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Introduction: Heart rate variability (HRV) is the variation in the time interval between heartbeats. It is controlled by the autonomic nervous system, which also regulates many other vital body functions. HRV has been used as a noninvasive marker of cardiac autonomic activity and cardiovascular risk stratification. The present study aimed to investigate the effect of cognitive behavior therapy (CBT) on different domains of HRV and their correlation at baseline and after 3 months of intervention. Methods: After obtaining institutional ethical clearance, the study was conducted from July to October 2022 among 140 1st-year Bachelor of Medicine and Bachelor of Surgery students at a medical college in Jaipur, Rajasthan, India. Linear component, i.e., time and frequency domain, and nonlinear components, i.e., Poincare plot of HRV assessed at baseline and after the 3 months of CBT. Results: Findings show that there was a significant decrease in linear components, i.e., time domain and frequency domain parameters (P < 0.001) and nonlinear components Poincare plot standard deviation (SD) 1/SD2 (P < .0.001) after 3 months of CBT. Linear and nonlinear components of HRV were positively correlated (P < 0.01). Conclusion: The study indicates that after 3 months of CBT, the autonomic nervous system shifted toward parasympathetic dominance, which was assessed by linear components, time domain and frequency domain parameters, and nonlinear components, i.e., Poincare plot (SD1/SD2) of HRV.

Background: Individuals suffering from major depressive disorder (MDD) frequently have abnormal heart rate variability (HRV) patterns. They have decreased HRV, which implies that there is less variance between subsequent heartbeats. Increased sympathetic nervous system activity (the "fight or flight" reaction) and decreased parasympathetic nervous system activity (the "rest and digest" response) are related to reduced HRV. This study investigates short-term HRV patterns in individuals with major depressive disorder. Methods: This observational study was conducted at RUHS College of Medical Sciences and Associated Hospitals, Jaipur, from July 2022 to January 2023, on a major depressive disorder population of either sex in the age group of 20-40 years. Cognitive functions were assessed using a questionnaire, and AD instruments recorded heart rate variability variables (time & frequency domain) using a digital physiograph (MLT004/ST). Data analyses were conducted using Microsoft Excel 2019. The Pearson correlation coefficient was calculated to determine the correlation, and a significance level of p

Background: Cognitive and autonomic dysfunction is increasingly being recognized as an important clinical dimension in major depressive disorder. AIM: The aim of this study is to evaluate the effect of a combined approach of yoga and diet intervention on cognitive and autonomic functions in individuals with major depressive disorders. Methods: This experimental observational study was conducted at RUHS College of Medical Sciences and Associated Hospitals, Jaipur, on the major depressive disorder population of either sex cognitive function (mini-mental score, Montreal cognitive protocol A and B, P300 latency and amplitude) and autonomic function parameters (frequency and time domain) were recorded at baseline and after three months of a combined approach of yoga and diet intervention. Results: This study compared cognitive and autonomic function parameters at baseline and after three months of yoga and diet intervention in a major depressive disorder population. Analysis revealed a significant decrease in body mass index (

Introduction: A group of related risk factors known as central obesity, elevated blood pressure, impaired fasting glucose, elevated triglycerides (TGs), and low levels of high-density lipoprotein (HDL) are collectively referred to as metabolic syndrome (MetS). A low quality of life (QoL) in terms of health is linked to MetS. This study sought to determine how lifestyle modifications affected the health-related quality of life (HRQoL) of primary care patients with MetS. Materials and Methods: In this study, we randomized 300 subjects diagnosed with MetS as per the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria, into control, yoga, and yoga + diet groups according to their intervention which was given for 6 months. Socio-demographic, anthropometric, and physiological and biochemical parameters were collected at baseline, 3 months, and 6 months. The 36-Item Short Form Health Survey (SF-36) was also used to assess HRQoL. Results: The results of this study indicate that yoga + diet and yoga intervention led to significant decrease in metabolic risk factors, such as waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FBG), TGs, and increase in HDL at 3 months and 6 months from baseline. SF-36 score also showed increment (from 0 score to 100) at 3 months and 6 months, which indicates improvement in HRQoL. Conclusion: Dietary changes and yoga are useful strategies for reducing the risk of MetS, which improves QoL in relation to health. Incorporating yoga practices and advocating a balanced diet within primary care systems can significantly benefit individuals with or at risk of MetS.

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.

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.

