Knowledge of Rights of Persons with Disability (RPwD) Act and caregiver burden in depressed parents of children with intellectual disability

Background: Caregiver burden and depression are related in parents of children with intellectual disability (ID), however, few Indian studies have addressed this. The Rights of Persons with Disabilities (RPwD) Act, 2016 outlines several benefits for persons with disability, but no study has looked into the knowledge parents of children with ID have about it. The present study assessed caregiver burden and the knowledge regarding RPwD Act in depressed parents of children with ID.. Methodology: The present cross – sectional, observational study recruited 50 parents of children with ID, diagnosed with Major Depressive Disorder as per DSM – 5. They were administered the Hamilton’s Depression Scale (HAM – D) and Pai and Kapur’s Family Burden Interview Schedule (FBIS) to assess for severity of depression and caregiver burden respectively. A semi-structured questionnaire was developed to assess knowledge of RPwD Act. Results: 26% of depressed parents had severe caregiver burden. Severity of depression correlated positively with caregiver’s and child’s age. Caregiver burden did not correlate with any factor. 88% of the parents were aware about the RPwD Act and certification procedure but more than 50% did not know regarding the specific provisions. Lowest knowledge was seen regarding tax rebates (4%), followed by reservations (6%). Conclusion: Caregiver burden is present in approximately one – fourth of caregivers with depression. Older children and older caregivers have more severe depression. Knowledge regarding tax rebates, educational and financial benefits in the RPwD Act appears to be poor in caregivers with depression.

Comparison of biochemical characterisation of ICRC bacilli with M. leprae: effect of substrate alteration in the medium.

ICRC-bacilli strain C-44 when grown in Dubos medium of its equivalent, express M. avium taxonomic biochemical characters. Assuming that difference in characters of M. leprae and ICRC bacilli, could be due to 'in vivo' and 'in vitro' milieu, we altered the substrates in the medium. The bacilli grow well in the new medium containing selenium, ferric nitrate, magnesium chloride and deleting Tween 80. The ICRC strain C-44 grown in new medium expressed characters: 9/10 similarity with M. leprae. The 10 day tween hydrolysis reaction in weak but positive. It is probable that 'M. leprae culture isolate', may have acquired 'in vitro' growth potential by recombination with M. avium, an ubiquitous mycobacterium. The M. leprae culture isolate thus may express some characters of both M. leprae and M. avium.

Antigeneic cross-reactivity between ICRC-bacilli and M. leprae--"in vitro" evaluation.

Leucocyte migration inhibition, in presence of specific particulate antigen, is a good correlate of CMI. It can detect small differences in related antigens. In the present study, LMI was used to study the cross-reactivity between ICRC bacilli and M. leprae and also to examine the antigenic relationship amongst different ICRC isolates. The study showed a close antigenic cross-reactivity in lepromin and ICRC-in. LMI has brought out strain differences in two ICRC culture isolates, C-44 and C-75. The data appear to elucidate the possible strain specific antigenic relationship of M. leprae with its culture isolate e.g. ICRC strains. This may have important bearing on the development effective antileprosy vaccine for human use.

Dopa-oxidase activity on ICRC bacilli.

Presence of O-phenoloxidase is regarded as M. leprae specific character. This enzyme activity was found to be present in ICRC bacilli, Strain C-44. Though this strain is cultivable 'in vitro', the expression of DOPA-Oxidase activity strongly suggests that it carries M. leprae genome. The ICRC bacilli, therefore, may thus from a group of M. leprae culture isolates, distinct from other known cultivable mycobacteria which do not possess this enzyme activity.