Effect of Structured Yoga Program on Stress and Well-being Among Frontline Healthcare Workers During COVID-19 Pandemic.

CONTEXT: Frontline healthcare workers are at risk of developing psychological distress during a pandemic. Yoga, a form of mind-body medicine can reduce body stress and increases well-being. AIMS: To assess the effect of yoga on the stress and well-being of healthcare workers during the COVID-19 pandemic. SETTINGS AND DESIGN: This single-arm pre-post study was conducted among frontline health workers (support staff, paramedics, and medics) posted at a secondary care hospital in a North Indian district. METHODS AND MATERIALS: Basic demographic details, blood pressure, anthropometric variables like height, weight, and biochemical variables like glycosylated hemoglobin (Hb1Ac), fasting and post-prandial blood sugar, lipid profile, serum cortisol, and C-reactive protein were measured. Stress levels were assessed using the depression anxiety and stress scale (DASS)-21 while well-being was assessed using the World Health Organization (WHO)-5 well-being scale. Twelve weeks of supervised yoga session was provided for 1 hour per session, 3 times per week. STATISTICAL ANALYSIS: The mean value was compared from baseline to post-intervention with paired t-test/Wilcoxon signed rank test. RESULT: A total of 89 participants were enrolled, 53 (59.5%) being male. Two-thirds of the participants were aged 20-39 years. During follow-up, 80 participants completed 12 weeks of yoga sessions. Post-intervention DASS-21 score decreased and WHO-5 increased significantly. The glycosylated hemoglobin (HbA1c) level and cholesterol-HDL ratio decreased significantly. Other variables didn't change significantly. No adverse effects were reported by the participants. CONCLUSION: Supervised structured yoga sessions helped decrease stress, depression, and anxiety and improved well-being. Therefore, it can be a feasible strategy to manage workplace-related stress and phycological morbidities.

Test concordance and diagnostic accuracy of three serological assays for detection of anti-SARS-CoV-2 antibody: result from a population-based sero-epidemiological study in Delhi.

BACKGROUND: Several methodological tests are available to detect SARS-CoV-2 antibody. Tests are mostly used in the aid of diagnosis or for serological assessment. No tests are fully confirmatory and have variable level of diagnostic ability. We aimed at assessing agreement with three serological tests: quantitative anti receptor binding domain ELISA (Q-RBD), qualitative ELISA (WANTAI SARS-CoV-2 Ab) and qualitative chemiluminescence assay (CLIA). METHODS: This study was a part of a large population based sero-epidemiological cohort study. Participants aged 1 year or older were included from 25 randomly selected clusters each in Delhi urban (urban resettlement colony of South Delhi district) and Delhi rural (villages in Faridabad district, Haryana). Three type of tests were applied to all the baseline blood samples. Result of the three tests were evaluated by estimating the total agreement and kappa value. RESULTS: Total 3491 blood samples collected from March to September, 2021, out of which 1700 (48.7%) from urban and 1791 (51.3%) from rural. Overall 44.1% of participants were male. The proportion of sero-positivity were 78.1%, 75.2% and 31.8% by Wantai, QRBD and CLIA tests respectively. The total agreement between Wantai and QRBD was 94.5%, 53.1% between Wantai and CLIA, and 56.8% between QRBD and CLIA. The kappa value between these three tests were 0.84 (95% CI 0.80-0.87), 0.22 (95% CI 0.19-0.24) and 0.26 (95% CI 0.23-0.28). CONCLUSIONS: There was strong concordance between Wantai and QRBD test. Agreement between CLIA with other two tests was low. Wantai and QRBD tests measuring the antibody to same S protein can be used with high agreement based on the relevant scenario.

Comparing the Effects of Oral HIV Self-Testing With Those of Standard HIV Testing for Men Who Have Sex With Men (MSM): A Systematic Review and Meta-Analysis.

The WHO recommends HIV self-testing (HIVST) as an innovative strategy and an additional testing approach to attain UNAIDS targets to end HIV by 2030. HIVST is a process whereby a person collects his or her own specimen (either oral fluid or blood), performs an HIV test, and interprets the result. It has been described as a discreet and convenient way to reach the hidden, unreached key populations (KPs) who do not know their HIV status or do not get tested. Among the KPs, men who have sex with men (MSM) is one such group that by far remains hidden due to feared stigma and discrimination associated both with their sexuality and HIV. Fear of pain and blood while HIV testing also deters MSM from getting tested. In this review, we assessed the effect of oral HIVST on the uptake and frequency of testing and risk behavior as compared to standard HIV testing. For this review, we systematically searched various electronic databases for clinical trials comparing HIVST to standard HIV testing from January 1, 2011, to December 31, 2021. A meta-analysis of studies was conducted using a random-effects model for relative risks (RRs) and 95% confidence intervals (CIs). The protocol was registered with PROSPERO, and PRISMA guidelines for systematic reviews and meta-analyses were followed. The quality of the clinical trials was assessed using Cochrane's risk of bias tool version 2.0 (RoB 2.0). We identified eight studies comparing HIVST to standard HIV testing services (HTSs). The eight randomized controlled trials (RCTs) enrolled 5,297 participants, of which 5,212 were MSM and 85 were transgender (TG) women. Seven RCTs were conducted in high-income countries (HICs): four in the USA, two in Australia, and one in Hong Kong. One was conducted in a low-middle-income country (LMIC) in Myanmar.In all the studies, HIVST intervention was provided with oral HIVST kits, except for one study in which both blood-based and oral HIVST kits were used. Meta-analysis (five RCTs) showed that HIVST increased the uptake of HIV testing by 1.43 times compared to standard of care (SoC) (RR = 1.43; 95% CI = 1.25, 1.64). Meta-analysis (four RCTs) found that HIVST increased the mean number of HIV tests by 2.34 during follow-up (mean difference = 2.34; 95% CI = 1.66, 3.02). Meta-analysis (four RCTs) showed that HIVST doubled the detection of new HIV infections among those tested (RR = 2.10; 95% CI = 1.35, 3.28) and reported higher repeat testing as compared to the control arm (RR = 2.04; 95% CI = 1.22, 3.42). A meta-analysis of three trials found no significant difference in risk behavior in respect of condomless anal intercourse (CAI) (odds ratio (OR) = 0.90; 95% CI = 0.67, 1.22) and multiple male partnership (RR = 0.89; 95% CI = 0.83, 0.94). Oral HIVST could increase the HIV testing and detection of new HIV infections among MSM who may not otherwise test, as compared to standard testing services alone. However, further research from low-middle-income countries is required for generalizability.

