Coping Strategy, Life Style and Health Status During Phase 3 of Indian National Lockdown for COVID-19 Pandemic-A Pan-India Survey.

The implementation of timely COVID-19 pan-India lockdown posed challenges to the lifestyle. We looked at the impact of lifestyle on health status during the lockdown in India. A self-rated scale, COVID Health Assessment Scale (CHAS) was circulated to evaluate the physical health or endurance, mental health i.e. anxiety and stress, and coping ability of the individuals under lockdown. This is a pan-India cross-sectional survey study. CHAS was designed by 11 experts in 3 Delphi rounds (CVR = 0.85) and was circulated through various social media platforms, from 9th May to 31st May 2020, across India by snowball circulation method. CHAS forms of 23,760 respondents were downloaded from the Google forms. Logistic regression using R software was used to compare vulnerable (>60 years and with chronic diseases) with non-vulnerable groups. There were 23,317 viable respondents. Majority of respondents included males (58·8%). Graduates/Postgraduates (72·5%), employed (33·0%), businessmen (6·0%), and professionals (9·7%). The vulnerable group had significantly (OR 1.31, p < 0.001) higher representation of overweight individuals as compared to non-vulnerable group. Regular use of tobacco (OR 1.62, p = 0.006) and other addictive substances (OR 1.80, p = 0.039) showed increased vulnerability. Respondents who consume junk food (OR 2.19, p < 0.001) and frequently snack (OR 1.16, p < 0.001) were more likely to be vulnerable. Respondents involved in fitness training (OR 0.57, p < 0.001) or did physical works other than exercise, yoga, walk or household activity (OR 0.88, p = 0.004) before lockdown were less likely to be vulnerable. Majority had a very good lifestyle, 94.4% never smoked or used tobacco, 92.1% were non-alcoholic, 97.5% never used addictive substances, 84.7% had good eating habits, 75.4% were vegetarians, 82.8% had "good" sleep, 71.7% did physical activities. Only 24.7% reported "poor" coping ability. Depression with somewhat low feeling were more likely to be vulnerable (OR 1.26, p < 0.001). A healthy lifestyle that includes healthy eating, proper sleep, physical activeness and non-addictive habits supports better coping ability with lesser psychological distress among Indian population during lockdown.

Yoga Practice Is Beneficial for Maintaining Healthy Lifestyle and Endurance Under Restrictions and Stress Imposed by Lockdown During COVID-19 Pandemic.

Uncertainty about Coronavirus disease 2019 (COVID-19) and resulting lockdown caused widespread panic, stress, and anxiety. Yoga is a known practice that reduces stress and anxiety and may enhance immunity. This study aimed to (1) investigate that including Yoga in daily routine is beneficial for physical and mental health, and (2) to evaluate lifestyle of Yoga practitioners that may be instrumental in coping with stress associated with lockdown. This is a pan-India cross-sectional survey study, which was conducted during the lockdown. A self-rated scale, COVID Health Assessment Scale (CHAS), was designed by 11 experts in 3 Delphi rounds (Content valid ratio = 0.85) to evaluate the physical health, mental health, lifestyle, and coping skills of the individuals. The survey was made available digitally using Google forms and collected 23,760 CHAS responses. There were 23,290 valid responses (98%). After the study's inclusion and exclusion criteria of yogic practices, the respondents were categorized into the Yoga (n = 9,840) and Non-Yoga (n = 3,377) groups, who actively practiced Yoga during the lockdown in India. The statistical analyses were performed running logistic and multinomial regression and calculating odds ratio estimation using R software version 4.0.0. The non-Yoga group was more likely to use substances and unhealthy food and less likely to have good quality sleep. Yoga practitioners reported good physical ability and endurance. Yoga group also showed less anxiety, stress, fear, and having better coping strategies than the non-Yoga group. The Yoga group displayed striking and superior ability to cope with stress and anxiety associated with lockdown and COVID-19. In the Yoga group, participants performing meditation reportedly had relatively better mental health. Yoga may lead to risk reduction of COVID-19 by decreasing stress and improving immunity if specific yoga protocols are implemented through a global public health initiative.

