Sunil Kumar Joshi

Publications

• Diabetes: A review of its associations with different environmental factors

  Joshi SK

  01/2010

  Degree: Post Graduate Diploma in Diabetology (PGDD)

• Biomass combustion and potential health effects in the developing countries

  Joshi SK, Dahl A, Kristensen T, Roldin P

  Kathmandu University Medical Journal. 01/2010; 8(2):276-280.

  Biomass combustion is a very large source of aerosol particles on a global scale. It is estimated that 20 % of the black carbon and 30 % of the organic carbon aerosol mass emissions are due to wild land fires and intentional burning of agricultural waste in Asia. However in those numbers residential... [more] Biomass combustion is a very large source of aerosol particles on a global scale. It is estimated that 20 % of the black carbon and 30 % of the organic carbon aerosol mass emissions are due to wild land fires and intentional burning of agricultural waste in Asia. However in those numbers residential fuel combustion is not included, which is considered a larger source of black carbon and organic carbon aerosol particles in developing countries. When it comes to residential fuel combustion it covers combustion of coal, kerosene, gas and biofuel in stoves, cookers and heaters1. In regions where the climate forces people to preserve heat in their houses, food is often cooked over open fire indoors. The hot emissions from the fi re are then directly used to heat the house, instead of using a heat exchanger such as a chimney. When wood or coal is used as fuel the particle concentration indoor reach hazardous levels. Especially women and their small children are exposed to the emissions, since they spend much time inside and often close to the fi re place2-7. This article elucidates the health effects related to biomass combustion in developing countries with focus on aerosol particles and the current knowledge in this field.

  Download

• Human trafficking in Nepal: A rising concern for all

  Joshi SK

  Kathmandu University Medical Journal. 01/2010; 8:3-4.

  Human traffi cking is the fastest growing, criminal industry in the world. But, relatively little is known about the issue of human traffi cking and the effectiveness of programmes aimed at combating traffi cking and rehabilitating victims/survivors.... [more] Human traffi cking is the fastest growing, criminal industry in the world. But, relatively little is known about the issue of human traffi cking and the effectiveness of programmes aimed at combating traffi cking and rehabilitating victims/survivors.

  Download

• Diabetes mellitus: A review of its associations with different environmental factors

  Joshi SK, Shrestha S

  Kathmandu University Medical Journal. 01/2010; 8:109-115.

  Diabetes Mellitus is a global health problem with a worldwide prevalence of 2.8% in 2000. Type 1 diabetes mellitus is an auto immune disorder genetically mediated, while type 2 is more of a life style induced disorder although the role of genetic susceptibility, infections are also equally strong. M... [more] Diabetes Mellitus is a global health problem with a worldwide prevalence of 2.8% in 2000. Type 1 diabetes mellitus is an auto immune disorder genetically mediated, while type 2 is more of a life style induced disorder although the role of genetic susceptibility, infections are also equally strong. Many studies have backed up these statements. However, there have been very few researches that show association of diabetes with environmental factors like pollution, exposure to chemicals e.g. mercury, arsenic, psychological condition e.g. depression, stress, and socio-economic conditions e.g. occupation, earnings etc. Recently, the role of these factors in causation and progression of diabetes have received much attention. Thus, this review has been designed to explore more on association of diabetes with physical, socio-economic and psychological environment.

  Download

• Child labour and associated hazards – a descriptive study

  Joshi SK, Sharma SC, Shrestha S.

  Asian-Pacific Newslett on Occup Health and Safety. 12/2009;

  Download

• Injuries: a serious public health problem in Nepal. Activities towards prevention and control of injuries, violence and disabilities in Nepal

  Joshi SK

  12/2009

  Degree: Doctor of Philosophy (PhD)

• Economic and social burden due to injuries and violence in Nepal: a cross-sectional study.

  SK Joshi, S Shrestha

  Kathmandu University medical journal (KUMJ). 01/2009; 7:344-350.

