Nostril Breathing Exercise Research Articles

Effect of an Alternate Nostril Breathing Exercise On Fatigue and Quality of Sleep Pattern Among Pregnant Women in Third Trimester

Effect of an Alternate Nostril Breathing Exercise On Fatigue and Quality of Sleep Pattern Among Pregnant Women in Third Trimester

Effect of Alternate Nostril Breathing Exercise on Reducing Anxiety and Blood Pressure among Pre-eclamptic Women

Effect of Alternate Nostril Breathing Exercise on Reducing Anxiety and Blood Pressure among Pre-eclamptic Women

Home Based Walking Exercises and Alternative Nasal Breathing Decrease Blood Pressure in Pre-Elderly People with Hypertension

The condition known as hypertension is brought on by the body's elevated blood pressure as a result of the heart pounding too hard. Hypertension is caused by a variety of causes, including both modifiable and unmodifiable ones. The purpose of this study is to evaluate the impact of alternate nostril breathing and walking exercise at home on the blood pressure of senior hypertension patients. A quasi-experiment with a pre-post test control group design methodology is used in the research design. Using the Total Sampling approach, 50 respondents with hypertension made up the research sample. In two weeks, the intervention was performed four times. The paired t-test results indicate that the combination of alternate nostril breathing and home-based walking exercise has an effect on blood pressure in the treatment group (both diastolic and systolic have p values = 0.000), while the control group experiences no change in blood pressure (diastolic has p values = 0.200 and systolic has p values = 0.195). The findings of the Independent T-Test demonstrated variations in blood pressure changes in both the systolic and diastolic domains between the treatment and control groups (diastolic p-value = 0.000), and systolic (p-value = 0.000). The findings of the Independent T-Test demonstrated variations in blood pressure changes in both the systolic and diastolic domains between the treatment and control groups ,diastolic (p-value = 0.000), and systolic (p-value = 0.000). Systolic and diastolic blood pressure drop as a result of an increase in endorphin chemicals and a decrease in cortisol. This calms and relaxes the body and balances the actions of the sympathetic and parasympathetic nervous systems. It is advised that individuals with pre-elderly hypertension who are able to independently implement combination therapies in an attempt to control their blood pressure. Kata kunci: Home Based Walking Exercise, Alternate Nostril Breathing, Pre-Elderly, Hypertension

Effect of Alternate Nostril Breathing Exercise versus Diaphragmatic Breathing Exercise on Dyspnea and Fatigue among Asthmatic Patients

Effect of Alternate Nostril Breathing Exercise versus Diaphragmatic Breathing Exercise on Dyspnea and Fatigue among Asthmatic Patients

Effect of alternate nostril breathing exercise on autonomic functions, ocular hypertension, and quality of life in elderly with systemic hypertension and high-tension primary open-angle glaucoma

Investigating the response of ocular hypertension and quality of life to a 4-week alternate-nostril breathing exercise (ANBE) in older adults with systemic hypertension (SH) and high-tension form of primary open-angle glaucoma (HTF-POAG) was our aim. Sixty older adults with SH and HTF-POAG were randomly assigned to the ANBE group (n=30, received morning and evening 30 min sessions of daily ANBE) or the control (waitlist) group (n=30). Right-eye intraocular pressure (IOP), left-eye IOP, blood pressure, short-form-36 survey (SF36S), rates of respiration and radial-artery pulsation, hospital anxiety and depression scale (depression subscale abbreviated as HADS-D and anxiety subscale abbreviated as HADS-A), and glaucoma quality-of-life 15-item questionnaire (GQoL-15) were assessed. All measurements were improved in the ANBE group only. In conclusion, a 4-week ANBE could be an adjunctive modality to improve HADS-D, rates of respiration and radial-artery pulsation, HADS-A, blood pressure, IOP, GQol-15, and SF36S in older adults SH and HTF-POAG.

Effect of alternate nostril breathing exercises on cardiorespiratory function- a systematic review

Introduction- Alternate nostril breathing has positively affected the cardio-respiratory system. This review aimed to compile information on the effects of alternate nostril breathing on cardiorespiratory function. Method– Databases such as PubMed, Medline, Scopus, Cochrane, and Google Scholar were systematically searched to review current evidence of randomized control trials (RCT) on alternate nostril breathing over the past two decades. Out of 89 articles, six were chosen for the final data extraction based on the inclusion and exclusion criteria. Results- All of the final included studies demonstrated a significant improvement in respiratory endurance and functioning and a high heart rate variability (HRV) that mostly has a parasympathetic effect. Conclusion- Alternate nostril breathing shows promising results in reducing stress, improving cardiovascular and respiratory function, and reducing complications of pulmonary problems in the future.

