Occupational therapy in rural India

India is called the land of villages. In 1951, 82.7% of the Indian population lived in rural areas. Sanskritisation and urbanisation have changed the pattern. It is expected that by the year 2020 this percentage would come down to 55%. These villagers are relocating in urban slums. Thus from the rehabilitation point of view both problems pose challenges. An Indian village community is a political, economic and cultural unit. At the urban slum area at Malwani and in small villages near Juchandra, community rehabilitation programmes were found to be most pragmatic. Community education and preventive occupational therapy are found to be essential steps in rural rehabilitation. Therapists have to work on ‘disability, attitude and beliefs’ and change the behaviour to deal with the grass root (basic) causes. It is felt that for longer sustainment, community-based rehabilitation should originate within the community. Heath professionals must recognise the capabilities of individuals within the support structure of the family and community, while helping individuals to improve the quality of their lives.     

Unusual presentation of culture positive brucellosis

We have reviewed the clinical presentation of 100 consecutive culture positive cases of brucellosis which came under our care during the last two years. Of these, six had atypical presentations and but for the routine practice of sending blood for brucella culture, the diagnosis would have been missed. The unusual presentations included a 19 year old boy presenting as an acute abdomen ending in laparotomy, a 52 year old man presenting with a psoas abscess, a 29 year old woman presenting with a transient perinephric mass, a 75 year old man with an acute flare up of his osteoarthritis, a 65 year old diabetic man presenting in an insulin-resistant diabetic state and a 35 year old man presenting with a cauda equina syndrome.     

Ascorbic acid metabolism in rats and guinea pigs after the administration of ethanol

Ascorbic acid metabolism was studied in guinea pigs and rats after the administration of ethanol and a high dose of ascorbic acid (AA). Male guinea pigs were maintained for 30 days as follows: (1) controls (1 mg AA/100 g body wt.); (2) ethanol (1 mg AA/100 g body wt. + 900 mg ethanol/100 g body wt); (3) ascorbic acid (25 mg AA/100 g body wt.); (4) ascorbic acid + ethanol (25 mg AA/100 g body wt. + 900 mg ethanol/100 g body wt.). Rats were also grouped into four groups as in the case of guinea pigs, but the dose of AA was 200 mg/100 g body weight. Rats adjusted to ethanol intoxication by enhancing the biosynthesis of ascorbate as evidenced by elevated activity of L-gulono lactone oxidase (GLO). Hence ascorbate levels were not lowered in rats after administration of alcohol. However, alcohol administration lowered tissue levels of ascorbate in guinea pigs. But the supplementation of ascorbate along with alcohol raised the tissue level of this vitamin. Guinea pigs responded to the ascorbate deficiency during alcohol administration by lowering the degradation of ascorbate, as seen by the lower activity of the degrading enzyme gulono lactone hydrolase. It is concluded that on the administration of alcohol, guinea pigs are dependent upon additional exogenous supplies of ascorbic acid, whereas rats are not.     

Use of in vivo-induced antigen technology for identification of Escherichia coli O157:H7 proteins expressed during human infection

Using in vivo-induced antigen technology (IVIAT), a modified immunoscreening technique that circumvents the need for animal models, we directly identified immunogenic Escherichia coli O157:H7 (O157) proteins expressed either specifically during human infection but not during growth under standard laboratory conditions or at significantly higher levels in vivo than in vitro. IVIAT identified 223 O157 proteins expressed during human infection, several of which were unique to this study. These in vivo-induced (ivi) proteins, encoded by ivi genes, mapped to the backbone, O islands (OIs), and pO157. Lack of in vitro expression of O157-specific ivi proteins was confirmed by proteomic analysis of a mid-exponential-phase culture of E. coli O157 grown in LB broth. Because ivi proteins are expressed in response to specific cues during infection and might help pathogens adapt to and counter hostile in vivo environments, those identified in this study are potential targets for drug and vaccine development. Also, such proteins may be exploited as markers of O157 infection in stool specimens.