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BackgroundRemote health monitoring technologies gained interest in the context of COVID-19 pandemic with potential for contactless monitoring of clinical patient status. Here, we examined whether vital parameters can be determined in a contactless manner using a novel smartphone-based technology called remote photoplethysmography (rPPG) and compared with comparable certified medical devices.MethodsWe enrolled a total of 150 normotensive adults in this comparative cross-sectional validation study. We used an advanced machine learning algorithm in the WellFie application to create computational models that predict reference systolic, diastolic blood pressure (BP), heart rate (HR), and respiratory rate (RR) from facial blood flow data. This study compared the predictive accuracy of smartphone-based, rPPG-enabled WellFie application with comparable certified medical devices.ResultsWhen compared with reference standards, on average our models predicted systolic blood pressure (BP) with an accuracy of 93.94%, diastolic BP with an accuracy of 92.95%, HR with an accuracy of 97.34%, RR with accuracy of 84.44%. For the WellFie application, the relative mean absolute percentage error (RMAPE) for HR was 2.66%, for RR was 15.66%, for systolic BP was 6.06%, and for diastolic BP was 7.05%.ConclusionOur results on normotensive adults demonstrates that rPPG technology-enabled Wellfie application can determine BP, HR, RR in normotensive participants with an accuracy that is comparable to clinical standards. WellFie smartphone application based on rPPG technology offers a convenient contactless video-based remote solution that could be used in any modern smartphone.

The global surge in teleconsultations in response to the COVID-19 pandemic resulted in flooding of the market with multiple telemedicine solutions. This placed healthcare providers and seekers in a dilemma, as they lacked benchmarks and assessing tools to identify the appropriate solution that would satisfy their individual demands. After reviewing the existing frameworks for evaluating telemedicine solutions and platforms, both scholarly and widely known, the authors realized that they all focused on either the commercial perspective or the information management competencies of telehealth delivery systems. After establishing this research gap, a new unified integrative model suitable for assessing telehealth solutions has been proposed, which is described in this chapter. They first summarize the methodology used to develop the framework, and then the framework's various components. This framework can be used by all stakeholders of the telehealth ecosystem: healthcare providers, patients, solution providers, and policy makers.

Abuse of legal substances in India includes alcohol and tobacco, which are the major risk factors for various non-communicable diseases and deaths. The current pandemic has identified tobacco consumption as a risk factor for COVID-19, highlighting the need to control substance abuse. The objective of this study was to estimate the prevalence of substance abuse in India and discuss the cost-effective public health strategies (such as yoga) to alleviate COVID-related anxiety in order to prevent substance abuse and its associated co-morbidities such as type 2 diabetes mellitus. This study reports the data on tobacco and alcohol abuse from a nationwide randomized two-arm diabetes control trial (Niyantrita Madhumeha Bharata, 2017) conducted by the Indian Yoga Association (IYA) through Swami Vivekananda Yoga Anusandhana Samsthana (S-VYASA), Bengaluru. Data of 30,354 participants who abuse tobacco and 30,159 participants who abuse alcohol were collected all over India. The prevalence is estimated at around 8.7% for alcohol abuse and 7.9% for tobacco abuse, Arunachal Pradesh state ranking the highest regarding both alcohol and tobacco abuse, while the Tripura state ranked the lowest. School and college-based mandatory yoga programs need to be implemented to prevent the increase of substance abuse in India to alleviate the psychosocial stress of adolescents and college-going students, besides the installation of the mindfulness-based diabetes yoga protocol (DYP) in the wellness centers of Ayushman Bharat.

Objectives The main purpose of this study is to investigate the prevalence of comorbid conditions in diabetic, prediabetic, and nondiabetic individuals. Additionally, the current study examines the levels of awareness of those comorbidities among North Indian population. Methods As a part of a national study (Niyantrit Madhumeh Bharat [NMB] screening program), different comorbidity parameters were screened in the northern part of India between April and September 2017. There were 1,215 participants recruited in this study. Biochemical analyses of hemoglobin A1c (HbA1c) were conducted on the study subjects. Subsequently, the study subjects were divided into diabetic, prediabetic, and nondiabetic groups based on their HbA1c results. Results The study analysis reveals a higher prevalence of peripheral vascular disease (21.2%), ocular diseases (18%), and hypertension (13.4%) in diabetics with other comorbidities. Furthermore, the study found that a vast majority of the participants were unaware of the presence of hypertension (67.2%), dyslipidemia (84.5%), kidney disease (95.2%), peripheral vascular disease (34.5%), and stroke (95.1%). Conclusion The study concluded that in the northern India, the prevalence of multiple comorbid conditions, such as peripheral vascular disease and hypertension, is higher among diabetic population. Also, the level of awareness of diabetic comorbidities is surprisingly low, which has implications for policymakers, health practitioners, and educators of alternate medicine to increase awareness about diabetes, comorbid conditions, health risk, and possible solution at community and rural level, such as periodic screening programs in this population.