EFFECT OF PRANAYAMA (SPECIFIED BREATHING EXERCISE) ON STRESS & ANXIETY AMONG THE STUDENTS IN TRINCOMALEE CAMPUS, EASTERN UNIVERSITY SRI LANKA

Introduction: Due to the competitiveness among the society which increases with the current lifestyle and education system, most of the students, especially the University students are under Stress & Anxiety1. Pranayama meant an Alternative nostril breathing exercise and it is a cost-free, amazing therapy. Objective: This study was conducted to evaluate the effect of Pranayama on Stress and Anxiety and the Pulse rate among the selected students from the Faculty of Applied Science, Trincomalee Campus, Eastern University Sri Lanka. Methodology: This is a randomized control experimental study. Screening was done by using the tool of the Hamilton Rating Scale for Anxiety (HMA-A or HARS- 1959)2. Among the 460 hostel students, 120 participants were selected based on the inclusive, exclusive & diagnostic criteria. They were divided into two groups by a random selection process; 60 participants from the study group were only performed Pranayama daily for 15 minutes in the morning and the evening for 48 days. The remaining 60 in the control group were not engaged with any breathing exercise or any type of physical exercise. The data was analyzed using SPSS. Results: A reduction in Stress & Anxiety level scores from 16 ± 4.7 to 8 ± 3.3 after practicing Pranayama. An extremely significant ‘p’ value of less than 0.001 was obtained. And also it showed a mild reduction in pulse rate from 74.9 ± 6.4 to 73.2 ± 2.7 bpm too. Conclusion: Regular practice of Pranayama for a certain period is beneficial to reduce the Stress and Anxiety level and regulating the pulse rate.

EFFECT OF YOGA BREATHING EXERCISE ON THE PULMONARY FUNCTION PARAMETER (PEAK EXPIRATORY FLOW RATE) AND SYMPTOM CONTROL OF CHILDREN WITH MODERATE PERSISTENT BRONCHIAL ASTHMA ATTENDING TERTIARY CARE CENTRE-A QUASI EXPERIMENTAL STUDY

Objectives: The study was undertaken with the objective of assessing the effect of breathing exercise ( Alternate Nostril Breathing Exercise with deep breathing and controlled relaxation, pranayama a form of yoga breathing technique) on the pulmonary function parameter as well as symptom control of children with moderate persistent bronchial asthma. Background: Childhood asthma is a chronic health condition that affects more than 1 million school-aged children and their families. Nonpharmacological therapy includes yoga breathing techniques such as Alternative Nostril Breathing techniques significantly reduces the stress and improves better asthma control in children with bronchial asthma. Design &Methods: Quasi-Experimental, two group pretest- post-test design were adopted. Sixty children with moderate persistent bronchial asthma attending asthma clinic of tertiary care hospital were selected for the study. Simple random sampling with a comparison group was used for selection of the sample. TREND checklist for quasi-experimental design used as guidelines for the current study. Results: Breathing exercise significantly changed the Peak Expiratory Flow Rate as evidenced by the significant change in the mean percentage of PEFR value from the predicted value in the experimental group. Comparison of mean percentage PEFR value from age wise predicted value in the experimental group showed that 69.5%/ 82.4% , t= 8.275, p= o.ooo (p< 0.05) and in the control group was 66.0%/ 66.2% , t= 1.326 , p = 0.195 ( p> 0.05). There was statistically significant change in asthma control parameters in the experimental group. Breathing exercise significantly improved the level of symptom control in the experimental group. No such significant improvement in Symptomcontrol was noted in the control group.(McNamer 0.000/ 0.063), (p< 0.05). Conclusion: Based on the above findings, the present study concluded that breathing exercise has an effect on improving the pulmonary functions and symptom control of children with bronchial asthma.Relevance to clinical practice:The practice of yogabreathing exercises improves asthma symptoms and helps children to achieve better control over asthma along with pharmacological management.

