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PubMed2001

Childhood cancer in the south Asian population of England (1990-1992).

Cancer incidence in 1990-92 among English south Asian (residents with ethnic origins in India, Pakistan or Bangladesh) and non-south Asian children is compared. Standardized incidence ratios show significant overall excesses in south Asians (131), largely due to higher rates in south Asian boys, and specific excesses for leukaemia (141), lymphoid leukaemia (141), lymphoma (172) and hepatic tumours (375). Aetiological investigation is required.

Adolescent↗
PubMed2004

Dietary PUFA and the metabolic syndrome in Indian Asians living in the UK.

Indian Asians living in the UK have a 50% higher CHD mortality rate compared with the indigenous Caucasian population, which cannot be attributed to traditional risk factors. Instead, features of the metabolic syndrome, including raised plasma triacylglycerol, reduced HDL-cholesterol (HDL-C) and an increased proportion of small dense LDL particles, together with insulin resistance and central obesity, are prevalent among this population. The present review examines evidence to support the hypothesis that an imbalance in dietary PUFA intake, specifically a higher intake of n-6 PUFA in combination with the lower intake of the long-chain (LC) n-3 PUFA, plays an important role in the prevalence of the metabolic syndrome observed in Indian Asians. Data are presented to illustrate the impact of manipulation of the background n-6 PUFA intake (moderate or high n-6 PUFA) and the subsequent response to supplementation with LC n-3 PUFA on blood lipids and insulin action in a group of Indian Asian volunteers. The results demonstrate that supplementation with LC n-3 PUFA had no impact on insulin action in those subjects consuming either the moderate- or high-n-6 PUFA diet. In the postprandial phase reductions in plasma triacylglycerol concentrations were greater in those consuming the high-n-6 PUFA background diet subsequent to fish oil supplementation. The present study concludes that, contrary to the central hypothesis, the prevalence of metabolic abnormalities in Indian Asians compared with Caucasians may not be attributable to differences in intakes of n-6 and n-3 PUFA.

Corn Oil↗
PubMed1997

Skin-color preferences and body satisfaction among South Asian-Canadian and European-Canadian female university students.

Skin-color preferences and body satisfaction among 100 South Asian-Canadian and 100 European-Canadian female university students were examined. South Asian-Canadian females were found to desire lighter skin than they possessed and had lower body satisfaction compared with European-Canadian females. Among South Asian-Canadians, the desire to be lighter skinned was greater the more participants differed from the cultural White ideal. Light- and medium-skinned South Asian-Canadians had the highest and lowest levels of body satisfaction, respectively.

Adolescent↗
PubMed2005

Lower lid epiblepharon as the presenting feature of spontaneous dural carotid cavernous fistula in an Asian patient.

Lower lid epiblepharon is a relatively common problem among young Asian patients. Occasionally, it may be secondary to underlying orbital pathology. We report a 33-year-old Chinese patient with a dural carotid cavernous fistula who presented with an ipsilateral lower lid epiblepharon in the absence of any other significant signs. After a recurrence following primary corrective lid surgery, she was investigated further because of mild ipsilateral proptosis. CT-scans of the orbit revealed an enlarged superior ophthalmic vein and a dural carotid cavernous fistula was confirmed on angiography. Subsequent embolisation of the fistula led to resolution of the proptosis as well as the epiblepharon. We believe that extension of orbital fat to the inferior tarsal border in Asian eyelids together with a poorly fixed anterior lamella contributes to the occurrence of epiblepharon when the Asian orbit becomes congested. The new onset of such features in the Asian patient should lead one to suspect underlying orbital pathology, even in the absence of other, more classic signs.

Adult↗
PubMed1999

Asian paralysis syndrome.

We report 20 children admitted to the paediatric ward of a public general hospital for acute flaccid paralysis, which was bilaterally symmetrical in all cases and was associated with bulbar involvement in eight of them. Recovery was partial. Nerve conduction studies showed motor axonal neuropathy. This new disease, variously termed as non-inflammatory neuropathy/Chinese paralysis syndrome must be differentiated from Guillain-Barré syndrome (GBS) and poliomyelitis. Both GBS and Asian paralysis syndrome have bilaterally symmetrical flaccid paralysis but GBS tends to have sensory involvement, full recovery occurs in 90% of cases and nerve conduction shows demyelinating neuropathy. Asian paralysis syndrome and poliomyelitis are pure motor lesions without sensory changes and partial recovery, but poliomyelitis differs in that paralysis is asymmetrical and unequal, muscle spasm is always present in the initial stage and there are prodromal symptoms. Nerve conduction studies show anterior horn cell disease. This new entity, common in Asian populations, assumes public health importance when it mimics poliomyelitis in a country that has tried to eliminate poliomyelitis by universal immunization. To the best of our knowledge, this is the first report of Asian paralysis syndrome in children in our area.