Background Even though Yoga is useful for prevention of obesity, diabetes and hypertension it is not universally practiced. The purpose of the study was to determine the benefits and barriers confronted by the community members while incorporating Yoga into routine practice and at workplace. Objective This study explored the motivators and barriers to Yoga practice by estimating how these elements can be useful for development and incorporation of Yoga as a workplace activity and as a profession. Methods A nationwide multi-centered prospective study was conducted recruiting individuals of different age groups and geographical zones in India. Participants of Yoga intervention group were administered a questionnaire with 19 items on benefits (YBS) and 18 items on barriers for Yoga practice (BFYS). Data was analyzed using SPSS v21 software. Results Majority of the participants perceived Yoga improves "physical fitness", "relaxes mind and body", improves "stamina", across age groups. "Lifestyle", "Family commitments", "Physical over-exertion", "No Encouragement from family", "Occupational commitments" and "Few places to do Yoga" were perceived barriers across various geographical zones. Despite knowing the benefits of Yoga, these barriers prevented individuals from integrating it into their daily routine. Conclusions The present study may be considered as a starting point for development of Yoga as a workplace activity and a profession based on the perceptions of its various benefits and barriers faced by a large study population spanning an entire nation.

Background Yoga is an ancient system of wellness with Asana and Pranayama as its most popular and propagated modules for management of lifestyle disorders. Objectives The aim of the study was to characterise the liver abnormalities, biochemical changes, and stress levels after Yoga intervention in prediabetic females. Materials and methods 37 females were randomly divided into Yoga practising and non-practising control groups. The Yoga practising group performed Diabetic Yoga Protocol (DYP) for 3 months. Parameters including size of liver, fatty infiltration, and grade of severity were measured using ultrasonography along with biochemical parameters and stress levels at baseline and after Yoga practice. Results The glycosylated hemoglobin (HbA1c) and glucose levels were found significantly reduced in prediabetic (p = 0.015) women after practising DYP, although cholesterol levels increased in menopausal women. No escalation of fatty liver was noted among women practising DYP. Conclusion DYP reduced the HbA1c and stress levels and therefore, could be a cost-effective tool for preventing prediabetes to diabetes progression.

Background Spinal cord injury (SCI) leads to serious complications involving primary trauma and progressive loss due to inflammation, local ischemia, or infection. Despite a worldwide annual incidence of 15 to 40 cases per million, methylprednisolone is the only treatment available to alleviate neurologic dysfunction; therefore, research is currently focused on identifying novel targets by biochemical and molecular studies. Purpose Here, we investigated the expression of various molecular markers at the messenger ribonucleic acid (mRNA) and protein level at day 0 and day 30 post-SCI. Methods Enzyme-linked immunosorbent assay (ELISA) was performed to determine the expression of CASPASE-3 and heat shock protein-27 (HSP-27) in serum samples. Real-time polymerase chain reaction (RT-PCR) was performed to determine the level of mRNA expression of vascular endothelial growth factor receptor-1 (VEGFR-1), VEGFR-2, HSP-27, monocyte chemoattractant protein-1 (MCP-1), and CASPASE-3. Results HSP-27 expression at day 30, as compared with day 0, showed significant downregulation. In contrast, there was elevated expression of MCP-1. ELISA analysis showed no significant change in the expression of CASPASE-3 or HSP-27. Conclusion There may be possible opposing role of HSP-27 and MCP-1 governing SCI. Their association can be studied by designing in vitro studies.

A data recording sheet (DRS) is a specialized document with a predefined format used to enter data related to and/or obtained from an experiment or to follow a protocol for assessing product quality. This is also a tool that can help an experimenter/researcher/study director in data verification, validation, and including the integrity of the project. The DRS should be coded and indexed, which can help finding its location in the laboratory or institution. This data can be collected on the DRS both manually as well as electronically. The present chapter describes the significance of DRS in academic research laboratories and summarizes the method of creating and using a DRS in different quality management systems.

