|Year : 2018 | Volume
| Issue : 2 | Page : 110-113
Role of yoga and naturopathy in a patient with left ovarian malignancy and nonalcoholic fatty liver with ascites
M Fathima-Jebin1, ST Venkateswaran2, N Manavalan1, A Mooventhan3
1 Department of Naturopathy, Government Yoga and Naturopathy Medical College and Hospital, Chennai, Tamil Nadu, India
2 Department of Yoga, Government Yoga and Naturopathy Medical College and Hospital, Chennai, Tamil Nadu, India
3 Department of Research and Development, Division of Yoga and Life Sciences, S-VYASA University, Bengaluru, Karnataka, India
|Date of Web Publication||2-May-2018|
Dr. A Mooventhan
Department of Research and Development, Division of Yoga and Life Sciences, S-VYASA University, Bengaluru, Karnataka
Source of Support: None, Conflict of Interest: None
A 70-year-old married woman diagnosed with left ovarian malignancy and nonalcoholic fatty liver with ascites in November 2016 underwent conventional management. In February 2017, the patient developed abdominal discomfort, bloatedness, nausea, and vomiting and underwent conventional management first in a government hospital, followed by in a private hospital, South India. Since no improvements were noted in any of the symptoms except vomiting, in March 2017, the patient was admitted to our hospital. The patient was advised to undergo yoga and naturopathy treatments for 30 days. Results showed a better improvement in weight, body mass index (BMI), abdominal girth, blood pressure (BP), plasma glucose, liver function test (LFT), and renal function test (RFT) along with very mild reduction in the size of left ovarian cancer. It suggests that yoga and naturopathic treatments may be effective in improving weight, BMI, BP, plasma glucose level, LFT, and RFT in patients with left ovarian malignancy and nonalcoholic fatty liver with ascites. Further studies are required to warrant the results.
Keywords: Ascites, cancer, fatty liver, naturopathy, yoga
|How to cite this article:|
Fathima-Jebin M, Venkateswaran S T, Manavalan N, Mooventhan A. Role of yoga and naturopathy in a patient with left ovarian malignancy and nonalcoholic fatty liver with ascites. Int J Health Allied Sci 2018;7:110-3
|How to cite this URL:|
Fathima-Jebin M, Venkateswaran S T, Manavalan N, Mooventhan A. Role of yoga and naturopathy in a patient with left ovarian malignancy and nonalcoholic fatty liver with ascites. Int J Health Allied Sci [serial online] 2018 [cited 2019 Jul 20];7:110-3. Available from: http://www.ijhas.in/text.asp?2018/7/2/110/231687
| Introduction|| |
In India, among females, about 25% of the total cancers are reproductive cancers. Cervix, ovary, and corpus uteri are the three leading sites of reproductive cancers. Among all cancers, ovarian cancer is the fourth most common cancer in Indian women. Nonalcoholic fatty liver disease (NAFLD) is an emerging public health issue, being not only a major cause of liver-related morbidity and mortality worldwide but also an independent risk factor for cardiovascular diseases. NAFLD treatment entails a consistent change in lifestyle habits. The best way of changing the lifestyle is adopting the practice of yoga and undergoing naturopathy treatments because these two are known as the system of medicine based on the lifestyle modifications. Although yoga and naturopathy are widely used for various noncommunicable diseases, there is a lack of scientific evidence for its efficacy, especially when used in combination. Hence, the present case study was conducted to find the effect of yoga and naturopathy in a patient with ovarian malignancy and nonalcoholic fatty liver with ascites.
| Case Report|| |
A 70-year-old married woman diagnosed with left ovarian malignancy and nonalcoholic fatty liver with ascites in November 2016 underwent conventional management. The patient's symptoms began with abdominal discomfort with distended abdomen, immediate vomiting after taking foods orally, and nauseating sensation present continuously. Symptoms were reduced after conventional management. Again in February 2017, the patient developed abdominal discomfort, bloatedness, nausea, and vomiting and underwent conventional management in a government hospital, South India, but no improvements were noted. Then, the patient got admitted in a private hospital, South India, and underwent conventional medication for 1 week. Within 2 days of medication, improvement was noted in vomiting, while no such improvements were noted in rest of the symptoms. No familial history of malignancy, diabetes, hypertension, and liver diseases were reported. In March 2017, with the above-mentioned complaints, the patient got admitted to our hospital. We advised the patient to undergo yoga and naturopathy intervention for 30 days. Weight, body mass index (BMI), abdominal girth (AG), blood pressure (BP), plasma glucose, hemoglobin, liver function test (LFT) and renal function test (RFT), and computerized tomography (CT) abdomen plain were assessed before and after the intervention. Written informed consent was obtained from participant.
The patient received 30 days of yoga and naturopathy treatments and was not under conventional medication. Details of the intervention given to the patient are provided in [Table 1].