Yoga based cardiac rehabilitation after coronary artery bypass surgery: one-year results on LVEF, lipid profile and psychological states--a randomized controlled study.

OBJECTIVE: To compare the long term effects of yoga based cardiac rehabilitation program with only physiotherapy based program as an add-on to conventional rehabilitation after coronary artery bypass grafting (CABG) on risk factors. METHODS: In this single blind prospective randomized parallel two armed active control study, 1026 patients posted for CABG at Narayana Hrudayalaya Institute of Cardiac Sciences, Bengaluru (India) were screened. Of these, 250 male participants (35-65 years) who satisfied the selection criteria and consented were randomized into two groups. Within and between group comparisons were done at three points of follow up (i.e. 6th week, 6th month, and 12th month) by using Wilcoxon's signed ranks test and Mann Whitney U test respectively. RESULTS: Yoga group had significantly (p = 0.001, Mann Whitney) better improvement in LVEF than control group in those with abnormal baseline EF (<53%) after 1 year. There was a better reduction in BMI in the yoga group (p = 0.038, between groups) in those with high baseline BMI (≥23) after 12 months. Yoga group showed significant (p = 0.008, Wilcoxon's) reduction in blood glucose at one year in those with high baseline FBS ≥110 mg/dl. There was significantly better improvement in yoga than the control group in HDL (p = 0.003), LDL (p = 0.01) and VLDL (p = 0.03) in those with abnormal baseline values. There was significantly better improvement (p = 0.02, between groups) in positive affect in yoga group. Within Yoga group, there was significant decrease in perceived stress (p = 0.001), anxiety (p = 0.001), depression (p = 0.001), and negative affect (p = 0.03) while in the control group there was reduction (p = 0.003) only in scores on anxiety. CONCLUSION: Addition of yoga based relaxation to conventional post-CABG cardiac rehabilitation helps in better management of risk factors in those with abnormal baseline values and may help in preventing recurrence.

Metallic stents in the management of ureteric strictures.

Management of ureteric strictures is a challenging task. Subtle presentation, silent progression and complex aetiology may delay diagnosis. A wide range of available treatment options combined with the lack of adequate randomised trials has led to the introduction of personal bias in the management of this difficult group of patients. Metallic ureteric stents offer an alternative to the conventional treatment modalities. A review of the currently available metallic stents and their role in the long-term management of ureteric strictures is presented. Materials used in the manufacture of indwelling urological devices are evolving all the time. Improved endo-urological techniques combined with new devices made from better compounds will continue to improve patient experience.

Investigation of colloidal properties of modified silicone polymers emulsified by non-ionic surfactants.

Functionalized silicones are a unique class of hybrid materials due to their simultaneous hydrophobic-oleophobic properties, which results in applications in a variety of surface modification techniques. Prior research has shown that changes in surface charge and turbidity of modified silicone emulsions as a function of pH have a marked effect on their performance in coating applications. The emulsion droplet size is also believed to play significant role in such coating applications. In this work, modified silicone polymer emulsions stabilized by non-ionic surfactants were studied using dynamic light scattering (dilute) and electroacoustic (concentrated) spectroscopy to monitor the emulsion droplet size. The dilute and concentrated regime studies showed the emulsion droplet to be in nanometer range with no appreciable change in size as a function of pH. Electroacoustic studies showed a small fraction of droplets to be present in the micron size range. The emulsions were examined using Cryo-TEM technique, and the effect of pH and dilution on hydrophobicity of nanodomains was studied by employing fluorescence spectroscopy. It is shown from pyrene excimer behavior that both the dilution and pH have an effect on emulsion stability with a presence of critical surfactant concentration after which the emulsion was destabilized. It is proposed that the emulsion stability characteristics and the particle size distribution both play a significant role in their ability to impart desired macro and nano surface properties to treated substrates through electrostatic interactions and selective binding.