The ability to hear is one of the five major senses that allows us to communicate effectively with others. Unfortunately, individuals frequently take their sense of hearing for granted, and they do not know how important it is until it is lost or compromised. Hearing loss was not a top concern for the Indian government until recently. Prevention, early diagnosis, and care can prevent half of all occurrences of deafness and hearing impairment. The auditory sense is critical for a child’s brain development. This will also reduce the strain of hearing loss, preventing the loss of many potentially productive years. The most cost-effective strategy to lessen the burden of hearing loss is to screen new-borns and babies. Hearing loss is the most frequent sensory deficiency in people all over the world. The severity of hearing loss can range from mild to severe. Kapoor Set al. suggested that by screening, the condition is detected earlier than it would otherwise be diagnosed. Because of the urgent need to prevent infectious causes of mortality, neonates and new-borns are not regularly checked for any specific disease in India. The Department of Prevention of Communication Disorders of All India Institute of Speech and Hearing (AIISH) located in the Southern India, conducts infant screening for hearing disorder on regular basis in different hospitals attached to it using Behavioural Observational Audiometry, Otoacoustic Emissions (OAE) screening, and administering High Risk Register (HRR). In the year 2009-2010, a total of 12416 new-borns in 10 hospitals associated with AIISH were screened for hearing disorder. The following paragraphs deals with various issues related to the hearing screening of infants in India. Methodology of study was as we searched PubMed Central and Google Scholar for relevant articles with key words «hearing, screening, hearing loss and infants». Full-text articles were downloaded dated July 2022 to September 19, 2022. Relevance was judged according to articles describing theories of hearing screening of infants India. Conclusion. Hearing screening for new-borns is critical for detecting congenital hearing loss and providing early management. Every person has the right to live a healthy lifestyle. Hearing impairment, like communication disorders, begins early in life. Infants with hearing loss will only be able to reach their full potential as fully active, contributing, and integrated members of society if systematic early screening programmes are implemented. Hearing screening for new-borns is critical for detecting congenital hearing loss. The AABR is considered necessary for HRNHS in high-risk new-borns (prematurity, anoxia, hyperbilirubinemia) who are at risk of auditory neuropathy that cannot be detected using the OAE test. The OAE test is faster and easier to conduct, but it has a larger false positive rate than the AABR. The ideal hearing procedure is still being developed. As a result, the hearing screening technique should be adapted to the specific demands of each centre.

Relevance. Metabolic syndrome (MetS) is existence of many abnormalities, such as abdominal obesity, hypertension, dyslipidemia, and glucose intolerance. The occurrence of MetS in hypertensive people is linked to poorly managed hypertension. One of the parameters for the diagnosis of the syndrome is the presence of increased blood pressure; nevertheless, research shows that MetS patients are likely to experience hypertension often. Materials and Methods. 300 metabolic subjects were selected from the medicine OPD as study participants based on the joint interim statement’s 2009 definition of the metabolic syndrome. They were divided into three groups (normotensive, pre-hypertensive, and hypertensive) based on blood pressure readings that met the American Heart Association’s (AHA) Asian blood pressure criteria. The following parameters were recorded for data collection: anthropometric (Weight, Height, Body Mass Index Waist Hip Ratio), Blood pressure, biochemical (Fasting blood glucose, Lipid profile parameters). Results and Discussion. According to the resting blood pressure readings, out of 300 metabolic syndrome participants, 37 were normotensive [male (40.54 %); female (59.45 %)], 115 were pre-hypertensive [male (58.26 %); female (41.74 %), and 148 were hypertensive [male (52.7 %); female (47.3 %)]. In several parameters, there was no such significant difference between male and female participants across all groups. However, the levels of blood total cholesterol, triglycerides, and low-density lipoprotein were considerably greater in hypertensive and pre-hypertensive metabolic participants than in normotensive subjects, while the levels of high-density lipoprotein were lower. Conclusion. Study findings suggest, hypertension and pre-hypertension were more prevalent in the group with metabolic syndrome. Additionally, hypertensives have a higher chance of manifesting dyslipidemia.

