INTRODUCTION:The COVID-19 pandemic, caused by the SARS-CoV-2 virus, has undergone significant evolutionary changes since its onset, resulting in the emergence of multiple variants with distinct genetic profiles and public health implications. Numerous genetic modifications have occurred in the virus since it first appeared, leading to the development of several variants with varying degrees of virulence, transmissibility, and immunological escape potential. MATERIALS AND METHODS:A total of 602 throat/nasopharyngeal swabs of SARS-CoV-2-positive patients were received at Sawai Man Singh Medical College (SMSMC), Jaipur, India, from April 30, 2025, to September 5, 2025, for next-generation sequencing, of which 373 samples having a Ct value ≤ 25 were further processed for sequencing. RESULTS:Among the 373 lineages identified, XFG was the predominant lineage and was detected in 182 (48.8%) cases, including​​​​​​​ XFG (85), XFG.3 (95), and XFG.3.1 (2). Other lineages identified were PY.1 (65, 17.43%), LF.7 and its sublineages (61, 16.35%), JN.1 and its sublineages (23, 6.17%), PY.2 (23, 6.17%), BA.2 and its sublineages (8, 2.14%), PL.1.1 (3, 0.8%), LP.8.1 (2, 0.53%), NB.1.8.1 (2, 0.53%), XFC.1 (1, 0.27%), XFJ (1, 0.27%), PQ.7 (1, 0.27%) and IN.1.16.1 (1, 0.27%). Among the total positive cases identified, 55.76% were males and 44.24% were females. Regarding age distribution, 10.19% were aged <18 years, 68.90% were aged 19-59 years, and 20.91% were aged ≥60 years. Overall, 21.18% of cases were asymptomatic, whereas 78.82% were symptomatic. Reinfection was observed in 28.95% (108) of cases. ​​​​​​​​​​​​​​​​​​Most positive cases were reported from the Jaipur district. The majority of positive cases (88.47%, 330) had already been vaccinated. Comorbidities or other underlying conditions were present in 25.74% (96) of patients. Hospitalization was required in 25.47% (95) of cases, and death due to COVID was reported in three cases. CONCLUSION:The highest upsurge in COVID cases during the study period was due to the XFG variant, which is a recombinant hybrid of the LF.7 and LP.8.1.2 Omicron subvariants. Continuous genomic surveillance helps in detecting real-time viral recombination and mapping spike protein mutations that lead to the emergence of such variants. Genomic surveillance revealed a wide range of SARS-CoV-2 variants in Rajasthan, with implications for public health response and vaccination strategies. The study underscores the critical importance of sustained genomic surveillance programs in Rajasthan to track viral evolution in near real-time, mitigate transmission risks, and strengthen pandemic preparedness at both regional and national levels.

OBJECTIVE:Restless legs syndrome (RLS) is a prevalent but frequently underrecognized neurological sleep disorder. It presents as an irresistible urge to move legs, often accompanied by unpleasant sensations. More than 25% of those affected report onset of symptoms between 10-20 years of age. This cross-sectional study examined the prevalence of RLS among adolescents and its association with sleep quality, daytime sleepiness, mood, and academic performance. METHODS:The study was conducted among school-going adolescents aged 10-19 years after obtaining approvals from school authorities, informed assent, and parental consent. They were assessed for sleep quality, daytime sleepiness, symptoms of RLS, and mood fluctuations using validated tools. RESULT:Among 2,289 adolescents with a mean age of 13.85 ± 1.92 years; (50.19% female), 29.18% (668) experienced restless leg sensations at night or during evening relaxation. Students with RLS reported poorer sleep quality (5.52 ± 2.70), increased daytime sleepiness (15.44 ± 5.31; p < .001), and a higher risk of depression (OR = 1.678; p < .001), anxiety (OR = 1.514; p < .001), and stress (OR = 1.706; p < .001). Mood derangements were significantly higher in both young (≤14 yrs) and old adolescents (>14 yrs) with RLS. Academically, students with RLS had lower scores in science (p = .033) in Grades 6-10 and in English (p = .018), mathematics (p = .035), economics (p = .026), and overall scores (p = .013) among commerce stream students of higher secondary school. CONCLUSION:RLS-related sleep difficulties and circadian issues combine with age-based circadian changes, leading to varied outcomes across the adolescent developmental spectrum.

