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Biomedical subjects

H Joshi

Publications and source records attributed to H Joshi.

At least 19 recordsLinked to original sources

Malaria among the Jarawas, a primitive and isolated tribe on the Andaman islands, India.

The Jarawas are a primitive Negrito tribe of the Andaman islands, India. The members of this tribe have been geographically and socially isolated from the other inhabitants of the islands. None had attended a hospital or health unit until 1997, when a Jarawa boy with a fractured leg was taken to a hospital in Port Blair, and successfully treated. Since then, increasing numbers of Jarawas have sought treatment at the hospital and/or begun to make other contact with non-Jarawas on the islands. No malaria had ever been reported in the tribe until 2001, when an outbreak of febrile illness triggered a malariological survey. Malarial parasites, all identified microscopically as Plasmodium falciparum, were detected in the bloodsmears of 30 of the 179 Jarawas investigated. Although most malaria among the non-Jarawa inhabitants of the islands is caused by P. vivax, only P. falciparum was detected when blood samples from 26 of the subjects were investigated in PCR-based assays. Genetic-diversity studies, based on the msp(1) and msp(2) polymorphic markers, also revealed a relatively low level of polymorphism in the P. falciparum parasites infecting the Jarawas, compared with that seen in other areas of India. It seems possible that malarial parasites have only recently reached the Jarawas, as the result of the weakening of the tribe's isolation from other humans on the Andaman islands.

Adolescent↗

Hyperhomocysteinemia masquerading as pulmonary embolism.

We describe a 30-year-old male who presented with acute onset of breathlessness, tachycardia, and palpitations associated with distension of jugular vein and clear lungs on physical examination. The chest X-ray was normal and ECG was showing S1Q3T3 and right ventricular strain pattern. His 2-D echocardiography was showing dilated right atrium, right ventricular dilatation and moderate pulmonary arterial hypertension. He was found to have thrombosis involving left side of deep venous system with normal superficial venous system (Doppler proved). All routine blood investigations for etiology of recurrent DVT were normal except serum homocyteine level, which was significantly raised. Megaloblastic anemia on peripheral smear and hyperhomocysteinemia prompted us to search for its cause, which was subsequently found to be vitamin B12 deficiency. Such an association of megaloblastic anemia due to vitamin B12 deficiency leading to hyperhomocysteinemia and subsequent thrombosis in left venous system presenting as acute pulmonary embolism has not been described earlier in the medical literature.

Adult↗

Place and personal circumstances in a multilevel account of women's long-term illness.

This paper investigates geographical variations in women's reports of limiting long-term illness in terms of individual inequalities and the contribution of area characteristics among wards and county districts. We use multilevel modelling of linked census data from the Office for National Statistics Longitudinal Study for England and Wales. We follow a random sample of 76.374 women aged between 16 and 45 at the time of the 1971 Census for 20 years to observe their reported limiting long-term illness (LLTI) at the 1991 Census. Car and home ownership were useful markers of social and material advantage, apparently protecting against the risk of reporting LLTI. Migration into the South-East region appeared beneficial, but otherwise there was little difference between those who moved home and those who did not. Differences between county districts persist after adjustment for individual circumstances (education and ethnicity), but almost all of these differences are explained by the social profile of wards in these areas. Geographical differences in LLTI are not, therefore, entirely explained by the distribution of individual characteristics: a woman with the same history may face a different risk of illness in different kinds of area. For women, the social composition of the locality (using the ward as a proxy) is more relevant than the broader economic and industrial classification of the surrounding county district, which is more important for health inequalities among men.

Adolescent↗

Flexible sigmoidoscopy in general practice.

