EnZolv delignification of cotton spinning mill waste and optimization of process parameters using response surface methodology (RSM).

BACKGROUND: EnZolv is a novel enzyme-based, eco-friendly biomass pretreatment process that has shown great potential in the field of textile engineering and biotechnology. It employs laccase from Hexagonia hirta MSF2 and 2% ethanol in the process of delignification. The process is designed to evaluate optimal conditions to remove lignin and other impurities from cotton spinning mill waste (CSMW), without compromising the quality and strength of the fibers. CSMW is a low-cost and readily available source of cellulose, making it an ideal candidate for delignification using EnZolv. By optimizing the pretreatment conditions and harnessing the potential of enzymatic delignification, this research aims to contribute to more sustainable and efficient ways of utilizing lignocellulosic biomass in various industries for the production of biochemical and bioproducts. RESULTS: The present study emphasizes the EnZolv pretreatment in the delignification of cotton spinning mill wastes irrespective of the cellulose content. EnZolv process parameters such as, moisture content, enzyme load, incubation time, incubation temperature, and shaking speed were optimized. Under pre-optimized conditions, the percent lignin reduction was 61.34%, 61.64%, 41.85%, 35.34%, and 35.83% in blowroom droppings (BD), flat strips (FS), lickerin fly (LF), microdust (MD) and comber noils (CN), respectively. Using response surface methodology (RSM), the statistically optimized EnZolv pretreatment conditions showed lignin reduction of 59.16%, 62.88%, 48.26%, 34.64%, and 45.99% in BD, FS, LF, MD, and CN, respectively. CONCLUSION: Traditional chemical-based pretreatment methods often involve harsh chemicals and high energy consumption, which can have detrimental effects on the environment. In contrast, EnZolv offers a greener approach by utilizing enzymes that are biodegradable and more environmentally friendly. The resulting fibers from EnZolv treatment exhibit improved properties that make them suitable for various applications. Some of the key properties include enhanced cellulose recovery, reduced lignin content, and improved biophysical and structural characteristics. These improvements can contribute to the fiber's performance and processability in different industries and future thrust for the production of cellulose-derived and lignin-derived bioproducts.

Validation of satisfaction questionnaire for services provided in the labour rooms of government health facilities.

INTRODUCTION AND OBJECTIVES: Using the assessment of satisfaction of patients of labour room services, the caregiver or policymakers can identify the gaps in the implemented programmes and health policies. This study was aimed to design a valid and reliable satisfaction questionnaire that will help in identifying the aspects of gaps that need improvement. METHODS: A facility and community-based observational cross-sectional study was conducted in the district of western Uttar Pradesh (India) between January 2019 and August 2020. Validation of the structured questionnaire with 34 dichotomous questions categorized under five subscales was performed by evaluating its validity and reliability. A total of 380 beneficiaries were selected from 48 government health facilities. RESULTS: The calculated Content validity index was calculated to be 9.5 which was adequate as per the guidelines. The reliability analysis of the questionnaire showed that the internal consistency was high with an overall Cronbach's alpha of 0.710. The variation in Cronbach's alpha on the elimination of any question from the questionnaire ranged from 0.676 to 0.767. The mean patient satisfaction score in the total surveyed population was 24.39±4.684 (total score=34) and there was a greater variation in the satisfaction score of infrastructure when compared with other subscales. CONCLUSION: The findings from this study support the reliability and validity of the patient satisfaction questionnaire as it is capable of evaluating the satisfaction in terms of delivery services provided in labour rooms as a whole.

ANN-GA based biosorption of As(III) from water through chemo-tailored and iron impregnated fungal biofilter system.

