Abstract: Background Sleep and immune function are interconnected aspects of health that mutually impact each other in disease development and inflammatory homeostasis. Different aspects of immunology are regulated by different sleep characteristics, impacting on specific aspects of immune function including cytokine production and T-cell activity. Ongoing disruptions of sleep have been linked to heightened inflammation and are suspected in the pathogenesis and disease course of a range of life-style-related illnesses, including diabetes and neurodegenerative diseases. Summary This review provides a comprehensive overview of knowledge on the interaction of sleep with the immune system, its modulation of inflammatory balance, and the pathogenesis of many diseases. It emphasizes how sleep deficiency compromises immune function by means of a systemic, low-grade inflammatory response, while adequate sleep promotes intense immune responses and thus enables efficient pathogen clearance and the maintenance of immune memory. The mutual influence of sleep on the immune system underlines its critical involvement in health preservation and the course of disease. Key Message Sleep plays an indispensable role in immune health, mediating the efficiency of immune responses and the course of the regulation of inflammation. Chronic sleep deprivation can result in a low-grade inflammation that substantially contributes to the onset and exacerbation of metabolic and neurodegenerative disorders. The intimate linkage between sleep and immune function can be one strategic approach to therapy, improving health outcomes by leveraging this sleep-immune connection.

Abstract: Background: It is estimated that 6%–7% of the population suffers from mental disorders. WHO reported that one in four families is likely to have at least one member with a behavioural or mental disorder. Post-pandemic, the world has experienced a huge surge in mental health issues. Unfortunately, not everyone is able to access the available mental health services due to constraints such as lack of financial assistance, living in remote areas, fear of being stigmatised and lack of awareness. The emergence of online mental health services could solve some of these problems, as these are easily accessible to people from anywhere, are cost effective and also reduce the fear of being judged or labelled. Lots of efforts are being made today to integrate artificial intelligence with the traditional form of psychotherapy. The role of chatbots for mental health services in the form of e-therapies has been found to be highly relevant and important. Summary: The present study aims to systematically review the evidence on the use of AI-based methods for treating mental health issues. Overall, 95 studies were extracted using some of the popular databases such as Mendeley, PubM, INFO and DOAJ. The terms used in the search included ‘psychotherapy’, ‘online therapies’, ‘artificial intelligence’ and ‘online counselling’. Finally, after screening, 13 studies were selected based on the eligibility criteria. Most of these studies had employed conversational agents as an intervention. The results obtained showed the significant positive consequences of using AI-based approaches in treating mental health issues. Key Message: The study strongly suggests integrating AI with the traditional form of counselling.

Abstract: Numerous investigations indicate the presence of a reciprocal association between type 2 diabetes (T2D) and a range of mental health conditions. However, research on the factors that contribute to depression and anxiety in T2D patients in India is scarce. The present study aims to identify the prevalence and predictors of depression and anxiety in patients with T2D in India. A cross-sectional study that included 2,730 patients with T2D was conducted at the Freedom from Diabetes Clinic in Pune, India. Anxiety and depression were measured by the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorders-7 (GAD-7) Scale. Binary logistic regression was applied to identify the factors predicting anxiety and depression. The prevalence of depression and anxiety were 20.3% and 17.3%, respectively. The major predictors of anxiety and depression were female gender, obesity, unmarried marital status, poor glycaemic control and the presence of comorbid conditions. This study’s findings highlight a significant prevalence of depression and anxiety among patients with T2D in India, with key predictors including gender, obesity, marital status, glycaemic control and comorbid conditions. These findings highlight the critical need for integrated mental health support in routine diabetes care to manage depression and anxiety.

