A study to assess the effect of yoga and diet on Framingham risk score among high-risk cardiovascular subjects.

Introduction: Cardiovascular diseases (CVDs) are a cluster of disorders of blood vessels and the heart. As a form of physical activity, yoga postures, and pranayama have been shown to be beneficial in various health conditions, i.e. hypertension, prediabetes, and diabetes among high-risk subjects. This study aimed to evaluate the impact of yoga and diet on the Framingham risk score (FRS) among high-risk cardiovascular subjects. Materials and Methods: The experimental interventional study was conducted at "RUHS College of Medical Sciences" and Associated Group of Hospitals", Jaipur among high-risk cardiovascular subjects. FRS was used as a measurement for the outcome of interest at baseline and six months of yoga diet intervention in the study and control groups. Results: Mean age of participants was 48.43 ± 6.4 years. Baseline values (mean ± SD) of FRS 24.59 ± 10.15 after six months of yogic lifestyle 15.1 ± 7.05. After six months of yogic lifestyle FRS scores and estimated 10-year cardiovascular risk were statistically significantly (P < 0.0001) decreased. Pearson correlation analysis results depict that FRS correlation. There was a strong positive correlation between the FRS score and total cholesterol (r = 0.787; P < 0.001) and a negative strong correlation between the FRS score and high-density lipoprotein was observed (r =-0.621; P < 0.002). Conclusion: The findings of this study conclude that six months of yoga and diet lifestyle intervention significantly decreased FRS among high-risk CVD subjects compared to the control group.

Influence of Physical Activity on Health-Related Fitness in Young Adults: An Observational Research.

Background: Health-related fitness directly depends on the level of physical activity of the individual. Inactivity contributes to around 3.3% of all deaths, making the lack of exercise and sedentary lifestyles among the young generation a current source of concern. There is a paucity of research on the association between PA and health-related physical fitness among young people. In the perspective of this, the objective of this research was to find out the effect of PA levels on physical fitness in healthy adults. Methodology: A total of 419 students between the ages of 18 and 25 participated in this cross-sectional survey. The "Global Physical Activity Questionnaire (GPAQ)" was used to evaluate the PA. Their body fat percentage was measured using a skin fold caliper, followed by measurement of VO2max using a gas analyzer and hand grip strength and endurance assessment with the help of a computerized dynamometer. For statistical analysis, Karl Pearson's correlation coefficients and the ANOVA test were utilized. Results: PA was positively correlated with VO2 max (r=0.429), and handgrip strength (r=0.408) while negatively correlated with body fat % (r=-.315). VO2 max, body fat, and hand grip strength differ significantly amongst participants having different physical activity levels. (p-value =<0.05). Conclusion: This research concludes that PA is associated with physical fitness. PA will lead to a definite improvement in overall physical fitness. With the help of the results of this study, young adults can be motivated for physical fitness.

A Study on Yoga-Based Lifestyle Intervention versus Dietary Intervention Alone on Cardiometabolic Risk Factors among People with Prediabetes.

BACKGROUND: Prediabetes is presented as a metabolic state that predisposes persons to a greater risk of diabetes progression in the future. Prediabetes is an intervening stage between normoglycemia and diabetes with impaired fasting glucose and impaired glucose tolerance. This study aimed to compare the effect of the yoga-based lifestyle intervention (including diet) versus dietary intervention (DI) alone on cardiometabolic parameters namely fasting blood glucose (FBG), glycated hemoglobin (HbA1C), lipid profile; triglyceride (TG), total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL), very low-density lipoprotein (VLDL), heart rate variability (HRV), and carotid intima-media thickness (CIMT) among people with prediabetes. METHODS: A randomized controlled study was conducted on 250 people with prediabetes who were randomly allocated by computer-generated methods to the yoga-based lifestyle intervention (including diet) (n = 125) and DI alone (n = 125) groups. Yoga sessions were approximately 45 min 6 days a week over a period of 6 months. Assessments were made at baseline and after 6 months of intervention. RESULTS: Post-intervention comparison of cardiometabolic parameters in yoga-based lifestyle intervention (including diet) versus DI alone showed a significant decline in body mass index (P = 0.0002), waist-hip ratio (P = 0.0001), systolic blood pressure (P = 0.0001), diastolic blood pressure (P = 0.0001), perceived stress score (P = 0.0001), FBG (P = 0.0001), HbA1C (P = 0.0001), lipid profile; TG (P = 0.008), LDL (P = 0.0001), VLDL (P = 0.0001), HRV (P = 0.0001), CIMT (P = 0.02) and a nonsignificant decline in, TC (P = 0.22), HDL (P = 0.211), FFQ (P = 0.164). CONCLUSION: The finding of this study suggests that a 24-week yoga-based lifestyle intervention which includes diet significantly decreased cardiometabolic parameters compared to DI alone among people with prediabetes.