Introduction: Cardiovascular Diseases (CVDs) are a group of disorders affecting the heart and blood vessels, including Coronary Heart Disease (CHD), cerebrovascular disease, rheumatic heart disease, peripheral artery disease, congenital heart disease, and pulmonary embolism. CVDs contribute to approximately 17.9 million deaths worldwide each year. Risk factors for CVDs can be classified as non modifiable (such as age, gender, ethnicity, and family history) and modifiable (such as obesity, dyslipidaemia, diabetes, hypertension, stress, poor diet, and physical inactivity). Men are more susceptible to CVDs than women. The QRISK3 risk score is an algorithm used to predict an individual’s 10 year risk of developing CVDs. Aim: To assess the distribution of CVD risk among men and women aged 30-70 years using the QRISK3 risk score and its correlation with dietary intake, physical activity, and perceived stress. Materials and Methods: A cross-sectional study was conducted at the Department of Physiology at RUHS-CMS and Associated Hospitals in Jaipur, Rajasthan, India. The study duration was six months, from July 2022 to December 2022. A total of 220 subjects, aged 30-70 years, of both sexes were recruited from the Outpatient Department (OPD) of Medicine, based on inclusion and exclusion criteria. The QRISK3 web calculator was used to calculate the CVD risk, which was then correlated with the Food Frequency Questionnaire (FFQ), Perceived Stress Scale (PSS), and Global Physical Activity Questionnaire (GPAQ). Statistical analysis was performed using the Chi-square test for qualitative analysis, and Pearson’s correlation analysis was used to assess correlations. Results: The mean age of the study participants (males) was 42.75±10.86 years and (females) was 42.82±10.85 years. A total of 220 participants (123 males and 97 females) aged between 30-70 years were included in the study. Among the males, 90 (73.17%) had low CVD risk, 15 (12.19%) had moderate risk, and 18 (14.63%) had high risk. Among the females, 83 (85.57%) had low risk, 9 (9.28%) had moderate risk, and 5 (5.15%) had high risk. There was a significant association between the QRISK3 risk score and gender (χ2 =6.14, df=218, p=0.04). Males showed a stronger association with the QRISK3 risk score compared to females within different age groups. Significant positive correlations were observed between the QRISK3 score and FFQ (r=0.28) and PSS (0.42). Additionally, a significant negative correlation was found between the QRISK3 score and GPAQ (-0.24). Conclusion: The QRISK3 score calculator was found to be useful in assessing the 10-year risk of developing CVDs in males and females across different age groups. The association between CVD risk and various scores suggests that perceived stress is strongly correlated with CVD risk.

Introduction: Cardiovascular Disease (CVD) and diabetes mellitus have a high correlation. Compared to individuals without diabetes, adults with diabetes have a greater prevalence rate of CVDs. This risk steadily increases along with Fasting Blood Glucose (FBG) levels, even before they are high enough to be classified as diabetes. One of the factors contributing to death among people with diabetes mellitus is CVD. QRISK3 algorithm calculates a person's risk of developing a heart attack or stroke over the next 10 years. Aim: To assess the QRISK3 cardiovascular risk score in normoglycaemic, prediabetic and diabetic subjects. Materials and Methods: The present analytical observational study was carried out in the Department of Physiology and Medicine, RUHS College of Medical Sciences and associated Hospital, Jaipur, India, from November 2021 to April 2022. A total of 200 subjects were recruited with >20% QRISK3 CVD risk scores out of 7154 screened patients. Subjects were categorised into three groups (normoglycaemic, prediabetics and diabetics) according to American Diabetes Association criteria. The following parameters were recorded for data collection: anthropometric {Body Mass Index (BMI) Waist Hip Ratio (WHR)}, blood pressure and biochemical {Fasting Blood Glucose (FBG), Glycated Haemoglobin (HbA1c) and lipid profile parameters). All data collected was entered into Microsoft Excel sheet 2019 and was analysed with help of Statistical Package for the Social Sciences (SPSS) software version 21.0 and tests of significance considering level of significance as p-value

