Effects of an 8-week intervention of anulom vilom pranayama combined with heartfulness meditation on psychological stress, autonomic function, inflammatory biomarkers, and oxidative stress in healthcare workers during COVID-19 pandemic: a randomized controlled trial.

OBJECTIVES: Health care workers were exposed to huge stress during COVID-19 pandemic affecting their physical and mental health. Practice of anulom vilom pranayama and heartfulness meditation (AVPHFN) can improve mental and physical health and counter stress. The present study explored the effect of 8-week AVPHFN intervention on autonomic functions, emotional stress, oxidative stress, and inflammation markers in the nurse group of health-care givers. METHODS: This was a randomized controlled trial where 50 nurses underwent AVPHFN and 50 participated as controls. At baseline and after 8 week intervention of AVPHFN anthropometric parameters, cardiovascular parameters, autonomic function including time and frequency domain parameters, biochemical parameters, and psychological stress using the questionnaire were assessed. RESULTS: Forty nurses in AVPHFN group and 46 in control group completed the study. AVPHFN intervention resulted in a significant reduction in cardiovascular parameters heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure and rate pressure product (p<0.001, p<0.001, p<0.001, p<0.001, and p<0.001, respectively), perceived stress score and depression, anxiety, and stress scale psychological variables of depression, and stress compared to the control group. Total power, ratio of low frequency to high frequency and change in successive normal sinus (NN) intervals exceeds 50 ms (p<0.01, p=0.05, and p<0.01 respectively) suggesting parasympathodominance due to higher vagal efferent activity. Serum cortisol, high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor-alpha, interleukin (IL)-1, IL-6 and telomerase significantly decreased in AVPHFN group post intervention. CONCLUSIONS: Eighty-week intervention of AVPHFN improved psychophysiological, autonomic and biochemistry profile of nurse group of health-care workers. AVPHFN module may be beneficial for curtailing stress and improving well-being.

Benign Chondroid Syringoma on Chin: A Case Report and Literature Review.

Chondroid syringoma is a cutaneous adnexal tumor originating from sweat glands origin. It is rare in occurrence and usually benign, having an incidence of 0.01 to 0.098%. As these tumors are uncommon, their diagnosis is missed many times and are misdiagnosed. Hence in any case of facial skin swelling increasing slowly in size, this entity should be kept in mind as one of the possibilities and differential diagnosis. Histopathological examination of the excision biopsy gives the definitive confirmatory diagnosis. Surgically excising the swelling locally along with a surrounding normal tissue cuff is the standard treatment given which prevents recurrence. Hereby we present a 35-year-old case of facial chondroid syringoma having a focal component of eccrine hidrocystoma, keratinous cyst as well as syringocystadenoma papilliferum on the chin that was clinically suspected to be an epidermoid cyst or mucocele.

COVID-19-induced Stress in Health-care Workers: Effect of 8-week Common Yoga Protocol on Autonomic Function and Inflammatory and Oxidative Stress Markers.

Background: COVID-19 pandemic posed a huge stress on health-care givers affecting their physical and mental health. Wellness strategies like yoga can improve flexibility, resilience, and outlook. Aim: The present study explored the effect of 8-week standard common yoga protocol (CYP) intervention on autonomic functions, emotional stress, oxidative stress, and inflammation markers in the nurse group of health-care givers. Materials and Methods: It is a randomized controlled trial where 50 nurses underwent CYP and 50 participated as controls. Anthropometric parameters, cardiovascular parameters, autonomic function including time and frequency domain parameters, biochemical parameters, and psychological stress using the questionnaire were assessed before and after 8-week CYP. Results: Total 88 nurses completed the study with 42 and 46 participants, respectively, in the CYP and control groups. CYP intervention resulted in a significant reduction in cardiovascular parameters systolic blood pressure, diastolic blood pressure, mean arterial pressure, pulse pressure, and rate pressure product (P < 0.001, P < 0.001, P < 0.001, P < 0.001, and P = 0.002, respectively), perceived stress score and Depression, Anxiety, and Stress Scale psychological variables of depression, anxiety, and stress, and serum lipid parameters compared to the control group. CYP significantly increased total power, low frequency, high frequency, root mean square of successive differences between adjacent NN intervals, change in successive normal sinus (NN) intervals exceeds 50 ms, and pNN50% (P < 0.001, P = 0.006, P = 0.006, P = 0.039, P < 0.001, and P = 0.013, respectively) suggesting improved resting autonomic modulation and parasympathodominance due to higher vagal efferent activity. There were significant reductions in serum cortisol, tumor necrosis factor-alpha, interleukin (IL)-1, and IL-6 in both the groups. Serum telomerase significantly reduced (P = 0.024) and total antioxidant capacity (P = 0.036) increased in the CYP group post intervention. Conclusion: CYP intervention was beneficial in improving psychophysiological, autonomic, and biochemical profile of the nurse group of health-care workers.

A clinico-pathological study of geriatric anemias.

