Individualizing Ovarian Stimulation Protocols for IVFSherInstitute
Have you experienced poor response to IVF medications? Been told you had "Empty Follicle Syndrome?" Had lots of eggs retrieved but very few fertilized? Experienced Ovarian Hyperstimulation Syndrome? All of these issues can be tied to or affected by your protocol of stimulation. Dr. Geoffrey Sher presents his approach to customizing ovarian stimulation based on 30 years' experience in the IVF field. He outlines a number of his stimulation protocols and discusses the factors that can cause IVF failure due to improper stimulation protocols.
there is a change in attitude for monofollicular ovulation induction to treat infertility: previously clomiphene citrate was the standard drug to start with : Now it is different
It is a method of multiplying microbial organisms in a predetermined culture media with favourable conditions and test perform to check the sensitivity of organism towards the drugs.
PURPOSE OF CULTURE TEST
To guide the clinician in selecting the best drug for an individual patient.
To control the use of inappropriate drug in clinical practice.
To accumulate epidemiological information on the resistance of microorganism of public health importance within the community.
To overcome the resistance to antibiotics.
Sensitivity to the drug determined from the inhibition of bacterial growth around the disc.
Methicillin resistant Staphylococcus aureus (MRSA)
minimum inhibitory concentration
The agar dilution method involves the incorporation of varying desired concentrations of the antimicrobial agent into an agar medium (molten agar medium).
serial two-fold dilutions
inoculation of a defined microbial inoculum onto the agar plate surface.
The MIC value is determined.
Antibiotic sensitivity tests are very useful for clinician in diagnostic bacteriology.
To provide a reliable prediction of whether an infection caused by a bacterial isolate will respond therapeutically to a particular antibiotic treatment.
It acts as a indicator for the spread of resistance to a antibiotic.
Antimicrobial sensitivity test are two types:- diffusion tests and dilution tests.
Stokes disc diffusion tests and Kirby-Bauer disc diffusion method are examples of diffusion tests.
Dilution tests include broth dilution method and agar dilution method.
Epsilometer or E-test combines the principle of dilution methods with that of diffusion methods.
Minimum inhibitory concentration (MIC) inhibits the bacterial growth while the minimum bactericidal concentration (MBC) kills the bacterium.
DIFFUSION TEST
PRINCIPLE:-
To allow the antimicrobial agent to diffuse through a solid medium so that the concentration is highest near the site of application of antimicrobial agent and decreases with distance.
DILUTION TEST:-
PRINCIPLE:-
Dilution tests are performed to determine the minimum inhibitory concentration (MIC) of an antimicrobial agent.
DISC-DIFFUSION METHOD
It is the most simple and easy method, hence most commonly used.
PRINCIPLE:-
This method involves the addition of known amount of an drug to a antibiotic discs measuring 6 mm in diameter.
The test bacterium is inoçulated on the medium and these antibiotic discs are applied.
Sensitivity to the drug determined from the inhibition of bacterial growth around the disc.
USES:-
Disc diffusion tests are most widely used to determine the susceptibility of isolates of pathogenic bacteria to antibiotics that are likely to be used in the treatment.
EPSILOMETER
MIC value is determined at the intersection of the strip and the zone of inhibition ellipse.
ADVANTAGE –
Easy to perform
Combination of antibiotics can be tested.
Does not require expertise.
Does not require special technologies.
Antibiotic sensitivity test PPT by Dr.C.P.PRINCEDR.PRINCE C P
Antibiotic sensitivity test: in vitro testing of bacterial cultures with antibiotics to determine susceptibility of bacteria to antibiotic therapy.
A laboratory test which determines how effective antibiotic therapy is against a bacterial infections.
Antibiotic sensitivity testing will control the use of Antibiotics in clinical practice
Testing will assist the clinicians in the choice of drugs for the treatment of infections.
Helps to guide the Physician in choosing Antibiotics
The accumulated results on different pathogens their sensitivity will guide the physician in choosing empirical treatment in serious patients before the individual’s laboratory results are analyzed in the Microbiology laboratory.
Reveals the changing trends in the local isolates.
Helps the local pattern of antibiotic prescribing.