The iron impregnated fungal bio-filter (IIFB) discs of luffa sponge containing Phanerochaete chrysosporium mycelia have been used for the removal of As(III) from water. Two different forms of same biomass viz. free fungal biomass (FFB) and modified free fungal biomass (chemically modified and iron impregnated; CFB and IIFB) have been simultaneously investigated to compare the performance of immobilization, chemo-tailoring and iron impregnation for remediation of As(III). IIFB showed highest uptake capacity and percentage removal of As(III), 1.32 mg/g and 92.4% respectively among FFB, CFB and IIFB. Further, the application of RSM and ANN-GA based mathematical model showed a substantial increase in removal i.e. 99.2% of As(III) was filtered out from water at optimised conditions i.e. biomass dose 0.72 g/L, pH 7.31, temperature 42 °C, and initial As(III) concentration 1.1 mg/L. Isotherm, kinetic and thermodynamic studies proved that the process followed monolayer sorption pattern in spontaneous and endothermic way through pseudo-second order kinetic pathway. Continuous mode of As(III) removal in IIFB packed bed bioreactor, revealed increased removal of As(III) from 76.40 to 88.23% with increased column height from 5 to 25 cm whereas the removal decreased from 88.23 to 69.45% while increasing flow rate from 1.66 to 8.30 mL/min. Moreover, the IIFB discs was regenerated by using 10% NaOH as eluting agent and evaluated for As(III) removal for four sorption-desorption cycles, showing slight decrease of their efficiency by 1-2%. SEM-EDX, pHzpc, and FTIR analysis, revealed the involvement of hydroxyl and amino surface groups following a non-electrostatic legend exchange sorption mechanism during removal of As(III).

Interference of bio-control Trichoderma to enhance physical and physiological strength of sugarcane during Pokkah boeng infection.

Tremendous benefits have been derived from the use of fungicides but excessive use of chemical fungicides not only posing threat to human and animal life but also contaminates the prevailing environment. Damage by pathogenic fungi alone causes significant damage to crops like maize, rice, wheat, soybeans, and potatoes. Therefore, it becomes imperative that these diseases are checked and controlled, for which chemical pesticides are being sprayed on plants extensively. Considering the devastating damage and toxicity, the global focus has taken a drift from synthetic chemicals to nature-friendly biological control agents. The present study focuses on the use of biological control agents particularly Trichoderma in sugarcane during Pokkah boeng infection. In the present experiment, twenty promising Trichoderma strains were evaluated for plant growth promotion, lytic enzymes, and physiological and biocontrol activity. Out of the twenty, four potential Trichoderma strains were assessed in the pot experiment viz. T. harzianum strain T28, T41 and T49 and T. aureoviride strain T38. The T. harzianum (T28) showed efficient plant growth-promoting traits as it produced IAA (20.67 µg/ml), phosphorus solubilization (18.57 µg/ml), and cell wall degrading enzymes such as chitinase (24.98 µg/ml) and ß-glucanase (29.98 µg/ml). The interference of biocontrol agent T. harzianum (T28) controlled the disease by 73.55%. Apart from this, the inoculation of Trichoderma (T28) enhanced growth attributes including germination percentage (26.61%), mean tiller number (8.28 tiller/pot), individual cane length (241.5 cm), single cane weight (1.13 kg) and the number of milleable canes (6.00 cane/pot). Improvements in physiological activities at different growth stages of the sugarcane crop were observed based on the photosynthetically active radiation (PAR) on the leaf surface, transpiration rate, stomatal conductance, and photosynthetic rate. Further, improvement in juice quality parameters was also observed as it recorded the highest 0brix, sucrose, and commercial cane sugar by 21.26%, 19.28%, and 13.50%, respectively, by applying T. harzianum strain T28. Thus, results proved that T. harzianum strain T28 may be an effective eco-friendly biocontrol tool for managing Pokkah boeng disease in sugarcane. This is the first report of the biocontrol potential of Trichoderma spp. against Fusarium proliferatum causing Pokkah boeng disease in sugarcane.

Diversification Options in Sugarcane-Based Cropping Systems for Doubling Farmers' Income in Subtropical India.