The effect of trataka, a yogic visual concentration practice, on critical flicker fusion.

OBJECTIVES: The study objective was to study the change in the critical flicker fusion (CFF) after a yogic visual concentration practice (trataka). DESIGN: Thirty (30) subjects participated in a study where they were evaluated for the CFF immediately before and after the practice. The subjects also participated in a comparable control session. SUBJECTS: The subjects were 30 volunteers in the age range 25-40. Fifteen (15) of the volunteers were male. The mean age was 31.33 ± 4.67. RESULTS: The CFF showed a statistically significant increase from 37.35 ± 2.84 to 38.66 ± 2.91 after the yoga practice of trataka. The control session did not produce a statistically significant change in the CFF. CONCLUSIONS: An increase in the CFF is seen immediately after the yogic concentration practice called trataka.

Measures of heart rate variability in women following a meditation technique.

Certain time domain, frequency domain and a nonlinear measure of heart rate variability are studied in women following a meditative practice called cyclic meditation. The nonlinear measure studied is the sampling entropy. We show that there is an increase in the sampling entropy in the meditative group as compared to the control group. The time domain measure called pNNx is shown to be useful in distinguishing between the meditative state and a normal resting state.

Measuring the tridosha symptoms of unmada (psychosis): a preliminary study.

OBJECTIVE: This is a preliminary report on the development of a scale to measure the symptoms of unmada (psychosis) attributable to tridosa (metabolic principles) by using the concepts of Ayurvedic medicine. DESIGN: The 67-item unmada specific symptom scale was developed on the basis of translation of Sanskrit verses describing vataja (V), pittaja (P), and kaphaja (K) unmada (specific symptoms of psychosis due to the imbalances of metabolic components) and by taking the opinions of experts (15 Ayurveda experts, 5 psychiatrists, and 5 psychologists). SETTINGS: The setting for this study was Spandana Psychiatric Nursing Home Bangalore, India. SUBJECTS: The scale was administered by an unblinded assessor to 30 consecutive patients with nonaffective psychotic disorders. RESULTS: The unmada specific symptom scale was associated with excellent internal consistency. The Cronbach's alpha for V, P, and K scales were 0.98, 0.98, and 0.97, respectively. The split-half reliability for V, P, and K scales were 0.97, 0.97, and 0.88 respectively. Scores on vataja, pittaja, and kaphaja scales were inversely correlated, suggesting that they are mutually exclusive. The three subgroups of psychoses--paranoid schizophrenia, schizophrenia (unspecified), and unspecified nonorganic psychosis--had significantly different loadings on the three scores, having high scores on vataja, pittaja, and kaphaja, respectively. CONCLUSIONS: The tridoshas in psychotic disorders can be measured reliably by this instrument. The scores on each of these dosas help in differentiating three types of psychosis (according to Ayurveda) that have good correspondence with prevailing classification. However, this scale must also be applied to the other 28 separate subcategories of the psychoses that are identified in the International Statistical Classifications of Diseases (version 10) and to the 10 variants of psychosis as defined by the American Psychiatric Association Diagnostic and Statistical Manual-IV-R to help better understand the true utility for use here with the various subcategories of schizophrenia.

Variation in emulsion stabilization behavior of hybrid silicone polymers with change in molecular structure: Phase diagram study.

