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Background and Aim: Evidence suggests a beneficial effect of sun exposure on type 2 diabetes mellitus (DM). However, little is known about the characteristics of sun exposure among DM patients or individuals at risk of developing DM. The aim of this study was to analyze the sun exposure behaviors of individuals diagnosed with DM and those susceptible to developing DM within a semi-urban community in North India. Materials and Methods: A population-based cross-sectional study was conducted in northern India with 494 participants aged 25–60, with or without DM. The participants’ sun exposure characteristics were assessed through a sunlight exposure questionnaire, and total sun exposure in a day was computed using the veritable sun exposure (VSE) index. Fasting blood sugar, anthropometric measurements, and demographic details were also collected. Results: The study had 56.5% female participants, and 9.1% of the participants had DM. The VSE of the study participants ranged from 0.01 to 0.81, with a mean of 0.15 (±0.14) and a median of 0.10, indicating that more than half of the study samples had less than 10% h/day of sunlight exposure. The use of sunscreen, gender, and disease status all influenced VSE. Our data suggest that the characteristics of sun exposure among Indians significantly deviate from standard recommendations. Conclusion: Our results propose a need for evidence-based guidelines and policies that promote awareness about sun exposure among DM patients as well as those at risk of developing DM. Nevertheless, these findings need to be validated through large-scale observational studies.

BACKGROUND: Due to the physical demands of work, blue-collar workers (BCW) frequently experience fatigue, musculoskeletal pain, and burnout. The purpose of this study was to determine the feasibility and utility of introducing yoga-based loosening exercises (YLE) at the workplace for improving fatigue, musculoskeletal pain, and burnout among BCW. MATERIALS AND METHODS: One hundred and twenty-eight BCW were randomized into a yoga group that received 40 minutes of supervised YLE daily, 5 days a week, for 1 month, followed by 1 month of unsupervised practice at home or a waitlisted control group. The Chalder Fatigue Scale (CFS), Visual Analog Scale for pain, Oldenburg Burnout Inventory (OLBI), sit-and-reach test (SRT), handgrip strength dynamometer, and the Short Form-8 (SF-8) questionnaire were measured at baseline, at the end of the first month, and at follow-up after the first month. RESULTS: All the participants adhered well to the YLE (≈86% at the workplace, ≈70% at home). Compared to the controls, the yoga group reported significant reductions in fatigue, pain, and burnout and significant improvements in flexibility, strength, and quality of life (P < 0.001) at all the time points. CONCLUSION: Our findings demonstrate that workplace yoga programs for BCW are feasible and can considerably reduce fatigue, pain, and burnout and improve their quality of life.

Purpose: Reports suggest that females experience more adverse events post-coronavirus disease 2019 (COVID-19) vaccination compared to males. However, no gender-specific data on the impact of vaccines on the Indian population are available. The present study was intended to understand the impact of COVID-19 vaccines on the health status of young Indian female adults and to identify the factors associated with experiencing adverse events post-vaccination. Methods: A web-based survey was conducted among 433 young female adults who have taken at least one dose of the COVID-19 vaccine. The prevalence and duration of systemic and generalized symptoms were analyzed using descriptive statistics. The factors associated with symptoms post-vaccination were analyzed using binary logistic regression. Adjusted odds ratios and 95% confidence intervals were computed. A P value of ≤ 0.05 was considered to be statistically significant. Results: Of the 404 surveys returned (93.3%), 371 respondents have received both vaccine doses. COVISHIELD™ was the vaccine of choice among 73% of respondents and nearly 91% of the respondents reported a re-infection post-vaccination. At least one form of the symptom as a side effect of vaccination was experienced by 88.4% (n = 357) of the participants. This included generalized symptoms (77.5%) followed by musculoskeletal (53.2%), localized (38.9%), psychological (35.1%), gastrointestinal (25.5%), gynecological (24%), and endocrine symptoms (22.5%). Presence of chronic ailments was significantly associated with experiencing localized symptoms (OR 2.21, 95% CI 1.25-3.91), psychological symptoms (OR 2.41, 95% CI 1.34-4.34), neurological symptoms (OR 2.98, 95% CI 1.38-6.46), gastrointestinal symptoms (OR 4.76, 95% CI 2.59-8.75), respiratory symptoms (OR 2.45, 95% CI 1.29-4.67), endocrine symptoms (OR 2.92, 95% CI 1.58-5.38), and gynecological symptoms (OR 4.05, 95% CI 2.21-7.44). Older than 21 years was significantly associated with the experience of gynecologic symptoms (OR 2.12, 95% CI 1.24-3.64). Not being re-infected post-vaccination has lower odds of experiencing psychological, gastrointestinal, and respiratory symptoms. Conclusion: Our result suggests serious planning and counseling are warranted while disseminating COVID-19 vaccination among young female adults especially those with comorbidities to foster trust and coverage.