Acute Disease↗
PubMed1998

Identification of sequence tagged sites in the Asian and African elephant.

To date, gene identification in elephants has essentially related to evolutionary studies. Further identification of genes in elephants could provide additional information for evolutionary studies and for evaluating genetic diversity in existing elephant populations. The objective of this project was to identify sequence tagged sites (STSs) in the Asian and the African elephant for the following genes: melatonin receptor 1a (MTNR1A), retinoic acid receptor beta (RARB), and leptin receptor (LEPR). These genes are highly conserved among mammals, and all may play a role in reproduction. Heterologous primers for PCR were designed from sequences available in other species. Fragments of size 141 base pairs (bp) for RARB and 327 bp for LEPR were obtained by amplifying genomic Asian and African elephant DNA. The LEPR fragment included an intron of 164 bp. Also, a 417 bp fragment for MTNR1A was obtained in the Asian elephant only. All PCR products were sequenced and comparison computations were made at the nucleotide and amino acid levels to sequence available in the GenBank database. Nucleotide sequence for RARB was identical for both Asian and African elephants and differed by only 3 bp for LEPR. Deduced amino acid sequence was identical for both STSs in both species. Elephants were relatively similar in comparison to other mammals and less similar to chickens.

Amino Acid Sequence↗
PubMed2000

Investigation of validity of closed questions in a survey of British South Asian and white populations.

OBJECTIVES: The paper concerns the validity of closed-format questions in an interview-based population survey and focuses on a comparison of South Asian and white respondents. METHOD: A two-part interview consisting of open, respondent-centred questions followed by closed questions taken from a large-scale interview-based health survey was carried out with 15 persons from white and 14 from South Asian communities resident in the UK. Interviewees' views of their stays in hospital was the focus. RESULTS: The two-part interview was found to provide a broadly satisfactory method for the investigation of validity although a limitation was recognised. Twenty-nine per cent of the variation in response to a closed question on 'overall satisfaction' was predictable from views expressed in the open interview. The views of both groups, as expressed in the open interview, were inadequately represented by the closed questions. This appeared to be especially true for the South Asian sample. The validity of the closed question appeared greater for white than for South Asian interviewees. CONCLUSIONS: It is concluded that when designing and piloting health surveys consideration should be given to members of all communities to be included in the survey.

Asia, Southeastern↗
PubMed2001

Longitudinal study of socio-economic differences in mortality among South Asian and West Indian migrants.

AIM: To examine socio-economic differences in mortality of South Asian and West Indian migrants. DESIGN: ONS Longitudinal Study, a 1% sample of the population of England and Wales. PARTICIPANTS: First generation South Asian and West Indian migrants present at the 1971 and 1981 censuses, aged under 65 years in 1981, were classified by occupational class, access to cars, housing, and a deprivation score. OUTCOME MEASURES: Relative risks of mortality, 1981-1997. RESULTS: There was considerable upward social mobility but most people remained socially stable, mainly relatively disadvantaged compared to all other study members. High levels of owner occupied housing among South Asians at both censuses were an exception. Socio-economic differentials in mortality were significant with car access in 1981 (relative risk 1.32, 95% confdence interval 1.03-1.70), and housing (rented vs owner occupied relative risk 1.50, 95% confidence interval 1.08-2.08) among South Asians and, among West Indians with car access in 1981 (relative risk 1.43, 95% confidence interval 1.05-1.94). Mortality was not significantly associated with socioeconomic circumstances in 1971. CONCLUSION: The disparity between those who remained advantaged or who moved up, and those who remained persistently disadvantaged, would have been a factor underlying the stronger differentials by later socio-economic circumstances. As these migrants age an increase in health inequalities could be expected.

Adult↗
PubMedDate not supplied

Project Dil: a co-ordinated Primary Care and Community Health Promotion Programme for reducing risk factors of coronary heart disease amongst the South Asian community of Leicester--experiences and evaluation of the project.

