Asiatic Indians Research Articles

STRICT VEGAN DIET LEADING TO MALNUTRITION AND ACTIVE TB

SESSION TITLE: Monday Fellow Case Report Posters SESSION TYPE: Fellow Case Report Posters PRESENTED ON: 10/21/2019 02:30 PM - 03:15 PM INTRODUCTION: Cell mediated immunity is the basis of the body’s defense mechanisms against mycobacterium tuberculosis. Effective cell mediated immunity requires effective adequate phagocytosis and T-cell function. Vitamin B12 and Vitamin D deficiency has been linked to impaired oxygen burst reaction, which is needed for effective phagocytosis. Experimental data has shown protein energy malnutrition to impair T-cell mediated immune pathways. Strict vegan and vegetarian diets are known to be lacking in cobalamin, protein and vitamin D. CASE PRESENTATION: A 40 yr old HIV negative Caucasian female presented to pulmonary clinic for evaluation of chronic cough. Social history revealed adherence to a strict vegan diet for many years. CT scan of the chest revealed consolidation in the superior and anterobasal segments of the right lower lobe. Bronchoscopy revealed mucoid secretions in the superior segment of the right upper lobe with associated edema. As well as thick whitish mucus in the superior segment of the right lower lobe. BAL was performed and was positive for AFB in two smears in keeping with the diagnosis of acute MTB infection. The patient was admitted for initiation of RIPE therapy. Albumin levels were noted to be 2.8 g/dl during her admission and Vitamin D was noted to be 29ng/ml. Hain testing showed pryrazinamide and isoniazid resistance. Sputum conversion by smear and culture occurred in week 20 of treatment. DISCUSSION: Vit B12 deficiency, was hypothesized to contribute to increased susceptibility of vegetarian Asiatic Indians to active MTB. The prevalence of MTB infection was noted to be higher in strict vegetarians when compared to lactovegetarians and omnivores. Exclusion of diary products in the vegan diet further predisposes patients to Vit B 12 deficiency. Vitamin D deficient patients have been shown to have greater susceptibility to MTB and worse disease course prognosis. There is evidence to suggest that a fall in serum Vitamin D levels can decrease cell mediated immunity. Some have suggested a dual role of Vit D supplementation in treating MTB infection. In the setting of extended drug resistant and multidrug resistant TB low BMI and hypoalbuminemia have been associated with poorer treatment outcomes. Hypoalbuminemia independently is associated with increased in hospital mortality in patients with TB. Our patient had both low BMI and hypoalbuminemia at the time of presentation. Hind testing revealed poly-resistant TB (PRTB). It is unclear in this case how much her dietary restrictions may have contributed to her vitamin deficiencies and predisposition to conversion to active TB CONCLUSIONS: Further research is needed into the effects of the vegan diet on the immune system and how these changes may alter the course of TB infection Reference #1: Vegetarian diet as a risk factor for tuberculosis in immigrant south London Asians. - PubMed - NCBI [Internet]. [cited 2018 Jul 26]. Available from: https://www.ncbi.nlm.nih.gov/pubmed/7701458 Reference #2: Kearns MD, Tangpricha V. The role of vitamin D in tuberculosis. J Clin Transl Endocrinol [Internet]. 2014 Aug 23 [cited 2018 Dec 12];1(4):167–9. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5684962/ Reference #3: Vegetarian diet as a risk factor for tuberculosis in immigrant south London Asians. - PubMed - NCBI [Internet]. [cited 2018 Jul 26]. Available from: https://www.ncbi.nlm.nih.gov/pubmed/7701458 DISCLOSURES: No relevant relationships by Armando Cabrera Alonso, source=Web Response No relevant relationships by Zeeshan Chauhan, source=Web Response No relevant relationships by Usha Deonarine, source=Web Response No relevant relationships by Gustavo Ferrer, source=Web Response No relevant relationships by Hector Vazquez Saad, source=Web Response

The Questionable Role of Saturated and Polyunsaturated Fatty Acids in Cardiovascular Disease

