Rajasthan University of Health Sciences

This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. For reprints contact: reprints@medknow.com How to cite this article: Hasan A, Saboo N, Kacker S. Effect of yoga and diet on cognitive functions among hypertensives: a review. MGM J Med Sci 2025;12:147-54. Abstract Hypertension (HTN), often referred to as a "silent culprit behind multiple bodily dysfunctions," is a growing global health burden, with its prevalence rising daily. Among its many complications, cognitive dysfunction in hypertensive individuals remains largely unnoticed, impacting daily life and personality traits. Unhealthy lifestyle choices and poor dietary habits further heighten the risk of cognitive impairment. Global research highlights the significant role of yoga and a balanced diet in reducing the risk of cognitive decline among individuals with HTN. Yoga originated in India over 5000 years ago and has become vital to a healthy lifestyle. Dietary factors, such as excessive salt and sugar intake, physical inactivity, obesity, smoking, and alcohol consumption, are key modifiable risk factors for HTN. However, only a limited number of studies have explored the impact of yoga and diet on cognitive function in hypertensive individuals. This review aims to emphasize the role of yoga and diet in addressing oxidative stress and inflammation, which contribute to the pathogenesis of HTN. By focusing on lifestyle modifications, this article seeks to raise awareness about the benefits of yoga and diet in mitigating the overall risk of cardiovascular (CV) diseases. Cognitive function will be assessed using event-related potential P300, mini-mental state examination, and Montreal Cognitive Assessment A and B, while quality of life will be measured using the Quality of Life Scale and stress levels using the Perceived Stress Score. Yoga has been widely recognized for its therapeutic benefits in enhancing immunity and aiding in managing chronic conditions such as CV, respiratory and endocrine disorders, obesity, cancer, and metabolic syndrome. Specific yoga practices, including asanas (postures), pranayama (breathing exercises), and dhyana (meditation), strengthen the immune system, regulate inflammation, and help prevent chronic diseases. These techniques effectively reduce both the psychological and physiological impact of chronic stress. Given the rising burden of lifestyle-related diseases, integrating yoga and dietary modifications into daily routines can significantly improve chronic disease management and overall well-being.

Background Type 2 diabetes (T2D) etiology is highly complex due to its multiple roots of origin. Polygenic risk scores (PRS) based on genome-wide association studies (GWAS) can partially explain T2D risk. Asian Indian people have up to six times higher risk of developing T2D than European people, and underlying causes of this disparity are unknown. Methods We have performed targeted sequencing of ten T2D GWAS/candidate regions using endogamous Punjabi Sikh families and replication studies using unrelated Sikh people and families from three other Indian endogamous ethnic groups (EEGs). Results We detect rare and ultra-rare variants (RVs) in KCNJ11-ABCC8 and HNF4A (MODY genes) cosegregated with late-onset T2D. We also identify RV enrichment in two new genes, SLC38A11 and ANPEP, associated with T2D. Gene-burden analysis reveals the highest RV burden contributed by HNF4A (p = 0.0003), followed by KCNJ11/ABCC8 (p = 0.0061) and SLC38A11 (p = 0.03). Some RVs detected in Sikh people are also found in Agarwals from Jaipur, both from Northern India, but were monomorphic in other two EEGs from South Indian people. Despite carrying a high burden of T2D and RVs, most families have a significantly lower burden of PRS. Functional studies show that an intronic regulatory variant (RV) in ABCC8 affects the binding of Pax4 and NF-kB transcription factors, influencing downstream gene regulation. Conclusions The high burden of T2D in these families may stem from the enrichment of noncoding RVs in a small number of major known genes (including MODY genes) with oligogenic inheritance alongside RVs from genes associated with polygenic susceptibility. These findings highlight the need to conduct deeper evaluations of families from non-European ancestries to identify potential novel therapeutics and implement preventative strategies.

