Yoga-based lifestyle intervention for healthy ageing in older adults: a two-armed, waitlist randomized controlled trial with multiple primary outcomes.

Yoga-based clinical research has shown considerable promise in varied ageing-related health outcomes in older adults. However, robust frameworks have yet to be used in intervention research to endorse yoga as a healthy ageing intervention to test the multidimensional construct of healthy ageing. This was an assessor-masked, randomized controlled trial conducted among 258 sedentary, community-dwelling older adults aged 60-80 years, randomly allocated to 26-week yoga-based intervention (YBI) (n = 132) or waitlist control (WLC) (n = 126). The effectiveness of YBI was assessed through two separate global statistical tests, generalized estimating equations and rank sum-based test, against a comprehensive healthy aging panel comprised of ten markers representing the domains of physiological and metabolic, cognitive, physical capability, psychological, and social well-being. The secondary outcomes were individual primary marker scores, Klotho, inflammatory markers, and auxiliary blood markers. We could establish the healthy aging effect of the 26-week YBI over WLC using two models of global statistical test (GEE, ß = 0.29; 95% CI = 0.20 to 0.38, p < 0.001), and rank sum-based test (ß = 0.28, 95% CI = 0.19 to 0.36, p < 0.001). There were also significant improvements in direction of benefit at individual levels of all the aging markers. Exploratory evaluation with adopted indices from contemporary clinical trials also validated the potential of YBI for healthy aging; HATICE adapted composite score (mean difference = - 0.18; 95% CI = - 0.26 to - 0.09, p < 0.001) and healthy ageing index (mean difference = - 0.33; 95% CI = - 0.63 to - 0.02, p = 0.03). The global effect of YBI across multiple ageing-related outcomes provides a proof of concept for further large-scale validation. The findings hold a great translational value given the accelerated pace of population aging across the globe. Trial registration: CTRI/2021/02/031373.

Predictors of behavioral and emotional issues in children involved in custody disputes: A cross sectional study in urban Bengaluru.

BACKGROUND: The increasing rates of divorce in urban India has led to the subsequent parental battle for the child's custody. This paper discusses the behavioral and emotional issues of these children in relation to their psychosocial environmental factors and other relevant socio-demographic variables. METHODS: We used samples from parent interviews concerning 52 children aged 7-17-years-old, involved in child custody cases in the Family court of urban Bengaluru. The Strengths and Difficulties Questionnaire was used to measure response variables of behavioral and emotional issues in these children. Predictor models of quantile and multiple linear regression were used to assess the influence of psychosocial environmental factors and socio-demographic variables on the response variables. RESULTS: The predictor models revealed that risk of child suffering emotional and behavioral issues increased with factors such as excessive parental control, change of academic environment, general unrest at school, frequency of child's court visit, child's visitation of non-custodian parent on occasions and vacations, and negatively altered family relationship. The model however intriguingly showed that residing in nuclear household rather than with their grandparents in a non-nuclear household, decreased the risk of mental health issues in these children. CONCLUSIONS: This study is a novel attempt to understand the influence of the psychosocial issues on the child's mental health in the context of custody cases in India. Despite the minimum sample size, the findings imply that family-based intervention is the need of the hour in these cases. The implications for clinical practice and research are discussed.

Effectiveness of Caregivers' Yoga Module on Psychological Distress and Mental Well-Being among Caregivers of Patients Admitted to Neurological Rehabilitation Wards of a Tertiary Care Institute, Bengaluru, Karnataka, India.

Background Caregivers of patients admitted to neurorehabilitation wards may experience higher psychological distress (PD) and poor mental well-being (MWB). This study aimed to empower caregivers to cope effectively with PD and maintain well-being by practicing yoga. Materials and Methods A total of 34 caregivers were randomized to the experimental group (EG) and waitlisted control group in a multiphase manner. Data were collected using sociodemographic schedule, Kessler's Psychological Distress scale-10, and Warwick-Edinburgh's Mental Well-being Scale. Caregivers' yoga module (CYM) consisting of satsanga (theory), asanas (postures), pranayama (breath control), imagery, meditation, and relaxation techniques was taught to those in the EG at 35 m/d for eight consecutive days. They were encouraged to continue on their own for another 3 weeks. Posttest data were collected from both groups on the 15th and 29th days. Analysis was done with IBM SPSS statistics version 22 (IBM Corp., Armonk, New York, United States). Results There was statistically significant reduction of PD and improvement of MWB among caregivers of EG within (PD: F = 17.78, p < 0.001; MWB: F = 5.48, p < 0.03) and between (PD: F = 15.87, p < 0.001; MWB: F = 15.87, p < 0.01) the groups after the CYM. A significant negative correlation was found between pretest MWB and PD ( r =-0.579, p < 0.01). Caregivers who were married and caregivers' perception of poor improvement of patient condition were significantly associated with PD. Conclusion Findings provide preliminary evidence for the effectiveness of CYM on PD and MWB among caregivers of patients admitted to neurorehabilitation wards.

Predictors of emotional and behavioral problems among Indian adolescents: A clinic-based study.