PPT Prepared by
Dr.Prince.C.P
Department of Microbiology
Mother Theresa PG&RIHS
Pondicherry
A culture test is performed to find germs (such as bacteria or a fungus) that can cause an infection. It is done by using a culture media for their growth
Susceptibility testing is used to determine which antimicrobials will inhibit the growth of the bacteria or fungi causing a specific infection. The results from this test will help a healthcare practitioner determine which drugs are likely to be most effective in treating a person's infection.
International Cancer Survivors Day is celebrated during June, placing the spotlight not only on cancer survivors, but also their caregivers.
CANSA has compiled a list of tips and guidelines of support:
https://cansa.org.za/who-cares-for-cancer-patients-caregivers/
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In order to protect visitors' safety and wellbeing, Travel Clinic Leicester offers a wide range of travel-related health treatments, including individualized counseling and vaccines. Our team of medical experts specializes in getting people ready for international travel, with a particular emphasis on vaccines and health consultations to prevent travel-related illnesses. We provide a range of travel-related services, such as health concerns unique to a trip, prevention of malaria, and travel-related medical supplies. Our clinic is dedicated to providing top-notch care, keeping abreast of the most recent recommendations for vaccinations and travel health precautions. The goal of Travel Clinic Leicester is to keep you safe and well-rested no matter what kind of travel you choose—business, pleasure, or adventure.
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Alka magic plan 1350 -we deliver alkaline water at your door step and you can make handsome money by referral programme
we also help and provide systematic guideline to setup 1000 lph alkaline water plant
This document is designed as an introductory to medical students,nursing students,midwives or other healthcare trainees to improve their understanding about how health system in Sri Lanka cares children health.
ICH Guidelines for Pharmacovigilance.pdfNEHA GUPTA
The "ICH Guidelines for Pharmacovigilance" PDF provides a comprehensive overview of the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) guidelines related to pharmacovigilance. These guidelines aim to ensure that drugs are safe and effective for patients by monitoring and assessing adverse effects, ensuring proper reporting systems, and improving risk management practices. The document is essential for professionals in the pharmaceutical industry, regulatory authorities, and healthcare providers, offering detailed procedures and standards for pharmacovigilance activities to enhance drug safety and protect public health.
Trauma Outpatient Center is a comprehensive facility dedicated to addressing mental health challenges and providing medication-assisted treatment. We offer a diverse range of services aimed at assisting individuals in overcoming addiction, mental health disorders, and related obstacles. Our team consists of seasoned professionals who are both experienced and compassionate, committed to delivering the highest standard of care to our clients. By utilizing evidence-based treatment methods, we strive to help our clients achieve their goals and lead healthier, more fulfilling lives.
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Under Pressure : Kenneth Kruk's StrategyKenneth Kruk
Kenneth Kruk's story of transforming challenges into opportunities by leading successful medical record transitions and bridging scientific knowledge gaps during COVID-19.
Rate Controlled Drug Delivery Systems, Activation Modulated Drug Delivery Systems, Mechanically activated, pH activated, Enzyme activated, Osmotic activated Drug Delivery Systems, Feedback regulated Drug Delivery Systems systems are discussed here.
Health Education on prevention of hypertensionRadhika kulvi
Hypertension is a chronic condition of concern due to its role in the causation of coronary heart diseases. Hypertension is a worldwide epidemic and important risk factor for coronary artery disease, stroke and renal diseases. Blood pressure is the force exerted by the blood against the walls of the blood vessels and is sufficient to maintain tissue perfusion during activity and rest. Hypertension is sustained elevation of BP. In adults, HTN exists when systolic blood pressure is equal to or greater than 140mmHg or diastolic BP is equal to or greater than 90mmHg. The
PET CT beginners Guide covers some of the underrepresented topics in PET CTMiadAlsulami
This lecture briefly covers some of the underrepresented topics in Molecular imaging with cases , such as:
- Primary pleural tumors and pleural metastases.
- Distinguishing between MPM and Talc Pleurodesis.
- Urological tumors.
- The role of FDG PET in NET.
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Mastoid cavity problem and obilteration presentation by Dr Salison Salim Pani...