Crop diversification provides an opportunity for farmers to maximize their profits, fulfilling multiple needs, avoid monsoon threats, and make the crop production system sustainable. Inclusion of various pulse/oilseed/vegetables/cereals/medicinal/aromatic crops with sugarcane brings forth cultivation of these crops in irrigated agro-system and improves the yields of component crops. Besides, the component crops improve soil fertility and create a favorable environment for the further growth of sugarcane crops. Sprouting in winter-initiated sugarcane ratoon could be enhanced by adopting fodder legumes such as Indian clover and Egyptian clover. Intercropping vegetables provides an ample opportunity for mid-season income generation and improves profitability. Besides, high-value medicinal and aromatic crops such as tulsi (holy basil), mentha could also be included in the sugarcane-based system. Crop residue management has been recognized as a critical issue in managing the crops in the various cropping systems. Including multiple bio-agents for fast decomposition of crop residues provides scope for managing soil organic carbon through crop residue recycling in the system. Resource use efficiencies, nutrient use, water use, and weed control could be increased by adopting suitable crops in intercropping systems. An integrated farming system involving crop, livestock, and fisheries options could improve farmers' profit besides employment generation in rural India. Recycling of bye products and co-products of other enterprises influences the viability and farmer's profitability of the system. Trash, press mud cake, vinasse, composted bagasse, rhizodeposition of stubble play a significant role in sustaining soil fertility and increasing crop productivity. New emerging crop diversification options, viz., intercropping of rajmash, winter maize, and garlic in autumn cane generate mid-season income and enhance the system's profitability for small and marginal cane growers. Dual-purpose legumes, viz., cowpea, and green gram as intercrops with spring-planted cane increase the pool of soil microbial biomass nitrogen capitalize allelopathic effects and sustain soil health. In the present paper, these issues have been discussed. Due to the adoption of location-specific and farmers-centric systems, farmers' profitability could be increased, providing sustainability to the sugarcane-based systems.

Impact of poor evidence management on DNA profiling in sexual assault and homicide: A case report.

Increasing numbers of female victims of violent sexual assaults are being murdered with the aim of concealing the identity of the perpetrator. Proper handling and analysis of evidence is very important in gaining a conviction in many criminal cases. After evidence is collected, due precautions must be taken to ensure that the integrity of the sample is maintained, and chances of contamination are minimised. This paper presents a case study where improper handling of biological evidence led to loss of evidentiary value, and the semen could not be located on the vaginal swabs and victim's garments due to improper preservation of samples. However, the DNA from the nail of a decomposed finger helped identify the victim, and the suspect was apprehended based on the clues given by her family.

Pancreatic exocrine insufficiency occurs in most patients following pancreaticoduodenectomy.

BACKGROUND: Pancreatic exocrine insufficiency (PEI) is a well-defined complication of malignant diseases and pancreatic resection; however, study results of PEI are less consistent. Assessment of PEI by estimation of fecal elastase (FE)-1 in stool by enzyme-linked immunosorbent essay (ELISA) is a relatively inexpensive, noninvasive, and simple test. This study assessed exocrine function of pancreas following pancreaticoduodenectomy (PD) by estimating FE-1. METHODS: This prospective hospital-based study involved 30 patients who had undergone PD for malignancy. All 30 patients had an uneventful postoperative period under the unit's enhanced recovery after surgery (ERAS) protocol with no Grade B, C postoperative pancreatic fistula/postpancreatectomy hemorrhage as per the International Study Group of Pancreatic Surgery (ISGPS) definitions. Stool samples were collected postoperatively 3 months after surgery from all patients irrespective of clinical symptoms. The analysis was based on a solid phase ELISA used for the quantitative determination of human elastase 1 in feces. Fecal elastase was considered normal if >200 µg/gm stool, moderately reduced if 100-200 µg/gm stool, and severely reduced if <100 µg/gm stool. RESULTS: Among 30 patients included, fecal elastase levels were moderately reduced in 10 (33.33%) and severely reduced in 20 (66.67%) patients (P <0.0001). Mean (± standard deviation) of fecal elastase was 87.12 ± 38.76 with median of 74.6 µg/gm stool. There was no significant difference in the fecal elastase levels between men and women (P = 0.057), age (P = 0.48), pancreatic duct diameter (P = 0.609), pancreatic texture (P = 0.286), and presence or absence of clinical symptoms (P = 0.181). CONCLUSIONS: PD was frequently associated with PEI. Unfortunately PEI is an under recognized and under treated long-term sequel of PD. Fecal elastase 1 should be performed routinely in both symptomatic and asymptomatic patients. Pancreatic enzyme replacement therapy should be considered in every patient after PD.

