Effect of 4-day Online Breath Meditation Workshop on Ballistocardiography-based Sleep and Cardiac Health Assessments among Medical Professionals of a Tertiary Care Hospital in North India during COVID-19

Background: Medical professionals (MPs) are facing stress, sleep deprivation, and burnout due to pandemic-related high patient inflow and consistent work shifts. Yoga and meditation are feasible, cost-effective, evidence-based, and well-accepted tools having multifold mental and physical health benefits. Design: In this ongoing open-label single-arm trial, we assessed changes in sleep, heart rate variability (HRV), and vitals before and after a 4-day online breath meditation workshop (OBMW) among 41 MPs at a tertiary care hospital in northern India during COVID-19 pandemic. Methods: Outcomes were assessed at baseline and after the 4-day workshop using a ballistocardiography-based contactless health monitoring device. The workshop was conducted online. Two participants were excluded due to a lack of adherence. Results: A highly significant increase was seen in total sleep duration (p = 0.000) and duration of deep sleep (p = 0.001), rapid eye movement (REM) sleep (p = 0.000), and light sleep (p = 0.032). HRV outcomes of the standard deviation of normal-to-normal R-R intervals (SDNN) and root mean square of successive differences between adjacent normal heartbeat (RMSSD) also improved significantly (p = 0.000) while heart rate reduced significantly (p = 0.001). No significant change was observed in breath rate, total time awake, or in the low-frequency by high-frequency (LF/HF) spectrum of HRV. Conclusion: Four days of OBMW improved sleep and HRV among MPs, strengthening the fact that yoga and meditation can help induce psychophysical relaxation and prove to be an effective tool to combat stress and sleep deprivation. As the stakeholders in patient care, that is, MPs are healthy, it will further improve patient care and reduce the chance of medical errors.

Is Maternal Anemia among Tribal Women being Neglected? A Study from Southern Rajasthan

Poor birth outcomes have been linked to maternal anemia. Tribal women are at higher risk of malnutrition and disease due to sociocultural barriers and poor educational status. The data on the prevalence of maternal anemia and its associated factors among pregnant tribal women are limited. A community‑based cross‑sectional study was conducted among 429 pregnant tribal women for maternal anemia from August 2021 to June 2022. A structured questionnaire was employed to collect sociodemographic data. The prevalence of anemia was 85.7%, with a mean hemoglobin level of 9.21 ± 1.3 g/dL. On applying WHO 2011 anemia criteria for pregnant women, 25.0% had mild anemia, 73.4% had moderate anemia, and 1.6% had severe anemia. The significant factors associated with anemic condition were household condition, monthly income, and husband’s occupation. The higher prevalence of anemia among pregnant tribal women is alarming that necessitates a rethinking of health infrastructure and outreach in tribal dominant areas.

The Trend of COVID-19 Pandemic in India: A Methodical Comparison with Italy, UK, and the US

Introduction: To statistically compare the trends of epidemiological indicators of COVID-19 in India with Italy, the UK, and the US. Methodology: In this descriptive analysis, epidemiological indicators were calculated and their trends were plotted and compared statistically. Regression analysis was done to predict the fatalities. Results: The trends of total and active cases per million populations are rising in India and US, while Italy has achieved the plateau in the total cases per million populations, and active cases have been sharply declining with time. The UK is about to achieve the same. India has remained far behind the other three countries in the number of tests per million populations (p<0.05). In the initial phase, the test positivity rate of India was quite lower but has overtaken Italy and UK. India has always reported a higher recovery rate than US and lower than Italy. CFRs have achieved a plateau in Italy and UK, in US it is declining, while it remained almost constant in India throughout the pandemic. Testing was a significant covariate in predicting the fatalities. Conclusions: India was able to manage the initial phase of this pandemic due to early and strict government interventions and strong public health responses.

Intra- and Inter-observer Variability in Different Methods of Measuring Carpal Collapse

@#Introduction:Carpal collapse of wrist occurs in disorders like rheumatoid arthritis and Kienbock's disease. Three techniques have been described to measure carpal collapse. First, the carpal height ratio (CHR), measured by dividing carpal height by 3rd metacarpal length. Second, the revised carpal height ratio (RCH ratio), measured by dividing carpal height by length of capitate. Third, capitate radius distance (CR index), measured by shortest distance between distal edge of radius and the proximal edge of capitate. The index publications describe good reliability of all these but which method out of the three is best in terms of intra- and inter-observer variability is not known. The purpose of this study was to find out which method had the least inter- and intra-observer variability for determining carpal collapse. Materials and Methods: Fifty normal wrist postero-anterior radiographs were studied by three assessors who measured CHR, RCH ratio and CR index separately. The measurements were repeated after one month by all the three observers. The results were then statistically analysed. Results: The p-value was <0.001 in all the three assessors in CR index meaning that the intra-observer variability was least in CR index. For the inter-observer variability intra class coefficient of 0.9 indicated that the CR index has the least variability. Conclusion: CR index is the most reproducible method to measure carpal collapse. The method which provides accurate measurement of carpal collapse will allow better staging of carpal disorders.

Current understanding on venous leg ulcer.