Relevance. Maximal oxygen consumption (VO2max) is the maximum amount of oxygen an individual can breathe in and utilize it to produce energy aerobically. The global epidemic of overweight and obesity -’globesity’ is emerging as a public health problem in many parts of the world. Almost 30-65 % of adult urban Indians is either overweight or obese or has abdominal obesity. Recently, cardiovascular ailments are increasing in the younger generation. Low levels of cardiovascular fitness and unfavorable cardiovascular risk profiles are detected in them. Total body fatness and aerobic capacity are frequently used in association with each other and it is often implied that these parameters are strongly inter-related. Both body fatness and status aerobic fitness have been shown to be risk factors for future health outcomes. The aim of this study was to assess the correlation of cardio-respiratory fitness with body fat percentage in young adults. Materials and Methods. This was a pilot study conducted in a group of 100 subjects of age group 18 to 25 years. Ethical clearance was obtained from institutional ethical committee and written informed consent were taken from all subjects participated in the study. Following parameters were taken (a) anthropometric parameters, (b) body fat percentage, (c) physical activity level and (d) VO2max. Results and Discussion. The mean ± SD for age, height, weight, global physical activity questionnaire (GPAQ score) and VO2max was found to be higher in male participants as compared to female participants while BMI was almost equal in both the genders but body fat percentage was higher in female participants. There was positive non-significant correlation of VO2max with body mass index and global physical activity in female subjects but positive significant in male subjects. And moderate negative correlation between body fat percentage and VO2max in male and female subjects but not significant (p 0.05). Conclusion. Body fat percentage was negatively correlated with maximum oxygenconsumption (VO2 max).

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.

Introduction: Medical students have high levels of stress that could be due to stressors related to the academic workload, time pressure competency, professionalism, physical, mental, and emotional issues. This study aimed to find out subjective assessment of stress, stressors, and coping strategies and objective assessment of stress with heart rate variability (HRV) and correlate subjective and objective assessment of stress scores among 1st year MBBS students at RUHS College of Medical Sciences. Materials and Methods: Institutional ethical clearance (EC-P-21/RUHS) was obtained after that study was conducted among a total of 150 1st year MBBS students. The students were asked to fill out a validated general health questionnaire (GHQ-12), “medical student stress questionnaire 40,” and a brief COPE inventory to assess stress, stressors, and various coping strategies for subjective assessment and objective assessment done by time and frequency domain parameters of HRV. Results: The mean age was 20.85 ± 1.56. The severity of stress categorized as mild, moderate, high, and severe were 17%, 40%, 13%, and 10%, respectively. The most affected stressor was academic contributed to 80% followed by teaching–learning related, social, intra- and interpersonal, group activities, drive, and desire-related stressors 78%, 75%, 73%, 70%, and 68%, respectively. Overall, the students' coping strategies were mostly avoidant followed by emotional and problem based. HRV is measured by time domain, i.e., PNN50, standard deviation of normal to normal RR intervals, root mean square of successive differences, and “frequency domain parameters,” i.e., low frequency (LF), high-frequency (HF), and LF/HF ratio. Conclusion: In the present study, a positive correlation was observed between HRV and stress score. More than 75% of RUHSCMS 1st year medical students were suffering from measurable academic stress. Time domain and frequency domain parameters were positively correlated with stress score.

Cardiovascular diseases 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. The most important behavioral risk factors for heart disease and stroke are poor diet, physical inactivity, smoking, and harmful alcohol use. The impact of behavioral risk factors may manifest in each individual as high blood pressure, hyperglycemia, hyperlipidemia, overweight, and obesity. The purpose of this study was to give a thorough scientific analysis of yoga’s contribution to the management and prevention of cardiovascular diseases and related risk factors. The records are collected from several databases. We performed an extensive search of the PubMed/Medline electronic database. However, it is believed that the risk of cardiovascular disease can be reduced by adjusting for several risk factors, such as increasing physical activity and using relaxation to reduce stress, both of which are elements of yoga. As yoga has become an increasingly popular form of exercise, it could be an important intervention for primary and secondary cardiovascular disease prevention. Evidence suggests that regular exercise can reduce the risk of death from cardiovascular disease, and it is beneficial when included in primary and secondary prevention strategies. This review assessed the effectiveness of yoga in reducing various cardiovascular risk factors (blood pressure, weight, body mass index, lipid profile, blood sugar). There is promising evidence that the practice of yoga improves cardiovascular health. Yoga practice length has a beneficial relationship with reducing the risk of сardiovascular diseases. Numerous studies used limited sample numbers, varied the forms and lengths of their yoga treatments, and omitted information on the processes behind change. The prevention and management of cardiovascular illnesses and associated risk factors, however, might be greatly aided by yoga. To even further understand the numerous possible mechanisms behind yoga’s effects, more research is necessary.