A fat diet, rich in saturated fatty acids (SFA) and low in polyunsaturated fatty acids (PUFA), is said to be an important cause of atherosclerosis and cardiovascular diseases (CVD). The evidence for this hypothesis was sought by reviewing studies of the direct link between dietary fats and atherosclerotic vascular disease in human beings. The review included ecological, dynamic population, cross-sectional, cohort, and case-control studies, as well as controlled, randomized trials of the effect of fat reduction alone. The positive ecological correlations between national intakes of total fat (TF) and SFA and cardiovascular mortality found in earlier studies were absent or negative in the larger, more recent studies. Secular trends of national fat consumption and mortality from coronary heart disease (CHD) in 18–35 countries (four studies) during different time periods diverged from each other as often as they coincided. In cross-sectional studies of CHD and atherosclerosis, one group of studies (Bantu people vs. Caucasians) were supportive; six groups of studies (West Indians vs. Americans, Japanese, and Japanese migrants vs. Americans, Yemenite Jews vs. Yemenite migrants; Seminole and Pima Indians vs. Americans, Seven Countries) gave partly supportive, partly contradictive results; in seven groups of studies (Navajo Indians vs. Americans; pure vegetarians vs. lacto-ovo-vegetarians and non-vegetarians, Masai people vs. Americans, Asiatic Indians vs. non-Indians, north vs. south Indians, Indian migrants vs. British residents, Geographic Study of Atherosclerosis) the findings were contradictory. Among 21 cohort studies of CHD including 28 cohorts, CHD patients had eaten significantly more SFA in three cohorts and significantly less in one cohort than had CHD-free individuals; in 22 cohorts no significant difference was noted. In three cohorts, CHD patients had eaten significantly more PUFA, in 24 cohorts no significant difference was noted. In three of four cohort studies of atherosclerosis, the vascular changes were unassociated with SFA or PUFA; in one study they were inversely related to TF. No significant differences in fat intake were noted in six case-control studies of CVD patients and CVD-free controls; and neither total or CHD mortality were lowered in a meta-analysis of nine controlled, randomized dietary trials with substantial reductions of dietary fats, in six trials combined with addition of PUFA. The harmful effect of dietary SFA and the protective effect of dietary PUFA on atherosclerosis and CVD are questioned.

Vegetarian diet and cobalamin deficiency: their association with tuberculosis.

To determine whether the high incidence of tuberculosis among Asiatic Indians in the United Kingdom was due to impaired killing of Mycobacterium tuberculosis by macrophages from patients deficient in cobalamin, a nutritional survey was carried out among 1187 Indians and the incidence of tuberculosis determined from medical records. The question asked was whether tuberculosis was significantly more common among life-long vegetarians compared with omnivores. The incidence of tuberculosis in vegetarians was 133 in 1000 and that in subjects on mixed diets 48 in 1000. These findings lend support to the hypothesis that dietary factors are of major importance in determining the susceptibility of Asiatic Indians to tuberculosis.

HLA A,B,C and DR association with insulin-dependent diabetes in Martinique.

HLA-A,B,C, and DR frequencies have been determined in 34 Coloured Martinican IDDM patients to establish the HLA and IDDM associations. HLA A3, B15, B18, Cw3 and DR4 antigens associations with IDDM are confirmed by this study. We found an increase of B21 similar to that found in Asiatic Indians. As in some African Black populations and in Cape coloured people, A1, B8, and DR3 are not increased in our population. We should point out that our patients' ages of onset were low, and that some studies have found DR4 association in young patients and DR3 in older ones. The protective role of DR2 is confirmed here. B35 and Cw4 negative associations have been found. We have observed that the antigens associated with IDDM are decreased in our control population, except DR4, and that the negative associated DR/ and Cw4 antigens are increased compared to the Continental French population. This corresponds with the low IDDM incidence in Blacks and Coloured people.