OBJECTIVE: Flexible sigmoidoscopy (FS) is increasingly being accepted as the method of choice for initial investigation of rectal bleeding and other lower gastrointestinal symptoms. The aim of this study was to assess the feasibility of FS in general practice and to compare the yield, cost and efficiency of a service provided by a consultant surgeon and a General Practitioner (GP). SUBJECTS AND METHODS: A prospective study of FS was undertaken on 430 unsedated patients with symptoms suggestive of lower bowel disease in two general practices. RESULTS: The yield was comparable to hospital based data. Fifteen (3.5%) cancers were detected, of which 40% were Dukes A, and 46 (10.7%) adenomatous polyps. Cost per patient examination by a GP including capital costs, depreciation of equipment, and training was calculated to be cheaper or at least equivalent to a hospital-based service but inefficient due to the low numbers examined per month. There were no complications and no missed cancers after a minimum follow up of 2 years. CONCLUSIONS: The results suggest that FS can be safely performed by a suitably trained GP in health centres, but better utilization of equipment and value for money would be obtained by providing the service for a group of practices rather than a single practice as in this study.

Journal Article↗

Do attitude and area influence health? A multilevel approach to health inequalities.

This paper demonstrates an area effect on health and suggests improvements in research practice for work in this field. We use an area classification which can be related clearly to factors that influence the health of individuals and take account of people's differing propensities to draw influence from their area. Multilevel analysis demonstrates that the degree of deindustrialisation which an area experienced in Britain, in the 1980s, has an independent association with the health of resident individuals. A significant relationship between a person's attitude to their community and their health is shown to be independent of individual and area characteristics. We conclude that both individual and area characteristics influence health.

Adolescent↗

Studies on Anopheles fluviatilis and Anopheles culicifacies sibling species in relation to malaria in forested hilly and deforested riverine ecosystems in northern Orissa, India.

In a malaria-endemic region in northwestern Orissa, India, a longitudinal study was undertaken to delineate information on the sibling species of Anopheles fluviatilis and Anopheles culicifacies and their bionomics and role in malaria transmission in forested and deforested ecosystems. In forested villages, An. fluviatilis sibling species S (97.97%) and T (2.02%) were present. The former was highly anthropophagic (human blood index 0.88). Among the sibling species of An. culicifacies, species B (27.96%), C (71.1%), and B/C heterozygotes (0.94%) were present and were highly zoophagic. In deforested riverine villages An. fluviatilis was nearly absent and An. culicifacies sibling species A (0.48%), B (21.1%), C (77.94%), and B/C heterozygotes (0.48%) were present. In forested villages, the annual parasite incidence (269 cases/1,000) and the slide positivity rate (45%) were significantly higher than those in deforested areas, which had values of 39 cases/1,000 and 27%, respectively. The study showed that the high endemicity of malaria in the forested villages was due primarily to 2 vectors, the high rate of anthropophagy of An. fluviatilis species S, and also the more favorable ecological conditions for this vector.

Animals↗

Children's family change: reports and records of mothers, fathers and children compared.

Family change, when adults depart or arrive around children, raises policy issues. Its measurement depends upon the evidence collected and from whom. This paper compares British children's histories obtained from fathers and mothers. The evidence, on one birth cohort of parents, comes from two sources: the National Child Development Study and the ONS Longitudinal Study. The resulting account of family change is not substantially different between parents. There is some under-reporting of children not living with their fathers. This is due to under-reporting by those included in the studies and to under-representation in them of absent fathers and lone parents.

Adolescent↗

The opportunity costs of childbearing: more than mothers' business.

"This paper is an argument about gender relations. It takes the entwined themes of men's interests in parenthood, the sex division of labour and its evolution, policy for gender equity and policy to support the level of social reproduction. The emphasis on women's employment as a determinant of low fertility has to be supplemented by an examination of the assumption that only women's time use is affected by child-rearing.... Descriptive evidence about the paid and unpaid work of couples and parents is presented, largely secondary material from the UK."

Behavior↗

Beta-adrenergic and fibroblast growth factor receptors induce neuronal process outgrowth through different mechanisms.