Objectives JN.1 was initially identified as a variant of Interest (VOI) by the World Health Organization (WHO), and was later recognized as a distinct VOI, after which the government of India issued an advisory to states for genome sequencing of COVID positive samples. Material and Methods A total of 335 throat/nasopharyngeal swabs of SARS-CoV-2 positive patients were received at Sawai Man Singh Medical College (SMSMC), Jaipur, from 19-12-23 till 18-04-24 for whole genome sequencing, of which 223 samples that were found positive for SARS-CoV-2 and having a Ct value <25 were further processed for sequencing. Results Out of 206 lineages identified, 62.14% (128) were JN.1 and 37.86%(78) were other lineages. Among the total 128 JN.1 cases identified, 60.16% were males and 39.84% were females. 14.84% were <18 years, 57.03% were in the age group 19-59 years, and 28.13% were ≥60 years of age. 22.65% cases were asymptomatic, while 77.34% cases were symptomatic. Re-infection was found in 23.44% (30) of cases. The maximum positive cases were from the Jaipur district. The majority (81.25%,104) of the JN.1 infected cases were already vaccinated, 3.91% (5) were unvaccinated, while 14.84% (19) were not eligible for vaccination. Co-morbidities/other conditions were present in 23.44% (30) of patients. Hospitalization was required in 18.75% (24) of cases. Only one patient had a history of international travel. Death due to COVID was reported in 2 cases. Conclusion Rapid spread of JN.1 variant implicates continuous evolution of the virus and emphasizes continuous monitoring for timely detection of new variants.

Background This study aimed to assess the changes in heart rate variability (HRV) before and after coronary artery bypass grafting (CABG) in patients with coronary artery disease (CAD) and evaluate the effect of Yoga Nidra as a postoperative intervention on autonomic function during recovery. Methodology A prospective study was conducted among 32 patients diagnosed with CAD and scheduled for elective CABG. Preoperative and postoperative HRV measurements were recorded. After discharge, participants were randomly divided into the following two groups: the case group received the Yoga Nidra intervention (guided sessions, two sessions daily for three months), while the control group received standard care without Yoga Nidra. HRV was assessed again three months postoperatively. Parameters such as high-frequency (HF) power, low-frequency (LF) power, and LF/HF ratio were analyzed to evaluate autonomic nervous system (ANS) modulation. Results In the case group, a significant decrease in HF (normalized units) was observed two weeks after surgery (from 40.38 to 30.85), reflecting a transient reduction in parasympathetic activity due to surgical stress. However, by the end of the three-month Yoga Nidra intervention, HF values improved significantly to 40.98, indicating a parasympathetic rebound. A decrease in the values of LF and the LF/HF ratio was noted, suggesting a restoration of autonomic balance in the Yoga Nidra group compared to the controls. In other words, at the end of three months, the HF component showed a statistically significant improvement in the Yoga Nidra group compared to controls (p = 0.003). The 95% confidence interval for the group difference (4.80, 21.50) did not cross zero, and the effect size (r = 0.61) indicated a large effect. Conclusions This study demonstrates that while CABG initially disrupts autonomic function, as evidenced by reduced parasympathetic markers, regular Yoga Nidra practice contributes to modulating the balance of the ANS during recovery periods, facilitating a favorable shift toward parasympathetic dominance. This shift, as assessed by HRV parameters, suggests improved autonomic recovery and enhanced myocardial electrical stability during the postoperative period.