In Vitro Primaquine Sensitivity Studies in Asiatic Indians from the State of Gularat

Glucose-6-Phosphate dedydrogenase deficiency is an inborn error of metabolism. Individuals suffering from this abnormality may experience an acute hemolytic episode after ingestion of certain drugs and some vegetable food products (Brewer, Tarlov & Alving, 1960). This deficiency trait has a wide geographic distribution and the incidence varies greatly in different racial and ethnic groups. Generally dark skinned groups have a much higher incidence and the highest incidence has been reported in Kurdish Jews (60%, Motulsky, 1960). The incidence amongst the various ethnic groups is presented in Table 1 (Keller, 1971). Extensive lists of G-6-PD deficiency and variants in several population groups have been compiled (Yoshida, Beutler & Motulsky, 1971; Yoshida & Beutler, 1978).

A Human Antibody to Gm (26): An Antigen Usually Present on the γ‐3 Chain of IgG When Gm (15) is Absent1

An antibody to an antigen on IgG was found in the serum of a healthy American Negro, whose phenotype is Gm (1, 13, 15, 17). (When tested for Gm [1, 2, 3, 5, 6, 13, 15, 16, 17, 21].) Subsequent tests of serum samples from US blacks and whites, from Japanese, Ainu, San (Bushmen), Negros, Asiatic Indians and Jews from Cochin India demonstrated that the antibody detects an antigen that is usually present in a haplotype when Gm (15) is absent from it. This antigen had been identified using an antibody produced in a baboon. Tests of isolated myeloma proteins and of Fc and Fab fragments of IgG confirmed that the antigen [Gm (26) or Gm (u) - originally Gm (Pa)] is carried by the Fc portion of the gamma3-chain.

A Human Antibody to Gm (26): An Antigen Usually Present on the r-3 Chain of IgG When Gm (15) is Absent

An antibody to an antigen on IgG was found in the serum of a healthy American Negro, whose phenotype is Gm (1, 13, 15, 17). (When tested for Gm [1, 2, 3, 5, 6, 13, 15, 16, 17, 21].) Subsequent tests of serum samples from US blacks and whites, from Japanese, Ainu, San (Bushmen), Negros, Asiatic Indians and Jews from Cochin India demonstrated that the antibody detects an antigen that is usually present in a haplotype when Gm (15) is absent from it. This antigen had been identified using an antibody produced in a baboon. Tests of isolated myeloma proteins and of Fc and Fab fragments of IgG confirmed that the antigen [Gm (26) or Gm (u) - originally Gm (Pa)] is carried by the Fc portion of the γ3-chain.

Polymorphism of esterase D in some population groups in Japan.

Electrophoretic types of red cell esterase D (Es D) have been determined in more than 1,000 blood samples from Tokyo. The allele frequency for Es D2 was found to be 0.342. Typing was also carried out in samples of the Ainu of Hokkaido and of the Ryukyuans of the Okinawa Island: the Es D2 frequencies were found to be 0.273 and 0.369, respectively. These values are considerably higher than those described in Europeans, Negroes and even in Asiatic Indians. The results indicate that Es D with a marked degree of heterogeneity is a valuable marker for genetic, anthropological and forensic application in Mongoloid groups.

The detection and differentiation of the products of the human carbonic anhydrase loci, CAI and CAII using fluorogenic substrates.

SUMMARY1. The carbonic anhydrase isozymes of human red cells have been investigated by starch‐gel electrophoresis using the fluorogenic substrates, 4‐methyl‐umbelliferyl acetate and fluorescein diacetate, for the detection of the CAI and CAII locus isozymes respectively.2. The previously described electrophoretic polymorphism at the CAII locus was easily distinguished using fluorescein diacetate as the stain, thus reducing the need for a specific anti CAII antiserum in future population and family tests.3. The variant allele CAII2 (previously designated CA II‐H) was found to occur with a frequency of 0·046 in a population sample of 196 Black Africans living in London. No electrophoretic variants of CAII were detected in a survey of 434 Europeans and 304 Asiatic Indians living in London.4. No electrophoretic variants of CAI were detected in the three population groups tested.