Résumé Contexte:Le prédiabète est présenté comme un état métabolique qui prédispose les personnes à un risque plus élevé de progression du diabète dans le futur. Le prédiabète est une étape intermédiaire entre la normoglycémie et le diabète avec une altération de la glycémie à jeun et une altération de la tolérance au glucose. Cette étude visait à comparer l'effet d'une intervention sur le style de vie basée sur le yoga (y compris le régime) par rapport à une intervention diététique (DI) seule sur les effets cardiométaboliques. paramètres à savoir glycémie à jeun (FBG), hémoglobine glyquée (HbA1C), profil lipidique; triglycéride (TG), cholestérol total (TC), lipoprotéines de haute densité (HDL), lipoprotéines de basse densité (LDL), lipoprotéines de très basse densité (VLDL), variabilité de la fréquence cardiaque (VRC) et carotide épaisseur intima-média (CIMT) chez les personnes atteintes de prédiabète.Méthodes:Une étude contrôlée randomisée a été menée auprès de 250 personnes atteintes prédiabétiques qui ont été répartis au hasard, par des méthodes générées par ordinateur, dans l'intervention sur le style de vie basée sur le yoga (y compris le régime alimentaire) (n = 125) et groupes DI seul (n = 125). Les séances de yoga duraient environ 45 minutes 6 jours par semaine sur une période de 6 mois. Des évaluations ont été faites au départ et après 6 mois d'intervention.Résultats:Comparaison post-intervention des paramètres cardiométaboliques dans un mode de vie basé sur le yoga L'intervention (y compris le régime alimentaire) par rapport à l'ID seul a montré une baisse significative de l'indice de masse corporelle (P = 0,0002), du rapport taille-hanche (P = 0,0001), de la pression systolique. tension artérielle (P = 0,0001), tension artérielle diastolique (P = 0,0001), score de stress perçu (P = 0,0001), FBG (P = 0,0001), HbA1C (P = 0,0001), profile lipidique; TG (P = 0,008), LDL (P = 0,0001), VLDL (P = 0,0001), HRV (P = 0,0001), CIMT (P = 0,02) et une baisse non significative dans, TC (P = 0,22), HDL (P = 0,211), FFQ (P = 0,164).Conclusion:Les résultats de cette étude suggèrent qu'un mode de vie basé sur le yoga pendant 24 semaines une intervention qui comprend un régime a considérablement réduit les paramètres cardiométaboliques par rapport à l'ID seul chez les personnes atteintes de prédiabète.

A study to evaluate the burden of hearing loss and its correlation with risk factors among high-risk infants at a teaching institution, Jaipur.

