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Integrated medicine system to alter future of disease management

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Using yoga as an additional treatment can help patients suffering from migraine headaches and from syncope, according to two papers recently published in the prestigious journals of the American College of Cardiology and the American Academy of Neurology.

The cardiology journal (2021) says that using yoga as an adjunctive therapy is superior to standalone standard therapy in reducing the symptomatic burden and improving the quality of life in patients with recurrent vasovagal syncope, which is a sudden drop in heart rate and blood pressure leading to fainting. The neurology journal states that yoga as an add-on therapy for migraine patients is superior to medical therapy alone, and suggests that it may be useful to integrate a cost-effective and safe intervention like yoga into the management of migraine.

These are two of the 21 papers — published recently in international scientific journals — that have generated renewed enthusiasm about yoga in the global medical fraternity. It is also a step towards validating such evidence-based integrative medicine and its imperative need in the future, giving credence to the clinical trials that have been going on at the All India Institute of Medical Sciences, Delhi, for the past six years.

Clinical trials

In a unique collaboration, 19 departments at AIIMS — including cardiology, gastroenterology, pulmonology, internal medicine, neurology, psychiatry, gynecology, community, oncology — are collectively working to identify areas of need where allopaths find modern medicines wanting and feel that the addition of a traditional medicine could provide relief to patients. Even before the Narendra Modi-led Central government began promoting yoga to bring it on the global health map, doctors at AIIMS had already started their clinical trials in 2012 to find out how yoga could deliver.

In 2016, the Centre for Integrative Medicine & Research (CIMR) was established within the AIIMS-Delhi campus under the Ayush Centre of Excellence programme, where proper scientific research on yoga began for the first time in the country. Small breakthroughs and mid-way results from the cardiology, neurology, pulmonology and gynaecology departments have now been released and are getting verified by peer groups and international medical journals.

Though yoga has been practised traditionally in India for centuries, the objective of the AIIMS initiative is to bring it under an official protocol to provide clinical services to treat various health conditions with an integrated medical system in place, according CIMR head Gautam Sharma, a cardiology professor at AIIMS. He said that new guidelines to combine mainstream and alternative medicines and therapy in ways that work best for the patient would soon be drafted based on the institute’s findings.

‘Integral to healthcare’

A senior officer of the Union Ministry of Health & Family Welfare said that traditional Ayurveda, homeopathy and yoga are not “alternative” medicine as they are often termed, but are rather “integral to healthcare”. The scientific findings from the AIIMS research is expected to align with the Centre’s plan to roll out a “One Nation, One Health System” policy by 2030.

Traditionally, yoga is known to resist the autonomic changes and impairment of cellular immunity but modern medicine demands proof of clinical efficacy and safety. Hence, the CIMR team, that has been given sanction to hire yoga and Ayurveda physicians, (earlier the AIIMS Act, Rules & Notifications did not provide for hiring yoga therapists) is also using the latest modern techniques, such as MRIs and PET scans, and multiple objective research methods to authenticate these traditional systems of medicine.

In a special 2021 issue of Medicina, the scientific journal of the Lithuanian University of Health Sciences, a paper on ‘The Future of Medicine’ states that integrative medicine is no longer just a possibility but a necessity. Despite advances in modern medicine, contemporary society has experienced a series of epidemics and pandemics of non-communicable, chronic, communicable and infectious diseases. These public health crises are related, at least in part, to behaviour and lifestyle, the paper said.

The World Health Organization is now developing standards for the implementation of Ayurveda, yoga, traditional Chinese medicine, meditation, herbal medicines, nutritional supplements, movement therapies, and other mind-body practices, terming them as Traditional Integrative Complementary Medicine (TCIM) that focuses on the “whole person” to achieve optimal health and healing.

The multiple studies at CIMR have so far revealed the potential benefits of simple, cost-effective yoga in patients with heart failure, rhythm disorders and those recovering from heart attacks. Patients suffering from depression, sleep disturbances, diabetes, blood pressure and episodic migraine have reported improvement in frequency, intensity and impact of their ailments, while prenatal yoga is helping pregnant women to stay calm to changes that take place in the body during pregnancy. The yoga programme includes slow and deep breathing exercises, relaxation techniques and yogic postures that influence the autoimmune nervous system, and improve the mindset and quality of life of patients.

The 10-year study at AIIMS is still a work in progress, supported and funded by the Ayush Ministry, the Departments of Biotechnology and Science & Technology, and the Indian Council of Medical Research. The AIIMS scientific community is currently investigating the clinical efficacy, mechanisms of action, protocols and policy implications of integrative medicine.

“The cost of modern healthcare is high and many drugs have side effects that compel about 10% of people to stop using them. An integrated approach will help doctors choose the best management options to combat the challenges of diseases in future,“ Dr. Sharma said.

Integrated medicine is an idea whose time has perhaps come.

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The use of yoga as an additional treatment has been found to be effective in reducing the symptomatic burden and improving the quality of life for patients suffering from migraine headaches and syncope, according to recent papers published in the American College of Cardiology and the American Academy of Neurology journals. These are among the 21 papers published recently in international scientific journals that have generated renewed enthusiasm for yoga in the global medical community, validating evidence-based integrative medicine and its imperative need in the future. A 10-year clinical trial is underway at the All India Institute of Medical Sciences (AIIMS) to identify areas of need where traditional medicine could provide relief to patients where allopathic medicines are inadequate. The Centre for Integrative Medicine & Research (CIMR) was established within the AIIMS-Delhi campus under the Ayush Centre of Excellence programme in 2016, where proper scientific research on yoga began for the first time in the country. Small breakthroughs and mid-way results from the cardiology, neurology, pulmonology, and gynecology departments have now been released and are getting verified by peer groups and international medical journals. The scientific findings from the AIIMS research are expected to align with the Centre’s plan to roll out a “One Nation, One Health System” policy by 2030.
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