Diphtheria infection in North West Canada, 1969, 1970 and 1971

In three years, Corynebacterium diphtheriae was isolated from 1238 people, consisting of 820 North American Indians or Metis, 318 people of Caucasian origin, 97 Eskimos and 3 Asiatic Indians. Diphtheria infection of the throat, nose, ears and skin was common in the North American Indian and Metis people, but rarely caused severe symptoms. The infection occurred less often in white people but was more serious; of 27 cases of toxic respiratory diphtheria, 25 were white people. The public health significance of the endemic infection of the North American Indian and Metis people is discussed.

Megaloblastic Anaemia among Indians in Britain

A high incidence of megaloblastic anaemia, approximately three times that in white persons, has been found in Indian immigrants in Britain. The clinical, haematological, and biochemical features of 25 patients are described. All but one of these were living in the Southall area of Middlesex. In 15 cases the presenting haemoglobin was less than 7 g/100 ml and three of these were teenage girls. The majority (17 cases) were nutritional anaemias; the type of deficiency was variable and this group included some patients with vitamin B18 deficiency, some with folic acid deficiency, and some with deficiency of both vitamins. Among the remaining eight patients there were cases of pernicious anaemia, tropical sprue, gluten enteropathy, post-gastrectomy anaemia, and unexplained vitamin Bla malabsorption. Some of these conditions have previously been considered uncommon in Asiatic Indians.

Frequency of Red Cell Adenosine Deaminase Phenotypes in Several Population Groups in Israel

The genetic polymorphism of red cell adenosine deaminase (ADA) was investigated in five population groups in Israel: Ashkenazi Jews, non-Ashkenazi Jews from Iraq, Yemen, North Africa, and Arabs. The distribution of the ADA¹ and ADA² genes was found to be heterogeneous. The highest frequency of the ADA² gene was observed among the Iraqi Jews (0.1494) and the lowest among North African Jews (0.0907). In spite of this heterogeneity, all the five communities shared a common trait, namely, significantly higher frequencies of the ADA² gene than those observed in most populations from Western or Northern Europe. The trait of high frequency of the ADA² gene had been described also in Mediterranean populations (Greece, Italy), Asiatic Indians and Filipinos.

Adenosine deaminase polymorphism in man

Summary A new and specific method for the study of adenosine deaminase isozymes is described. Examination of red‐cell lysates has revealed three genetically determined electrophoretically different ADA phenotypes: ADA 1, ADA 2–1 and ADA 2. Family studies indicate that these phenotypes are determined by two alleles, ADA1 and ADA2 at an autosomal locus. Preliminary population data suggest that ADA2 has a frequency of about 0.06 in European, 0.04 in Negroes and 0.11 in Asiatic Indians. The behaviour of the ADA isozyme pattern on storage or after treatment with thiol reagents suggests the occurrence of reactive sulphydryl groups in the enzyme molecules.

Variants of red cell glucose-6-phosphate dehydrogenase among Asiatic Indians.

SUMMARYAmong one hundfed and one unrelated Asiatic Indian males living in the Pacific north‐west, five G‐6‐PD‐deficient individuals were identified. The enzyme of three of these individuals was indistinguished elctrophoreticaly and biochemically from the Mediterranean type of deficiency. These individuals originated from the north‐western parts of the Indian subcontinent.The enzyme of one individual and that of his subsequently studied beother (G‐6‐PD Kerala) was found to be simialr to G‐6‐PD Seattle by km G‐6‐P, km TPN, pH optimum, utilization of 2d‐g‐6P and Gal‐6‐P and electrophoretic migration rate in Tris buffer, pH 8.8. Electrophoresis on TEB buffer (pH 8.6) however, showed this variant to be different from G‐6‐PD Seattle, The desirability of using multiple electrophoretic methods in the elucidation of new variants is emphasized by these observations.The third abmormal G‐6‐PD (G‐6‐PD West Bengal) was unlike other mutations previously described in having higher‐than normal km TPN and lower‐than‐normal km G‐6‐P and a slow electrophoretic mobilty.The identification of the Mediterranean type of G‐6‐PD deficiency in the north‐western part of the Indian subcontinent, together with histrorical and molecular considerations, suggests affiinities of Mediterranean, Near Eastern, and North‐west Indian populations.