Polymeric nano-discs offer a promising and adaptable nanocarrier platform for topical applications involving the targeted administration of drugs. These biocompatible polymer-based, disc-shaped, nanoscale structures have drawn interest due to their exceptional capacity to encapsulate a diverse range of theranostics. Theranostics, the concept of combining treatments and diagnos-tics into a single system, is the core of attraction. Precision and fewer adverse effects are provided by the regulated and prolonged release of these drugs made possible by polymeric nano-discs. They also offer the perfect foundation for keeping track of the effectiveness of treatments. The selection of polymeric materials that provide biocompatibility and customized release mechanisms is critical to effectively implementing polymeric nano-discs. Recent pre-clinical and clinical research has demonstrated efficacy in targeted therapeutic interventions. Nevertheless, there are obstacles and restrictions in real-world implementation, and more study is necessary to fully realize their potential. Hence polymeric nano-discs offer controlled drug release and simultaneous diagnostic capabilities, making them a flexible and viable path forward for topical theranostics. Their advancement has opportunities for improved treatment results; however, more study is needed to properly resolve obstacles and realize their therapeutic potential.

Wolff-Parkinson-White (WPW) syndrome was first described by Louis Wolff, John Parkinson, and Paul Dudley White in 1930.[1] This cardiac condition is characterized by an abnormal accessory pathway that predisposes patients to tachyarrhythmias. A 45-year-old female patient with chief complaints of chest pain and palpitations for one day. An ECG revealed a short PR interval, broad QRS complex and delta wave, leading to a diagnosis of WPW syndrome. Advanced imaging and electrophysiological studies confirmed the presence of an accessory pathway. Treatment options were discussed, including antiarrhythmic medications and radiofrequency catheter ablation (RFCA). WPW syndrome is associated with a risk of sudden cardiac death, but advancements in diagnostic and therapeutic techniques have significantly improved the prognosis. RFCA is particularly noted for its high success rate and low complication profile, offering a potential curative solution for many patients.

Cardiovascular disease is a major cause of mortality and morbidity, and symptoms may not always be visible. Improved preventive strategies could reduce the burden of disease. Yoga is an accessible, affordable lifestyle modification program that has been shown to reduce cardiometabolic risk factors in individuals at high risk for cardiovascular disease. The present randomized controlled trial aimed to evaluate the effect of a yoga lifestyle encompassing diet on QRISK3 score in individuals at high risk for cardiovascular disease. For 6 months, participants (mean age 48.43 ± 6.40) underwent a yoga and diet intervention, the latter based on Asian Indian dietary guidelines. The 45-minute yoga sessions took place 6 days a week over 6 months. One-way analysis of variance was conducted to compare baseline, 3-month, and 6-month data. To determine the relationship between the variable and the QRISK3 score, a multivariate linear regression analysis was conducted in both the control and study groups. Following 6 months of the yoga and diet intervention, QRISK3 score decreased to 20.10 ± 7.05 from baseline values of 28.59 ± 10.15, a change that was statistically significant (p < 0.0001) in the study group. The QRISK3 score was found to be a dependent risk factor for cardiovascular disease (p < 0.001) in univariate linear regression analysis. For individuals who were at high risk for cardiovascular disease, significant independent risk factors were body mass index (β = -0.137, p = 0.034), systolic blood pressure (β = 0.208, p = 0.000), and total cholesterol/high-density lipoprotein (β = 2.59, p = 0.042). This study's findings suggest that a 24-week yoga lifestyle intervention (including diet) significantly decreased the QRISK3 score among individuals at high risk for cardiovascular disease compared to the control group. Keywords: QRISK3 score; cardiovascular disease; dietary intervention; risk factors; yoga.