INTRODUCTION: Anemia in the older age (e.g., >60 years) is a major health problem in India and many parts of the world since it signifies an underlying disease and is associated with poor clinical outcome like increased morbidity and affects health-related quality of life. Since symptoms like fatigue or shortness of breath related to anemia could also be attributed to the aging process, anemia is often easily overlooked in the elderly. AIMS AND OBJECTIVES: Clinico-hematological patterns and morphological types of anemia in older age (e.g. >60 years) are manifold, hence this study was undertaken to determine them and to know more about associated disorders. MATERIALS AND METHODOLOGY: The present study was conducted on a sample size of 1257 patients who were 60 years and above and clinically diagnosed as anemic. Routine haematological investigations including peripheral blood smear examination and complete hemogram were done. Special investigations like bone-marrow examination and iron studies were done whenever required. RESULTS: Males (aged >60 years) were more affected than females (aged >60 years) and patients in the age group of 60-69 years were affected the most. The most common presenting symptom was generalized weakness. The most common morphological type was normocytic normochromic anemia, and chronic diseases were the commonest etiological factors. CONCLUSION: In spite of modern diagnostic advances, geriatric anemias still remain under-reported and inadequately investigated, necessitating evaluation of even mild anemias. Prompt diagnosis and definite categorization helps in appropriate management of anemias.

Fibroma of the tendon sheath: A diagnostic dilemma on fine-needle aspiration cytology.

Fibroma of the tendon sheath (FTS) is an uncommon benign soft tissue tumor (STS) of the tendon sheath. Clinical and radiological features are not distinctive enough to clinch the diagnosis preoperatively. Although histological features are well described, diagnostic cytological features of FTS are still lacking. Till date only two reports describe the fine-needle aspiration cytology (FNAC) findings of FTS. The present case is a 50-year-old female who presented with a slow growing nodule on the right thigh over a period of 2 years. FNAC revealed low cell yield with loose clusters of fibrotic spindle cells and stellate cells intermingled with fibro-collagenous and myxoid matrix. Few cells showed mild degree of nuclear atypia. Necrosis and atypical mitoses were not seen. Cytology findings were suggestive of benign/low-grade fibroblastic or fibromyxoid lesion. Histology confirmed the diagnosis of FTS. This article discusses the diagnostic role of FNAC in FTS with its differential diagnosis.

Well-differentiated papillary mesothelioma of the peritoneum: a diagnostic dilemma on fine-needle aspiration cytology.

OBJECTIVES: Well-differentiated papillary mesothelioma of the peritoneum (WDPMP) is an uncommon subtype of epithelioid mesothelioma. Usually, WDPMP has a benign course, while a few patients have multiple recurrence and malignant transformation on long-term follow-up. The histology of WDPMP has been well studied compared with the cytology. Although accurate diagnosis is based only on histology and immunohistochemical stains, knowledge of the cytologic features of WDPMP in context with clinical and radiologic features is essential to predict a preoperative diagnosis and guide proper management, after excluding reactive mesothelial hyperplasia, malignant mesothelioma, and serous neoplasms of the ovaries and peritoneum. Surgical excision gives a favorable outcome. METHODS: We describe a case of 28-year-old woman who sought treatment for chronic lower abdominal pain, dysuria, and dyspareunia. RESULTS: Radiologic findings suggested multiple metastatic peritoneal deposits. Ultrasound-guided fine-needle aspiration cytology showed many papillae, tubulopapillary and spheroid groups, monolayered pavement-like sheets, and many dispersed cells. Papillae showed many layers of round to ovoid cells, with minimal atypia. Atypical mitoses and necrosis were not found. A cytologic diagnosis of WDPMP was suggested. After complete resection of all the tumor nodules, histopathology and immunohistochemical findings were compatible with WDPMP. On follow-up, she developed tumor recurrence at 9 months and was managed successfully with adjuvant chemotherapy. CONCLUSIONS: This article highlights the cytologic features of WDPMP with relevant review of the literature and differential diagnosis.

Granular cell tumor of hand presenting as subcutaneous nodule mimicking dermal adnexal tumor: A diagnosis by cytology.

Granular cell tumor (GCT) is an uncommon tumor and is believed to be of schwannian origin. GCT is benign but rare malignant cases are recorded. GCT occurs in almost any part of the body. The common sites are the tongue, skin, and subcutaneous tissue. GCT of hand is an extremely rare. Till date only 17 cases are reported in the literature. Preoperative diagnosis of GCT is important, because GCT mimics dermal adnexal tumor in subcutaneous tissue, other soft tissue tumor or inflammatory lesions. GCT is composed of large polygonal cells with eosinophilic granular cytoplasm and these cells are often immunoreactive for the S-100 protein. Fine-needle aspiration cytology has been suggested to be diagnostic modality of choice and this would undoubtedly aid the correct diagnosis. Excision with wide surgical margins is curative for benign GCT. Recurrence and malignant transformation requires regular follow-up. Here, this communication documents a case of cytological diagnosis of the granular cell tumor of hand in a 21-year-old female, clinically suspected to be a dermal adnexal tumor.