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Balkrishna A, Katiyar P, Ghosh S, Singh SK, Arya V. Impact assessment of integrated-pathy on cancer-related fatigue in cancer patients: an observational study. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2024; 43:48. [PMID: 38576058 PMCID: PMC10993513 DOI: 10.1186/s41043-024-00537-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 03/19/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND Integrated-pathy aims to integrate modern medicine with traditional systems via applying the holistic approach of Ayurveda, Yoga, and natural medicine. This is important for addressing the challenges surrounding the delivery of long-term palliative care for chronic ailments including cancer. The prime intent of this study was to substantiate the underlying hypothesis behind the differential and integrative approach having a positive impact on Quality of Life of cancer patients. STUDY DESIGN Cross-sectional Observational study. METHODS A standardized questionnaire was developed and used, after obtaining written informed consent from patients to assess the impact of Integrated-pathy on patients (n = 103) diagnosed with cancer receiving care at Patanjali Yoggram. The research was carried out over 8 months. All participants received a uniform treatment protocol as prescribed by Patanjali. For the sample size determination and validation, α and 1-β was calculated and for the significance of the pre- and post-treatment QoL ratings, Shapiro wilk test and other descriptive statistics techniques were explored. RESULTS A total of 103 patients seeking cancer special-healthcare were interviewed, out of which 39 (37.86%) remained finally based on the inclusion/exclusion criteria with age (25-65 years), types of cancers (Carcinoma and Sarcoma), chemotherapy/radiotherapy received or not, before opting Integrated-pathy. Follow-ups revealed a significant increase in the QoL (17.91%) after receiving the integrated therapy over a course of at least 1 month. Further, a significant reduction in cancer-related pain followed by an increase in QoL index was reported in the patients. Shapiro-wilk test revealed significant pairing (p < 0.001) with validation of the model using test. CONCLUSIONS To bolster evidence-based backing for Integrated-pathy, there is a need for clearly delineated clinical indicators that are measurable and trackable over time. Clinical investigators are encouraged to incorporate Integrated-pathy into their proposed interventions and conduct analogous studies to yield sustained advantages in the long run.
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Affiliation(s)
- Acharya Balkrishna
- Herbal Research Division, Patanjali Herbal Research Department, Patanjali Research Foundation, Haridwar, Uttarakhand, 249405, India
- Department of Applied and Allied Sciences, University of Patanjali, Haridwar, Uttarakhand, India
| | - Prashant Katiyar
- Herbal Research Division, Patanjali Herbal Research Department, Patanjali Research Foundation, Haridwar, Uttarakhand, 249405, India.
| | - Sourav Ghosh
- Herbal Research Division, Patanjali Herbal Research Department, Patanjali Research Foundation, Haridwar, Uttarakhand, 249405, India
| | - Sumit Kumar Singh
- Herbal Research Division, Patanjali Herbal Research Department, Patanjali Research Foundation, Haridwar, Uttarakhand, 249405, India
| | - Vedpriya Arya
- Herbal Research Division, Patanjali Herbal Research Department, Patanjali Research Foundation, Haridwar, Uttarakhand, 249405, India
- Department of Applied and Allied Sciences, University of Patanjali, Haridwar, Uttarakhand, India
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Joshi AM, Raveendran AV, Arumugam M. Therapeutic role of yoga in hypertension. World J Methodol 2024; 14:90127. [PMID: 38577206 PMCID: PMC10989416 DOI: 10.5662/wjm.v14.i1.90127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 12/19/2023] [Accepted: 01/16/2024] [Indexed: 03/07/2024] Open
Abstract
Systemic hypertension is an established risk factor for coronary artery disease and cerebrovascular accident and control of blood pressure reduces the risk of a major cardiovascular event. Both non-pharmacological and pharmacological treatment options are available to treat hypertension. Yoga, recently received more attention as a treatment modality for various lifestyle disorders, even though practiced in India since ancient times. In this review, we are analyzing the role of yoga in the treatment of systemic hypertension.