Introduction: Hearing loss is a global issue of hearing disability and early detection and rehabilitation of hearing loss are important for the development of speech and language skills in hearing-impaired infants. There are multiple risk factors that aid in hearing loss but some are potential factors that contribute toward hearing loss in infants. The aim of this study was to assess the burden of hearing loss and its correlation with risk factors among high-risk infants at a teaching institution in Jaipur, Rajasthan. Method: This study was carried out after approval of institutional ethics committee on a total of 320 high-risk infants at RUHS College of medical sciences and associated hospitals. Hearing loss was assessed by brainstem evoked response audiometry (BERA). Statistical analysis of data was done by cross-tabulation analysis with Pearson correlation and quantile regression. Results: Out of 320 high-risk infants, 59.69% of infants had normal hearing, 9.09% Unilaterally hearing impaired, 20.31% were bilaterally mild-moderate hearing loss, and 10.94% had severe-profound deafness. The prevalence of important risk factors viz. hyperbilirubinemia, low birth weight, appearance, pulse, grimace, activity, and respiration score, meconium aspiration, respiratory distress, and ventilation greater than five days were 86%, 58.9%, 40%, 36%, 29%, and 22%, respectively. Conclusion: In high-risk infants, hearing loss is a common hearing disorder. Because of this, early diagnosis of hearing loss gives them the best chance of developing functional speech. Brainstem evoked response audiometry is a simple, reliable, and effective technique for the assessment of auditory functions in infants.

A Study to Assess and Correlate Metabolic Parameters with Carotid Intima-Media Thickness after Combined Approach of Yoga Therapy among Prediabetics.

Background: Prediabetes is an intermediate hyperglycemia in which the fasting blood glucose (FBG) level is greater than normal (100-125 mg/dl) but lower than diabetic levels (more than 125 mg/dl). The aim of the present study was to evaluate and correlate the impact of the combined approach of yoga therapy (CAYT) on carotid intima-media thickness (CIMT) and metabolic parameters including FBG, glycated hemoglobin (HbA1C), and lipid profile-like triglyceride (TG), total cholesterol (TC), and high-density lipoprotein (HDL). Materials and Methods: Experimental Interventional study was conducted on a total of 250 prediabetics divided into the control (n = 125) and study group (n = 125) at "RUHS College of Medical Sciences and associated hospitals." Assessments were made at baseline and after six months of the CAYT. The study group (n = 125) was engaged in the CAYT, which consists of yoga, dietary modification, counseling, and follow-up. The control group not participated in CAYT. Result: Mean age of participants was 45.3 ± 5.4 years. Pearson correlation analysis of CIMT and metabolic parameters which were fasting blood sugar, HbA1C, and lipid parameters (TC, TG, and HDL) showed that significant positive correlation with FBG (r =.880), HbA1C (r =.514), TC (r =.523), TG (r =.832), and negative correlation with HDL (r = -0.591) after six months of CAYT. Conclusion: This study demonstrated that after six months of CAYT metabolic parameters, CIMT were significantly decreased. We have observed a significant correlation exists between CIMT and metabolic parameters. Therefore, regular CIMT measurement might be beneficial for the assessment of cardiovascular disease (CVD) risk and facilitate better use of treatment modalities in prediabetics.

A Study to Evaluate the Effect of a Combined Approach of Yoga and Diet in High-risk Cardiovascular Subjects.

Background: Cardiovascular disease (CVD) is a group of disorders of the heart and blood vessels, including coronary heart disease, cerebrovascular disease, rheumatic heart disease, peripheral artery disease, congenital heart disease, deep vein thrombosis, and pulmonary embolism. Aim: The aim of this study was to assess cardiovascular risk factors and evaluate the effectiveness of combined approach of yoga and diet in reducing cardiovascular risk factors among high-risk subjects. Materials and Methods: This interventional study was conducted at RUHS College of Medical Sciences and Associated Hospitals, Jaipur, on the high-risk population of either sex in the age group of 40-70 years. QRISK3 web calculator was used as the method of measurement for outcome of interest. The combined approach of yoga intervention includes yogic asanas and pranayamas and dietary modification. Results: This study compared physiological parameters (blood pressure) and biochemical parameters (fasting blood sugar, glycosylated hemoglobin, lipid profile) at baseline, three months and six months after yoga and diet intervention in participants who were at high-risk of cardiovascular disease development in future and were found to be having significantly decreased systolic blood pressure (P=0.000), fasting blood glucose (P=0.000), glycosylated hemoglobin (HbA1C) (P=0.011), total cholesterol-high density lipoprotein ratio (P=0.000), low density lipoprotein (P=0.009), triglyceride (P=0.034), and QRISK3 Score (P=0.000) after combined approach of yoga and diet. Conclusions: This study concluded that the short-term combined approach of yoga-based life-style intervention and diet reduced cardiovascular risk factors in subjects at high-risk of developing cardiovascular disease.