Introduction:Shift in circadian clock of adolescence with delayed bedtime and early awakening to catch morning school effects their sleep. Present study elucidated sleep hygiene practices of school-going adolescents and explored its association with their sleep quality and mood. Methods:Students of 6th to 12th grade were enrolled after requisite permissions, parental consent, and written informed assent from students. Standardized questionnaires were used to evaluate for sleep hygiene practices-Adolescent Sleep Hygiene Scale (ASHS), sleep quality- Pittsburgh Sleep Quality Index (PSQI), daytime sleepiness-Pediatric Daytime Sleepiness Scale (PDSS) and mood (DASS-21-Depression Anxiety Stress Scale-21). CTRI/2022/06/043556 is the study number in Clinical Trial Registry of India. Results:Adolescents with mean age 14.28 ± 1.86 years, including 48.7% (479) males and 51.2% (503) females participated in this study. Mean sleep hygiene score was 4.37 ± 0.60, with no difference between males and females. On ASHS subscales comparison, females had poorer sleep quality (0.009), higher daytime sleepiness (P = 0.001), poorer cognitive/emotional factor (P = 0.001) and higher depression, anxiety, and stress (DASS-21). Young adolescents (10-14 years; N = 528) had better total sleep hygiene scores (P = 0.016), better bedtime routine, cognitive/emotional factor (P = 0.001), but had poor sleep environment factor (P = 0.001). Younger adolescents also exhibited better quality of sleep (P = 0.003), lesser daytime sleepiness, and lesser mood derangements compared to older adolescents (15-19 years; N = 453). Sleep hygiene scores showed a significantly negative correlation with mood and sleep quality. Conclusion:A clear relationship between sleep hygiene practices, mood and sleep quality has been observed among adolescents. Young adolescents who followed better sleep hygiene practices had lesser mood derangements and better sleep quality. Though ASHS scores were same among both genders but females had poor sleep quality, higher daytime sleepiness and mood.

Background: Sleep-related breathing disorders (SRBD) are widely prevalent among adolescents; however, are often undiagnosed, impacting their physical and psychological well-being. This study examined SRBD prevalence and its association with obesity, sleep patterns and mental health of adolescents. Methods: Adolescents aged 10-19 years were enrolled after requisite permission of school authorities and necessary assent and consent for participation. Participants were explored for their sleep quality, daytime sleepiness, SRBD and mood changes using standardized questionnaires like Pittsburgh sleep quality index (PSQI), pediatric daytime sleepiness scale (PDSS), sleep related breathing disorder-pediatric sleep questionnaire (SRBD- PSQ) and depression anxiety stress scale-21 (DASS-21) respectively. Results: SRBD was present in 18.05% (389) adolescents and 15.83% (341) were obese. Males, as well as older adolescents, had higher SRBD susceptibility with 56%; p=0.008 and 52.7%; p<0.001, respectively. Older adolescents had higher body mass index (p=0.017), shorter sleep durations (p<0.001), poorer sleep quality (p=0.006), increased daytime sleepiness (p<0.001), and elevated levels of depression, anxiety, and stress (p<0.001). Among SRBD-positive adolescents, 40.1% were obese, 32.1% were overweight, 82.5% experienced poor sleep quality (p<0.001) and 66.3% (258) were sleep deprived. Conclusions: An increasing trend in sleep disturbances, reduction in sleep quality and duration, increase in obesity as well as SRBD was observed with age among adolescents, with Older adolescents exhibiting the highest scores for all the parameters, including compromised emotional health.