Serological prevalence of SARS-CoV-2 antibody among children and young age group (between 2 and 17 years) in India: An interim result from a large multicentric population-based seroepidemiological study.

Background: Estimating seroepidemiolgical prevalence of SARS-CoV-2 antibody is an essential public health strategy. There is insufficient evidence of prevalence among those belonging to young age population in India. Objective: To compare the SARS-CoV-2 seropositivity rate between children and adults in selected sites from India. Materials and Methods: This was a multicentric population-based seroepidemiological study conducted in selected urban and rural areas of five sites selected from four states (Delhi, Odisha, Uttar Pradesh, Tripura) of India. Participants aged ≥1 year were included from different clusters of each area. Total serum antibody against SARS-CoV-2 virus was assessed qualitatively by using a standard enzyme-linked immunosorbent assay (ELISA) kit. Results: Data collection period was from 15 March 2021 to 10 June 2021. Total available data was of 4509 participants, of whom 700 were <18 years of age and 3809 were ≥18 years of age. The site-wise number of available data among those aged 2-17 years was 92, 189, 165, 146 and 108 for the sites of Delhi urban, Delhi rural, Bhubaneswar rural, Gorakhpur rural and Agartala rural area, respectively. The seroprevalence was 55.7% in the <18 years age group and 63.5% in the ≥18 years age group. The prevalence among female children was 58% and among male children was 53%. Conclusion: SARS-CoV-2 seropositivity rate among children was high and comparable to that of the adult population. Hence, it is unlikely that any future third wave by prevailing SARS-CoV-2 variant would disproportionately infect children 2 years or older.

Antibody Response to SARS-CoV-2 among COVID-19 Confirmed Cases and Correlates with Neutralizing Assay in a Subgroup of Patients in Delhi National Capital Region, India.

Background: The plaque reduction neutralization test (PRNT) is the gold standard to detect the neutralizing capacity of serum antibodies. Neutralizing antibodies confer protection against further infection. The present study measured the antibody level against SARS-CoV-2 among laboratory-confirmed COVID-19 cases and evaluated whether the presence of anti-SARS-CoV-2 antibodies indicates virus neutralizing capacity. Methods: One hundred COVID-19 confirmed cases were recruited. Their sociodemographic details and history of COVID-19 vaccination, contact with positive COVID-19 cases, and symptoms were ascertained using a self-developed semi-structured interview schedule. Serum samples of the participants were collected within three months from the date of the positive report of COVID-19. The presence of anti-SARS-CoV-2 antibodies (IgA, IgG and IgM antibodies), receptor binding domain antibodies (anti-RBD), and neutralizing antibodies were measured. Findings: Almost all the participants had anti-SARS-CoV-2 antibodies (IgA, IgG and IgM) (99%) and anti-RBD IgG antibodies (97%). However, only 69% had neutralizing antibodies against SARS-CoV-2. Anti-RBD antibody levels were significantly higher among participants having neutralizing antibodies compared with those who did not. Interpretation: The present study highlights that the presence of antibodies against SARS-CoV-2, or the presence of anti-RBD antibodies does not necessarily imply the presence of neutralizing antibodies.

Effect of Community-Based Structured Yoga Program on Hba1c Level among Type 2 Diabetes Mellitus Patients: An Interventional Study.

CONTEXT: In view of the rising burden of type 2 diabetes mellitus (DM) cases in India, there is an urgent need for an effective, low-cost, sustainable intervention controlling diabetes thus preventing complications. AIMS: This study aimed to assess the effect of structured yoga programs on diabetes. SUBJECTS AND METHODS: This was a community-based interventional study that was conducted in an urban resettlement colony of Delhi, India. Known diabetes patients with glycated hemoglobin (Hb1Ac) ≥6.5% were enrolled from 12 randomly selected blocks of the community with a sample size of 192 in each intervention and wait-listed control arm. The intervention was structured yoga of 50 min daily, 2 consecutive weeks in a nearby park and health center followed by twice a week home practice up to the 3rd month. The primary outcome measure was HbA1c% and secondary outcome measures were lipid profile and fasting blood glucose. STATISTICAL ANALYSIS USED: Aper-protocol analysis was done. Mean, standard deviation (SD), and 95% confidence interval were estimated. The level of significance was considered for 0.05. RESULTS: There was a significant decrease of Hb1Ac (0.5%, SD = 1.5, P = 0.02), total cholesterol (11.7 mg/dl, SD = 40.5, P < 0.01), and low-density lipoprotein (3.2 mg/dl, SD = 37.4, P < 0.01) from baseline to end line in the intervention group. These changes in intervention group were also significantly different from the change in the wait-listed control group. The other variables did not change significantly. CONCLUSIONS: It revealed that structured yoga program improved glycemic outcome and lipid profile of individuals in a community-based setting. Yoga can be a feasible strategy to control hyperglycemia, lipid levels, and can help better control type 2 DM.