Abstract: Background Anxiety disorders are commonly associated with a higher risk of fatal cardiovascular diseases (CVD). Anxiety disorders lead to dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, thus weakening the key neuronal components of the autonomic nervous system (ANS) that are involved in cardiovascular functions, leading to increased cardiovascular risk. Purpose Impaired ANS activity, as reduced parasympathetic tone is strongly associated with an increased risk of CVD in anxiety disorders. Slow pranayama influences the ANS by activating the parasympathetic tone and deactivating the sympathetic tone in healthy volunteers and various diseased conditions. Therefore, we aimed to study the effects of slow pranayama and savasana on cardiac autonomic function tests in anxiety disorder patients. Methods Anxiety disorder patients (N = 140) of either sex between the age group 18 and 40 years attending the psychiatry outpatient department (OPD) in JIPMER were recruited for the study and were randomly assigned into the pranayama group and control group. The Pranayama group practised slow pranayama and savasana for 8 weeks along with routine psychiatric care, while the control group continued with routine psychiatric care only. Outcome measures were heart rate variability (HRV), baroreflex sensitivity (BRS), 30:15 ratio during lying to standing, E: I ratio during deep breathing, and ∇DBP during isometric handgrip, which were assessed before and after the intervention period. Results After 8 weeks in the Pranayama group, the HRV parameters showed significant improvement towards the parasympathetic domain. Also, there was a significant increase in parasympathetic reactivity with a decrease in sympathetic reactivity and significant improvement in BRS. Conclusion Slow pranayama and savasana practice in anxiety disorder patients as an adjunct to routine psychiatric care effectively improves cardiac autonomic function with a shift towards parasympathetic predominance, with significant improvements in cardiovascular parameters. Slow pranayamas with savasana may be incorporated into the routine care of these patients to enhance their cardiovascular health.

Abstract: Background Healthcare technical workers are responsible for service delivery and are indispensable to the organisation. However, being in a client facing role, they perform under client pressures thereby experiencing stress. The enormity of the healthcare industry ensures the existence of multiple competing organisations. Therefore, attrition is a cause of concern for these industries. Not only do organisations suffer as a consequence of such actions, the end users of such services may also be affected by attrition. Purpose The purpose of this study is to examine whether the intent to stay of healthcare workers is influenced by their job satisfaction and affective commitment. It also attempts to understand if affective commitment moderates the influence of job satisfaction on the intent to stay Methods The study has adopted a quantitative survey-based and primary data-based approach. The sample consists of technical healthcare staff such as medical imaging technicians, pathology laboratory technicians and medical equipment technicians. Two stage sampling has been adopted, with convenience sampling being used to approach private sector hospitals, and random sampling being used to select the respondents. Standard and established scales have been used in the study. Results The results indicate a significant correlation among job satisfaction, affective commitment and intent to stay. Further, the findings of analysis indicate that job satisfaction significantly influences the intent to stay. Affective commitment also significantly impacts the intent to stay. Moreover, affective commitment moderates the influence of job satisfaction on the intent to stay. Conclusion Healthcare organisations need to focus not only on enhancing the job satisfaction of healthcare staff but also pay attention effective commitment. They therefore need to focus not only on enhancing job skills and competencies but also provide a congenial organisation climate conducive to growth and development.

Abstract: Background: Physical activity is associated with improved brain health and cognition in humans. However, the validity, range, and quality of evidence for the beneficial outcomes linked to exercise in experimental models of vascular dementia (VaD) have not been evaluated. We performed a systematic review and meta-analysis of studies that assessed the effect of exercise intervention on models of VaD to provide an unbiased and comprehensive determination of the cognitive function and brain morphology benefits of exercise. Summary: A systematic search in three databases as well as study design characteristics and experimental data extraction were completed in December 2021. We investigated the effects of exercise on cognitive function and brain-morphology outcomes in VaD models. Twenty-five studies were included for systematic review, while 21 studies were included in the meta-analysis. These studies included seven models of VaD in rats (60%, 15 studies), mice (36%, 9 studies), and pigs (4%, 1 study). None of the included studies used aged animals, and the majority of studies (80%) used only male animals. Key Message: Exercise improves cognition but increased neuro-inflammation in VaD models. Exercise improved cognitive function as well as some markers of brain morphology in models of VaD. However, exercise increased anxiety and neuro-inflammatory signals in VaD models. Further, we observed increased reporting anomalies such as a lack of blinding to group treatment or data analysis and randomization of animals to groups. Our report could help in the appropriate design of experimental studies seeking to investigate the effects of exercise as a non-pharmacological intervention on VaD models with a high translational impact.