Effect of a 6-month yoga intervention on heart rate variability among pre-diabetics.

Objectives: Pre-diabetes represents the initial stage of type 2 diabetic disease. This study aimed to highlight the importance of the 6-month integrated approach of yoga therapy (IAYT) on the time domain and frequency domain of heart rate variability (HRV) in pre-diabetic subjects. Method: The study was conducted on 250 pre-diabetic adults aged 30-50 years attending a tertiary care hospital. The patients were divided into two groups: The study group (n = 125) was subjected to the IAYT and the control group (n = 125) was not engaged in yoga therapy. Biochemical parameters such as blood glucose, glycated hemoglobin, and the time domain and frequency domain of HRV were recorded at baseline and after 6 months of yoga intervention. Results: Participants had a mean age of 45.4 ± 6.4 years, the post-yoga intervention resulted in a significant decline in blood glucose, glycated hemoglobin, and significantly decreased frequency domain parameters low frequency (LF), and LF/high-frequency ratio (LF/HF ratio), and significantly increased in high frequency (HF) and in time-domain parameter standard deviation of normal-normal (NN) interval, mean percentage of differences higher than 50 ms in RR intervals (pRR50), and root mean square of successive differences between normal heartbeat (RMSSD). The number of pairs of successive NN (R-R) intervals that differ by more than 50 ms (NN50) significantly increased. Conclusion: The study clearly indicates that after 6 months of yoga intervention, autonomic nervous system shifted toward parasympathetic dominance, which was assessed by time domain and frequency domain parameters of HRV.

P300 Wave Latency and Amplitude in Healthy Young Adults: A Normative Data.

Background: Electrophysiological investigations are now very common in clinical investigations. Event-related potential (ERP) is also common in most electrophysiological recording in which P300 is considered as the best indicator of psychological status. P300wave latency and amplitude are the best indicators of superior mental function status. Variability in P300 has been demonstrated in diseases exhibiting cognitive abnormalities. Objective: The present study aimed to generate the normative data of P300 wave latency and amplitude in healthy young adults of 18-25 years age group in healthy young adults. Material and Methods: Hundred healthy young adults age (18-25 years) were analyzed for P300 using auditory oddball paradigm [Octopus NCV/EMG/EP-4 Channel Machine (Model name- CMEMG 01)], after taking anthropometric measurements (height, weight, and BMI). Whole data were collected after taking the willing consent of participants recruited for the study, and approval of Institute's ethics committee was taken before the start of study. Normally, distributive data were presented in the form of mean, standard deviation, and Pearson correlation was used to see check the correlation using MS-excel 2007. Results: The mean P300 latency and amplitude were 281.38 ± 33.39 ms and 4.53 ± 1.67µV, respectively, in healthy young adults with mean age 19.81 ± 1.80 years. With age the P300 latency was significantly positively correlated. Conclusions: This study results reflected normative data of P300wave latency and amplitude in healthy young adults of 18-25 years age group.

A study to correlate effect of dietary modification on biochemical and cardiovascular parameters among prediabetics.