Silicone oils are widely used in cosmetics and personal care applications to improve softness and condition skin and hair. Being insoluble in water and most hydrocarbons, a common mode of delivering them is in the form of emulsions. Currently most applications use polyoxyethylene (non-ionic) modified siloxanes as emulsifiers to stabilize silicone oil emulsions. However, ionically grafted silicone polymers have not received much attention. Ionic silicones have significantly different properties than the non-ionic counterpart. Thus considerable potential exists to formulate emulsions of silicones with different water/silicone oil ratios for novel applications. In order to understand the mechanisms underlying the effects of hydrophilic modifications on the ability of hybrid silicone polymers to stabilize various emulsions, this article focuses on the phase diagram studies for silicone emulsions. The emulsifying ability of functional silicones was seen to depend on a number of factors including hydrophilicity of the polymer, nature of the functional groups, the extent of modification, and the method of emulsification. It was observed that the region of stable emulsion in a phase diagram expanded with increase in shear rate. At a given shear rate, the region of stable emulsion and the nature of emulsion (water-in-oil or oil-in-water) was observed to depend on hydrophilic-hydrophobic balance of the hybrid silicone emulsifier. At a fixed amount of modification, the non-ionically modified silicone stabilized an oil-in-water emulsion, whereas the ionic silicones stabilized inverse water-in-oil emulsions. This was attributed to the greater hydrophilicity of the polyoxyethylene modified silicones than the ionic counterparts. In general, it is postulated that with progressive increase in hydrophilicity of hybrid silicone emulsifiers, their tendency to stabilize water-in-oil emulsion decreases with corresponding increase in oil-in-water emulsion. Further, this behavior is hypothesized to depend on the nature of modifying functional groups. Thus a hybrid silicone polymer can be tailored by selecting the nature and degree of hydrophilicity to obtain a desired silicone emulsion.

The thermo-expandable metallic ureteric stent: an 11-year follow-up.

OBJECTIVE: To review our long-term use of the thermo-expandable metallic ureteric stent, (model 051, PNN Medical, Denmark) for ureteric obstruction, and review current reports on its use. PATIENTS AND METHODS: Data were collected prospectively on all patients who had a Memokath 051 ureteric stent inserted between November 1996 and November 2007. The standard stent, and wide and dual expansion versions were used. The stricture characteristics were recorded in a standard way. All stents were inserted by one surgeon in the UK and internationally, following a standard protocol. RESULTS: In all, 74 stents were inserted into 55 patients in the study period (mean age 60 years, range 11-90). The indications for metallic stenting included primary stenting for malignancy, failed conventional open and endoscopic techniques, palliation, and where significant comorbidity limited repetitive stent changes. In 28 patients the obstruction was caused by malignancy, whereas in 27 it was caused by recurrent benign disease. The mean (range) hospital stay was 1.43 (0-7) days. Imaging after insertion showed normal or improved functional drainage in all but three patients, with immediate complications including urinary extravasation (one), poor thermo-expansion (one) and equipment failure (locking assembly) (one). Late complications included migration (13), encrustation (two) and fungal infections (three). In all, 14 patients needed reinsertion (mean of 7.1 months, range 1-14) after insertion for migration (eight), encrustation (two), stricture progression (three) and incorrect stent length (one). Overall, 29 patients have died with the stents in-situ. The mean (range) follow-up was 16 (4-98) months. CONCLUSIONS: The thermo-expandable metallic Memokath 051 ureteric stent offers effective and durable long-term relief from ureteric obstruction, and is a safe alternative to conventional JJ stenting. In addition there is an emerging role in palliation and the primary management of ureteric strictures.

Factor analysis of Greene's Climacteric Scale for Indian women.

OBJECTIVE: Do a factor analysis of the Greene Climacteric Scale for a population of Indian perimenopausal women and establish normative values. METHODS: Five hundred and eighteen women, in the age range 45-55 years, were selected and asked to fill out the Greene Climacteric Scale. RESULTS: The mean age of the women was 48.03+/-3.40 years. A factor analysis of the data using an oblique rotation yielded three distinct factors with loadings more than 0.4. The breakup of the psychological factor into an anxiety and a depression factor which has been hypothesized earlier could only be verified using varimax rotation. The last item, "Loss of sexual interest" is shown to be part of the vasomotor factor. The means of the scores on the three factors are: psychological: 8.28+/-5.87, somatic: 4.64+/-3.73 and vasomotor: 2.39+/-2.10. These are much lower than the values given by Greene, but are in consonance with values published in two earlier studies for different populations.