Abstract: Contemporary cancer care primarily focuses on advanced biomedical treatments, often overlooking the psychological and social challenges associated with the illness (psychosocial factors). This oversight can undermine the efficacy of healthcare and subsequently impact the overall well-being of cancer patients. There is a widespread consensus among medical professionals that psychological factors play a crucial role in the care and treatment of cancer patients. The main aim of this study was to examine the effects of treatment as usual (TAU) and a combined intervention (CI) of TAU and psychological intervention (PI) on stress, coping strategies and quality of life among adult cancer patients. The present study employed a pretest–post-test control group design comprising two groups—Group I (a control group involving TAU only) and Group II (an experimental group involving TAU and PI). In Group I ( n1 = 30), the patients with cancer were randomly selected from a pool of 105 cancer patients from three cancer types, lung cancer (LC), breast cancer (BC) and head/neck cancer (HNC), and were administered only TAU (e.g., surgery, chemotherapy and radiation‑hormonal therapy). In Group II ( n2 = 30), the participants were administered not only the regular TAU but also the PI involving psychoeducation, cognitive-behavioural therapy (CBT) and guided imagery. Three research instruments, namely QSC-R23, Brief Cope Inventory and EORTC QLQ-C30 version 3.0, were used for the present study. The study findings revealed that both TAU and CI resulted in positive outcomes across the measured variables. Notably, there was a decrease in stress levels and an improvement in coping strategies, encompassing problem-focused, emotion-focused and adaptive coping. Furthermore, participants showed a decreased reliance on maladaptive coping strategies and reported an enhanced quality of life, as evidenced by improvements in symptom scales. The study indicated that combining PI with TAU resulted in better outcomes, highlighting the effectiveness of CI (TAU with PI) for cancer patients compared to TAU alone.

Abstract: Background An injury to the brain affects a person in some or all cognitive, emotional, behavioural and physical domains impacting quality of life. Quality of life is essential to well-being and optimum functioning of a person in daily life. It is influenced by various individual and social aspects like physical, psychological, social relationships and environment. This article discusses an overview of impact of acquired brain injury on quality of life. Purpose This article aims to create an awareness of the nature of brain injury, factors impacting quality of life, and inter-relationships amongst them which can have implications for clinical rehabilitation. Conclusion An acquired brain injury is a life-changing event for the affected person and the family. It is globally considered a national burden. As compared to the developed countries, the availability and access to social determinants of health is low in the underdeveloped, and developing countries. An awareness of the nature of brain injury, the prognosis, available approaches to treatment can enable simple cost-effective psychosocial interventions to complement overall rehabilitation plan.

Abstract: Background Excessive internet use is a growing concern globally, and internet addiction negatively impacts academic performance. Limited research has been conducted on this topic among undergraduate medical students in Bangladesh. Purpose This study aimed to determine the prevalence of internet addiction and its impact on academic performance among medical students in Bangladesh, with a focus on the role of yoga in reducing Internet addiction as a proposed intervention. Methods A cross-sectional study was conducted among third-year medical students in four colleges in Dhaka, Bangladesh. Simple random sampling techniques were used to select participants, and data were collected using pretested questionnaires and a checklist for office records through face-to-face interviews. SPSS version 25 was used for data processing and analysis. Results Out of 312 students, 84% were addicted to the internet, and only 16% were normal. In total, 64.4% had good results in the first professional examination, while 35.6% had poor results. In total, 85.9% had good attendance, while 14.1% had poor attendance. The association between internet addiction level and first professional examination results and class attendance was highly significant. Conclusion This study highlights the high prevalence and negative impacts of internet addiction among medical students in Bangladesh. The study suggests that promoting awareness about healthy technology use, establishing a better balance between internet usage and academic study, and encouraging the practice of yoga can help alleviate this problem. Further research and interventions are needed to tackle this emerging public health issue. Encouraging students to use the internet for academic purposes and providing education and resources can help promote healthy technology use. Healthcare professionals should also be aware of the risks and encourage seeking help if needed.

Abstract: Currently, wearable sensors significantly impact health care through continuous monitoring and event prediction. The types and clinical applications of wearable technology for the prevention of mental illnesses, as well as associated health authority rules, are covered in the current review. The technologies behind wearable ECG monitors, biosensors, electronic skin patches, neural interfaces, retinal prosthesis, and smart contact lenses were discussed. We described how sensors will examine neuronal impulses using verified machine-learning algorithms running in real-time. These sensors will closely monitor body signals and demonstrate continuous sensing with wireless functionality. The wearable applications in the following medical fields were covered in our review: sleep, neurology, mental health, anxiety, depression, Parkinson’s disease, epilepsy, seizures, and schizophrenia. These mental health conditions can cause serious issues, even death. Inflammation brought on by mental health problems can worsen hypothalamic-pituitary-adrenal axis dysfunction and interfere with certain neuroregulatory systems such as the neural peptide Y, serotonergic, and cholinergic systems. Severe depressive disorder symptoms are correlated with elevated Interleukin (IL-6) levels. On the basis of previous and present data collected utilizing a variety of sensory modalities, researchers are currently investigating ways to identify or detect the current mental state. This review explores the potential of various mental health monitoring technologies. The types and clinical uses of wearable technology, such as ECG monitors, biosensors, electronic skin patches, brain interfaces, retinal prostheses, and smart contact lenses, were covered in the current review will be beneficial for patients with mental health problems like Alzheimer, epilepsy, dementia. The sensors will closely monitor bodily signals with wireless functionality while using machine learning algorithms to analyse neural impulses in real time.

