Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Dr Mohan Z Mani

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Dr Mohan Z Mani,
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Believers Church Medical College,
Thiruvalla, Kerala
On Sep 2018

Prof. Somashekhar Nimbalkar

"Over the last few years, we have published our research regularly in Journal of Clinical and Diagnostic Research. Having published in more than 20 high impact journals over the last five years including several high impact ones and reviewing articles for even more journals across my fields of interest, we value our published work in JCDR for their high standards in publishing scientific articles. The ease of submission, the rapid reviews in under a month, the high quality of their reviewers and keen attention to the final process of proofs and publication, ensure that there are no mistakes in the final article. We have been asked clarifications on several occasions and have been happy to provide them and it exemplifies the commitment to quality of the team at JCDR."

Prof. Somashekhar Nimbalkar
Head, Department of Pediatrics, Pramukhswami Medical College, Karamsad
Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
Ex-President - National Neonatology Forum Gujarat State Chapter
Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018

Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."

Dr Kalyani R
Professor and Head
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Sri Devaraj Urs Medical College
Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
On Sep 2018

Dr. Saumya Navit

"As a peer-reviewed journal, the Journal of Clinical and Diagnostic Research provides an opportunity to researchers, scientists and budding professionals to explore the developments in the field of medicine and dentistry and their varied specialities, thus extending our view on biological diversities of living species in relation to medicine.
‘Knowledge is treasure of a wise man.’ The free access of this journal provides an immense scope of learning for the both the old and the young in field of medicine and dentistry as well. The multidisciplinary nature of the journal makes it a better platform to absorb all that is being researched and developed. The publication process is systematic and professional. Online submission, publication and peer reviewing makes it a user-friendly journal.
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I wish JCDR a great success and I hope that journal will soar higher with the passing time."

Dr Saumya Navit
Professor and Head
Department of Pediatric Dentistry
Saraswati Dental College
On Sep 2018

Dr. Arunava Biswas

"My sincere attachment with JCDR as an author as well as reviewer is a learning experience . Their systematic approach in publication of article in various categories is really praiseworthy.
Their prompt and timely response to review's query and the manner in which they have set the reviewing process helps in extracting the best possible scientific writings for publication.
It's a honour and pride to be a part of the JCDR team. My very best wishes to JCDR and hope it will sparkle up above the sky as a high indexed journal in near future."

Dr. Arunava Biswas
MD, DM (Clinical Pharmacology)
Assistant Professor
Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata

Dr. C.S. Ramesh Babu
" Journal of Clinical and Diagnostic Research (JCDR) is a multi-specialty medical and dental journal publishing high quality research articles in almost all branches of medicine. The quality of printing of figures and tables is excellent and comparable to any International journal. An added advantage is nominal publication charges and monthly issue of the journal and more chances of an article being accepted for publication. Moreover being a multi-specialty journal an article concerning a particular specialty has a wider reach of readers of other related specialties also. As an author and reviewer for several years I find this Journal most suitable and highly recommend this Journal."
Best regards,
C.S. Ramesh Babu,
Associate Professor of Anatomy,
Muzaffarnagar Medical College,
On Aug 2018

Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".

Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
On Aug 2018

Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".

Dr. Mamta Gupta
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018

Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.

Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."

Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
On May 11,2011

Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."

Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
On April 2011

Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.

Dr. Anuradha
On Jan 2020

Important Notice

Research Protocol
Year : 2022 | Month : May | Volume : 16 | Issue : 5 | Page : CK01 - CK04 Full Version

Yoga Intervention for Patients with Systemic Lupus Erythematosus- A Research Protocol

Published: May 1, 2022 | DOI:
R Shobana, Emmanuel Bhaskar, K Maheshkumar, Santhi Silambanan

1. Assistant Professor, Department of Physiology, ACS Medical College and Hospital, Velappanchavadi, Chennai, Tamil Nadu, India. 2. Professor, Department of General Medicine, Sri Ramachandra Medical College and Research Institute, Porur, Chennai, Tamil Nadu, India. 3. Assistant Medical Office/Lecture Grade II, Department of Physiology, Govt. Yoga and Naturopathy Medical College and Hospital, Chennai, Tamil Nadu, India. 4. Professor, Department of Biochemistry, Sri Ramachandra Medical College and Research Institute, Porur, Chennai, Tamil Nadu, India.

