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Disinfection of medical instruments is important for preventing the spread of disease. Cleaning and disinfecting reusable equipment after it comes into contact with patients can be expensive, both in the cost of the disinfection procedure, but also in terms of time away from the patients themselves. Not all medical instruments can be fully sterilized after each use. Thankfully, not all reusable instruments need the highest level of disinfection. But how to determine the minimum level of disinfection in a given situation? Earle H. Spaulding devised a rational approach to disinfection and sterilization of patient-care items and equipment Spaulding believed the nature of disinfection could be understood readily if instruments and items for patient care were categorized as critical, semi-critical, and non-critical according to the degree of risk for infection involved in use of the items. Spaulding recognized that the need for disinfection of equipment in medical settings ranged from non-critical to semi-critical to critical, depending on the likelihood of spreading disease. For example, sterilization is necessary for equipment that comes into contact with a patient’s bloodstream or sterile tissue. This category of equipment, such as surgical knives, is designated “critical” because it presents a high risk of disease transmission from patient to patient. Equipment that only touches healthy, unbroken skin presents a low risk of contamination because intact skin acts as an effective barrier to most microorganisms. Examples in this “non-critical” category include bedpans, blood-pressure cuffs, and bedrails. In between those two scenarios, a “semi-critical” level of disinfection presents a medium risk of contamination. This would include equipment such as endoscopes used on mucous membranes or areas of broken skin.

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WORLD HEALTH ORGANIZATION WE CHAMPION HEALTH AND A BETTER FUTURE FOR ALL’ INTRODUCTION- WHO leads and champions global efforts to give everyone, everywhere, an equal chance to live a healthy life. HISTORY- founded in 1948, 7 April HEADQUARTERS- Geneva OFFICES- 6 semi autonomus regional and 150 fields offices DIRECTOR- Dr. Tedros Adhanam Ghebeyesus OBJECTIVES- Direction, co-ordination agencies Collaboration with local bodies Help the government in health services Proper technological assistance To attain highest possible level of health Prioritize and support health Formulate health policies Disease inspection and analysis Health education GOAL: To ensure that a billion more people have universal health coverage, to protect a billion more people from health emergencies and provide a further billion people with better health and well being ORGANIZATION: executive board, secretariat, world health assembly FUNCTION: FOR UNIVERSAL HEALTH Focus on PHCare Sustainable financing and protection Access to health products and medicines Training of health workforce and advice on labor policies Support people participation in National health policies Increasing monitoring, data and information FOR HEALTH EMERGENCIES Identification, mitigation and risk management Prevention and support of development of tools Detect and respond to acute health emergencies Support delivery of essential health services FOR HEALTH AND WELL BEING Address social determinants Promote intersectoral approach for health Prioritize health in all policies and healthy settings THROUGH WORK, ADDRESS Prevention of non- communicable disease Mental health promotion Climate change Antimicrobial resistance Elimination and eradication of communicable disease UNITED NATION FUND FOR POPULATION ACTIVITYINTRODUCTION- SEXUAL AND REPRODUCTIVE HEALTH AGENCY MISSION- To deliver a world where every pregnancy is wanted, every childbirth is safe, and every young person’s potential is fullfilled AIM- to improve reproductive and maternal health worldwide ESTABLISHED YEAR- 1969 (1974 in INDIA) HEADQUARTER- NEW YORK DIRECTOR- Dr. Natalia Kanem (2017) FUNCTION Develop national healthcare Increasing the access to birthcontrol Leading campaigns against child marriage Prevention of violence against gender Prevention of female genital mutiliation Treatment and prevention of STD and RTI MCH care HIV prevention and treatment IEC on sexuality and treatment of infertility and Abortion FOCUS area: Reproductive health Gender equality Population and development strategies Girl education Political participation for women FGM Child marriage UNITED NATION DEVELOPMENT PROGRAMME 1965 ESTABLISHED- 22 November. 1965 HEADQUARTER- New York HEAD- Achim steiner STRUCTURE- 170 member countries and territories INTRODUCTION- Advocates for change and connect countries to knowledge, experience and resources to help people bulid a better life for themselves Encourages Human right protection, women empowerment in all its programme