Soil quality parameters vis-a-vis growth and yield attributes of sugarcane as influenced by integration of microbial consortium with NPK fertilizers.

Intensive agriculture involving high crop intensity, unavailability of organics, and higher use of straight fertilizers causes imbalanced use and deficiencies of several other macro and micronutrients. Nutrients supply through the integration of microbial consortium containing Gluconacetobater diazotrophicus, Trichoderma harzianum, and Pseudomonas fluorescens can reduce the requirements on the one hand and can also increase the response of chemical fertilizers. Thus we had planned the present experiment with the objectives (i) to determine the effect of integrated application of microbial consortium (MC) and NPK fertilizer on soil quality parameters and crop growth and yield attributes and (ii) to assess the effect of integration on agronomic efficiency of N, P and K and find out the possibilities for reduction in applied doses of NPK, if any. Five treatments viz., T1; N0P0K0; T2: N75P13K25; T3: N150P26K50; T4: N75P13K25 + microbial consortium and T5: N150P26K50 + microbial consortium containing new strains of Trichoderma harzianum, Gluconcetobacter diazotrophicus, and Pseudomonas fluorescens (CFU 109-10 per ml liquid culture) were evaluated under four replications in a randomized block design (RBD). Experimental results indicated that integrating microbial consortium and NPK fertilizers' application proved effective in improving soil organic carbon, soil microbial population, microbial biomass carbon, microbial biomass nitrogen, and soil respiration. Integrated use of microbial consortium with NPK also improved the cation exchange capacity of soil and roots. However, the growth and yield attributes, nutrients uptake, sugarcane, and sugar yields also revealed a positive effect of microbial consortium's integrated application with NPK. The integration of MC and NPK also improved the agronomic efficiency of applied nutrients (NPK). Reduction of 50% NPK with these microbial consortia (Trichoderma harzianum, Gluconcetobacter diazotrophicus, and Pseudomonas fluorescens) was found better than the application of full NPK through chemical fertilizers. Thus application of N150P26K50 with microbial consortium can sustain soil fertility besides improving sugarcane and sugar yields in subtropical Indian conditions.

Potentiometric extractive sensing of lead ions over a nickel oxide intercalated chitosan-grafted-polyaniline composite.

The present research paper reports the extractive potentiometric sensing of lead ions over a chemically functionalized ternary nanocomposite of nickel oxide intercalated chitosan grafted polyaniline (NiO-in-CHIT-g-PANI) prepared by the in situ chemical polymerization and composite formation technique under optimized conditions. The structural, morphological, and physical properties of the composite material were investigated by Fourier transform infrared (FT-IR) spectroscopy, X-ray diffraction (XRD), scanning electron microscopy (SEM), and other suitable ASTM methods. The obtained analytical result suggests the formation of a porous hybrid composite matrix with better electrical conductivity ∼ 5.25 × 10-3 S cm-1, free interactive carbonyl sites, and evolved aligned crystallinity. Furthermore, a film of the synthesized composite was cast on ITO coated glass by the spin coating technique for potentiometric sensing and the recovery of adsorbed Pb2+ ions from natural and artificial water solutions. Under optimum conditions of ∼pH = 7.0 and a temperature of 25 °C, the electrode exhibited potential responses for Pb2+ ions in concentrations ranging from 1.0 × 10-6 M to 1 × 10-3 M along with a sensitivity of 0.2379 mV µM-1 cm-2, response time of 40 s, recovery time of 10 s, and stability for 64 days. The adsorbed Pb2+ ions were recovered at a rate of 84% after applying an optimized reverse voltage on the above-used electrodes. The adsorption and desorption mechanism has been explained based on the induced potential due to the electrochemical surface interaction between Pb2+ and the NiO-in-CHIT-g-PANI based electrode. The analytical application of the fabricated electrode in the real sample was also explored for the sensing and recovery of the respective metal ions in wastewater samples along with the possibility of optimization of the required metal concentrations.