Background: Cardiovascular diseases (CVDs) are a group of disorders of the heart and blood vessels. Yoga is a low-cost, easily accessible lifestyle modification program that holds as an approach to decreasing cardiometabolic risk factors and increasing exercise self-efficacy among high-risk subjects. This study aimed to assess the impact of the yogic lifestyle (including diet) on cardiovascular risk scores by using the Framingham (FRS), QRISK3 score, and World Health Organization (WHO) CVD risk prediction charts at baseline, three months, and six months. The present study compares and correlates FRS, QRISK3, and WHO cardiovascular risk scores. Methodology: The experimental interventional study was conducted among the high-risk population at RUHS College of Medical Sciences and Associated Group of Hospitals, Jaipur. Framingham risk Score, QRISK3 score, and WHO CVD risk prediction charts were used as a method of measurement for the outcome of interest at baseline, three months, and six months in the study and control group. Randomization and allocation in yoga and control groups were performed using computer-generated random numbers. The statistical analysis was done using advanced SPSS-22 software at significant level tests as p≤0.05, ensuring the highest level of accuracy. Data were analyzed using a one-way variance ANOVA test analysis at baseline, three, and six months. Pearson correlation analysis was done to compare different risk scores. Results: Participants had a mean age of 48.43 ± 6.4 years. Baseline values (mean±SD) of FRS, Qrisk3, WHO were 24.59±10.15,28.59±10.11,15.71±6.07. After six months of yogic lifestyle, these values decreased significantly to 15.1±7.05, 20.09±7.08, and 13.85±4.96. The decrease in cardiovascular scores was statistically significant (p<0.0001), providing strong evidence for the effectiveness of the yogic lifestyle. Pearson correlation analysis results depict that FRS and Q risk 3 (r=0.840, p<0.0001), FRS and WHO risk chart (r=0.768, p<0.0001), Q risk3 and WHO risk chart (r=0.778, p<0.0001) have a statistically significant strong positive correlation. Conclusion: This study's findings suggest that a 24-week yogic lifestyle intervention (including diet) significantly decreased FRS, Q RISK 3, and WHO CVD risk scores among high-risk subjects compared to the control group. How to cite: Saboo N, Roa A, Kacker S.-A study to compare and correlate the effect of a yogic lifestyle on Framingham, Q RISK 3, and WHO risk scores among high-risk cardiovascular subjects. Nig Med J 2024;65(6):911-924.https://doi.org/10.60787/nmj.v65i6.531 Original Article Abstract Quick Response Code: Original Research Saboo N, et al-The effect of a yogic lifestyle on Framingham, Q RISK 3, and WHO risk scores among high-risk cardiovascular subjects 912 Niger Med J 2024; 65(6):911-924.

Carpal tunnel syndrome (CTS) is a compression neuropathy causing significant morbidity. Over the years, ultrasound has been evaluated as an alternative to nerve conduction study (NCS) for diagnosing CTS, however, there is no consensus as to which ultrasound parameter is the best. Our study aimed to determine and compare the efficacy of various ultrasound-based variables for diagnosis of CTS. 80 patients with clinical suspicion of CTS underwent ultrasound examination with calculation of cross-sectional area (CSA), delta CSA, wrist forearm ratio (WFR), palmer bowing (PB), flattening ratio (FR), flexor retinaculum thickness (FT), and evaluation of echogenicity and vascularity of median nerve. NCS was taken as the gold standard and the diagnostic efficacy of all these variables was compared, followed by receiver operator curve (ROC) analysis. Delta CSA had the highest accuracy (91.25%), followed by CSAc (80%), WFR (78.75%), and PB (73.75%). Youden’s index and sensitivity were highest for delta CSA (0.783 and 96.15% respectively), while specificity was highest for FT (89.29%). The highest area under the curve was noted for delta CSA (97.1%), followed by WFR (AUC = 87.4%) and CSAc (AUC = 86.0%). Delta CSA was found to be the best ultrasound parameter for diagnosis of CTS, followed by CSAc, WFR, and PB, and can be used as an alternative to NCS. Using ROC analysis this study also predicted the best cut-off values for these parameters which could improve their diagnostic accuracy and further research is needed to confirm these findings.