Correspondence Address :
Dr. Santhi Silambanan,
Department of Biochemistry, Sri Ramachandra Medical College and Research
Institute, SRIHER, Chennai, Tamil Nadu, India.


Introduction: Systemic Lupus Erythematosus (SLE) is one of the most common systemic autoimmune disease with a wide range of clinical manifestations. SLE patients experience periods of exacerbation or flare and quiescent disease activity. An increase in the frequency of exacerbations or flares causes permanent organ damage, increased morbidity, and early mortality, which are mainly due to the increased activity of immune-mediated inflammatory reactions. Yoga interventions have an immune-modulatory potential that regulates the psycho-neuro-immune axis, moderates disease activity, and improves the Quality Of Life (QOL) for patients.

Aim: To report the methodology for the six months specified yoga interventions to reduce the inflammatory markers and enhance health-related QOL among SLE patients.

Materials and Methods: A randomised controlled trial will be conducted with a sample size of 128 SLE participants. Newly diagnosed and treatment-resistant SLE participants, patients more than 18 years of age, will be recruited. Participants divided into three groups: newly diagnosed, treatment-resistant SLE, and control; patients diagnosed with SLE within six months, unresponsive to "standard therapy" will be placed in the respective group. Participants in the newly diagnosed and treatment-resistant groups are given yoga sessions, and the effects will be compared with controls.

Results: A baseline and postintervention (after six months) assessment will be performed for all the patients. Primary outcomes like anti-double stranded Deoxyribonucleic Acid (anti-dsDNA), complements-C3, C4, and inflammatory markers like Interleukin 6 (IL-6), 10, 17, Interferon-gamma, and plasma micro-RNA will be measured and quantified. The secondary outcome included measurement of health-related QOL using the Lupus-QoL questionnaire.

Conclusion: Yoga integration, along with conventional treatment for SLE, as adjunctive therapy might enhance physical functioning and improve psychological health.


Autoimmune diseases, Inflammatory markers, Plasma micro-RNA, Quality of life

The SLE is an autoimmune disorder characterised by immune dysfunction, causing inflammation and tissue damage in various organs (1),(2). The overall global incidence of SLE ranges between 1.5-11 per 100,000 person-years, and the global prevalence ranges from 13 to 7,713.5 per 100,000 individuals (3). In India, SLE affects one in every 1,000 people, out of which the majority are women (4). Auto-antibodies are formed against the body’s own tissues with the deposition of immune complexes in various organs like the skin, brain, lungs, kidney, and blood vessels (5). The course and presentation of the disease vary with time (2).

Clinical manifestations of SLE vary due to the influence of various factors like genetics, hormones, and environmental factors (6),(7). SLE has both short- and long-term consequences in a person's life, limiting their physical, mental, and social functioning (8),(9). SLE does not have a cure, but the symptoms can be improved by medications like corticosteroids and immunosuppressants with inherent side-effects (10). Despite the fact that SLE mortality has decreased, it remains high (11). Cardiovascular disease, renal disease, and infections remain the most common causes of death in SLE (12),(13). The risk of developing complications can be decreased by reducing the frequency of flares and remissions (14). The signs and symptoms of SLE mimic other diseases, which complicate the diagnosis further (15).

Of late, research has been focused primarily on the assessment of reliable biomarkers for early diagnosis and assessing the prognosis of the disease (16). However, none has achieved the status of a surrogate endpoint to assess the outcome.

Yoga interventions that are intended to be given to the subjects have been practised for decades, with no known harmful effects (17). Efforts are made to ensure that protocols are suitable for the study population as well as accepted by yoga experts. A study by Middleton KR et al., which found that patients who practiced yoga regularly reported less pain and could handle stress, there has been little research into the effects of yoga on SLE (18). Patients also have experienced fewer lupus symptoms as yoga practice caused vagal dominance with subsequent inhibition of release of pro-inflammatory cytokines like IL-17 and Tumour Necrosis Factor (TNF)-alpha (19).