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Affiliation(s)
- Anjali Mangesh Joshi
- Department of Psycho-Oncology, HCG NCHRI Cancer Center, Nagpur 440026, Maharashtra, India
| | - Arkiath Veettil Raveendran
- Department of Internal Medicine, Former Assistant Professor of Medicine, Govt. Medical College, Kozhikode 673010, Kerala, India
| | - Muruganathan Arumugam
- Department of Internal Medicine, Past president API Past Governor American College of Physicians Past President Hypertension Society of India Past Dean Indian College of Physicians, Tirupur 641602, Tamilnadu, India
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Fronczek M, Kopacz K, Kopacz Ł, Padula G. The Role of Objective Movement Analysis in the Control of Yoga Asanas: A Case Study. Complement Med Res 2024; 31:201-209. [PMID: 38330929 DOI: 10.1159/000535312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 11/15/2023] [Indexed: 02/10/2024]
Abstract
INTRODUCTION Yoga is classified as a form of complementary and alternative medicine. It can be used in many disciplines including physiotherapy, medicine, and sport. The objective of the study was to identify possible biomechanical problems during yoga practice and to minimize the risk of injury. CASE PRESENTATION Objective evaluation of the symmetry of asanas, balance, stability, and muscle tension was provided in case of a 37-year-old woman, practicing mainly aerial and Hatha yoga for 6 years. The bigger body tilt and deviations in center of pressure (COP) parameters were observed in tadasana during forward examinations. In tadasana, the highest muscle activity was observed in the rectus femoris. In case of forward tadasana observation, the highest activity was found in the gastrocnemius and in the lumbar portion of the erector spinae. During backward tadasana trial, the most active were the tibialis anterior and rectus femoris muscles. In garudasana and natarajasana, the symmetry of the trunk position in relation to the lower limbs was observed, regardless of the supporting limb. In the same way, COP parameters in garudasana were similar regardless of the supporting limb. However, in natarajasana, the higher COP displacement parameters were observed in the case of the nondominant supporting limb. As for the electromyographic evaluation of garudasana and natarajasana, the highest muscle activity was observed in the lumbar portion of the erector spinae. In chakrasana, a slightly greater angle of the hip extension was observed in the left hip. A higher muscle activity in chakrasana was observed in the lumbar portion of the right erector spinae. In sirsasana, no significant displacements of the cervical spine were observed, but a higher activity of the left sternocleidomastoid muscle was found. CONCLUSION With the use of objective movement analysis, possible biomechanical problems were identified. Attention should be paid to the normalization of the tension in the lumbar part of the right erector spinae and the right sternocleidomastoid muscle, as well as to the balance training in positions on the nondominant lower limb. Objective movement analysis can be a useful tool for instructors or physiotherapists to adjust yoga programs and correct asanas in order to avoid future injuries. Einleitung Yoga gilt als Form der Komplementär- und Alternativmedizin. Es ist in vielen Disziplinen einsetzbar, von Physiotherapie über Medizin bis Sport. Das Ziel dieser Studie war es, mögliche biomechanische Probleme bei der Ausübung von Yoga zu identifizieren, um das Verletzungsrisiko zu minimieren. Vorstellung des Falls Eine objektive Beurteilung der Symmetrie der Asanas, des Gleichgewichts, der Stabilität und der Muskelspannung erfolgte bei einer 37-jährigen Frau, die seit 6 Jahren hauptsächlich Aerial- und Hatha-Yoga praktiziert. Stärkere Körperneigung und Abweichungen bei Druckmittelpunkt-Parametern wurden in Tadasana bei der Vorwärts-Beobachtung festgestellt. In Tadasana wurde die höchste Muskelaktivität im Rectus femoris beobachtet. Bei der Tadasana-Vorwärts-Beobachtung war die höchste Aktivität im Gastrocnemius und im lumbalen Anteil des Erector spinae zu verzeichnen. Während der Tadasana-Rückwärts-Übung waren die aktivsten Muskeln der Tibialis anterior und Rectus femoris. In Garudasana und Natarajasana wurde die Symmetrie der Rumpfposition im Verhältnis zu den unteren Gliedmaßen unabhängig von der belasteten Gliedmaße beobachtet. Ebenso waren die Parameter des Druckmittelpunkts (DMP) in Garudasana unabhängig von der belasteten Gliedmaße vergleichbar. In Natarajasana wurden jedoch höhere Parameter der DMP-Verschiebung bei der nicht-dominanten belasteten Gliedmaße beobachtet. Bei der elektromyografischen Auswertung von Garudasana und Natarajasana wurde die höchste Muskelaktivität im lumbalen Anteil des Erector spinae beobachtet. In Chakrasana wurde ein etwas größerer Winkel der Hüftstreckung im linken Hüftgelenk beobachtet. Eine höhere Muskelaktivität in Chakrasana wurde im lumbalen Anteil des rechten Erector spinae beobachtet. In Sirsasana wurden keine signifikanten Verschiebungen der Halswirbelsäule beobachtet, jedoch war eine höhere Aktivität des linken Sternocleidomastoideus zu verzeichnen. Schlussfolgerung Mit Hilfe einer objektiven Bewegungsanalyse wurden mögliche biomechanische Probleme identifiziert. Mit besonderer Aufmerksamkeit sollte auf die Normalisierung der Spannung im lumbalen Anteil des rechten Erector spinae und des rechten Sternocleidomastoideus sowie auf die Schulung des Gleichgewichts in Positionen auf der nicht-dominanten unteren Extremität geachtet werden. Die objektive Bewegungsanalyse kann ein nützliches Instrument für Instruktoren oder Physiotherapeuten sein, um Yoga-Programme anzupassen und Asanas zu korrigieren, um Verletzungen vorzubeugen.