Lecture 05.2014
1. Lecture Five
Topics:
•Laboratory studies on antibiotic
action
Dr. G. Kattam Maiyoh
01/23/15 GKM/KISIIU/MBSM713 /BIOC.AMIC.AGENS.LEC05 1
MBSM 713: BIOCHEMISTRY OF ANTI
MICROBIAL AGENTS
2. Laboratory studies on antibiotic action
• In the laboratory, susceptibility is most often
measured using a disk diffusion test.
• Antibiotic solutions of particular concentrations
are dried onto filter paper disks.
• These are then applied to a lawn of the microbe
under examination which has previously been
inoculated onto an appropriate solid medium.
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3. Sensitivity tests
• Susceptible or resistant to antibiotic
• MIC = Minimum inhibitory concentration
• MBC = Minimum bactericidal concentration
• Minimum concentration required to inhibit growth
– Disc diffusion
– Agar dilution
– Etest
– Breakpoint MIC
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4. Diffusion of antibiotic from a paper disc
After
Incubation
Zone of
Sensitivity
Concentration of
antibiotic at
periphery of zone
equals the MIC
Disc
Area of
Bacterial
growth
Disc
Concentration
Gradient
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6. MIC
• Breakpoint: concentration above which the isolate is
described at resistant and below which is susceptible
e.g. S < 8mg/L R ≥ 8mg/L
Breakpoint = 8mg/L
• Range: Lowest to highest MIC for population
• MIC50Median for series of MICs
• MIC90
– MICs of population ordered from lowest to highest
– MIC value of the strains that appears 90% up the series.
– Antibiotic considered to be successful if > 90% of population inhibited.
– Also show if resistance is emerging i.e. 10% of population resistant.
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8. Etest Determination of MIC
16
8
4
32
24
12
6
3
2
1.5
1
CI
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9. Breakpoint Test to Determine Bacterial
Sensitivity
Trimethoprim (4mg/L)
Inoculation of Plates
Determination of
growth at fixed
concentrations
shows resistanceAmoxycillin (4mg/L)
Gentamicin (2mg/L)Ciprofloxacin (1mg/L) Cefotaxime (2mg/L) Ceftazidime (4mg/L)
Control - No drug
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10. Evaluation of Laboratory Tests
• MIC test on plates is the best
– Time consuming and costly
– Most detailed
• Disc test/Etest is easiest
– Requires more skill to interpret
• Breakpoint
– Least skill required
– Technique must be exact
– Can be read by computer
– Large amounts of data
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11. Minimum Bactericidal Concentration
MIC
64 32 16 8 4 2 1 mg/l
Subculture onto drug-free agar
16 8 4 2 1 mg/l
MBC
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12. Stokes controlled sensitivity test
• A control organism is inoculated on part of a
plate and the test organism is plated on the
remainder.
• Disks are placed at the interface and the zones
of inhibition are compared.
• The use of a sensitive control shows that the
antibiotic is active, so that if the test organism
grows up to the disk it may safely be assumed
that the test organism is resistant to that
drug.
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13. Stokes' sensitivity test
•The bacterium in the
diagram is susceptible to
drug "x" but resistant to
drug "y".
• The disc containing
drug "y" contains active
antibiotic as shown by the
zone of inhibition it
causes in the control
bacterium.
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14. MIC and MBC
• An alternative measure of susceptibility is to
determine the Minimum Inhibitory
Concentration (MIC) and the Minimum
Bactericidal Concentration (MBC) of a drug.
• A series of broths are mixed with serially diluted
antibiotic solutions and a standard inoculum is
applied.
• After incubation, the MIC is the first broth in
which growth of the organism has been inhibited.
• The more resistant an organism is, then the
higher will be the MIC.
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15. Minimum Bactericidal Concentration (MBC)
• The MBC is measured by inoculating the
broths used for MIC determinations onto
drug-free medium.
• The MBC is the first dilution at which no
growth is observed.
• Cidal drugs have MBC values that are close to
the MIC value for particular organisms.
• With static agents, the MIC is much lower
than the MBC.
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Editor's Notes
Hamburg 2
The conventional method of sensitivity testing is by the disc sensitivity test or agar dilution method.
In the correct hands this is a powerful technique that is capable of showing the relative sensitivities of a range of antibiotics to a specific pathogen.
The size of the zone of sensitivity is dependent on the MIC and the concentration of the interface between growth and no growth is the MIC.