This study evaluates the sealing ability of multi-walled carbon nanotube (MWCNT)-incorporated root canal sealers in the apical third of the root canal. Fifty extracted single-rooted human teeth were divided into five groups: control (no sealer), MWCNT-incorporated AH Plus, MWCNT-incorporated Seal Apex, AH Plus, and Seal Apex. The sealing ability was assessed through dye penetration microleakage. Results indicated that the MWCNT-incorporated sealers exhibited significantly less microleakage compared to traditional sealers, with MWCNT-incorporated AH Plus showing the least leakage. The control group exhibited the highest microleakage. MWCNTs enhanced the sealing efficacy by improving sealer adaptation to the canal walls. These findings highlight the potential of carbon nanotube-enhanced sealers to improve endodontic treatment outcomes. Further studies incorporating in vivo models and longer evaluation periods are recommended to confirm the clinical applicability of these advanced materials.

BACKGROUND Regulations on Graduate Medical Education (Amendment), 2019 (GME) introduced competency-based medical education (CMBE) for undergraduate medical students and were implemented in the 2019 entrance batch in medical colleges all over India. This study aimed to find out the challenges faced by medical teachers in CBME implementation, lessons learned, and the level of preparedness for upcoming batches. MATERIAL AND METHODS A cross-sectional, multi-centric descriptive study was conducted from November 2021 to February 2022 including first-year faculty of medical colleges. A self-administered questionnaire was provided through electronic media, about challenges faced during CBME implementation and suggestions for improvement. Responses were analyzed as descriptive statistics, and content analysis was conducted for open-ended questions. RESULTS A total of 50 responses were analyzed. About 46% believed that the foundation course (FC) could satisfy the GME Regulation’s goal to only some extent. About 60% believed that integration was not optimum, and 40% had not taken any integrated session. About 36% had not taken any attitude, ethics and communication (AETCOM) session, and 30% considered that they were not sufficiently competent. About 68% believed that early clinical exposure (ECE) given is insufficient. “Skills” (50%) and “attitude-communication” (34%) could not be satisfactorily assessed. About 72% believed that the coronavirus disease 2019 (COVID-19) pandemic significantly affected academics, 20% are still confused about the complexities of CBME, and 58% believed they are better prepared for the future. The COVID-19 pandemic (78%), lack of proper training (70%), and adequate faculty (60%) were common difficulties. Frequent hands-on workshops (68%) and better inter-departmental coordination (68%) were suggested. CONCLUSION First professional-year faculties are slowly getting accustomed to the transition from a traditional to a competency-based curriculum. These reforms are complex, and the challenges need to be addressed sincerely and timely.

Objectives Complementary and Alternative Medicine (CAM) is a group of diverse medical and healthcare systems, practices, and products that are not generally considered part of conventional medicine. Pregnant women are vulnerable to adverse effects of medicines, especially during the first trimester. Though it is advised to avoid unnecessary intake of medicine during pregnancy, CAM use is widespread. Methods A cross-sectional questionnaire-based study was conducted on 120 pregnant women attending the antenatal clinic of a tertiary-care teaching hospital in Udaipur district of Southern Rajasthan, India. Women of age 18 years and above were surveyed between July 2022 to December 2023 by convenient sampling strategy and data were entered in a pretested and pre-validated questionnaire. The data were analyzed using descriptive statistics, the Chi-square test was applied to compare CAM use among different demographic categories and a p-value less than 0.05 was considered statistically significant. Results Out of 120 participants, 58 (48.33 %) were using CAM therapy. Out of 58 users, 44 (75.86 %) were using herbal & traditional medicines. Twenty (34.48 %) were using CAM for a healthy baby, 18 (31.03 %) for easy delivery and 17 (29.31 %) for boosting immunity. Forty (68.96 %) participants started CAM on the advice of a relative/friend. Fifty six (46.67 %) participants believe that CAM therapy cannot cause adverse effects on the in utero child, while 32 (26.67 %) believe that CAM and modern medicines don’t interact. Conclusions CAM use among pregnant women is substantial. There is a need to raise awareness among the healthcare professionals and pregnant women regarding possible adverse effects and drug-drug interactions with CAM use.