  BACKGROUND: Injury and violence cause five million deaths annually in the world which is around 9% of the global mortality. Eight out of fifteen leading causes of deaths in the age group 15-25 years are injury related. OBJECTIVE: The objective of this study was to assess the incidence, severity and ... [more] BACKGROUND: Injury and violence cause five million deaths annually in the world which is around 9% of the global mortality. Eight out of fifteen leading causes of deaths in the age group 15-25 years are injury related. OBJECTIVE: The objective of this study was to assess the incidence, severity and socio-economic burden of injuries and violence in two cities of Nepal. MATERIALS AND METHODS: Relevant data was collected from 17th August 2008 to 16th September 2008 from injured patients attending emergency departments at six health centres in two cities. RESULTS: In total, 505 injury cases were reported. 42.5% of the injuries occurred in roads and 34.1% at home. 65% of road traffic injuries involved motorcycles. The majority (60%) of the injured subjects were economically active. A single injury case cost 126.2 US$ including all the expenses and the loss due to inability to work. CONCLUSION: The high incidence of injuries, especially road traffic injuries, adds a huge economic burden to nation.

• Asymptomatic throat carriage rate and antimicrobial resistance pattern of Streptococcus pyogenes in Nepalese school children.

  SP Dhumre, K Sapkota, N Adhikari, D Acharya, M Karki, S Bista, SR Basanyat, SK Joshi

  Kathmandu University medical journal (KUMJ). 01/2009; 7:392-396.

  BACKGROUND: Streptococcus pyogenes or Group A streptococcus (GAS) causes several suppurative and non suppurative infections. In addition to pharyngitis and skin infections, GAS are also the causative agent of post-streptococcal infection syndromes such as acute rheumatic fever (ARF) and post-strepto... [more] BACKGROUND: Streptococcus pyogenes or Group A streptococcus (GAS) causes several suppurative and non suppurative infections. In addition to pharyngitis and skin infections, GAS are also the causative agent of post-streptococcal infection syndromes such as acute rheumatic fever (ARF) and post-streptococcal glumerulonephritis (PSG). GAS frequently colonises in the throat of an asymptomatic person. Pharyngeal carriage rates of GAS among healthy school children vary with geographical location and seasons. OBJECTIVES: We carried out this preliminary study to determine the throat carriage rate and antimicrobial resistance trend of Streptococcus pyogenes or Group A streptococcus (GAS) among the Nepalese school children. MATERIALS AND METHODS: Four schools situated at different locations of Kathmandu valley were included in the study. Throat swabs from 350 students of age group 5-15 years were collected, immediately transported to the laboratory and were processed for S. pyogenes following standard microbiolog

• Analysis of possible occupational related lung cancer among the patients attending Bhaktapur Cancer Centre, Bhaktapur, Nepal

  Joshi SK

  07/2002

  Degree: Master of Philosophy (M Phil)
• 5.65

  Impact points

  Flexibility in MHC and TCR recognition: degenerate specificity at the T cell level in the recognition of promiscuous Th epitopes exhibiting no primary sequence homology.

  S K Joshi, P R Suresh, V S Chauhan

  Journal of immunology (Baltimore, Md. : 1950). 07/2001; 166(11):6693-703.

  Recognition of peptide Ags by T cells through the TCR can be highly specific. In this report we show the degeneracy of Ag recognition at both MHC and TCR levels. We present evidence that unrelated promiscuous Th cell epitopes from various protein sources exhibit sufficient structural homology, despi... [more] Recognition of peptide Ags by T cells through the TCR can be highly specific. In this report we show the degeneracy of Ag recognition at both MHC and TCR levels. We present evidence that unrelated promiscuous Th cell epitopes from various protein sources exhibit sufficient structural homology, despite minimal structural identity, to elicit cross-reactive proliferative responses at the bulk T cell level. This epitopic mimicry was also observed when peptide (CS.T3(378-395) and TT(830-844))-specific CD4+ T cell lines and T cell hybridoma clones were used in proliferation and Ag presentation assays. A scrambled CS.T3(378-395) peptide did not show any proliferation, indicating that the specificity of the cross-reactive responses may be linked with the primary structure of the peptides. Blocking of CS.T3(378-395)-specific CD4+ T cell proliferation by anti-MHC class II mAb showed that recognition of promiscuous T cell epitopes is largely in association with MHC class II molecules. These findings suggest that promiscuous Th epitopes may be useful in designing peptide-based vaccine constructs. At the same time these results show that at the T cell level there may be a great deal of immunological cross-reactivity between heterologous pathogens, and because of this the host's response to a pathogen may be modified by its previous experience with other unrelated pathogens.
• 14.51