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Affiliation(s)
- Magdalena Fronczek
- Academic Laboratory of Movement and Human Physical Performance "DynamoLab", Medical University of Lodz, Lodz, Poland
- Warsaw Medical Academy, Warsaw, Poland
| | - Karolina Kopacz
- Academic Laboratory of Movement and Human Physical Performance "DynamoLab", Medical University of Lodz, Lodz, Poland
- Warsaw Medical Academy, Warsaw, Poland
| | - Łukasz Kopacz
- Academic Laboratory of Movement and Human Physical Performance "DynamoLab", Medical University of Lodz, Lodz, Poland
| | - Gianluca Padula
- Academic Laboratory of Movement and Human Physical Performance "DynamoLab", Medical University of Lodz, Lodz, Poland
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Saini A, Dogra SS, Singh H, Gargi G. Yoga Technique of Sutra Neti Causing Nasopharyngeal Stenosis: A Case Report. Indian J Otolaryngol Head Neck Surg 2023; 75:3821-3824. [PMID: 37974705 PMCID: PMC10645669 DOI: 10.1007/s12070-023-03865-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 05/04/2023] [Indexed: 11/19/2023] Open
Abstract
Yoga is becoming way of life world over to stay fit and agile both physically and mentally. Sutra neti is an ancient yoga practice in which a thread/tube is passed through nostrils and taken out through mouth and is then moved back and forth. This technique is believed to clean nasal passages and is considered relatively safe. We report a case of nasopharyngeal stenosis caused due to this ancient practice. People and yoga trainers all over the world should be made aware of this complication of sutra neti as it is difficult to treat and has high recurrence rate. Supplementary Information The online version contains supplementary material available at 10.1007/s12070-023-03865-4.
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Affiliation(s)
- Amit Saini
- Department of Otolaryngology, Dr RKGMC, Hamirpur, H.P India
| | | | | | - Gaveshna Gargi
- Department of General Medicine, Dr RKGMC, Hamirpur, H.P India
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Balkrishna A, Katiyar P, Singh SK, Ghosh S, Arya V. Impact Assessment of Integrated-pathy on Cancer-Related Fatigue in Cancer Patients: An Observational study.. [DOI: 10.21203/rs.3.rs-3201641/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/26/2024]
Abstract
Abstract
Background: Integrated-pathy aims to integrate modern medicine with traditional systems via applying the holistic approach of Ayurveda, Yoga, Yagya, Panchkarma and natural medicine. This is important for addressing the challenges surrounding the delivery of long-term palliative care for chronic ailments including cancer. The prime intent of this study was to substantiate the underlying hypothesis behind the differential and integrative approach having a positive impact on Quality of Life of cancer patients.
Study Design: Observational study
Methods: A standardized questionnaire was developed and used, after obtaining written informed consent from patients to assess the impact of Integrated-pathy on patients (n=103) diagnosed with cancer receiving care at Patanjali Yoggram. The research was carried out over an eight-month period (December-2021 to July-2022). For the significance of the pre- and post-treatment QoL ratings, Wilcoxon signed-rank pair test, Kolmogorov-Smirnov test and other descriptive statistics techniques were explored.
Results: A total of 103 patients seeking cancer special-healthcare were interviewed, out of which 39 (37.86%) were selected based on the inclusion/exclusion criteria with age (25-65 years), period of Integrated-pathy received (≥1 months), allopathic treatment received prior to opting for Integrated-pathy. Results revealed a significant increase in the QoL (17.91%) after receiving the integrated therapy over a course of at least one month. Further, a significant reduction in cancer related pain followed by an increase in QoL index was reported in the patients. Wilcoxon rank test revealed significant pairing (p<0.0001) with validation of the model using Kolmogorov-Smirnov test.
Conclusions: In order to enhance evidence-based support to the Integrated-pathy, well-defined clinical indicators that can be assessed and monitored over time are required. Clinical researchers should add Integrated-pathy into their proposed interventions and undertake similar studies to provide long-term benefits.