The mechanisms that initiate and direct neuronal process formation remain poorly understood. We have recently described a neuronal progenitor cell line, AS583-8.E4.22 (AS583-8) which undergoes neurite formation in response to beta2-adrenergic and basic fibroblast growth factor (bFGF) receptor activation [Kwon, J.H. et al., (1996) Eur. J. Neurosci., 8, 2042-2055]. In the present study, a comparison of these responses revealed that isoproterenol (ISO), a beta-adrenergic receptor agonist, induces multiple, highly branched processes within 30 min while bFGF induces fewer, unbranched processes within 24 h. In contrast to the ISO response, bFGF induces mitogen-activated protein kinase activation and c-fos expression in the cell line and results in neurite outgrowth that is dependent on new mRNA and protein synthesis. Two-dimensional isoelectric focusing-sodium dodecyl sulphate-polyacrylamide gel electrophoresis of cytoskeletal preparations revealed different patterns following ISO vs. bFGF exposure suggesting selective changes in protein expression and/or post-translational modifications. Immunoblot analysis of these preparations for beta-tubulin, tyrosinated alpha-tubulin and acetylated alpha-tubulin also revealed different patterns following each type of treatment. Follow-up confocal microscopy revealed that following ISO, the distribution of tyrosinated tubulin extends to the distal ends of processes whereas acetylated alpha-tubulin is diminished within distal ends. This pattern has been reported to be associated with enhanced microtubule dynamics, a state in which process outgrowth is facilitated. In contrast, following bFGF treatment the distributions of tyrosinated and acetylated alpha-tubulin were identical, a state associated with a diminution of microtubule dynamics. These results, a different time course of neurite formation, dependency on new gene expression and differential expression and cellular distribution of major cytoskeleton proteins suggest that neurite outgrowth induced by ISO vs. bFGF is mediated by two distinct intracellular effector mechanisms in AS583-8 cells. In addition, studies, using the differential distribution of post-translational modified alpha-tubulins in neurites of primary neuronal cultures as marker for the two distinct processes of neurite formation suggest, that similar mechanisms are present in vivo. Therefore, the AS583-8 cell line provides a useful model to study these signalling mechanisms that couple neurotransmitter and growth factor receptor activation to the cytoskeletal changes that mediate neurite formation.

Animals↗

Deprivation indicators as predictors of life events 1981-1992 based on the UK ONS Longitudinal Study.

STUDY OBJECTIVE: To investigate the association between the level of social deprivation in electoral wards and various life events. Life events include mortality, self reported long term illness, and for women: still-birth, underweight birth, birth while a teenager, and sole registered birth. Associations with area deprivation are tested before and after allowing for levels of personal deprivation. DESIGN: Prospective census follow up using the Office for National Statistics Longitudinal Study. SETTING: England and Wales. PARTICIPANTS: A random sample of more than 300,000 people enumerated at the 1981 census, and aged 10 to 64 in 1981. Some analyses are necessarily restricted to certain age/sex groups. OUTCOME MEASURES: Several outcomes in the decade 1981-1992 are investigated: risk of premature death (before age 70, all cause), risk of long term limiting illness in 1991, and risk of inauspicious fertility outcomes in women. MAIN RESULTS: Without adjusting for personal circumstances all outcomes, except risk of stillbirth, show a clear, significant, and approximately linear association with social deprivation of ward of residence in 1981. Associations are much stronger for outcomes where a greater "social" component can be constructed (teenage birth, sole registered birth) than for outcomes that are probably more physiologically determined (mortality, stillbirth, low birth weight). When adjustment is made for personal disadvantage the simple associations with local area deprivation are all attenuated, especially for those living in the more deprived areas. CONCLUSIONS: A variety of adverse or "inauspicious" life events show association with residence in more deprived areas. These are particularly strong for teenage birth and sole registered birth, but are also stronger for long term illness than mortality. These associations seem to be largely because residence in more deprived areas is associated with personal disadvantage, which is more damaging to life chances than area of residence. For some outcomes there is evidence that the personally disadvantaged fare less well if living in relatively advantaged areas, than if living in more homogenously deprived areas.

Adolescent↗

Studies on bionomics of Anopheles fluviatilis and its sibling species in Nainital district, U.P.

A study on the bionomics of Anopheles fluviatilis sensu lato was carried out in two physiographic regions, viz. Bhabar and Terai of District Nainital, Uttar Pradesh. In both areas, An. fluviatilis was found resting indoors predominantly in cattlesheds. Cytological examination of An. fluviatilis revealed that species T and U were sympatric in Bhabar and Terai villages with predominance of species T. These two sibling species appear to be poor vectors of malaria.