ObjectivesThe aim of this study is to identify the characteristics of patients who underwent yoga therapy for pain in yoga and naturopathy clinical settings in India.MethodsElectronic medical records of patients who received yoga therapy for pain in three inpatient yoga and naturopathy hospitals were reviewed retrospectively from January 2021 to September 2022. Demographic characteristics and details on pain condition, socioeconomic status, comorbidities, ancillary therapies received, and insurance status were collected. In addition, we prospectively collected data on adherence to yoga practice through a telephonic interview.ResultsA total of 984 patients were identified from a pool of 3,164 patients who received yoga therapy for pain for an average of 9.48 (1.13) days. Patients aged between 8 and 80 underwent therapy for varying pain conditions and diseases that include pain in the extremities, pain due to infection, trauma, degenerative diseases, autoimmune diseases, and spine and neurological diseases. The majority of the patients were females (66.3%), from middle class families (74.8%), and who did not have any insurance coverage (93.8%). Most of the patients were under naturopathy treatment (99.8%), followed by ayurveda (56%), and physiotherapy (49.3%), along with yoga therapy. All patients reported a significant reduction in pain post-integrated yoga therapy (p

Hypothyroidism is one of the most common endocrine disorders linked to various systemic diseases ranging from obesity to cancers. The present line of management is insufficient as reports suggest that there is persistence of symptoms and poor adherence that makes the management of said disease challenging. Acupuncture and other Traditional Chinese Medicine (TCM) therapies are proven to alleviate endocrine dysfunctions. However, reports on acupuncture and cupping therapy on hypothyroidism are very scarce. Here, we report 5 cases of hypothyroid patients aged between 38-44 yrs who were treated with acupuncture and fire cupping for a period of three months. At the baseline, the patients presented with either a weak, wiry or vacuum pulse which represents spleen Qi deficiency. Further, they presented with elevated levels of Thyroid Stimulating Hormone (TSH), and higher Body Mass Index (BMI). Acupuncture treatment at ST36, LI4, SP6, and BL20 was given bilaterally whilst CV4, LR3, LR4, SP9, ST40, SP10, GV4, KI3, ST12, and SI17 were punctured unilaterally. At the end of the time period of three months, patients progressed to normal levels of TSH, reduction in BMI and had succeeded in tapering their medication doses. Supplementing this, the patients reported marked improvement in other symptoms like fatigue, hair loss, and cold feet post-treatment. The effects were consistent even during the three month follow-up period post-interventions. The results encourage the utilization of acupuncture and fire cupping in the management of hypothyroidism. However, large scale studies are warranted to strengthen this recommendation.