Background:Restless leg syndrome is a sensorimotor disorder characterized by unpleasant sensations primarily involving lower limb but may involve trunk, neck and upper limb. The present study analyzed the clinical profile of RLS patients and explored its association with sleep and quality of life. Methods:A cross-sectional study was conducted among adult patients diagnosed of RLS based on the IRLSSG (International RLS Study Group) diagnostic criteria. Severity of RLS was assessed using the IRLSSG rating scale. Sleep quality, daytime sleepiness, and quality of life were assessed using the Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, and RLS Quality Of Life Scale (RLSQOL). Results:We enrolled 133 participants, of mean age 45.9 ± 15.2 years and 57.14% (76) being females. Different sensory-motor complaints were present, predominant sensory complaints being pain in 56.39% (75) and motor complaint being excessive movements (78.20% (104)). 80.45% (107) of individuals had sleep complaints including delayed onset sleep, repeated awakening, and nonrefreshing sleep. Excessive daytime sleepiness was present in 56.39% (75), and 78.2% (104) were poor sleepers. Upper limb was involved in 12.78% (17) of patients. Symptoms were majorly bilateral, but 6.02% (8) of patients had unilateral symptoms. RLSQOL score was 35.23 ± 10.3, and there was significant deterioration of sleep quality as well as quality of life with the increasing severity of RLS. Conclusion:RLS remains an underdiagnosed, misdiagnosed, and undertreated clinical entity which has a negative effect on individuals' sleep as well as quality of life. Early detection of RLS by primary care physician will not only reduce the morbidity but also enhance the QOL of these individuals.

Chronic primary pain is persistent pain that leads to emotional distress, anxiety, and depression. It cannot be explained by any alternative diagnosis and disrupts daily functioning, including sleep and social activities. The present meta-analysis evaluated the impact of yoga on depression and anxiety in people with chronic primary pain; we also evaluated yoga's effect on pain, quality of life, adherence, and adverse effects. Randomized controlled trials involving patients with chronic primary pain and utilizing yoga as an intervention were included. The databases PubMed, Cochrane Library, CINAHL, and Ovid were searched to extract participant demographics, intervention characteristics, outcomes, and study quality. Data synthesis involved random-effects meta-analysis for effect sizes and subgroup analyses based on control groups. Among the six trials involving 382 subjects, yoga significantly improved depression (standard mean difference -1.54), anxiety (standard mean difference -1.56), pain (mean difference -1.56), and quality of life (standard mean difference -1.26) compared to controls; no significant adverse events were observed. Yoga has a positive effect on levels of depression, anxiety, and pain in people with chronic primary pain, improving their quality of life. The grade of evidence for depression and anxiety ranged from low to very low; however, in comparisons with active and passive control groups, yoga may serve as a valuable nonpharmacological intervention for managing both physiological and psychological symptoms in patients with chronic primary pain, complementing standard medical care. Future studies should explore the optimal duration/ frequency of yoga practices, along with different types of yoga practices and yoga traditions, which may help to formulate delivery models for chronic primary pain management.

Fibromyalgia syndrome is a musculoskeletal condition and presents with fatigue, sleep disturbances, cognitive symptoms, and heightened sensitivity to touch. Autonomic dysfunction is an associated symptom observed in fibromyalgia. The present study examines the association between autonomic dysfunction and fibromyalgia severity. The study enrolled 144 individuals based on the American College of Rheumatology diagnostic criteria (2010) for fibromyalgia. Autonomic functions were assessed using heart rate variability and Ewing's battery of tests. Fibromyalgia Impact Questionnaire-Revised was used to explore fibromyalgiya severity. A varying degree of fibromyalgia severity was observed in the enrolled individuals with associated increases in pain sensitivity and intensity. Autonomic dysfunction was present in 45.8% (66) of individuals and 8.3% (12) individuals had definite autonomic dysfunction. No correlation was found between fibromyalgia severity and level of autonomic dysfunction. Additionally, no difference was observed in the levels of pain or daily functioning among the three categories of cardiac autonomic dysfunction. Different levels of autonomic dysfunction may be associated with varying levels of fibromyalgia severity, but no definite grade of autonomic dysfunction is associated with a particular grade of severity of fibromyalgia. Conclusion: Autonomic interaction with chronic pain requires further exploration, considering potential confounders that may impact both factors.