Objectives: Dietary factors are important in the prevention and treatment of prediabetes and diabetes mellitus (DM). This study was designed to evaluate the prevalence, associated risk factors, dietary modification, and calories consumption calculated by the food frequency questionnaire and correlate them with the metabolic parameters, namely blood glucose, HbA1c, lipid profile, and cardiovascular parameters as heart rate variability and carotid intima media thickness (CIMT) among the prediabetics. Methods: An experimental interventional study was carried out in the Department of Physiology and Medicine at the RUHS College of Medical Sciences and Associated Group of Hospitals. The assessments were done at baseline and after 6 months of post-dietary modification. The total duration of the study was 6 months. A total of 250 prediabetic subjects were enrolled. Study Group A (n = 125) was engaged in dietary modification, whereas Group B (n = 125) was considered as control. The dietary assessment was done by a food frequency questionnaire. Result: After dietary modification, a decrease in the body mass index (1.3%), systolic blood pressure (3.1%), diastolic blood pressure (3.1%), blood glucose (2.8%), triglyceride (2.8%), high density lipoprotein (0.9%), HbA1c (2%), cholesterol (1.4%), and low-frequency/high-frequency ratios (1%), carotid intima media thickness (1.6%), as compared to control, was noticed after 6 months of dietary modification. Conclusion: This study suggested that prediabetics required health education including nutritional education as diet modification can play an important role to encourage diabetes-onset prevention and its related complications. The health-care providers and workers should increase the awareness about the importance of diet and encourage the prediabetics toward a healthy lifestyle, which may help in the quality of life and appropriate self-care, primary prevention of diabetes and its complications. CTRI Registration: CTRI/2017/06/008825.

Correlation of Heart Rate Variability with Carotid Intima Media Thickness after 6 Month of Yoga Intervention in Prediabetics.

INTRODUCTION: Atherosclerotic carotid intimamedia thickness (CIMT) may be associated with alterations in the autonomic functions. The aim of this study was to investigate the effect of 6-month yoga intervention on heart rate variability (HRV) and CIMT in elderly subjects and the correlation between HRV and CIMT. METHODOLOGY: This was a randomized controlled study, in which a total of 250 subjects were enrolled. Randomization and allocation in yoga and control groups were performed using computer-generated random numbers. The CIMT was determined by B-mode ultrasonography, and cardiac autonomic function was determined through frequency domain parameter of HRV measures at baseline and after 6 months of yoga intervention. RESULTS: Participants had a mean age of 45.4 ± 6.4 years, and a mean CIMT in control (0.70 ± 0.05) and study group (0.69 ± 0.073), and low frequency/high frequency (LF/HF) ratio in control (2.20 ± 1.05) and study group (0.57 ± 0.54). Yoga group had evidence of increased vagal activity in the frequency domain (HF and LF/HF ratio, P < 0.001) with respect to control group. Moreover, a study group showed lower intimamedia thickness (IMT) than control subjects (P < 0.01). In the whole population, LF/HF ratio positively and significantly correlated (r = 0.665, P < 0.01) to IMT. CONCLUSION: This study demonstrated that, after yoga intervention, LF/HF ratio is positively correlated with CIMT, a putative index of atherosclerosis, confirming cardiac autonomic neuropathy as a part of the pathophysiological pathway for atherosclerosis. It confirms that the regular yoga represents a valuable strategy to counter impairments of cardiac autonomic activity and artery structural changes.

Characteristics and Outcomes of Hospitalized Young Adults with Mild Covid -19.

BACKGROUND: Stormy course has been reported among hospitalized adults with COVID-19 in high- and middle-income countries. To assess clinical outcomes in consecutively hospitalized patients with mild covid-19 in India we performed a study. METHODS: We developed a case registry of successive patients admitted with suspected covid-19 infection to our hospital (n=501). Covid-19 was diagnosed using reverse transcriptase polymerase chain reaction (RT-PCR). Demographic, clinical, investigations details and outcomes were recorded. Descriptive statistics are presented. RESULTS: Covid-19 was diagnosed in 234 (46.7%) and data compared with 267 (53.3%) negative controls. Mean age of covid-19 patients was 35.1±16.6y, 59.4% were <40y and 64% men. Symptoms were in less than 10% and comorbidities were in 4-8%. History of BCG vaccination was in 49% cases vs 10% controls. Cases compared to controls had significantly greater white cell (6.96+1.89 vs 6.12+1.69x109 cells/L) and lower lymphocyte count (1.98+0.79 vs 2.32+0.91x109 cells/L). No radiological and electrocardiographic abnormality was observed. All these were isolated or quarantined in the hospital and observed. Covid-19 patients received hydroxychloroquine and azithromycin according to prevalent guidelines. One patient needed oxygen support while hospital course was uncomplicated in the rest. All were discharged alive. Conversion to virus negative status was in 10.2±6.4 days and was significantly lower in age >40y (9.1±5.2) compared to 40-59y (11.3±6.1) and ≥60y (16.4±13.3) (p=0.001). CONCLUSIONS: This hospital-based registry shows that mildly symptomatic or asymptomatic young covid-19 patients have excellent prognosis.