Metabolic syndrome (MS) is defined by a cluster of risk factors including insulin resistance, hypertension, dyslipidemia, and obesity. Metabolic syndrome is also defined as having at least three metabolic risk factors — increased blood pressure, high blood sugar level, excess body fat, and abnormal cholesterol levels — and greatly increases the chance of future cardiovascular problems. The last 50 years have seen a dramatic increase in metabolic disorders, including obesity and type 2 diabetes, with the number of individuals diagnosed with type 2 diabetes worldwide expected to surpass 360 million by 2030. Early diagnosis is important in order to employ effectively lifestyle and risk factor modification. Pharmaceutical therapy in MS is aimed at treating the individual components of MS such as antihypertensives, statins, and metformin. Some natural compounds, Yoga and dietary elements. Therefore in this article various therapies (possible treatments) were reviewed. The world is in emergent need for searching of treatments for metabolic syndrome. The MS is a constellation of common metabolic disorders that is associated with type 2 diabetes and cardiovascular disease. Insulin resistance and dyslipidemia play central roles in the pathophysiology of this syndrome. In this modern world, metabolic syndrome is reaching epidemic proportions. With only a handful of people following the healthy diet and lifestyle, majority still fall in the bracket of those with compromised diet and lifestyle, burdening the health services. Socio economic changes and eventually globalization has led to transformation in the society. This has led to alterations in the dietary habits eventually resulting in nutrition transition. Pharmacological treatment is only based on only diagnosis and symptoms. Recently approved anti-obesity drugs can be prescribed to reduce body weight, particularly abdominal visceral fat. A first line intervention targeting MS involves dietary and lifestyle modification with regular physical activity over a period of time. However, improvement in MS parameters can only be maintained when these modifications can be sustained. Therefore, dietary and lifestyle modification in continuum is required to overcome MS holistically. The main and foremost treatment for metabolic syndrome is to eliminate the causative risk factors of it.

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.

Objective: Maximal oxygen consumption (VO2max) can be estimated using maximal or sub-maximal tests, by direct or indirect methods.The Queen’s College Step Test (QCT) is used very frequently to estimate VO2max due to its simple, safe, quick and feasible approach. Originally the QCT was developed for the white race population, which is different from the Indian population in terms of ethnicity. So the present study was conducted to validate the applicability of the QCT to indirectly estimate VO2max in Indian adults. Material and Methods: A total of 419 apparently healthy students (male and female) were recruited for the study by the RUHS College of Medical Sciences (RUHS-CMS), Jaipur from January 2019 to March 2020 by random number table generator sampling. Direct estimation of VO2max was performed by sub-maximal exercise testing on a treadmill using a gas analyzer, while VO2max was indirectly predicted by the standard QCT protocol. The collected data were entered into Microsoft Excel and analyzed using unpaired student t-test, analysis of variance (ANOVA), and regression analysis. Results: The average directly measured VO2max (ml/kg/min) in males was 45.30±7.35, and for women was 35.71±5.29, and predicted by the QCT was 49.01 for males and 38.83±5.30 for females. The difference between the measured and predicted mean VO2max (PVO2max) values was statistically significant (p-value

Introduction: Maximal oxygen uptake (VO2 max) is the maximum quantity of oxygen a person can consume, and it remains constant over time despite increased exertion. The amount of oxygen consumed by the working muscles is measured by maximal oxygen consumption. The maximal oxygen uptake can be measured using maximal or submaximal tests, by gas analyser or field methods. The estimated VO2 max can be used to study people’s fitness and raise awareness about physical activity and lifestyle changes. Aim: To determine the VO2 max values using a direct method and provide normative data of VO2 max for healthy young adults in the age group of 18-25 years in both sexes. Materials and Methods: This cross-sectional study was approved by the Institutional Ethical Committee of RUHS College of Medical Sciences, Jaipur, Rajasthan, India. A total of 419 healthy young adults (male and female students) were recruited from RUHS-College of Medical Sciences and MNIT College, Jaipur, Rajasthan, India from January 2019 to March 2020. Anthropometric data included age, height, weight according to the National Health and Nutrition Examination Survey (NHANES) and followed by measurement of VO2 max using a gas analyser of AD-Instrument (model-ML206). Collected data was entered in Microsoft excel. Paired t-test was used to compare mean and Standard Deviation (SD) of variables between male and female participants. The p-value of

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.