An investigation into the prognostic significance of necrosis and hypoxia in high grade and invasive bladder cancer.

PURPOSE: We investigated hypoxia and necrosis in high grade and invasive bladder cancer, and related this to prognosis. MATERIALS AND METHODS: We performed a retrospective observational study of 98 primary cystectomy specimens scored for necrosis, and the hypoxia associated markers carbonic anhydrase IX, hypoxia-inducible factor 1 alpha and 2 alpha, and Bcl2/adenovirus EIB 19 kDa interacting protein 3. Tumor tissue array was used with cores taken from representative and perinecrotic tumor regions. Necrosis was scored on whole sections as absent, less than 5 mm (comedo) or more than 5 mm (gross). RESULTS: Of the 98 cases analyzed followup data were available on 91. Median followup was 22 months (IQR 8-35). Stage was T0/1 to T4 in 18, 20, 41 and 12 cases, respectively. The prevalence of necrosis in bladder cancer was high and it increased with stage (17%, 30%, 70% and 71% at stages T0/1 to T4, respectively). Necrosis was significantly associated with stage (p = 0.0001) and nodal status (p = 0.016). Hypoxia-inducible factor 1 alpha showed no association with stage, grade or nodal status. Hypoxia-inducible factor 1 alpha and carbonic anhydrase IX showed a significant association with necrosis, whereas hypoxia-inducible factor 2 alpha and Bcl2/adenovirus EIB 19 kDa interacting protein 3 did not. Stage (p <0.0001), necrosis (p <0.0001) and intense hypoxia-inducible factor 1 positivity (p = 0.048) were the only significant prognostic factors on univariate analysis. Stage (HR 3.29, 95% CI 1.80-6.04, p <0.001) and necrosis (HR 1.92, 95% CI 1.05-3.51, p = 0.04) were independent prognostic factors on multivariate analysis, while hypoxia-inducible factor 1 lost significance (HR 1.36, 95% CI 0.98-1.88, p = 0.07). Node status was only reported in 45% of cases. CONCLUSIONS: Necrosis (the presence and amount) in high grade and invasive bladder cancer is an independent prognostic risk factor.

Effects of functional groups on surface pressure-area isotherms of hydrophilic silicone polymers.

Organic/inorganic hybrid silicone polymers are increasingly used in cosmetics, inks and paints, and fabric care applications owing to their special Si-O bond characteristics. Because of the presence of organic as well as inorganic groups, they show the properties of both, and the presence of hydrophobic as well as hydrophilic character makes them behave like a hybrid polymer. Though they are widely used, the utilization of hydrophilically modified silicones on a large scale has mainly been empirical due to lack of fundamental knowledge about variation in their properties with systematic change in their structure. The choice of moieties for hydrophilic modification of silicones in most of the earlier works has been nonionic based on ethylene oxide and propylene oxide groups, however, very little is known about their ionic counterparts. The current work focuses on understanding the behavior of functionally grafted silicone polymers with respect to the variation in the hydrophilic part of the grafting chain. Hydrophilically grafted silicone polymers form monolayers at the air-water interface, which are stabilized by interactions of functional groups with water. The present work examined the effects of functional group modifications on the conformational behavior of chains at the interface. It was observed that the shape of the chain depends on the available area at the interface (or surface pressure), and there are conformational changes with an increase in the number of molecules per unit area. While a poly(dimethylsiloxanes) (PDMS) chain may undergo stretched to helix transition as predicted earlier, this may not be the case for hydrophilically grafted chains. On the basis of the shape of the surface pressure-area isotherm and correlation with the scaling theory, a gradation in hydrophilicity of functional groups and hence modified silicone chains at the air-water interface is predicted.