PURPOSE:Genomic surveillance of positive SARS-CoV-2 samples is important to monitor the genetic changes occurring in virus, this was enhanced after the WHO designation of XBB.1.16 as a variant under monitoring in March 2023. From 5th February till May 6, 2023 all positive SARS-CoV-2 samples were monitored for genetic changes. METHODS:A total of 1757 samples having Ct value <25 (for E and ORF gene) from different districts of Rajasthan were processed for Next Generation Sequencing (NGS). The FASTA files obtained on sequencing were used for lineage determination using Nextclade and phylogenetic tree construction. RESULTS AND CONCLUSIONS:Sequencing and lineage identification was done in 1624 samples. XBB.1.16 was the predominant lineage in 1413 (87.0%) cases while rest was other XBB (207, 12.74%) and other lineages (4, 0.2%). Of the 1413 XBB.1.16 cases, 57.47% were males and 42.53% were females. Majority (66.53%) belonged to 19-59 year age. 84.15% of XBB.1.16 cases were infected for the first time. Hospitalization was required in only 2.2% cases and death was reported in 5 (0.35%) patients. Most of the cases were symptomatic and the commonest symptoms were fever, cough and rhinorrhea. Co-morbidities were present in 414 (29.3%) cases. Enhanced genomic surveillance helped to rapidly identify the spread of XBB variant in Rajasthan. This in turn helped to take control measures to prevent spread of virus and estimate public health risks of the new variant relative to the previously circulating lineages. XBB variant was found to spread rapidly but produced milder disease.

Reflective writing develops meta-cognition among students. Therefore, it is of interest to compare effectiveness of post lecture reflective writing to didactic lecture between individual and group reflective writing. Hence, we included 124 first-year students from AIIMS Bhopal, India and divided them in two groups of 62 students. Both groups took a pre-test using a reflection questionnaire. Students were taught reflective writing. Both groups attended physiology lectures on two different topics. First lecture on body fluids where Group A wrote reflections individually and Group B did so in sub-groups (B1 to B6). After another lecture on Pathophysiology of oedema, Group A wrote reflections in groups and Group B wrote individually (A1 to A6). Both groups took a test in the form of MCQ about reflective writing on lectures. After intervention both groups took a post-test using a reflection questionnaire. Mean and standard deviation of Pre-test is 3.86 ± 0.86 and Post-test is 7.58 ± 1.01, respectively. The Mean and standard deviation of reflection who wrote individually is 38.05 ± 4.41 and in group is 27.45 ± 3.93, respectively with p-value < 0.05. Evaluation of students who wrote reflection in groups after second lecture the mean and standard deviation of reflection who wrote individually is 38.22 ± 4.64 and in group is 27.03 ± 2.87 respectively with p-value < 0.05. The performance of students who wrote reflection in groups is not satisfactory as compared to students who wrote their reflection individually.

Fibromyalgia syndrome (FMS) is a widespread musculoskeletal pain, often accompanied by fatigue and sleep disturbances. Poor sleep exacerbates inflammation and pain, potentially increasing levels of inflammatory markers. This study explored the effect of FMS severity on CRP levels, sleep quality and pain intensity. 89 FMS individuals were explored for FMS severity, pain and sleep quality. CRP levels in blood and erythrocyte sedimentation rate (ESR) were measured to assess inflammation. An increase in FMS severity was associated with an increase in CRP and ESR levels, pain intensity and sleep disturbances. However, a positive correlation between CRP levels and sleep quality indicates that Poor sleep quality in FMS may contribute to elevated CRP levels. Addressing sleep quality may mitigate the severity of FMS and its associated symptoms.