  Impact points

  Conditional vascular cell adhesion molecule 1 deletion in mice: impaired lymphocyte migration to bone marrow.

  P A Koni, S K Joshi, U A Temann, D. Olson, L Burkly, R A Flavell

  The Journal of experimental medicine. 04/2001; 193(6):741-54.

  We generated vascular cell adhesion molecule (VCAM)-1 "knock-in" mice and Cre recombinase transgenic mice to delete the VCAM-1 gene (vcam-1) in whole mice, thereby overcoming the embryonic lethality seen with conventional vcam-1-deficient mice. vcam-1 knock-in mice expressed normal levels ... [more] We generated vascular cell adhesion molecule (VCAM)-1 "knock-in" mice and Cre recombinase transgenic mice to delete the VCAM-1 gene (vcam-1) in whole mice, thereby overcoming the embryonic lethality seen with conventional vcam-1-deficient mice. vcam-1 knock-in mice expressed normal levels of VCAM-1 but showed loss of VCAM-1 on endothelial and hematopoietic cells when interbred with a "TIE2Cre" transgene. Analysis of peripheral blood from conditional vcam-1-deficient mice revealed mild leukocytosis, including elevated immature B cell numbers. Conversely, the bone marrow (BM) had reduced immature B cell numbers, but normal numbers of pro-B cells. vcam-1-deficient mice also had reduced mature IgD+ B and T cells in BM and a greatly reduced capacity to support short-term migration of transferred B cells, CD4+ T cells, CD8+ T cells, and preactivated CD4+ T cells to the BM. Thus, we report an until now unappreciated dominant role for VCAM-1 in lymphocyte homing to BM.
• 4.21

  Impact points

  Analysis of immune responses against T- and B-cell epitopes from Plasmodium falciparum liver-stage antigen 1 in rodent malaria models and malaria-exposed human subjects in India.

  S K Joshi, A Bharadwaj, S Chatterjee, V S Chauhan

  Infection and immunity. 02/2000; 68(1):141-50.

  Liver-stage antigen 1 (LSA-1) is a potential vaccine candidate against preerythrocytic stages of malaria. We report here the immunogenicity of linear synthetic constructs delineated as T(H)-cell determinants from the nonrepeat regions of Plasmodium falciparum LSA-1 in murine models and human subject... [more] Liver-stage antigen 1 (LSA-1) is a potential vaccine candidate against preerythrocytic stages of malaria. We report here the immunogenicity of linear synthetic constructs delineated as T(H)-cell determinants from the nonrepeat regions of Plasmodium falciparum LSA-1 in murine models and human subjects from areas where malaria is endemic in Rajasthan State, India. Seven peptide constructs (LS1.1 to LS1.7) corresponding to predicted T-cell sites from both the N- and C-terminal regions and peptide LS1R from a repeat region of PfLSA-1 were synthesized to analyze the cellular immune responses. These linear peptides were also tested for humoral responses in order to determine if there were any overlapping B-cell epitopes in the predicted T-cell sites. Most peptides induced cellular responses in peptide-immunized BALB/c and C57BL/6 mice as measured by proliferation and cytokine analysis. Cross-reactive T-cell recognition of P. falciparum-based peptides in Plasmodium berghei-immune animals was evaluated, but only one peptide, LS1.2 (amino acids 1742 to 1760) triggered T-cell proliferation and interleukin-2 and gamma interferon secretion in P. berghei-immune splenocytes of BALB/c and C57BL/6 mice as well as in Thamnomys gazellae (natural host of P. berghei ANKA). In an enzyme-linked immunosorbent assay with the peptides, only one peptide, LS1.1, was recognized by anti-P. berghei liver-stage serum. Three peptides (LS1. 1, LS1.2, and LS1.3) of the eight peptides tested in this study were recognized by a relatively large percentage of P. falciparum-exposed human subjects; the reactivities ranged from approximately 45% for LS1.3 to approximately 60% for LS1.1 and LS1.2. Interestingly, all of the eight putative T-cell determinants were also recognized by the sera collected from malaria patients, although the response was variable in nature. These T(H)- and B-cell epitopes may be of potential value for preerythrocytic antigen-based malaria subunit vaccine formulations.
• 3.29