OBJECTIVES: To improve the effectiveness of primary and secondary prevention of coronary heart disease (CHD) in volunteer Leicestershire general practices with a high percentage of South Asian patients. To increase the awareness of lifestyle risk factors amongst the South Asian community with means of reducing CHD. DESIGN: Development and implementation of: A CHD training and awareness programme for health care professionals. Organizational change to ensure adoption of an effective secondary prevention programme for general practice. A public awareness campaign including a peer education programme for the South Asian community of Leicestershire. Interim evaluation using participation data, user satisfaction and organizational development of primary care is reported. RESULTS: A multi-disciplinary training programme accessed by 88% of staff from 23 volunteer practices has been developed and implemented. Organizational development in practices including CHD registers, action planning and establishing CHD clinics has taken place at a much faster pace than comparable non-Project Dil practices. An externally accredited peer education programme has been completed by 45 community volunteers. Within 6 months of completion, a total of 54 peer education sessions accessed by over 2,000 people from the Asian community had taken place. Project Dil, although initially funded only for 2 years, has now been adopted by Leicestershire Health Services (via a Primary Care Trust) as a mainstream programme. CONCLUSION: Project Dil has made considerable progress in engaging and driving changes in general practices to facilitate improvement in CHD management. In parallel, the project has developed a community education programme, including the use of peer education. The project is now hosted by a Primary Care Trust on behalf of Leicestershire Health Services. External evaluation of the peer education programme has commenced.

Adolescent↗
PubMed2006

Differential prevalence of quality-of-life categories (domains) in Asian women and changes after therapy with three doses of conjugated estrogens/medroxyprogesterone acetate: the Pan-Asia Menopause (PAM) study.

OBJECTIVES: To assess the prevalence of four categories (domains) of menopausal symptoms as markers for quality of life in nine ethnic groups of Asian women. To evaluate changes in quality of life (MENQOL scores) in Asian women following hormone therapy. METHODS: A prospective, randomized, double-blind, multinational clinical trial in 1028 healthy postmenopausal women of nine ethnic groups from 11 Asian countries/regions. Following 2 weeks of baseline observation, the women received one of three conjugated estrogens (CE)/medroxyprogesterone acetate (MPA) doses (in mg) daily for 24 weeks: 0.625/2.5, 0.45/1.5, or 0.3/1.5. At baseline and at the end of weeks 4, 12 and 24 following the start of therapy, the study participants were asked to record, on a menopause-specific quality of life (MENQOL) questionnaire, 29 menopausal symptoms, as experienced during the preceding month. The symptoms were categorized into four domains: vasomotor, psychosocial, physical and sexual. RESULTS: The baseline (pretreatment) symptom scores in each of the four domains varied substantially among the different ethnic groups, ranging from 2.21 to 5.71 in the vasomotor, 2.37-5.96 in the psychosocial, 2.66-5.39 in the physical, and 2.11-6.55 in the sexual domain. Overall, Vietnamese and Pakistani women had the highest baseline scores, i.e. were most afflicted by each set of symptoms in a given domain, and Indonesian, Malay, Taiwanese and Thai women were least afflicted. In the overall population, intervention resulted in statistically significant decreases in the scores of all four domains within 4 weeks of intervention. The beneficial effects were similar in the three dose groups. CONCLUSIONS: The prevalence of four domains of menopausal symptoms, representative of quality of life as recorded on a MENQOL questionnaire, varies considerably among ethnic groups of Asian women. The MENQOL scores in the overall population were significantly lowered in the course of the study, indicating an improvement in quality of life. In the absence of a placebo group, the relative contribution of hormones and placebo in our intervention is unknown.

Adult↗
PubMed1960

Genetic studies of influenza viruses. I. Viral morphology and growth capacity as exchangeable genetic traits. Rapid in ovo adaptation of early passage Asian strain isolates by combination with PR8.

The passage of newly isolated, filamentous Asian (A2) influenza viruses in the presence of non-infective PR8 (A) virus results in the rapid emergence of virus of Asian (A2) antigenicity but PRS-like growth capacity and spherical morphology. Evidence is presented that this effect results from genetic interaction of the infective Asian and non-infective PR8 viruses rather than from spontaneous change of the Asian strain. It is concluded that influenza viral morphology, growth rate and growth capacity are associated genetic traits which distinguish unadapted from adapted strains, and which are transferable by recombination. A pragmatic consequence of these experiments is the fact that conditions have been defined for the rapid adaptation of early passage influenza virus isolates to the chick embryo allantoic sac. Such adaptation is attended by an increase in viral yield which has obvious implications for vaccine production during future epidemics with new antigenic types.