Abstract: Background The problem of treatment of patients in coma and persistent disturbances of consciousness is difficult and often neglected. Purpose The study validated the effectiveness of functional magnetic resonance imaging, electroencephalography and isotopic brain perfusion in differentiating vegetative state from minimal conscious state. Methods The study was performed in a group of 61 patients with persistent disturbances of consciousness. All patients underwent CRS-R differentiation of consciousness and functional magnetic resonance imaging, EEG, and SPECT/CT studies according to a uniform diagnostic protocol. Results Analysis has shown that functional magnetic resonance imaging is an effective tool for detecting of consciousness. Analysis of the EEG showed that the occurrence of primary alpha rhythm in patients with impaired consciousness coincides with the state of minimal conscious and may indicate a favourable prognosis. Sector analysis of isotopic cerebral perfusion allowed to put forward the thesis that the key role in the maintenance of consciousness plays a medial part of the left parietal lobe. Conclusion On the basis of these results, diagnostic protocol was developed for patients with disturbances of consciousness.

Abstract: Background: Measuring pain objectively or quantitatively is difficult. Since urine oxytocin (OXT) concentration has been reported to be potentially associated with chronic pain. Purpose: We conducted a pilot study to evaluate the relationship between changes in numerical rating scale (NRS) score following nerve block and urine OXT concentration in patients with chronic pain. Methods: We investigated 19 chronic pain patients who were admitted to our hospital for nerve intervention. NRS score and urine OXT concentration were assessed before and after the nerve block. Results: NRS scores were 7 [6, 9] and 2 [1, 4] (median [interquartile range]) before and after the treatment intervention, respectively. Urinary OXT levels were 523 [293, 743] and 531 [308, 887] pg/mL (median [interquartile range]) before and after the treatment, respectively. We compared the group with greater improvement in NRS after the treatment intervention and those with less improvement. The group with greater improvement in NRS after the treatment intervention showed a greater increase in OXT level. However, baseline urine OXT concentrations were highly variable in patients with chronic pain and the changes in urinary OXT concentrations were also variable. Conclusion: Based on this pilot study, the utility of urine OXT concentration as an objective biomarker of chronic pain needs further investigation.

Abstract: Background: Adversity quotient (AQ) is an individual’s ability to persist during the phase of constant alteration within one’s context, privation and response is measured by assessing AQ. It is a measure of resilience including four components which are ‘control’, ‘ownership’, ‘reach’ and ‘endurance’. Healthcare professionals face regularly changing adversities and new challenges, yet perform with optimal functioning. This also sometimes results in anxiety, depression, burnout and poor professional quality of life (ProQOL). Summary: The current systematic review’s aim is to explore the existing literature on AQ and the ProQOL of doctors, counsellors, psychologists, nurses, nursing students, psychiatric social workers and other healthcare professionals. Electronic databases of PubMed, NIH and Scopus were searched and authors conducted a systematic review of 23 published, unpublished studies and dissertations on the impact of workplace adversities on AQ and ProQOL of healthcare professionals, medical students and other helping professionals, up to 2024. Key Message: Showed a significant relationship between AQ, ProQOL, anxiety, depression and burnout among healthcare professionals and other helping professions. It was also observed that healthcare professionals with high AQ were able to experience a better ProQOL and improved well-being at the workplace.