A structurally aligned nickel oxide encapsulated polypyrrole nanocomposite for hydrogen peroxide sensing.

A chemically responsive and structurally aligned nickel oxide encapsulated polypyrrole nano-composite (NiO-en-PPy) has been prepared using intrinsically functionalized pyrrole monomers by in situ polymerization and composite formation techniques under optimized conditions. The prepared samples were characterized by FT-IR spectroscopy, Raman spectroscopy, X-ray diffraction (XRD), scanning electron microscopy (SEM), and thermal gravimetric analysis. Thus, the obtained results revealed the formation of the nanocomposite with aligned crystallinity, an interactive surface, improved electrical conductivity by 103 times, and better thermal stability than those of pristine polypyrrole due to in situ functionalization and structural synergism between nickel oxide and pyrrole molecules. Furthermore, a spin-cast film of the prepared NiO-en-PPy composite on ITO coated glass was explored for the electrochemical sensing of hydrogen peroxide in liquid and the gas phase by monitoring the change in the resistance and potential. The observed sensing parameters in the gaseous and liquid state were sensitivity 22.7 Ω ppm-1 in gas and 92.25 µV ppm-1 cm-2 in liquid, response time 30s in gas and 150 s in liquid, recovery time 70s in gas and 20 s in liquid, and the limit of detection 0.073692 ppm in gas and 0.073649 ppm in liquid with a durability of 90 days. Furthermore, a sensing mechanism has also been explained based on the electroactive interaction between the evolved interactive Ni sites of the composite matrix and peroxide molecules along with the role of induced conductivity in the functionalized PPy chain. The finding reveals the advancements in functional materials science and the properties of PPy for its use in chemical responsive devices and biosensors, and in the non-enzymatic estimation of reactive peroxide oxygen species.

Potentiometric detection of copper ion using chitin grafted polyaniline electrode.

Potentiometric detection of copper ion over chemically interactive and electrically responsive chitin grafted polyaniline (Chit-g-PANI) electrode has been demonstrated for natural as well as artificial samples under optimized conditions using a portable sensing setup. The physical properties and chemical structure of developed electrode were evaluated by different Infrared spectrometry, X-ray diffraction, scanning electron microscope, thermal gravimetric analyzer and ASTM methods. The result indicates the formation of electrically responsive, chemically interactive, stable grafted hybrid matrix for durable and reproducible potentiometric electrode for a self-designed portable potentiometric cell. The potentiometric response of electrode toward Cu2+ ions follows the nernst relation in the range from 1 to 103 ppm with detection limit of 13.77 ppm and negligible interference for different co-existing cations and anions. Further, on the basis of interaction between cupric ion and Chit-g-PANI matrix, the sensing mechanism and ion to electron transduction has been discussed along with future prospects for on-site applications.

Assessment of Exocrine Function of Pancreas Following Pancreaticoduodenectomy.

Pancreatic exocrine insufficiency (PEI) is a common long-term complication after pancreaticoduodenectomy (PD) and is observed in 23-80% of patients. As the postoperative mortality after PD has substantially decreased, it warrants more attention on the diagnosis and treatment of functional long-term consequences after PD. These include PEI and endocrine insufficiency that can result in significant nutritional impairment and often adversely impacts quality of life (QOL) of the patient. A PubMed search was performed for articles using key words "pancreatic exocrine insufficiency"; "pancreaticoduodenectomy"; "quality of life after pancreaticoduodenectomy"; "stool elastase"; "direct, indirect tests for pancreatic exocrine insufficiency"; "pancreatic enzyme replacement therapy." Relevant studies were shortlisted and analyzed. This review summarizes relevant studies addressing PEI following PD. We also discuss functional changes after PD, risk factors and predictive factors for postoperative PEI, clinical symptoms, direct and indirect tests for estimation of PEI, pancreatic enzyme replacement therapy (PERT), and QOL after pancreatic resection for malignancy. It was found that significant PEI occurs in most patients following PD. Fecal elastase 1 is an easy indirect test and should be performed routinely in both symptomatic and asymptomatic patients after PD. PERT should be considered in every patient after PD with the aim to improve the QOL and perhaps even their long time survival.

