Objectives:To study the cleft lip and cleft palate in the poverty stricken Sub-Himalayan Garhwal region of India, being a commonly seen congenital abnormality and scarcity of studies about the demography of cleft in this region.Design:A prospective cohort observational case series was performed on 4657 cleft patients at a Tertiary care Hospital in Dehradun, India, over a period of 5 years.Outcome measures:The authors investigated the differences between age and sex with cleft status and family history of clefts, birth order, religion, socioeconomic status, parent literacy, source of information for treatment, haematological investigations showing the status of infection and coagulation in such children and satisfaction after treatment.Results:Seventy-two percent parents of cleft lip patients were illiterate, and only 8% were graduates, the majority of patients were from the low socioeconomic class. The siblings of 1.1% of the cleft patients had similar deformity. Anemia was seen in 83.16% cases which was commonly microcytic hypochromic type and eosinophilia was seen in 25.50% of cases. In the coagulation profile, International Nationalized Ratio was found to be raised in 52.12%. Almost 95% of the families were fully satisfied by the treatment and results.Conclusion:This study will provide baseline information on the status of these less privileged cleft patients in this mountainous region for future reference to health workers.

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INTRODUCTIONBreathing process is the manner in which air is inspired or expired has great importance in maintaining health. Rhythmic breathing can be of major significance in determining one's physical and emotional state. Breathing often reflects our state of relaxation or excitation. When at rest, breathing is usually slow and rhythmic, and when tense, breathing may be erratic, or we may hold our breath. 2There are many pranayamic techniques described in the ancient literature which have an effect on cardiovascular system. Amongst these are alternate nostril breathing and diaphragmatic breathing. Also some rhythmic and ratio breathing pattern produces the same effect. There are different breathing techniques that essentially work on three main things: regulation of breath, control of vital force and channelization of the pranas in right direction. 3Control of prana is regulation of inhalation and exhalation. This is accomplished by eliminating the pause between inhalation and exhalation. Thus, by regulating the motion of the lungs, the heart and the vagus nerve are controlled. 4 It is known that regular practice of breathing exercises (pranayama) increases parasympathetic tone, decreases sympathetic activity, improves cardiovascular and respiratory functions, decreases the effect of stress and strain on the body and improves physical and mental ABSTRACT Background: The study was performed to see the effect of slow breathing (6 breaths/minute) training on spontaneous respiratory rate, heart rate and pattern of breathing. Methods: Sixty subjects between the ages 20-50 years were included in the study. After the rest of 10 -15 minutes in a comfortable sitting posture their baseline heart rate (HR), respiratory rate (RR) and pattern of breathing were recorded on digital polygraph. Then they were guided to do slow breathing maintaining rate of around 6 per minute. Subjects were then instructed to do slow breathing exercise for 8-10 minutes twice daily for next three months. Subjects reported back after three months of practicing slow breathing and their HR, RR, and pattern of breathing were again assessed by digital polygraph. Results: After three months of practicing slow breathing there was statistically significant reduction in heart rate and spontaneous respiratory rate. Shifting of pattern of breathing from thoracic pattern to abdominal pattern of breathing was also very highly significant. Conclusions: The study showed that slow breathing technique causes comprehensive change in body physiology by controlling autonomic nervous system. It regularizes rate and pattern of breathing.