Perceptions of community participation and health gain in a community project for the South Asian population: a qualitative study

BACKGROUND Surgical site infections following total hip or knee arthroplasties have a reported rate of 0.49%-2.5% and can cause significant morbidity as well as tripling the cost of health care expenses. Both methicillin sensitive and methicillin resistant strains of Staphylococcus aureus surgical site infections have been established as a major risk factor for postoperative surgical site infections. S. aureus colonizes the nose, axillae, and perineal region in up to 20%-30% of individuals. Although the literature has reported a higher prevalence of methicillin resistant S. aureus in the South Asian population, routine preoperative screening and prophylaxis have not yet been implemented. OBJECTIVE The primary objective of our study is to identify the relationship between preoperative colonization status of S. aureus and incidence of postoperative surgical site infections in patients undergoing following total hip and knee arthroplasties. As part of the secondary objectives of this study, we will also investigate patient characteristics acting as risk factors for S. aureus colonization as well as the outcomes of total hip and knee arthroplasty patients which are affected by surgical site infections. METHODS This prospective cohort study will comprise of screening all patients older than 18 years of age admitted to the Aga Khan University Hospital for a primary total hip or knee arthroplasty for preoperative colonization with S. aureus. The patients will be followed postoperatively for up to one year following the surgery to assess the incidence of surgical site infections. The study duration will be 2 years (March 2018 to March 2020). For the purpose of screening, pooled swabs will be taken from the nose, axillae, and groin of each patient and inoculated in a brain heart infusion, followed by subculture onto mannitol salt agar and sheep blood agar. For methicillin resistant S. aureus identification, a cefoxitin disk screen will be done. Data will be analyzed using SPSS v23 and both univariate and multivariate regression analysis will be conducted. RESULTS Data collection for this study will commence at the Aga Khan University Hospital, Pakistan during March 2018. CONCLUSIONS This study will not only estimate the true burden caused by S. aureus in the population under study but will also help identify the patients at a high risk of surgical site infections so that appropriate interventions, including prophylaxis with antibiotics such as muciprocin ointment or linezolid, can be made. Given the differences in lifestyle, quality, and affordability of health care and the geographical variation in patterns of antibiotic resistance, this study will contribute significantly to providing incentive for routine screening and prophylaxis for S. aureus including methicillin resistant S. aureus colonization in the South Asian population. REGISTERED REPORT IDENTIFIER RR1-10.2196/10219

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Diabetes and Associated Complications in the South Asian Population

Current Cardiology Reports ◽

10.1007/s11886-014-0476-5 ◽

2014 ◽

Vol 16 (5) ◽

Cited By ~ 40

Author(s):

Arti Shah ◽

Alka M. Kanaya

Keyword(s):

South Asian ◽

Asian Population ◽

The South ◽

South Asian Population

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Abstract P472: Addressing Hypertension and Cardiovascular Disease in South Asian San Joaquin Population

Circulation ◽

10.1161/circ.141.suppl_1.p472 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Author(s):

Maha Siddiqui

Keyword(s):

Blood Pressure ◽

At Risk ◽

South Asian ◽

Low Income ◽

South Asians ◽

Asian Population ◽

The South ◽

South Asian Population ◽

Asian Community ◽

South Asian Community

Introduction: South Asians have a higher death rate than any other population for cardiovascular disease (CVD) and high blood pressure (HBP). San Joaquin has a growing rate of South Asians immigrants who may be at risk for CVD. Objectives: Trainees conducted hypertension and CVD screenings at South Asians religious organizations to reduce the risk of CVD and spread awareness about the factors that lead to CVD and its implications in the South Asians population due to environmental racism in the most underserved county for health care, San Joaquin. Methods: I trained low-income minority high school students to conduct weekly blood pressure screenings and serve as a health technology coach by each student monitoring 2 hypertensive patients of 48 hypertensive or at risk hypertensive and low-income San Joaquin residents and constantly stressed, and at risk for CVD. CVD screenings were conducted at all San Joaquin gurdwaras and mosques to spread awareness about heart health and track hypertension in the South Asians community. Findings: -61.7% of the South Asian population of San Joaquin are at risk for CVD -3.3% of the South Asian population of San Joaquin are hypotensive -28.6% of the South Asian population of San Joaquin are Stage 1 hypertensive -29.7% of the South Asian population of San Joaquin are Stage 2 hypertensive -38.3% of the South Asian population of San Joaquin have normal blood pressure but consume red meat more than 4 times a month Direct Outcomes of Events: -Development of self-advocacy in the South Asian community. Community members became activists for their own heart health. -Increased participation of youth, in an otherwise adult dominant environment (i.e. the mosques and gurdwaras). -Increased awareness of CVD, hypertension, hypotension, and periodontal disease (PD) among the South Asian community. -Increased participation by youth and adults on activities such as games, challenges and information booths dispensing awareness on CVD and PD. -Increased interaction between community members of different religions, creed, and socioeconomic backgrounds. -Awareness, education among the South Asian community for better heart and oral health -Diagnoses and referrals of suspected cases of hypertension and CVD -Improved patient-provider trust -San Joaquin high school students trained for community outreach events and determined to address CVD. -Youth learned the value of empathy, multiculturalism, and service to disadvantaged communities through the program and volunteering.