Inherited variations in human phosphohexose isomerase

SUMMARY1. The elctrophoretic pattern of phosphohexose isomerase has been examine in the blood of 3397 unrelated individuals from several different populations groups.2. Eight variant phenotypes were identinfied and these were designated PHI 2‐1, 3‐1, 4‐1, 5‐11 6‐1, 7‐1, 8‐1, 9‐1. All of these were rare in the populations studied except the variant designated PHI 3‐1, which was observed with a frequency of about 1% in a mixed population of Asiatic Indians.3. Studies of selected families indicated that the variants occured in individuals who are heterozygous for one or another of a series of rare alleles at an autosomal locus.4. Studies on the family of a patient that the patient was heterozygous for two different rare alleles at the PHI locus, each associated with reduced PHI activity. The patinet's mother showed the PHI 9‐1 phenotype and his father showed a new phenotype designated PHI 10‐1. The patient's phenotype has been designeated PHI 9‐10.5. The enzyme appears to be a dimer and in heterozygotes isozymes of hybrid submit compostion as well as isozymes of like subunit compostion are apparently formed.

Who Should Bear Children?

Who Should Bear Children?

The Diego factor among Asiatic Indians, Apaches and West African Negroes: Blood types of Asiatic Indians and Apaches

The apparent restriction of the Diego blood factor to the Mongoloid peoples (Leyrisse and Arends, ’56) has provided the anthropologist with a tool of great potential usefulness in the evaluation of populations of mixed origin. In order to use this system to its full advantage, it is necessary to have considerable information on groups whose origin can with considerable certainty be labelled “mongolian” or “nonmongolian.” The present study, undertaken as a contribution towards expanding knowledge of the distribution of the Diego system, is concerned with the findings in 75 Asiatic Indians, 108 American Apache Indians, and 775 West African Negroes.

The frequencies of haptoglobin types in five populations.

SummaryHaptoglobin types have been determined by starch gel electrophoresis of blood from five populations. The gene frequencies obtained for allele Hp1 were as follows: American whites, 043; American Negroes, 0.59; African Negroes, 0.72; Apaches, 0.59; and Asiatic Indians, 0.18. In tribes of the Ivory Coast and Liberia, there was a suggestion of a cline which parallels that for haemoglobin S.Evidence is presented that the condition of ahaptoglobinemia is under genetic control but not by a gene allelic to the Hp1‐Hp2 series. The importance of the ahaptoglobinemic individuals for genetic studies and the possibility of selection in the maintenance of the genetic polymorphism are discussed.The authors wish to acknowledge the excellent assistance of Alojzia Sandor, who carried out the electrophoretic separations.

The tonsil and adenoid question as seen by the internist.

Of how many operations can it be truthfully said that they are neither dreadful in the doing nor melancholy in the event? This unique pronouncement, which was intended to popularize the removal of tonsils by ligature, is found in the Critical Inquiry into the Present State of Surgery by Samuel Sharp, surgeon to Guy's Hospital, 1733 to 1757. Sharp's work is cited in an article by Mollison. 1 The tonsils, being easily visible and readily accessible, must have been among the very first of our internal organs to be removed by the surgeon's knife. Wise, 2 in his Review of the History of Medicine, speaks of the Asiatic Indians, who were highly skilled in medicine 1,000 years B.C., or 460 years before Hippocrates. These Asiatics removed troublesome tonsils saying, They are to be seized between the blades of a forcep and drawn forward, and with a semicircular knife the third

Pernicious Anemia in Asiatic Indians

Abstract Three cases of pernicious anemia in Asiatic Indians are reported. The prevailing idea regarding the low incidence of pernicious anemia in Indians is corroborated. The pathogenesis of pernicious anemia and nutritional macrocytic anemia is discussed briefly.