Evaluation of the Effect of Left Nostril Breathing on Cardiorespiratory Parameters and Reaction Time in Young Healthy Individuals

Background: Pranayama, a yogic breathing practice, produces several physiological responses in healthy individuals. Hypertension is a critical and booming public health challenge all over the world. Yoga is one of the effective methods to reduce blood pressure (BP) and pulse rate (PR).Objective: To evaluate the effect of left nostril breathing (LNB) exercise on cardiorespiratory parameters and reaction time (RT) in young healthy individuals.Materials and methods: In this study, 106 young healthy individuals between 18 and 25 years of age were included. The systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse rate (PR), respiratory rate (RR), vital capacity (VC), peak expiratory flow rate (PEFR), and reaction time (RT) of volunteers were recorded at baseline (before exercise) and after two weeks of left nostril breathing exercise performed 45 minutes daily.Results: There was a significant reduction in SBP (126.64 ± 15.51 mmHg versus 116.29 ± 11.91 mmHg; Cohen’s d (effect size): 0.87; p < 0.0001)), DBP (76.57 ± 14.87 mmHg versus 71.07 ± 11.39 mmHg; Cohen’s d: 0.48; p < 0.0001), PR (85.32 ± 15.44/minute versus 81.77 ± 13.02/minute; Cohen’s d: 0.27; p < 0.0001), and RR (14.26 ± 2.15/minute to 13.17 ± 2.03/minute; Cohen’s d: 0.54; p < 0.0001). A significant increase was observed in VC (3.42 ± 0.62 versus 3.67 ± 0.65; Cohen’s d: 0.39; p < 0.0001) and PEFR (467.81 ± 46.66 versus 498.29 ± 51.50; Cohen’s d: 0.59; p < 0.0001). There was a significant decrement in auditory reaction time (ART) (164.36 ± 27.20 ms versus 143.84 ± 20.32 ms; Cohen’s d: 0.85; p < 0.0001) and visual reaction time (VRT) (190.25 ± 31.48 ms versus 163.75 ± 21.72 ms; Cohen’s d: 0.98; p < 0.0001). There was no significant change in maximum heart rate (MHR) after cardiorespiratory activity (CRA) (p > 0.434).Conclusion: Left nostril breathing is associated with a decrease in cardiovascular parameters and an increase in VC and PEFR. This technique may be useful for putting up a fight against the stress and strain of daily life. This simple exercise may also be a beneficial adjuvant to pharmacological therapy in hypertensive patients.

Penurunan Tekanan Darah pada Pasien Hipertensi Menggunakan Teknik Alternate Nostril Breathing Exercise

This study aims to determine the effect of alternative nostril breathing exercises on reducing blood pressure in hypertensive patients in the Telaga Dewa Health Center work area, Bengkulu City. This research is quantitative research with a quasi-experimental research design. The results of the univariate analysis obtained that the respondent's age was 64 years, all genders of the respondents were found, and most of them had a family history. The results of the bivariate analysis showed that the p-value &lt;0.05. In conclusion, there was a decrease in systolic and diastolic blood pressure before and after an alternative breathing exercise intervention in hypertension patients in the Telaga Dewa Health Center work area, Bengkulu City. Keywords: Nostril Alternative Breathing, Blood Pressure

Effect of Application of an Alternate Nostril Breathing Exercise on Fatigue and Quality of Sleep Pattern among Nursing Students

Background: The higher the energy level, the more efficient body. The more efficient body, the better feel and the more will use talent to produce outstanding results. Breathing exercise is one of the yogic techniques that can produce different physiological responses in healthy individuals. Aim: determine the effect of the application of an alternate nostril breathing exercise on fatigue and sleep quality pattern among nursing students enrolled in the Faculty of Nursing, Alexandria University, Egypt. Design: A quasi-experimental design was used to conduct this study. Subjects: A simple random sample of 100 volunteers of first-year nursing students enrolled in the winter semester of 2019 (males and females). Tools: Two tools were used to collect the necessary data for the present study. The tool I: Alternate nostril breathing assessment and tool II: Iowa Fatigue Scale. Results: indicated that regular practice of alternate nostril breathing increases parasympathetic activity. Participants experienced decrease levels of fatigue and improving the quality of sleep pattern. The majority of participants agreed that work drains their energy every day, that they never have enough time between classes to recover their energy, and that they dread waking up to another day of work. Conclusion: Implementation of alternate nostril breathing exercises helped in decreasing nursing students' fatigue levels before, during, and after their practice. Also, it improved the quality of sleep patterns. Recommendations: Apply the proposed protocol of alternate nostril breathing techniques. The developed colored illustrated booklet regarding the alternate nostril breathing has to be distributed to the newly enrolled nursing students each year. As well as fatigue in nursing students needs further study including the application of the alternate nostril breathing exercises that address chronic and acute fatigue and promote recovery.