Abstract: Background: Progressive supranuclear palsy (PSP) and multiple system atrophy (MSA) are less responsive to usual antiparkinsonian drugs. Purpose: To assess the treatment outcome of the combination of low-dose amantadine and escitalopram in the study population. Methods: A retrospective study of PSP and MSA patients from June 2021 to December 2022 treated with the dose of amantadine 100 mg and escitalopram 5 mg per day with a follow-up of 2 months at a tertiary care centre in India. The primary outcome measure was a change in the PSP and MSA severity rating scale scores, while cognition, neuropsychiatric symptoms and functionality scale scores were secondary outcomes on follow-up visits. Repeated measures ANOVA and Friedman rank test were used to analyse the data. Results: A total of 21 patients (8 PSP and 13 MSA), including 19 males, with a mean age of 72.84 years, were included. The mean total PSP rating scale score had a significant decline from baseline to week 2 and 8 ( p < .001), along with the scores for limb symptoms ( p < .001), ocular ( p = .001), history ( p = .003), gait ( p = .007), mentation ( p = .014) and bulbar ( p = .018) symptoms. Similarly, the mean score of the MSA rating scale significantly decreased on follow-up visits ( p < .001). The cognition, functional disability and behavioural symptoms scores also had significant improvement with p < .01. Conclusion: The PSP and MSA patients had clinically significant improvement with the combination treatment in both motor and non-motor domains. Further prospective trials for longer durations are needed to establish the effect size and stability of response.

Abstract: Background Hypertension, a prevalent cardiovascular condition, is linked to autonomic nervous system dysregulation, often evidenced by reduced heart rate variability (HRV). Yoga, particularly Uddiyana Bandha, may influence autonomic control and improve HRV, thus offering potential benefits for hypertension management. Purpose This study intended to assess the impact of the regular use of Uddiyana Bandha practice on HRV among hypertensive patients. Methods This randomised controlled study included 60 hypertensive patients aged between 40 and 60. Participants were randomised into an intervention group practicing Uddiyana Bandha ( n = 30) and a control group with no intervention ( n = 30). The outcome measures included time and frequency domain HRV variables, specifically the standard deviation of NN intervals (SDNN), the square root of the mean squared differences of successive NN intervals (RMSSD), high-frequency (HF) and low-frequency (LF) components in normalised units (n.u), and the LF/HF ratio. These were assessed both before and immediately after the intervention. The intervention group performed three rounds of Uddiyana Bandha under supervision, while the control group rested quietly for an equivalent duration. Results The Uddiyana Bandha group demonstrated significant ( p < .05) improvements in HRV parameters post-intervention compared to the control group. Mean RR interval, SDNN and RMSSD increased immediately after Uddiyana Bandha practice. The HF component (n.u) increased, while the LF component (n.u) and LF/HF ratio decreased ( p < .05), indicating enhanced parasympathetic activity. No significant changes were observed in the control group. Conclusion Uddiyana Bandha’s practice immediately has notable effects on HRV in hypertensive patients, showing better autonomic balance and cardiovascular performance. These results suggest Uddiyana Bandha as a possible non-pharmacological strategy for hypertension management. Future studies with larger sample sizes and longer durations are needed to support these results and explore long-term effects.

Abstract: Background This study explored the relationship between personality attributes and substance use disorder (SUD). Research has identified specific personality dimensions, such as neuroticism, psychoticism, antisocial personality traits, paranoia, and anxiety, as contributing factors on the way to the initiation, continuation, and relapse of SUD. Purpose To explore this connection, we examined the personality profiles of subjects with alcohol use disorder (AUD) and opioid use disorder (OUD). Methods A total of 928 subjects, 320 with AUD, 490 with OUD and 118 healthy controls (HC), in the age range of 16–65 years were recruited in the study. The Clinical Profile Sheet and the Multiphasic Personality Questionnaire (MPQ) were administered to HC and patients who fulfil the diagnostic criteria for substance dependence as defined by ICD-10 (WHO-1992). Results We found significant differences in personality profiles between individuals with OUD and AUD. Patients with AUD scored higher than OUD on the MPQ subscales for depression, mania, paranoia, and antisocial personality traits. All subscales of the MPQ showed elevated scores in subjects with SUD compared to HC. Conclusion Elevated scores on the MPQ subscales suggest that personality factors may contribute to the pattern of substance use and misuse in this cohort.