The intervention goals in SLE will minimise patient exposure to excessive corticosteroids and other immunosuppressive therapies and decrease the frequency of flare recurrence. There are very limited studies on the effects of yoga on the management of SLE. Conventional diagnostic tests like ANA, anti-ds DNA (20), and complement levels are used to diagnose and monitor disease activity. So, this study will be conducted with an aim to analyse the effect of yoga on inflammatory biomarkers such as IL-6, 17, and TNF-alpha and QOL in both newly diagnosed and resistant cases of SLE. The hypothesis is that yoga as a complementary therapy for patients with SLE will decrease the frequency of relapse and remission by diminishing the pro-inflammatory markers, stress markers, antibodies and reversing the damage observed in DNA.

Material and Methods

The present study was a randomised controlled trial will be conducted on patients from Sri Ramachandra Medical College (SRMC) and ACS Medical College. The study is planned to start on January 2022 and complete it by February 2023. Institutional Ethical Committee (IEC) approval from both the institutes has been taken, vide letter numbers IEC-NI/21/FEB/77/39 (from SRMC), and 335/2021/IEC/ACSMCH (ACS Medical College and Hospital). The Clinical Trial registration: Ref/2021/03/041865. Outcome variables will be performed at baseline and after six months as depicted in (Table/Fig 1).

Sample size: The sample size calculation is based on a similar study that was conducted on 48 male participants (21). With 80% power, two-tailed significance, an expected drop-out rate of 20%, and a 1:1:1 allocation, a total sample of 128 participants is estimated.

Randomisation and blinding: A confidential list of randomisations will be prepared either using computer-generated random numbers or coin tossing. The categorisation of allocation will be kept in a sealed cover for the research assistant to open following the assessment of baseline parameters. The allocation of participants can be unblinded as a result of participant withdrawal or adverse outcomes.

Selection of Participants

Inclusion criteria: Participants fulfilling 4 out of 11 revised American College of Rheumatology (ACR) classification criteria will be included in this study (22). SLE subjects unresponsive to conventional treatment for more than six months will be involved in this study.

Exclusion criteria: Participants with a severe form of SLE (based on flares presenting with significant kidney disease, brain disease, very low platelet or red blood cell count, vasculitis) (23), any other inflammatory disorder or immune deficiency disorder, acute infectious diseases, associated co-morbidity or depression, or psychological illnesses will be excluded from this study. Participants practising yoga in the past 3-6 months will be excluded.

Statistical Analysis

All the data set will be assessed for normality using Shapiro-Wilk Test and based on the distribution parametric test or non-parametric test of preference will be performed to find the intra and inter group variation using R statistical software version 4.0.2.

A total of 128 participants will be selected based on criteria and grouped into Group I: newly diagnosed SLE patients (n=64), Group II: resistant SLE patients, i.e., unresponsive to conservative treatment (n=64). The participants will be randomised and subjected to the allocated intervention. Both newly diagnosed Group I and resistant SLE patients Group II are divided into two groups, A – control and B – intervention, with 32 participants in each. Yoga intervention details is shown in (Table/Fig 2).

Yoga technique: The yoga protocol will be adjusted according to the needs of SLE participants. Repetitive substantiations of the yoga protocol will be done by yoga experts to maintain the uniqueness and holistic approach of the yoga techniques (24). The yoga sessions will be conducted at least three times a week, with each session lasting about 45-60 minutes. Daily home practises will be complemented either through online yoga sessions or with handouts on video recordings of yoga instructions and yoga practice. The participants who are willing to undergo online yoga sessions to practise at their homes will either join through online sessions or they can practise using the handout video. The intervention period will be for six months.

Components of the yoga intervention: Yoga interventions will be given in the form of asanas (postures), pranayama (breathing techniques), relaxation, and meditation. The participants will be given a video recording containing modules on yoga practises with instructions given by the yoga teacher to be practised at their convenience in their homes. This yoga intervention will take place over the next six months.