Background: Type 2 diabetes needs a better understanding of etiological factors and management strategies based on lifestyle and constitutional factors, given its high association rate with many cardiovascular, neurological disorders, and COVID-19 infection. Purpose: The present study was undertaken to investigate the effect of Diabetes-specific integrated Yoga lifestyle Protocol (DYP) on glycemic control and lipid profiles of diabetic adults. Along with the DYP intervention, the individuals residing in Chandigarh and Panchkula union territories in the northern part of India were assessed for Ayurveda-based body–mind constitutional type. Ayurveda describes body–mind constitution as “ prakriti,” which has been discussed from two angles, namely physiological and psychological as body and mind are correlated. Methods: Cluster sampling of waitlist control study subjects was used as the sampling method for the study. A total of 1,215 registered subjects (81 diabetic) responded in randomly selected clusters in Chandigarh and Panchkula. Ayurveda physicians did Ayurveda body–mind constitutional assessment called prakriti assessment (physiological body–mind constitution assessment) in 35 participants (23 diabetic, 12 prediabetic) as a part of the study. Results: A group of 50 subjects was randomly selected for yoga intervention out of 81 diabetes mellitus adults, and 31 subjects were enrolled as waitlist controls. A significant decrease in the glycosylated hemoglobin levels from 8.49 ± 1.94% to 7.97 ± 2.20% in the intervention group was noticed. The lipid profiles of the DYP intervention and control groups were monitored. Three-month follow-up results of lipid profile diagnostic tests in intervention and control groups showed a significant difference between the two groups ( P < 0.05). Most diabetic and prediabetic individuals were found to have pitta dosha ( pitta controls all heat, metabolism, and transformation in the mind and body) as dominant constitution type. Conclusion: The study results demonstrated significant positive effects of yoga in diabetic individuals. This study has indicated the evidence for the safety and efficacy of the validated DYP for community-level interventions to prevent maladies like brain damage and stroke.

There is a rapid increase in the prevalence of diabetes in India. We wanted to review the status of prediabetes and diabetes in the combined population of Chandigarh and Panchkula region based on both Indian Diabetes Risk Score (IDRS) and Glycated Haemoglobin (HbA1c). A total of 1215 subjects were recruited during the screening process, out of which 444 i subjects have been analysed for the current study on the basis of high risk for IDRS (≥60) and their known diabetes status. This study included 431 subjects having high risk for IDRS (≥60) and 13 known subjects with diabetes (IDRS, The study has revealed that high prevalence of diabetes in the sampled population when compared with the national average of 8.8%.

Rheumatoid Arthritis (RA), an autoimmune disorder develops pain, synovitis, cartilage degradation and bony erosion along with showing the symptoms of depression among the patients. Recent studies have shown that mind body interventions like yoga is effective improving quality of life and depression among patients in such autoimmune conditions. This study has shown improvement of systematic inflammatory markers and co-morbid depression among the yoga group of the active RA patients.

Background In this study, we demonstrate a collective collaborative, conversational, pre-publication peer review of a randomized controlled trial. Methods Using Critical Appraisal Skills Programme checklist, a group of research-oriented undergraduate medical and pharmacy students and their teacher collectively on an online forum, discuss and review a randomized controlled trial submitted to the Annals of Neurosciences and the explanatory commentary from each reviewer makes a basic scaffold for critical appraisal of the manuscript. Results This method provided the opportunity for students to engage in online interactive training and allowed them to understand tools used for critical appraisal of a study. Students were incentivized by the potential publication credit and they look forward to continuing this work and perhaps providing one small step to making medical education more interactive. Conclusion Open peer review involving a group of reviewers at a time produces multidirectional reviewing concepts, thus helps to improve the quality of paper and also may reduce the time between review and publication.

Background The state of disarray from unhygienic conditions and excessive litter throughout urban highways, alleyways, and byways across rural and urban localities of India is abysmal. Such unsanitary conditions impinge upon the future health and welfare of its citizens, tourists and economic development. Purpose The NRL volunteered PGIMER's campus hygiene initiative" is a pioneering effort spearheaded in compliance with Indian Prime Minister's call that citizens of India work together to establish a cleaner and healthier environment. Methods A group of 15 highly motivated students in the Neuroscience Division of the PGIMER, worked together vigorously 2 hours a week to affect a cleaner urban environment in the city. Result The results were national Kayakalp and Skoch award to PGIMER as the cleanest hospital in the country, the vendors or patients no longer litter around the campus, the pot holes have been converted into greener patches, signs board adorn the campus. Conclusion To inspire citizens through faculty- student led sanitation programs.

Background: Diabetes mellitus (DM) is widely spread in South Asian (ASEAN) and Indian sub-continent. The increasing healthcare costs of DM can be prevented in the developing world by improved public healthcare interventions. Modifiable risk factors of DM like sedentary lifestyle, obesity, and stressful conditions are associated with its progression; however, the epidemiological data collected by Public Institutions are limited. Summary: A review of published literature describing geographic distribution of DM and associated dementia in South Asian region, particularly India, was conducted with the purpose of assessing the feasibility and challenges associated with the Yoga-based risk reduction. PubMed and Google Scholar databases were searched for DM and dementia-related articles by using a combination of keywords: Diabetes, Diabetes related Dementia Southeast Asia, Pre-diabetes, Yoga, lifestyle modification, Dementia and Exercise. The epidemiological data generated from these diseases have not prompted to any major public health policies. Yoga can be a cost-effective intervention for the prevention of Type 2 DM (T2DM) and its associated cognitive decline when detected early. If nationwide intervention of Yoga is brought about by the state, its integration in health care will become more meaningful and acceptable. Key Message: Studies suggest that Yoga and change in lifestyle can modify the health risks associated with T2DM and associated dementia if it is mainstreamed with the public health initiative of Ayushman Bharat scheme.