Venous leg ulcer (VLU) or stasis ulcer is a relatively common, chronic and recurring problem. Besides being costly to the health-care system, it significantly impairs the quality of life of the patients. Nearly 1% of adults and 3.6% of older patients are reported to suffer from this chronic condition. Chronic venous insufficiency is considered to be the predominant cause of VLU. The most recent theories associate the pathogenesis of venous ulcer with microcirculatory abnormalities and generation of an inflammatory response. The pharmacological treatment for VLU is based on the pathogenesis and often includes diosmin, pentoxifylline, diuretics as well as antibiotics and the non-pharmacological treatment like compression and skin grafting. VLU has a high rate of recurrence and requires self-care to avoid relapse. Treatment of VLU should always focus for complete treatment, and improve quality of life for patients along with minimum relapse. In recent years novel therapeutic approaches for venous ulcers have offered valuable tools for the management of patients with this disorder.

Statistical reporting in indian pediatrics.

We analyzed 45 original articles from Indian Pediatrics for appropriateness of the statistical methods. Appropriate statistical tests (93%), no use of obscure test and use of exact P value were the positive findings observed. Sample size was calculated in 24% and confidence interval in 13%. There is a need to generate awareness regarding confidence interval and sample size calculations.

Biodiversity of earthworm resources of arid environment.

Biodiversity of earthworms was studied in arid zone of Jodhpur district of Rajasthan. A total nine species of earthworms were recorded from different pedoecosystems of desert environment. These species were Pontoscolex corethrurus, Amynthas morrisi, Metaphire posthuma, Lampito mauritii, Perionyx sansibaricus, Ocnerodrilus occidentalis, Dichogaster bolaui, Octochaetona paliensis and Ramiella bishambari. They belonged to the families Glossoscolicidae, Megascolicidae, Ocnerodrilidae and Octochaetidae. The species P. sansibaricus, O. paliensis and P. corethrurus were reported for the first time from Rajasthan. The earthworm fauna of Jodhpur district were either exotic peregrine or native peregrine. Exotic species like A. morrisi and M. posthuma, and native peregrine species like L. mauritii were widely distributed in arid region. They appear to be better adapted to withstand drought conditions, as they have enteronephric meronephridia and excrete their urine into the guts for conservation of water in their bodies.

Seasonal changes in population of some selected earthworm species and soil nutrients in cultivated agroecosystem.

Studies were conducted on population dynamics of Metaphire posthuma, Lampito mauritii and Dichogaster bolaui in cultivated pedoecosystem of desert region of Rajasthan. The populations of aclitellate and clitellate M. posthuma, L. mauritii and D. bolaui were maximum in rainy season and minimum in summer season. The abundant population of these worms were found during the months of July to October. The species M. posthuma breed throughout the year except in extreme summer but L. mauritii breed twice in a year in the field. However, D. bolaui breed once in a year. Among these earthworm species D. bolaui with relative density of 44.2% was the most dominant species in cultivated land while L. mauritii and M. posthuma contributed 33.3% and 22.5% of density, respectively. The total population of earthworms showed significant positive correlation with different soil nutrients.

Value of clinico-psychiatric assessment in the diagnosis of chronic intractable pain in abdomen.

To evaluate the role of psychiatric illness in patients with chronic abdominal pain, 50 patients with this symptom were subjected to thorough clinical examination, detailed investigations and Goldberg's 60-item General Health Questionnaire. Those scoring 12 in this questionnaire were subjected to a detailed psychiatric evaluation. Sixteen (32%) patients had pure organic illnesses, 8 (16%) had organic illness with associated psychiatric factors and 26 (52%) had definite psychiatric illness. We conclude that chronic abdominal pain is often associated with psychiatric illness.

Effective reduction of LDL cholesterol by indigenous plant product.

A herbal powder containing guar gum, methi, tundika and meshasringi was administered to 30 control and 30 type 2 (non-insulin dependent) diabetes mellitus patients for a month. Total serum cholesterol and its fractions eg, high density lipoprotein, low density lipoproteins, very low density lipoproteins and serum triglyceride were determined before and after the trial period. Total and low density lipoprotein (LDL) cholesterols were reduced significantly after the therapy. There were no significant changes in high density lipoproteins (HDL), very low density lipoproteins (VLDL) or triglyceride levels. Side-effects eg, mild flatulence and looseness of bowel were noticed in less than 40% cases.

Control of hyperglycaemia and hyperlipidaemia by plant product.

A herbal powder consisting of Guargum, Methi, Tundika and Meshasringi was administered to thirty control and thirty NIDDM patients twice daily before principal meals for four weeks. Oral GTT showed improvement in both control and patient groups. Serum total and LDL cholesterol also fell significantly in both the groups after the trial period. Test meal of the herbal powder with D-Xylose excretion was otherwise normal. Follow up for upto two years did not reveal any long term side effect of the powder. This powder, therefore, can be effectively used to reduce postprandial blood glucose and LDL cholesterol in NIDDM patients as a long term measure.

Electrocardiographic changes in experimental drowning.

Healthy mongrel dogs were subjected to aspiration of 20 ml/kg of fresh water (group I) or sea water (group II). Fresh water as well as sea water aspiration produced an immediate and significant bradycardia and the heart rate remained appreciably low throughout the forty minute study period. Appearance of tall T waves was the chief electro-cardiographic abnormality seen in both the groups. Out of seven dogs subjected to fresh water aspiration, two died of ventricular fibrillation and the other five survived. On the other hand, out of seven dogs subjected to sea water aspiration, five died of ventricular asystole within 10 min. This shows that equivalent volume of sea water is more lethal than fresh water. Further it is concluded that ventricular fibrillation is common after fresh water aspiration whereas sea water aspiration commonly leads to ventricular asystole.