Background Many patients experience pain in their upper limbs following surgical procedures involving median sternotomy, particularly those undergoing coronary artery bypass grafting (CABG). This type of pain, commonly reported by CABG patients, is often overlooked in hospital settings. Our study aims to address this issue by utilizing electrodiagnostic studies to understand this postoperative discomfort better. Objectives Cardiovascular procedures are standard and are trending toward endovascular interventions. Through this study, we aim to assess the occurrence of neurological issues in the upper limbs after CABG by comparing patients' preoperative and postoperative electrophysiological studies of the upper limb nerves. Materials and methods A prospective study was performed on 32 coronary artery disease (CAD) patients undergoing CABG to determine the effects of surgery on the upper limb nerves (median and ulnar nerves). We performed nerve conduction studies (NCS) and analyzed different parameters of both median and ulnar nerves pre and post- surgery. Results A change was noted in different NCS parameters of the median and ulnar nerves when we compared the pre and post-surgical values. The mean latency of the median nerve sensory increased from a minimum of 3.01 milliseconds at the preoperative level to a maximum of 3.60 milliseconds when assessed two weeks post- surgery. The mean amplitude decreased from 16.49 microvolts to a minimum of 12.30 microvolts when assessed two weeks post-surgery. The mean velocity decreased from 55.83 m/s at the preoperative value to a minimum of 45.03 m/s at the two weeks post-surgery assessment. The ulnar nerve also underwent similar changes. Conclusion The observed changes in latency, amplitude, and velocity might be attributed to various factors, including surgical trauma, inflammation, or alterations in the physiological state post-surgery. The sternotomy technique and the position and extent of opening the sternal retractor determine the prevalence of complications by causing injury to the medial and lateral cords of the brachial plexus after CABG. Careful preoperative and postoperative assessments of patients may aid in preventing, minimizing, and treating these often undiagnosed complications.

Objectives: Fibromyalgia syndrome (FMS) is characterized by persistent widespread pain which greatly impacts the quality of life (QOL). Pain not only limits patients' daily activities but also restricts their social activities further leading to depression, anxiety, and stress. The present cross-sectional study elucidated the association of sleep quality and mood with increasing symptom severity of fibromyalgia and its impact on the QOL of fibromyalgia patients. Materials and Methods: Hundred adult fibromyalgia patients diagnosed by the American College of Rheumatology 2010 criteria were evaluated for: sleep - using the Pittsburgh sleep quality index, QOL by SF -36, pain -visual analog scales (VASs) and global pain scale (GPS), mood -depression, anxiety, stress scale -21, somatic symptoms, anxiety and depression - by patients health questionnaire somatic, anxiety, and depressive symptom scales (PHQ-SADS), and FMS severity was evaluated using fibromyalgia impact questionnaire (FIQR). Results: The mean pain score was 6.80 +/- 1.58 on VAS and 54.10 +/- 14.33 on GPS. FIQR score was 50.62 +/- 13.68, mean sleep quality was poor (9.30 +/- 3.88), and depression, anxiety, and stress scores were increased (10.04 +/- 4.59, 8.33 +/- 4.48, and 10.75 +/- 4.66). An increasing trend of depression, anxiety, stress, and somatoform symptoms was observed with an increase in the severity of FMS when patients were compared according to FMS severity scores. Sleep also deteriorated with increasing severity of FMS from 5.66 +/- 1.92 in mild FMS to 12.0 +/- 3.41 in highly severe FMS patients. The QOL too deteriorated in all the domains with increasing severity. Conclusion: With the increasing severity of fibromyalgia, not only does the pain increase but mood and sleep quality also deteriorate, which further impacts the QOL of FMS patients. Thus, comorbid mood derangements must also be screened and addressed for maximum benefit of the patients.

During October 2020, suddenly many cases were reported with Dengue like Illness in Sahawa village, Rajasthan. Blood samples collected from 68 patients were tested for Dengue NS1 antigen and IgM antibodies for Dengue, Chikungunya, Scrub typhus, Leptospira and Brucella by ELISA, Dengue, Chikungunya and Zika viral RNA by multiplex Polymerase Chain Reaction (PCR), 41.17% samples were positive for Dengue; 25% were positive by Dengue PCR, 17.64% for NS1 Ag,14.70% for IgM ELISA, 20.58% were positive for antibodies either for Scrub typhus (4.41%), Leptospira (7.35%) or Brucella (10.29%). Dengue was seen in 41.17% cases and other etiological agents in 20.58% cases.