Animals↗
PubMed2004

Where west meets east: the complex mtDNA landscape of the southwest and Central Asian corridor.

The southwestern and Central Asian corridor has played a pivotal role in the history of humankind, witnessing numerous waves of migration of different peoples at different times. To evaluate the effects of these population movements on the current genetic landscape of the Iranian plateau, the Indus Valley, and Central Asia, we have analyzed 910 mitochondrial DNAs (mtDNAs) from 23 populations of the region. This study has allowed a refinement of the phylogenetic relationships of some lineages and the identification of new haplogroups in the southwestern and Central Asian mtDNA tree. Both lineage geographical distribution and spatial analysis of molecular variance showed that populations located west of the Indus Valley mainly harbor mtDNAs of western Eurasian origin, whereas those inhabiting the Indo-Gangetic region and Central Asia present substantial proportions of lineages that can be allocated to three different genetic components of western Eurasian, eastern Eurasian, and south Asian origin. In addition to the overall composite picture of lineage clusters of different origin, we observed a number of deep-rooting lineages, whose relative clustering and coalescent ages suggest an autochthonous origin in the southwestern Asian corridor during the Pleistocene. The comparison with Y-chromosome data revealed a highly complex genetic and demographic history of the region, which includes sexually asymmetrical mating patterns, founder effects, and female-specific traces of the East African slave trade.

Asia, Central↗
PubMed2004

Evolution of erythromycin-resistant Streptococcus pneumoniae from Asian countries that contains erm(B) and mef(A) genes.

To investigate the genetic characteristics of erythromycin-resistant Streptococcus pneumoniae in Asian countries, 110 pneumococcal isolates were analyzed by multilocus sequence typing (MLST). MLST analysis showed that 2 clonal complexes--CC236 (Taiwan19F-14 clone) and CC81 (Spain23F-1 clone)--are the major lineages of erythromycin-resistant S. pneumoniae in the Asian region. Pneumococcal isolates containing both the erm(B) and the mef(A) genes are thought to have originated from the Taiwan19F-14 clone containing the mef(A) gene, after introduction of the erm(B) gene. Further evolution of this variant clone has generated resistant strains with different sequence types. Dissemination of these variant clones of the Taiwan19F-14 could be the main reason for the high frequency of pneumococcal isolates containing both erm(B) and mef(A) in some Asian countries. Data suggest that the high prevalence of erythromycin-resistant S. pneumoniae in the Asian region is partly due to the clonal spread of a few multidrug-resistant clones.

Asia↗
PubMed2001

Differential susceptibility of Aedes aegypti to infection by the American and Southeast Asian genotypes of dengue type 2 virus.

Outbreaks of dengue hemorrhagic fever have coincided with the introduction of the Southeast (SE) Asian genotype of dengue type 2 virus in the Western Hemisphere. This introduced genotype appears to be rapidly displacing the indigenous, American genotype of dengue 2 virus throughout the region. These field observations raise the possibility that the SE Asian genotype of dengue 2 is better adapted for vector transmission than its American counterpart. To evaluate this hypothesis, we compared the ability of viral strains of the SE Asian and American genotypes to infect, replicate, and disseminate within vector mosquitoes (Aedes aegypti). Viral strains of the SE Asian genotype tended to infect and disseminate more efficiently in mosquitoes than did variants of the American genotype. These differences, however, were observed solely in field-derived mosquitoes, whereas viral infection rates were virtually identical in the laboratory-adapted Rockefeller colony of Ae. aegypti. Our findings could provide a physiological basis for the contrasting patterns of dengue virus genotype transmission and spread. Such an understanding of functional differences between viral strains and genotypes may ultimately improve surveillance and intervention strategies.

Aedes↗
PubMed1989

Diet and fecal steroid profile in a South Asian population with a low colon-cancer rate.

South Asian immigrants to England and Wales have low mortality from colon cancer and high mortality from coronary heart disease compared with the general population. In a survey of a predominantly Gujarati population in northwest London, both vegetarians and nonvegetarians had similar total dietary fat intake to the native British population but higher dietary fiber intake. Total fecal bile acid and neutral animal sterol concentrations were lower in South Asians than in a native British comparison group. Sixty-two percent of South Asians excreted detectable quantities of free primary bile acids, which were not present in stools from native British subjects. The ratio of fecal coprostanol to total neutral animal sterols was also lower in South Asians. Low risk of colon cancer in this population may be related to reduced microbial activity in the bowel and low levels of tumor-promoting secondary bile acids.