Animals↗

Epidemiology of echinococcosis in Nepal.

Echinococcosis and hydatidosis is a parasitic zoonotic disease of human and animals. This disease has created public health and environment problems in all urban areas of Nepal. Based on the three year study (1993-1995) it has been revealed that the epidemiological cycle (indigenous) of Echinococcus granulosus parasite is dog-pig-dog cycle and human acquire infection accidentally through infected dog stool. However, this study has proved also the epidemiological cycle like dog-sheep-dog, dog-goat-dog and dog-buffalo-dog. This study was supported by International Development Research Centre (IDRC), Ottawa, Canada.

Adolescent↗

Employment after childbearing and women's subsequent labour force participation: evidence from the British 1958 birth cohort.

"Data on women from the British 1958 Cohort Study is used as evidence on the determinants of their labour force participation at age 33. A conventional cross-sectional model of full or part-time employment makes use of some longitudinal material not normally included in such models. Whether the woman made the hitherto customary break from employment at the time of the first maternity is included in recognition that this cohort was among the first generation to be offered Statutory Maternity Leave. Results suggest that the presence of children (still) inhibits full-time employment and raises the probability of part-time employment; that income effects on participation have continued to weaken while wage elasticity for full-time employment is high. Continuity of employment straight after childbearing raises the chances of subsequent full-time employment, but by no means guarantees it. Gains from maternity leave and other family friendly employment policies have been far from uniform."

Demography↗

Women's health: dimensions and differentials.

This paper is concerned with the social patterning of ill-health amongst women in Britain. It uses the various health measures available in the Health and Lifestyle Survey (self-assessed health, disease/disability, illness, psycho-social well-being and fitness) to explore whether there are particular aspects of health systematically associated with social advantage and disadvantage, as measured by current or last occupation, employment status, household composition and household income. Among women aged 18-59, after controlling for age, number of psychological symptoms experienced in the past month showed the greatest social variation. Number of physical illness symptoms in the last month showed the least. Lone mothers with dependent children were found to have particularly poor psycho-social health, although this was confined to those in full-time employment. The presence of a long-standing disease/disability proved useful as a control for the influence of health selection in to and out of both employment and motherhood.

Adolescent↗

Anopheles fluviatilis complex: host feeding patterns of species S, T, and U.

The host feeding specificity of Anopheles fluviatilis sibling species S, T, and U was determined by analyzing blood meal source using countercurrent immunoelectrophoresis. A distinct difference in the feeding patterns was observed among these species. Species S was found to be predominantly anthropophagic with 91% of the population having fed on human blood. In contrast, species T and U were either exclusively or primarily zoophagic.

Animals↗

A role for microfilaments but not microtubules in processing soluble antigens.

Ag processing involves multiple intracellular membrane transport events required for delivery of Ag to degradative compartments in the endocytic pathway of antigen-presenting cells (APC) and transport of newly synthesized class II MHC proteins to compartments where peptide loading occurs. Movement and distribution of various subcellular vesicles have been shown to involve elements of the cytoskeletal network. We have examined the role of microtubules and microfilaments in Ag processing and presentation by B lymphoblastoid cells. Experiments with nocodazole or colchicine, drugs that disrupt the microtubule network, demonstrate that intact microtubules are not required for efficient processing of soluble Ag in these cells. Cytochalasins, which disrupt actin microfilaments, are observed to partially inhibit processing of soluble Ag. Inhibition is reversible and dependent on both the dose of drug and length of exposure. Control experiments demonstrate that the effect does not result from drug toxicity or decreased Ag uptake. Treatment of APC with cytochalasin B does not block delivery of internalized protein to dense lysosomes. However, the ability of the cells to catabolize internalized protein is partially inhibited. Our results suggest that microfilament-dependent, but not microtubule-dependent, vesicular transport may be required for efficient Ag processing in B lymphoblastoid cells.

Actin Cytoskeleton↗