Abstract: Background Physical, emotional, and behavioural symptoms that can significantly impact daily life are the hallmarks of premenstrual syndrome (PMS), a common illness affecting women of reproductive age. There are many different ways to manage PMS, and there is mounting evidence that physical activity may be helpful in reducing symptoms. With an emphasis on different exercise modalities such as weight training, yoga, and aerobic activity, this systematic review attempts to investigate how physical activity affects the management of PMS symptoms. Summary A systematic review of studies published between 2009 and 2023 was conducted, adhering to PRISMA guidelines. Articles from PubMed, Embase, and the Cochrane Library were evaluated based on inclusion criteria focusing on the effects of physical activity on PMS symptoms. The findings indicate that regular participation in exercises such as weight training, yoga, and aerobic activities significantly reduces fatigue, improves mood regulation, and alleviates physical discomfort associated with PMS. These results highlight the benefits of exercise as an effective, non-pharmacological intervention for managing PMS symptoms. Key Messages Incorporating regular physical activity into daily routines can serve as a practical and sustainable approach to managing PMS symptoms. Women suffering from PMS can experience improved physical and psychological well-being through diverse forms of exercise, including yoga and aerobic workouts. This underscores the role of exercise as a holistic and accessible intervention for enhancing women’s health.

Abstract: The pathophysiology of dystonia in Wilson disease (WD) is complex and poorly understood. Copper accumulation in the basal ganglia, disrupts dopaminergic pathways, contributing to dystonia’s development via neurotransmitter imbalance. Despite advances in diagnosis and management, WD with dystonia remains a challenging condition to treat. We aim to report the unprecedented co-occurrence of pathogenic genetic variants in both the ATP7B and KMT2B genes in a patient with WD. A 13-year-old male presented at 12 with dysarthria and bilateral Kayser-Fleischer rings. Over months, dystonia spread to his left foot, upper limb, and trunk, accompanied by slowed daily activities. Diagnostic tests included MRI for brain structure, abdominal ultrasound for liver function, serum ceruloplasmin and copper levels to assess copper metabolism, and 24-hour urine copper tests for excretion levels. Whole exome sequencing was conducted using genomic DNA from peripheral blood samples. Variant classification followed guidelines from the American College of Medical Genetics and Genomics. The sequencing revealed compound heterozygous pathogenic variants in the ATP7B gene: NM_000053.4:c.2165dupT and NM_000053.4:c.813C>A. A pathogenic variant in the KMT2B gene, NM_014727:c.3052delA, was identified. This case highlights WD co-occurrence with ATP7B and KMT2B mutations, suggesting KMT2B as a potential genetic modifier.

Abstract: In India, the incidence of orthopaedic conditions is significantly increasing, with 63 million people suffering from various orthopaedic issues, causing considerable distress to patients. This study aims to assess stress, resilience, sexual functioning, and quality of life in participants who underwent arthroplasty and arthroscopy surgery at baseline, one month, and three months.

Abstract: Background: Antiepileptic drugs (AEDs), the predominant treatment for epilepsy, are also utilised for migraine, neuropathic pain, and bipolar disorders, accounting for 1% of usage among the common population. There is a greater risk of stroke, heart attack, and arrhythmia among AED users particularly those with enzyme-inducing properties. Summary: This systematic review aimed to look into the ischemic stroke risk among AED users, particularly in patients who had never had a cerebrovascular accident before. English-language literature was searched in the databases of PubMed, EMBASE, and Google Scholar between 2000 and 2021. Studies should report the association between AEDs and the ischemic stroke risk. The outcomes for assessing efficacy and safety were: event ratio, hazard ratio, odds ratio, and risk ratio. Seven of the eight studies showed an increased risk of ischemic stroke associated with AEDs among individuals without a history of cardiovascular accidents Phenytoin, sodium valproate, oxcarbamazepine, levetiracetam, phenobarbital, and carbamazepine were all linked to an increased risk of stroke. Adequate data on the association between the duration of AED exposure and stroke was missing. Key message: Not all AEDs are enzyme inducers. We conclude significant stroke risk with AEDs (mainly enzyme inducers), and dose dependency need to be assessed. The risks and benefits of AEDs should be weighed among the patients, especially with vascular risk factors to limit the risk of ischemic stroke.