Background: Post-stroke cognitive impairment (PSCI) is a clinical entity that encompasses all types of cognitive impairment following an index stroke. Yoga has been proven to have a beneficial effect not only on cardiovascular risk factors but also on cognition. Hence, this study explored the PSCI spectrum and assessed the effect of yoga on PSCI. Methods: Forty stroke patients were enrolled in each yoga and control arm in this study. After the baseline assessment, control arm was administered standard care (including physiotherapy) while yoga arm received additional yoga intervention. Change in MoCA scores by 2 points in either direction, or FAB scale by 2 points at 6 months was taken as primary outcome, whereas improvement in MRS, CDPSS, CBS, and P300 values were considered as secondary outcomes. Results: Significant improvements were observed in MoCA, FAB, MRS, CPDSS, and CBS scores in both groups after 6 months. However, intergroup comparisons revealed better MoCA (25.5, IQR 22-27) and FAB scores (15.5, IQR 14-17) in yoga group compared to controls (24, IQR20-25.75) and (14, IQR12-15.75). Equivalent improvement was observed in MRS and CBS scores in both groups at 6 months; however, CDPSS score was better in yoga group (p = 0.0008). Both P300 amplitudes and latencies improved in all patients and median P300 amplitudes were significantly better in control group; however, no difference could be appreciated in P300 latencies improvement on intergroup comparisons at follow-up. Conclusion: Study reveals that early yoga intervention in stroke survivors leads to better improvement in cognitive abilities which would further facilitate in early reduction of caregiver burden.

Background and Objective: Parkinson's disease sleep scale-2 (PDSS-2) is a reliable sleep assessment tool which has been validated in several languages. As sleep problems have a great impact on the quality of life of Parkinson's disease patients, we aimed to translate and validate PDSS-2 in Hindi for its wider use among Hindi-speaking Indian patients. Our study objective was to translate PDSS-2 in Hindi (H-PDSS-2) and to assess the psychometric properties of H-PDSS-2 questionnaire for its use in Hindi-speaking Indian PD patients. Secondly, we aimed to compare the results with those of the other language PDSS-2 validation studies. Material and Methods: This study was done in two phases, enrolling 16 patients and 16 controls in the first/translation phase for assessment of internal consistency and discriminative power of PDSS-2. The test–retest reliability was determined in the second phase on 35 Parkinson's disease patients who were followed-up at an interval of 7–10 days. Results: No difficulties were faced by the patients and controls in the first phase, and internal consistency of the scale was good (Cronbach's alpha = 0.804). There was no significant difference in total H-PDSS-2 score at baseline 16.86 ± 10.59 and on retest 16.40 ± 9.54, suggesting good reliability. Intraclass correlation coefficients ranged from 0.710 to 0.901, and precision was 2.82 over the period of 7–10 days. Subdomains of H-PDSS-2 had moderate/high internal validity, and they showed significant correlation with Unified PD Rating Scale (UPDRS) and HY disease scale. Conclusion: H-PDSS-2 is equivalent to the original PDSS-2 for tested psychometric attributes. Its use among Indian Parkinson's disease patients will help in the comprehensive assessment of sleep problems among PD patients.

Review question / Objective: The treatment of choice for patients of Parkinson's disease is levodopa. However, levodopa has been suggested to decrease Vit B12 level in these patients. Thus, the research question for this systematic review is whether vit B 12 supplementation in Parkinson's disease(PD) patients on treatment with levodopa improves vit B12 level effecting the Cognition, Motor functions and Mood instability among them in comparison to PD patients on levodopa treatment who are not supplemented with Vit B12. Condition being studied: Parkinson disease is the progressive degeneration of dopaminergic neurons present within the substantia nigra that can lead to altered movements along with the prevalence of cognitive and mood instability as a result of dopamine(neurotransmitter) deficiency. The most effective treatment for the Parkinson's disease is the administration of levodopa, a dopamine precursor . Long term treatment with levodopa causes an increase in homocysteine levels and tissue deficiency of vitamin B12 and folate may occur. Vitamin B12 supplementation is administered as after management regime, in Parkinson patient on levodopa treatment . This study aims to conduct a systematic review, of studies , randomized control trials investigating the ability of vitamin B12 supplementation to enhances the recovery/reduce the decline, if any, of the symptoms of cognitive, motor, mood impairments associated with Parkinson's disease patient on levodopa treatment.