Background The pandemic exacerbated burnout experienced by healthcare personnel, whose mental health had long been a public health concern before COVID-19. This study used the Copenhagen burnout inventory (CBI) tool to assess burnout and identify predictors among Indian healthcare workers managing COVID-19. Methods A cross-sectional study was conducted from June to December 2022, after the third pandemic wave. A web-based, fillable Google form was used to recruit COVID-19 management professionals from multiple Jaipur district hospitals. Healthcare professionals provided socio-demographic, work-related, and CBI scores. Multiple linear regression was used to control for model covariant independent variables. Results We evaluated the responses of a total of 578 participants with a mean age of 36.59 ± 9.1 years. Based on the CBI cut-off score of 50, 68.1% reported burnout. A total of 67.5%, 56.4%, and 48.6% of healthcare workers reported work-related, personal, and patient-related burnout, respectively. High burnout scores were significantly associated with the nursing profession ( β = 7.89, 95% CI; 3.66, 12.11, p < 0.0001). The p -value indicates the probability of observing the data if the null hypothesis is true, and the confidence interval shows the range within which we can be 95% confident that the true effect lies. An independent relationship exists between male gender and higher personal-related burnout scores ( β = 4.45, 95% CI 1.9–6.9). Conclusion This study identified key indicators that need further emphasis and the need for organizational and individual-level burnout monitoring in healthcare delivery sectors. Health workers continue to experience burnout due to a combination of personal, professional, and patient-related factors. This underscores the need for targeted organizational and individual interventions. The findings also suggest that the CBI tool could identify healthcare worker burnout risk groups.

Background and Objectives The study aimed to assess the control of asthma and the severity of chronic obstructive pulmonary disease (COPD) and evaluate the adequacy of treatment in patients presenting to the outpatient department (OPD) across India. The secondary aim was to assess the risk factors associated with poorly controlled asthma and severe COPD. Materials and Methods This is the analysis of Phase IV of the multicenter questionnaire-based point prevalence SWORD survey, conducted in May 2018, and designed to capture details on disease control and treatment as per the global initiative for asthma and the global initiative for chronic obstructive lung disease guidelines. Results Of the 5,311 respiratory disease patients presenting to the OPD, there were 1,419 and 412 patients with asthma and COPD, respectively, across 290 sites in India. There were 1,022 (72%) patients having well-controlled asthma, 293 (20.6%) patients with partly controlled asthma, and 104 (7.4%) patients with poorly controlled asthma. Of the 412 patients with COPD, there were 307 (74.5%) in A, 54 (13.1%) in B, and 51 (12.4%) in the E category. In spite of poor control or severe disease, 34.8% of asthmatic and 25.7% of patients in the B and E categories of COPD were not using any medicine. Risk factors for partly and poorly controlled asthma included rain wetting (adjusted odds ratio [AOR]: 1.59, 95% confidence interval [CI]: 1.02–2.47) and gastroesophageal reflux disease (AOR: 1.50, 95%CI: 1.08–2.10). Conclusion This study identifies a gap in the treatment of both poorly controlled asthma and severe COPD. A substantial number of patients had poorly controlled asthma and severe COPD, and many were either not taking treatment or taking it inappropriately.

