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Eco-restoration initiative work in the high altitude Dayara pastureland (3501 m) from the Indian Himalayan Region has been considered to be one of the successful field demonstration against both natural and anthropogenic degradation. The present study therefore attempts to assess the implications of entire eco-restoration model as practiced by Department of Forest, Government of Uttarakhand in 2019. Its assessment was done by calculating restoration success index by way of considering three categories, viz., direct management measure (M), environmental desirability (E) and socio-economic feasibility (SE) considering 22 individual variables. 'M' comprised both biotic and abiotic pressures. Grazing and tourism were biotic, while abiotic pressure was considered mainly soil erosion in alpine area due to topographic fragility. Above ground vegetation profile and below ground soil nutrient profile (N, P, K, pH and water holding capacity) were analyzed in 'E' component. In the last but not least, 'SE' was analyzed to assess the social acceptability of the local communities and stakeholders who are supposed to be ultimate beneficiary of alike interventions. Direct management measure was found with the variable index score of 0.8 indicating the higher score as compared to environmental desirability (0.56). Under direct management measure, grazing and tourists' carrying capacity of the area was analyzed with high management needs to call the region sustainable in terms of availability of bio-resources. The ecosystem index score was evaluated for the reference (81.94), treated (64.5) and untreated zones (52.03), wherein increasing profile of these values were found. The outcomes like improved vegetation profile in terms of total herb density, soil nutrient profile of the restored area along with soil pH (4.96) and water holding capacity (49.85%) were found to be restored significantly along with controlling 169.64 tonne year -1 soil erosion from draining. The assessment of grazing pattern of 118 migratory Cow Unit (CU) (76 horse/mule and 18 sheep/goat, already controlled), 318 local CU (30 horse/mule and 187 sheep/goat) were calculated and recommended to be controlled. Tourists' carrying capacity of 274 tourists per day and manual removal of Rumex nepalensis at the shepherd camping site were found to be worth to apply in the area. Use of biodegradable but locally sourced material and engaging local villagers in this endeavor were also found to be in harmony with SDG Goal 1 (no poverty). Therefore, the restoration and its evaluation model could have its future prospects to prove as a successful restoration practice. This restoration practice could not only be worth in high altitude degraded alpine pastures of the Indian Himalayan Region but also to other mountain alpine and sub-alpine ecosystems., (© 2021. The Author(s).)

Purpose: To compare early outcome after total knee arthroplasty (TKA) in women with a positive or negative urine culture., Methods: 128 women underwent bilateral (n=89) or unilateral (n=39) primary TKA. Diabetes mellitus was present in 38%, obesity in 53%, and asymptomatic urinary tract infection (positive urine culture) in 36% of women. Women with a positive or negative urine culture were compared., Results: In the 46 women with a positive urine culture, Escherichia coli (n=29) and Klebsiella (n=17) were grown. Women with a positive or negative urine culture were comparable in terms of the incidence of diabetes (28% vs. 43%, p=0.1), obesity (52% vs. 54%, p=0.87), fever (9% vs. 15%, p=0.32), leucocytosis (28% vs. 17%, p=0.13), and delayed wound healing (0% vs. 1%, p=0.45)., Conclusion: Women with or without a positive urine culture had comparable early complication rates following TKA.

Basal ganglia stroke is known following trivial head trauma. Recently a distinct clinic-radiological entity termed 'mineralizing angiopathy' was described. We report an infant who developed basal ganglia stroke following trivial fall. His clinic-radiological features are described.

Analytical functioning of a point-of-care analyzer, i-Smart 30 (i-sens: Seoul, South Korea), for electrolyte quantification was investigated at Sant Parmanand Hospital, a tertiary-care hospital in Delhi, India. Samples that were received for electrolyte assay were assayed, double-blinded for their Na and K level using the arterial blood gas analyzer, the ABL 555 (Radiometer, Copenhagen) and the i-Smart 30 electrolyte analyzer. There was satisfactory correlation between the results obtained with the two analyzers with an encouraging bias, standard deviation and the 95 % limits of agreement between the data generated for Na and K levels. The performance of the i-Smart 30 would be satisfactory during the point-of-care measurements of Na and K levels in emergency rooms and clinical laboratories with inadequate infrastructure only if its day-to-day performance was monitored to ensure reliability of the generated reports.

The objective of this study was to investigate the impact of clinical syndrome-wise categorisation of antimicrobials on the antibiotic susceptibility of nosocomial bacteria at a tertiary care hospital in Delhi, India. The susceptibility of 226 nosocomial bacterial isolates collected during 2008-2011 to meropenem, piperacillin/tazobactam, cefepime, tigecycline, amoxicillin/clavulanic acid (AMC), amikacin, ceftriaxone and ciprofloxacin was monitored and was compared with the antibiotic susceptibility profiles of 72 isolates collected during 2002-2007. During 2008-2011, the isolates included 85% Gram-negative isolates and 15% meticillin-sensitive staphylococci. There was no difference in the susceptibility of the isolates between 2002 and 2007 and 2008-2011, except for a significant increase in Escherichia coli isolates susceptible to AMC (from 73% to 100%), amikacin (70-100%) and cefepime (22-86%), in Klebsiella isolates susceptible to ciprofloxacin (from 25% to 80%) and cefepime (45-75%) and in Pseudomonas isolates susceptible to AMC (from 25% to 86%). In conclusion, during the past decade a clinical syndrome-wise categorisation of antimicrobials in frequent usage as well as culture-based categorisation of infections into nosocomial/community-acquired was useful in establishing the generally insignificant change in the susceptibility of nosocomial isolates and an upsurge in the susceptibility of some isolates to a few antimicrobials. Regular updates on drifts in the antimicrobial susceptibility of local isolates and surveillance of nosocomial infections would be valuable for tackling the emergence of antibiotic-resistant bacteria., (Copyright © 2013 International Society for Chemotherapy of Infection and Cancer. Published by Elsevier Ltd. All rights reserved.)

The mortality, morbidity and economic loss accompanying hospital acquired infection (HAI) needs constant surveillance. The usefulness of an integrated culture-based watch on the incidence of HAI was established at a tertiary care, multidisciplinary hospital in Delhi. Isolates from all culture-positive hospitalized cases including antibiotic susceptibility profiles were shared instantly with clinicians and nursing personnel. HAI categorization was based on the interval between hospital admission and isolation of a pathogen. The monthly incidence of HAI was calculated as episodes per 100 admissions, while the nature of HAI isolates including infection sites were computed annually. During 2008 to 2010, the monthly HAI rates ranged from 0 to 0.9 per 100 admissions, with no significant difference in annual incidence (P = 0.45, Kruskal Wallis). There was a subtle but insignificant change in HAI localization in urine, blood, pulmonary tissues or surgical sites of the patients (P = 0.104). While 197 of the 229 isolates were Gram-negative, Klebsiella species, E Coli, Pseudomonas aeroginosa, there were 32 methicillin-sensitive Staphylococcus aureus (P < 0.0001). The combined strategy of constant surveillance of all culture-positive hospitalized cases and dialogues with clinicians, and nursing personnel enabled a monitoring of HAI incidence and ensured freedom from any spikes of HAI episodes or their cross infection, it was possible to monitor the incidence of HAI and to ensure there were no episodes on any spikes or a cross-infection. An identical nonstop approach should result in an earlier detection and management of HAI., (Copyright © 2013 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.)