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Nadholta P, Kumar S, Anand A. Yoga for Control of Progression in the Early Stage of NCDs. Ann Neurosci 2023; 30:79-83. [PMID: 37706099 PMCID: PMC10496796 DOI: 10.1177/09727531231161995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/15/2023] Open
Affiliation(s)
- Pooja Nadholta
- Neuroscience Research Lab, Department of Neurology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Saurabh Kumar
- CCRYN-Collaborative Centre for Mind Body Intervention through Yoga, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Akshay Anand
- Neuroscience Research Lab, Department of Neurology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
- CCRYN-Collaborative Centre for Mind Body Intervention through Yoga, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
- Centre for Cognitive Science and Phenomenology, Panjab University, Chandigarh, India
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Psychophysiological Adaptations to Yoga Practice in Overweight and Obese Individuals: A Topical Review. Diseases 2022; 10:diseases10040107. [PMID: 36412601 PMCID: PMC9680480 DOI: 10.3390/diseases10040107] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 11/10/2022] [Accepted: 11/16/2022] [Indexed: 11/19/2022] Open
Abstract
Physical activity has been documented as a foundational approach for weight management and obesity, improving several cardiometabolic and mental health indices. However, it is not clear whether yoga practice can induce beneficial improvements in anthropometric and body composition parameters, performance, metabolic health, and well-being among overweight/obese people. The aim of this topical review was to catalog training studies examining the psychophysiological responses to yoga interventions in order to detect which outcomes have been investigated, the research methods applied, and the conclusions. The inclusion/exclusion criteria were met by 22 published articles involving 1178 (56% female) overweight/obese participants. This brief review on yoga-induced adaptations demonstrates that this widely used meditative movement activity can meaningfully improve the vast majority of the selected markers. These beneficial alterations are focused mostly on various anthropometric and body composition variables, cardiovascular disease risk factors, physical fitness parameters, quality of life, and stress in previously inactive overweight/obese individuals. Instead, yoga-based physical exercise interventions investigating anxiety, depression, mood state, exercise enjoyment, affect valence, and adherence were limited. Further research should focus on the yoga intervention configuration and potential mechanisms behind favorable changes in various psychophysiological indices through large-scale, rigorously designed randomized controlled trials implementing long-term interventions in overweight/obese individuals.
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Abdelazeem B, Abbas KS, Manasrah N, Amin MA, Mohammed SM, Mostafa MR. Yoga as a treatment for vasovagal syncope: A systematic review and meta-analysis. Complement Ther Clin Pract 2022; 48:101579. [PMID: 35390588 DOI: 10.1016/j.ctcp.2022.101579] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 03/16/2022] [Accepted: 03/27/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND Yoga therapy is being used for vasovagal syncope (VVS). However, there is no sufficient evidence. We aimed to evaluate the effect of yoga as an adjunct to the standard therapy on patients with recurrent VVS. METHODS Electronic databases were systematically searched to collect studies assessing the clinical effects of yoga along with guideline-directed treatment in patients with recurrent VVS. The outcomes were the number of VVS attacks and quality of life (QoL) assessment by Syncope Functional Status Questionnaire (SFSQ) scores at 12 months. We used the Mantel- Haenszel random-effects model to calculate the mean difference (MD) and 95% confidence interval (CI). We used The Cochrane Collaboration Risk of Bias Tool and Newcastle-Ottawa Scale for risk of bias assessment. RESULTS Four studies were included, two RCTs and two observational studies. The total of participants was 309, with a mean age of 36.4 ± 13.5 years. The male participants represented 141 (45.6%) being males. The baseline syncope burden was 3.5 ± 2.38 episodes over 15.6 ± 12.8 months. Yoga therapy significantly reduced the number of episodes of syncope and presyncope compared to the control group (MD -1.86; 95% CI -3.30, -0.43; P = 0.01). Nevertheless, yoga therapy did not show significant improvement in the QoL assessed by SFSQ scores (MD -30.69; 95% CI -62.22,0.83; P = 0.06). CONCLUSION Yoga therapy is a useful lifestyle intervention that can reduce the frequency of syncope and presyncope among patients with recurrent VVS. However, higher-quality RCTs are needed to confirm our results.