  Impact points

  A colorimetric assay for heme in biological samples using 96-well plates.

  A V Pandey, S K Joshi, B L Tekwani, V S Chauhan

  Analytical biochemistry. 04/1999; 268(1):159-61.
• 4.21

  Impact points

  Induction of protective immune responses by immunization with linear multiepitope peptides based on conserved sequences from Plasmodium falciparum antigens.

  A Bharadwaj, P Sharma, S K Joshi, B Singh, V S Chauhan

  Infection and immunity. 07/1998; 66(7):3232-41.

  A cysteine-containing peptide motif, EWSPCSVTCG, is found highly conserved in the circumsporozoite protein (CSP) and the thrombospondin-related anonymous protein (TRAP) of all the Plasmodium species analyzed so far and has been shown to be crucially involved in the sporozoite invasion of hepatocytes... [more] A cysteine-containing peptide motif, EWSPCSVTCG, is found highly conserved in the circumsporozoite protein (CSP) and the thrombospondin-related anonymous protein (TRAP) of all the Plasmodium species analyzed so far and has been shown to be crucially involved in the sporozoite invasion of hepatocytes. We have recently shown that peptide sequences containing this motif, and also the antibodies raised against the motif, inhibit the merozoite invasion of erythrocytes. However, during natural infection, and upon immunization with recombinant CSP, this motif represents a cryptic epitope. Here we present the results of immunization studies with two linear multiepitopic constructs, a 60-residue (P60) and a 32-residue (P32) peptide, containing the conserved motif sequence. Both the peptides per se generated high levels of specific antibodies in BALB/c mice. P32 was found to be genetically restricted to H-2(d) and H-2(b) haplotypes of mice, whereas P60 was found to be immunogenic in five different strains of mice. The antibody response was predominantly targeted to the otherwise cryptic, conserved motif sequence in P60. Anti-P60 antibodies specifically stained the asexual blood stages of Plasmodium falciparum and Plasmodium yoelii in an immunofluorescence assay, recognized a 60- to 65-kDa parasite protein in an immunoblot assay, and blocked P. falciparum merozoite invasion of erythrocytes in a dose-dependent manner. Immunization with P60 also induced significant levels of the cytokines interleukin-2 (IL-2), IL-4, and gamma interferon in BALB/c mice. Moreover, >60% of mice immunized with P60 survived a heterologous challenge infection with a lethal strain of P. yoelii. These results indicate that appropriate medium-sized synthetic peptides might prove useful in generating specific immune responses to an otherwise cryptic but critical and putatively protective epitope in an antigen and could form part of a multicomponent malaria vaccine.
• 0.75

  Impact points

  Peak expiratory flow rate of carpet weaving children.

  S K Joshi, P Sharma, U Sharma, S Sitaraman, S S Pathak

  Indian pediatrics. 03/1996; 33(2):105-8.