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Signatures of natural selection and ethnic-specific prevalence of NPC1 pathogenic mutations contributing to obesity and Niemann–Pick disease type C1

Scientific Reports ◽

10.1038/s41598-020-75919-4 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Andreea Chiorean ◽

William S. Garver ◽

David Meyre

Keyword(s):

Natural Selection ◽

South Asian ◽

Asian Population ◽

Loss Of Function ◽

The South ◽

South Asian Population ◽

Asian Populations ◽

Pathogenic Mutations ◽

Z Scores ◽

Niemann Pick

Abstract While homozygous pathogenic mutations in the NPC1 gene cause Niemann-Pick type C1 disease, heterozygous mutations cause highly-penetrant obesity. We aimed to investigate the prevalence of NPC1 mutations and their signatures of natural selection in 122,678 exome sequenced participants from six ethnic groups in the Genome Aggregation Database. Pathogenic missense coding mutations were identified by in silico tools and the ClinVar database. Signatures of natural selection were assessed by the probability of NPC1 being loss-of-function mutation intolerant and Z-scores of observed/expected synonymous and non-synonymous mutation ratios. There was no evidence of negative selection observed for synonymous, non-synonymous and loss-of-function mutations. However, there were significant ethnic differences in the prevalence of heterozygous pathogenic NPC1 mutations ranging from 0.56% in Ashkenazi Jewish to 3.26% in African/African Americans (5.8-fold difference). Four homozygous carriers of pathogenic NPC1 mutations were also identified, belonging to the South Asian population. In conclusion, NPC1 mutations are consistent with a model of balanced selection, where heterozygotes and homozygotes have higher and lower reproductive fitness, respectively. Therefore, NPC1 heterozygous mutations may account for a substantial and ethnic-dependent percentage of obesity in the general population, while NPC1 homozygous mutations may be frequent in the South Asian populations and warrants more investigation.

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Caucasian and south Asian men show equivalent improvements in surrogate biomarkers of cardiovascular and metabolic health following 6-weeks of supervised resistance training

F1000Research ◽

10.12688/f1000research.15376.1 ◽

2018 ◽

Vol 7 ◽

pp. 1334

Author(s):

Allan Knox ◽

Nicholas Sculthorpe ◽

Fergal Grace

Keyword(s):

Resistance Exercise ◽

South Asian ◽

Metabolic Response ◽

South Asians ◽

Fasting Blood Glucose ◽

Density Lipoprotein ◽

Asian Population ◽

Metabolic Health ◽

The South ◽

South Asian Population

Background: The South Asian population have greater cardiovascular risk than their age-matched Caucasian counterparts, characterized by unfavorable biomarkers. South Asians may also be partially resistant to the pleiotropic benefits of physical activity on cardiovascular health. There is a current absence of studies that compare markers of cardio-metabolic health between Caucasians and South Asians employing resistance exercise. This study set out to compare the response in biomarkers of cardio-metabolic health in Caucasians and South Asians in response to resistance exercise.Methods: Caucasian (n=15, 25.5 ± 4.8 yrs) and South Asian (n=13, 25.4 ± 7.0 yrs) males completed a 6-week progressive resistance exercise protocol. Fasting blood glucose, insulin, and their product insulin resistance (HOMA-IR), triglycerides (TRIGS), low density lipoprotein (LDL), high density lipoprotein (HDL), total cholesterol (TC), vascular endothelial growth factor (VEGF), asymmetric dimythylarginine (ADMA), L-arginine (L-ARG) and C-reactive protein (CRP) were established at baseline and following resistance exercise.Results: There were significant improvements in fasting glucose, TC, LDL, HDL and VEGF in both groups following resistance exercise (p<0.05, for all). No change was observed in insulin, HOMA-IR, TRIGS, ADMA, L-ARG following resistance exercise (p>0.05, in both groups). CRP increased in the South Asian group (p<0.05) but not the Caucasian group (p>0.05)Conclusions: The cardio-metabolic response to resistance exercise is comparable in young Caucasian and South Asian males though inflammatory response to exercise may be prolonged in South Asians.

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