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Catheterization of the bladder involves introducing a latex or plastic tube through the urethra and into the bladder. The catheter provides a continuous flow of urine in patients unable to control micturition or those with obstructions. It also provides a means of assessing urine output in hemodynamically unstable patients. Because bladder catheterization carries the risk of UTI, blockage, and trauma to the urethra, it is preferable to rely on other measures for either specimen collection or management of incontinence. Types of Catheterization. Intermittent and indwelling retention catheterizations are the two forms of catheter insertion INTERMITTENT CATHETERIZATION introduce a straight single-use catheter long enough to drain the bladder (5 to 10 minutes When the bladder is empty, you immediately withdraw the catheter. COMPLICATION- increases risk of trauma and infection. INDICATION- It is common for people with spinal cord injury or other neurological problems such as multiple sclerosis to perform self– intermittent catheterization up to every 4 hours daily for months or years. UTI rate is lower than for patients with long-term indwelling catheters. INDWELLING CATHETERIZATION- remains in place for a longer period, until a patient is able to void voluntarily or continuous accurate urine measurements are no longer needed The straight single-use catheter has a single lumen with a small opening about 1.3 cm ( 1 2 inch) from the tip. . Urine drains from the tip, through the lumen, and to a receptacle. An indwelling Foley catheter has a small inflatable balloon that encircles the catheter just above the tip. When inflated the balloon rests against the bladder outlet to anchor the catheter in place. The indwelling retention catheter often has two or three lumens within the body of the catheter . One lumen drains urine through the catheter to a collecting tube. A second lumen carries sterile water to and from the balloon when it is inflated or deflated. A third (optional) lumen is sometimes used to instill fluids or medications into the bladder. It is easy to determine the number of lumens by the number of drainage and injection ports at the end of the catheter A second type of intermittent catheter has a curved tip A Coudé catheter is used on male patients who may have enlarged prostates that partly obstruct the urethra. It is less traumatic during insertion because it is stiffer and easier to control than the straight-tip catheter Plastic catheters are suitable only for intermittent use because of their inflexibility Latex catheters are recommended for use up to 3 weeks. Be aware of allergies. Pure silicon or Teflon catheters are best suited for long-term use (2 to 3 months) because of less encrustation at the urethral meatus Balloon sizes range from 3 mL (pediatric) to large postoperative volumes (75 mL). In adults the 5-mL and 30-mL sizes are the most common: The 5-mL size allows for optimal drainage, whereas the 30-mL size is used after pros

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A well-known hospital in Gwalior, Madhya Pradesh, ITM Hospital & Research Center has recently updated its super specialty and elevated the pre-existing facilities including critical care and minimal invasive surgery protocols. As per the hospital's management team, "The 300-bedded tertiary care hospital operates under the guidance of highly experienced medical and healthcare professionals and includes 20 ICU beds, 20 beds for Obs, Gynae, and NICU, three modern operating theaters, a well- equipped and 24x7 available ER department, dialysis center, a dedicated mother and child care unit, along with highly advanced technologies like CT scan, MRI, Bone DEXA along with ECHO, TMT, Physiotherapy and more. Our highly experienced doctors bring a multidisciplinary approach across 25+ super specialties, including oncology, cardiology, joint replacement, minimal access surgery and others. We aim to enhance health care in Gwalior, Madhya Pradesh by providing quality medical care with trust, transparency and empathy while meeting all safety standards," says Mr. Ramashankar Singh, Chairman of the hospital. The hospital has also been recognised as the best emerging hospital in the vicinity for several specialties for following the moral of “Sewa Samta aur Sammaan”. Dr. Ramashankar adds, "This recognition is a testament to our mission of serving people with the best critical care and minimal invasive surgery. We remain committed to delivering outcome-driven experiences and care to treat and heal people, based on the same values that the group has followed for the past three decades”

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