BACKGROUND: Emotional and behavioral problems place a heavy burden on the adolescents and their families. Many factors are known to influence adolescent mental health. The current study was designed to determine the predictors of emotional and behavioral problems among Indian adolescents. METHODS: The parents of adolescents in the age group of 10 to 18 (N = 81) were recruited from the National Institute of Mental Health and Neuro Sciences, Bangalore, Karnataka, India. Alabama Parenting Questionnaire (Parent version), Strength and Difficulty Questionnaire (Parent version) and, the Parent Interview Schedule (PIS) were used to assess the parental practices, emotional and behavioral problems and abnormal psychosocial environment of the adolescents. The data were analyzed with stepwise multiple linear and Quantile regression to find out significant predictors of emotional and behavioral problems among adolescents. RESULTS: Adolescent's age, parental involvement, and paternal age are the significant predictors of emotional problems. Parental mental disorder or deviance, gender, and inconsistent discipline are the significant predictors for conduct problems. Poor monitoring and supervision, paternal and maternal age are statistically significant predictors of prosocial skills among the adolescents. Inadequate or distorted intrafamilial communication and parental mental disorder are the significant predictors of total difficulties among the adolescents. CONCLUSION: The study validates the role of abnormal psychosocial environments and negative parenting practices as risk factors for emotional and behavioral problems among the adolescents. A comprehensive analysis which covers all possible variables related to adolescent mental health is mandatory for the health professionals before planning the intervention.

Immunohistochemical evaluation of myofibroblasts in odontogenic cysts and tumors: A comparative study.

CONTEXT: Myofibroblasts are fibroblasts with smooth muscle-like features characterized by the presence of a contractile apparatus and found in the connective tissue stroma of normal tissues such as blood vessels and lymph nodes. They are now thought to play a role in the synthesis and reorganization of extracellular matrix, which could contribute to the aggressive biologic behavior of the lesions. AIMS: To compare the mean number of stromal myofibroblasts in dentigerous cysts (DCs), keratocystic odontogenic tumor (KCOT) and ameloblastoma; and to derive a correlation between the stromal myofibroblasts and the known biologic behavior of the lesions. SETTINGS AND DESIGN: A cross-sectional immunohistochemical analysis of cases of DC, KCOT and ameloblastoma. MATERIALS AND METHODS: Twenty paraffin-embedded tissue blocks each of DC, KCOT and multicystic ameloblastoma were selected for the study and diagnosis confirmed through hematoxylin and eosin staining. Tissue sections were analyzed for the number of myofibroblasts using alpha smooth muscle actin (α-SMA) immunostaining. STATISTICAL ANALYSIS: Differences in the mean number of α-SMA positive cells in each group were analyzed using one-way ANOVA test. Intergroup comparisons of mean values of α-SMA positive cells were performed using Mann-Whitney U-test. RESULTS: Ameloblastoma showed the highest number of myofibroblasts, whereas DC showed the lowest. Among the groups, there were significant differences between the myofibroblast counts among DC and KCOT and between DC and ameloblastoma, whereas the difference in counts was not statistically significant between KCOT and ameloblastoma. A positive correlation was observed between the myofibroblast count and the known biologic behavior of the lesions. CONCLUSION: Myofibroblasts may act in close association with the epithelial cells to bring about changes in stromal microenvironment, favorable to the growth and progression of the lesion. They may be of great value in predicting the biologic behavior and growth potential of such lesions.

Clinical Study of Endometrial Polyp and Role of Diagnostic Hysteroscopy and Blind Avulsion of Polyp.

INTRODUCTION: Endometrial polyp is one of the common causes of Abnormal Uterine Bleeding (AUB) in the reproductive age group as well as postmenopausal age group. AIM: To study the clinical features of endometrial polyp and the safety and feasibility of blind polypectomy following diagnostic hysteroscopy. MATERIALS AND METHODS: Total of 256 women who were diagnosed to have endometrial polyp by transvaginal ultrasound and underwent diagnostic hysteroscopy and blind polypectomy by simple avulsion in the period of January 2008 to December 2014 were included in our study. Polyp was confirmed by the histopathology. RESULTS: The prevalence of polyp among women who underwent diagnostic hysteroscopy and blind polypectomy was more common in the age group of 40-49years. Polyps manifested as AUB in 45.6% of our study population. The mean size of the polyp was not significantly different between premenopausal and postmenopausal women and single and multiple polyps. Histopathological study of the polyp showed two malignant polyps in our study population. Premalignant lesions i.e., endometrial hyperplasia without atypia and with atypia was found in 33 women. There was one uterine perforation, one cervical tear; one false passage and one patient had mild bleeding after the procedure. In our study, in the mean follow-up period of 37.57±28.12 months, 3.9% (7 women) had recurrence. In the follow-up period of 16.56±18.96 months, 78.9% women didn't have recurrence. CONCLUSION: Diagnostic hysteroscopy and blind polypectomy has low complication rate and recurrence rate and technically feasible for the practicing gynaecologists which don't need much training and is cost-effective also.