- Weight: It was assessed in kilogram using as standard weighing machine
- BMI: It was calculated using a formula (weight in kilogram/height in meter square)
- AG: It was assessed in centimeter using a standard measuring tape
- BP: Systolic BP (SBP) and diastolic BP (DBP) were assessed using a sphygmomanometer
- CT abdomen plain: A serial axial section of abdomen was studied without administrating oral or intravenous contrast
- Blood analysis: Blood analysis was performed to assess hemoglobin, fasting plasma glucose (FPG) and postprandial plasma glucose (PPPG) levels, and LFT and RFTs.
| Results and Discussion|| |
The results of this study showed a better improvement in weight, BMI, AG, SBP, FPG, LFT, and RFT along with mild improvement in DBP, PPPG, and the size of left ovarian cancer in the patient's postassessments compared to its respective baseline assessments [Table 2]. It indicates that 30 days of yoga (asana and pranayama) and naturopathy treatments such as diet therapy, hydrotherapy, massage therapy, acupuncture, acupressure, reflexology, and chromo (color) therapy were effective in improving body weight, cardiovascular functions, blood glucose levels, and liver and renal functions alone with reducing (very mild)/not increasing the size of the ovarian cancer. Moreover, yoga and naturopathy might be useful for the prevention of cardiovascular diseases in this patient. It is because the present study showed a better improvement in the major risk factors (increase in weight, blood glucose levels, BP, and the presence of NAFLD) of cardiovascular diseases. The reduction in the weight, BMI, BP, and blood glucose levels might be mainly due to the effect of practice of yoga, and the diet rich in fruits and vegetables. In a previous study also, yoga and naturopathy were reported to produce a similar kind of improvement in patients with metabolic syndrome.
Liver functions are known to deteriorate in patients with NAFLD. Impaired liver functions are associated with development of ascites that leads to bulging of abdomen, bloatedness, indigestion, nausea, and vomiting as mentioned by our study participant. Results of this study showed a better improvement in LFT and reduction in AG (sign of reduced ascites) and reduction in the above-said symptoms. It indicates that the practice of yoga and the naturopathy treatments might be effective not only in improving LFT but also in improving the symptoms that are associated with impaired liver function in patients with NAFLD. The possible reason for this result could be mainly due to the change in diet as well as mud application to abdomen. Because metabolism is highly affected in patients with impaired liver functions, intake of normal diet would end up with indigestion, bloating, nausea, and vomiting. Thus, change in the diet with easily digestible foods such as fruits and vegetables, low fat, and protein as given in the study would reduce the load on the liver and other digestive organs. Inflammation and oxidative stress play a vital role in the development of NAFLD. Mud application is shown to produce anti-inflammatory effect, and fruits and vegetables are known to have high antioxidant properties. Thus, mud application to abdomen that was given to the patient might have reduced the severity of inflammation, while the diet reduced the oxidative stress and thereby improved liver function and its associated problems such as bloatedness, nausea, and vomiting. Physical exercise and weight loss were reported to produce beneficial effects in NAFLD. Yoga is one of the best physical exercises, reported to produce reduction in weight in the previous study  as well as in the present study along with naturopathy treatments. Hence, combinations of these therapies were expected to produce some positive effects in the patient.
Oxidative stress is the key role in the progression of NAFLD  and even deterioration of renal functions. Practice of yoga has shown to be effective in improving oxidative stress. Foods rich in fruits and vegetables are known to have antioxidant properties, and thus help in reducing the oxidative stress level. It leads to the prevention of further development of NAFLD and improvement of liver functions and renal functions. Improvement in the renal functions (reduced level of urea, creatinine, and uric acid after the treatment) of this patient could also be possibly through the naturopathic treatments such as renal pack, ginger pack, mudpack, and acupuncture, and acupressure at Back-Shu points. This improvement in renal function might have played a role in reducing the symptoms (nausea and vomiting) of the patient. Strengths of this study are as follows: (1) this is a first ovarian malignancy and nonalcoholic fatty liver with ascites case, reporting the effects of yoga and naturopathic treatments; (2) it was well tolerated and no side effects were reported by the patient throughout the study; and (3) it showed more effectiveness in improving weight, BMI, AG, SBP, FPG, LFT, and RFT which is very much important for the patient. Limitations of this study are as follows: (1) Although functional changes were improved, structural changes were minimal, and no obvious changes were detected in CT abdomen and (2) Validity and reliability of this result may vary because of single case. Hence, further well-planned clinical studies are suggested with large sample size to validate our results.
| Conclusion|| |
The results of this study suggest that yoga and naturopathic treatments may be effective in improving weight, BMI, BP, blood glucose level, LFT, and RFT in patients with left ovarian malignancy and nonalcoholic fatty liver with ascites. Further studies are required to warrant the results.
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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[Table 1], [Table 2]