Quasi Prospective Comparative Study on Effect of Yoga among Prediabetics on Progression of Cardiovascular Risk Factors.

INTRODUCTION: Prediabetic patients have higher risk for cardiovascular diseases, which further increases the rate of mortality. Reason for the rate of increase may be lack of observation, follow-up programs, and self-awareness about the conditions of disease. Lifestyle interventions such as yoga can prove to be a beneficial nonpharmacologic intervention in preventing progression of prediabetes to type 2 diabetes. This study highlights importance of short-term intervention, i.e., yoga in prediabetic patients and use it as a tool for primary prevention of diabetes. METHODS: This was an interventional study among adults aged 30-50 years in RUHS college of Medical Sciences and Associated Rukmani Devi Beni Prasad Jaipuria Hospital in Jaipur city. The design of study was quasi prospective comparative study. A total of 102 prediabetic patients of age group 30-50 years were recruited from Jaipuria Hospital. These were divided into two groups: study group (Group A, n = 51) were engaged in yoga session and control group (B, n = 51) not performed any yoga session. RESULTS: Yoga intervention resulted in a significant decline in blood glucose (P < 0.001), glycated hemoglobin (P < 0.01), lipid profile cholesterol (P < 0.01), triglyceride (P < 0.01), and low-density lipoprotein (P < 0.01), but high-density lipoprotein (P < 0.02) and very low-density lipoprotein increase (P < 0.03) but not statistically significant relative to the control group. CONCLUSION: Short-term yoga intervention is helpful in the control of glycemic parameters like blood glucose, glycated hemoglobin and lipid profile in prediabetic patients. This preliminary study indicates that a yoga program would be a possible risk reduction option for adults at high risk for type 2 diabetes. In addition, yoga holds promise as an approach to reducing cardiometabolic risk factors and increasing exercise self-efficacy for prediabetics performing yoga.

A cross-sectional study of knowledge regarding rabies among attendees of anti-rabies clinic of a teaching hospital, Jaipur.

BACKGROUND: Being a fatal and 100% preventable disease, all efforts must be made by the health system to prevent even a single case of rabies. By assessing the knowledge of people regarding rabies prevention, we can make plans and policies for its prevention. The aim of this study was to assess the knowledge regarding rabies among attendees of anti-rabies clinic of a teaching hospital, Jaipur. METHODS: This observational cross-sectional study was conducted among attendees of anti-rabies clinic, Govt. R.D.B.P. Jaipuria hospital, Jaipur from February 2018 to July 2018. A total of 107 participants were included in the study. Data was collected using preformed questionnaire. Continuous data were expressed in mean and standard deviation and count data were expressed in proportion. RESULTS: In our study population, only 22.5% respondents had good knowledge, 56% had fair, and 21.5% had poor knowledge. Fatality of rabies was known to 68.2% of participants. One fourth of the participants knew that rabies is not curable, however, approximately 83% knew that it is preventable. Fifty-six percent of the participants were aware about washing the bite wound with soap and water. Approximately one-third (36%) of the participants knew that it is an infectious disease, however, only 7.5% knew that saliva, vomitus, tear, and urine of rabies patient may have rabies virus. Approximately 15% of the attendees had a wrong concept that a single injection is sufficient for immunization. CONCLUSION: Although this study was done at a teaching hospital, lack of knowledge is still a big issue in urban population as well. This study concludes that knowledge regarding rabies should be highlighted in national programs of India to acknowledge Indian population regarding fatal rabies.