Effects of alternate nostril breathing exercise on cardiorespiratory functions in healthy young adults.

Introduction:Alternate nostril breathing (ANB) is an effective breathing exercise with therapeutic benefits on cardiorespiratory functions for healthy and diseased individuals. This study was conducted to assess the effects of ANB exercise on cardiorespiratory tasks in healthy adults.Materials and Methods:This randomized experimental study was conducted in the Department of Physiology, Chittagong Medical College, Chattogram, from July 2017 to June 2018. A total of 100 1st-year students, aged between 18 and 20 years, were included by a random sampling method. Fifty participants (25 males and 25 females) were enrolled in the experimental group, while age- and body mass index-matched another 50 participants (25 males and 25 females) served as the control group. Experimental group participants performed ANB exercise for 4 weeks. Cardiorespiratory parameters (pulse rate, blood pressure, forced vital capacity, forced expiratory volume in 1st s [FEV1], and peak expiratory flow rate [PEFR] were measured. Data were taken at the start and after 4 weeks in both groups.Results:Independent t-test showed no significant differences in the cardiorespiratory functions between the experimental and control groups among the male and female participants, except for the females’ PEFR which showed small differences. On the other hand, repeated measure ANOVA shows significant improvement in the experimental groups among males (P < 0.001–0.028) and females (P < 0.001–0.001) in all the cardiorespiratory functions measured, except for the FEV1 and PEFR among males.Conclusion:The results of this study suggest that cardiorespiratory functions were improved after breathing exercise, and therefore, ANB can be recommended for increasing cardiorespiratory efficiency.

Effect of breathing practices on visual and auditory reaction time of adolescent population in Madurai, India -A comparison of right and left nostril breathing

Introduction: Specific nostril breathing techniques are known to influence the autonomic function. Various studies have recorded that Right nostril breathing (RNB) exercises stimulate sympathetic activity and left nostril breathing (LNB) exercises stimulate parasympathetic activity. The present study was done to find out whether this is true by observing the immediate effect of specific nostril breathing on Visual Reaction Time (VRT) and Auditory Reaction Time (ART) of the same individual before and after training. Aim and Objectives: 1. To assess the immediate effect of RNB & LNB on VRT and ART. 2. To compare the immediate effect of RNB &LNB on VRT & ART. 3. To assess the Gender difference in the RNB & LNB on VRT & ART. Materials and Methods: 40 MBBS students in the age group of 18-20 years were randomly selected. Group A (n=20) consisted of male and Group B (n=20) consisted of female volunteers. Subjects were taught breathing exercises on the first day and after 30 minutes of RNB, VRT & ART and again after 30 minutes of LNB, VRT & ART were recorded. Results: A significant reduction in ART& VRT and a significant increase in ART& VRT were seen after RNB & LNB exercises .No significant gender difference was observed on reaction time. Conclusion: RNB stimulates sympathetic activity and LNB stimulates parasympathetic activity. ART is faster than VRT and no difference in reaction times between males and females were found after immediate breathing exercises. Keywords: Autonomic function, Breathing exercises, Immediate, Reaction time.

Gender differences on pain threshold, body temperature and reaction time among elderly population after alternate nostril breathing exercises-A comparative study

Introduction: It is a known fact that elderly males have a faster reaction time than females, and females exhibit greater pain sensitivity than males. Results on body core temperature between genders are inconsistent. Alternate Nostril Breathing (ANB) exercises were known to modulate the autonomic nervous system. The present study was done to find whether such differences between elderly males and females on pain sensitivity, body temperature and reaction time still persisted after ANB exercises. Objectives: 1. To measure the pain sensitivity, body temperature and reaction time in elderly males and females; 2: To compare the effects of 30 minutes of ANB exercises on all these parameters between elderly males and females. Materials and Methods: 30 elderly males (n=14) and females (n=16) with a mean age of 70.3 years participated in the study. Pain sensitivity was measured with digital algometer, temperature with clinical thermometer and reaction time with choice time apparatus before and immediately after ANB exercises. Results: A significant decrease (

Can Breathing Exercise or Pranayama Affect the Intraocular Pressure in the Short-term?