Identification of source mobile hand sets using audio latency feature.

An experiment has been carried out for determination of source of digital audio recording using audio latency feature of mobile phones. The legal requirement of the source correspondence with the audio recordings in question has driven the necessity of such study. The evaluation is based on 300 audio recordings recorded with ten mobile handsets of MOTOROLA make but different model in three different format "3gp", "wav" and "m4a" format (ten audio recording in each format) recorded in stereo signal at 16 kHz and in different recording sessions using EASY VOICE RECORDER application. Adobe audition 3.0 software is used for analysis. The analysis of audio latency has been carried out in a set of ten mobile handsets having multimedia capability. The result of this study shows that the audio latency of mobile handsets of same make but different model carry the specific feature of latency and such audio latency is robust for establishing the source of audio recordings.

Developmental dental anomalies and their potential role in establishing identity in post-mortem cases: a review.

Teeth may provide useful forensic evidence owing to features like uniqueness, stability and comparability. Moreover, the human dentition is heterodont, i.e. all the teeth have different morphology - incisors, canines, premolars and molars. There are sometimes deviations from normal morphology, such as the presence of extra teeth, variation in their shape and size eg the presence of an extra cusp, fractured crown/root, Carabelli's cusp, peg laterals, transpositions, fusion, etc. These differences can help forensic personnel identify bodies, especially where other methods of identification like facial features, fingerprints or DNA typing cannot yield satisfactory results as in cases of badly decomposed bodies, burnt remains, mass disasters, etc. Identification from dentition is based on the direct comparison of post-mortem dental profiles with ante-mortem dental records of the deceased. This article aims to review these developmental and morphological dental traits and their role in post-mortem identification.

Differential organic DNA extraction of semen sample contaminated with blood for the identification of a serial sexual offender: A case report.

In many cases of sexual assault, traces of semen are left behind on the victim's body, clothes and the area in which the assault has taken place. The positive identification of semen is instrumental in supporting such cases. There are several methods of forensic examination of semen reported in literature, but the presence of blood complicates the identification of semen stains. This paper presents one such case study where the presence of blood makes DNA profiling more challenging as the PCR amplification becomes complicated, and the absolute differential isolation is the only way to get the clear profile using identifiler kits.

Performance, carcass characteristics and economics of broiler chickens fed dietary enzymes and probiotic.

BACKGROUND: Researchers are challenged with identification of possible feed additives with the ability to increase the efficiency of feed utilization. AIMS: The present work aimed at studying growth pattern and carcass traits in broiler fed on dietary enzymes (Enzymex) and probiotic (Yeamark) over a period of six weeks. METHODS: A completely randomized design, including 8 treatments, 3 replications and 15 birds in each experimental unit was applied. Results: The results showed that feed intake decreased significantly (P<0.05) which might be due to the birds fulfilling their nutrient requirements by taking less amount of feed with improved digestibility of energy sources and amino acids. The results of present study also demonstrate the beneficial effects on performance and dressed yield in the treated groups in broiler. CONCLUSION: Enzymes and probiotic are, therefore, suggested to be used as feed additives in broiler rations for higher profitability.

Integrated approach for efficient humidity sensing over zinc oxide and polypyrole composite.