Introduction: Resting Energy Expenditure (REE) is the main determinant of energy requirements. An inaccurate estimation of REE can lead to the over or under-prediction of energy requirements. Indirect calorimetry is considered as the gold standard for the assessment of REE. The most of the predictive equations which are formed, are from the studies conducted on Caucasian people while on Asian population these studies are very limited. Aim: To compare the REE measured by indirect calorimetry and predictive equation in healthy young adults. Materials and Methods: A cross-sectional study was done on 100 healthy young adult participants from November 2018 to May 2019, of age group 18 to 25 years to measure REE using indirect calorimetry and predictive equations (Harris-Benedict’s, Schofield, FAO/WHO/UNU and Mifflin-St. Jeor equations). Statistical analysis was carried out using SPSS version 16.0. Unpaired student t-test for comparison of data and Bland Altman test to check for validity of predictive equations were applied. Results: The mean value of REE using Indirect calorimetry was 1994.20±577.33 and that of using four Harris-Benedict’s, Schofield, FAO/WHO/UNU and Mifflin-St.Jeor equations were 1638.15±335.64 kcal/day, 1636.21±359.85 kcal/day, 1636.93±367.59 kcal/day and 1582.41±251.29 kcal/day, respectively. Thus, the highest mean difference between values of REE obtained using predictive equation and indirect calorimetry was 411.79±326.04 kcal/day with respect to Mifflin-St.Jeorand’s and the lowest mean difference was 356.05±241.69 kcal/day with respect to Herris Benedict’s equation. Conclusion: Predictive equations underestimated the REE of young adults when compared with that measured by indirect calorimetry

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.

Introduction: Diabetes, the most common endocrine disorder, is projected to show a worldwide increase from 366 million people in the year 2011 to 552 million in the year 2030, out of which around 101 million is expected to be contributed by India. Moreover, the disease manifestations start in the early stages of diabetes and before it gets established as a full blown condition in the pre-stage called prediabetes. Aim: To highlight the importance of yoga intervention on metabolic profile and Carotid Intima Media Thickness (CIMT) in prediabetic subjects and implement it as a therapy for primary prevention of diabetes. Materials and Methods: This interventional study was done among adults aged 31-50 years in RUHS College of Medical Sciences and Associated Rukmani Devi Beni Prasad Jaipuria Hospital in Jaipur City, Rajasthan, India. A total of 250 prediabetic subjects were recruited from Jaipuria Hospital. These were divided into two groups, Study group (Group A, n=125) were engaged in yoga session and Control group (Group B, n=125) did not perform any yoga session. Written informed consent was taken from the participants in the local language. Study was conducted over a period of six months from July to December 2018. Statistical analysis was done by student’s paired t-test for intragroup comparison before applying this test the Smirnov-Kolmogorov test was conducted to confirm the normality of each parameter. Results: Yoga intervention resulted in a significant decline in blood glucose (p0.05) and Very Low Density Lipoprotein (VLDL) (p-value >0.05), CIMT (p-value

Introduction: Cognition is composed of intellectual function, memory, speech and language, complex perception, orientation, attention, judgment, planning and decision-making. Behaviour is the exhibition of these cognitive functions. Cognitive function can be assessed by different methods. The most commonly used are P300 and Mini Mental State Examination (MMSE). As both measures evaluate cognitive functions but objective method P300 evaluate endogenously and give the best picture of cognitive functions. Aim: To check the correlation between the results of MMSE with event related potential (P300). Materials and Methods: A prospective cross-sectional study was done on 100 healthy young adult subjects of both genders, aged between 18-25 years after taking written informed consent from January 2019 to June 2019. Cognitive functions were assessed by using MMSE questionnaire through face to face interview and event related potential (P300) latency and amplitude were assessed by using octopus NCV/EMG/EP- 4 Ch. Machine (model- CMEMG 01). Pearson correlation was performed to identify correlation. Results: The mean MMSE score was 24.28±2.89. The mean P300 (latency and amplitude) was 269.61±43.11 ms and 3.1±4.13 μV. Pearson correlation were used to calculate the correlation between P300 (latency and amplitude) with MMSE. The inverse correlation (-0.086) was in between P300 latency and MMSE. There was no correlation between P300 amplitude and MMSE. Conclusion: There was no correlation established between P300 amplitude and MMSE and inverse correlation was seen between P300 latency and MMSE. Hence, P300 cannot replace the MMSE in clinical settings.