Abstract: Background: Living conditions are becoming challenging day by day. Mental stress on individuals is increasing due to multiple reasons. As mental stress is a major cause of mental illness, it must be detected at the earliest to prevent serious conditions such as depression and anxiety. Purpose: The focus of this study is to detect the exact location of the source which causes such damage. In this article, we analyse the mental conditions of subjects under a workload of performing mental arithmetic calculations for various frequency bands and plot the topography to understand the areas of active potentials. Methods: We propose a Novel Cluster Ensemble Verifier (CLEVER) algorithm, which combines two different techniques: clustering and source localisation. The proposed algorithm is highly efficient in identifying the exact location of the source. It is seen that the topographic plots of the independent component analysis (ICA), which has the maximum percentage of relative variance, correlates to the cluster generated. We are able to give the percentage-wise contribution of every component which is responsible for brain source activation with less time complexity. Results: Out of 72 subjects, in 67 subjects, 299 out of 433 components originate from the occipital and parietal areas of the brain with a maximum power of 43.5 µv 2 . As an example, the relative variance of one component is found to be contributing up to 74.03% to source activations. Clusters show similarity across the subjects in the parietal and occipital areas of the brain. The dataset used for experimentation is EEGMAT from Physionet’s repository. The computation time for the algorithms is 17.6 ± 3.2 minutes. Conclusion: Findings show that during mental arithmetic calculations, both occipital and parietal areas of the brain are involved. As the data is acquired by orally mentioning the mathematical problem, subjects tend to visualise the numbers while finding the solution, which is reflected in the occipital area of the brain. CLEVER algorithm verifies the origin of the activity in the occipital and parietal areas of the brain.

Abstract: Background: Osteoporosis is one of the detrimental effects of spinal cord injury (SCI), leading to bone loss. It has already been established that superparamagnetic nanoparticles when exposed to an external magnetic field (MF) show strong magnetisation and promote locomotor recovery. Purpose: The aim of the present study is to explore the role of magnetised nanoparticles in ameliorating SCI-induced osteoporosis. Methods: The rats were divided into Sham, SCI, SCI+MF, SCI+V, SCI+NP and SCI+NP+MF groups. A complete transection was performed at the T13 level, followed by iron oxide nanoparticle implantation along with MF exposure for 7 or 14 days. Results: A significant increase in locomotor score was evident at day 5 in all groups except in the SCI+V group, and at day 7, all groups showed a significant increase in Basso, Beattie and Bresnahan score as compared to the pre-surgery score at week 1 of the study period. A significant decrease in bone volume/total volume ratio and trabecular thickness and increase in trabecular separation were observed in all groups as compared to Sham. A significant increase in trabecular thickness in the SCI+NP+MF group as compared to the SCI+MF group was observed after one week. After two weeks, the SCI+MF group showed a significant increase in locomotor scores at days 5 and 13 as compared to the SCI, SCI+V and SCI+NP groups. Bone loss was significantly observed in all groups except SCI+MF, as compared to Sham. Cortical bone showed no significant change at both time points. On histopathological examination of the spinal cord, we observed significant improvement in lesion volume in SCI+MF and SCI+NP+MF groups after one week, whereas only the SCI+NP+MF group showed a significant decrease after two weeks. Conclusion: Electromagnetic field stimulation partially restored bone architecture after superparamagnetic nanoparticle implantation, which may be due to reduced lesion volume and improved locomotor behaviour.

Abstract: Background Hypothyroidism (HT) is the most prevalent endocrine disorder, affecting approximately one in 10 out of 35 adults, with a higher prevalence in females and the elderly. Purpose This systematic review (SR) aimed to discuss the effects of yoga on markers and comorbid conditions of HT. Methods The SR was registered with the PROSPERO (PROSPERO 2022 CRD42022312990). Google Scholar, PubMed, Cochrane, and EMBASE were searched for the relevant English language interventional studies published from 31 December 1947 to 31 December 2023 by using the keywords ‘meditation OR breath regulation OR yoga OR yoga nidra AND hypothyroidism OR hypothyreosis OR underactive thyroid OR low thyroid’. Of the 4078 screened studies, eight eligible studies (three RCTs, two pilot studies, two pre-post trials, and one case study) with 421 HT patients (392 females and 29 males) and three to six-month yoga interventions were included. Two independent review authors extracted study characteristics and synthesised them descriptively. RCTs and NRSIs were assessed for risk-of-bias (RoB) using Cochrane tools RoB2 and ROBINS-1. Results The findings suggest that yoga effectively improves the thyroid profile, lipid profile, heart rate variability, pulmonary functions, anxiety, depression, and quality of life among HT patients. Conclusion Yoga may be an inexpensive add-on preventive and therapeutic option for HT. The clinical and methodological heterogeneity among the studies did not allow for meta-analysis (MA). Well-designed MAs are warranted by including rigorous RCTs to draw valid conclusions and defined mechanisms regarding the efficacy of yoga practices/interventions on HT.