Background: Human immunodeficiency virus (HIV) infection is one of the most debilitating conditions which have affected nearly 32 million people across the globe. Antiretroviral therapy (ART) is the standard care given to the HIV positive individuals. But the patient adherence to ART is found to be very less as per previous studies. Complementary and alternative medicine is becoming a pillar in the rehabilitative efforts for many living with HIV/AIDS. Aim: To evaluate the effect of naturopathy and yoga intervention on CD4 counts of HIV patients. Methods: Ninety-six patients prediagnosed as HIV positive were enrolled after obtaining written consent and treated with naturopathy and yoga interventions like hydrotherapy, diet therapy, mud therapy, counseling, etc., for various durations at National Institute of Naturopathy Sanatorium. They were grouped into four groups (G1: 1-7 days, G2: 8-15 days, G3: 16-30 days, G4: >30 days) based on duration of stay. CD4 count of each individual was recorded pre- and post-stay. Results: All analyses were conducted using R package version 3.01. Dependent sample t-tests were conducted to examine the significance at 95% confidence interval. Of the 96 patients, male patients constitute 55.2% and female patients 44.8% with mean age 34.74 received 1-180 days (mean 28.75, standard deviation: 14.16) treatment. Significant increase in the CD4 count was observed in two out of the four groups (G2: P = 0.052, and G4: P = 0.00038, respectively). Conclusion: An increasing trend in the CD4 count was observed that was proportional to the length of the stay of participants at the HIV sanatorium. This indicates the possibility of lifestyle changes can bring positive outcomes in people living with HIV/AIDS when used as an adjuvant with ART care. The lack of control group is a major limitation of this study. No attempt was made to study the subjective changes in the quality of life, viral load, etc., However, larger controlled studies are warranted for conclusive results.

Objective: The objective of this study was to assess the test–retest reliability and inter-rater agreement between the traditional Chinese medicine (TCM) pulse diagnosis between two Indian TCM practitioners. Methods: A total of 300 participants were evaluated for their bilateral pulse based on TCM independently by two investigators with similar years of experience but who graduated from different medical schools. The investigators who were blinded diagnosed the participants as per TCM based on the depth, rate, and strength of their pulse. Cronbach α and weighted kappa were used for assessing the reliability and repeatability. Results: The data of all the 300 participants were included in the analysis. The test–retest reliability computed using Cronbach's alpha indicated high reliability between the investigators (α =0.963). There were a total of 37 different types of diagnoses identified by both investigators. The investigators diagnoses matched for 116 participants out of 300 participants; whereas 184 cases were not matched between the investigators. The inter-rater agreement for the TCM diagnosis tested by weighted Kappa did not returned any significant agreement (Kappa = 0.370). Discussion: The present study shows higher reliability between the pulse diagnoses between the investigators. However, the inter-rater agreement for TCM diagnosis based on pulse diagnosis was not significant probably due to the variation in subjective assessments. This calls for the standardization of training in TCM diagnostic methods among practitioners. Future studies should include the differences in training, medical education, and experience among the practitioners while determining the reliability of pulse diagnosis.

Problem Considered: Vitamin D deficiency is a global concern that needs significant attention. This observational study reports the impact of Vitamin D supplementation on general body aches, frequency of infection, and energy levels among Indian adults. Methods: This study included 508 adults aged 19–89 years old from low socioeconomic backgrounds who were given Vitamin D supplements for 4 months. The severity of musculoskeletal symptoms, frequency of infection or its symptoms, and perceived energy levels of the participants before and after the exposure were measured using a structured questionnaire. Data were analyzed descriptively for the frequencies, and a Chi-square and Wilcoxon signed-rank test was used to analyze the impact of Vitamin D on the variables studied. Results: The majority of the participants were female (82.3%) and were never exposed to Vitamin D supplementation earlier (84%). Nearly 65% of the participants were either homemakers, students, unemployed, or retired. Vitamin D supplementation was significantly associated with the reduction in back pain (P < 0.001), fatigue and body pain (P < 0.001), knee pain (P < 0.001), and pain in the hands and legs (P < 0.001). Vitamin D also significantly reduced the frequency of infection and/or its symptoms (P < 0.001) and improved physical work capacity (P < 0.001). Conclusion: Vitamin D supplementation for urban low socioeconomic groups may be beneficial as it can reduce the pain, frequency of infection and improve general well-being. The limitations of this study, such as the lack of a nonexposed group and data on the Vitamin D status of the participants, warrant consideration in future studies.