Synergism between individual components of a polymer composite evolve many promising interfacial surface properties for wide range of applications. The significant synergism in sensing materials are responsiveness to conductance; catalysis to luminescence; absorbance to porosity. In this context, present work reports the preparation of polypyrrole and zinc oxide (PPy/ZnO) composite by in-situ polymerization and composite formation (I.P.C.F.) technique. Thus obtained materials have been characterized by Fourier transform infrared spectroscopy (FT-IR), X-ray diffraction (XRD), and scanning electron microscopy (SEM) techniques for their structural and morphological properties. The results prove the formation of composite with optimized crystallinity, electrical conductivity and mechanical properties. The optimization effect in the properties of ZnO/PPy and pure PPy films were studied and result indicates the enhancement in the electrical conductivity of ZnO/PPy than PPy due to the higher ionization in ZnO/PPy than pure PPy along with humidity responsive behavior. Further, ZnO/PPy composite has been explored for humidity sensing purposes by monitoring the electrical resistance against different humidity level of a closed chamber. The observed humidity sensing parameters are response time 12 s, recovery time 8 s and negligible interference. The sensing behavior has been explained with an appropriate schematic model using synergistic effect between ionization and dissociative adsorption of water molecules.

Prevalence, outcome and risk factor associated with vancomycin-resistant Enterococcus faecalis and Enterococcus faecium at a Tertiary Care Hospital in Northern India.

PURPOSE: To determine the prevalence, genotype, risk factors and mortality in patients having vancomycin-resistant Enterococcus faecalis (VR E. faecalis) and Enterococcus faecium (VR E. faecium) infection or colonisation. MATERIALS AND METHODS: A total of 1488 clinical isolates of E. faecalis and E. faecium were tested for vancomycin resistance by phenotypic (disk diffusion, E-test and broth micro-dilution test) and genotypic polymerase chain reaction methods. Records of all 1488 patients who had E. faecalis or E. faecium infection or colonisation were reviewed for the identification of host, hospital and medication related risk factors associated with VR E. faecalis and VR E. faecium. RESULTS: Of 1488 isolates, 118 (7.9%) were vancomycin-resistant and their distributions were as follows: E. faecalis=72 (61%) and E. faecium=46 (39%). All 118 vancomycin-resistant isolates were vanA genotype (minimum inhibitory concentration [MIC] to vancomycin ≥64 µg/ml and MIC to teicoplanin≥32 µg/ml) and none of the isolates was vanB genotype. Multivariate logistic regression analysis identified ventilator support and hospital stay for ≥48 h as independent risk factors associated with VR E. faecalis and VR E. faecium infection or colonisation. Hospital stay≥48 h was the only independent risk factor for mortality in patients infected with vancomycin-resistant enterococci. CONCLUSIONS: Strategies to limit the nosocomial infection especially in patients on ventilator support can reduce VRE incidence and related mortality.

Solitary rectal ulcer syndrome: clinical, endoscopic, histological and anorectal manometry findings in north Indian patients.

BACKGROUND: Solitary rectal ulcer syndrome (SRUS) is a chronic, benign defecation disorder often related to excessive straining. SRUS is diagnosed on the basis of clinical symptoms, endoscopic and histological findings. METHODS: All patients diagnosed with SRUS by colonoscopy and confirmed by histopathology from October 2012 to August 2014 in the Department of Gastroenterology, Institute of Medical Sciences, Banaras Hindu University, India, were included in the study. Out of 92 patients, thirty-four patients underwent anorectal manometry. Twenty age-matched healthy volunteers were also studied with anorectal manometry to serve as controls. RESULTS: Mean age of the group was 41 ± 19 years with age range of 10-82 years; males were 58 (63%) with male to female ratio of 1.7:1. Bleeding per rectum was present in 83%, constipation in 46.7%, abdominal pain in 27.2%, and diarrhea in 25% of the patients. On endoscopy, ulcerative lesions were seen in 83% patients of whom solitary and multiple lesions were present in 44% and 39%, respectively. Polypoidal lesions were reported in 17.4% whilst rectal polyps and erythematous mucosa were found in 5.4% and 2.2%, respectively. Histological examination revealed fibromuscular obliteration in 100% of patients, surface ulceration in 70.6% and crypt distortion in 20.65% of patients. Anal relaxation and balloon expulsion test was significantly abnormal in SRUS patients compared to healthy controls (53% vs. 20%, p < 0.01). CONCLUSION: Rectal bleeding was the most common symptom and ulcerative lesions the most common endoscopic finding. Fecal evaluation disorder was more prevalent inpatients with SRUS.