Context Knee osteoarthritis (KOA) is the most common type of lower extremity osteoarthritis (OA), with pain being the predominant symptom, leading to significant morbidity and impaired quality of life. Objectives This study was designed to ascertain the effectiveness of ultrasound-guided adductor canal block (ACB), ensuing functional improvement and change in the quality of life in KOA patients with anteromedial knee pain and compare it with conservative treatment. Materials and Methods A total of 196 patients were recruited for this trial and initially treated conservatively with oral analgesics and exercise. At the end of 2 and 4 weeks from the inclusion date, they were offered a crossover to the intervention with ACB for the saphenous nerve. The outcome measures, such as Visual Analogue Scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, Timed Up and Go test, number of analgesics ingested per day and World Health Organization Quality of Life-BREF (WHOQoL-BREF) scores, were recorded at pre-decided time points. Results After multiple structured follow-ups, 76 and 86 patients were analysed in the intervention and conservative groups, respectively. The two groups had no significant differences in the demographic and clinical patterns. The intervention group showed improvements in VAS (at week 2) ( P < 0.05), WOMAC and the number of analgesics ingested per day (weeks 2 and 4) ( P < 0.05). At ‘week 8’ follow-up, most patient outcomes including physical health and psychological domains of WHOQoL-BREF scores were better for conservative group ( P < 0.05). The rest of the outcome measures were comparable for both groups at all time points. No adverse events were reported. Conclusion This study suggests that ACB is effective only for a short duration and does not offer any significant advantage over conservative management in the long run.

The biotechnology field has witnessed rapid advancements, leading to the development of numerous proteins and peptides (PPs) for disease management. The production and isolation of bioactive milk peptides (BAPs) involve enzymatic hydrolysis and fermentation, followed by purification through various techniques such as ultrafiltration and chromatography. The nutraceutical potential of bioactive milk peptides has gained significant attention in nutritional research, as these peptides may regulate blood sugar levels, mitigate oxidative stress, improve cardiovascular health, gut health, bone health, and immune responses, and exhibit anticancer properties. However, to enhance BAP bioavailability, the encapsulation method can be used to offer protection against protease degradation and controlled release. This article provides insights into the composition, types, production, isolation, bioavailability, and health benefits of BAPs.

Thrombocytopenia is the platelet disorder in which the thrombocytes count reduces less than 1.5 lakhs. Medication is the prime management of any treatment, the medicines advised to patients help in curing the disease, however these medications have adverse effects too, these adverse reactions are local and systemic, one such drug used in clotting disorder develops thrombocytopenia and the condition is called Heparin induced thrombocytopenia. The present study aims to study the prevalence of heparin induced thrombocytopenia in multiple cities in India. A cross sectional study designed to assess the prevalence of heparin induced thrombocytopenia in India for a period of 6 months from December 2021 to June 2022.A total of 2860 samples were selected from different diagnostic centers at Lucknow, Panipat, Sonipat, Gohana, Delhi all heparin administrated patients samples were collected in the clinical area and who were at risk of developing decreased platelets counts or any skin related symptoms like rashes, petechiae ,redness, red spots were identified. The study was conducted for 2860 samples of which 109 found have heparin induced thrombocytopenia, the prevalence of heparin-induced thrombocytopenia was 3.8. Heparin is used in clotting disorder; the adverse effect of heparin usage can lead to heparin-induced thrombocytopenia. The present study identified the prevalence rate of heparin-induced thrombocytopenia, which help in identifying the complication associated with the heparin therapy and its induced thrombocytopenia.

Psoriasis, recognized as a chronic inflammatory skin disorder, disrupts immune system functionality. Global estimates by the World Psoriasis Day consortium indicate its impact on approximately 130 million people, constituting 4 to 5 percent of the worldwide population. Conventional drug delivery systems, mainly designed to alleviate psoriasis symptoms, fall short in achieving targeted action and optimal bioavailability due to inherent challenges such as the drug’s brief half-life, instability, and a deficiency in ensuring both safety and efficacy. Liposomes, employed in drug delivery systems, emerge as highly promising carriers for augmenting the therapeutic efficacy of topically applied drugs. These small unilamellar vesicles demonstrate enhanced penetration capabilities, facilitating drug delivery through the stratum corneum layer of skin. This comprehensive review article illuminates diverse facets of liposomes as a promising drug delivery system to treat psoriasis. Addressing various aspects such as formulation strategies, encapsulation techniques, and targeted delivery, the review underscores the potential of liposomes in enhancing the efficacy and specificity of psoriasis treatments.