Abstract: Background The fascinating ability of brain to integrate information from multiple sensory inputs has intrigued many researchers. Audio–visual (AV) interaction is a form of multisensory integration which we encounter to form meaningful representations of the environment around us. There is limited literature related to the underlying neural mechanisms. Purpose Quantitative EEG (QEEG), a tool with high temporal resolution can be used to understand cortical sources of AV interactions. Methods EEG data was recorded using 128 channels from 30 healthy subjects using audio, visual and AV stimuli in ‘object detection task’. Electrical source imaging was performed using s-LORETA across seven frequency bands (lower alpha 1, lower alpha 2, upper alpha, beta, delta, gamma, theta) during AV versus unimodal conditions across 66 gyri. Results The cortical sources were activated in the theta, beta, and gamma bands in cross modal versus unimodal conditions, which we propose, reflect neural communication for AV interaction network. The cortical sources constituted areas involved with visual processing, auditory processing, established multisensory (frontotemporal cortex, parietal cortex, middle temporal gyrus, superior frontal gyrus, inferior frontal gyrus, precentral gyrus) and potential multisensory areas (paracentral, postcentral and subcallosal). Conclusion Together, these results offer an integrative view of cortical areas in frequency oscillations during AV interactions.

Abstract: Background: In today’s world, developing resilience is crucial for managing stress, preserving mental and emotional health, managing work–life balance, fostering self-growth and good relationships and promoting physical health. Nourishing the mind–body connection, using methods for stress reduction and self-care and incorporating a Mind Body Module can contribute to resilience-building initiatives as well as help in wellness promotion. Purpose: This study aims to design, develop and validate a resilience-building module that incorporates mind–body practices. Method: The existing literature on traditional yoga texts and published scientific studies in the area of mind–body practices was used to build the Mind Body Module. Through this approach, a total of 26 practices were identified based on the strength of evidence. Each of these practices was scored by subject matter experts, and the content validity ratio (CVR) was calculated using Lawshe’s formula for validation. Result: The practices/techniques that scored ≥50% along with those suggested by the experts were grouped, and an eight-week module for resilience building and wellness promotion was developed. Conclusion: The Mind Body Module crafted to foster resilience has brought together the knowledge from the Indian system and the well-being practices from the West in a cogent manner. The module’s viability and effectiveness will be evaluated appropriately.

Abstract: Background Many military service members are victims of repetitive blast traumatic brain injuries (rbTBI) and endure diverse altered psychological and behavioural conditions during their lifetime. Some of these conditions include anxiety, post-traumatic stress and pain. Thus, this study attempts to fill the knowledge gap on enduring behavioural and neuroinflammatory marker alterations 1 month after rbTBI. Purpose Although previous rbTBI animal studies have shown behavioural and histopathological changes either a few days (acute) or many months (chronic) after trauma, knowledge related to post-traumatic changes during the intermediate timeframe, i.e. a month after rbTBI is less clear or unavailable. Methods Sprague–Dawley rats (male; n = 12) were assigned to either rbTBI or sham conditions. Animals assigned to the rbTBI group were subjected to 1 blast exposure per day for three consecutive days, while animals in the sham group were exposed to identical experimental conditions sans blast exposure. All animals were tested for anxiety at baseline. 30 days post-injury, animals were tested again for anxiety and paw thermal sensitivity, followed by brain harvest for immunohistochemical analyses. Results Animals exposed to rbTBI showed signs of anxiety-like behaviour on parameters of elevated plus-maze and behavioural signs of pain indicated by reduced thermal withdrawal latency of the forepaw. Histologically, brain sections from animals exposed to rbTBI showed a significantly increased number of microglial/macrophage and astrocytic counts in the medial prefrontal cortex. Conclusion Data from this initial preclinical study support the prevalence of putative anxiety-like behaviour, enhancement in forepaw thermal sensitivity and increase in the number of glial cells even 1 month after rbTBI. These findings have potential implications in the treatment evaluation of blast-exposed military and civilian populations and emphasise the need for devising protective measures for people susceptible to single or repeated exposures. A greater further understanding of rbTBI-related chronic concurrent behavioural and neuropathological sequela is warranted.

Abstract: Early detection of developmental delays in children can significantly help them realise their full potential. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V), is the system in use at the moment to detect neurodevelopmental delays among children in the United States and other Western nations. However, due to cultural differences, there is a pertinent need for a content-validated module in the context of low- and middle-income countries, including India.