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Affiliation(s)
- Basel Abdelazeem
- McLaren Health Care, Flint, MI, USA; Michigan State University, East Lansing, MI, USA.
| | | | - Nouraldeen Manasrah
- Detroit Medical Center/Sinai Grace Hospital, Detroit, MI, USA; Wayne State University, Detroit, MI, USA
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Sreenivas SB, M U S, D T, Selvam Ramachandran, Shashidhara, Y.N.. Effectiveness of yoga on attention of medical students: A prospective study. Biomedicine (Taipei) 2022. [DOI: 10.51248/.v42i1.1021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Introduction and Aim: Attention plays a huge role in cognitive processes like comprehension and reasoning. Lack of focused attention and easy distractibility adversely affects learning. It has been observed that the optimal attention span of medical students was about twenty minutes which is not quiet adequate. There is a need for improving attention of learners to sustain their ability to focus. Yoga addresses this need. Hence this study was taken up to assess the effectiveness of yoga on sustained and divided attention in Medical students.
Materials and Methods: This is a cross sectional, interventional study done on sixty healthy volunteer Medical Students in the age group of 18-22 years. Thirty volunteer students formed the yoga group and thirty participated in the study but did not perform yoga. Attention tests namely, Digit vigilance test, Colour trail test 1 and 2 were administered for all participants. Yoga training was conducted by yoga expert with a curated yoga module for one hour daily evening for 30 hours. Same tests were repeated following intervention.
Results: A significant reduction in the completion timings of all attention tests were observed post intervention in the yoga group. A reduction in the number of errors in DVT was also noted in the same group.
Conclusion: A pronounced improvement in sustained and focused attention along with enhanced attention control processing, was observed post intervention. This indicates that the yoga module has been effective in improving the mental focus of Medical Students. Regular Yoga practice complements in improving attention in medical students thus facilitating their academic performance.
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Muñoz-Vergara D, Grabowska W, Yeh GY, Khalsa SB, Schreiber KL, Huang CA, Zavacki AM, Wayne PM. A systematic review of in vivo stretching regimens on inflammation and its relevance to translational yoga research. PLoS One 2022; 17:e0269300. [PMID: 35648793 PMCID: PMC9159623 DOI: 10.1371/journal.pone.0269300] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 05/18/2022] [Indexed: 12/09/2022] Open
Abstract
OBJECTIVE To conduct a systematic review evaluating the impact of stretching on inflammation and its resolution using in vivo rodent models. Findings are evaluated for their potential to inform the design of clinical yoga studies to assess the impact of yogic stretching on inflammation and health. METHODS Studies were identified using four databases. Eligible publications included English original peer-reviewed articles between 1900-May 2020. Studies included those investigating the effect of different stretching techniques administered to a whole rodent model and evaluating at least one inflammatory outcome. Studies stretching the musculoskeletal and integumentary systems were considered. Two reviewers removed duplicates, screened abstracts, conducted full-text reviews, and assessed methodological quality. RESULTS Of 766 studies identified, 25 were included for synthesis. Seven (28%) studies had a high risk of bias in 3 out of 10 criteria. Experimental stretching protocols resulted in a continuum of inflammatory responses with therapeutic and injurious effects, which varied with a combination of three stretching parameters--duration, frequency, and intensity. Relative to injurious stretching, therapeutic stretching featured longer-term stretching protocols. Evidence of pro- and mixed-inflammatory effects of stretching was found in 16 muscle studies. Evidence of pro-, anti-, and mixed-inflammatory effects was found in nine longer-term stretching studies of the integumentary system. CONCLUSION Despite the overall high quality of these summarized studies, evaluation of stretching protocols paralleling yogic stretching is limited. Both injurious and therapeutic stretching induce aspects of inflammatory responses that varied among the different stretching protocols. Inflammatory markers, such as cytokines, are potential outcomes to consider in clinical yoga studies. Future translational research evaluating therapeutic benefits should consider in vitro studies, active vs. passive stretching, shorter-term vs. longer-term interventions, systemic vs. local effects of stretching, animal models resembling human anatomy, control and estimation of non-specific stresses, development of in vivo self-stretching paradigms targeting myofascial tissues, and in vivo models accounting for gross musculoskeletal posture.
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Affiliation(s)
- Dennis Muñoz-Vergara
- Division of Preventive Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States of America
- Osher Center for Integrative Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States of America
- * E-mail:
| | - Weronika Grabowska
- Division of Preventive Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States of America
| | - Gloria Y. Yeh
- Osher Center for Integrative Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States of America
- Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States of America
| | - Sat Bir Khalsa
- Osher Center for Integrative Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States of America
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States of America
| | - Kristin L. Schreiber
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States of America
| | - Christene A. Huang
- The Department of Surgery, School of Medicine, University of Colorado, Denver, CO, United States of America
| | - Ann Marie Zavacki
- Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States of America
| | - Peter M. Wayne
- Division of Preventive Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States of America
- Osher Center for Integrative Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States of America
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