To demonstrate any transient short-term effect of a particular type of breathing exercise (alternate nostril breathing of Nadi Shuddhi type of pranayama exercise) on the intraocular pressure (IOP) in glaucomatous as well as healthy eyes. A prospective, nonrandomized, observational, cross-sectional study was conducted in a tertiary eyecare hospital setup recruiting 3 groups of subjects-glaucoma group and a normal group that underwent the breathing exercise as well as a normal group that did not. IOP was recorded at baseline, then at 4 minutes after 10 cycles of the breathing exercise and also after 10 minutes of rest-corresponding to IOPb, IOPc, and IOPr of all the study groups. Only those subjects were recruited who were above 18 and under 80 years and were naive to breathing exercise. A total of 56 normal eyes (28 subjects, Normalb) and 33 glaucomatous eyes (19 subjects) were recruited for the breathing exercise and were compared with the IOP as obtained for 26 eyes of 26 subjects that did not undergo the breathing exercise (Normalnb). IOPb did not differ between both normal groups (13.7±1.4 mm Hg in Normalb vs. 13.9±1.6 mm Hg in Normalnb, P=0.183) but was significantly different between groups (16.7±3.1 mm Hg in the glaucoma group and 13.7±1.4 in Normalb, P<0.001 and Normalnb 13.9±1.6 mm Hg, P<0.001) but analysis of variance was not significant within groups comparing IOPb, IOPc, and IOPr of all the study groups. There is no short-term transient effect of alternate nostril breathing exercise on IOP; a longitudinal study is recommended.

The effect of alternate nostril breathing exercise in vital signs of congestive heart failure patients

Background: Changes in vital signs such as tachycardia, dyspnea, tachipnea, decreased oxygenation, caused by the inability of the heart to pump enough blood to meet the needs of oxygen and nutrients needed by the tissue, so that alternative therapies are needed: alternate nostril breathing exercise (ANBE) as a companion to pharmacological therapy for congestive heart failure (CHF) patients. The purpose of this study was to see the effect of ANBE on the vital sign of CHF patients.Methods: This Quasy experimental study was used one group pretest and Posttes design, conducted at one of the Padang City Hospitals from March to August 2019. Study population includes CHF sufferers, with a sample of 16 people, using accidental sampling technique. Univariate data analysis to get the mean of vital sign and bivariate measurements using parametric test i.e. Paired t-test to see the effect of this therapy.Results: Mean vital signs pretest and posttest was given in a row The observations are: respiratory rate (RR): 5.4978; 4.6078, pulse: 10.1804; 8,7770, systolic blood pressure (SBP): 12,5963; 11,1481, and diastolic blood pressure (DBP): 10,3009; 8.8606. Paired t-test obtained p-value of RR, pulse, SBP and DBP: 0.000, and existing t count&gt; from t table (t count&gt; 2.13145), so that there is an effect of ANBE on vital signs.Conclusions: ANBE affects the vital sign of CHF patients and can be continued as an intervention that can be carried out independently by CHF sufferers.

Effect of pranayama on anxiety and pain among patients undergoing cardiac surgery: A non-randomized controlled trial

BackgroundMajor cardiac surgery could be physically and mentally stressful. Anxiety and pain are commonly experienced by patients while undergoing cardiac surgery. Yoga is recognized as the most beneficial complementary and alternative therapy. ObjectiveTo assess the effect of alternate nostril breathing exercises (pranayama) on anxiety and pain among patients undergoing cardiac surgery. MethodsA non-randomized controlled trial was adopted as study design and involved 48 patients undergoing cardiac surgery. The experimental group (n = 24) received pranayama study intervention while the control group (n = 24) received routine care of the hospital. Outcomes were state anxiety and pain, measured with the state anxiety inventory and a visual analogue scale respectively. Data were analyzed by SPSS version 20.0. Repeated measures ANOVA was used to test the effect of the intervention. ResultsStudy results showed that patients in the experimental group experienced a significant decrease in anxiety (p < 0.05) than the control group. There was a decrease in pain scores but was not statistically significant across different time point measurements at p < 0.05 between the groups. ConclusionThese findings support the use of pranayama for decreasing anxiety among patients undergoing cardiac surgery. However, there is a need for randomized controlled trials with higher sample size to confirm this results. Future trials also should focus on the estimation of relevant biomarkers such as endorphins to understand the scientific rationale.