Asia, Southeastern↗
PubMed1994

Accessibility and use of health care services in the British Asian community.

British Asians make up 3% of the population. There is evidence that Asians have difficulty obtaining good quality health care, appropriate to their needs. This article examines some of this evidence, with examples of specific communities in Britain. In the past, specific health education programmes for Asians have targeted their 'special' needs such as rickets, tuberculosis and thalassaemia. In fact the population itself perceives its needs differently--improved communication, easier access to services, and more information on asthma, diabetes, ischaemic heart disease and skin disorders. It is important to appreciate that the 'Asian' community is made up of disparate groups with widely differing needs and expectations, and that each community should be considered by health service planners as unique within the context of the health authority within which they lie. Reasons for the mismatch between need and service provision are discussed in the light of the recent reforms in the National Health Service and recommendations for change are given.

Adult↗
PubMed2001

Prescribing rates for psychotropic medication amongst east London general practices: low rates where Asian populations are greatest.

OBJECTIVES: The aim of this study was to examine the contribution of Asian ethnicity to the variation in rates of practice prescribing for antidepressant and anxiolytic medication, taking into account other population and practice organizational factors. METHODS: A practice-based cross-sectional survey was carried out of the prescribing of antidepressants and anxiolytics (daily defined dosages) in 164 general practices. The study was set in East London and the City Health Authority, which includes the multiethnic inner London boroughs of Hackney, Tower Hamlets, Newham and the City of London. The main outcome measures were the annual prescribing rates for each group of drugs, calculated as the total annual daily defined dosages divided by the practice population, and the ratio of antidepressant/ anxiolytic annual prescribing rates. RESULTS: Prescribing rates for antidepressants showed a 25-fold variation between practices; this was greater for anxiolytics. The median annual prescribing rate for all antidepressants combined was 4.13 (interquartile range 2.50-5.88). For all anxiolytics and hypnotics combined the median annual prescribing rate was 3.55 (interquartile range 1.71-6.36). Univariate analysis showed that Asian ethnicity alone accounted for 28% of the variation in antidepressant prescribing and 20.5% of the variation in the anxiolytic prescribing. A backwards multiple regression model using 10 explanatory practice and population variables accounted for 47.7% of the variance in antidepressant prescribing and 34% of the variance in the anxiolytic prescribing. CONCLUSION: In practices where the proportion of Asian patients is high, both antidepressant and anxiolytic prescribing is low. This is important for understanding interpractice prescribing variation and for setting levels of drug budgets. This study confirms that the low rates of non-psychotic disorders presented by Asian populations is not a selective feature of access to secondary care, but is evident in the prescribing behaviour of GPs. Uncertainty remains as to how much this is due to a lower prevalence rate, "culture-bound syndromes" or practical difficulties in diagnosis and management within the general practice setting.

Anxiety Disorders↗
PubMed2005

Empowering patients with diabetes: a qualitative primary care study focusing on South Asians in Leicester, UK.

OBJECTIVES: We aimed to explore the experience and attitudes of primary care patients with diabetes living in a UK community with a high proportion of South Asian patients of Indian origin, with particular reference to patient empowerment. METHODS: Semi-structured interviews were conducted with patients with diabetes attending two general practices in Leicester, UK. Patients were interviewed in English, Gujarati or Punjabi and interviews were transcribed with translation into English where necessary. Broad themes were identified and Framework charting was used to organise data for analysis. RESULTS: Interviews were conducted with 15 South Asian and 5 white patients. We identified both similar and culturally specific elements within the experience, attitudes and barriers in the two ethnic groups. High regard for education, particularly in South Asians, was associated with a positive attitude to empowerment through knowledge, but also sometimes led to low motivation to become partners in diabetes management. High prevalence of diabetes and strong family networks meant that families were an important source of knowledge for South Asians and that these patients generally had good emotional support. Practical considerations such as the need for a convenient venue for educational initiatives were common to both ethnic groups, but some cultural preferences were also identified, for example for appropriate language provision and separate gender sessions. CONCLUSIONS: Educational initiatives aimed at promoting self-management in chronic diseases such as diabetes need to be designed with an awareness of the complexity of social and cultural experiences and attitudes in target communities.

Adult↗