Introduction: The maximal oxygen consumption (VO2 max) has been considered the single best indicator of the cardio respiratory fitness. Maximal oxygen consumption (VO2 max) is the maximum amount of oxygen a person can intake and utilise during intense exercise. Aim: To estimate and compare VO2 max measured by using direct and indirect methods. Materials and Methods: A prospective cross-sectional pilot study in which total of 100 apparently healthy students (male and female) were recruited from RUHS-College of Medical Sciences, Jaipur from January 2019 to August 2019. VO2 max of each participant was determined. Direct estimation of VO2 max comprised of sub-maximal exercise test on treadmill using gas analyser whereas VO2 max was indirectly predicted by standard protocol of Queen College step Test (QCT) with a gap of four days in between the tests. Collected data were entered in Microsoft-Excel and Paired t-test was used for statistical analysis of data. Results: The mean value of VO2 max (mL/kg/min) using direct method was 44.66±9.25 and that of using indirect method was 48.00±8.02. There was statistically very significant difference between two methods of VO2 max estimation (p=0.0032). Mean value of VO2 max for males was 47.56±8.37 mL/kg/min and for females it was 37.62±7.40 mL/kg/min, which was found statistically significant (p=0.0001) higher in males than in females. Conclusion: From the present investigation it may be concluded that the actual VO2 max is lower than the predicted VO2 max from the QCT which suggest that the prediction equation is not applicable to the studied population due to difference of ethnicity. With the help of estimated VO2 max we can find out physical fitness in individuals and creating awareness about physical activity and life style modification for primary prevention of cardiovascular, metabolic and mental disorders.

Introduction: Pre-diabetes represents the initial stage of type 2 diabetic disease developments. Prediabetes disease progression to overt type 2 diabetes occurs when pancreatic beta cells cannot produce insulin to overcome insulin resistance, resulting in further hyperglycaemia. Prediabetic patients have higher risk for Cardiovascular Diseases (CVDs) which further increases the rate of mortality. Lifestyle interventions such as yoga can prove to be a beneficial non pharmacologic intervention in preventing progression of prediabetes to type 2 diabetes. Aim: Present study highlights the importance of short term intervention i.e., yoga on Heart Rate Variability (HRV) in prediabetic subjects and its use as a tool for homeostasis of Autonomic Nervous System (ANS) and primary prevention of diabetes. Materials and Methods: This was an interventional study conducted on adults aged 30 to 50 years for analysis of frequency domain parameters i.e., Low Frequency (LF), High Frequency (HF), ratio of low frequency to high frequency of HRV. A total 102 prediabetic subjects were recruited from OPD of Jaipuria Hospital. These were divided into two groups A and B. Group A (n=51) were given intervention of set of yogic exercises and Group B (n=51) did not perform any yoga session. Statistical analysis was done by student’s paired t test for intragroup comparison before applying this test the SmirnovKolmogorov test was conducted to confirm the normality of each parameter. Results: Yoga intervention resulted in a significant decline in LF component and increase in HF component and LF/HF (Low Frequency/High Frequency) ratio shift sympathetic to parasympathetic dominance (p-value

Introduction: Diabetes mellitus has become a worldwide pandemic and is causing huge costs and burdens upon patients as well as health care providers. There is increasing evidence that lifestyle alterations are extremely effective in delaying the onset of pre diabetes or development from pre diabetes to Type-2 diabetes mellitus. Aim: The purpose of this study was to determine the prevalence of pre diabetes and to assess the risk factors associated with pre diabetes in Tertiary Health care center of Jaipur city. Materials and Methods: The study was cross-sectional carried out in Department of Physiology at Rukmani Beni Prasad Jaipuria Hospital. A total 1000 subjects age group 30 to 50 years were screened out between August and October 2017. Data collected by an interviewed questionnaire, anthropometric measurements and laboratory investigation. Results: The prevalence rate of pre diabetes in the present study is 12.5%. Prevalence was more among the females compared to males. There was a statistically significant difference between pre diabetic and normal groups regarding increasing age, overweight and obesity, sedentary life style, tobacco consumption, dietary habits. Prevalence of pre diabetes was higher in adults with physical inactivity (11.11%), obesity (high body mass index) (18%), central obesity (12.69%) and tobacco use (8%), psychological stress (12.5%). To compare the significant difference between the proportions (percentages) the test of proportion is applied. Conclusion: The study emphasis the need for effective health education program to increase awareness including importance of regular exercise and healthy diet towards pre diabetes.