Impact of alternate nostril breathing exercises on vascular parameters in hypertensive patients - An interventional study

Background: Hypertension is characterized by overactivity of sympathetic nervous system. Sympathetic activation increases blood pressure both by stimulating heart and blood vessels. Breathing exercises are known to balance the autonomic function. Previous studies on hypertensives had shown that alternate nostril breathing (ANB) exercises reduce sympathetic activity by decreasing systolic and diastolic pressure. Since the effect of ANB on blood vessels was not documented so far, the present study was done to confirm the sympathetic lowering effect of ANB on vessel wall parameters immediately after 30 min of ANB exercises. Aims and Objectives: This study aims to measure and compare the immediate effect of 30 min of ANB exercises on the left brachial artery diameter, peak systolic velocity (PSV), and resistive index (RI) in hypertensive subjects. Materials and Methods: A total of 40 hypertensive patients in the age group of 45–65 years of both the genders were recruited for this study. The study group (interventional) and the control group included 20 hypertensive subjects each. Gray scale and Doppler ultrasound of the left brachial artery were done to assess the diameter of arteries, PSV, and RI before and immediately after 30 min of ANB. Results: In the study group, significant increase in vessel diameter (VD) (P < 0.001), and decrease in PSV (P = 0.040), RI (P < 0.001) were observed after ANB exercises. In the control group, no significant change in VD (P = 0.485), RI (P = 0.789), and PSV (P = 0.777) was seen after 30 min. Conclusion: ANB exercises reduced sympathetic activity in hypertensive patients.

Effect of alternate nostril breathing exercise on blood pressure, heart rate, and rate pressure product among patients with hypertension in JIPMER, Puducherry.

INTRODUCTION:Hypertension has a direct relationship with the circulation, respiration, and function of vital organs. Similarly, complementary therapy such as alternate nostril breathing exercise has a direct effect on mental and physical health.MATERIALS AND METHODS:This is a quantitative experimental research with randomized controlled trial design. A total of 170 and 85 individuals were allotted to each group. Patients in the study group were instructed alternate nostril breathing exercise two times a day (10 min duration of exercise each time) for 5 days along with routine treatment, and patients in the control group underwent routine treatment.RESULTS:There was a marked reduction in systolic blood pressure (BP), diastolic BP, heart rate, and rate pressure product after the continuous 5-day alternate nostril breathing exercise in the study group. P < 0.0001 demonstrated a statistically significant difference in systolic BP, diastolic BP, heart rate, and rate pressure product that existed pre- and post-assessment on 1st day and 5th day.CONCLUSION:It can be concluded that regular simple alternate nostril breathing exercise effectively reduces hypertension.

Immediate effect of slow right and left nostril deep breathing exercises on reaction time, pain sensitivity, and temperature of elderly population in Madurai

Background: Falls and fractures are very common in the elderly due to reduced swiftness of the response, decreased attention, and concentration. Normal reference point of temperature and pain threshold also varies in old age adding to their chronic illness. Important factor contributing to this is an imbalance in the autonomic nervous system (ANS). As nostril breathing exercises were known to modulate the ANS, the present study was done to find out the immediate effect of slow right nostril breathing (RNB) and left nostril breathing (LNB) exercises on reaction time, pain sensitivity, and temperature in the elderly population. Aims and Objectives: The objectives of the study were to measure the effect of 30 min of RNB and LNB exercises on auditory and visual reaction time, pain sensitivity, and temperature in elderly individuals. Materials and Methods: The study was done in the Department of Physiology of a Private Medical College in Madurai, on 30 healthy subjects aged 50–70 years. Reaction time was measured with discriminatory and choice time reaction apparatus, pain with digital algometer, and temperature with clinical thermometer. Results: A significant decrease in reaction time and pain threshold (P < 0.001 and