Conflicts and humanitarian crises lead to serious mental health disorders, including depression, anxiety, stress, and cognitive decline. Exposure to these circumstances in early life can lead to the development of disorders such as mild cognitive impairment, dementia, and Alzheimer's disease (AD), for which no treatments are available. In this review, various research papers have been compiled to develop an understanding about mental health of population affected due to wars and conflicts and how stress and depression can accelerate the development of dementia and AD. Due to failure of drugs in the treatment of dementia and AD, yoga and mindfulness-based approach has been proposed for future investigations. Although studies have shown that yoga and mindfulness can be helpful in the management of stress, anxiety, depression, and posttraumatic stress disorder in the war-afflicted areas, limited mechanistic studies in yoga and mindfulness remain the chief cause precluding its clinical application in such warzones. The molecular studies in the field of yoga can be undertaken by targeting these warzones. This review provides a scientific evaluation of mind–body techniques as a justification for mental health rehabilitation in the war-afflicted zones in face of failed clinical trials for various drugs. This may help reduce the risk of developing dementia and AD in this susceptible population.

Background: To examine the knowledge, attitudes, and practice gap of yoga across India based on implicit perceptions. Methods: The present study is a nationwide door-to-door survey conducted using a questionnaire/screening form. The data were collected from a national survey conducted under the Niyantrit Madhumeh Bharat (NMB) program initiated by The Ministry of Ayurveda, Yoga, Unani, Siddha, Homeopathy (AYUSH), Government of India, from all major zones of the country. A total of 162,330 participants who joined the NMB program were recruited in our study. Results: Out of the total respondents to the survey, it was observed that 11.8% [13,336/112,735] practice yoga, which was highest in the north zone [4,567/112,735] and lowest in the east zone [971/112,735]. Out of 101,643 respondents, 94,135 of the individuals who participated in the survey believed that yoga improved their lifestyle, and 90,102/98,518 believed that yoga prevented diabetes, revealing a huge knowledge&ndash, practice gap. Conclusions: The scale of the knowledge&ndash, practice gap coupled with the general acceptability of yoga calls for a change in the conventional healthcare provisions by its integration with modern medicine. The population-wide positive perceptions about yoga as a preventive health tool can not only catalyze consensus disease-specific yoga modules but also bridge the knowledge&ndash, practice gap that exists because of limited yoga centers and professionals.

Introduction: Precision medicine aims to focus on meeting patient requirements accurately, optimizing patient outcomes, and reducing under-/overdiagnosis and therapy. We aim to offer a fresh perspective on accuracy driven &ldquo, age-old precision medicine&rdquo, and illustrate how newer case-based blended learning ecosystems (CBBLE) can strengthen the bridge between age-old precision approaches with modern technology and omics-driven approaches. Methodology: We present a series of cases and examine the role of precision medicine within a &ldquo, case-based blended learning ecosystem&rdquo, (CBBLE) as a practicable tool to reduce overdiagnosis and overtreatment. We illustrated the workflow of our CBBLE through case-based narratives from global students of CBBLE in high and low resource settings as is reflected in global health. Results: Four micro-narratives based on collective past experiences were generated to explain concepts of age-old patient-centered scientific accuracy and precision and four macro-narratives were collected from individual learners in our CBBLE. Insights gathered from a critical appraisal and thematic analysis of the narratives were discussed. Discussion and conclusion: Case-based narratives from the individual learners in our CBBLE amply illustrate their journeys beginning with &ldquo, age-old precision thinking&rdquo, in low-resource settings and progressing to &ldquo, omics-driven&rdquo, high-resource precision medicine setups to demonstrate how the approaches, used judiciously, might reduce the current pandemic of over-/underdiagnosis and over-/undertreatment.

Coronary artery disease managed by percutaneous coronary intervention (PCI) has been noted for profit-driven overuse medicine. Concerns mount over inappropriate use of PCI for patients in India. We describe the case of a 55-year-old Indian man who presented for a second opinion following an urgent recommendation for PCI by two cardiologists following a recent acute myocardial infarction even though the patient was symptom-free and out of the window period for primary PCI. The proposed intervention placed the patient at financial risk for insolvency. This case report highlights the challenges and consequences of inappropriate overuse of PCI. Also, we outline the current lack of shared decision-making among patients and physicians for the PCI procedure. The challenges, inherent in the assumptions that overuse of PCI is evidence-based, are discussed including recommendations for the practice of evidence based medicine for this intervention.