  OBJECTIVE: To assess the adverse influence of carpet weaving on lung functions and the nurtritional status of children employed in such factories. DESIGN: Comparison of the peak expiratory flow rate (PEFR) of the study group with controls of similar socio-economic status and correlate it with anthro... [more] OBJECTIVE: To assess the adverse influence of carpet weaving on lung functions and the nurtritional status of children employed in such factories. DESIGN: Comparison of the peak expiratory flow rate (PEFR) of the study group with controls of similar socio-economic status and correlate it with anthropometric values. SETTING: Field study. SUBJECTS: One hundred and ten boys, 6-15 years of age engaged in 23 carpet weaving factories of Jaipur city. OUTCOME MEASURES: Linear regression analysis using age, height and weight as independent variables and PEFR as the dependent variable. RESULTS: PEFR of carpet weaving children were significantly lower (p < 0.05) than controls for all except 6-7 years group. The height, weight and chest circumference of these children were also lower (p < 0.05). PEFR did not show significant difference when children were grouped according to their height. CONCLUSIONS: Children working in carpet weaving factories are shorter and lighter compared to normal school going children. As a consequence of the growth retardation, their PEFR values were also lower as compared to normal children.
• 0.75

  Impact points

  Health status of carpet weaving children.

  S K Joshi, U Sharma, P Sharma, S S Pathak, S Sitaraman, C R Verma

  Indian pediatrics. 06/1994; 31(5):571-4.

  A cross-sectional study was undertaken to determine the health status of children engaged in carpet weaving factories of Jaipur City. Two hundred and ninety school going boys of similar socio-economic status served as controls. A higher prevalence of signs of nutritional deficiencies was observed in... [more] A cross-sectional study was undertaken to determine the health status of children engaged in carpet weaving factories of Jaipur City. Two hundred and ninety school going boys of similar socio-economic status served as controls. A higher prevalence of signs of nutritional deficiencies was observed in carpet weaving children. Analysis of the presenting complaints and the illness suffered in the past six months also revealed a significantly higher morbidity in these children. A statistically significant difference was also observed in anthropometric measurements of the two groups.

• Transcatheter therapeutic arterial embolization of renal tumours.

  N Malik, S K Sharma, B Nagi, S K Joshi, S Dhawan, S Jain, J S Sodhi

  Indian journal of cancer. 10/1981; 18(3):218-21.

• Meningitis due to Haemophilus Influenza.

  K B Grant, R N Ichaporia, S K Joshi, R S Wadia

  The Journal of the Association of Physicians of India. 09/1965; 13(8):619-26.

• CLINICAL STUDIES IN ISCHAEMIC HEART DISEASE.

  K B Grant, G S Mutalik, R S Wadia, S K Joshi

  The Journal of the Association of Physicians of India. 07/1964; 12:407-17.

• Occupational health in small scale and household industries in Nepal: a situation analysis.

  S K Joshi, P Dahal

  Kathmandu University medical journal (KUMJ). 6(2):152-60.

  Introduction: Making working conditions safe and healthy is the interest of workers, employers and the Government. Although it seems simple and obvious, this idea has not yet gained meaningful recognition in Nepal. Methods: The study was conducted in ten small scale industries of Kathmandu valley. A... [more] Introduction: Making working conditions safe and healthy is the interest of workers, employers and the Government. Although it seems simple and obvious, this idea has not yet gained meaningful recognition in Nepal. Methods: The study was conducted in ten small scale industries of Kathmandu valley. Altogether 545 questionnaires on socioeconomic and occupational history were filled up. Similarly, Workplace Occupational Health Assessment was done in all ten industries. A thorough medical examination of 135 child workers was done using a structured questionnaire to find out the health effects due to occupational hazards. Results: Out of the total 545 workers present in the industries under study, 135 (24.8%) were child workers. Higher proportion of child workers (97%) was illiterate compared to 3% of children with primary level education. Among the child workers, 23 (17%) were girls. The majority of the child labourers were suffering from conditions like otitis externa, otitis media, scabies, anaemia, upper respiratory diseases, nasal problems, abdominal pain etc. Conclusion: The occupational health and safety practices in small scale industries in Kathmandu have been found to be unsatisfactory. Child labour is a serious problem. Out of ten industries, six have employed child workers and the working conditions range from bad to terrible. Health and welfare of the child workers was also not satisfactory. Keywords: Situation Analysis, Occupational Hazards, Occupational Health and Safety, Small Scale and Household Industries, Child Labour, Kathmandu, Nepal.