostly during the usual time of activity and light exposure. Peak melatonin concentration is followedby peak clock gene expression. The oscillation of clock genes in peripheral tissues often lags several hours behind oscillation of the supra-chiasmatic nuclei. Immune clock: Circadian clock keeps immune system more active during day time. The sympathetic autonomic nerves keep them activated during habitual time of activity. Circadian clock genes are expressed in a circadian manner in human peripheral blood mononuclear cells (PBMCs), with the peak level occurring during the habitual time of activity. Oscillation of clock genes in PBMC takes place even in absence of sleep/darkness which suggests an endogenous nature for this oscillation. Hence PBMC is an accessible surrogate for the identification of rhythmic clock gene expression in humans. Conclusion: Functional circadian machinery in human PBMCs suggests that peripheral blood cells may be useful for the investigation of human circadian rhythms and their associated disorders.
  57. 57. National Conference on Chronobiology and Health 57 Gut clock: the implications of circadian rhythm on GIT Nandagopal S S, Senthilkumari K R Department of Physiology, Government Villupuram Medical College, Villupuram Introduction: Circadian and seasonal rhythms are a fundamental feature of all living organisms and their organelles. Biological rhythms are responsible for daily food intake. The period of hunger and satiety is controlled by the central pacemaker, which resides in the supra-chiasmatic nucleus (SCN) of the hypothalamus. Clocks in the GIT are responsible for the periodic activities which transit along the GIT. They are localized in special interstitial cells. Endocrine encoding: Melatonin, produced by neuro-endocrine cells of the gastrointestinal mucosa, plays an important role in the internal biological clock, related to food intake and the myoelectric rhythm. This appears to be an endocrine encoding of the light-dark cycle, conveying photic information. Effect of disruption of circadian physiology: i) irritable bowel syndrome (IBS) ii) gastroesophageal reflux disease (GERD) and iii) peptic ulcer disease. It also accelerates aging, and promotes tumor genesis in the liver and GIT. Disruption of circadian regulation may also lead to obesity by shifting food intake schedules. Role of melatonin: The role of melatonin in the regulation of circadian rhythm allows researchers and clinicians to approach gastrointestinal diseases from a chronobiological perspective. Clinical studies have demonstrated that the administration of melatonin improves symptoms in patients with IBS and GERD. Melatonin significantly protects gastrointestinal mucosa, and has strong protective effects on the liver in patients with non-alcoholic steatohepatitis (NASH). Conclusion: Hence the role of clock genes in the pathophysiology of the GIT and liver is a probe to be discussed in this modern day scenario.
  58. 58. National Conference on Chronobiology and Health 58 Inadequate sleep as a risk factor for neurodegenerative diseases Hemamalini R V, Prabhavathi K, Thamaraiselvi K, Christy A, Saravanan A SRM Medical College Hospital & Research Center, Kattankulathur Inadequate sleep refers to sleep of shorter duration than the average need of seven to eight hours per night. The cumulative effects of sleep loss have been associated with a wide range of deleterious health consequences including an increased risk of hypertension, diabetes, obesity, depression, heart attack, and stroke. Recently it has also been considered as serious risk factor for neurodegerative diseases like Alzheimer‟s, Parkinsons disease, Lewy body dementia. Studies have shown that in those who carried the APOE-E4 gene and who slept most soundly showed the greatest preservation of memory and thinking skills. Among study participants who died, the poor sleepers were more likely to exhibit the characteristic brain plaques and tangles of Alzheimer‟s disease. It was found that those getting less sleep or sleeping poorly was tied to an increase in brain levels of beta-amyloid, a toxic protein that builds up and forms plaques in the brains of those with Alzheimer‟s. Brain scans revealed that individual who slept less than five hours a night had higher levels of beta-amyloid in the brain than those who slept over seven hours a night. A SPECT study showed a trend towards decreased dopamine transporter density in the nigrostriatal regions of the brain and Parkinsonism in the follow-up data of patients with REM sleep disturbance who had no previous evidence of neurodegenerative disease. A lack of tracer binding in these regions of the brain is closely linked to neuronal degeneration and the development of dementia and movement disorders.REM sleep disturbances also results in Lewy body dementia. There is an increasing amount of research linking sleep disturbance resulting in inadequate sleep with increased risk of dementia. It is extremely important to identify the individuals at risk such as night shift workers who are sleep deprived, those with sleep apnea which causes them to awaken several times during the night and those with various sleep disorders. As early detection and adequate treatment of their sleep problems may reduce the risk of developing neuro- degenerative diseases.

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