Sequences of specific classes: The sessions start with a prayer, then the participants will be subjected to mild stretching exercises, postures (asana), breathing practises (pranayama), relaxation techniques, and chanting with meditation. The yoga instructor will address the queries of the participants before the start of the session and also look into the physical status of every individual during and after the session is completed.

The aim of the intervention will be to decrease the stress, fatigue, and rate of relapse, thus reducing the complications associated with it. Though yoga can be customised for each individual, a standard protocol for everyone is needed. The present protocol is anticipated not to have many risks that could be associated with the intervention since the activities selected in this protocol are mild and are performed in comfortable supine posture.

Selection and instructors: Yoga trainers with certification will be identified and confirmed based on their experience in teaching yoga to people with chronic diseases. The selected instructor will be guided to teach the specific yoga practise to the participants.

Measurement of intervention fidelity over time: A manual checklist will be developed for the participants so as to document the practise session. A video recording of self-yoga practised at home will be entrained and brought with them to the direct contact session for further evaluation or modification.

Outcome Variables

Primary outcomes: Quantitative measurement of autoantibodies - Anti-dsDNA, ANA, Anti-cardiolipin; complements - C3, C4; Plasma micro-RNA; and pro-inflammatory markers - IL-6, IL- 17, TNF-alpha, Interferon-gamma; anti-inflammatory markers - IL-10.

Secondary outcomes: Subjective health related QOL will be measured by lupus-QoL questionnaire containing 34 questions across eight domains i.e., on physical health, emotional health, body image, pain, planning, fatigue, intimate relationships, and burden to others (25).

All the parameters will be checked ‘before’ and ‘after’ six months of yoga intervention.


The positive effects of yoga on inflammation and immune response have been reported (26). Regular yoga practice decreases the level of the pro-inflammatory cytokine IL-1 beta, which in turn enhances the immune response among individuals (27). However, no such convincing evidence was reported for other cytokines such as IL-6, TNF-alpha, and C-reactive protein. Yoga practice increases the level of the anti-inflammatory cytokine IL-10, with a medium effect size (27). In addition, yoga interventions help to maintain the oxidative stress and antioxidant levels among individuals, which would improve their immune function (28). Furthermore, yoga has the potential to inhibit inflammatory processes at the transcriptional level as well. The mechanism of action of yoga intervention is vagal stimulation, which improves baroreflex sensitivity and lowers inflammatory cytokines and parasympathetic activation, which is associated with antistress mechanisms (29). So, yoga could be recommended for patients with immune compromised people and could be implemented as a complementary and integrative therapy for effective management.

A study, conducted among 57 SLE patients, showed a better QOL with a reduction in stress, pain score, and sleep disturbance after yoga intervention (30). The researchers used 60-minute yoga practices, including 16 sessions over a period of eight weeks at home. After completion of the study, the majority of the patients showed hesitation about incorporating the common yoga protocol, which is not designed for SLE specifically. So it shows the importance of developing a unique yoga protocol for patients with SLE. While developing a protocol for SLE patients, special consideration may be advised to include specific yoga poses that play an important role. Some yoga poses or techniques should be avoided and you should be cautious because they may damage or aggravate the inflamed joints. For these reasons, yoga interventions can be framed with an expert’s opinions to meet the prime needs and care of the patients.


Present study findings will provide high-quality clinical evidence on the efficacy and safety of the yoga protocol in the treatment of SLE patients. If the observations of this study ascertain the improvement in biomarkers and QOL among SLE patients, it could be recommended as an adjuvant therapy for better care and management for the patients along with conventional care.


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DOI and Others

DOI: 10.7860/JCDR/2022/53287.16295

Date of Submission: Nov 12, 2021
Date of Peer Review: Dec 23, 2021
Date of Acceptance: Feb 08, 2022
Date of Publishing: May 01, 2022

• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. NA

• Plagiarism X-checker: Nov 16, 2021
• Manual Googling: Feb 07, 2022
• iThenticate Software: Mar 01, 2022 (6%)

ETYMOLOGY: Author Origin

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